Newly Identified Microexons Offer Clues to Autism Spectrum Disorder’s Genetic Roots

Scientists from the University of Toronto, the Sloan Kettering Institute, King’s College London, and the Francis Crick Institute have published data that points to a role for several new microexons in the development of autism spectrum disorder (ASD). According to the findings, published today in Nature, the scientists identified hundreds of new microexons that appear to be involved in ASD and other neurological conditions, and developed a machine learning approach to predict the impact of ASD-associated genetic variants on how these segments are regulated. 

Full details are available in a paper titled “A microexon regulatory code reveals autism-linked genetic variation.” In it, the scientists described how they used a computational tool dubbed MicroExonator to analyze over 100 terabytes of publicly available RNA sequencing data. The tool was developed by Guillermo Parada, PhD, the study’s co-lead author and a postdoctoral fellow in the laboratory of Benjamin Blencowe, PhD,  at King’s and the Crick. Using the tool, he identified more than 1,500 new microexons, of which nearly 300 appeared to be specifically spliced in the brain. Furthermore, many are concentrated in genes associated with critical brain-specific processes, supporting a potential link to neurological health. 

The scientists also explored whether DNA variants found in people with autism might preferentially impact the expanded repertoire of microexons. Specifically they built and applied a machine learning model designed to identify the key regulatory features governing whether a microexon is spliced in or out of messenger RNAs. “What surprised me was that the sequences the model identified as important closely matched those conserved throughout vertebrate evolution,” says Parada.

Next, the scientists applied the model to whole-genome sequence data from thousands of people with autism and neurotypical sibling pairs. Specifically, they analyzed the predicted impact of ASD-associated genetic variants on the microexon regulatory code. “We were able to show that rare genetic variants generally have the largest predicted effects on the splicing of neuronal microexons,” says Blencowe, one of the study’s senior authors and a professor of molecular genetics at University of Toronto. The model further pinpointed a subset of rare variants predicted to alter microexon splicing that are associated with autism.

Additionally, the team found that the variants predicted to affect microexons are predominantly detected among the 85% of autistic individuals that previously lacked a genetic link to autism. This is an important point because “hundreds of genomic variants have been associated with autism, and these deliver a genetic diagnosis in 15 percent of autistic individuals,” says Blencowe, who is also a part-time professor at King’s and the Crick. That means that for 85 percent of people with an ASD diagnosis, the genetic explanation for their condition remains unknown. The findings from this study could provide some answers. 

“In terms of future work, it will be important to understand how disrupted microexons affect interactions between proteins that are important for nervous system development and function,” Blencowe adds. One of the research programs in his lab is also exploring new therapeutic approaches to target microexon dysregulation.

Furthermore, the scientists believe that the machine learning model they developed can be used to characterize other newly discovered genetic variants and their effects in neurological conditions like schizophrenia and epilepsy where microexons are believed to play a role.

 

The post Newly Identified Microexons Offer Clues to Autism Spectrum Disorder’s Genetic Roots appeared first on GEN – Genetic Engineering and Biotechnology News.

[Comment] Action needed to address HbA1C and weight increases in people initiating antipsychotic medicines

Juan Bazo-Alvarez and colleagues1 present a compelling study investigating trajectories of HbA1C concentration and bodyweight before and after the initiation of second-generation antipsychotic medicines in adults living with severe mental illness (SMI). The findings provide valuable real-world data from electronic health records in England on the metabolic alterations that emerge early after antipsychotic initiation. Several important findings stand out from the study. First, increases in HbA1C concentration were not proportional to weight gain.

