Utilisation de cannabis et de cannabinoïdes dans les "troubles du spectre de l'autisme" : une revue systématique

Aperçu: G.M.

Introduction:
Le trouble du spectre de l'autisme (TSA) est un trouble neurodéveloppemental caractérisé par des déficits persistants de la communication sociale et des interactions sociales, associés à la présence de modèles de comportement, d'intérêts ou d'activités restreints et répétitifs. Le cannabis a été utilisé pour soulager les symptômes associés aux TSA. 

Méthode:
Nous avons effectué une revue systématique des études portant sur les effets cliniques de l'usage du cannabis et des cannabinoïdes sur les TSA, selon les éléments de rapport préférés pour les revues systématiques et les méta-analyses (liste de contrôle PRISMA). La recherche a été effectuée dans quatre bases de données: MEDLINE / PubMed, Scientific Electronic Library Online (SciELO), Scopus et Web of Science. Aucune limite n'a été établie pour la langue lors du processus de sélection. Neuf études ont été sélectionnées et analysées. 

Résultats:
Certaines études ont montré que les produits à base de cannabis réduisaient le nombre et / ou l'intensité des différents symptômes, y compris l'hyperactivité, les attaques d'automutilation et de colère, les problèmes de sommeil, l'anxiété, l'agitation, l'agitation psychomotrice, l'irritabilité, l'agressivité, la persévérance et la dépression. De plus, ils ont constaté une amélioration de la cognition, de la sensibilité sensorielle, de l'attention, de l'interaction sociale et du langage. Les effets indésirables les plus courants étaient les troubles du sommeil, l'agitation, la nervosité et les changements d'appétit. 

Conclusion:
Le cannabis et les cannabinoïdes peuvent avoir des effets prometteurs dans le traitement des symptômes liés aux TSA et peuvent être utilisés comme alternative thérapeutique pour soulager ces symptômes. Cependant, des essais cliniques randomisés, à l'aveugle et contrôlés par placebo sont nécessaires pour clarifier les résultats sur les effets du cannabis et de ses cannabinoïdes chez les personnes avec un diagnostic de TSA.

. 2021 May 21.  doi: 10.47626/2237-6089-2020-0149. 

Cannabis and cannabinoid use in autism spectrum disorder: a systematic review

Estácio Amaro da Silva Junior  ¹ , Wandersonia Moreira Brito Medeiros  ¹ , Nelson Torro  ¹ , João Marçal Medeiros de Sousa  ² , Igor Bronzeado Cahino Moura de Almeida  ² , Filipe Barbosa da Costa  ² , Katiúscia Moreira Pontes  ² , Eliane Lima Guerra Nunes  ³ , Marine Diniz da Rosa  ⁴ , Katy Lísias Gondim Dias de Albuquerque  ⁵

Affiliations

• PMID: 34043900
• DOI: 10.47626/2237-6089-2020-0149

Abstract

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD.

Method: We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed.

Results: Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite.

Conclusion: Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD.

Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO), code 164161.

Keywords: Cannabis; autism; cannabidiol; cannabinoid; systematic review.

Support orthographique pour l'apprentissage des mots dans les populations cliniques: une revue systématique

Aperçu: G.M.

Objectif
Une revue systématique a été réalisée pour déterminer dans quelle mesure la facilitation orthographique, une stratégie pour améliorer l'apprentissage des mots, a été démontrée comme étant efficace dans la littérature pour les enfants et les adolescents de catégories cliniques telles que les troubles du développement du langage (DLD), les "troubles du spectre de l'autisme' (TSA), Syndrome de Down, dyslexie, déficience auditive, déficience intellectuelle et paralysie cérébrale. 

Méthode
Cinq bases de données ont été utilisées comme rechercher pour toutes les études publiées jusqu'en décembre 2019. Les études éligibles incluaient des participants d'une population clinique (DLD, TSA, dyslexie, paralysie cérébrale, syndrome de Down, déficience auditive, etc.) et comparaient l'apprentissage des mots avec et sans orthographe. Des études sélectionnées ont été extraites pour obtenir des informations pertinentes. De plus, une évaluation de la rigueur méthodologique a été réalisée pour chaque étude. 

Résultats
La revue a produit cinq études qui ciblaient l'apprentissage des mots avec la facilitation orthographique pour les enfants de diverses populations cliniques, y compris la DLD, les enfants autistes verbaux, le syndrome de Down et la dyslexie.
Toutes les populations étudiées ont montré un avantage pour l'apprentissage des mots dans les post-tests de dénomination des images lorsque les mots étaient formés en présence de l'orthographe. 

Conclusions
Pour les populations étudiées, l'apprentissage des mots en présence d'orthographe améliorera l'enseignement de la précision et la rétention des mots. L'examen met en évidence la nécessité de poursuivre la recherche dans ce domaine auprès d'autres populations cliniques.

. 2021 May 24;1-12.  doi: 10.1044/2021_LSHSS-20-00123. 

