Today, the Centers for Disease Control released the Autism and Developmental Disabilities, Monitoring (ADDM) Network report. This report estimates how many autistic 8 year olds there are in certain areas of the country. The report shows that better recognition of autism and continued efforts to reduce racial and gender disparities have caused rates of diagnosis to continue to rise. There is still more work to do to address the remaining disparities in diagnosis, and more work to do to ensure autistic people in all communities receive the support we need.

The report released today uses data gathered in 2018. This research reviewed records of 8-year-old children in 11 communities across the United States. The report released today shows that the rate of autism diagnosis has increased to 1 in 44children, or 2.3percent of the children surveyed. This is an increase from earlier reports, which estimated that 1 in 54 children were diagnosed with autism.

ASAN is not surprised to see the diagnosis rate increase. We believe this increase reflects better recognition and diagnosis of autism across the U.S. We know that many disparities in diagnosis have become smaller, and we know that children were evaluated earlier in some places and later in others. We expect that diagnosis rates will continue to rise as we work to address diagnostic disparities and improve access to diagnosis and support. 

Unfortunately, the report shows that while some improvements have been made, diagnostic disparities continue to be a major issue for autistic people of marginalized races, ethnicities, and genders. The report showed that Hispanic children were less likely to be diagnosed than white children. Black children were more likely to also be diagnosed with an intellectual disability compared to white or Hispanic children, reflecting a longstanding history of racism in how Black children with disabilities are labelled. Children assigned female at birth were less likely to be diagnosed than children assigned male at birth. Researchers, clinicians, and policymakers must work to end these disparities and remove bias from the diagnostic process.

The results of this report also make clear the need for improved study of rates of autism diagnosis in adults. While improvements in early diagnosis are important, substantial disparities remain. Autistics of color and those who are assigned female at birth are less likely to receive early diagnoses, meaning that a survey of 8-year-olds gives an incomplete picture of the autistic community. Surveying adults can provide a clearer picture of how frequently early diagnoses are missed, demonstrate the need for adult services, and help to correct misconceptions by demonstrating that autism is just as common among adults as children.

Autism is not a bad thing, and autistic people, of all races, genders, and ages have always been here. The ADDM report represents an encouraging sign that our diagnosis practices are catching up to that reality. This is good news for the many autistic people who have been overlooked in the past, and can now get the recognition and support they need.

Women with MS often report fewer symptoms during pregnancy. But studies exploring whether becoming pregnant or having children affects whether or when someone develops MS have so far been inconclusive. Now, the biggest study yet suggests pregnancy may be linked to a delay in experiencing one of the early signs of MS.

MS and clinically-isolated syndrome (CIS)

The new study, from Australia and the Czech Republic, suggests pregnancy is associated with a 3 year delay to the onset of clinically-isolated syndrome (CIS). 

CIS is a first episode of neurological conditions that lasts at least 24 hours. It’s caused by the loss of the myelin coat that surround nerves. It is often the first stage in a diagnosis of MS, but some people never go on to experience further symptoms or develop MS.

What happened in the study?

The researchers analysed data from 2557 women who were all signed up to MS Base – a large database with information from people with MS and MS clinics. All the women in this study had MS and had previously been diagnosed with CIS. The researchers then looked back at when they developed CIS and whether they had ever been pregnant.

They found women who had been pregnant were diagnosed with CIS, on average, just over three years later than women who had never been pregnant. The researchers didn’t find a link between the number of times women had been pregnant and the time of CIS onset.

What does this mean for people with MS who are thinking about having children?

MS affects over 130,000 of us in the UK, with women ‘of reproductive age’ almost three times more likely to be diagnosed. So there are often lots of questions around family planning.

The authors are clear they aren’t claiming that being pregnant actually causes a delay in the onset of CIS. The study shows only an association between the two.

What’s more, the study looked at the link between pregnancy and onset of CIS, not MS itself. The researchers specifically chose to look at CIS so they could be more confident that the onset of symptoms was linked to pregnancy and not to other factors. For example we know that some people may change their behaviour after being diagnosed with CIS, for example by starting to take a DMT.

MS is different for everyone. And women with and without MS choose not to become pregnant for many reasons.

New avenues for MS treatments

Dr Emma Gray, our Assistant Director of Research, says: “The reasons for pregnancy’s positive effect are not fully understood, but it’s thought the answer lies in our immune system – which misbehaves in MS, but is dampened during pregnancy.

“We want to slow, stop and eventually prevent MS, and these findings could help us with that goal. If we can figure out the mechanisms underlying this apparent protective effect of pregnancy, it could lead to new avenues for treatment.”

