Abstract
Epilepsy co-occurs frequently in autism spectrum disorders (ASD). Understanding this co-occurrence requires a better understanding of the ASD-epilepsy phenotype (or phenotypes). To address this, we conducted latent class cluster analysis (LCCA) on an ASD dataset (N = 577) which included 64 individuals with epilepsy. We identified a 5-cluster solution with one cluster showing a high rate of epilepsy (29%), earlier age at first recognition, and high rates of repetitive object use and unusual sensory interests. We also conducted LCCA on an ASD-epilepsy subset from the overall dataset (N = 64) which yielded three clusters, the largest of which had impairments in language and motor development; the remaining clusters, while not as developmentally impaired were characterized by different levels of repetitive and sensory behaviors.
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Aman, M. G., & Singh, N. B. (1994). Aberrant behavior checklist–community, supplementary manual. East Aurora, NY: Slosson Educational Publications.
Amiet, C., Gourfinkel-An, I., Bouzamon, A., Tordjman, S., Baulac, M., Lechat, P., et al. (2010). Epilepsy in autism is associated with intellectual disability and gender: Evidence from a meta-analysis. Biological Psychiatry, 7, 577–582.
Anderson, G. M. (2008). The potential role for emergence in autism. Autism Research: Official Journal of the International Society for Autism Research, 1(1), 18–30.
Baird, G., Charman, T., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., et al. (2008). Regression, developmental trajectory and associated problems in disorders in the autism spectrum: The SNAP study. Journal of Autism and Developmental Disorders, 38(10), 1827–1836.
Brinkley, J., Nations, L., Abramson, R. K., Hall, A., Wright, H. H., Gabriels, R., et al. (2007). Factor analysis of the aberrant behavior checklist in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1049–1059.
Canitano, R., Luchetti, A., & Zappella, M. (2005). Epilepsy, electroencephalographic abnormalities, and regression in children with autism. Journal of Virology, 20, 27–31.
Cuccaro, M. L., Shao, Y., Bass, M. P., Abramson, R. K., Ravan, S. A., Wright, H. H., et al. (2003). Behavioral comparisons in autistic individuals from multiplex and singleton families. Journal of Autism and Developmental Disorders, 33, 87–91.
Eaves, L. C., Ho, H. H., & Eaves, D. M. (1994). Subtypes of autism by cluster analysis. Journal of Autism and Developmental Disorders, 24, 3–22.
Ganesalingam, J., Stahl, D., Wijesekera, L., Galtrey, C., Shaw, C. E., Leigh, P. N., et al. (2009). Latent cluster analysis of ALS phenotypes identifies prognostically differing groups. PloS One, 4(9), e7107.
Giannotti, F., Cortesi, F., Cerquiglini, A., Miraglia, D., Vagnoni, C., Sebastiani, T., et al. (2008). An investigation of sleep characteristics, EEG abnormalities and epilepsy in developmentally regressed and non-regressed children with autism. Journal of Autism and Developmental Disorders, 38(10), 1888–1897.
Giovanardi, R. P., Posar, A., & Parmeggiani, A. (2000). Epilepsy in adolescents and young adults with autistic disorder. Brain & Development, 22, 102–106.
Hansen, R. L., Ozonoff, S., Krakowiak, P., Angkustsiri, K., Jones, C., Deprey, L. J., et al. (2008). Regression in autism: Prevalence and associated factors in the CHARGE study. Ambulatory Pediatrics: The Official Journal of the Ambulatory Pediatric Association, 8(1), 25–31.
Hara, H. (2007). Autism and epilepsy: A retrospective follow-up study. Brain & Development, 29(8), 486–490.
Hrdlicka, M., Dudova, I., Beranova, I., Lisy, J., Belsan, T., Neuwirth, J., et al. (2005). Subtypes of autism by cluster analysis based on structural MRI data. European Child and Adolescent Psychiatry, 14(3), 138–144.
Hu, V. W., & Steinberg, M. E. (2009). Novel clustering of items from the autism diagnostic interview-revised to define phenotypes within autism spectrum disorders. Autism Research : Official Journal of the International Society for Autism Research, 2(2), 67–77.
Kilincaslan, A., & Mukaddes, N. M. (2009). Pervasive developmental disorders in individuals with cerebral palsy. Developmental Medicine and Child Neurology, 51(4), 289–294.
Ma, D., Salyakina, D., Jaworski, J. M., Konidari, I., Whitehead, P. L., Andersen, A. N., et al. (2009). A genome-wide association study of autism reveals a common novel risk locus at 5p14.1. Annals of Human Genetics, 73(Pt 3), 263–273.
Meghani, S. H., Lee, C. S., Hanlon, A. L., & Bruner, D. W. (2009). Latent class cluster analysis to understand heterogeneity in prostate cancer treatment utilities. BMC Medical Informatics and Decision Making, 9, 47.
