Infantile Autism: Adult Outcome/ Plus Four New Abstracts

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April 11, 2001 Search www.feat.org/search/news.asp

Also: * Amygdala Damage Reveals Data on Theory of Mind and

Executive Function

* Serotonin and a Boy with Asperger's

* Asperger, ADHD, and Reading and Writing Disorder

* On Reward Deficiency Syndrome with Compulsion,

Impulsivity and Addiction

* A Call for Help For Photos Outside the US

Infantile Autism: Adult Outcome

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11291011 & dopt=Abstract

1: Semin Clin Neuropsychiatry 2000 Jul;5(3):164-170 Korkmaz B.

Istanbul University, Istanbul, Turkey.

Although the core features of autism do not change qualitatively, a

gradual overall symptomatic improvement including an increase in adaptive

skills is observed in most cases with age. Follow-up studies show that the

diagnostic features, the differential diagnosis, and clinical problems of

adult autistics differ substantially from that of autistic children.

The differential diagnosis of older autistics include personality

disorders, learning disabilities, and mood disorder. Depression, epilepsy,

and behavioral problems such as aggression and agitation may be major

clinical problems during adolescence. The early indicators of a better

outcome include a higher level of IQ and language.

Among the neuropsychological variables, measures of flexibility and

cognitive shift are important as prognostic factors. Early behavioral and

educational intervention may especially increase the adaptive skills of the

patients and promote the in-family communication.

The outcome studies of autism are particularly helpful in addre ssing

the appropriate and most effective programs of remediation for adult

autistics. Copyright 2000 by W.B. Saunders Company

PMID: 11291011 [PubMed - as supplied by publisher]

* * *

Amygdala Damage Reveals Data on Theory of Mind and Executive Function

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11157556 & dopt=Abstract

1: Brain 2001 Feb;124(Pt 2):287-98 Related Articles, Books, LinkOut

Dissociation between 'theory of mind' and executive functions in a

patient with early left amygdala damage.

Fine C, Lumsden J, Blair RJ.

Institute of Cognitive Neuroscience and Department of Psychology,

University College London, UK.

There have been recent suggestions that the amygdala may be involved

in the development or mediation of 'theory of mind'. We report a patient,

B.M., with early or congenital left amygdala damage who, by adulthood, had

received the psychiatric diagnoses of schizophrenia and Asperger's syndrome.

We conducted a series of experimental investigations to determine

B.M.'s cognitive functioning. In line with his diagnoses, B.M. was found to

be severely impaired in his ability to represent mental states.

Following this, we conducted a second series of studies to determine

B.M.'s executive functioning.

In the literature, there have been frequent claims that theory of mind

is mediated by general executive functioning. B.M. showed no indication of

executive function impairment, passing 16 tests assessing his ability to

inhibit dominant responses, create and maintain goal-related behaviours, and

temporally sequence behaviour.

The findings are discussed with reference to models regarding the role

of the amygdala in the development of theory of mind and the degree of

dissociation between theory of mind and executive functioning.

We conclude that theory of mind is not simply a function of more

general executive functions, and that executive functions can develop and

function on-line, independently of theory of mind. Moreover, we conclude

that the amygdala may play some role in the development of the circuitry

mediating theory of mind.

PMID: 11157556

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* * *

Serotonin and a Boy with Asperger's

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11248465 & dopt=Abstract

1: Brain Dev 2001 Mar;23(2):135-7

Alleviation of sleep disturbance and repetitive behavior by a selective

serotonin re-uptake inhibitor in a boy with Asperger's syndrome.

Furusho J, Matsuzaki K, Ichihashi I, Satoh H, Yamaguchi K, Kumagai K.

Department of Pediatrics, School of Medicine, Showa University, 1-5-8

Hatanodai Shinagawa-ku, 142-8666, Tokyo, Japan

An 8 year-old boy with Asperger's syndrome had difficulties in

communicating with his teachers and classmates. He occasionally stole out of

the classroom. He could not sleep at night recalling his awful experience

and kept crying every night and refused to go to school.

The treatment with fluvoxamine was started at the dose of 25 mg daily.

Four weeks after the treatment, his repetitive behavior and hyperactivity

decreased and night crying diminished.

Although he still has difficulties in communicating with others, he is

now able to attend extra-curricular classes in a private school.

Fluvoxamine, a selective serotonin re-uptake inhibitor that has been mainly

used for patients with depression and obsessive-compulsive disorder, might

be effective for compulsive symptoms and sleep disturbance of patients with

pervasive developmental disorders.

