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Autistic children, mainly characterized by communication disorders and repetitive behaviors, also frequently suffer from gastrointestinal problems. Abdominal pain, diarrhea and constipation are diagnosed in 70% of the cases. Among the etiologies of autism spectrum disorders that are constantly growing, scientists are beginning to show interest in the gut microbiota. This final thesis describes first the main etiologies of autism as well as the psychosocial and medical interventions used to date in Belgium. Second, through the scientific sources currently available, hypotheses attempting to explain the involvement of the gut microbiota in the pathophysiology of autism are quoted. Finally, four types of intestinal microbiota modulation are analyzed : namely : probiotics, prebiotics, antibiotics and fecal transplantation. Their interests in the gastrointestinal, psychosocial and neurological disorders present in children with autism is discussed as well/ Could interventions on gut microbiota be used to reduce autism spectrum disorders ? Les enfants autistes, principalement caractérisés par des troubles de la communication et par des comportements répétés, souffrent aussi fréquemment de problèmes gastro-intestinaux. Douleurs abdominales, diarrhées et constipations sont présentes chez 70% d’entre eux. Parmi les étiologies des troubles du spectre autistique qui ne cessent de croître, les scientifiques commencent à s’intéresser au microbiote intestinal. Ce mémoire désigne en premier lieu les principales étiologies de l’autisme ainsi que les interventions psychosociales et médicales utilisées actuellement en Belgique. En second lieu, de par les sources scientifiques actuellement disponibles, des hypothèses tentant d’expliquer l’implication du microbiote intestinal dans la physiopathologie de l’autisme sont citées. Enfin, quatre types de modulation du microbiote intestinal sont abordés, à savoir les probiotiques., les prébiotiques, les antibiotiques et la transplantation fécale tout comme leurs intérêts dans les troubles gastro-intestinaux, psycho-sociaux et neurologiques présents chez les enfants autistes. Les interventions sur le microbiote intestinal pourraient-elles servir à atténuer les troubles du spectre autistique ?

Microbiota --- Autism Spectrum Disorder --- Child

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Autism spectrum disorders (ASD) affect one in 160 children (World Health Organization, 2016). It is a kind of pervasive developmental disorder characterized by severe disorders of communication and social interaction during which repetitive and stereotyped behaviors occur. The cause of ASD remains unknown, this work will review the major genetic, environmental and neurobiological axes potentially involved in the etiology of these disorders. After describing the main symptoms of autism, this work will focus on the different kinds of ASD management. The Federaal Kennicentrum voor de Gezondheidszorg (KEC) recommends in the first place a complete and multidisciplinary nonpharmacological management. In the event of failure or inadequacy of the latter, the use of melatonin or atypical neuroleptics may be considered. The use of other medications is not considered by the KCE, and few medicines may be eligible for an indication in ASD have sufficient efficacy and safety studies for access to a pediatric indication in the summery of product characterics (RCP). The use of these drugs is sometimes justified, but it will be necessary to evaluate the benefit/risk ration for each patient. Finally, this work will focus on the treatment with oxytocin, a new therapeutic option of TSA. The results obtained so far are mixed but encouraging, which explains the multitude of very recent articles dealing with the subject. Les troubles du spectre de l’autisme (TSA) touchent un enfant sur 160 (Organisation Mondiale de la Santé, 2016). Il s’agit d’un type de troubles envahissants du développement caractérisés par des troubles sévères de la communication et de l’interaction sociale au cours de laquelle apparaissent des comportements répétitifs et stéréotypés. La cause des TSA demeurant inconnue, ce travail parcourra brièvement les grands aces génétiques, environnementaux et neurobiologiques potentiellement impliqués dans l’étiologie de ces troubles. Après description de principaux symptômes autistiques, ce travail se concentrera sur les différents types de prise en charge des TSA. Le Federaal Kenniscentrum voor de Gezondheiszorg (KCE) recommande en premier lieu une prise en charge non pharmacologique complète et pluridisciplinaire. En cas d’échec ou d’insuffisance de cette dernière, le recours à la mélatonine ou à des neuroleptiques atypiques peut-être envisagé. L’usage d’autres médications n’est pas considéré par le KCE et rares sont les médicaments qui pourraient prétendre à une indication dans les TSA pourvus d’études d’efficacité et de sécurité suffisantes pour accéder à une indication pédiatrique dans les Résumés des Caractéristiques du Produit (RCP). Le recours à l’emploi de ces médicaments est parfois justifié mais il sera pour cela nécessaire d’en évaluer le rapport bénéfices/risques pour chaque patient. Enfin, ce travail se focalisera sur le traitement par ocytocine : une nouvelle option thérapeutique des TSA. Les résultats obtenus jusqu’à présent avec cette médication sont mitigés mais encourageants, ce qui explique la multitude d’articles très récents se pendant sur le sujet.

