Serotonin (5-hydroxytryptamine, 5-HT) type-1 G protein-coupled receptors are expressed throughout the central nervous system. 5-HT1AR activation is the putative mechanism of approved drugs for generalized anxiety disorder and major depressive disorder and is being studied in the treatment of autism and neurological disorders. The 5-HT1B and 5-HT1DRs are the putative therapeutic targets for "triptan"-type migraine drugs, and the 5-HT1BR is associated with prosocial effects, relative to autism treatment, consistent with its high expression in limbic and cortical brain regions. Under study is a recently developed drug candidate for autism, (S)-5-(2'-fluorophenyl)-2-dimethylaminotetralin (FPT), that is a full efficacy pan-5-HT1R agonist (pEC50 = 7.4, 9.4, and 8.6 at 5-HT1A, 5-HT1B, and 5-HT1DRs, respectively). FPT demonstrates anti-seizure, anxiolytic, and prosocial properties, as well as reduces stereotypic movements in Fmr1 knockout mice, a model for autism. The goal of this study was to compare brain activation patterns of the pan-5-HT1R agonist FPT to NLX-112, a highly selective 5-HT1AR full agonist (pEC50 = 7.5) which also prevents seizures in Fmr1 knockout mice, to help establish therapeutic mechanisms in autism. We used pharmacological magnetic resonance imaging (phMRI) in awake C57BL/J6 mice to assess activation of integrated neuronal circuits as measured by blood oxygen level dependent volume of activation changes, comparing dose-related effects of FPT and NLX-112. The selective 5HT1AR agonist NLX-112 broadly inhibited brain activity in a dose-dependent manner. In contrast, FPT increased global brain activity; however, dose-related effects were complex, suggesting FPT's polypharmacology at 5-HT1Rs and perhaps other receptors are involved in its brain activation pattern.

Major neuropsychiatric disorders such as major depressive disorder (MDD) and schizophrenia (SCZ), as well as the neurodevelopmental disorder autism spectrum disorder (ASD), are traditionally treated as distinct clinical entities. However, genome-wide association studies indicate shared genetic risks, motivating a transdiagnostic view. Resting-state functional connectivity (rsFC) is a promising biomarker for these disorders, but its high dimensionality complicates inference of inter-disorder relationships in the native feature space. Here, we develop an rsFC-based embedding-relation workflow that quantifies disorder relationships in a connectivity-informed, low-dimensional embedding space. Central to the workflow is a mutual information-based embedding framework that evaluates candidate embedding approaches and selects an optimal strategy. Using synthetic connectivity data, the framework indicates that rsFC embeddings are best represented in a spherical space under a moderate level of supervision. Building on this insight, we applied the workflow to curated, multi-disorder rsFC datasets to derive shared embedding spaces encompassing the connectivity features of ASD, MDD, and SCZ. In these spaces, we consistently observed a robust three-way relationship: a pronounced neurobiological dissimilarity between ASD and MDD, contrasted with greater similarity between SCZ and both disorders. These findings support a dimensional, transdiagnostic perspective on neuropsychiatric disorders and offer new insights into their shared and distinct neural underpinnings.