More research is needed

We don’t fully understand why pregnancy seems to play a protective role in MS but researchers think it could be to do with the hormones oestrogen and progesterone. During pregnancy, the levels of these hormones change dramatically, which may impact the immune system.

We now need further research to understand the link between MS, pregnancy and hormone levels. Large registry studies involving data from thousands of people with MS – like MS Base and the UK’s MS Register – are one way to help us build this picture.

Brain imaging techniques are being widely used to find clues about the underlying neurological causes of autism . Now, researchers from University of Fukui, Japan and Korea Brain Research Institute, Korea have shed new light on this front that could enable better diagnostics and treatment options. CREDIT Dr. Kaie Habata from University of Fukui.

Autism is a condition involving atypical brain development that affects behavior, communication, and learning. People with autism often have trouble functioning in certain contexts and adjusting socially, and tend to engage in restrictive and repetitive behaviors. Although remarkable progress has been made over the past few decades in how autism cases are diagnosed and handled, the underlying neurological basis responsible for the main features of ASD remains a mystery.

Could the ways autistic individuals perceive the world hold clues about the key differences in their brains? It is not news to scientists that people with autism exhibit sensory abnormalities, such as sensory hypersensitivity, insensitivity, or avoidance, depending on the type of stimuli. In fact, sensory abnormalities are now regarded as a core symptom in the diagnostic guidelines for autism , and specialists have linked them to the social impairment features typical of autistic individuals. Additionally, brain imaging can shed some light on the neurological basis of autism. Scientists have linked differences in brain morphology—the volume and shape of the different brain regions—to specific social impairments. However, very few studies have focused on the relationship between the sensory aspects of autism and brain morphology.

In a recent study published in Translational Psychiatry, a team of researchers from Japan and South Korea sought to address this knowledge gap. Led by Professor Hirotaka Kosaka from University of Fukui, Japan, the team recruited 43 adults with autism and 84 adults with neurotypical development, and performed magnetic resonance imaging (MRI) scans of their brains. They used a specialized software to automatically quantify various morphological features of brain anatomy with high accuracy. They also had all recruited individuals fill in the Adolescent/Adult Sensory Profile (AASP), a self-reported questionnaire that is widely used to assess a person’s behavioral response patterns to sensory stimuli and symptoms.

The researchers first looked for differences in brain morphology and AASP scores between the neurotypical and autistic groups and then investigated if there were any statistical relationships between the shape or volume of specific brain regions and sensory characteristics. “We found marked correlations between the visual characteristics and the thickness of the orbitofrontal and lingual cortices as well as between the taste/smell characteristics and the hippocampal volume in adults with ASD,” remarks Professor Kosaka. “Therefore, it’s possible that structural changes in the brains of adults with ASD may cause sensory abnormalities.”

Overall, the results provide some evidence that alterations in brain morphology could be responsible, at the neurological level, for the sensory abnormalities commonly found in autistic individuals. Taken together with the results from previous studies, they extend our knowledge of how different sensory abnormalities contribute to the social impairments that affect autistic individuals.

From a more practical standpoint, these findings could benefit both autistic individuals and their families, as Dr. Habata explains: “The burden on family members caring for autistic individuals is enormous, and many of them suffer from anxiety. In clinical settings, giving such families an appropriate diagnosis and sharing information related to the disease can provide them a sense of relief. By understanding that autistic symptoms could arise from structural problems in the brain, families will be less likely to blame themselves for poor parenting.” From a more technical standpoint, MRI could help diagnose autism better, as Dr. Jung, principal investigator of KBRI, explains: “Magnetic resonance imaging is a non-invasive technique for gathering highly accurate anatomical information of the brain. It could, therefore, help us better understand autism symptoms that occur in brain.”

The study could pave the way for better diagnostic options for autism beyond behavioral indicators, the only criteria used today. If further research confirms that specific brain regions are consistently involved in the pathogenesis of autism , its diagnosis and even treatment could become easier.

A study by Dr Ruth Dobson and colleagues at Queen Mary University London found that people with MS had higher levels of vitamin D than people without MS, because they were more likely to take a supplement. 

We know vitamin D plays a role in your risk of developing MS but we don’t yet know whether vitamin D supplements could help reduce relapses or slow progression in MS.

About vitamin D and MS

We get most of our vitamin D through sun exposure. Because of the UK climate, the NHS recommends everyone living here takes a daily vitamin D supplement and some neurologists advise people with MS to take higher doses.

The first step to discovering whether vitamin D supplements could help treat MS is to find out whether vitamin D levels are different in people with MS compared with the general population, and if so, why.

Now Dr Ruth Dobson and colleagues at Queen Mary University London have the answer: in their study, people with MS had higher levels of vitamin D because they were more likely to take a supplement.

