Tag: Autism Spectrum Disorder (ASD)

Astronomers discover unusual monster galaxy in the very early universe

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Photo by Suzy Hazelwood on Pexels.com

An international team of astronomers led by scientists at the University of California, Riverside, has found an unusual monster galaxy that existed about 12 billion years ago, when the universe was only 1.8 billion years old.

Dubbed XMM-2599, the galaxy formed stars at a high rate and then died. Why it suddenly stopped forming stars is unclear.

“Even before the universe was 2 billion years old, XMM-2599 had already formed a mass of more than 300 billion suns, making it an ultramassive galaxy,” said Benjamin Forrest, a postdoctoral researcher in the UC Riverside Department of Physics and Astronomy and the study’s lead author. “More remarkably, we show that XMM-2599 formed most of its stars in a huge frenzy when the universe was less than 1 billion years old, and then became inactive by the time the universe was only 1.8 billion years old.”

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The team used spectroscopic observations from the W. M. Keck Observatory‘s powerful Multi-Object Spectrograph for Infrared Exploration, or MOSFIRE, to make detailed measurements of XMM-2599 and precisely quantify its distance.

Study results appear in the Astrophysical Journal.

“In this epoch, very few galaxies have stopped forming stars, and none are as massive as XMM-2599,” said Gillian Wilson, a professor of physics and astronomy at UCR in whose lab Forrest works.  “The mere existence of ultramassive galaxies like XMM-2599 proves quite a challenge to numerical models. Even though such massive galaxies are incredibly rare at this epoch, the models do predict them. The predicted galaxies, however, are expected to be actively forming stars. What makes XMM-2599 so interesting, unusual, and surprising is that it is no longer forming stars, perhaps because it stopped getting fuel or its black hole began to turn on. Our results call for changes in how models turn off star formation in early galaxies.”

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The research team found XMM-2599 formed more than 1,000 solar masses a year in stars at its peak of activity — an extremely high rate of star formation. In contrast, the Milky Way forms about one new star a year.

“XMM-2599 may be a descendant of a population of highly star-forming dusty galaxies in the very early universe that new infrared telescopes have recently discovered,” said Danilo Marchesini, an associate professor of astronomy at Tufts University and a co-author on the study.

The evolutionary pathway of XMM-2599 is unclear.

“We have caught XMM-2599 in its inactive phase,” Wilson said. “We do not know what it will turn into by the present day. We know it cannot lose mass. An interesting question is what happens around it. As time goes by, could it gravitationally attract nearby star-forming galaxies and become a bright city of galaxies?”

Co-author Michael Cooper, a professor of astronomy at UC Irvine, said this outcome is a strong possibility.

“Perhaps during the following 11.7 billion years of cosmic history, XMM-2599 will become the central member of one of the brightest and most massive clusters of galaxies in the local universe,” he said. “Alternatively, it could continue to exist in isolation. Or we could have a scenario that lies between these two outcomes.”

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The team has been awarded more time at the Keck Observatory to follow up on unanswered questions prompted by XMM-2599.

“We identified XMM-2599 as an interesting candidate with imaging alone,” said co-author Marianna Annunziatella, a postdoctoral researcher at Tufts University. “We used Keck to better characterize and confirm its nature and help us understand how monster galaxies form and die. MOSFIRE is one of the most efficient and effective instruments in the world for conducting this type of research.”

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Human Brain Protein Associated with Autism

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The human dopamine transporter protein is missing a single amino acid.

Credit: UAB
Aurelio Galli
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A mutant gene that encodes a brain protein in a child with autism has been placed into the brains of fruit flies. Fruit flies hosting that gene produce the variant human brain protein and show abnormal behaviors of fear, repetitive activity and altered social interaction, reminiscent of autism impairments.

The genetic variant was found in the Simon Simplex Collection, which has collected genetic samples from 2,600 simplex families with autism spectrum disorder, or ASD. The brain protein is the dopamine transporter, or DAT, whose job is to pump the neurotransmitter dopamine back into nerve cells once the neurotransmitter has been released. The mutant protein is missing a single amino acid.

A study of this variant DAT — from its impaired molecular mechanism to its effect on fruit fly behavior — has been published in Proceedings of the National Academy of Sciences by co-corresponding authors Aurelio Galli, Ph.D., and Eric Gouaux, Ph.D.