Autism Spectrum Disorder --- Autistic Disorder --- Child

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"Sleep problems are highly prevalent in autism spectrum disorder (ASD) with evidence suggesting that majority of these children will experience a sleep problem at some point. Sleep problems in ASD are often chronic, and are associated with more severe child behaviour difficulties, anxiety, and ADHD symptoms. Mothers of children with sleep problems experience disturbed sleep, more stress and poorer psychological well being. Most commonly parents report their children to have difficulties with settling and night waking which are often amenable to behavioural treatment or melatonin. Nevertheless other sleep issues such as short night sleep, early waking, extended periods of night waking, early waking and circadian sleep disturbances are also reported and can be difficult to treat. While there is now a considerable body of evidence to support that those with ASD can experience significant and sometimes debilitating sleep difficulties, there is little research on the aetiology, prevention or intervention. This book brings together current research and clinical experience by experts from North America, UK, Europe and Australasia regarding the behavioural and medical factors that might underlie these prevalent sleep difficulties, as well as both medical and behavioural approaches to treatment. The book has three major section Aetiological factors and Diagnosis which covers the impacts of ASD on sleep, comorbid medical and psychiatric conditions, and diagnostic tools; Impact of Sleep Problems covering both the child and their family; and Treatment, including pharmacological and behavioural treatments, and the usefulness or otherwise of alternative treatments. This book will be useful for clinicians and researchers with an interest in ASD and paediatric sleep"--

Sleep Wake Disorders. --- Pediatrics --- Autism Spectrum Disorder.

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In the last twenty years, many attempts have been made to provide neurobiological models of autism. Functional, structural and connectivity analyses have highlighted reduced responses in key social areas, such as amygdala, medial prefrontal cortex, cingulate cortex, and superior temporal sulcus. However, these studies present discrepant results and some of them have been questioned for methodological limitations. The aim of this research topic is to present advanced neuroimaging methods able to capture the complexity of the neural deficits displayed in autism. This special issue presents new studies using structural and functional MRI, as well as magnetoencephalography, and novel protocols to analyze data (Analysis of Cluster Variability, Noise Reduction Strategies, Source-based Morphometry, Functional Connectivity Density, Restriction Spectrum Imaging and the others). We believe it is time to integrate data provided by different techniques and methodologies in order to have a better understanding of autism.

magnetic resonance imaging --- biomarkers --- social deficits --- autism spectrum disorder --- magnetoencephalography

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In the last twenty years, many attempts have been made to provide neurobiological models of autism. Functional, structural and connectivity analyses have highlighted reduced responses in key social areas, such as amygdala, medial prefrontal cortex, cingulate cortex, and superior temporal sulcus. However, these studies present discrepant results and some of them have been questioned for methodological limitations. The aim of this research topic is to present advanced neuroimaging methods able to capture the complexity of the neural deficits displayed in autism. This special issue presents new studies using structural and functional MRI, as well as magnetoencephalography, and novel protocols to analyze data (Analysis of Cluster Variability, Noise Reduction Strategies, Source-based Morphometry, Functional Connectivity Density, Restriction Spectrum Imaging and the others). We believe it is time to integrate data provided by different techniques and methodologies in order to have a better understanding of autism.

magnetic resonance imaging --- biomarkers --- social deficits --- autism spectrum disorder --- magnetoencephalography