Autism – Autism Spectrum Disorders (ASD) Not a unitary disease: it’s not “Rain Man” or “normal” Actually a “multi-dimensional space” not just than a 2-dimensional spectrum

Social deficits Communication deficits Repetitive, stereotyped behaviors Intellectual deficits

The term autism was first introduced in 1943, awareness has increased greatly in the last decade or two

“Asperger’s” no longer om DSM – instead diagnosis on a spectrum It has an onset in the first 3 years after birth, persists throughout life Autism is not caused by “bad parenting” nor “cold mothers”

Genetics are important, some evidence that neonatal hypoxia may predispose

There is no connection between vaccines and autism

Vaccines are not the cause of autism

THERE IS NO CONNECTION BETWEEN VACCINES AND AUTISM REALLY! This possibility has been as thoroughly researched as anything in

medicine, and there is absolutely no evidence to support a connection…

..at least no credible, good, scientific evidence. There is highly suspect/verifiably fraudulent evidence:

Andrew Wakeflield (formerly MD, license revoked) This is NOT a viable hypothesis; it is no more valid than invoking

birthday cake or walking as a cause of autism

Autism has a significant genetic component

Twin studies that compared concordance for autism in identical (MZ) and fraternal (DZ) twins showed, that contrary to dogma, autism was a highly genetic disorder with heritability indices of up to 0.92.

Average concordance for identical twins of 64% vs. 9% for fraternal twins Irritable bowel syndrome (IBS) has low heritability: (IBS), is 28% for MZ, 27% DZ. Eye color, has hugh heritability: 98% for MZ, 49% for DZ pairs

Pevalence of 0.1%; the risk of classic autism in siblings is 20- 40-X greater.

A recent study found that all three subscales were highly heritable but showed low covariation.

Bisphenol A (BPA) and Autism?

Very recent paper by Stein et al. (2015) states that their results “suggest there is an association between BPA and ASD.”

In their methods section they also state that “No statistical correction, such as a Bonferroni adjustment, was made to alpha to control for the family wise error rate that was incurred in conducting the numerous statistical analyses that were made.” Hmm!?

The introduction mentions that their previous studies of same children found that “there was evidence for abnormal amino acid metabolism, increased oxidative stress, and altered gut microbiomes in the ASD group.”

Which is cause, and which is effect? Couldn’t these metabolic differences cause autism?

Stein et al. did find this:

However, they did not control for socioeconomic status, time of day for sampling, diet,…

They intended to exclude medication, but found CNS-active drugs In several subjects with ASD

Bottom line: •Press releases are not a reliable source of scientific info•The devil is in the detail•Studies on humans are tricky

Brain connectivity may be different as early as 3 monthswith a different difference by 12 months!

Connectivity differences in cerebellum in autism

Autism vs Schizophrenia

SCHIZ: fMRI data suggest a pattern of increased long-range connectivity, with disrupted short-range connectivity, in keeping with pathology of exaggerated synaptic pruning

ASD: In contrast, fMRI data in ASD suggest to some extent an opposite pattern, with increased local but decreased global connectivity.

Large fMRI data sharing stuty revealed hyperconnectivity in subcortical networks, and hypoconnectivity in cortical networks in adult males with ASD.

Some studies with younger children with ASD seemingly showing more hyperconnectivity than adults.

Multiple Sclerosis

Multiple Sclerosis – general features

The disease usually begins between the ages of 20 and 50 and is twice as common in women as in men.

MS is more common in people who live farther from the equator, although exceptions exist

MS is more common in regions with northern European populations and the geographic variation may simply reflect the global distribution of these high-risk populations.

A relationship between season of birth and MS lends support to this idea, with fewer people born in the northern hemisphere in November as compared to May being affected later in life.

A variety of viruses, such as Epstein-Barr virus and others, appear to be associated with multiple sclerosis.

Different types of MS

Multiple Sclerosis - pathophysiology

MS is a neurodegenerative, autoimmune disease of uncertain etiology.

It involves the inflammation and disruption of myelin

Multiple Sclerosis

http://www.msdiscovery.org/news/news_synthesis/322-more-meets-eye

The destruction in MS is caused by the immune system

It is now generally accepted that the demyelination seen in MS is caused by an abnormal immune process — that is, by activation of “T cells” against some component of central nervous system myelin

1.The most widely-used (though imperfect) experimental animal model of MS involves injecting myelin or CNS tissue extracts that include myelin to induce an autoimmune response.

2.T-Cells A type of white blood cell that play a central role in cell-mediated immunity;

called T cells because they mature in the thymus (although some also mature in the tonsils). There are several subsets of T cells, each with a distinct function.

Interesting news in neuroscience

Myelination may not be as “all or none” as previously thought!

Reconstructions of three neurons from mouse cortex

Neurological & Psychiatric Disorders Have Had a “Bad Rap”

The brain is a part of your body, like bones, pancreas, eye lenses etc. “Mental Disorders” are ‘physical problems’, like osteoarthritis, cataracts, diabetes

etc.

Lack of “will power” and “character” are not the cause of brain disorders

The Stigmatization of mental disorders is illogical and ignorant

Unlike many diseases, brain disorders (neurological and psychiatric) are diagnosed by symptoms rather than underlying cause

Pain, depression, sleep problems etc. can look the same, but have different causes Cases can have unique presentations and not fall into clear, consistent categories This makes diagnosis and choosing how to treat difficult

Thank you for your attention

Questions? Comments?