Personalized connectivity-guided accelerated intermittent theta burst stimulation (iTBS), like the Stanford Accelerated Intelligent Neuromodulation Therapy (SNT), shows high efficacy for treatment-resistant depression (TRD) in Western cohorts. However, generalizability to other demographics with substantial comorbidity remains unclear. Here, we evaluate connectivity-guided iTBS in a naturalistic Asian TRD population with high comorbidity burden. Twenty TRD participants received 50 sessions of TAO-TMS (Tree-based Algorithm for Optimized Transcranial Magnetic Stimulation) over 5 days. Participants averaged 1.6 psychiatric comorbidities, including personality disorders, autism and obsessive-compulsive disorder. TAO-TMS personalizes targets within attentional networks and maximize anti-correlation with the subgenual anterior cingulate cortex. Its near-scalp targets reduce stimulation intensity under the SNT protocol, improving patient comfort. Clinical response was defined as ≥50% reduction in the Montgomery-Åsberg Depression Rating Scale within four weeks of treatment. TAO-TMS yielded 70% response rate. Among patients who met typical randomized-trial eligibility criteria (N = 11), response rate was 83%. For context, non-accelerated BeamF3 TMS at the same hospital historically achieved response rate of 21%, indicating a patient population profile less responsive to TMS than those recruited in typical clinical trials. Post-hoc electric-field modeling showed that TAO-TMS improved network focality by 21% over BeamF3 targets. Functional connectivity changes were significant within every participant, but highly heterogeneous across participants. TAO-TMS was more cost-effective than electroconvulsive therapy (ECT), saving US$37,838 with higher quality-adjusted life years (QALYs 0.69 vs 0.65). These findings provide early evidence for the generalizability of connectivity-guided personalized TMS in a naturalistic Asian TRD population with substantial psychiatric comorbidities. TAO-TMS offers a cost-effective alternative to ECT, positioning it as a viable precision psychiatry intervention.

Little is known as to what drives feelings of grief and relief observed following the late identification of neurodivergence, and its significance as it relates to sense of self and self-understanding. As such, this study considers how grief is understood and experienced by neurodivergent individuals in the context of late identification. This study used qualitative content analysis to identify themes from 225 public social media posts discussing grief and relief in relation to a late identification. With a sample focused mainly on autism, attention deficit hyperactivity disorder, and both co-occurring, four main themes, under an overarching theme and process, titled the Grief, Relief, and Belief Cycle, were identified: (1) The Life I Could Have Had; (2) Grieving for My Younger Self; (3) Feeling Gratitude; and (4) Post-Diagnosis Burnout. Overall, this study calls for a paradigm shift in how we understand and support neurodivergent individuals diagnosed in adulthood, seeing diagnosis as a first step, rather than a terminal component of a service, emphasising the need for comprehensive, individualised, wraparound care that addresses the emotional and practical aspects of their lives before, during, and beyond diagnosis.Lay AbstractLittle is known as to why some individuals may experience feelings of grief and relief following late identification, by clinical diagnosis or self-identification, of neurodivergence (e.g. autism or attention deficit hyperactivity disorder), and how this relates to their sense of self. This study looks at how grief is understood and experienced by late-identified neurodivergent individuals using qualitative content analysis to analyse social media posts discussing grief in relation to late identification. A total of 225 public social media posts were analysed. These posts were mostly made by people who identified as autistic, having attention deficit hyperactivity disorder, or both. Four main themes and one overarching theme and process were identified. The overarching theme was named the Grief, Relief, and Belief Cycle, and the four themes were (1) The Life I Could Have Had; (2) Grieving for My Younger Self; (3) Feeling Gratitude; and (4) Post-Diagnosis Burnout. Theme 1 highlights the sense of loss and regret some late-identified neurodivergent individuals' experience. Theme 2 explores the ways in which late identified neurodivergent individuals look at their past experiences with this newfound understanding of their neurodivergence. Theme 3 highlights the experiences of relief and gratitude these individuals have for the self-understanding that they discuss coming with their diagnosis. Theme 4 emphasises the intense emotional and physical toll and lack of available support that people can experience when their neurodivergence is identified later in life. Overall, this study emphasises the need for comprehensive, individualised, and ongoing care that addresses the emotional and practical aspects of individuals' lives before, during, and beyond diagnosis.

