Monday, January 13, 2014

Cure for Autism?

     Deep Brain Stimulation (DBS) has been an FDA-approved treatment for Parkinson's disease for twelve years, and for essential tremor for sixteen.  In both conditions electrodes are implanted into the motor cortex of the brain, resulting in improvement in motor function.
     A non-FDA-approved use of DBS is for severe depression (DBS-Psychcentral).  A few intriguing pilot studies have shown that some people--six out of seven according to one report--have been cured of intractable depression with this treatment.
     DBS, known in neurosurgery circles as "stereotaxic surgery" involves "placement of unilateral or bilateral electrodes in target brain regions connected to a permanently implanted neurostimulator which electrically stimulates that brain region" (DBS--German study).  No one knows how it works.  The electrodes are not unlike pacemaker wires:  instead of being lodged in heart muscle they're implanted in the brain and connected to a rechargeable battery that rests above the clavicle.
     In Parkinson's disease the electrodes are placed in the basal ganglia, a region known to release dopamine, a neurotransmitter deficient in this condition.  More than 30,000 patients have been safely treated with DBS.
     Between 2003 and 2005, five studies reported that DBS resulted in improvements in Tourettes syndrome.   In 2005 one patient was cured of depression when DBS was applied to an anatomical region of the brain called Brodman area 25, a place that is metabolically overactive in people who are extremely sad.  The authors of the German study cited above believe that using DBS on a brain region called the nucleus accumbens will relieve depression because it acts as a gateway for information going to and from the emotional centers of the brain.
     Like stem-cell research, the possibilities for GBS seem as boundless as the places in the brain it might succeed in manipulating:  appetite centers for obesity, new motor regions for people with partial strokes, speech centers in autism, areas for memory, sleep, vision, anxiety, impotence, cardiac rhythm, smoking, drug addiction, music appreciation, you  name it.
     Because DBS has been used with success in obsessive-compulsive disorder, and because autism is an obsessive-compulsive syndrome with a wide range of expression, a few years ago I began to wonder whether it might be effective for autism--especially for my son, Carmine, whose autism is so severe that he cannot initiate any activity, except breathing, without nonstop verbal or tactile prompts from caregivers.  Over the past few years a team of behaviorists and I have made modest progress in reducing Carmine's prompt-dependency, using upgraded, nonviolent Pavlovian techniques, but he continues to live a life so completely dependent on us that without someone alongside him every minute of the day he would remain in one position, immobile, all day.  He can't respond to the internal prompts we take for granted, the physical stimuli that impel us to move our limbs, eat, drink, use the bathroom, or shift position.  He can't voice preferences--he can't speak at all.  Assistive communication devices and iPad apps have been, mostly, a waste of effort.
     I did an internet search and found a case study in Frontiers in Human Neuroscience from January 2013 describing a favorable response to DBA in a 13-year-old autistic boy (DBA for autism ScienceNews) (DBA autism Frontiers in Neuroscience).  This may be the first time DBA has been used in autism, and it was justified by the boy's extreme self-injurious behavior.  Electrodes were placed in areas comprising the amygdala, a region of the brain that regulates emotion.  Not only were the boy's behaviors reduced but his parents reported that after DBS surgery he used two words for the first time, began to try new foods, and continued to improve for months.
     Autism affects one in every110 children (one in 80 boys), and most parents of severely autistic individuals, desperate for help, have tried dozens--if not hundreds--of treatments.  While we parents don't think in terms of cures once our children are adults, even small improvements in communication and social functioning can make dramatic differences in an autistic person's quality of life.  DBS is a minimally invasive surgical procedure and is completely reversible, so it's likely to be safe, as the DBS-treated Parkinson's population has proven.  If there is any current treatment that shows promise for curing some of the symptoms that make autism so difficult to bear, it's probably DBS.  I will continue to follow news about this innovative possibility, and may even look for a research center where Carmine might evaluated as a candidate for DBS.             

4 comments:

  1. Off subject, though relevant, bought a condo in what used to be a Vineyard. Deer in the backyard, community property, one out there sleeping, with one eye open, 4:29am. This place was built back in the late, early 60's and 70's. Instinct and also I suspect habit is the answer to why deer are seemingly unhindered by the building of homes on this 1000 or so acres, which they have roomed for so many years. Obviously they call it home, as some deer who have been removed and placed elsewhere come back home. Everyone, perhaps not everyone, thinks Humans are different than animals. How can we be different than animals when our DNA can be traced back 1000's of years? Technology and brilliance of the human brain, though why all the strife? Autism, males, Tibetan Book of the Dead, choose the womb carefully. Who is making absolute Love and who is just F........, which is why choose the womb carefully. Seems new research has found animals, female choose perhaps the sex of the offspring. Interesting. Humans evidently have the same capability, though we only use one tenth of one percent of our actual brain power. Perhaps Autism is the trauma of the child in the womb knowing they chose the perhaps wrong womb. Perhaps they chose the womb hoping to change the heart of the mother who was just F........, even though they failed. It is like looking at the side effects of so called medicine, take it, even though it may kill you. No wonder animals are so smart, and we are so stupid.

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  2. It's important to avoid blame in our explanations for why people must face hardships like mine--having a child with autism--or others, such as trauma, illness, disability, abuse, and all forms of strife. Your explanation that unborn children choose their mothers--and if those mothers hadn't truly loved their partners but had instead given in to lustful urges, these children, in their infancies, traumatized by having made the wrong choice develop autism…seems high improbable, completely unscientific, and the product of a mind that has not been disciplined by rational thought or rigorous self-examination.

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    1. Well said. The tenets of Scientology make more sense than that post.

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    2. Exactly, as Scientific is completely man/woman made, not the law of nature and the Universe. I.E.- it is OK for men to be sodomizing men, as in OK to be gay/homosexual, same with women, though perhaps not quite so queer, so to speak. Thank God I never had children to have to put up with this crap of "Oh it is Ok, you were born this, that way. Science is insane in some instances. Scientology is also insane.

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