Ming, X., Brimacombe, M., & Wagner, G. C. (2007). Prevalence of motor impairment in autism spectrum disorders. Brain & Development, 29(9), 565–570.
Moss, H. B., Chen, C. M., & Yi, H. Y. (2007). Subtypes of alcohol dependence in a nationally representative sample. Drug and Alcohol Dependence, 91(2–3), 149–158.
Muthen, L. K., & Muthen, B. O. (2008). Mplus user’s guide (5th ed.). Los Angeles, CA: Muthen & Muthen.
Parmeggiani, A., Barcia, G., Posar, A., Raimondi, E., Santucci, M., & Scaduto, M. C. (2010). Epilepsy and EEG paroxysmal abnormalities in autism spectrum disorders. Brain & Development, 32(9), 783–789.
Rutter, M., LeCouteur, A., & Lord, C. (2003). Autism diagnostic interview, revised (ADI-R). Los Angeles, CA: Western Psychological Services.
Sevin, J. A., Matson, J. L., Coe, D., Love, S. R., Matese, M. J., & Benavidez, D. A. (1995). Empirically derived subtypes of pervasive developmental disorders: A cluster analytic study. Journal of Autism and Developmental Disorders, 25, 561–578.
Shinnar, S., Rapin, I., Arnold, S., Tuchman, R. F., Shulman, L., Ballaban-Gil, K., et al. (2001). Language regression in childhood. Pediatric Neurology, 24(3), 183–189.
Sparrow, S. S., Cicchetti, D. V., & Balla, D. (2005). Vineland adaptive behavior scales (2nd ed.). Circle Pines, MN: AGS.
Spence, S. J., & Schneider, M. T. (2009). The role of epilepsy and epileptiform EEGs in autism spectrum disorders. Pediatric Research, 65, 599–606.
Stevens, M. C., Fein, D. A., Dunn, M., Allen, D., Waterhouse, L. H., Feinstein, C., et al. (2000). Subgroups of children with autism by cluster analysis: A longitudinal examination. Journal of the American Academy of Child and Adolescent Psychiatry, 39(3), 346–352.
Tuchman, R. (2006). Autism and epilepsy: What has regression got to do with it? Epilepsy Currents/American Epilepsy Society, 6(4), 107–111.
Tuchman, R., Cuccaro, M., & Alessandri, M. (2010). Autism and epilepsy: Historical perspective. Brain and Development, 32, 709–718.
Tuchman, R., Moshe, S. L., & Rapin, I. (2009). Convulsing toward the pathophysiology of autism. Brain and Development, 31, 95–103.
Tuchman, R. F., & Rapin, I. (1997). Regression in pervasive developmental disorders: Seizures and epileptiform electroencephalogram correlates. Pediatrics, 99(4), 560–566.
Tuchman, R., & Rapin, I. (2002). Epilepsy in autism. The Lancet Neurology, 1, 352–358.
Turk, J., Bax, M., Williams, C., Amin, P., Eriksson, M., & Gillberg, C. (2009). Autism spectrum disorder in children with and without epilepsy: Impact on social functioning and communication. Acta Paediatrica (Oslo, Norway: 1992), 98(4), 675–681.
Vermunt, J. K., & Magidson, J. (2002). Latent class cluster analysis. In J. A. Hagenaars & A. L. McCutcheon (Eds.), Applied latent class analysis (pp. 89–106). Cambridge, UK: University of Cambridge Press.
Wardlaw, A. J., Silverman, M., Siva, R., Pavord, I. D., & Green, R. (2005). Multi-dimensional phenotyping: Towards a new taxonomy for airway disease. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 35(10), 1254–1262.
Weatherall, M., Travers, J., Shirtcliffe, P. M., Marsh, S. E., Williams, M. V., Nowitz, M. R., et al. (2009). Distinct clinical phenotypes of airways disease defined by cluster analysis. The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology, 34(4), 812–818.
Acknowledgments
We thank the individuals with autism and their family members who participated in this study and personnel at the John P. Hussman Institute of Human Genomics (HIHG). This research was supported by grants from the National Institutes of Health (NIH) (NS26630, NS36768 and MH080647) and by a gift from the Hussman Foundation. A subset of the participants was ascertained while Dr. Cuccaro was a faculty member at Duke University.
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Cuccaro, M.L., Tuchman, R.F., Hamilton, K.L. et al. Exploring the Relationship Between Autism Spectrum Disorder and Epilepsy Using Latent Class Cluster Analysis. J Autism Dev Disord 42, 1630–1641 (2012). https://doi.org/10.1007/s10803-011-1402-y
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DOI: https://doi.org/10.1007/s10803-011-1402-y