Previous research has suggested potential phenotypic similarities between autism and borderline personality disorder (BPD). We aimed to identify overlapping and differentiating characteristics of the two diagnostic groups in women and people assigned female at birth (PAFAB). Women and PAFAB with an autism diagnosis (n = 51) or a BPD diagnosis (n = 51), who had few or subclinical traits of the comparator diagnosis, completed a range of self-report questionnaires. Emotional reactivity, emotional dysregulation, identity disruption, difficulties being alone and rejection sensitivity were significantly more characteristic of BPD-diagnosed participants, with identity disruption representing the biggest difference from autistic participants (d = -1.36, 95% confidence interval [CI] = [-1.79, -0.92]). Autistic participants scored significantly more highly on measures of sensory processing, social cognition and behaviour, preference for sameness and repetitive motor behaviour, with sensory processing representing the biggest difference from BPD-diagnosed participants (d = 1.19, 95% CI = [0.76, 1.60]). Group differences in social cognition, social camouflaging, identity disruption, impulsivity and coping with being alone, together correctly classified 95.1% of participants (area under the curve [AUC] = 0.98). However, comparison with measure scores in previous research suggests more complex phenotypic similarities, whereby autistic individuals may show more BPD-aligned characteristics than the general population and vice versa.Lay AbstractAutism can look similar to borderline personality disorder (BPD), leading to misdiagnosis. For example, both diagnostic groups may experience difficulties in regulating their emotions. To improve diagnosis, we wanted to understand similarities and differences between autism and BPD in adult women and people assigned female at birth (PAFAB). We asked two groups of people to complete online questionnaires: (1) 51 women/PAFAB with an autism diagnosis, who do not meet diagnostic criteria for BPD and (2) 51 women/PAFAB diagnosed with and meeting diagnostic criteria for BPD, who are not autistic. The questionnaires asked participants how they experience their emotions, how they interact and relate with other people, how they experience their identity and self-concept, how they react to sensory input, for example, sounds and smells, and how they use repetitive movements, as well as their preferences for sticking to familiar ways of doing things. We found more differences than we expected between autistic people and people meeting diagnostic criteria for BPD. For example, autistic people described being more sensitive to sensory input, described 'masking' more during social interactions and described more challenges in understanding the social behaviour of non-autistic people, compared to people meeting diagnostic criteria for BPD. People meeting diagnostic criteria for BPD described more difficulties with emotion regulation and with their sense of self ('knowing who I am'), were more likely to behave impulsively and found being on their own more difficult, compared to autistic people. Clinicians, and people with a BPD diagnosis who think they may be autistic, can use these findings to better understand the differences between the two diagnoses. Even though we found lots of differences, it is still likely that autistic people experience more similarities with BPD than non-autistic people do and vice versa.

Autism and Attention Deficit Hyperactivity Disorder (ADHD) are both linked to internalising problems (e.g., anxiety, depression) but their frequent co-occurrence makes these relationships difficult to disentangle. We, therefore, adopted a trait-based approach to examine the unique associations of autism and ADHD with internalising problem diagnoses in a large general population sample of adults from the United Kingdom and United States (N = 4996). We then assessed whether these associations would conceptually replicate in a clinical sub-sample (n = 292) using a case-control design. We found that, across the whole sample, ADHD traits were an overall stronger predictor of internalising problem diagnoses than autistic traits. The case-control analyses revealed that both autistic adults and adults with ADHD had greater odds of being diagnosed with anxiety, depression and an overall internalising problem (i.e., depression and/or anxiety) than neurotypical adults. Although the clinical groups did not significantly differ from each other in their associations with mental health diagnoses, having and ADHD diagnosis was more closely linked with depression while having an autism diagnosis was more closely linked with anxiety. We discuss potential psychological mechanisms underlying these findings and the implications for research and clinical practice concerning neurodevelopmental conditions.

Diagnosis of autism disorder from rs-fMRI brain images through hierarchical YOLO and mechanism of attention (HYMA)

Across psychiatry, neurodivergence is highly prevalent yet under-recognised. Psychiatric vulnerability, treatment response and prognosis are critically shaped by co-occurring neurodevelopmental conditions, including attention-deficit hyperactivity disorder, autism and tic disorder. Clinical recognition of neurodivergence and effective management can mitigate mental illness, prevent suicide and reduce societal costs. Services and training should adapt accordingly.