PMID: 11248465

* * *

Asperger, ADHD, and Reading and Writing Disorder

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11263686 & dopt=Abstract

1: Dev Med Child Neurol 2001 Mar;43(3):165-71 Related Articles, Books,

LinkOut

Neurocognitive stability in Asperger syndrome, ADHD, and reading and writing

disorder: a pilot study.

Nyden A, Billstedt E, Hjelmquist E, Gillberg C.

Department of Child and Adolescent Psychiatry, Goteborg University, Sweden.

Boys with Asperger syndrome (n=20), attention-deficit-hyperactivity

disorder (n=20), and reading and writing disorder (n=20) were followed up

and retested on several neuropsychological measures 1 to 2 years after

initial assessments. Wechsler Intelligence Scale for Children (WISC-III)

Full Scale, Verbal, and Performance IQ scores remained stable for all

diagnostic groups. Kaufman factors and 'fluid' and 'crystallized' abilities

were also stable measures.

Subtest stability over time, was slightly more variable. There was a

tendency for the group with Asperger syndrome to deteriorate over time with

respect to logical reasoning abilities. Measures of executive

function/attention ('go-no-go' and 'conflict' tests) showed good test-retest

stability in all diagnostic groups. This is the first study of its kind.

PMID: 11263686 [PubMed - indexed for MEDLINE]

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On Reward Deficiency Syndrome with Compulsion, Impulsivity and Addiction

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11280926 & dopt=Abstract

Reward deficiency syndrome: a biogenetic model for the diagnosis and

treatment of impulsive, addictive, and compulsive behaviors.

1: J Psychoactive Drugs 2000 Nov;32 Suppl:i-iv, 1-112 Related Articles,

Books

Blum K, Braverman ER, Holder JM, Lubar JF, Monastra VJ, D, Lubar JO,

Chen TJ, Comings DE

Department of Biological Sciences, University of North Texas, Denton, Texas,

USA.

The dopaminergic system, and in particular the dopamine D2 receptor,

has been implicated in reward mechanisms. The net effect of neurotransmitter

interaction at the mesolimbic brain region induces " reward " when dopamine

(DA) is released from the neuron at the nucleus accumbens and interacts with

a dopamine D2 receptor.

" The reward cascade " involves the release of serotonin, which in turn

at the hypothalmus stimulates enkephalin, which in turn inhibits GABA at the

substania nigra, which in turn fine tunes the amount of DA released at the

nucleus accumbens or " reward site. "

It is well known that under normal conditions in the reward site DA

works to maintain our normal drives. In fact, DA has become to be known as

the " pleasure molecule " and/or the " antistress molecule. "

When DA is released into the synapse, it stimulates a number a DA

receptors (D1-D5) which results in increased feelings of well-being and

stress reduction.

A consensus of the literature suggests that when there is a

dysfunction in the brain rew ard cascade, which could be caused by certain

genetic variants (polygenic), especially in the DA system causing a

hypodopaminergic trait, the brain of that person requires a DA fix to feel

good. This trait leads to multiple drug-seeking behavior.

This is so because alcohol, cocaine, heroin, marijuana, nicotine, and

glucose all cause activation and neuronal release of brain DA, which could

heal the abnormal cravings. Certainly after ten years of study we could say

with confidence that carriers of the DAD2 receptor A1 allele have

compromised D2 receptors.

Therefore lack of D2 receptors causes individuals to have a high risk

for multiple addictive, impulsive and compulsive behavioral propensities,

such as severe alcoholism, cocaine, heroin, marijuana and nicotine use,

glucose bingeing, pathological gambling, sex addiction, ADHD, Tourette's

Syndrome, autism, chronic violence, posttraumatic stress disorder,

schizoid/avoidant cluster, conduct disorder and antisocial behavior.

In order to explain the breakdown of the reward cascade due to both

multiple genes and environmental stimuli (pleiotropism) and resultant

aberrant behaviors, Blum united this hypodopaminergic trait under the rubric

of a reward deficiency syndrome.

PMID: 11280926

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A Call for Help For Photos Outside the US

[From Cale of Unlocking Autism, www.unlockingautism.org.]

Unlocking Autism, the organization helping to put on the Washington DC

Autism conference and rally need helpers from outside the US. The main

project needing assistance at this time is the collecting of photographs of

those of us in the spectrum for our picture display boards. The approx. 2

meters x 1 meter boards, each displaying 42 photos, are heartrending to say

the least. They get attention and raise awareness when people see how very

precious our kids are and how handsome our adults are.

If you are in a country outside the United States and would like to

work with us, please email me at Nancale@... and pass the word.

All photos must be in photo print, not digital form. Each must be

accompanied by a parental release form.

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Lenny Schafer, Editor PhD Ron Sleith Kay Stammers

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