Group Transdiagnostic Cognitive Behavioural Therapy for Intolerance of Uncertainty Versus Applied Relaxation

Conditions: Mental Disorders; Mood Disorders; Anxiety Disorders; Generalized Anxiety Disorder

Interventions: Behavioral: Group Transdiagnostic Cognitive Behavioural Therapy for Intolerance of Uncertainty (CBT-IU); Behavioral: Group Transdiagnostic Applied Relaxation (AR)

Sponsors: Medical Research Council Cognition and Brain Sciences Unit; University of Cambridge

Not yet recruiting

Efficacy of artificial intelligence-driven conversational agents (chatbots) for mental health promotion among university students: a systematic review and meta-analysis

BackgroundUniversity students experience substantial mental-health burdens, while access to timely support remains uneven. AI conversational agents may provide low-threshold support, but the evidence base has expanded rapidly and prior reviews have often combined different age groups, intervention types, outcome domains, and comparator conditions.ObjectiveTo evaluate the effects of AI-mediated conversational interventions on depressive and anxiety symptoms in university students, while distinguishing outcome domains, comparator intensity, intervention architecture, and the evidential requirements for standardized post-intervention effect estimation.MethodsWe updated the search in PubMed, Embase, PsycINFO, CENTRAL, and Web of Science to the revised search date and rebuilt an auditable cross-database record ledger. The updated workflow included 3,786 exported records, 451 DOI/PMID duplicates, 41 confirmed title/author duplicates, and 3,294 unique records screened. All title/abstract records completed a two-reviewer screening and consensus chain. Forty-six update-search records entered research-level/full-text assessment. Randomized controlled trials were eligible for causal quantitative synthesis; relevant feasibility, acceptability, usability, and non-comparable controlled studies were retained narratively. Standard post-intervention analyses used Hedges g, REML random-effects models, and Hartung-Knapp adjustment, and were restricted to attributable two-group post-intervention data.ResultsIn the final locked non-active/low-intensity comparator analysis, three depression comparisons favored conversational interventions (k=3; Hedges g=-0.413, 95% CI -0.557 to -0.268; I2 = 0.0%) and four anxiety comparisons also favored them (k=4; Hedges g=-0.435, 95% CI -0.603 to -0.268; I2 = 2.1%). In the separate active conversational-control analysis, two MYLO comparisons did not show a reliable incremental effect for depression (k=2; g=0.165, 95% CI -0.580 to 0.911) or anxiety (k=2; g=0.190, 95% CI -0.556 to 0.937). The evidence base remained small, clinically heterogeneous, and limited by attrition, self-reported outcomes, and uncertainty regarding generalizability.ConclusionsAI conversational interventions may improve depressive and anxiety symptoms relative to non-active or low-intensity comparators in university students, but the certainty of evidence is low and estimates are based on few comparisons. Evidence against active conversational controls is very uncertain. Outcome-domain differences and architecture-related claims should be treated as hypothesis-generating. Secure, consent-based, human-supervised implementation and objective outcome assessment are priorities for future research.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261323382, identifier CRD420261323382.

Australian Digital Mental Health Services for Anxiety and Depression: Meta-Analysis and Comparison Study

