Why Fever Helps Autism: A New Theory

[Guest guest]

Blows my mind that they will believe the parents on other things, like the

fact that the symptoms of autism go away at the onset of fever (as well they

SHOULD believe them), but they refuse to believe the thousands upon

thousands of parents who say they watched their child regress into autism

after a vaccine.

Why Fever Helps Autism: A New Theory By *

Kluger*<javascript:void(0)> Tuesday,

Apr. 07, 2009

[image: A doctor treats an autistic child]

A doctor treats an autistic child

Bernard Bisson / Sygma / Corbis

The autism wars go on and on, and the debates go round and round. Is the

number of afflicted kids climbing or are we just overdiagnosing the

condition? If mercury in vaccines isn't the culprit (the metal has been

removed from nearly all of them), then it must be environmental toxins. But

if that's so, why aren't we all showing symptoms?

Too often, what's lost in all the finger-pointing over what's to blame for

the problem is the salient question of how to fix it. A paper just published

in the journal *Brain Research Reviews* is taking a stab at that, suggesting

a brand-new strategy — one that focuses on a very particular part of the

brain. (See pictures of a school for autistic

students.<http://www.time.com/time/photoessays/2006/autismschool/>)

The brain region that drew the attention of the authors is known as the

locus coeruleus, a small knot of neurons located in the brain stem. Not a

lot of high-order processing goes on so deep in the brain's basement, but

the locus coeruleus does govern the release of the neurotransmitter

noradrenaline, which is critical in triggering arousal or alarm, as in the

famed fight-or-flight response. Arousal also plays a role in our ability to

pay attention — you can't deal with the lion trying to eat you, after all,

if you don't focus on it first. And attention, in turn, plays a critical

role in such complex functions as responding to environmental cues and

smoothly switching your concentration from one task to another. Those are

abilities kids with autism lack. (Read a TIME cover story on autism and

vaccines. <http://www.time.com/time/magazine/0,9263,7601080602,00.html>)

Certainly, many other parts of the brain govern concentration and attention,

but the locus coeruleus does one other thing too: it regulates fever.

Generations of parents of autistic kids have reported that when their child

runs a fever, the symptoms of autism seem to abate. When the fever goes

down, the symptoms return. In 2007, a paper in the journal

*Pediatrics*reported on that phenomenon and confirmed that, yes, the

parents'

observations are right. What no one had done before, at least not formally,

was tie it to the locus coeruleus — that is, until Drs. Dominick Purpura and

Mark Mehler of the Albert Einstein College of Medicine published the idea

this week.

" It wasn't an experiment; it was more of a eureka moment, " says Purpura. " We

came to the conclusion that there could only be one system that would both

ameliorate the effects of autism and govern fever. "

It's not often that a mere flash of insight — as opposed to a formal,

controlled study — commands much space in a medical journal, and Purpura and

Mehler readily concede that a good deal of empiricism will have to be

applied to their theory before it can become anything more than that. Still,

they're convinced that the idea deserves attention. If the locus coeruleus

is indeed malfunctioning in autism, the problem could involve hundreds or

even thousands of genes. The researchers are careful to avoid the shooting

war over what damaged those genes, suggesting that environment and toxic

chemicals — but not vaccines — may have a role. They also, tellingly, think

stress is involved.

Stress is thought to have a significant impact on the ability of the locus

coeruleus to regulate noradrenaline properly, and Mehler and Purpura cite an

improbable 2008 study published in the *Journal of Autism and Developmental

Disorders* showing that mothers who lived through a hurricane during their

pregnancy — particularly at the mid-gestational point — had a greater

likelihood of giving birth to an autistic child than other women. " What

would be involved here would be the mother's level of [the stress hormone]

cortisol, " says Purpura. " Between fetus and mother, the placenta acts as a

very good barrier for maternal cortisol, except when the stress is extreme. "

In theory, that blast of stress chemistry could alter the development of the

fetal locus coeruleus, though Purpura is quick to point out that the study

showing how cortisol can make it through the placenta was conducted in

animals, not humans. Nonetheless, one day after their article in *Brain

Research Reviews* was published, the journal

*Psychoneuroendocrinology*published a study linking cortisol imbalance

to Asperger's syndrome, a

condition along the autism spectrum.

The question is, How can any of this be used to help autistic kids? Nobody

recommends inducing fevers to kick-start the locus coeruleus, since that

could lead to all manner of side effects and other ills. Instead, Mehler and

Purpura believe the likeliest answer is in medications that target

noradrenaline brain receptors. " First, we should look at the signaling

pathways in the region of the brain involved, " Purpura says. " Then we could

look at treating the receptor sites with some kind of pharmacotherapy. " For

once, the step that's missing from a proposal is the one that involves

shouting about what's to blame.