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Galli is professor in the Department of Surgery at the University of Alabama at Birmingham, and Gouaux is professor in the Vollum Institute at the Oregon Health & Science University and Howard Hughes Medical Institute.

Researchers found that fruit flies with the human variant DAT, or vDAT, are hyperactive. They had increased locomotor activity in both day and night, as compared with normal fruit flies. They also showed repetitive behavior — the vDAT fruit flies groomed themselves 23 percent of the time, versus 6 percent of the time for normal fruit flies. Repetitive behavior like self-grooming has been observed in animal models of neuropsychiatric disorders.

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The vDAT fruit flies were also more fearful than normal fruit flies. In response to the sound of a predatory wasp, normal flies froze for about 150 milliseconds, and then they fled, as shown by a distinctive and rapid increase in average velocity that was captured by a 1,000-frame per second camera. In contrast, the vDAT fruit flies froze at the sound of the predator and showed little signs of fleeing during 600 milliseconds.

The vDAT fruit flies had impaired social interaction, as measured by changes in grouping. Many animal populations form temporary or permanent groups, such as flocks, schools or herds, that aid survival in the face of predators. Fleeing, in response to a threat, is an escape behavior where the flock size may compress or expand. The researchers found that normal fruit flies expanded their flock size in response to a threat — the sound of the predator wasp. The vDAT fruit flies, in contrast, compressed their flock size.

Besides the fruit fly behavior, the PNAS study is a comprehensive multidisciplinary approach that gets at some root causes of autism to a degree of detail that could make potential therapeutic treatments more realizable in the future.

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Besides vDAT, the labs of Galli and Heinrich Matthies, Ph.D., assistant professor in the UAB Department of Surgery, have identified several other mutations in the human DAT gene that affect DAT function in individuals with ASD. For these people, disruption of dopamine transport appears to be a risk factor that promotes complications associated with ASD.

“The experimental paradigms we describe here,” Galli said, “provide a framework for molecular and behavioral analysis of novel DAT variants that are discovered by genetic analyses of individuals with ASD or related neuropsychiatric illness, as well as other disease-linked mutants that are emerging from precision medicine initiatives.”

Galli and Gouaux’s PNAS research went from human genetics to a basic animal model with simplified behavior, as detected by a new high-powered analysis. It investigated the underlying molecular mechanisms and basic biological functions with ever greater resolution, through studies at the cell level and all the way down to a bacterial system. Each added system was more fundamental with regard to biological complexity and phylogenetic level.

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Details of vDAT structure and function
Besides altered fly behavior caused by the mutant protein, the PNAS study probed the molecular structure and function of vDAT using mutation of a related transporter protein from a thermophilic bacterium as a model. Experiments included X-ray crystallography, spin resonance spectroscopy, molecular modeling, cell culture studies and electrophysiology studies of fruit fly brains expressing the mutant.

The researchers showed that vDAT cells have impaired dopamine transport and impaired DAT-mediated electrical currents. Also, expression of the human vDAT reduced dopamine uptake in the whole brain of fruit flies. These findings support the idea that human DAT dysfunction in ASD stems from specific and yet distinct mechanisms.

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To probe the mechanism of impaired transporter function, researchers used the related bacterial transporter as a model. They removed the single amino acid from the related bacterial transporter that correlates with the single amino acid missing in vDAT. Like DAT, the bacterial transporter protein embeds across the cell membrane and has domains called the extracellular gate and the intracellular gate to receive and release the molecule being transported from outside the cell to inside.

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Deletion of the single amino acid altered conformation of the bacterial protein and appeared to lock its extracellular gate, apparently through disrupted hydrogen bonds between amino acids of the protein that abnormally left the intracellular gate in a conformation called “half-open and inward facing.” Molecular dynamics simulation of vDAT showed similar conformational changes and altered hydrogen bonding.