Background: Mental Health Online, MindSpot, and THIS WAY UP are 3 Australian Government–funded digital mental health services (DMHSs). These services are free for consumers and deliver a range of (depression and anxiety disorder) psychological assessments and interventions using the internet, with or without clinician support. Objective: This study examines the uptake and effectiveness of these services. Methods: We used 3 data sources to examine the performance of the three DMHSs: (1) aggregated routinely collected service data to describe uptake of the services from January 2013 to December 2021, (2) peer-reviewed and gray literature reporting treatment outcomes, and (3) treatment outcome data from one evaluation conducted by Mental Health Online. The second and third data sources were used to analyze the effectiveness of the DMHSs compared to other mental health treatment programs (Australian primary, public, and low-intensity mental health care; UK stepped psychological care). We generated pooled mental health symptom (Cohen ) effect sizes for each service’s clinician-supported and self-directed treatments and compared those with effect sizes we calculated for the alternative treatment programs. Results: The 3 DMHSs offered care to more than 282,000 consumers and therefore contributed to improving overall access to mental health care in Australia. Clinician-supported online treatment significantly improved the mental health of consumers who use these services (Mental Health Online, Cohen =0.95; MindSpot, Cohen =1.42; and THIS WAY UP, Cohen =1.04), and self-directed treatment by Mental Health Online produced a moderate reduction (Cohen =0.59) in anxiety disorder severity ratings. Clinician-supported treatments produced improvements in mental health symptoms that are close or equivalent to most (face-to-face, phone, and stepped or symptom severity–matched mental health care) comparison treatments examined. Conclusions: Mental Health Online, MindSpot, and THIS WAY UP are producing clinically significant improvement for consumers experiencing psychological distress and anxiety and depression symptoms. The magnitude of improvement produced by clinician-supported treatment is comparable with more resource-intensive face-to-face treatment options. Heterogeneity in the magnitude of improvements produced by the 3 DMHSs (and comparator interventions across levels of clinical need) indicates that findings should be interpreted with caution, particularly in relation to the populations for whom DMHSs may be most appropriate.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/ddd844e9a62d6a34e5a9a1339f8c7d62" />

Effectiveness of Chatbots in Mental Health Screening and Assessment: Systematic Review

Background: Mental health disorders affect 970 million people globally; yet, over 50% do not access timely evaluation due to structural barriers and professional shortages. Chatbots and AI-based conversational agents have emerged as promising tools for mental health screening and assessment. Objective: This study systematically evaluated the effectiveness, accuracy, reliability, and acceptability of chatbots and AI-based conversational agents for mental health screening and assessment in adults. Methods: Systematic search conducted in May 2025 across PubMed/MEDLINE, PsycINFO, Scopus, and Web of Science (2019‐2025), following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Eligible studies evaluated chatbots or AI for mental health screening/assessment in adults (≥18 y). Risk of bias was assessed using appropriate tools (Risk of Bias 2, Quality Assessment of Diagnostic Accuracy Studies-2, Joanna Briggs Institute checklists, and Mixed Methods Appraisal Tool). This systematic review was registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD420251072392). Results: Eighteen studies (2021‐2025) were included, with samples ranging from 20 to 3902 participants. Rule-based chatbots demonstrated high reliability (Cronbach α >0.85) and good acceptability (Acceptability of Intervention Measure >19/25). Generative models (large language models) achieved sensitivities of 0.84 to 0.93 and specificities of 0.80 to 0.96 for depression and anxiety, with correlations up to =0.96 with expert clinicians in suicide risk assessment. Hybrid approaches combining large language models with machine learning achieved exceptional performance for cognitive impairment (-score of 92.1%, specificity of 99.6%). Most studies reported high user satisfaction (≥70%), although barriers existed among older populations. Methodological quality was heterogeneous with a moderate risk of bias in critical dimensions. Conclusions: Chatbots and AI conversational agents demonstrate clinically relevant performance in mental health screening and assessment. However, safe implementation requires clear clinical protocols, professional supervision, integration with electronic health records, and active mitigation of algorithmic bias. These technologies should complement rather than replace clinical judgment. Trial Registration: PROSPERO CRD420251072392; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251072392

Trauma-informed psychological support alongside long-acting injectable buprenorphine: clients’ perspectives on the Buvidal psychological support service (BPSS) pilot in Wales

