Journal
Meta analysis of correlation between autism and epilepsy
المستخلص
Abstract
Background: Autism spectrum disorder (ASD) and epilepsy are prevalent neurodevelopmental conditions with early onset, lifelong impact, and high health-care burden. Their frequent co-occurrence is supported by shared neurobiological mechanisms, including disrupted synaptogenesis, cortical malformations, and excitatory–inhibitory imbalance, as well as overlapping genetic syndromes such as tuberous sclerosis, Rett, and Fragile X. Despite multiple reviews, estimates of co-occurrence remain inconsistent due to heterogeneity in study design, populations, and diagnostic methods.
Objective: To quantify the correlation between ASD and epilepsy through systematic review and meta-analysis, and to identify moderators influencing prevalence estimates.
Methods: Following PRISMA 2020 guidelines, we searched PubMed, EMBASE, PsycINFO, Scopus, Web of Science, and Cochrane Library through March 2025. Eligible studies included observational cohorts, cross-sectional, and case-control designs reporting prevalence or correlation between ASD and epilepsy. Random-effects models generated pooled prevalence and correlation coefficients (r), with heterogeneity assessed using Q and I² statistics. Subgroup analyses examined age, sex, intellectual disability, and sampling frame. Risk of bias was appraised using Newcastle–Ottawa and JBI tools.
Results: Across 66 studies, pooled prevalence of epilepsy in ASD was 10.0% (95% CI 6–14), higher in adults (19%) than children (7%), and substantially elevated in those with intellectual disability (≈21.5% vs 8%). Pooled prevalence of ASD in epilepsy cohorts was 6.3% (range 0.6–41.9%). The pooled correlation coefficient indicated a robust association, though heterogeneity was high (I² >70%). Evidence of publication bias was detected.
Conclusion: ASD and epilepsy co-occur at rates far above chance, shaped by age, sex, and intellectual disability. Findings support routine bidirectional screening and integrated clinical management, while highlighting the need for standardized diagnostic approaches and longitudinal studies to clarify causal mechanisms.
Background: Autism spectrum disorder (ASD) and epilepsy are prevalent neurodevelopmental conditions with early onset, lifelong impact, and high health-care burden. Their frequent co-occurrence is supported by shared neurobiological mechanisms, including disrupted synaptogenesis, cortical malformations, and excitatory–inhibitory imbalance, as well as overlapping genetic syndromes such as tuberous sclerosis, Rett, and Fragile X. Despite multiple reviews, estimates of co-occurrence remain inconsistent due to heterogeneity in study design, populations, and diagnostic methods.
Objective: To quantify the correlation between ASD and epilepsy through systematic review and meta-analysis, and to identify moderators influencing prevalence estimates.
Methods: Following PRISMA 2020 guidelines, we searched PubMed, EMBASE, PsycINFO, Scopus, Web of Science, and Cochrane Library through March 2025. Eligible studies included observational cohorts, cross-sectional, and case-control designs reporting prevalence or correlation between ASD and epilepsy. Random-effects models generated pooled prevalence and correlation coefficients (r), with heterogeneity assessed using Q and I² statistics. Subgroup analyses examined age, sex, intellectual disability, and sampling frame. Risk of bias was appraised using Newcastle–Ottawa and JBI tools.
Results: Across 66 studies, pooled prevalence of epilepsy in ASD was 10.0% (95% CI 6–14), higher in adults (19%) than children (7%), and substantially elevated in those with intellectual disability (≈21.5% vs 8%). Pooled prevalence of ASD in epilepsy cohorts was 6.3% (range 0.6–41.9%). The pooled correlation coefficient indicated a robust association, though heterogeneity was high (I² >70%). Evidence of publication bias was detected.
Conclusion: ASD and epilepsy co-occur at rates far above chance, shaped by age, sex, and intellectual disability. Findings support routine bidirectional screening and integrated clinical management, while highlighting the need for standardized diagnostic approaches and longitudinal studies to clarify causal mechanisms.
الكلمات المفتاحية
bidirectional
epilepsy
Autism spectrum disorder (ASD)
neurodevelopmental
heterogeneity