Read the full study on the journal website

Studying vitamin D remotely

The team looked at data from 388 people with relapsing, primary progressive and secondary progressive MS. Each participant was asked to recruit a friend of a similar age without MS to take part as well.

Using the UK MS Register, participants filled in surveys asking whether they take vitamin D supplements, as well as questions like how much time they spend outdoors, their use of sun protection and even how often they eat oily fish (another possible source of vitamin D).

They also received kits to collect their own blood samples so the researchers could measure their vitamin D levels. This is the first study to investigate vitamin D remotely, with participants only needing to travel as far as the nearest post box.

Higher levels of vitamin D the result of taking supplements

The researchers found that people with MS spent significantly less time doing outdoor activities (and therefore getting vitamin D from the sun) than those without MS. Yet they had higher levels of vitamin D.

The main cause of this difference was that more people with MS took vitamin D supplements. Almost ¾ of people with MS in the study (72%) said they took a supplement compared to only a quarter (26%) of people without MS. Of those taking supplements, the dose was also higher in people with MS. 

However, when the researchers only looked at people who were not taking supplements, people with MS had lower levels of vitamin D than people without. We don’t yet know exactly why this might be, but researchers are looking at things like the interaction between your genetics and your vitamin D levels.

One of our top 10 research priorities

Our Assistant Director of Research, Dr Emma Gray, said: “Understanding the potential benefits of vitamin D supplements as a disease modifying therapy for MS is one of our top 10 research priorities.

“We are proud to have funded this study. It has given us a valuable insight into the vitamin D levels of the UK MS community which is vital for informing the design of future studies. The UK MS Register is a really important tool for gathering data from people with MS around the country and we’re really grateful to all those who took part.”

Dr Ruth Dobson, who led the study, said: “More work is now needed to establish whether these findings can be generalised to the entire UK MS community. Importantly, most of our participants identified as White British.

“An important finding is that researchers need to use a range of recruitment methods in order to make sure that all people with MS have a chance to take part in studies like this. We had planned to do work around this, but unfortunately it has been put on hold due to COVID-19”. 

Neurotransmitter analysis through a subminiature chip 1/8th the size of commercial chips. Simultaneous pharmaceutical injection, cerebrospinal fluid extraction, and brain signal measurement expected to contribute to the development of medicine

Cross-sectional image of the shank showing the embedded glass anchor and microfluidic channels and the electrical signal lines CREDIT Korea Institute of Science and Technology(KIST)

Various neurotransmitters play a key role in the signal transmission process between neurons in the brain. If the concentration of neurotransmitters is higher or lower than normal, it triggers various brain diseases for which neurotransmitters are injected as treatments. Therefore, the accurate measurement of neurotransmitter concentration is crucial for investigating the cause or during the treatment of brain diseases.

Previously, neurotransmitter concentrations were measured by inserting a 0.5 mm cerebrospinal fluid tube in the brain. This method could damage brain tissues, and the tube, which is attached to several brain sections, impedes the analysis of neurotransmitters in specific segments. Moreover, the correlation analysis between neurotransmitters and brain activity has been challenging as the brain signals that are the main indicators of normal brain activity could not be measured.

A research team led by Dr. Il-Joo Cho at the Brain Science Institute of the Korea Institute of Science and Technology (KIST, President Seok-jin Yoon) announced that they had developed a subminiature multifunctional brain chip that integrated the fluid channel for extracting cerebrospinal fluid, the fluid channel for injecting medicine, and the electrodes that measure brain signals, to overcome the abovementioned limitations.

The research team had previously published an article in an international journal regarding their development of the world’s first brain chip that can simultaneously inject medicine and measure signals. They also integrated a fluid tube for extracting the cerebrospinal fluid as they considered it critical to analyzing brain activity as well as brain signals. The developed chip is 1/8th the size of the current commercial cerebrospinal fluid extraction device, minimizes the damage of brain tissues during the insertion process, and enables a precise analysis of brain activities by observing neurotransmitters and brain signals. Furthermore, the cerebrospinal fluid is extracted at a low pressure through the small fluid tube to minimize channel blockages occurring from prolonged use.

They inserted the multifunctional brain chip into a living mouse to extract its cerebrospinal fluid and measure brain signals. After injecting a substance that controls the neurological activity into the mouse, the neurotransmitter and brain signal change were examined over time to verify the substance’s treatment effect from multiple aspects. Consequently, the developed brain chip was confirmed as a new tool that can potentially verify the medicine for brain disease treatment.

Dr. Il-Joo Cho claimed, “The new brain chip is small, yet it can perform various functions simultaneously. It will be useful in minimizing brain damage and studying the cause and treatment for brain diseases. We expect that the system we developed will be applied to various brain disease model animals and contribute to developing treatment for brain diseases.”