When the Ears Speak: Otorhinolaryngological Clues in Autism Spectrum Disorder Anita Silva Brunel Alves, Maria Fernanda Pedro Ebs, Flavia da Silva Daros, Gustavo Zanette Fernandes, Júlio César Claudino dos Santos, Marcelo Rodrigues Masruha, Fabricia Petronilho, Cinara Ludvig Gonçalves Current Developmental Disorders Reports, 2026 Objective of the Review To investigate the otorhinolaryngological manifestations associated with Autism Spectrum Disorder (ASD), exploring how dysfunctions in sleep, hearing, smell, and taste may act as relevant sensory and clinical markers. This review also aims to contextualize these findings within a sensory integration framework and to discuss their clinical relevance beyond isolated peripheral alterations. Recent Findings Recent studies indicate a high prevalence of sleep disturbances (50–80%), auditory hypersensitivity (around 37%), and olfactory and gustatory alterations in children with ASD, influencing food selectivity and social behavior. Sleep disturbances include not only insomnia but also sleep-disordered breathing and may be associated with alterations in melatonin synthesis, serotonergic imbalance, and broader neurochemical dysregulation. Research using both animal and clinical models suggests that dysfunctions in GABAergic and serotonergic systems, as well as abnormal melatonin secretion patterns, contribute to sensory and sleep dysregulation. Auditory abnormalities extend beyond peripheral hearing loss and include central auditory processing differences and hypersensitivity to sound. Advances in combined therapies such as prolonged-release melatonin, cognitive behavioral therapy, and family-based approaches have demonstrated clinical benefits. Summary Integration of current evidence shows that otorhinolaryngological manifestations are frequent and clinically relevant components of ASD, although their causal role remains to be fully elucidated. Early identification of sleep disorders, auditory hypersensitivity, and alterations in taste and smell can support more comprehensive clinical assessment and guide multidisciplinary interventions. Recognizing these dysfunctions within an integrated sensory and neurobiological framework, rather than as isolated findings, may improve clinical care and inform future research on potential sensory markers and intervention strategies.
Brazil’s first national census estimate of autism prevalence: Implications for surveillance and policy in the Global South Júlio César Claudino dos Santos, Luana Stangherlin dos Santos, Cinara Ludvig Gonçalves Autism, 2026 Autism prevalence data remain scarce in low- and middle-income countries. In 2022, Brazil incorporated, for the first time, a specific question on prior medical diagnosis of autism in its national census. Results from the preliminary publication of the 2022 Census sample, released in 2025, indicated that 1.2% of the population, approximately 2.42 million individuals, reported a diagnosis of autism. Among boys aged 5 to 9 years, prevalence reached 2.6%, declining to 1.6% among adolescents and 0.3% among adults aged 30 years or older. Although based on self-reported diagnosis, these data provide the first nationwide population estimate of autism in Brazil. Comparisons with U.S. figures from the Autism and Developmental Disabilities Monitoring Network should be interpreted cautiously given methodological differences. The observed age gradient suggests potential historical under-identification in older cohorts. Regional variation further highlights differences in diagnostic patterns across the country. The inclusion of autism in Brazil’s national census represents an important step toward strengthening surveillance, research, and policy planning in low- and middle-income settings. Lay Abstract In 2022, Brazil included, for the first time, a specific question on medical diagnosis of autism in its national census, as mandated by federal law. Results from the 2025 preliminary publication of the Census sample showed that 1.2% of the population reported a prior medical diagnosis of autism, totaling about 2.42 million people. Among boys aged 5 to 9 years, prevalence reached 2.6%, while rates were lower among adolescents and adults. This age pattern may reflect historical differences in access to diagnosis. Regional variation was also observed across states. Including autism in Brazil’s national census represents a major step forward for epidemiological monitoring and policy planning in Latin America.
