@article{e78fe804b7bf4b8da7ca5a773c76c729,
title = "Infant Excitation/Inhibition Balance Interacts with Executive Attention to Predict Autistic Traits in Childhood",
abstract = "Background: Autism is proposed to be characterised by an atypical balance of cortical excitation and inhibition (E/I). However, most studies have examined E/I alterations in older autistic individuals, meaning that findings could in part reflect homeostatic compensation. To assess the directionality of effects, it is necessary to examine alterations in E/I balance early in the lifespan before symptom emergence. Recent explanatory frameworks have argued it is also necessary to consider how early risk features interact with later developing modifier factors to predict autism outcomes.Method: We indexed E/I balance in early infancy by extracting the aperiodic exponent of the slope of the electroencephalogram (EEG) power spectrum ({\textquoteleft}1/f{\textquoteright}). To validate our index of E/I balance we tested for differences in the aperiodic exponent in 10-month-old infants with (n=22) and without (n=27) Neurofibromatosis type 1 (NF1), a condition thought to be characterised by alterations to cortical inhibition. We then tested for E/I alterations in a larger heterogeneous longitudinal cohort of infants with and without a family history of neurodevelopmental conditions (n=150) who had been followed to early childhood. We tested the relevance of alterations in E/I balance and our proposed modifier, executive attention, by assessing whether associations between 10-month aperiodic slope and 36-month neurodevelopmental traits were moderated by 24-month executive attention. Analyses adjusted for age at EEG assessment, sex and number of EEG trials. Results: Infants with NF1 were characterised by a higher aperiodic exponent, indicative of greater inhibition, supporting our infant measure of E/I. Longitudinal analyses showed a significant interaction between aperiodic slope and executive attention, such that higher aperiodic exponents predicted greater autistic traits in childhood, but only in infants who also had weaker executive functioning abilities. Limitations: The current study relied on parent report of infant executive functioning-type abilities; future work is required to replicate effects with objective measures of cognition. Conclusions: Results suggest alterations in E/I balance are on the developmental pathway to autism outcomes, and that higher executive functioning abilities may buffer the impact of early cortical atypicalities, consistent with proposals that stronger executive functioning abilities may modify the impact of a wide range of risk factors. ",
keywords = "ADHD, Autism, E/I balance, Executive functioning, Infants, NF1",
author = "{the EDEN} and {STAARS Teams} and {Carter Leno}, Virginia and Jannath Begum-Ali and Amy Goodwin and Luke Mason and Greg Pasco and Andrew Pickles and Shruti Garg and Jonathan Green and Tony Charman and Johnson, {Mark H.} and Jones, {Emily J.H.} and Grace Vassallo and Emma Burkitt-Wright and Judith Eelloo and {Gareth Evans}, D. and Siobhan West and Eileen Hupton and Lauren Lewis and Louise Robinson and Angus Dobbie and Ruth Drimer and Helen Bethell and Rachel Jones and Susan Musson and Catherine Prem and Miranda Splitt and Karen Horridge and Diana Baralle and Carolyn Redman and Helen Tomkins and Ankita Bhojwani and Shannon Connelly and Francesca Conti and Beth Evans and Meg Jackson and Emily Powell and Mary Agyapong and Tessel Bazelmans and Leila Dafner and Mutluhan Ersoy and Teea Gliga and Rianne Haartsen and Hanna Halkola and Alexandra Hendry and Rebecca Holman and Sarah Kalwarowsky and Anna Kolesnik and Nisha Narvekar and Chlo{\"e} Taylor",
note = "Funding Information: This research received funding from the UK Medical Research Council (MR/T003057/, MR/K021389/1), Action for Medical Research, Great Ormond Street Hospital Children{\textquoteright}s Charity and the Bailey Thomas Charitable Fund (GN2385) and the Rosetrees Trust (A2213). MHJ, EJHJ and TC were supported by the Innovative Medicines Initiative joint undertaking Grant Agreement No. 115300 (EU-AIMS), resources of which are composed of financial contributions from the European Union{\textquoteright}s Seventh Framework Programme (FP7/2007–2013) and EFPIA companies{\textquoteright} in-kind contribution) and the Innovative Medicines Initiative 2 Joint Undertaking (IMI 2 JU) under Grant Agreement No. 777394 (AIMS-2-TRIALS). This Joint Undertaking receives support from the European Union{\textquoteright}s Horizon 2020 research and innovation program, EFPIA, Autism Speaks, Autistica, and SFARI. V.C.L. is supported by a Henry Wellcome Postdoctoral Fellowship (213608/Z/18/Z). J.G. and A.P are National Institute for Health Research (NIHR) Senior Investigator (NIHR NF-SI-0617-10120, NF-SI-0617–10168), and A.P. receives support from the NIHR Biomedical Research Centre at South London and Maudsley Foundation Trust (IS-BRC-1215-20018). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or other funders. Funding Information: We thank all the individuals and families who participated in this research. The EDEN team : Grace Vassallo, Emma Burkitt-Wright, Judith Eelloo, D. Gareth Evans, Siobhan West, Eileen Hupton, Lauren Lewis, Louise Robinson, Angus Dobbie, Ruth Drimer, Saghira Malik Sharif, Helen Bethell, Rachel Jones, Susan Musson, Catherine Prem, Miranda Splitt, Karen Horridge, Diana Baralle, Carolyn Redman & Helen Tomkins. We would also like to thank Marian Greensmith, who helped with visit scheduling, and the placement students who helped in data collection and coding: Ankita Bhojwani, Shannon Connelly, Francesca Conti, Beth Evans, Meg Jackson and Emily Powell. The STAARS team : Mary Agyapong, Tessel Bazelmans, Leila Dafner, Mutluhan Ersoy, Teea Gliga, Rianne Haartsen, Hanna Halkola, Alexandra Hendry, Rebecca Holman, Sarah Kalwarowsky, Anna Kolesnik, Nisha Narvekar and Chlo{\"e} Taylor. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
doi = "10.1186/s13229-022-00526-1",
language = "English",
volume = "13",
journal = "Molecular Autism",
issn = "2040-2392",
publisher = "BioMed Central",
number = "1",
}