AIMS-2-TRIALS

IMI Associated Partner the Simons Foundation Autism Research Initiative (SFARI) is a research programme whose mission is 'to improve the understanding, diagnosis and treatment of autism spectrum disorders by funding innovative research of the highest quality and relevance.' ### The project started working with IMI through the IMI1 project EU-AIMS, and is now an Associated Partner in the IMI2 project AIMS-2-TRIALS.

‘In addition to expanding and sharing our SPARK cohort — which will be a community of over 50 000 individuals with autism, and their families, for a majority of whom we will have genomic data — we have provided supplies of an experimental medication that is being tested in a clinical trial run by AIMS-2-TRIALS,’ says SFARI Deputy Director of Clinical Research, Paul Wang, in an interview with the IMI Programme Office. 

‘Autism is enormously complex, and we believe that collaborative efforts spanning academia, industry, and the non-profit sectors, are invaluable for advancing autism science. Indeed, we strive to have representation from all of these sectors in many of our own workshops and other initiatives,’ he says.

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Researchers from AIMS-2-TRIALS have published a report that shows that the COVID-19 pandemic has further exacerbated existing healthcare inequalities for autistic people and has likely contributed to disproportionate increases in morbidity and mortality, mental health/behavioural difficulties and reduced quality of life. ###The researchers arrived at this conclusion after studying COVID-19 policies from 15 countries and analysing data from a survey of over 1 000 autistic people and caregivers. Writing in BMJ OPEN, the team explains that autistic people experienced four significant barriers accessing COVID-19 services:

• despite being at elevated risk for severe illness due to co-occurring health conditions, there was a lack of accessibility of COVID-19 testing (e.g. lack of reasonable adjustments/provision of preparatory materials);
• many COVID-19 outpatient and inpatient treatment services were reported to be inaccessible – predominantly resulting from individual differences in communication needs;
• ICU triage protocols in many European countries may have (directly or indirectly) resulted in discriminatory exclusion from lifesaving treatments;
• interruptions to standard health and social care left over 70% of autistic people without everyday support, in the absence of appropriate mitigation measures.

Dr Bethany Oakley of Kings College London said: ‘Increasing service capacity and investing in resilience planning should be the primary response for decision makers to make sure that there is equal access to hospital and intensive care resources, across the population, and that steps are taken to make sure that autistic people and all those with developmental differences are not put at a disadvantage.’

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Around three times as many males are diagnosed with autism than females, which suggests that sex-related biological factors play a key role in its development. However, little is known about the ways that autistic males and females differ in terms of brain structure and function.###

AIMS-2-TRIALS researchers, in collaboration with colleagues from the Child Mind Institute, explored this further using resting-state functional magnetic resonance imaging (R-fMRI) to study brain function in three large samples of autistic males and females and a control group of non-autistic people. They used one sample for discovery of new information and two additional large samples to see if those findings could be repeated (i.e. replicated).

Across these three samples, the researchers found that both neurotypical males and autistic people showed reduced resting-state brain function in the so-called ‘default network’, a network that is active when we engage in social cognition or thoughts about ourselves. Additionally, in the discovery sample and in one of the largest of the two replication samples, it was shown that connections crossing between the two halves of the brain in the visual cortex are reduced in autistic females, while autistic males are not different from males who are not autistic. The results suggest that many autistic people may have different interactions between the two hemispheres of their brain when compared to non-autistic people. This reflects a combination of effects, including some that appear to be unrelated to sex, and some in which there is an interaction between sex and autism diagnosis. Each of these effects appears specific to a different system in the brain.

Until now, lack of replication of imaging findings has hampered brain imaging research in autism. This study, which included replication analyses, highlights that autistic people may have non-typical interactions in the connections between their brain’s hemispheres. Further, these findings may shed light on the mechanisms underlying sex-differences in autism. The research is published in the journal Molecular Autism.

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