Stereotipik Hareket Bozukluğu ve Nöroinflamasyon İlişkisi

Abstract

Stereotypes are repetitive, rhythmic, coordinated and stereotyped movements that occur involuntarily but are not reflexive. Stereotypical movement disorder; ıt is divided into primary and secondary according to whether the person has a concomitant autism, mental retardation, sensory deprivation or a neurological disease. It is a disorder whose etiology has not been clarified yet, which is common in the society, causes the person to be labeled, and has no definite treatment. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that begins early in life, is characterized by inadequate communication and social interaction, includes limited interests and behaviors, and is often accompanied by stereotypes. It is a disorder that is reported to be seen in 1 out of 59 children in recent publications, the etiology of which has not been clarified yet, and there is no definite treatment. Co-occurrence of this neurodevelopmental disorder is high. Therefore, it is thought that there may be common mechanisms in their pathophysiology. In recent years, the role of neuroinflammatory processes in the etiology of ASD has been widely investigated and evidence has been presented. Although there are animal models investigating the role of the neuroinflammatory process in the etiology of stereotypical movement disorder, there is no human study in the literature yet. This study, which was conducted with the hypothesis that neuroinflammatory mechanisms play a role in the pathophysiology of stereotypical movement disorder, is a cross-sectional study in which IL-1β levels in the plasma of children and adolescents with stereotypical movement disorder and ASD were evaluated by ELISA method. The sample of our study consisted of 22 primary stereotypical movement disorders (Primary SMD), 20 secondary stereotypical movement disorders (Secondary SMD), 18 non-stereotypical ASD (non-SMD ASD), 18 healthy controls. Mood Disorders and Schizophrenia Interview Schedule for School-Age Children – Now and Lifetime Version DSM-5 (K-SADS-PL) psychiatric diagnostic interview as well as Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (AuBC) were given to all participants. Problem Behavior Checklist (PBCL), Repetitive Behaviors Scale-Revised-Turkish Version (RBS-R-TV), Conners Parent Rating Scale-Revised Short Form (CPRS-RS) were applied. There was no significant difference between the groups in terms of age, gender, socioeconomic level, parental age, family structure, prenatal and natal factors. The education level of the mothers of the children in the ASD group was found to be significantly lower than the Primary SMD and Healthy Control groups. It was determined that half of the children in the secondary SMD group were single children. It was determined that the incidence of psychopathology was increased in the parents of children in the primary SMD group. It was determined that the children in the Primary SMD group had more health problems in the postnatal period compared to the children in the other groups, and the most common health problem was neonatal jaundice. It was determined that the children in the Primary SMD group started to form sentences significantly later when compared to the Healthy Controls. It was determined that the children and adolescents in the Primary SMD group had lower school achievement levels compared to the Healthy Controls. It was determined that the left hand preference rates of the Secondary SMD group were significantly higher than the other groups. It has been found that the frequency of having stereotypes in the families and close relatives of children with stereotypical movement disorder is increased. However, it was found that the frequency of stereotypes increased in the families of children and adolescents in ASD groups. In the Primary SMD group, 86.6% of children and adolescents were found to have at least one comorbid psychiatric disorder. PBCL Stereotypic behaviors, PBCL Lethargy/Withdrawal subscale scores and ABC Social and Self-Care skills subscale scores, RBS-R-TV Sameness/Uniformity behaviors and RBS-R-TV Stereotypic behavior subscale scores in the Primary SMD group were significant compared to the Healthy Control group was found to be higher. Plasma IL-1β levels of the participants were evaluated by ELISA technique in order to examine the relationship of stereotypical movement disorder and ASD with neuroinflammatory processes. L-1β levels were found to be significantly higher in Primary SMD and non-SMD ASD groups compared to the Healthy Control group; Secondary SMD group IL-1β levels were higher than the Healthy Control IL-1β levels, but the difference was not significant. The results of our study indicate that neuroinflammatory processes may play a role in the pathophysiology of stereotypical movement disorder and ASD. Expanding the study with more neuroinflammatory parameters in the future will increase our knowledge in this area.