BackgroundOpioid use disorder (OUD) is associated with persistent drug use, high relapse rates, and significant morbidity, mortality, and psychosocial harm. While Long-Acting Injectable Buprenorphine (LAIB), marketed as Buvidal, offers improved pharmacological management over traditional opioid substitution therapy (OST), the mental clarity provided by LAIB often surfaces unresolved trauma and mental health needs. Integrating trauma-informed psychological care alongside pharmacological intervention is increasingly recognized as critical to optimize recovery outcomes for individuals with co-occurring psychiatric co-morbidities and substance use disorder.ObjectiveThis evaluation aimed to explore client experience of the Buvidal Psychological Support Service, a tiered trauma-informed psychological service, piloted to support individuals with OUD receiving LAIB in Wales, UK.MethodsQualitative data were derived from nine semi-structured interviews with BPSS service users, exploring their experiences, perceived impacts, and recovery journeys through reflexive thematic analysis.ResultsFindings indicated the transition to LAIB was often transformative but exposed trauma and emotional difficulties previously masked by substance use, making the availability of timely psychological support critical for maintaining abstinence and wellbeing. Clients valued the BPSS’s rapid access, continuity, person-centered care and non-judgmental ethos, reporting enhanced agency, emotional regulation, and social reintegration. Relapse prevention was strongly linked to psychological support alongside pharmacological treatment.ConclusionThe findings suggest that participants experienced BPSS as a valuable adjunct to LAIB, particularly where increased mental clarity brought trauma-related and emotional difficulties into focus. The pilot highlights the potential value of integrating trauma-informed psychological support within LAIB pathways, while further evaluation is needed to assess transferability and longer-term outcomes.

STAT+: Pharmalittle: We’re reading about Novo plans to expand its pipeline, early Alkermes ADHD data, and more

Hello there and welcome to a new week. STAT reporter Andrew Joseph here in London filling in for Mr. Pharmalot for the day. Before we get to the headlines, an extra dose of encouragement to check out all the great pieces that STAT has to offer today, from Reed Jobs opining on the NIH budget to our new trust-in-science reporter Nick Florko outlining his own experience grappling with, as he puts it, “how frustrating it is to realize that modern medicine does not have all the answers.” Now to those headlines. … 

Novo Nordisk is seeking to assure investors that it can regain its momentum in the coming years, outlining plans to expand its pipeline and find new products that it could sell more like consumer goods than traditional medicines, building off what’s occurring with its obesity treatments, STAT shares. At the company’s capital markets day in London, CEO Mike Doustdar said Novo would launch at least five multi-blockbusters by 2030 and deliver revenue growth on par with other major pharma firms. He also presented a strategy that involved investing more in disease areas outside diabetes and obesity and said the company “will be more active within business development,” an acknowledgment of investors’ concerns that Novo was too reliant on its landmark GLP-1 drugs and needed to develop other products.

Drugs called orexin agonists have been hailed for their ability to treat rare sleep disorders, but with new data, Alkermes is showing for the first time that the new class of therapies may benefit people with ADHD, STAT writes. In a randomized Phase 1 study, the company’s new drug, called ALKS 7290, was well tolerated and showed a signal of efficacy. Participants in the study started with a median score of 39 on a diagnostic known as the Adult ADHD Investigator Symptom Rating Scale, indicating that they had moderate to severe symptoms. After two weeks, those taking a high dose of 50 milligrams of ALKS 7290 experienced a 19-point reduction on the scale, indicating that their symptoms had become mild.

Continue to STAT+ to read the full story…

A comparative study of traditional Chinese mind-body therapies on sleep quality, mental health, and quality of life in patients with sleep disorders: a network meta-analysis based on randomized controlled trials

