CCMV Public Health and Policy Conference Series: CCMV and Autism Spectrum Disorder

CCMV Public Health and Policy Conference Series: CCMV and Autism Spectrum Disorder

Author: Dr. Megan Pesch

In October of 2023, researchers, clinicians, and families from around the world gathered in Salt Lake City, Utah for the Congenital CMV Public Health and Policy Conference. It was an exciting three-and-a-half days-- jam-packed with presentations about the latest clinical practices and research findings, as well as congenital CMV families sharing their experiences and lessons learned from their own journeys. This series highlights some of the presenters and their work featured at the conference, to share with our NCMVF community. In this installment, we learn about the relationship between congenital CMV and Autism Spectrum Disorder.  

Samantha Nikirk, MPH, CCRC is a Clinical Research Program Manager at the University of Michigan in the Division of Hepatology. She also serves as Co-Chair of the Michigan Congenital CMV Community Alliance for the National CMV Foundation. Ms. Nikirk has partnered with several organizations to create patient and clinician-focused congenital CMV resources including MedScape, Hands and Voices, and WebMD. She also sits on the Michigan Early Hearing Detection and Intervention Advisory Committee and is a Newborn Screening Ambassador with Expecting Health. Most importantly, she is the proud mother to a toddler with congenital CMV and autism.
 
Ms. Nikirk gave a presentation at the recent Congenital CMV Public Health and Policy Conference entitled “Autism spectrum disorder and Congenital CMV: More than just a coincidence”. She recently sat down with me to answer some questions and share highlights of her inspirational presentation.

1. Let's start with the basics. What is autism?

Autism, or autism spectrum disorder (ASD), is a condition that affects how people interact socially, communicate, and engage in repetitive behaviors. It's called a spectrum disorder because the symptoms can vary widely among individuals. People with autism may find it challenging to understand social cues, express themselves verbally or non-verbally, and may show repetitive behaviors or intense interests in specific topics. Sensory sensitivities are also common, affecting how they perceive and respond to stimuli in their environment.

2. Can you tell me about research linking congenital infections with the risk of autism?

Studies have explored the connection between maternal infections during pregnancy and the risk of autism in children. Researchers suggest three potential mechanisms:

Placental injury: Infections can harm the placenta, affecting blood vessels and compromising its function. This may lead to inadequate oxygen and nutrient supply to the fetus, impacting brain development.

Maternal immune response: The maternal immune system's response to infection can contribute to placental dysfunction and adverse outcomes, affecting fetal brain development and increasing the risk of autism.

Viral replication in fetal brain cells: Some viruses, like CMV, can cross the placenta and infect fetal brain cells, disrupting normal development and potentially causing autism.

It's important to note that not all infections lead to these outcomes, and the impact varies based on factors like the type and timing of the infection.

3. Are there studies on children with congenital CMV and their risk of autism?

Research has explored the association between congenital CMV infection and autism. The largest studies have found that children with CMV were more likely to have a diagnosis than children without congenital CMV. However, the studies have been relatively small and have not proved that congenital CMV causes autism.

4. Many CMV families report a connection between congenital CMV and autism. Why isn't there more evidence?

Anecdotal evidence suggests a correlation, but limited research and challenges in diagnosing autism in CMV-affected children contribute to the lack of evidence. CMV and its effects are understudied, and autism diagnosis in children with CMV can be challenging due to overlapping symptoms with hearing loss.

5. Did your personal experience drive your research in this area? Can you tell me about your current study?

My professional background in infectious diseases and personal experience as a parent led me to research congenital CMV. I aim to increase awareness through advocacy, newborn screening, and research.

6. What if future research confirms a link between congenital CMV and autism? How would it impact support for these children and families?

Confirmation of a link would make children with congenital CMV and autism eligible for more services, improved tailored supports and therapies, and a better understanding of each child as an individual.

7. What should families do if they are concerned about autism in their child with or without congenital CMV?

Early recognition is crucial. Consult a developmental pediatrician or primary pediatrician for evaluation. Some states mandate insurance coverage for unlimited therapies with an autism diagnosis. Ensure a proper evaluation considering co-morbidities like hearing loss.