1. Anderson JS, Lange N, Froehlich A, Dubray MB, Druzgal TJ, Froimowitz MP, Alexander AL, Bigler ED, Lainhart JE. {{Decreased Left Posterior Insular Activity during Auditory Language in Autism}}. {AJNR Am J Neuroradiol};2009 (Sep 12)
BACKGROUND AND PURPOSE: Individuals with autism spectrum disorders often exhibit atypical language patterns, including delay of speech onset, literal speech interpretation, and poor recognition of social and emotional cues in speech. We acquired functional MR images during an auditory language task to evaluate systematic differences in language-network activation between control and high-functioning autistic populations. MATERIALS AND METHODS: Forty-one right-handed male subjects (26 high-functioning autistic subjects, 15 controls) were studied by using an auditory phrase-recognition task, and areas of differential activation between groups were identified. Hand preference, verbal intelligence quotient (IQ), age, and language-function testing were included as covariables in the analysis. RESULTS: Control and autistic subjects showed similar language-activation networks, with 2 notable differences. Control subjects showed significantly increased activation in the left posterior insula compared with autistic subjects (P < .05, false discovery rate), and autistic subjects showed increased bilaterality of receptive language compared with control subjects. Higher receptive-language scores on standardized testing were associated with greater activation of the posterior aspect of the left Wernicke area. A higher verbal IQ was associated with greater activation of the bilateral Broca area and involvement of the prefrontal cortex and lateral premotor cortex. CONCLUSIONS: Control subjects showed greater activation of the posterior insula during receptive language, which may correlate with impaired emotive processing of language in autism. Subjects with autism showed greater bilateral activation of receptive-language areas, which was out of proportion to the differences in hand preference in autism and control populations.
2. Armand-Branger S, Poisson N, Gaudoneix-Taieb M, Ramos O. {{[Pharmaco-therapeutic evaluation of medical treatments of adult autistics and multi-handicapped patients in a public mental health unit.]}}. {Encephale};2009 (Sep);35(4):370-376.{{Les traitements psychotropes prescrits dans un etablissement public de sante mentale accueillant des personnes atteintes d’autisme et des polyhandicapes}}.
INTRODUCTION: This paper presents a survey conducted on a population of multi-handicapped patients and autistic adults hospitalised long term in the Paul Guiraud mental health Hospital in Villejuif France. OBJECTIVE: The aim of the survey is to deepen the knowledge of the treatments for this specific population. METHODS: A preliminary medical investigation was conducted on the population in order to target different groups of patients. Once patients had listed and defined their medical needs, prescriptions were analysed to assess whether clinical characteristics had an impact. Thus, the analysis of treatments was carried out for the 57 patients (14% of the hospital population) and compared to other investigations conducted on the population commonly hospitalised in Psychiatry. The evaluation of the treatments was obtained through a questionnaire which enabled us to target the therapeutical goals and to obtain additional clinical information. The drugs with a high rate of prescription were compared between the autistic group and the multi-handicapped group. The important comorbidity and the multi-symptomatology of autism often involves the polymedication of these patients (8+/-0.8 drugs per patient). RESULTS: Fifty per cent of the treatments are referred to as somatic treatments. The average length of stay (22.3 years) and the high average age are aggravating factors for polymedication. The average number of psychotropic molecules also appears higher than in the populations studied in the literature. The heterogeneity of clinical forms of autism and polyhandicap encourages prescribers to multidrug therapy. The prescriptions usually remain stable (17.5% of psychiatric treatment is adapted and only 7% of somatic treatment). Epilepsy and constipation are the main treated somatic disorders. In psychiatry, the oral route is the privileged route of administration (81% of treatments) with, more specifically, the use of drinkable solutions for the psychiatric treatment. Neuroleptic drugs are the basic treatment of these patients (82% of prescriptions). The aim of the prescription of neuroleptics is essentially to obtain behavioural or antipsychotic sedation. Cyamemazin is the most prescribed drug (46% of neuroleptic prescriptions), mainly for its anxiolytic effects. Co-prescription is frequent (55.3%) and corresponds to 53% of co-prescriptions of an association of phenothiazine and butyrophenone. Doses are high, which implies the prescription of treatments against the neuroleptics side-effects (86% of patients have such a prescription). The rate of prescriptions of the other psychotropic drugs (hypnotics, anxiolytics, etc.) is approximately equivalent between our population and the « classical » hospitalised psychiatric population, except for antidepressants (7% of prescriptions) because the differential diagnosis is difficult in these patients. Nearly 60% of patients have prescriptions of hypnotic drugs. However, this figure is tempered by prescriptions of drugs « if necessary » in two-thirds of the cases. Finally, only 30% of patients have systematic hypnotic prescriptions. CONCLUSION: Although autistics are clinically different from multi-handicapped patients, no statistically significant difference was demonstrated in their prescriptions, which implies a similar pharmacological management. It is difficult to clearly distinguish these two populations only according to the type of drugs used and the doses prescribed.
3. Becker KG, Schultz ST. {{Similarities in features of autism and asthma and a possible link to acetaminophen use}}. {Med Hypotheses};2009 (Sep 10)
Autism and autism spectrum disorders are enigmatic conditions that have their origins in the interaction of genes and environmental factors. In this hypothesis, genes statistically associated with autism are emphasized to be important in inflammation and in innate immune pathways, including pathways for susceptibility to asthma. The role of acetaminophen (paracetamol) in an increased risk for asthma is described and a possible similar link to an increased risk for autism is suggested.
