Traits neurodivergents durant l'enfance, inflammation et fatigue chronique invalidante à l'adolescence : une étude longitudinale cas-témoins

Titre original en anglais : Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study

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Quadt, L., Csecs, J. L. L., Bond, R., Harrison, N. A., Critchley, H. D., Davies, K. A., & Eccles, J. A. (2024). Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study. BMJ Open, 14(7), e084203. https://doi.org/10.1136/bmjopen-2024-084203

Date de publication: 01/07/2024 Ajout dans AutiHub: 25/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
7
Auteur·ices de la publication identifié·es comme autistes
1 / 7 (14,3 %)
  1. Lisa Quadt *
  2. Jenny L. L. Csecs
  3. Rod Bond
  4. Neil A Harrison
  1. Hugo D. Critchley
  2. Kevin A Davies
  3. Jessica A. Eccles

Résumé

Objectifs Tester si des processus inflammatoires relient l'expression de traits neurodivergents durant l'enfance à une fatigue chronique invalidante à l'adolescence. Plan d'étude Étude longitudinale cas-témoins. Cadre Nous avons analysé les données de The Avon Longitudinal Study of Parents and Children (ALSPAC). Participants 8115 et 8036 enfants de la cohorte ALSPAC âgés respectivement de 7 et 9 ans, dont 4563 ont également rempli des mesures d'autoévaluation à l'âge de 18 ans. Critères de jugement principaux et secondaires Nous avons évalué si les enfants obtenant un score supérieur au seuil de dépistage de l'autisme/trouble du déficit de l'attention avec hyperactivité (TDAH) à l'âge de 7 et 9 ans présentaient un risque accru de fatigue chronique invalidante à l'âge de 18 ans, en calculant les OR et les IC des effets au moyen d'une régression logistique binaire. Des analyses de médiation ont été menées afin de déterminer si un marqueur inflammatoire (interleukine 6 (IL-6)) à l'âge de 9 ans reliait les traits neurodivergents à la fatigue chronique invalidante à l'âge de 18 ans. Résultats Les enfants présentant des traits neurodivergents à l'âge de 7 et 9 ans étaient deux fois plus susceptibles de présenter une fatigue chronique invalidante à l'âge de 18 ans (TDAH probable OR=2.18 (IC à 95 %=1.33 à 3.56) ; p=0.002 ; autisme probable OR=1.78 (IC à 95 %=1.17 à 2.72) ; p=0.004). Les taux d'IL-6 à l'âge de 9 ans étaient associés à la fatigue chronique invalidante à l'âge de 18 ans (OR=1.54 (IC à 95 %=1.13 à 2.11) ; p=0.006). L'inflammation à l'âge de 9 ans a médié les effets des traits neurodivergents sur la fatigue chronique invalidante (effet indirect via l'IL-6 : TDAH b=1.08 (IC à 95 %=1.01 à 1.15) ; autisme b=1.06 ; (IC à 95 %=1.03 à 1.10)). Tous les effets sont restés significatifs après contrôle de la présence de symptômes dépressifs. Conclusions Nos résultats indiquent un risque plus élevé de fatigue chronique invalidante chez les enfants présentant des traits neurodivergents, probablement lié à des taux d'inflammation plus élevés. La mise en oeuvre de critères de dépistage transdiagnostiques afin d'éclairer les stratégies de soutien visant à contrer précocement le risque au cours de la vie est recommandée.

Objectives To test whether inflammatory processes link the expression of childhood neurodivergent traits to chronic disabling fatigue in adolescence. Design Longitudinal case–control study. Setting We analysed data from The Avon Longitudinal Study of Parents and Children (ALSPAC). Participants 8115 and 8036 children of the ALSPAC cohort at ages 7 and 9 years, respectively, 4563 of whom also completed self-report measures at age 18 years. Primary and secondary outcome measures We assessed if children scoring above screening threshold for autism/attention deficit hyperactivity disorder (ADHD) at ages 7 and 9 years had increased risk of chronic disabling fatigue at age 18 years, computing ORs and CIs for effects using binary logistic regression. Mediation analyses were conducted to test if an inflammatory marker (interleukin 6 (IL-6)) at age 9 years linked neurodivergent traits to chronic disabling fatigue at age 18 years. Results Children with neurodivergent traits at ages 7 and 9 years were two times as likely to experience chronic disabling fatigue at age 18 years (likely ADHD OR=2.18 (95% CI=1.33 to 3.56); p=0.002; likely autism OR=1.78 (95% CI=1.17 to 2.72); p=0.004). Levels of IL-6 at age 9 were associated with chronic disabling fatigue at age 18 (OR=1.54 (95% CI=1.13 to 2.11); p=0.006). Inflammation at age 9 years mediated effects of neurodivergent traits on chronic disabling fatigue (indirect effect via IL-6: ADHD b=1.08 (95% CI=1.01 to 1.15); autism b=1.06; (95% CI=1.03 to 1.10)). All effects remained significant when controlling for the presence of depressive symptoms. Conclusions Our results indicate higher risk of chronic disabling fatigue for children with neurodivergent traits, likely linked to higher levels of inflammation. The implementation of transdiagnostic screening criteria to inform support strategies to counteract risk early in life is recommended.

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Références citées
91
Avec un DOI
88
Sans DOI, à partir du texte brut de la bibliographie
3
9 / 91 (9,9 %) références citées comprennent au moins une personne identifiée comme autiste.
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3 / 91 (3,3 %)
Références avec noms d’auteurices détectés
88 / 91 (96,7 %)
Sans nom d’auteurice détecté
3
Sans titre structuré
3
Sans identifiant stable
3
Références avec noms bruts d’auteurices restant à vérifier
3
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1
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Noms d’auteurices détectés dans la bibliographie citée
537
À partir du DOI ou de métadonnées externes
537
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
4
93 / 537 (17,3 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 444 / 537 (82,7 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
12 / 537 (2,2 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 12 / 93 (12,9 %). Personnes distinctes identifiées comme autistes : 11 / 504 (2,2 %).
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