Autism spectrum disorder (ASD) is an early-onset neurodevelopmental disorder with complex genetic underpinning in its etiology. Copy number variations (CNVs) as one of the genetic factors associated with ASD have been addressed in recent genome-wide association studies (GWAS). However, the significance of CNV has not been well investigated in non-Caucasian ASD population. To identify the pathogenic CNVs responsible for ASD in Han Chinese, we performed a segment-based GWAS of CNV in 335 ASD cases and 1093 healthy controls using Affymetrix single nucleotide polymorphism (SNP) array by focusing on case-specific CNVs. PARK2 was one of the important genes with several case-specific regions overlapped on it. The findings were validated in the initial screen sample set and replicated in another sample set by real-time quantitative PCR (qPCR). A total of six CNVs at 6q26 that spanned different exons of PARK2 were identified. The PARK2 expression level was down-regulated at exon-dependent manner in cases with either deletion or duplication. The result revealed that the gene function might be disrupted by exonic deletion and duplication. We also observed that the ASD case with exonic duplication demonstrated a more severe interference of PARK2 expression and the clinical feature than the ones with deletion at the exons 2–4 of the PARK2 gene. Our finding provides evidence to support that CNVs affecting PARK2 function might contribute to genetic etiology of a proportion of cases with ASD. The intriguing results of this work warrant further study on characterizing the functional impact of various exonic CNVs on the PARK2 gene. ClinicalTrials.gov NCT00494754

This study aimed to examine whether probiotics supplements using Bifidobacterium bifidum (Bf-688) can improve clinical characteristics and gut microbiomes among patients with attention-deficit/hyperactivity disorder (ADHD). This open-label, single-arm trial consisted of 30 children aged 4–16 years who met the criteria for ADHD diagnosis. Each subject took Bf-688, with one sachet in the morning and one in the evening (daily bacteria count 5 × 10⁹ CFUs), for 8 weeks. Patients’ clinical symptoms were assessed using the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV). We collected stool samples at the baseline, the 8th week, and the 12th week for gut microbiota examination. During the 8-week Bf-688 supplement period, patients’ inattention symptoms and hyperactivity/impulsive symptoms improved, and their weights and BMIs increased. For gut microbiota, the Firmicutes to Bacteroidetes ratio (F/B ratio) decreased significantly. LEfSe analysis revealed that Firmicutes significantly decreased while Proteobacteria significantly increased during the 8-week treatment period. After Bf-688 was discontinued for 4 weeks (12 weeks from baseline), Bacteroidota significantly decreased and Shigella significantly increased. The probiotic Bf-688 supplement was associated with an improvement of clinical symptoms and with weight gain among ADHD children. Furthermore, gut microbiota composition was significantly altered by the Bf-688 supplement. A future randomized control trial is warranted to verify these findings.

Background: Heavy metals are known to be harmful for neurodevelopment and they may correlate to attention deficit/hyperactivity disorder (ADHD). In this study, we aim to explore the relationships between multiple heavy metals (manganese, lead, cadmium, mercury, antimony, and bismuth), neurocognitive function, and ADHD symptoms. Methods: We recruited 29 patients with ADHD inattentive type (ADHD-I), 47 patients with ADHD hyperactivity/impulsivity type (ADHD-H/I), and 46 healthy control children. Urine samples were obtained to measure the levels of the aforementioned heavy metals in each child. Participants’ cognitive function and clinical symptoms were assessed, respectively. Results: We found ADHD-H/I patients demonstrated the highest antimony levels (p = 0.028), and ADHD-I patients demonstrated the highest cadmium levels (p = 0.034). Antimony levels were positively correlated with the severity of ADHD symptoms that were rated by teachers, and cadmium levels were negatively correlated with the Full Scale Intelligence Quotient. Lead levels were negatively correlated with most indices of the Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV), but positively correlated with inattention and hyperactivity/impulsivity symptoms (p < 0.05). Conclusion: Lead, cadmium and antimony were associated with susceptibility to ADHD and symptom severity in school-age children. Eliminating exposure to heavy metals may help to prevent neurodevelopmental disorders in children.

The present study aimed to identify the distinct classes of motivations to get vaccinated and to adopt preventive behaviors against the coronavirus disease 2019 (COVID-19) among people in Taiwan and to examine the roles of Protection Motivation Theory (PMT) cognitive constructs in these unique classes of motivations to get vaccinated and to adopt preventive behaviors. We recruited 1047 participants by using a Facebook advertisement. Participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19, PMT constructs of threat appraisal (perceived severity and perceived vulnerability), and PMT constructs of coping appraisal (self-efficacy, response efficacy, response cost, knowledge, and previous vaccination for seasonal influenza) were determined. We analyzed participants’ motivations to get vaccinated and to adopt preventive behaviors against COVID-19 by using latent profile analysis. The present study identified three latent classes, including the participants with high motivation for vaccination and preventive behaviors (the class of Both High), those with low motivation for vaccination and preventive behaviors (the class of Both Low), and those with high motivation for vaccination but low motivation for preventive behaviors (the class of High Vaccination but Low Preventive Behaviors). Compared with the participants in the class of Both High, participants in the class of Both Low had lower levels of perceived vulnerability, perceived severity, self-efficacy to have vaccination, response efficacy of vaccination, knowledge about vaccination, and previous vaccination for seasonal influenza; participants in the class of High Vaccination but Low Preventive Behaviors had lower levels of perceived vulnerability and perceived severity but higher levels of response cost of vaccination. We concluded that varieties of motivations, threat, and coping appraisals should be considered in intervention programs aiming to increase motivation to adopt recommended protective behaviors against COVID-19.

The aim of this study was to examine the prevalence of self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration and the associations of autistic social impairment and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms with bullying involvement in adolescents with high functioning autism spectrum disorder (ASD). A total of 219 adolescents with high functioning ASD participated in this study. The associations of sociodemographic characteristics, parent-reported autistic social impairment, and parent-reported ADHD and ODD symptoms with self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration were examined using logistic regression analysis. The results found that the agreement between self-reported and parent-reported bullying involvement was low. Compared with bullying involvement experiences reported by adolescents themselves, parents reported higher rates of pure bullying victimization (23.7% vs. 17.8%) and victimization-perpetration (28.8% vs. 9.1%) but a lower rate of pure bullying perpetration (5.9% vs. 9.1%). Deficit in socio-communication increases the risk of being pure victims and victim-perpetrators. Parent-reported victim-perpetrators had more severe ODD symptoms than did parent-reported pure victims.

Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The aims of this study were to examine the role of social anxiety in victimization and perpetration of cyberbullying and traditional bullying in adolescents with ASD and ADHD in Taiwan. A total of 219 adolescents with ASD and 287 adolescents with ADHD aged 11–18 years and their caregivers were recruited from the child psychiatry outpatient clinics into this study. The associations of social anxiety with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results indicated that after the effects of sex, age, and autistic social impairment were controlled, social anxiety increased the risk of being a victim of cyberbullying (Odds Ratios (OR) = 1.048; 95% Confidence Interval (CI): 1.013–1.084), a victim of traditional bullying (OR = 1.066; 95% CI: 1.036–1.097), and a perpetrator of traditional bullying (OR = 1.061; 95% CI: 1.027–1.096) in adolescents with ASD. After the effects of sex, age, and ADHD symptoms were controlled for, social anxiety increased the risk of being a victim of traditional bullying in adolescents with ADHD (OR = 1.067; 95% CI: 1.039–1.096). Social anxiety was significantly associated with several forms of bullying involvement in adolescents with ASD and ADHD and warrants being considered into prevention and intervention programs for bullying involvement.