Abstract

Autism spectrum disorders (ASDs) are a spectrum of neurodevelopmental disorders characterized by impaired social interaction and communication, as well as stereotyped and repetitive behaviors. ASDs affect nearly 2% of the United States child population and the worldwide prevalence has dramatically increased in recent years. The etiology is not clear but ASD is thought to be caused by a combination of intrinsic and extrinsic factors. Circadian rhythms are the ∼24 h rhythms driven by the endogenous biological clock, and they are found in a variety of physiological processes. Growing evidence from basic and clinical studies suggest that the dysfunction of the circadian timing system may be associated with ASD and its pathogenesis. Here we review the findings that link circadian dysfunctions to ASD in both experimental and clinical studies. We first introduce the organization of the circadian system and ASD. Next, we review physiological indicators of circadian rhythms that are found disrupted in ASD individuals, including sleep–wake cycles, melatonin, cortisol, and serotonin. Finally, we review evidence in epidemiology, human genetics, and biochemistry that indicates underlying associations between circadian regulation and the pathogenesis of ASD. In conclusion, we propose that understanding the functional importance of the circadian clock in normal and aberrant neurodevelopmental processes may provide a novel perspective to tackle ASD, and clinical treatments for ASD individuals should comprise an integrative approach considering the dynamics of daily rhythms in physical, mental, and social processes.

Highlights

  • Circadian rhythms are evolved as a result of the axial rotation of the earth and have been observed in almost all living organisms including human beings

  • Two polymorphisms located in the promoter were more frequent in Autism spectrum disorders (ASDs) compared to controls associated with a decrease in Acetylserotonin O-methyltransferase (ASMT) transcripts in blood cell lines (2) Decreased in ASMT activity and melatonin levels in individuals with ASD and damped melatonin daily rhythms in ASD (3) Increased serotonin levels in ASD and their parents compared to controls (4) Poor sleep efficiency and higher arousal index but normal REM and slow wave sleep in patients with ASMT mutations (1) Children with autism showed consistently higher cortisol levels in the evening (2) Diurnal variations of cortisol are more inconsistent in autism individuals

  • In an era of rapidly increased prevalence of ASD, there is an urgent need to understand the mechanisms underlying ASD pathogenesis and develop new therapeutic strategies. Various physiological parameters such as circadian biomarkers, sleep/wake rhythms, neurotransmitters, language and communication, information processing and brain rhythms are associated with circadian clock function and are altered in ASD patients

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Summary

Introduction

Circadian rhythms are evolved as a result of the axial rotation of the earth and have been observed in almost all living organisms including human beings. We review physiological parameters of endogenous rhythms that are found disrupted in ASD patients, including the sleep/wake cycle, and the daily oscillations of the circadian biomarkers melatonin, cortisol and serotonin.

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