BackgroundSleep disorders are a common clinical condition characterized primarily by difficulty falling asleep, trouble maintaining sleep, and impaired daytime functioning, with a high prevalence among adults. This condition can lead to a persistent decline in sleep quality, trigger mental health issues such as anxiety and depression, and ultimately reduce overall quality of life. Traditional Chinese mind-body exercise therapies are considered potentially effective non-pharmacological interventions due to their low risk, high accessibility, and dual mind-body regulation effects. However, the relative efficacy of different exercise therapies on sleep quality, mental health, and quality of life in patients with sleep disorders remains unclear. This study employed a web-based meta-analysis to systematically evaluate the effects of three interventions—Tai Chi, Baduanjin, and Tai Chi combined with transcranial magnetic stimulation—on three outcome measures and to rank their efficacy, aiming to provide evidence-based support for clinical decision-making.MethodsThis study conducted a systematic search of the PubMed, Embase, Web of Science, Cochrane, EBSCO, and CNKI databases and included 18 randomized controlled trials that met the inclusion criteria. Outcome measures included sleep quality, mental health, and quality of life. A network meta-analysis using a random-effects model was performed to calculate standardized mean differences and 95% confidence intervals, and the cumulative ranking probability curve area was used to rank the efficacy of the interventions.ResultThis study included a total of 18 randomized controlled trials. Regarding sleep quality, TCCWTMS yielded the best results (SMD = −1.15, 95% CI [−2.07, −0.22]). Regarding mental health, only the Tai Chi intervention achieved statistical significance (SMD = 0.64, 95% CI [0.07, 1.21], P = 0.03); although Baduanjin ranked first in the SUCRA ranking (92.6%), pairwise comparisons did not reach statistical significance (P = 0.07). Regarding quality of life, both Tai Chi (SMD = -0.47, 95% CI [-0.71, -0.24], P < 0.0001) and Baduanjin (SMD = -0.57, 95% CI [-0.91, -0.23], P = 0.001) were significantly effective. There were significant heterogeneous differences in the efficacy of the three interventions across different outcome measures.ConclusionThis study indicates that the TCCWTMS is the most effective intervention for improving sleep quality in patients with sleep disorders. Regarding quality of life, both Baduanjin and Tai Chi demonstrated significant effects, with Baduanjin showing superior efficacy. Regarding mental health, the current evidence is insufficient to determine the optimal intervention strategy. There are significant differences in the efficacy of the three interventions across various outcome measures; clinical decisions can be made by selecting the appropriate intervention based on the patient’s score needs.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261415202, identifier CRD420261415202.

Efficacy of mindfulness-based interventions for children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis

Background and objectiveAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood. Although mindfulness-based interventions (MBIs) have been proposed as promising non-pharmacological treatments, evidence regarding their efficacy in children and adolescents with ADHD remains inconsistent.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Scopus, and Web of Science was conducted up to December 31, 2025, supplemented by manual screening of reference lists. Eligible studies were randomized controlled trials (RCTs) in which mindfulness-based intervention was the primary treatment for children or adolescents with ADHD, even alongside other therapies. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Cochrane RoB 1.0 tool. Meta-analyses employed random-effects or fixed-effects models based on heterogeneity.ResultsFourteen randomized controlled trials were included in the meta-analysis. The results demonstrated that MBIs significantly alleviated core ADHD symptoms in children (standardized mean difference (SMD) = -1.30; 95% confidence interval (95% CI) [-2.14, -0.45]; p = 0.003). However, the heterogeneity was considerably high (I² = 91%), and publication bias could not be excluded (as suggested by funnel plot/Egger’s test, if available). Regarding neurocognitive functions, MBIs showed potential benefits in improving attention network function (SMD = 0.44; 95% CI [0.01, 0.87]; p = 0.04; I² = 88%) and executive function (SMD = 0.45; 95% CI [0.02, 0.88]; p = 0.04; I² = 84%), though the high heterogeneity (I² > 75%) and possible publication bias warrant cautious interpretation. No significant effects were observed on emotional problems, social problems, externalizing behavioral problems (including oppositional defiant, disruptive, and aggressive behaviors), or mindfulness skills.ConclusionsThis systematic review suggests that MBIs may improve core ADHD symptoms and neurocognitive functions (including attention and executive functions) in children and adolescents. Yet, effects on emotional health, social relationships, externalizing behaviors, and mindfulness skills remain inconclusive. While suggesting that MBIs hold promise as a potential adjunctive intervention alongside standard treatments, significant heterogeneity underscores the need for further high-quality research to confirm these therapeutic benefits.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251171407, identifier CRD420251171407.