Asperger’s syndrome: diagnosis, comorbidity and therapy

Abstract

Asperger’s syndrome (AS), a behavioral disorder that is related to autism, is associated with abnormal social functioning and repetitive behaviors but not with a decrease in intelligence or linguistic functionality. This article reviews the clinical diagnosis of AS and discusses the comorbid disorders that may be present with AS, as well as the efficacy, safety, and tolerability of pharmacotherapies given to AS patients, as reported in preclinical and clinical studies. AS may be present with several comorbid disorders including: attention deficit hyperactivity disorder, anxiety, schizophrenia, bipolar disorder, depression, and Tourette’s syndrome. The difficulty in distinguishing AS from autism results in treating the comorbid disorder symptoms, rather than treating the symptoms of AS. Accordingly, there is a great need to further understand the psychobiology of AS and its association with other disorders, which should expand the pharmacological and non-pharmacological therapeutic options and improve the quality of life for AS patients.

Keywords:

• Asperger’s syndrome
• autistic spectrum disorders
• cognitive behavioral therapy
• comorbid disorders
• pharmacotherapy
• symptoms

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Erratum

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Asperger’s syndrome (AS) is a neurodevelopmental disorder characterized by abnormal social functioning, poor coordination, repetitive behaviors and strange speaking patterns.

• AS is not associated with decrease in intelligence or delays in language development, which differentiates it from other autistic spectrum disorders.

• Imaging studies revealed significant reductions in gray matter in frontostriatal and cerebellar regions in brains of AS patients. Deficits in sensorimotor gating may contribute to their repetitive behaviors and strange speaking patterns.

• AS is commonly associated with other comorbid disorders, including attention deficit hyperactivity disorder, depression, anxiety, bipolar disorder, Tourette’s syndrome and obsessive compulsive disorder. Improved treatment of AS depends on proper diagnosis of this disorder and other comorbid conditions.

• Pharmacological treatments for AS include the use of stimulants, α-2 adrenergic agonists, atypical antipsychotics, antidepressant and anticonvulsant medications.

• Non-pharmacological therapeutic interventions are increasingly utilized in AS patients, including sociobehavioral therapy and cognitive behavioral therapy. These interventions are effective in improving AS-comorbid disorders.

• Other experimental therapeutic interventions include the use of the hormone oxytocin, traditional Japanese herbs as well as stem cells. Nonetheless, these interventions require extensive validation before being approved for the treatment of AS patients.

• The development of new diagnostic tools, behavioral scales, imaging techniques as well as increasing public awareness of AS and its ramifications should improve its long-term outcomes.