Gabriel Dichter, PhD: Professor of Psychiatry and investigator at the Carolina Institute for Neurodevelopmental Disorders and Melissa Wash, PhD: Research Instructor, Department of Psychiatry received a 3-year award from the Foundation of Hope to study parkinsonism in autism.
Although autism spectrum disorder (ASD) is a lifelong condition, research has historically centered on pediatric populations, and almost no research has included older autistic adults. Because of this, there is almost no knowledge of: (1) psychiatric comorbidities in the aging subset of the autistic population, (2) evidence-based psychiatric care for aging autistic individuals; or (3) training needs for service providers of this population. This project addresses the critical need for research on older autistic adults to speak to an important and prevalent public health issue.
Recent data from multiple independent studies indicate that autistic older adults have a far higher risk for parkinsonism that leads to worse psychosocial, physical health, cognitive, and mental health outcomes. These associations have critical implications for clinical care, healthcare policy, and understanding the shared pathogenetic mechanisms underlying ASD and parkinsonism. However, the biological mechanisms underlying the link between parkinsonism and ASD have not been studied.
This project aims to examine clinical profiles and biological mechanisms of older autistic adults with parkinsonism by comparing three groups: older autistic adults with parkinsonism, older autistic adults without parkinsonism, and typically developing control adults. Older autistic adults will be recruited from a unique North Carolina statewide outpatient clinic cohort of autistic adults diagnosed in childhood, beginning in the 1960s.
Older autistic adults with and without parkinsonism and typically developing control adults will undergo a comprehensive evaluation, including an autism diagnostic assessment, a neurologic exam, 18F-DOPA PET imaging, skin biopsies to assess α-synuclein pathology, and a levodopa challenge test.
By addressing critical gaps in understanding autism in older adulthood, this project has the potential to inform interventions, services, workforce training, and public health policy while also elucidating pathogenic mechanisms underlying the co-occurrence of autism and parkinsonism.
The project team includes Laura Klinger, PhD, Professor of Psychiatry & TEACCH Director, Joseph Piven, MD, Professor of Psychiatry, John Younce, MD, Assistant Professor of Neurology, David Lalush, PhD, Associate Professor in the joint UNC-Chapel Hill & NC State Department of Biomedical Engineering, and Kai Xia PhD, lead biostatistician in the UNC Psychiatry Biostatistics and Data Management Unit.