Abnormal circadian rhythm and cortisol excretion in autistic children: a clinical study

Geetha Arumugam, Department of Biochemistry, Bharathi Women's College (Affiliated to University of Madras), North Chennai - 600 108, Tamil Nadu, India, .
Croatian Medical Journal (Impact Factor: 1.37). 02/2013; 54(1):33-41. DOI: 10.3325/cmj.2013.54.33
Source: PubMed

To determine the circadian rhythm alteration of cortisol excretion and the level of corticosteroids in children with different grades of autism severity.

The study included 45 children with different grades of autism severity (low [LFA], medium [MFA], and high functioning autism [HFA]), 15 in each group, and 45 age/sex-matched children with typical development. The urinary levels of free cortisol (at three phases of 24-hour cycle), corticosteroids, vanilylmandelic acid, and 5-hydroxyindole acetic acid were determined.

Alteration in the pattern of cortisol excretion (Phases I, II, and III) was observed in children with LFA (Phase I: 43.8 ± 4.43 vs 74.30±8.62, P = 0.000; Phase II: 21.1±2.87 vs 62±7.68, P < 0.001; Phase III: 9.9 ± 1.20 vs 40 ± 5.73, P < 0.001) and MFA (Phase I: 43.8 ± 4.43 vs 52.6±7.90, P < 0.001; Phase II: 21.1±2.87 vs 27.4±4.05, P < 0.001; Phase III: 9.9 ± 1.20 vs 19 ± 2.50, P < 0.001) compared to the control group. The corticosteroids excretion levels were higher in all the groups of children with autism than in the control group. The level of 5-hydroxyindole acetic acid was significantly higher in children with LFA (8.2±1.48 vs 6.8±0.85, P < 0.001) and MFA (8.2±1.48 vs 7.4± 0.89, P = 0.001) and not significantly higher in children with HFA than in the control group. The changes were correlated with degrees of severity of the disorder.

These data suggest that altered cortisol excretion pattern and high level of corticosteroids in urine may probably be a consequence of altered hypothalamic-pituitary-adrenal axis function, which may contribute to the pathogenesis and affect the severity of autism.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Autism Spectrum Disorder (ASD) is a developmental disability that manifests as impairments in social interaction, communication, and behavior. The objective of this study is to determine if Zen Shiatsu can reduce short- and long-term stress levels in a child with ASD. This is a longitudinal case study of a seven-year-old male with a diagnosis of autism who was given 20-min Zen Shiatsu sessions weekly for six consecutive weeks. Using a five-point stress scale designed for children with autism, the client indicated his stress level before and after each session. In addition, the parent was given the PEDS QL 4.0 Young Child Questionnaire to determine the child's HRQoL (Health Related Quality of Life) prior to Zen Shiatsu treatment to establish a baseline. The parent completed the same questionnaire after six weeks of sessions to compare results. Based on the five-point pictorial stress scale, data collected before and after each Zen Shiatsu session indicated a decrease in stress levels after treatment. The PEDS QL 4.0 showed higher HRQoL scores in all domains, indicating that the child's overall quality of life improved within the six weeks of receiving Zen Shiatsu. Zen Shiatsu, a Japanese modality based on traditional Chinese medicine, provided meaningful and positive benefits for a child with autism. This case study offers preliminary evidence for the possibility of Zen Shiatsu providing a viable complementary therapy for alleviating stress in children with Autism Spectrum Disorder, thereby potentially improving the overall health-related quality of life.
    International Journal of Therapeutic Massage & Bodywork Research Education & Practice 12/2014; 7(4):23-28. DOI:10.3822/ijtmb.v7i4.246
  • [Show abstract] [Hide abstract]
    ABSTRACT: Autism spectrum disorders (ASD) is a severe neurodevelopmental disorder characterized by impairments in social interaction and repetitive behaviors. Diagnosis of ASD is currently phenotype based with no reliable laboratory test available to assist clinicians. The desire for clinically useful and reliable biomarkers is strong. Researches have shown that individuals with autism often exhibit dysfunction of hypothalamic–pituitary–adrenal (HPA) axis and cytokines. The purpose of this study was to evaluate diurnal variation of cortisol (cortisol VAR), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) as potential biomarkers for ASD. The present results demonstrated that in comparison to the healthy controls, the individuals with autism showed a lower level of cortisol VAR, higher level of IL-6 and TNF-α. The levels of cortisol VAR, IL-6 and TNF-α have significantly correlations with the severity of ASD measured by CARS scores. The results of ROC analysis indicated the cortisol VAR, IL-6 and TNF-α were potential biomarkers in diagnosis of ASD. The combination of three factors performed the best sensitivity and specificity for diagnosis of ASD. Therefore, the present study may reveal a simple clinical approach with great potential for assisting the diagnosis of ASD.
    Research in Autism Spectrum Disorders 11/2014; 9. DOI:10.1016/j.rasd.2014.10.012 · 2.96 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Repetitive behaviors are a key feature of many pervasive developmental disorders, such as autism. As a heterogeneous group of symptoms, repetitive behaviors are conceptualized into two main subgroups: sensory/motor (lower-order) and cognitive rigidity (higher-order). Although lower-order repetitive behaviors are measured in mouse models in several paradigms, so far there have been no high-throughput tests directly measuring cognitive rigidity. We describe a novel approach for monitoring repetitive behaviors during reversal learning in mice in the automated IntelliCage system. During the reward-motivated place preference reversal learning, designed to assess cognitive abilities of mice, visits to the previously rewarded places were recorded to measure cognitive flexibility. Thereafter, emotional flexibility was assessed by measuring conditioned fear extinction. Additionally, to look for neuronal correlates of cognitive impairments, we measured CA3-CA1 hippocampal long term potentiation (LTP). To standardize the designed tests we used C57BL/6 and BALB/c mice, representing two genetic backgrounds, for induction of autism by prenatal exposure to the sodium valproate. We found impairments of place learning related to perseveration and no LTP impairments in C57BL/6 valproate-treated mice. In contrast, BALB/c valproate-treated mice displayed severe deficits of place learning not associated with perseverative behaviors and accompanied by hippocampal LTP impairments. Alterations of cognitive flexibility observed in C57BL/6 valproate-treated mice were related to neither restricted exploration pattern nor to emotional flexibility. Altogether, we showed that the designed tests of cognitive performance and perseverative behaviors are efficient and highly replicable. Moreover, the results suggest that genetic background is crucial for the behavioral effects of prenatal valproate treatment.
    Frontiers in Behavioral Neuroscience 04/2014; 8:140. DOI:10.3389/fnbeh.2014.00140 · 4.16 Impact Factor


Available from