4. Bourreau Y, Roux S, Gomot M, Barthelemy C. {{[Repetitive and restricted behaviours (RRB) in autism: Clinical evaluation.]}}. {Encephale};2009 (Sep);35(4):340-346.{{Comportements repetes et restreints (C2R) dans les troubles autistiques : evaluation clinique}}.
INTRODUCTION: Restricted and repetitive behaviours (RRB) represent a common problem throughout the autistic spectrum. They comprise a wide range of behavioural manifestations that persist over time and resist therapeutics. Furthermore, degrees of heterogeneity have been reported in the clinical expression of autistic syndrome, particularly in the restricted and repetitive aspects. Advances are needed in the understanding of this complex and heterogeneous clinical dimension of autism to improve efficacy of therapeutics. LITERATURE FINDINGS: Most clinical studies have subdivided RRB into « lower-level » sensory-motor behaviours and « higher-level » behaviours, which are more complex and characteristic features of autism. However, none of these studies have taken into account all the forms of RRB. To date, there is no specific and thorough tool to evaluate this dimension of autism. From the analysis of the literature, we proposed a list of 43 behaviours covering the full range of repetitive, restricted and stereotyped activities observed in autism. AIM OF THE STUDY: The aim of the present study was to test the relevance of these 43 RRB in a family context. CLINICAL SETTINGS: The participants were 14 children with an autism spectrum disorder, aged from six to 16 years. Circumscribed interests were the most commonly reported RRB, and motor stereotypies, aggressive and body-focused behaviours were the least expressed behaviours. RESULTS: Multivariate statistical analysis identified three groups of children with different behavioural profiles and three clusters of RRB, i.e. repetitive motor behaviours, repetitive sensory-vocal behaviours and restricted ideational behaviours. DISCUSSION: Although these preliminary results need to be validated in a wider population, the list of 43 RRB allowed us to describe accurately this symptomatology of autism and to confirm the heterogeneity of this dimension of autistic disorders. The identification of clinical subgroups, possibly underlain by different psychopathological or physiopathological factors would help research and contribute to the development of specific new therapeutic strategies which are still needed to improve quality of life of patients with autistic disorder and their families.
5. Frazier TW, Hardan AY. {{A Meta-Analysis of the Corpus Callosum in Autism}}. {Biol Psychiatry};2009 (Sep 11)
BACKGROUND: Previous magnetic resonance imaging (MRI) studies have reported reductions in corpus callosum (CC) total area and CC regions in individuals with autism. However, studies have differed concerning the magnitude and/or region contributing to CC reductions. The present study determined the significance and magnitude of reductions in CC total and regional area measures in autism. METHOD: PubMed and PsycINFO databases were searched to identify MRI studies examining corpus callosum area in autism. Ten studies contributed data from 253 patients with autism (mean age = 14.58, SD = 6.00) and 250 healthy control subjects (mean age = 14.47, SD = 5.31). Of these 10 studies, 8 reported area measurements for corpus callosum regions (anterior, mid/body, and posterior), and 6 reported area for Witelson subdivisions. Meta-analytic procedures were used to quantify differences in total and region CC area measurements. RESULTS: Total CC area was reduced in autism and the magnitude of the reduction was medium (weighted mean d = .48, 95% confidence interval [CI] = .30-.66). All regions showed reductions in size with the magnitude of the effect decreasing caudally (anterior d = .49, mid/body d = .43, posterior d = .37). Witelson subdivision 3 (rostral body) showed the largest effect, indicating greatest reduction in the region containing premotor/supplementary motor neurons. CONCLUSIONS: Corpus callosum reductions are present in autism and support the aberrant connectivity hypothesis. Future diffusion tensor imaging studies examining specific fiber tracts connecting the hemispheres are needed to identify the cortical regions most affected by CC reductions.
6. Laud RB, Girolami PA, Boscoe JH, Gulotta CS. {{Treatment Outcomes for Severe Feeding Problems in Children With Autism Spectrum Disorder}}. {Behav Modif};2009 (Sep 10)
There is abundant research to support that children with autism spectrum disorder (ASD) exhibit challenging feeding behaviors. Despite increase in empirical evidence supporting the role of behavior analysis in treating severe feeding problems, evaluation of the short- and long-term effects of these treatments for a large group of children with ASD is warranted. The purpose of the current study was to evaluate treatment outcomes of an interdisciplinary feeding program for 46 children with ASD. A retrospective chart analysis indicated these children were treated successfully overall and follow-up data suggest gains were maintained following discharge from the program.
7. Morris CM, Zimmerman AW, Singer HS. {{Childhood serum anti-fetal brain antibodies do not predict autism}}. {Pediatr Neurol};2009 (Oct);41(4):288-290.
Autoimmune hypotheses for autism include in utero transplacental exposure to maternal antibodies and acquired postnatal insults. Previous work demonstrated that some mothers of children with autistic disorder have specific antibodies against human fetal brain that differentiate them from mothers with typical children. In the present study, Western immunoblotting was used to determine whether children with autistic spectrum disorders (n = 29) have serum reactivity against human fetal brain that differs from that of controls (n = 14). There was no significant difference in reactivity, corrected for serum immunoglobulin G content and brain actin content and with special attention to reactive bands at 36, 39, 61, and 73 kDa, between autistic children and normal control subjects. Thus, in contrast to mothers, antibody reactivity against human fetal brain as measured in children ages 3-12 years does not appear to be a useful biomarker for autism.