Background Autism spectrum disorder (ASD) is characterized by persistent difficulties in social communication and interaction, alongside restrictive and repetitive patterns of behavior. Virtual reality (VR) has emerged as a promising tool to enhance participation and engagement in individuals with ASD. Objective This bibliometric study aims to map the current research landscape on the intersection between ASD and VR, identifying trends in authorship, publication, geographic distribution, thematic focus, and keyword evolution. Methods A bibliometric analysis was conducted using the Web of Science Core Collection. Classic bibliometric laws and indicators (e.g., Bradford’s, Lotka’s, and Zipf’s laws) were applied to analyze publication volume, citation impact, author productivity, and thematic clustering. Results A total of 398 publications were identified between 2007 and 2024, showing an exponential growth trend (R2 = 0.97). The United States led in total output. Sarkar and Warren were among the most productive authors. The Journal of Autism and Developmental Disorders and IEEE Transactions on Neural Systems and Rehabilitation Engineering published the highest number of relevant articles. Fifty-six articles received 58 or more citations. Thematic clusters revealed emphasis on social skills training, immersive environments, and technological applications in ASD interventions. Conclusion Research on VR applications in ASD has increased exponentially, reflecting growing scientific and clinical interest. These findings provide a foundation for future interdisciplinary investigations and intervention development in developmental disabilities research.

This study examines how families of children diagnosed with Autism Spectrum Disorder (ASD) in Türkiye’s Southeastern Anatolia Region interpret autism within social, cultural, and religious contexts. By focusing on a socio-culturally conservative region characterized by strong religious values, patriarchal norms, and limited institutional resources, the research aims to reveal how belief systems, social expectations, and cultural narratives shape families’ perceptions of autism, the diagnostic process, and caregiving experiences. AA qualitative research design was employed. Data were collected from 12 parents (8 mothers and 4 fathers) who have children diagnosed with ASD through semi-structured interviews and home-based observations. Participants were selected using purposive and snowball sampling methods. The data were analyzed using Erlingsson and Brysiewicz’s four-stage content analysis approach, which involved coding meaning units, developing categories, and identifying overarching themes. The analysis revealed four major themes: (1) delays in diagnosis and processes of denial and acceptance; (2) interpretations of autism through cultural values, social norms, and religious beliefs; (3) mothers’ multiple caregiving roles as educators, therapists, and guides; and (4) strategies of resisting stigmatization and normalizing autism. The findings indicate that autism diagnosis carries social, cultural, and psychological meanings beyond the biomedical framework. Religious narratives frequently function as coping mechanisms that help families reinterpret the diagnosis and manage social stigma. The study demonstrates that families’ experiences with autism are deeply embedded within sociocultural and religious meaning systems. Faith-based interpretations, gender roles, and social expectations significantly influence both the diagnostic process and caregiving practices. The findings highlight the importance of culturally sensitive social policies and family support programs that acknowledge the cultural and religious contexts shaping families’ experiences. This study explores how families of individuals diagnosed with autism disorder in Turkey’s Southeastern Anatolia Region understand autism within social, cultural, and religious contexts. Set in Türkiye’s Southeastern Anatolia Region a socio-culturally conservative area marked by strong religious values, patriarchal norms, and limited institutional resources - this study provides a geographically and culturally grounded perspective that is often underrepresented in global autism research. Specifically, it examines the dynamics of delay, denial, and acceptance; the influence of religious references and social norms; and the multiple roles that mothers assume in the care process. Adopting a qualitative research design, data were collected from 12 parents (8 mothers, 4 fathers) through semi-structured interviews and home observations, using purposive and snowball sampling. Data were analyzed with Erlingsson and Brysiewicz’s four-dimensional content analysis method. The analysis identified four key themes: (1) delays in diagnosis and processes of denial and acceptance; (2) interpretations of autism through cultural values, social norms, and religious beliefs; (3) mothers’ multiple caregiving roles as educators, therapists, and guides; and (4) resistance to stigmatization and strategies for normalizing autism. The findings highlight that diagnosis carries social, cultural, and psychological meanings beyond the medical sphere. Religious and cultural narratives serve as both coping mechanisms and acceptance tools. Mothers emerge as resilient yet often invisible figures who struggle for recognition and support. These results underscore the need for culturally sensitive social policies and comprehensive family support programs.

Increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) in childhood are now reaching adulthood, yet knowledge of their long-term outcomes remains limited. This study evaluated adult clinical characteristics, outcomes, and prognostic factors in individuals diagnosed with ASD in childhood. Eighty-seven adults participated, including five (5.7%) in whom loss of autism diagnosis (LAD) was identified. The remaining participants (n = 82) were classified by their initial childhood diagnoses: autistic disorder (49.4%), pervasive developmental disorder–not otherwise specified (20.7%), and Asperger’s syndrome (24.7%). Adult outcomes were assessed using a structured functional and psychosocial rating system. Subtypes differed significantly in age at first sentence, regression history, age at diagnosis, and initiation of special education. Individuals with Asperger’s syndrome and LAD had higher university attendance and graduation rates. Overall outcomes were very poor (5.7%), poor (55.2%), fair (24.2%), good (8%), and very good (6.9%), with significant group differences. Poor outcomes were significantly more frequent among individuals with intellectual disability (ID), regression history, co-occurring psychiatric conditions, and older age at first sentence. ID and regression significantly predicted poor outcomes, while absence of ID predicted LAD. Findings highlight the heterogeneity of ASD trajectories across the lifespan. While some individuals lose the diagnosis, outcomes vary widely depending on individual characteristics and diagnostic subtype. ID and regression emerged as key predictors for poorer outcomes. These findings offer clinically relevant insights by clarifying prognostic markers and long-term outcomes, informing diagnostic assessment and intervention planning, and emphasizing the need for tailored support strategies.

Mutations in the chromatin remodeler CHD8 are associated with autism and macrocephaly. While mouse models of Chd8 haploinsufficiency recapitulate brain overgrowth, the specific cellular mechanisms and developmental timing that lead to these anatomical abnormalities remain poorly understood. Here, we conducted 3D imaging of Chd8V986*/+ mouse brains using magnetic resonance imaging followed by tissue clearing and cellular resolution light-sheet microscopy across embryonic and postnatal developmental stages. We found that brain overgrowth occurs postnatally, driven by an expansion of oligodendrocytes and microglia. Unexpectedly, we identified prevalent molecular layer heterotopias within the frontal cortex of Chd8V986*/+ mice appearing during embryonic development and persisting throughout life. Molecular layer heterotopias were previously identified in post-mortem brains from individuals with autism and other neurodevelopmental disorders, suggesting functional significance in human patients.

Abstract This qualitative study investigated the acceptability and suitability of neurodiversity‐affirming psychoeducational resources for children aged 7–11 years without formal autism or attention deficit hyperactivity disorder (ADHD) diagnoses. Using a reflexive thematic analysis of semi‐structured interviews with 24 families and written feedback from seven stakeholders, the research explored perceptions of repurposed resources. One overarching theme ‘Empowering Individualised Engagement’ and six themes were developed: (1) Active Participation, (2) Harnessing Words, (3) Personal Resonance, (4) Communication, (5) Tailoring for Growth and (6) Strategies for Challenges. These were driven by the resources' engaging, co‐produced design, strengths‐based language non‐clinical terminology, and ability to foster personal resonance. The resources enabled children to develop a shared vocabulary for their needs and equipped families with practical strategies, which fostered a positive identity. This study concludes that non‐clinical, strength‐based resources can bridge service gaps for children on diagnostic waitlists or with suspected neurodivergent traits, offering a scalable inclusive model for supporting child well‐being by prioritising empowerment over deficit‐based approaches.

Communication between the medial frontal cortex and mediodorsal thalamus is required for timing performance in rats.

