Pediatric Research ( IF 3.1 ) Pub Date : 2021-09-08 , DOI: 10.1038/s41390-021-01730-0 Nicole M Talge 1, 2 , Melanie Adkins 1, 2 , Paul R Kileny 3 , Isabella Frownfelter 2
Background
Click-evoked auditory brainstem response (ABR) alterations are associated with autism spectrum disorder (ASD), but the specificity of these findings to the disorder is unclear. We therefore performed a meta-analysis on ABRs and attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder that shares some etiologic and symptom overlap with ASD.
Methods
Seven papers compared ABR latency components (I, III, V, I–III, III–V, and I–V) between participants with and without ADHD. We used random-effects regression to generate component-specific estimates (Hedges’s g) that adjusted for study sample sizes and the number of studies contributing to each estimate. We compared these estimates to our recently published meta-analysis of ABRs and ASD.
Results
All ADHD studies employed cross-sectional designs. ADHD was associated with longer latencies for waves III and V (g = 0.6, 95% confidence interval (CI) 0.3, 1.0 and g = 0.6, 95% CI 0.3, 0.9) and waves I–III and I–V (g = 0.7, 95% CI 0.2, 1.3 and g = 0.6, 95% CI 0.3, 1.0). Effect sizes from the ASD and ADHD meta-analyses did not differ from each other.
Conclusions
Similar patterns of ABR alterations are observed in ADHD and ASD. However, studies rarely screen for middle ear dysfunction or hearing loss and rely upon cross-sectional designs. Addressing these issues will inform the viability of ABRs as a prognostic and/or etiologic biomarker for these disorders.
Impact
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Click-evoked ABR alterations are associated with ASD, but the specificity of these findings to the disorder is unclear. We therefore performed a meta-analysis of the association between ABRs and ADHD, a disorder that shares some etiologic and symptom overlap with ASD.
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ADHD was associated with longer ABR latencies for several components. These components are identical to those implicated in ASD. Effect sizes were similar in magnitude across disorders.
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The viability of ABRs as prognostic and/or etiologic biomarkers for neurodevelopmental risk requires addressing limitations in the literature (e.g., cross-sectional data, non-standardized ABR protocols, minimal characterization of symptom heterogeneity).
中文翻译：
点击诱发的听觉脑干反应和自闭症谱系障碍：疾病特异性的荟萃分析研究
背景
点击诱发的听觉脑干反应 (ABR) 改变与自闭症谱系障碍 (ASD) 相关，但这些发现对该疾病的特异性尚不清楚。因此，我们对 ABR 和注意力缺陷/多动障碍 (ADHD) 进行了荟萃分析，ADHD 是一种与 ASD 有一些病因和症状重叠的神经发育障碍。
方法
七篇论文比较了患有和不患有 ADHD 的参与者之间的 ABR 潜伏期成分（I、III、V、I-III、III-V 和 I-V）。我们使用随机效应回归来生成特定成分的估计值（Hedges's g），该估计值根据研究样本量和对每个估计值做出贡献的研究数量进行了调整。我们将这些估计与我们最近发表的 ABR 和 ASD 的荟萃分析进行了比较。
结果
所有 ADHD 研究均采用横断面设计。ADHD 与波 III 和 V ( g = 0.6, 95% 置信区间 (CI) 0.3, 1.0 和g = 0.6, 95% CI 0.3, 0.9) 以及波 I-III 和 I-V ( g = 0.7, 95% CI 0.2, 1.3 和g = 0.6, 95% CI 0.3, 1.0)。ASD 和 ADHD 荟萃分析的效应大小彼此之间没有差异。
结论
在 ADHD 和 ASD 中观察到类似的 ABR 改变模式。然而，研究很少筛查中耳功能障碍或听力损失，并且依赖于横断面设计。解决这些问题将告知 ABR 作为这些疾病的预后和/或病因生物标志物的可行性。
影响
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点击诱发的 ABR 改变与 ASD 相关，但这些发现对该疾病的特异性尚不清楚。因此，我们对 ABR 和 ADHD 之间的关联进行了荟萃分析，ADHD 是一种与 ASD 有一些病因和症状重叠的疾病。
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ADHD 与多个组件的较长 ABR 延迟有关。这些组件与 ASD 中涉及的组件相同。不同疾病的效应大小相似。
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ABR 作为神经发育风险的预后和/或病因生物标志物的可行性需要解决文献中的局限性（例如，横断面数据、非标准化 ABR 方案、症状异质性的最小表征）。
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