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Am J Psychiatry. 2017 Jun 1;174(6):576-585. doi: 10.1176/appi.ajp.2017.16101115. Epub 2017 Mar 3.

Identification of Developmental and Behavioral Markers Associated With Genetic Abnormalities in Autism Spectrum Disorder.

Author information

1
From the Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco; the Pediatrics and Developmental Neuroscience Branch, NIMH, Bethesda, Md.; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston; the Stanley Center for Psychiatric Research and the Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Mass.; and the MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, Bristol, U.K.

Abstract

OBJECTIVE:

Aside from features associated with risk of neurogenetic syndromes in general (e.g., cognitive impairment), limited progress has been made in identifying phenotype-genotype relationships in autism spectrum disorder (ASD). The objective of this study was to extend work in the Simons Simplex Collection by comparing the phenotypic profiles of ASD probands with or without identified de novo loss of function mutations or copy number variants in high-confidence ASD-associated genes or loci.

METHOD:

Analyses preemptively accounted for documented differences in sex and IQ in affected individuals with de novo mutations by matching probands with and without these genetic events on sex, IQ, and age before comparing them on multiple behavioral domains.

RESULTS:

Children with de novo mutations (N=112) had a greater likelihood of motor delay during early development (later age at walking), but they were less impaired on certain measures of ASD core symptoms (parent-rated social communication abnormalities and clinician-rated diagnostic certainty about ASD) in later childhood. These children also showed relative strengths in verbal and language abilities, including a smaller discrepancy between nonverbal and verbal IQ and a greater likelihood of having achieved fluent language (i.e., regular use of complex sentences).

CONCLUSIONS:

Children with ASD with de novo mutations may exhibit a "muted" symptom profile with respect to social communication and language deficits relative to those with ASD with no identified genetic abnormalities. Such findings suggest that examining early milestone differences and standardized testing results may be helpful in etiologic efforts, and potentially in clinical differentiation of various subtypes of ASD, but only if developmental and demographic variables are properly accounted for first.

KEYWORDS:

Autism Spectrum Disorder; De Novo Mutations; Idiopathic ASD; Phenotype; Simons Simplex Collection; Syndromic ASD

PMID:
28253736
PMCID:
PMC5578709
DOI:
10.1176/appi.ajp.2017.16101115
[Indexed for MEDLINE]
Free PMC Article

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