Auditory Processing Disorder in childhood: a critical appraisal of diagnostic validity, functional assessment, and interdisciplinary practice Júlio César Claudino dos Santos, Marco Antonio Arruda, Marcelo Rodrigues Masruha Frontiers in Human Neuroscience, 2026 Auditory Processing Disorder (APD) refers to listening difficulties in individuals with normal hearing thresholds but impaired processing of auditory information. Despite decades of research, its diagnostic validity in childhood remains highly debated. This narrative review critically examines the conceptual foundations, methodological limitations, and clinical implications of APD, with the goal of promoting more functional and interdisciplinary approaches to auditory assessment. National and international literature, including professional guidelines, systematic reviews, and observational studies, was reviewed to analyze diagnostic definitions, criteria, assessment instruments, overlap with other neurodevelopmental disorders, and implications for clinical decision-making. The findings reveal considerable heterogeneity across diagnostic criteria and testing protocols, leading to wide variability in reported prevalence. Many assessment tools were originally designed for adults and lack developmental calibration or psychometric validation for children, which limits diagnostic reliability. In addition, there is significant overlap between APD and other neurodevelopmental conditions such as developmental language disorder, dyslexia, attention-deficit/hyperactivity disorder, and learning difficulties, which challenges the specificity and clinical validity of the construct. Although international guidelines recognize these inconsistencies, their implementation in clinical practice remains fragmented, producing variable and sometimes inconclusive diagnostic outcomes. Current evidence provides limited support for APD as a distinct diagnostic entity in childhood. A shift toward functional, ecologically valid, and interdisciplinary assessment is needed. Integrating behavioral, cognitive, linguistic, and neurophysiological measures may improve the ability to differentiate developmental variability from genuine auditory dysfunction. Such an approach emphasizes functionality over categorization, supports ethical and evidence-based clinical practice, and enhances the precision and effectiveness of interventions for children with listening difficulties.
The silent saboteur: oxidative stress and the path to cognitive dysfunction Tulia Fernanda Meira Garcia, Janaína Aparecida Favero Desio, Everton Ferreira de Souza, Silvana Fátima Costa Henkes, Luana Stangherlin Santos, Julcileia de Carvalho Muenho, Cinara Ludvig Gonçalves, Júlio César Claudino dos Santos Neurodegenerative Disease Management, 2025
Screen use in children – two sides of the coin: a critical narrative review Everton Ferreira de Souza, Rafael Antônio Vicente Lacerda, Janaína Aparecida Favero Desio, Camila Marciele Kammers, Silvana Henkes, Natasha Ferraz da Paixão Ribeiro, Monique Freitas de Sá, Driele Martins da Silva, Anna Carolina de Oliveira Resende Teixeira, Júlio César Claudino dos Santos Dementia E Neuropsychologia, 2025
Addressing treatment hurdles in adults with late-onset attention-deficit/hyperactivity disorder: a detailed case report Sandra Isamar da Silva Leandro, Kelvin Corrêa Miranda Alves, Francisco Ícaro Silvério de Oliveira, Lavínnya Yáskara de Aquino Matoso, Beatriz Mazzer Zamoner, Thaís Malta Romano, Karoliny de Lima Nardin, Fernanda Susy Bessa Menezes Cavalcante, Paulo Guilherme Müller, Bruna Capello Gervásio, Camilla Teixeira Pinheiro Gusmão, Júlio César Claudino dos Santos Egyptian Journal of Neurology Psychiatry and Neurosurgery, 2024
The Molecular Impact of Glucosylceramidase Beta 1 (Gba1) in Parkinson’s Disease: a New Genetic State of the Art Júlio César Claudino dos Santos, Gabriela Braga Cabrera Mano, André Rodrigues da Cunha Barreto-Vianna, Tulia Fernanda Meira Garcia, Aline Vieira de Vasconcelos, Caio Sérgio Gomes Sá, Sarah Lopes de Souza Santana, Ana Gabriela Ponte Farias, Beatriz Seimaru, Micael Porto Portela Lima, João Vitor Caetano Goes, Camilla Teixeira Pinheiro Gusmão, Howard Lopes Ribeiro Junior Molecular Neurobiology, 2024
Reversible cerebral vasoconstriction syndrome: literature review Michelle Zonkowski Ribas, Gabriela Ferreira Paticcié, Sara Diógenes Peixoto de Medeiros, Arthur de Oliveira Veras, Felipe Micelli Noleto, Júlio César Claudino dos Santos Egyptian Journal of Neurology Psychiatry and Neurosurgery, 2023
