Autonomic Dysfunction in Autism Spectrum Disorder.

Area of Science:

• Neuroscience
• Cardiology
• Genetics

Background:

• Autism spectrum disorder (ASD) has shown links to increased sympathoexcitation.
• Autonomic dysfunction has not been formally investigated in ASD.
• Joint hypermobile Ehlers-Danlos syndrome (hE-DS) may be overrepresented in ASD and linked to orthostatic autonomic dysfunction.

Purpose of the Study:

• To investigate the comorbidity of ASD, autonomic dysfunction, and hE-DS.
• To assess neuro-cardiovascular autonomic function in ASD subjects compared to controls.

Main Methods:

• Compared clinical data from 28 ASD referrals over 10 years with 19 age-matched healthy controls.
• Utilized globally accepted clinical autonomic investigations to assess neuro-cardiovascular autonomic function.
• Assessed autonomic function using established center protocols.

Main Results:

• 20/28 ASD subjects had diagnosed autonomic conditions, including postural tachycardia syndrome (PoTS) and vasovagal syncope (VVS).
• 16/20 ASD subjects with autonomic dysfunction also had hE-DS.
• ASD subjects exhibited elevated basal heart rate and orthostatic responses, indicating increased sympathoexcitation, but impaired sympathetic vasoconstriction.

Conclusions:

• Intermittent neuro-cardiovascular autonomic dysfunction is over-represented in ASD, with a strong association with hE-DS.
• Autonomic dysfunction may negatively impact the quality of life in individuals with ASD, especially those with communication challenges.
• Findings highlight the need for recognizing and managing autonomic dysfunction in ASD, particularly in conjunction with hE-DS.