Orthographic Support for Word Learning in Clinical Populations: A Systematic Review

Grace T Clark  ¹ , Christina Reuterskiöld  ¹

Affiliations

• PMID: 34029128
• DOI: 10.1044/2021_LSHSS-20-00123

Abstract

Purpose A systematic review was performed to determine the extent to which orthographic facilitation, a strategy to improve word learning, has been demonstrated in the literature for children and adolescents from clinical categories such as developmental language disorders (DLD), autism spectrum disorders (ASD), Down syndrome, dyslexia, hearing impairment, intellectual disability, and cerebral palsy. Method Five databases were searched for all studies published through December 2019. Eligible studies included participants from a clinical population (DLD, ASD, dyslexia, cerebral palsy, Down syndrome, hearing impairment, etc.) and compared word learning with and without orthography. Selected studies were extracted for pertinent information. In addition, assessment of the methodological rigor was performed for each study. Results The review yielded five studies that targeted word learning with orthographic facilitation for children from various clinical populations including DLD, verbal children with autism, Down syndrome, and dyslexia. All studied populations showed a benefit for word learning in picture naming posttests when words were trained in the presence of orthography. Conclusions For the studied populations, training words in the presence of orthography will improve word learning accuracy and retention. The review highlights the need for more research in this area across other clinical populations. Supplemental Material https://doi.org/10.23641/asha.14632791.

Le profil de la mémoire épisodique dans les "troubles du spectre de l'autisme": une méta-analyse bayésienne

Aperçu: G.M.

Bien que les "troubles du spectre de l'autisme" (TSA) soient généralement caractérisés par une mémoire épisodique diminuée, la littérature dans ce domaine est mitigée.
Nous abordons ces résultats inconsistants en utilisant une méta-analyse bayésienne à plusieurs niveaux pour quantifier les différences de mémoire épisodiques entre les personnes avec un diagnostic de TSA et les témoins au développement typique (TD).
Nous avons utilisé la méta-régression pour évaluer les effets de la modalité de test (par exemple, liste de mots, rappel d'histoire), de l'intervalle de retard (immédiat vs retardé), des demandes de récupération (reconnaissance vs rappel) et de la modalité sensorielle (auditive vs visuelle) sur la mémoire épisodique dans les TSA.
Un total de 338 tailles d'effet provenant de 113 articles empiriques, dont 5 632 participants uniques (TSA = 2 777, DT = 2 855), ont été inclus. 

Les résultats montrent que les déficits de mémoire associés aux TSA étaient plus importants pour le rappel (g = -0,52, se = 0,04, 95% CrI [-0,60, -0,43]) par rapport à la reconnaissance (g = -0,25, se = 0,05, 95% CrI [-0,35, -0,14]) et différaient en fonction de la modalité de test.
Par exemple, les tailles d'effet étaient les plus petites pour les mots (g = -0,28, se = 0,05, 95% CrI [-0,38, -0,18]), les images (g = -0,38, se = 0,07, 95% CrI [-0,52, - 0,24]) et la reproduction de la figure (g = -0,49, se = 0,11, 95% CrI [-0,70, -0,27]).
Cependant, les tailles d'effet pour les phrases (g = -0,59, se = 0,20, 95% CrI [-1,00, -0,21]), les histoires (Hedges 'g = -0,54, se = 0,08, 95% CrI [-0,69, -0,38 ]) et les événements par étapes (g = -0,75, se = 0,10, 95% CrI [-0,95, -0,55]) étaient beaucoup plus importants. 

Ces résultats suggèrent que le TSA est associé à une réduction faible à moyenne des scores aux tests de mémoire épisodique par rapport aux témoins TD.

. 2021 May 5. doi: 10.1007/s11065-021-09493-5. 

The Episodic Memory Profile in Autism Spectrum Disorder: A Bayesian Meta-Analysis

Jason W Griffin  ¹ , Russell Bauer  ² , Brandon E Gavett  ³

Affiliations

• PMID: 33954915
• DOI: 10.1007/s11065-021-09493-5

Abstract

Although autism spectrum disorders (ASD) are commonly characterized by diminished episodic memory, the literature in this area is mixed. We address these inconsistent findings by employing multilevel Bayesian meta-analysis to quantify episodic memory differences between individuals with ASD and typically developing (TD) controls. We used meta-regression to evaluate the effects of test modality (e.g., word list, story recall), delay interval (immediate vs. delayed), retrieval demands (recognition vs. recall), and sensory modality (auditory vs. visual) on episodic memory in ASD. A total of 338 effect sizes from 113 empirical articles, including 5,632 unique participants (ASD = 2,777, TD = 2,855), were included. Results show that the memory deficits associated with ASD were larger for recall (g = -0.52, se = 0.04, 95% CrI [-0.60, -0.43]) compared to recognition (g = -0.25, se = 0.05, 95% CrI [-0.35, -0.14]) and differed based on the testing modality. For example, effect sizes were smallest for words (g = -0.28, se = 0.05, 95% CrI [-0.38, -0.18]), pictures (g = -0.38, se = 0.07, 95% CrI [-0.52, -0.24]), and figure reproduction (g = -0.49, se = 0.11, 95% CrI [-0.70, -0.27]). However, effect sizes for sentences (g = -0.59, se = 0.20, 95% CrI [-1.00, -0.21]), stories (Hedges' g = -0.54, se = 0.08, 95% CrI [-0.69, -0.38]) and staged events (g = -0.75, se = 0.10, 95% CrI [-0.95, -0.55]) were much larger. These findings suggest that ASD is associated with a small to medium reduction in scores on episodic memory tests relative to TD controls.

Keywords: ASD; Neuropsychological tests; Recall; Recognition; Systematic review.

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