Mechanism Study of Sulforaphane in ASD Improvement

Detect resting state and task state EEG, analyze and calculate the functional E/I ratio.

The content and ratio of Glu/Cr, γ-GABA/Cr, NAA/Cr, Cho/Cr, and MI/Cr were detected by magnetic resonance spectroscopy to evaluate the changes in the key transmitters of neural E/I balance.

This outcome measure will utilize an eye tracker to record and analyze the visual movement trajectories of participants while they engage in cognitive tasks. The analysis will focus on the following parameters: (1) the fixation points, indicating what the participants look at during the tasks; (2) the frequency of fixations, reflecting how many times each visual target is observed; and (3) the duration of each fixation, representing how long participants focus on specific elements.

The "Reading the Mind in the Eyes" test is a psychological assessment designed to measure a subject's ability to understand or infer the mental states of others through the observation of their eyes. It is used to investigate social cognition, empathy, and theory of mind. The test consists of 36 images, and for each image, participants receive one point if they correctly identify the mental state being expressed; otherwise, they receive zero points. A higher score indicates a greater proficiency in understanding others' mental states through facial cues.

The Frith-Happe animations task is used to measure individuals' ability to understand and interpret social interactions. In this task, participants are shown 8 short animated video clips depicting simple social interactions between triangle shapes. Participants will be asked whether the type of interaction of triangles in these animations is random or psychological, and be rated according to their choice of the type of interaction presented by the triangle animation. Each animation gets one point if it chooses the interaction type correctly; otherwise, it gets zero points. The total score is eight.

Strange Stories Task involves presenting participants with a series of short narrative vignettes that involve interactions between characters that require the reader to infer the characters' thoughts, beliefs, intentions, and emotions. After reading each story, participants are asked questions or prompted to make judgments about the characters' mental states, motivations, and interpretations. Responses are then scored based on the participant's ability to accurately interpret the social cues presented in the narratives. Each question is scored 0, 1, and 2 according to the scoring standard.

The Clinical Global Impression Scale (CGI) is utilized to evaluate clinical efficacy. It consists of three components: Severity of Illness (SI), Global Improvement (GI), and Efficacy Index (EI). Each component uses an 8-point scale from 0 to 7, where 0 indicates no issues and 7 reflects the most severe condition. The total scores help clinicians assess the severity of the patient's condition, the degree of improvement or worsening from baseline, and the overall efficacy of the treatment considering both its effects and side effects. Higher scores generally indicate greater severity or deterioration, while lower scores suggest better outcomes.

The Autism Treatment Evaluation Checklist (ATEC) is used to assess changes in the severity of Autism Spectrum Disorder (ASD) in children aged 2 to 12 years following treatment. The ATEC consists of four sections: I. Expression/Language Communication (14 items), II. Social Skills (20 items), III. Perception/Cognitive Skills (18 items), and IV. Health/Behavior (25 items). The scores from each subscale are combined to calculate a total score, which ranges from 0 to 179. The initial assessment score is referred to as the 'baseline total score,' with mild (baseline ATEC total score 20-49), moderate (baseline ATEC total score 50-79), and severe (baseline ATEC total score >80) classifications. A lower score indicates milder severity of ASD. The primary purpose of the ATEC is to evaluate individual changes following interventions by comparing the baseline ATEC score with subsequent scores.

The Adult Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) are self-report tools for adults to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms.

The ASRS has 18 questions covering two dimensions: attention deficits and hyperactive/impulsive behavior. Responses are rated on frequency using options like 'never,' 'rarely,' 'sometimes,' 'often,' or 'very frequently.' Each item scores from 0 (no problem) to 4 (most severe). The total ASRS score is the sum of all item scores.

The WURS consists of 15 questions assessing childhood symptoms related to ADHD that may persist into adulthood. Responses are rated similarly, with options like 'not at all or very rarely,' 'rarely,' 'sometimes,' 'often,' or 'very often.' Each item scores from 0 to 4, with the total WURS score reflecting the severity of ADHD symptoms.

The Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) is a standardized measure designed to assess executive functioning and self-regulation in adults within everyday environments. It utilizes both self-report and informant-report formats. The scale comprises 75 items across 9 theoretically and empirically derived clinical scales: inhibition, self-monitoring, planning/organization, shifting, initiation, task monitoring, emotional control, working memory, and material organization. Responses are typically rated based on frequency, with options such as 'never,' 'occasionally,' and 'often.' Each item is scored on a scale from 1 to 3, where 1 indicates no problem and the highest score reflects the most severe problem. The total score of the BRIEF-A is the sum of the scores of all items, providing an overall assessment of executive function difficulties.

The Patient Health Questionnaire-9 (PHQ-9) is a widely used clinical tool for assessing depressive symptoms. Based on the diagnostic criteria of the American Psychiatric Association, it helps clinicians screen for, diagnose, and evaluate the treatment effects of depression by asking patients about their depressive symptoms over the past two weeks. The scale consists of 9 items, with responses typically rated based on frequency and duration options such as 'not at all,' 'several days,' 'more than half the days,' and 'nearly every day.' Each item is scored on a scale from 0 to 3, where 0 indicates no problem and the highest score reflects the most severe symptoms. The total score of the PHQ-9 is the sum of all item scores, providing an overall assessment of depressive symptom severity.

The Generalized Anxiety Disorder 7-item scale (GAD-7) is a self-assessment tool used to evaluate anxiety symptoms. The scale consists of 7 items that assess various aspects of anxiety. Responses are typically rated based on frequency and duration options such as 'not at all,' 'several days,' 'more than half the days,' and 'nearly every day.' Each item is scored on a scale from 0 to 3, with 0 indicating no problem and the highest score reflecting the most severe symptoms. The total score of the GAD-7 is the sum of all item scores, providing an overall assessment of anxiety symptom severity.

The Altman Self-Rating Mania Scale (ASRM) is a diagnostic tool designed to assess the presence and severity of manic symptoms in individuals. The scale consists of 5 questions that evaluate various aspects of mania. Responses are typically rated based on frequency and duration options such as 'none,' 'occasionally,' 'often,' 'most of the time,' and 'nearly every day.' Each item is scored on a scale from 0 to 4, with 0 indicating no problem and the highest score reflecting the most severe symptoms. The total score of the ASRM is the sum of all item scores, providing an overall assessment of manic symptom severity.

The Cross-Cutting Symptom Measures, developed by the DSM-5 Working Group, is a self-report tool for dimensional evaluation of adult patients' mental symptoms. It encompasses 13 dimensions and 23 items, including depression, anger, anxiety, and substance use. Ratings are based on frequency and duration, using a scale from 'not at all' to 'nearly every day.' Each item is scored from 0 (no problem) to 4 (most severe), with the total score reflecting the overall symptom severity.

Camouflaging Autistic Traits Questionnaire (CAT-Q) is used to assess social camouflaging behaviors in adults. The questionnaire consists of 25 items, covering three dimensions: compensation, masking, and blending in, which reflect different social camouflage strategies. Ratings are based on a scale from 1 to 7, indicating the severity of behaviors. Higher scores indicate a greater level of social camouflaging, suggesting that individuals may engage in more camouflage behaviors in their daily lives; lower scores suggest less camouflage behavior, which may be associated with a more natural social approach.

The Borderline Symptom List 23 (BSL-23) is a self-assessment scale used to measure the extent of intrapsychic stress in patients with borderline personality disorder. The BSL-23 consists of three parts: 23 items that assess the individual's mental state over the past week, a visual analog scale to evaluate current mental well-being, and a supplementary scale with 11 items to record the extent of current dysfunctional behaviors. Ratings are typically based on severity, using a scale from "none" to "very strong," with each item scored from 0 to 4, where 0 indicates no problem and 4 indicates the most severe level. The total score is the sum of all item scores, with higher scores reflecting greater severity of symptoms.

The Interpersonal Reactivity Index-C (IRI) is a tool used to measure individual differences in empathy. The scale consists of 28 items that encompass four relatively independent dimensions: fantasy, empathic concern, perspective taking, and personal distress. Ratings are typically based on a scale from 0 to 4, corresponding to "does not apply at all," "partially applies," "somewhat applies," "mostly applies," and "fully applies." The scores for each dimension are calculated by summing the ratings of the relevant items and averaging them, with higher scores indicating a stronger empathetic ability in that dimension.