Co-authors with Galli, Gouaux and Matthies for the paper, “Structural, functional, and behavioral insights of dopamine dysfunction revealed by a deletion in SLC6A3,” are Nicholas G. Campbell, Aparna Shekar, Dungeng Peng, Amanda M. Duran, Brian O’Grady, Ramnarayan Ramachandran, James S. Sutcliffe, Jens Meiler, Leon M. Bellan and Hassane S. Mchaourab, Vanderbilt University; Jenny I. Aguilar and Kevin Erreger, Department of Surgery, UAB School of Medicine; Vikas Navratna and Dongxue Yang, Vollum Institute, Oregon Health and Science University; Alexander N. Morley, Harald H. Sitte and Thomas Stockner, Medical University of Vienna, Austria; and Greta Galli, University School of Nashville, Tennessee.

Mchaourab is co-senior author with Galli, and Greta Galli is daughter of Aurelio Galli.

Support for this work came from National Institutes of Health grants MH070039, GM080403, HL122010, DA35263, DA38058 and NS007491-14.

Early Intervention in Autism Improves Language, IQ and Social Skills

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Credit: UC Davis Health
Sally Rogers, PhD works with a child.

Breakthrough research demonstrating that children with autism as young as 18 months can vastly improve their language, cognition and social skills with an early intervention developed by UC Davis Professor Sally Rogers has been replicated in a major new study.

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Rogers, a professor of Psychiatry and Behavioral Sciences at the MIND Institute, began work on a novel developmental approach to autism in Denver in 1981, and in partnership with her colleague and co-author Geraldine Dawson developed an approach to improving long-term outcomes for very young children. The Early Start Denver Model has since become a method used throughout the U.S. and around the world.

But until now ESDM had not been tested in the most rigorous fashion − a multi-site randomized trial, comparing the approach with community-based autism interventions. The study, which appears today in Journal of the American Academy of Child and Adolescent Psychiatry, began in 2007 at three university sites around the country. The new research replicates an ESDM study published in 2010. Rogers emphasized that replication studies are rare and costly but critical to validate novel scientific findings.

The new study found that children receiving intensive ESDM in their homes for an average of 15 hours per week made significantly greater language gains than did children in the community interventions, and this was true for both children with more severe delays and those with less.

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In addition to validating the efficacy of ESDM for language development, the study also found that children receiving services in the community settings made large gains in several areas.

“The idea that little children with autism who are getting good treatment can make this much IQ and language gain means we should expect this from quality early-intervention experiences,” Rogers said. “These findings should raise families’ hopes a whole lot.”

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Pioneering autism treatment was a new idea

What distinguishes ESDM from the more traditional, behavioral interventions used with children with autism is that it combines developmental and behavioral approaches and is carried out within in everyday routines. ESDM is built on moment-to-moment interactions that young children typically have with other people, especially their parents, and uses children’s interests and favorite activities to assure that social interaction is interesting and fun.

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“Unlike other approaches popular at the time that the Denver Model began, we used a typical preschool physical environment and focused on the learning opportunities that existed in social interactions between children and adults to accelerate children’s development,” Rogers said. “This was a new idea at the time.”

In 2012, TIME magazine named ESDM one of the top 10 medical breakthroughs because their work demonstrated that brain function among young children with autism can normalize with effective early intervention in profound, enduring ways.

For the current study 118 children with autism, ages 14 months to two years, were enrolled and randomly assigned to either ESDM or community interventions for 27 months. Children assigned to ESDM intervention received three months of weekly parent coaching followed by 24 months of one-on-one treatment about 15 hours per week in homes or daycare settings from supervised therapy assistants. Parents received coaching four hours monthly from a certified ESDM therapist. In the community setting, hours of treatment varied by site.

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What researchers found was that at two of the three sites, children receiving ESDM had significantly more language improvement than the children in the community interventions, and there was no significant difference in language gain at the third site between the two modalities. When results from all three sites were pooled, there was a significant advantage for the children in the ESDM group overall.

“Language is the bridge to learning,” Rogers said. “Language is the door that opens up social communication and education and interactions with people in your community. It’s how you share with people. It’s a main vehicle for social interaction once you pass infancy.”

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Autism treatment in the community greatly improved over time

 The study also found that in terms of cognition and social skills, both the ESDM and community treatment groups made significant gains. Fortunately, Rogers said, laws requiring insurance coverage for early autism intervention and new knowledge about effective treatment have greatly improved community options for families seeking help for young children diagnosed with autism.

