D1.468 - Association Between Autism Spectrum Disorder and Skin Barrier Integrity

The nervous system and skin share a common embryonic origin and are interconnected through epigenetic mechanisms, suggesting potential neurocutaneous involvement in autism spectrum disorder (ASD). Electrical impedance spectroscopy (EIS) provides a rapid, noninvasive assessment of skin barrier properties. We aimed to evaluate whether skin impedance measurements differentiate children with ASD from healthy controls and whether they reflect clinical subtypes of ASD.

Children with ASD and healthy controls were examined by a child psychiatrist and neurologist, including attention deficit hyperactivity disorder (ADHD) assessment, Childhood Autism Rating Scale (CARS; CARS0: 15–29, CARS1: 30–38, CARS2: 39–60) and neurological exam. EIS was measured with the Nevisense® device from the left antecubital fossa and volar forearm 8 cm distal. Z1 represents the mean at 1 kHz, and Mix represents the impedance slope between 20–500 kHz; lower values indicate reduced skin barrier integrity.

A total of 66 healthy children with a median age of 6.2 (interquartile range: 4.5–8.4) years and 67 children with ASD with a median age of 7.7 (5.8–9.2) years (28 ASD, 39 ASD+ADHD) were included. The forearm Z1 EIS scores of healthy participants [81.7 (61.1–118.3)] were found to be significantly higher compared to those of participants with ASD [75.4 (51.3–110.4)] (p=0.035). When evaluated according to the CARS score classification determining autism severity in participants with ASD, EIS scores in individuals in the CARS0 group [121.5 (64.4–192.7)] were significantly higher than in those in the CARS1 (72.5 (54.9–109.8)) and CARS2 (75.3 (43.9–100.2)) groups (Z1-forearm p=0.018, forearm-Mix p=0.001, Z1-antecubital p=0.007, antecubital-Mix p<0.001). In addition, in children with ASD accompanied by cognitive impairment as determined by the CARS questionnaire, EIS forearm Z1 scores [73.1 (49.3–105.5)] were found to be significantly lower compared with ASD children without cognitive impairment [115.6 (66.5–135.1)] (p=0.006).

Skin impedance profiles differ between children with ASD and healthy controls and vary according to ASD severity and cognitive status as defined by CARS.These findings support the potential role of EIS as a noninvasive biomarker for neurocutaneous alterations in autism spectrum disorder.