Η συμβολή των σωματοαισθητικών προκλητών δυναμικών στην εκτίμηση των αισθητηριακών διαταραχών και στη συνολική πρόγνωση παιδιών με διαταραχές του φάσματος του αυτισμού

The aim of the present study was the evaluation of Somatosensory Evoked Potentials (SSEPs) utility in the assessment of sensory disorders and in the overall prognosis of children with Autism Spectrum Disorders (ASD). Additionally, the presence of SSEPs asymmetry and its relation to other clinical/laboratory findings of children with ASD was examined. Patients & Methods: The sample included 49 boys with autism aged 3-9 years, who underwent SSEPs, brainstem auditory evoked potentials, electroencephalogram and brain MRI. The children were categorized as manifesting “mild/moderate” or “severe” autism, according to the Childhood Autism Rating Scale (CARS). Furthermore, they were grouped as having “possible”, “definite” or “no” difference in sensory processing, compared to the general population, according to their score in the Sensory Profile Questionnaire (SPQ). Last but not least, the study included two control groups of 49 and 43 boys for SSEPs and auditory evoked potentials, respectively. Results: SSEPs recordings revealed a significant increase of cortical parameters Ρ25 (p=0.002) and Ν20-Ρ25 (p<0.001) in children with ASD, compared to controls. Furthermore, cortical parameter Ν20-Ρ25 exhibited a positive correlation with CARS score (rp=0.34, p=0.024) in children with autism, as well as a negative correlation with controls’ age (rp=-0.305, p=0.03). The correlation with age was not detected in boys with autism. The same parameter Ν20-Ρ25 (p=0.001), along with latency Ρ25 (p=0.001), were significantly increased in children with autism and a “definite” difference, as opposed to children with autism and a “possible” difference in touch processing. Additionally, latency Ρ25 was significantly prolonged in boys with ASD and encephalogram abnormalities (paroxysmal activity or slow rhythm) (p=0.047), whereas brain MRI findings were not associated with any SSEPs parameter. Cortical lateralization was detected in peak-to-peak amplitude N20-P25, which was significantly higher (p=0.002) in the right, compared to the left hemisphere of children with ASD. Reversely, the control group manifested a significantly higher peak-to-peak amplitude in the left hemisphere (p<0.001). Last but not least, boys with autism exhibited a high percentage (24.5%) of right giant SSEPs, which were completely absent in controls. As far as auditory evoked potentials were concerned, abnormalities (indicative of peripheral, central or mixed disorders) were detected in 10 (23.3%) children with autism and in only two (4.7%) controls. The auditory parameters were neither increased unilaterally nor significantly different in boys with ASD, compared to controls. Conclusions: The index study revealed the presence of abnormal cortical SSEPs parameters, which were, furthermore, associated with the severity of sensory disorders, as well as the overall phenotype of children with autism. The abnormal recordings were probably due to a cortical disturbance and, more specifically, to a maturational disorder, as evidenced by the stability of SSEPs parameters,…