Rogers said families with a child diagnosed with autism should take some comfort knowing that the early treatments now widely available do make a difference.

“It says the autism scores at the time of diagnosis are just a starting point,” she said. “It says that the developmental paths and learning capacity of young children with autism are more plastic than we knew, and there are many ways to get learning opportunities to them.”

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In addition to Rogers, UC Davis authors on the study were Marie Rocha, Laurie Vismara and Meagan Talbott. Other co-authors on the study included: Annette Estes and Jessica Greenson of the University of Washington; Catherine Lord and Jamie Winter of Weill Cornell Medicine, Cornell University; Costanza Colombi of University of Michigan; Geraldine Dawson of Duke University, and Gerhard Hellemann of UCLA.

This study was supported by individual Autism Speaks grants to Annette Estes and to Sally Rogers and by NIMH/NICHD award number R01 081757 as part of the Autism Centers of Excellence (ACE) Treatment Network, clinicaltrials.gov identifier NCT 00698997.

Black Children Tend to be Diagnosed with Autism Later than White Children

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Photo by Zach Vessels
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The rate of diagnosis for autism spectrum disorders (ASD) is the same among all racial groups — one in 110, according to current estimates. However, a study by a Florida State University researcher has found that African-American children tend to be diagnosed later than white children, which results in a longer and more intensive intervention. The reasons for later diagnoses include a lack of access to quality, affordable, culturally competent health care, according to Martell Teasley, an associate professor in Florida State’s College of Social Work who has conducted a comprehensive review of researchliterature on autism and African-American children. In addition, the stigmaattached to mental health conditions within the black community contribute to misdiagnoses of autism, and underuse of available treatment services.

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“There are no subjective criteria for diagnosing autism. Only brain scans can truly provide appropriate diagnoses, because we are dealing with biological and chemical imbalances in the brain,” Teasley said. “Not every child is going to have access to this kind of medical evaluation, particularly those who are indigent and don’t have health care funding.”

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Teasley examined ASD diagnosis and treatment strategies, and their effect on African-American families, in “Autism and the African-American Community,” a paper published in a special issue of the journal Social Work in Public Health (Vol. 26, Issue 4, 2011) that dealt with health-care policy issues in the black community related to the human genome.

Credit: FSU Photography
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Associate Professor in Florida State’s College of Social Work

Teasley co-wrote the paper with Ruby Gourdine, a professor of social work at Howard University in Washington, D.C., and Tiffany Baffour, an associate professor of social work at Winston-Salem State University in North Carolina. Because of the social stigma, Teasley says that some African-American families might be resistant to accept a diagnosis and treatment. “Less discussion about autism among African-Americans or between African-Americans and health care providers leads to misdiagnoses, a lack of treatment and a lack of services,” Teasley said.

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“This will lead to greater challenges for families — more stress and anxiety, and poorer developmental outcomes.” African-Americans also might resist a diagnosis and treatment because of a mistrust of mainstream health care providers over past discrimination. “African-Americans are well versed in going to a doctor who might have biases or discriminatory practices, so they may not readily accept what a doctor says,” Teasley said. In addition, a cultural divide between African-Americans and mainstream health care providers can hinder a timely and correct diagnosis.

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“There are not enough health care professionals who understand the cultural norms and attributes of the African-American community,” Teasley said. African-Americans live in all types of settings, but the majority live in urban areas, which have seen a decline in the number of mental-health care agencies since the 1980s. “This lack of accessibility causes a problem for some African-Americans,” Teasley said. Once a child is diagnosed with ASD, Teasley says both the child and the members of his or her family needs to receive appropriate training and counseling. “The children need behavioral counseling so they can develop the skills to live as independently as possible,” he said. “The families need to learn how to work with children who are autistic. “Intervention for any autistic child needs to start around age 3, so we can get the child to begin to learn how to eat right and develop normal, healthy routines, which will result in a better developmental outcome,” Teasley said. “Later intervention will result in a poorer developmental outcome that can have a lasting impact on the child’s and family’s quality of life.”

Martell Teasley, College of Social Work(850) 644-9595; mteasley@fsu.edu

“Could My Child Have Autism?”

