首页|孤独症谱系障碍儿童共患睡眠障碍的机制研究进展

孤独症谱系障碍儿童共患睡眠障碍的机制研究进展

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孤独症谱系障碍(autism spectrum disorder,ASD)是一组异质性的神经发育障碍性疾病,发病率逐年上升,共患睡眠障碍比率高,其发病机制未明.中枢神经系统的兴奋/抑制(excitation/inhibition,E/I)失衡、神经可塑性改变是ASD的可能发病机制,儿童早期的睡眠则是影响E/I平衡和神经可塑性的重要因素,儿童ASD与睡眠可能存在共同的发病机制.多种基因变异(如Shank3、SynGAP等)及相关染色体疾病(如16p11.2缺失),及其所致的综合征如Rett综合征、Smith-Magenis综合征、Angelman综合征等均同时具有ASD和睡眠障碍的表型.另外,褪黑激素、催产素、下丘脑泌素和血清素等均参与了睡眠异常、ASD病理和神经可塑性的神经环路,促进了 ASD共患睡眠障碍的发生.一些治疗如补充褪黑素、催产素、锌、铁及膳食补充剂在治疗ASD儿童睡眠障碍的同时能改善ASD临床症状.该文就ASD儿童共患睡眠障碍的机制进行综述,以期为临床诊疗提供更多依据和思路.
Progress on the mechanism of sleep disorder in children with autism spectrum disorder
Autism spectrum disorder(ASD)is a heterogeneous group of neurodevelopmental disorders.The prevalence of ASD increases year by year.Sleep disorder is the common comorbidity of ASD.The pathogenesis is still unknown.The imbalance of excitation/inhibition(E/I)and neuroplasticity changes are the possible pathogenesis of ASD.Early childhood sleep is an important factor affecting E/I balance and neuroplasticity.ASD and sleep disorder may share common pathogenesis.Various genetic variants(such as Shank3,SynGAP,et al)and related chromosomal disease(such as 16p11.2 deletion)and their associated syndromes such as Rett syndrome,Smith-Magenis syndrome,and Angelman syndrome,ect,all manifest both ASD and sleep disorder phenotypes.In addition,melatonin,oxytocin,hypothalamic hormone,serotonin,etc,may participate in the neural pathways of sleep disorder,ASD pathology and neuroplasticity,promoting the incidence of ASD and sleep disorder.Some treatments such as supplementing with melatonin,oxytocin,zinc,iron,and dietary supplements can improve the clinical symptoms of ASD while treating sleep disorder in children with ASD.This article reviews the mechanism of comorbid sleep disorder in children with ASD to improve clinical diagnosis and treatment.

Autism spectrum disorderChildrenSleep disorderMechanism

胡莉菲、廖爱琴、张秀春、宋超

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国家儿童健康与疾病临床医学研究中心 浙江大学医学院附属儿童医院发育行为科,杭州 310051

孤独症谱系障碍 儿童 睡眠障碍 机制

浙江省自然科学基金浙江省残疾人福利基金会孤独症研究专项基金

LTGY24H0900052023006

2024

国际儿科学杂志
中华医学会,中国医科大学

国际儿科学杂志

CSTPCD
影响因子:1.057
ISSN:1673-4408
年,卷(期):2024.51(6)
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