As anesthesia is often needed for childhood surgery and procedures, researchers have examined the potential effects of anesthesia on neurodevelopment. There are few studies that have examined the effect of anesthesia on neurodevelopment in children with confirmed diagnoses of ASD, and the results of these studies are mixed. Children with neurodevelopmental disorders can have age-dependent variations in brain anatomy, function, and connectivity, which may alter their sensitivity to the potential neurotoxic effects of anesthetic and sedative drugs. Given the potential adverse neurodevelopmental effects of anesthesia on typically developing children, it is important to examine if anesthesia exposure can worsen the clinical course of ASD.
We hypothesize that children with a confirmed diagnosis of ASD will regress developmentally following general anesthesia for dental surgery in comparison to children without ASD (controls) undergoing dental surgery. In this pilot study, we will investigate this hypothesis through the following objectives: 1. to determine in a clinical study if anesthesia induces post-operative persistent adverse changes children with ASD as compared with typically developing controls; 2. to determine the potential mechanism for the adverse effects of anesthetics on patients with ASD compared to healthy controls, peripheral blood mononuclear cells will be isolated from blood samples (PBMCs), before genomic DNA isolation for mitochondrial content analysis.
Study Type
OBSERVATIONAL
Enrollment
51
All types of dental surgery
The Hospital for Sick Children
Toronto, Ontario, Canada
Current language and behaviour skills
measured using the Autism Diagnostic Interview - Revised
Time frame: up to 3 months before surgery
Regression in language and behaviour skills
measured using the Autism Diagnostic Interview - Revised
Time frame: up to 12 weeks following anesthetic exposure
Metabolic make-up
measured using quantitative polymerase chain reactions
Time frame: immediately prior to anesthetic exposure
Metabolic changes
measured using quantitative polymerase chain reactions
Time frame: within 1-2 hours following anesthetic exposure
Current non-specific behaviour skills
measured using the Abberant Behaviour Checklist
Time frame: up to 3 months before surgery
Regression in non-specific behaviour skills
measured using the Abberant Behaviour Checklist
Time frame: up to 12 weeks following anesthetic exposure
Current sleep habits
measured using the Children's Sleep Habits Questionnaire
Time frame: up to 3 months before surgery
Regression in sleep habits
measured using the Children's Sleep Habits Questionnaire
Time frame: up to 12 weeks following anesthetic exposure
Current social communication skills
measured using the Social Communication Questionnaire
Time frame: up to 3 months before surgery
Regression in social communication skills
measured using the Social Communication Questionnaire
Time frame: up to 12 weeks following anesthetic exposure
Current social responsiveness skills
measured using the Social Responsiveness Scale
Time frame: up to 3 months before surgery
Regression in social responsiveness skills
measured using the Social Responsiveness Scale
Time frame: up to 12 weeks following anesthetic exposure
Posthospitalization Behaviours
measured using the Posthospitalization Behaviour Questionnaire
Time frame: 3 days following anesthetic exposure
Changes in posthospitalization behaviours
measured using semi-structured interview
Time frame: up to 12 weeks following anesthetic exposure
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