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Ten Signs of Possible Autism-Related Delays in 6- to 12-Month-Old Children

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Though autism is often not diagnosed until the age of three, some children begin to show signs of developmental delay before they turn a year old. While not all infants and toddlers with delays will develop autism spectrum disorders (ASD), experts point to early detection of these signs as key to capitalizing on early diagnosis and intervention, which is believed to improve developmental outcomes.

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According to Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, Md., parents need to be empowered to identify the warning signs of ASD and other communication delays. “We want to encourage parents to become good observers of their children’s development so that they can see the earliest indicators of delays in a baby’s communication, social and motor skills,” says Dr. Landa, who also cautions that some children who develop ASD don’t show signs until after the second birthday or regress after appearing to develop typically.

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For the past decade, Dr. Landa has followed infant siblings of children with autism to identify red flags of the disorder in their earliest form. Her research has shown that diagnosis is possible in some children as young as 14 months and sparked the development of early intervention models that have been shown to improve outcomes for toddlers showing signs of ASD as young as one and two years old. Dr. Landa recommends that as parents play with their infant (6 – 12 months), they look for the following signs that have been linked to later diagnosis of ASD or other communication disorders: 1. Rarely smiles when approached by caregivers2. Rarely tries to imitate sounds and movements others make, such as smiling and laughing, during simple social exchanges3. Delayed or infrequent babbling4. Does not respond to his or her name with increasing consistency from 6 – 12 months 5. Does not gesture to communicate by 10 months6. Poor eye contact7. Seeks your attention infrequently8. Repeatedly stiffens arms, hands, legs or displays unusual body movements such as rotating the hands on the wrists, uncommon postures or other repetitive behaviors9. Does not reach up toward you when you reach to pick him or her up10. Delays in motor development, including delayed rolling over, pushing up and crawling

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“If parents suspect something is wrong with their child’s development, or that their child is losing skills, they should talk to their pediatrician or another developmental expert,” says Dr. Landa. “Don’t adopt a ‘wait and see’ perspective. We want to identify delays early in development so that intervention can begin when children’s brains are more malleable and still developing their circuitry.”

About the Kennedy Krieger Institute Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 16,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit: www.kennedykrieger.org.

Art Museum Offers New Tools for Visitors with Sensory-Related Disorders

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Credit: Zimmerli Art Museum/Rutgers University
Items inside sensory inclusive bags from KultureCity

Museum staff are trained to help visitors have a rewarding experience

New Brunswick, N.J. (Dec. 16, 2019) – The Zimmerli Art Museum at Rutgers University-New Brunswick is the first art museum in New Jersey to offer specialized tools to help visitors in the autism spectrum enjoy their visit without stressful sensory overload.

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The museum is collaborating with KultureCity, a nonprofit that has also worked with MetLife Stadium, to offer the training and materials needed to provide a more positive experience for those with autism, PTSD or other conditions that may cause sensory overload.

Free sensory inclusive bags include fidget tools (handheld objects that can be squeezed and manipulated to help focus the user’s sense of touch), cue cards that people with verbal impairments can use to communicate their needs and moods, noise-cancelling headphones and weighted lap pads to help direct the user’s feeling of their center of gravity.

“A common misperception is that autism is just a behavioral disorder, but it affects processes in our nervous system, which can create a feeling of vertigo or the sense of a lack of gravity,” said Elizabeth Torres, a Rutgers professor of psychology and director of The New Jersey Autism Center of Excellence at Rutgers–New Brunswick. “Astronauts who return from a long space mission are given weighted suits to bring back their center of gravity until they readjust. In a similar fashion, people with autism can’t always feel their own body weight. For some, the feeling is constant and very disorienting.”

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Through the partnership with Kulture City, Zimmerli staff received training on how to recognize when a visitor may have sensory needs, such as covering their ears or flapping their hands, and how to step in and offer them sensory support.

“We’re now better prepared to assist guests with autism and other sensory sensitivities in having the most comfortable and accommodating experience possible when attending any exhibition or program at the museum,” said Thomas Sokolowski, Zimmerli Art Museum Director.

Before adopting the new sensory tools, the Zimmerli offered customized group tours to visitors with autism and related conditions.  A KultureCity app is also available for download that displays available sensory devices at Zimmerli and how they can be accessed, as well as a customized social story, that helps visitors prepare for their visit

 “People with sensory disorders and their families now have the freedom to visit at any time and have confidence they will be assisted properly if they experience sensory overload or otherwise need support,” said Amanda Potter, curator of education at the Zimmerli.

