Browsing by Author "Carpenter, Kimberly"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder.
    (The Journal of pediatrics, 2020-07) Dawson, Geraldine; Sun, Jessica M; Baker, Jennifer; Carpenter, Kimberly; Compton, Scott; Deaver, Megan; Franz, Lauren; Heilbron, Nicole; Herold, Brianna; Horrigan, Joseph; Howard, Jill; Kosinski, Andrzej; Major, Samantha; Murias, Michael; Page, Kristin; Prasad, Vinod K; Sabatos-DeVito, Maura; Sanfilippo, Fred; Sikich, Linmarie; Simmons, Ryan; Song, Allen; Vermeer, Saritha; Waters-Pick, Barbara; Troy, Jesse; Kurtzberg, Joanne

    Objective

    To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD).

    Study design

    This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo (n = 61) and were evaluated at 6 months postinfusion.

    Results

    CB infusion was safe and well tolerated. Analysis of the entire sample showed no evidence that CB was associated with improvements in the primary outcome, social communication (Vineland Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes, autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary (Expressive One-Word Picture Vocabulary Test). There was also no overall evidence of differential effects by type of CB infused. In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale, but the OR for improvement was not significant. Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power.

    Conclusions

    Overall, a single infusion of CB was not associated with improved socialization skills or reduced autism symptoms. More research is warranted to determine whether CB infusion is an effective treatment for some children with ASD.
  • Thumbnail Image
    ItemOpen Access
    Evaluating risk for adolescent anxiety: The role of preschool sensory over-responsivity and differential volume of subcortical regions
    (2023-04-20) Haughey, Connor
    Anxiety disorders represent one of the most prevalent groups of mental health disorders and can cause immense problems in psychosocial functioning and overall well-being. Sensory over-responsivity, which is typically only evaluated as a symptom of autism spectrum disorder, represents when an individual experiences an abnormally heightened reaction to at least one sensory stimulus. Recent studies have found that sensory over-responsivity at preschool age is associated with many forms of psychopathology at school age, including anxiety disorders. At present, no studies have examined if this relationship continues later in life nor how sensory over-responsivity manifests structurally in the brain. The primary aim of the present study was to evaluate whether preschool sensory over-responsivity is associated with adolescent anxiety, and whether the volumes of the amygdala, hippocampus, and caudate nucleus at school age might moderate this relationship. We conducted a longitudinal follow-up study that has a sample of 210 adolescents ages 15 to 22 who underwent psychiatric assessment at the preschool age, which included a diagnostic screening for anxiety disorders and sensory over-responsivity. A subset of these 210 adolescents also underwent magnetic resonance brain imaging at school age. At the most recent follow-up, they completed an assessment of anxiety, allowing us to investigate mental health changes across their lifespan. First, we found no significant relationship between preschool sensory over-responsivity and adolescent anxiety. Second, we did not find any significant moderation effect of bilateral amygdala, hippocampus, and caudate nucleus volumes on the relationship between preschool sensory over-responsivity and adolescent anxiety. However, we found a significant interaction between left hippocampus volume at school-age and preschool sensory over-responsivity on total externalizing and internalizing problems. These findings add to the growing literature seeking to understand early life risk factors for anxiety during adolescence. Furthermore, these findings emphasize the role of brain structure, particularly the hippocampus, during early life development in a model of risk for adolescent anxiety.