5.75 Prevalence of Connective Tissue–Related Symptoms in Children With Neurodevelopmental Disorders: Insights Supporting the Connectivome Theory

Objectives ASD, ADHD, and Tourette’s disorder (TD) exhibit overlapping neuropathological mechanisms, such as impaired brain connectivity. A more complete view of the alteration of connectivity that characterizes neurodevelopmental disorders both at the central and peripheral levels has recently been formulated through the “Connectivome Theory,” which is based on the role of connective tissue in the different organs. The objective of this study is to investigate the prevalence of symptoms arising from connective tissue alterations in individuals diagnosed with ASD, ADHD, or TD and to compare it with a sample of healthy controls. Methods A questionnaire investigating connective tissue–related symptoms was administered from December 2019 to January 2022 to the families of 120 children diagnosed with ASD (n = 48), ADHD (n = 36), and TD (n = 36) attending the Child Neuropsychiatry Outpatient Clinics of the University Hospital of Verona. The questionnaire was also administered to the families of a control group, composed of 44 typically developing children. The symptoms assessed by the questionnaire were: 1) striae rubre/skin irregularities/flushed skin; 2) excessive sweating of hands/feet; 3) back pain/transient limb muscle aches/chronic fatigue; 4) hip dysplasia/scoliosis/hunched back; 5) flat feet; 6) constipation/diarrhea/alternating bowel; 7) heartburn/gastroesophageal reflux/hiatus hernia; 8) use of orthodontic appliances; 9) tactile/visual/auditory/olfactory/gustatory hypersensitivity; and 10) myopia/drooping eyelids/eyelid ptosis. Results Mean ages of cases and controls were 10.1 (SD: 3.6) and 9.5 (SD: 2.5) years, respectively. Most of the cases (110 subjects, 91.7%) were males; controls were distributed in 22 (50.0%) males and 22 (50.0%) females. Of the 10 symptoms assessed, 7 were more prevalent in cases than controls. Despite the small sample, the difference in prevalence reaches statistical significance with regards to flat feet (cases 47.97% vs controls 13.64%; p = .001), hypersensitivity (cases 54.47% vs controls 18.18%; p = .001) and myopia (cases 16.26% vs controls 2.27%; p = .016). Conclusions This exploratory study indicates a likely association of connective tissue–related disorders in children with neurodevelopmental disorders. Further studies will aim to confirm this hypothesis and evaluate ASD, ADHD, and TD separately.