Overlap of Autism and Seizures: Understanding Cognitive Comorbidity

Khetrapal, Neha

doi:10.4103/0973-1229.58823

Cited by 6 publications

(2 citation statements)

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“…For example, estimates of comorbidity between PTSD and some types of TBI, including combat-related TBI, are as high as 73% (Hoge et al, 2008;Taylor et al, 2012). Moreover, epilepsy is often found to occur with diseases, including autism/fragile X (Berry-Kravis et al, 2010;Khetrapal, 2010), schizophrenia (Kandratavicius et al, 2012), AD (Palop et al, 2007;Chan et al, 2015), and anxiety disorders (Trimble and Van Elst, 2003;Vazquez and Devinsky, 2003). Indeed, many of these disorders have comorbidities, and often these comorbidities involve deficiencies within the BLA GABAergic system.…”

Section: Discussionmentioning

confidence: 99%

The basolateral amygdala γ‐aminobutyric acidergic system in health and disease

Prager

Bergstrom

Wynn

et al. 2015

J of Neuroscience Research

144

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The brain comprises an excitatory/inhibitory neuronal network that maintains a finely tuned balance of activity critical for normal functioning. Excitatory activity in the basolateral amygdala (BLA), a brain region that plays a central role in emotion and motivational processing, is tightly regulated by a relatively small population of gamma-aminobutyric acid (GABA) inhibitory neurons. Disruption in GABAergic inhibition in the BLA can occur when there is a loss of local GABAergic interneurons, alterations in GABAA receptor activation, or dysregulation of mechanisms that modulate BLA GABAergic inhibition. Disruptions in GABAergic control of the BLA emerge during development, in aging populations, or after a trauma, ultimately resulting in hyperexcitability. BLA hyperexcitability manifests behaviorally as an increase in anxiety, emotional dysregulation, or the development of seizure activity. This article reviews the anatomy, development, and physiology of the GABAergic system in the BLA, and circuits that modulate GABAergic inhibition, including the dopaminergic, serotonergic, noradrenergic, and cholinergic systems. We highlight how alterations in various neurotransmitter receptors, including the acid sensing ion channel 1a (ASIC1a), cannabinoid receptor 1 (CB1), and glutamate receptor subtypes, expressed on BLA interneurons, modulate GABAergic transmission and how defects of these systems affects inhibitory tonus within the BLA. Finally, we discuss alterations in the BLA GABAergic system in neurodevelopmental (autism/Fragile X syndrome) and neurodegenerative (Alzheimer’s disease) diseases, and after the development of epilepsy, anxiety, and traumatic brain injury. A more complete understanding of the intrinsic excitatory/inhibitory circuit balance of the amygdala and how imbalances in inhibitory control contribute to excessive BLA excitability will guide the development of novel therapeutic approaches in neuropsychiatric diseases.

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Section: Discussionmentioning

confidence: 99%

The basolateral amygdala γ‐aminobutyric acidergic system in health and disease

Prager

Bergstrom

Wynn

et al. 2015

J of Neuroscience Research

144

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“…A literature review of ASD focusing on comorbidity revealed few articles that were based on population studies. 3,4 Studies of comorbidity with ASD focus primarily on other psychiatric disorders, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] neurologic disorders, [24][25][26][27][28] or congenital disorders. [29][30][31][32] Few studies focused on physical disorders, [33][34][35] and fewer still focused on adults.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Description of Comorbidity for Autism Spectrum Disorder in a General Population

Cawthorpe

2017

TPJ

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Context: Few published studies of autism spectrum disorder (ASD) and comorbidity are population based.Objective: To describe the comorbidity of ASD and disorders listed in the main classes of the International Classification of Diseases, Ninth Revision (ICD-9) in a general population.Design: Direct physician billing data for the city of Calgary, Alberta, Canada, for the treatment of any presenting concern in the Calgary Health Zone (n = 763,449) from 1994 to 2009 were extracted. Diagnosed ICD-9 disorders (independent variable) were grouped into 17 categories using ICD-9 diagnosis codes. ASD (dependent variable) was classified under ICD-9 Code 299. Individuals with and without independent disorder classes were counted by the presence or absence of any ASD. Odds ratios (ORs) and 95% confidence intervals of the association were calculated.Main Outcome Measures: ORs of ASD comorbidities. Results: Annual rates of ASD increased 3.9-fold for males and 1.4-fold for females. Diagnosed disorders ranked by OR in the independent ICD-9 categories indicated that males with ASD had overall higher ORs (> 1.0) in 11 main ICD-9 classes, and females with ASD had higher ORs (> 1.0) in 12 main ICD-9 classes. Males with ASD had lower ORs in 4 main ICD-9 disease classes; females with ASD had lower ORs related only to the main class "complications of pregnancy and childbirth." Five main ICD-9 classes were not significant for males or females.Conclusions: Patients with ASD have significant comorbidity of physical disorders. This finding may inform other areas of research and assessment in clinical management.

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