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      The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children – What Do We Know?

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          Abstract

          Symptoms of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) often co-occur. The DSM-IV had specified that an ASD diagnosis is an exclusion criterion for ADHD, thereby limiting research of this common clinical co-occurrence. As neurodevelopmental disorders, both ASD and ADHD share some phenotypic similarities, but are characterized by distinct diagnostic criteria. The present review will examine the frequency and implications of this clinical co-occurrence in children, with an emphasis on the available data regarding pre-school age. The review will highlight possible etiologies explaining it, and suggest future research directions necessary to enhance our understanding of both etiology and therapeutic interventions, in light of the new DSM-V criteria, allowing for a dual diagnosis.

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          Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder

          Nanda N J Rommelse, Barbara Franke, Hilde M Geurts … (2010)
          Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both highly heritable neurodevelopmental disorders. Evidence indicates both disorders co-occur with a high frequency, in 20–50% of children with ADHD meeting criteria for ASD and in 30-80% of ASD children meeting criteria for ADHD. This review will provide an overview on all available studies [family based, twin, candidate gene, linkage, and genome wide association (GWA) studies] shedding light on the role of shared genetic underpinnings of ADHD and ASD. It is concluded that family and twin studies do provide support for the hypothesis that ADHD and ASD originate from partly similar familial/genetic factors. Only a few candidate gene studies, linkage studies and GWA studies have specifically addressed this co-occurrence, pinpointing to some promising pleiotropic genes, loci and single nucleotide polymorphisms (SNPs), but the research field is in urgent need for better designed and powered studies to tackle this complex issue. We propose that future studies examining shared familial etiological factors for ADHD and ASD use a family-based design in which the same phenotypic (ADHD and ASD), candidate endophenotypic, and environmental measurements are obtained from all family members. Multivariate multi-level models are probably best suited for the statistical analysis.
          Article 0 comments Cited 196 times – based on 0 reviews     Review now
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            Social intelligence in the normal and autistic brain: an fMRI study.

            S Baron-Cohen, H A Ring, S Wheelwright … (1999)
            There is increasing support for the existence of 'social intelligence' [Humphrey (1984) Consciousness Regained], independent of general intelligence. Brothers et al. 1990) J. Cog. Neurosci., 4, 107-118] proposed a network of neural regions that comprise the 'social brain': the orbito-frontal cortex (OFC), superior temporal gyrus (STG) and amygdala. We tested Brothers' theory by examining both normal subjects as well as patients with high-functioning autism or Asperger syndrome (AS), who are well known to have deficits in social intelligence, and perhaps deficits in amygdala function [Bauman & Kemper (1988) J. Neuropath. Exp. Neurol., 47, 369]. We used a test of judging from the expressions of another person's eyes what that other person might be thinking or feeling. Using functional magnetic resonance imaging (fMRI) we confirmed Brothers' prediction that the STG and amygdala show increased activation when using social intelligence. Some areas of the prefrontal cortex also showed activation. In contrast, patients with autism or AS activated the fronto-temporal regions but not the amygdala when making mentalistic inferences from the eyes. These results provide support for the social brain theory of normal function, and the amygdala theory of autism.
            Article 0 comments Cited 155 times – based on 0 reviews     Review now
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              A review on cognitive and brain endophenotypes that may be common in autism spectrum disorder and attention-deficit/hyperactivity disorder and facilitate the search for pleiotropic genes.

              Nanda N.J. Rommelse, Hilde M Geurts, Barbara Franke … (2011)
              We propose to bring together the hitherto rather separate research fields of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), and argue that by contrasting and combining findings of the endophenotypes of ASD and ADHD new insights can be gained into the etiology and pathophysiology of these two disorders. Given the highly heritable nature of both disorders, studies of the genes explaining the shared origins of the two neurodevelopmental disorders seem particularly called for. Instead of the clinical diagnosis, using neurocognitive measures as (endo)phenotypes that index genetic liability appears a powerful tool in gene finding. We, therefore, extensively reviewed the literature and not only included research wherein ASD and ADHD were compared within a single study, but extended our search also to the separate lines of cognitive neuroscience research. We discuss which cognitive and brain measures will be useful in future genetic studies targeting pleiotropic genes for ASD and ADHD. By specifying the most promising endophenotypic measures we chart the future course for endophenotypic research in ASD and ADHD. We also discuss the various models that may explain the frequent co-occurrence of ASD and ADHD. Copyright © 2011 Elsevier Ltd. All rights reserved.
              Article 0 comments Cited 152 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Hum Neurosci
                Journal ID (iso-abbrev): Front Hum Neurosci
                Journal ID (publisher-id): Front. Hum. Neurosci.
                Title: Frontiers in Human Neuroscience
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1662-5161
                Publication date (Electronic): 29 April 2014
                Publication date Collection: 2014
                Volume: 8
                Electronic Location Identifier: 268
                Affiliations
                [1] 1Child Development Center, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv, Israel
                [2] 2Sackler School of Medicine, Tel Aviv University , Tel Aviv, Israel
                Author notes

                Edited by: Itai Berger, Hadassah-Hebrew University Medical Center, Israel

                Reviewed by: Adriana Di Martino, New York University Langone Medical Center, USA; Itai Berger, Hadassah-Hebrew University Medical Center, Israel; Linda Sprenger, Philipps-University Marburg, Germany

                *Correspondence: Yael Leitner, Child Development Center, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Weitzman St. 6, Tel Aviv 6423906, Israel e-mail: leitnery@ 123456tlvmc.gov.il

                This article was submitted to the journal Frontiers in Human Neuroscience.

                Article
                DOI: 10.3389/fnhum.2014.00268
                PMC ID: 4010758
                PubMed ID: 24808851
                SO-VID: 8a73d8c8-8b9f-4cf4-a017-b647bda4c0fb
                Copyright © Copyright © 2014 Leitner.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 13 October 2013
                Date accepted : 10 April 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 75, Pages: 8, Words: 8178
                Categories
                Subject: Neuroscience
                Subject: Review Article

                ScienceOpen disciplines: Neurosciences
                Keywords: autistic spectrum disorders,attention deficit hyperactivity disorder,diagnostic and statistical manual,co-morbidity,co-occurrence
                Data availability:
                ScienceOpen disciplines: Neurosciences
                Keywords: autistic spectrum disorders, attention deficit hyperactivity disorder, diagnostic and statistical manual, co-morbidity, co-occurrence

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