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Potter said the sensory tools can help people of all ages. “There is also a necklace that visitors can wear that alerts staff to keep a close eye on a person so they don’t get separated from their group, which can happen not only to children but to people with dementia.”

While the sensory tools are a big first step to helping combat sensory sensitivity, Torres said museums can do more, such as partnering with autism centers and offering information cards to improve public understanding of autism-related disorders.

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“We are having exploratory conversations with Rutgers’ Center for Adult Autism Services to find more ways to help the autism community in New Jersey, including by providing job services and creating designated quiet spaces during crowded events, such as Rutgers Day,” Potter said. “Autism services are an area for growth, so we will work to expand our services. This is just the start.” 

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Rutgers-New Brunswick, is a leader in autism research and services, recently appointing its inaugural director of the Rutgers Center for Autism Research, Education and Services (RUCARES) and CHS-RUCARES, a clinical entity created through Rutgers’ partnership with Children’s Specialized Hospital. The university’s Douglass Developmental Disabilities Center includes an on-campus K-12 day school for children with autism. In addition, the university broke ground on a new state-of-the-art facility for the Rutger Center for Adult Autism Services, which provides employment, vocational training and other services and partners with Children’s Specialized Hospital to operate the New Jersey Autism Center of Excellence.

Neurodevelopment-Related Gene Deficiency

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Findings may lead to clues for possible treatments for autism spectrum disorders and schizophrenia

Credit: CWRU

Lin Mei, the Allen C. Holmes Professor of Neurological Diseases and chair of the Department of Neurosciences at the Case Western Reserve University School of Medicine

CLEVELAND—Researchers at the Case Western Reserve University School of Medicine have identified that a gene critical to clearing up unnecessary proteins plays a role in brain development and contributes to the development of autism spectrum disorders (ASD) and schizophrenia.

The discovery, published today in Neuron (embargo lifts online Nov. 25 at 11 a.m.), provides important insight into the mechanism of both diseases—a possible step toward finding how to treat the disorders.

Cullin 3 is a core component of an E3 ubiquitin ligase responsible for the cell’s clearance of proteins. Mutations of its gene CUL3 have been associated with autism and schizophrenia. However, pathologic mechanisms of CUL3 deficiency have been unclear.

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“CUL3 is abundant in the brain, yet little is known of its function,” said Lin Mei, the Allen C. Holmes Professor of Neurological Diseases and chair of the Department of Neurosciences at the Case Western Reserve University School of Medicine. “Here, we show that CUL3 is critical for brain development and communication between cells in the brain.”

Mei, also director of the Cleveland Brain Health Initiative, is the principal investigator with research assistants Zhaoqi Dong and Wenbing Chen. (The published research is titled “CUL3 deficiency causes social deficits and anxiety-like behaviors by impairing excitation-inhibition balance through the promotion of Cap-dependent translation.”)

ASD is a complicated condition that includes difficulty with communication and social interaction, obsessive interests and repetitive behaviors. It affects 1 in 59 children in the United States, according to a recent report by the Centers for Disease Control. Schizophrenia affects about 1 in 100 people worldwide. However, autism and schizophrenia remain among the most mysterious disorders.

Mei and his team studied how CUL3 mutation impacts the brain in mouse models. The researchers were able to demonstrate that altering the gene in mouse models can cause similar social problems that appear in people with these disorders.

Normal mice would spend more time with a mouse over an inanimate object, Mei said. But CUL3-mutant mice couldn’t differentiate between a mouse and an inanimate object, showing a problem with social preference.

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In another test, normal mice would spend more time with an unfamiliar mouse over a familiar one. But CUL3-mutant mice couldn’t remember seeing a familiar mouse, suggesting a problem of social memory. Also, CUL3-mutant mice were more anxious than normal mice.

Researchers at Beijing Normal University and the Louis Stokes Cleveland Veterans Affairs Medical Center contributed to the research.

Case Western Reserve University is one of the country’s leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing and social work. About 5,100 undergraduate and 6,700 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.