The Inventory of Callous-Unemotional (ICU) is used to measure callous-unemotional traits. The scale consists of 24 items that assess three dimensions: Callousness, Uncaring, and Unemotional. Each statement is rated on a scale from "does not apply at all" to "applies completely," with scores ranging from 0 to 3 for each item. A higher total score indicates a more pronounced presence of traits in that dimension.

The Athens Insomnia Scale (AIS) is used to evaluate insomnia. It consists of 8 items, with each item rated on a scale from "no problem" to "mild," "moderate," and "severe or almost no sleep," corresponding to scores of 0 to 3. Respondents rate their sleep quality based on the severity of their insomnia symptoms. The total score of the AIS is the sum of the scores of all entries. A higher total score indicates poorer sleep quality.

The Autism Spectrum Quotient-10 (AQ-10) is a simplified self-report screening tool designed to assess the presence of traits associated with Autism Spectrum Disorder (ASD). The scale consists of 10 items, each rated on a 4-point scale ranging from "strongly agree" to "strongly disagree," with scores assigned as 1, 1, 0, and 0. A higher total score indicates a greater likelihood of the individual exhibiting characteristics of Autism Spectrum Disorder.

The Empathy Quotient-10 (EQ-10) is a brief self-assessment tool designed to evaluate an individual's empathic ability. The scale consists of 10 items that assess the individual's skills in recognizing, understanding, and responding to the emotions of others. Each item is rated on a scale of 0 to 2 based on the responses "strongly agree," "slightly agree," "slightly disagree," and "strongly disagree," with scores assigned as 2, 1, 0, and 0. A lower total score indicates a poorer level of empathic ability.

The Systemizing Quotient-10 (SQ-R-10) is a self-report measure designed to assess an individual's systemizing cognitive style. This simplified version is based on the more comprehensive Systemizing Quotient-Revised (SQ-R) questionnaire and consists of 10 items aimed at quickly evaluating an individual's propensity for systemizing. Each item is rated on a scale of 0 to 2 based on the responses "strongly agree," "slightly agree," "slightly disagree," and "strongly disagree," with scores assigned as 2, 1, 0, and 0. A higher total score indicates a greater presence of traits associated with autism.

The Sensory Perception Quotient (SPQ) is a self-report tool designed to quantify basic sensory sensitivity in adults. The scale consists of 10 items, each rated on a 4-point scale ranging from "strongly agree" to "strongly disagree," with scores assigned as 3, 2, 1, and 0. A higher total score indicates greater sensory sensitivity.

The Behavioral Inhibition and Activation Systems Scale (BIS/BAS Scale) is used to measure an individual's behavioral inhibition and activation systems based on reinforcement sensitivity theory. This scale consists of 24 items, divided into two systems: the Behavioral Inhibition System and the Behavioral Activation System, which further includes dimensions such as reward responsiveness, drive, and pleasure-seeking. Scoring employs a 4-point scale ranging from "strongly agree" to "strongly disagree," corresponding to scores of 1 to 4. The total score is the sum of all item scores, with higher scores typically reflecting greater activity in the behavioral activation system, while lower scores indicate a tendency toward behavioral inhibition.

The Adult Self-Report (ASR) is part of the Achenbach System, designed to assess adaptive functioning and psychopathology (Achenbach and Rescorla, 2003; Achenbach et al., 2017). The ASR includes eight syndrome scales, with internalizing problems comprising Anxious/Depressed (18 items), Withdrawn (9 items), and Somatic Complaints (12 items), while externalizing problems consist of Aggressive Behavior (15 items), Rule-breaking Behavior (14 items), and Intrusive Behavior (6 items). Other syndrome scales include Attention Problems (15 items) and Thought Problems (10 items), along with 21 additional items that do not fit any syndrome. The total score on the ASR is based on all problem items (120 items in total) and reflects the total problems score for adult psychopathology. Scoring is categorized into three levels: "not true" (0 points), "somewhat or sometimes true" (1 point), and "very true or often true" (2 points).