The role of gut-brain axis in a rotenone-induced rat model of Parkinson's disease Júlio César Claudino dos Santos, Conceição da Silva Martins Rebouças, Leandro Freitas Oliveira, Fabrizio dos Santos Cardoso, Tyciane de Souza Nascimento, Alfaete Vieira Oliveira, Micael Porto Portela Lima, Geanne Matos de Andrade, Gerly Anne de Castro Brito, Glauce Socorro de Barros Viana Neurobiology of Aging, 2023
Impact of dysexecutive syndrome in quality of life in Alzheimer disease: What we know now and where we are headed Michelle Zonkowski Ribas, Gabriela Ferreira Paticcié, Felipe Micelli Noleto, Luís Guilherme Ramanzini, Arthur de Oliveira Veras, Renato Dall'Oglio, Luciano Barroso de Albuquerque Filho, Jaiurte Gomes Martins da Silva, Micael Porto Portela Lima, Beatriz Esmeraldo Teixeira, Gabrielle Nunes de Sousa, André Felipe Costa Alves, Lara Maria Fujita Vieira Lima, Camilla Costa Sallem, Tulia Fernanda Meira Garcia, Isadora Mônica Ponte de Oliveira, Raul Sancho de Carvalho Rocha, Mikaio de Sousa Jucá, Sarah Távora Barroso, Júlio César Claudino dos Santos Ageing Research Reviews, 2023
Cerebral cryptococcoma successfully treated by isavuconazole in an immunocompetent patient: A case report Luis Guilherme Ramanzini, Sara Diógenes Peixoto de Medeiros, Lara Maria Fujita Vieira Lima, Marcéu Veríssimo Ramos dos Santos, Elizeu Alves Herbster, Guilherme Dourado Aragão Sá Araújo, Victor Oliveira Araújo, Jessica Maria Bezerra Braga, Diogo Pasquali Nones, Júlio César Claudino dos Santos Radiology Case Reports, 2023
Reversible cerebral vasoconstriction syndrome associated with probable drug poisoning Arthur de Oliveira Veras, Felipe Micelli Noleto, Michelle Zonkowski Ribas, Gabriela Ferreira Paticcié, Raphael Palomo Barreira, Beatriz Medeiros Correa, Thomas Zurga Markus Torres, Vanessa Moraes Rossette, Natalia Figueiredo Miranda, Clara Kimie Miyahira, Júlio César Claudino dos Santos Radiology Case Reports, 2023
Premotor, nonmotor and motor symptoms of Parkinson's Disease: A new clinical state of the art Ana Beatriz Ramalho Leite Silva, Roger Wilson Gonçalves de Oliveira, Guilherme Pinheiro Diógenes, Marina Feitosa de Castro Aguiar, Camilla Costa Sallem, Micael Porto Portela Lima, Luciano Barroso de Albuquerque Filho, Sara Diógenes Peixoto de Medeiros, Lucas Lopes Penido de Mendonça, Paulo Cesar de Santiago Filho, Diogo Pasquali Nones, Pamella Mendes Martiniano da Silva Cardoso, Michelle Zonkowski Ribas, Stéfani Lara Galvão, Gabriel Felipe Gomes, Amanda Rebouças Bezerra de Menezes, Nayla Lima dos Santos, Victor Monteiro Mororó, Fairane Sousa Duarte, Júlio César Claudino dos Santos Ageing Research Reviews, 2023
Ocular contrapulsion followed by ipsipulsion in Wallenberg syndrome: The first case report in literature Euldes Mendes Junior, Fernando Magri, Ana Beatriz Ramalho Leite Silva, Guilherme Pinheiro Diógenes, Marina Feitosa de Castro Aguiar, Lucas Bessa, Luciano Barroso de Albuquerque Filho, Sara Diógenes Peixoto de Medeiros, Luiz Aldir da Silva, Tiago Antoniol, Leandro Freitas Oliveira, Júlio César Claudino dos Santos Radiology Case Reports, 2022
Tumefactive demyelination after covid-19 successfully treated with betainterferon 1A Victor Oliveira Araújo, Paulo Filho Soares Marcelino, Samuel Ramos Rabelo, Fabio Antonio Serra de Lima Junior, Vitor Gil Gonçalves Teixeira, Roberto Rocha Eisele, Afonso Rocha Eisele, João Pedro Serenario Ferreira de Carvalho, Luciano Barroso de Albuquerque Filho, Sara Diógenes Peixoto de Medeiros, Leandro Freitas Oliveira, Julio Cesar Claudino dos Santos, Euldes Mendes Júnior Radiology Case Reports, 2022
Vertical one-and-a-half syndrome in a patient with pecheron artery ischemia: A case report Daniel Buzaglo Gonçalves, Raphael Palomo Barreira, Thomas Zurga Markus Torres, Beatriz Medeiros Correa, Vanessa Moraes Rossette, Thiago da Cruz Marques, Fernando Pierini Costa, Bruna Guimarães Dutra, Euldes Mendes Júnior, Álvaro Rivelli Moreira, Júlio César Claudino dos Santos Radiology Case Reports, 2021
The role of microglia in prion diseases and possible therapeutic targets: a literature review Ananda Sampaio Lamenha Falcão de Melo, Juliana Louise Dias Lima, Maria Carolina Silva Malta, Natália França Marroquim, Álvaro Rivelli Moreira, Isabelle de Almeida Ladeia, Fabrizio dos Santos Cardoso, Daniel Buzaglo Gonçalves, Bruna Guimarães Dutra, Júlio César Claudino dos Santos Prion, 2021
