1H-MRS in autism spectrum disorders: a systematic meta-analysis.

We conducted a systematic review and meta-analysis of proton magnetic resonance spectroscopy (1H-MRS) studies comparing autism spectrum disorder (ASD) patients with healthy controls, with the aim of profiling ASD-associated changes in the metabolites N-acetyl-aspartate (NAA) and Creatine (Cr). Meta-regression models of NAA and Cr levels were employed, using data from 20 eligible studies (N = 852), to investigate age-dependent differences in both global brain and region-specific metabolite levels, while controlling for measurement method (Cr-ratio versus absolute concentrations). Decreased NAA concentrations that were specific to children were found for whole-brain grey and white matter. In addition, a significant decrease in NAA was evident across age categories in the parietal cortex, the cerebellum, and the anterior cingulate cortex. Higher levels of Cr were observed for ASD adults than children in global grey matter, with specific increases for adults in the temporal lobe and decreased Cr in the occipital lobe in children. No differences were found for either NAA or Cr in the frontal lobes. These data provide some evidence that ASD is characterized by age-dependent fluctuations in metabolite levels across the whole brain and at the level of specific regions thought to underlie ASD-associated behavioural and affective deficits. Differences in Cr as a function of age and brain region suggests caution in the interpretation of Cr-based ratio measures of metabolites. Despite efforts to control for sources of heterogeneity, considerable variability in metabolite levels was observed in frontal and temporal regions, warranting further investigation.

Building a local agenda for dissemination of research into practice.

Across North America and in other parts of the world, there has been a growing recognition that a large gap exists between public health knowledge generated through scientific discovery and its application in individual, community, organizational, and policy innovation. An academic-funder partnership sought to identify potential actions to improve the translation of public health research to practice in Missouri. Concept mapping, a structured conceptualization process, was used to develop information to support a local action planning effort to improve research translation to practice in Missouri. Nine conceptual clusters emerged: (1) provide education and training; (2) enhance capacity; (3) change incentives and accountability; (4) shift funding toward community needs; (5) support practice-based research; (6) engage and collaborate with the community; (7) share knowledge; (8) engage influentials; and (9) sustain momentum; action plans were drafted to address priorities in each cluster. The project connected the ideas of a wide-ranging set of stakeholders, identified areas of high-level agreement among stakeholders, and supported shared agenda setting.