Catatonia in Autism and Neurodevelopmental Disorders: A Scoping Review for Advancing Identification, Practice, and Research.

Effectiveness of adapted curriculum for autism and neurodevelopmental disorders skills education program (AC-AND-SEP)

Body dysmorphic disorder (BDD) is a persistently under-recognised psychiatric condition. Evidence suggests a degree of shared cognitive dysfunction and clinical presentation of BDD with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The current study is the first to investigate the co-occurrence of BDD, ASD and ADHD in a large online community sample. Utilising data from an online survey, we investigated the comorbidity frequency of BDD, ASD and ADHD, as well as the presence of possible undiagnosed BDD in these neurodevelopmental populations (N = 6844). Individuals with BDD did not report a higher frequency of ASD or ADHD comorbidity than those without BDD. However, individuals with neurodevelopmental diagnoses were significantly more likely to have possible undiagnosed BDD than those without a neurodevelopmental diagnosis (ASD adjusted odds ratio [AOR] = 3.55, ADHD AOR = 2.45). These preliminary findings cautiously suggest that elevated body image concern and possible BDD in ASD and ADHD are potentially missed or misattributed to individuals' neurodevelopmental diagnoses without further investigation.

Cannflavin B ameliorates behavioural and neuronal systems alterations in adolescent rats exposed to prenatal valproic acid.

Recent litigation in the United States - specifically the Texas Attorney General's lawsuit against the makers of Tylenol - has reignited global concern over the safety of paracetamol use during pregnancy and its alleged link to neurodevelopmental disorders such as autism and attention deficit hyperactivity disorder (ADHD). Although South African clinical guidelines continue to endorse paracetamol as safe and essential during pregnancy, the legal implications of such international controversies warrant closer scrutiny. A narrative legal-ethical review was conducted, drawing on comparative legal frameworks, South African clinical guidelines and recent consensus statements. The article analyses the Texas Tylenol lawsuit, evaluates the evidentiary standards in South African versus US law and considers the ethical obligations of disclosure and risk communication. Sources include peer-reviewed literature, professional guidelines (e.g. Health Professions Council of South Africa [HPCSA] and South African Society of Obstetricians and Gynaecologists [SASOG]) and public health statements. No meta-analysis was performed. The review found that while South African law requires a causal link for liability, international litigation can influence patient perceptions and clinical behaviour. South African guidelines continue to support paracetamol use in pregnancy, and adherence to these guidelines provides legal and ethical protection. However, practitioners may face increased patient anxiety, pressure to alter prescribing habits and the risk of defensive medicine. Ethical tensions arise between the duty to inform and the risk of fuelling misinformation. South African family practitioners must remain vigilant in their communication, documentation and reliance on evidence-based consensus.Contribution:By grounding clinical decisions in local guidelines and ethical reasoning, practitioners can navigate the challenges posed by global controversies while maintaining patient trust and legal defensibility.

Autism and attention deficit hyperactivity disorder (ADHD) frequently co-occur and show a positive correlation when examined as traits in the general population. Both are associated with anxiety, and Atypical Sensory Processing (ASP) may play a role in this relationship. A cross-sectional design was used to examine ASP as a mediator between autistic / ADHD traits and anxiety and explore the role of ASP in their shared variance. A total of 224 adults from the general population completed self-report surveys of ADHD traits, autistic traits, ASP, and anxiety. All measures correlated positively, and ASP was a partial mediator between autistic traits and anxiety and between ADHD traits and anxiety. In a partial correlation, ASP accounted for the majority of the shared variance between ADHD and autistic traits. Mediation of anxiety via ASP appeared to stem from the shared variance between ADHD and autism but not their unique variance. These results highlight the importance of considering ASP as a source of anxiety for those with higher autistic and ADHD traits. ASP is suggested as a transdiagnostic factor that may help explain the high co-occurrence of ADHD and autism. Areas for further research are discussed.