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Autism Spectrum Disorders

  • Evdokia Anagnostou
  • Eric Hollander
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Autism is a developmental disorder, characterized by repetitive behaviors and by deficits in social skills and communicative abilities. Autism spectrum disorders affect 60 out of 10,000 individuals, resulting in significant costs to families and society. Neuropathological and imaging studies point to abnormalities in the limbic system and the cerebellum, and accelerated brain grown in the first 2 years of life. Abnormalities in serotonin function have been identified in affected patients and their families. Genetic studies document high concordance in monozygotic twins and genome screens have identified multiple loci as possibly associated with autism, with the strongest evidence pointing to regions 2q and 7q. Although there is a relative lack of well-controlled treatment studies, selective serotonin reuptake inhibitors and atypical antipsychotics are useful in the treatment of repetitive behaviors and aggression. Nonpharamacological interventions include intensive early childhood educational programs, and interventions targeted at problem behaviors and social skills improvement.

Key Words

PDD autism Asperger’s neurobiology genetics phenomenology treatment 

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References

  1. 1.
    Kemper TL, Bauman ML. Neuropathology of infantile autism. J Neuropathol Exp Neurol 1998;57:645–652.PubMedCrossRefGoogle Scholar
  2. 2.
    Bailey A, Luthert P, Dean A, et al. A clinicopathological study of autism. Brain 1998;121:889–905.PubMedCrossRefGoogle Scholar
  3. 3.
    Zilbovicius M, Boddaert N, Belin P et al. Temporal lobe dysfunction in childhood autism: a PET study. Am J Psychiatry 2000;157:1988–93.PubMedCrossRefGoogle Scholar
  4. 4.
    Ohnishi T, Matsuda H, Hashimoto T et al. Abnormal regional blood flow in childhood autism. Brain 123:1838–1844.Google Scholar
  5. 5.
    Ritvo ER, Freeman BJ, Scheibel AB et al. Lower Purkinje cell counts in the cerebella of four autistic subjects: initial findings of the UCLA-NSAC autopsy research report. Am J Psychiatry 1984;143(7):862–866.Google Scholar
  6. 6.
    Courchesne E, Yeung-Courchesne R, Press G et al. Hypoplasia of cerebellar vermal lobules VI and VII in autism. N Engl J Med 1998;318:1349–1354.CrossRefGoogle Scholar
  7. 7.
    Courchesne E, Carper R, Akshoomoff N. Evidence of brain overgrowth in the first year of life in autism. JAMA 2003;290(3):393,394.CrossRefGoogle Scholar
  8. 8.
    Schultz RT, Gauthier I, Klin A et al. Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger syndrome. Arch Gen Psych 2000;57:331–340.CrossRefGoogle Scholar
  9. 9.
    Hollander E, Novotny S, Allen A, Aranowitz B, Cartwrite C, DeCaria C. The relationship between repetitive behaviors and growth hormone response to sumatriptan challenge in adult autistic disorder. Neuropsychopharmacology 2000;22:163–167.PubMedCrossRefGoogle Scholar
  10. 10.
    Popik P, Vetulani S, Van Ree JM. Low dose of oxytocin facilitates social recognition in rats. Psychopharm 1992;106(1):71–74.CrossRefGoogle Scholar
  11. 11.
    Popik P, Van Ree JM. Long term facilitation of social recognition in rats by vasopressin related peptide: a structure-activity study. Life Sci 1992;50(8):567–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Hollander E, Novortny S, Hanratty M et al. Oxytocin infusion reduces repetitive behaviors in adults with autistic and Asperger’s disorders. Neuropsychopharmacology 2003;28:193–98.PubMedCrossRefGoogle Scholar
  13. 13.
    Ciaranello AL, Ciaranello RD. The neurobiology of infantile autism. Annu Rev Neurosci 1995;18:101–128.PubMedCrossRefGoogle Scholar
  14. 14.
    Buxbaum JD, Silverman JM, Smith CJ et al. Evidence for susceptibility gene for autism on chromosome 2 and for genetic heterogeneity. Am J Hum Genetics 2001;68:1514–1520.CrossRefGoogle Scholar
  15. 15.
    International Molecular Genetics Study of Autism Consortium. A full genome screen for autism with evidence for linkage to a region on chromosome 7q. Human Mol Genetics 1998;7:571–578.Google Scholar
  16. 16.
    Barrett S, Beck JC, Bernier R et al. An autosomal genomic screen for autism. Collaborative Linkage study of Autism. Am J Med Genet 1999;88:609–615.PubMedCrossRefGoogle Scholar
  17. 17.
    Koch A, Wolpert CM, Menold MM et al. Genetic studies of autistic disorder and chromosome 7. Genomics 1999;61:227–236.CrossRefGoogle Scholar
  18. 18.
    Lamb JA, Moore J, Bailey A, Monaco AP. Autism: recent molecular genetic advances. Hum Mol Genet 200; 9:861–868.Google Scholar
  19. 19.
    Evers M, Cunningham-Rundles C, Hollander E. Heat shock protein 90 antibodies in autism. Mol Psych 2002;7(Suppl2):S26–S28.CrossRefGoogle Scholar
  20. 20.
    Hollander E, DelGiudice-Asch G, Simon L et al. B lymphocyte antigen D8/17 and repetitive behaviors in autism. J Am Psych 1999;156:317–20.Google Scholar
  21. 21.
    Fombonne E. Epidemiology of the pervasive developmental disorders. TEN 2003;5(1):29–36.Google Scholar
  22. 22.
    Hollander E, Phillips AT, Yeh CC. Targeted treatments for symptom domains in child and adolescent autism. Lancet 2003;362:732–734.PubMedCrossRefGoogle Scholar
  23. 23.
    Gordon CT, State RC, Nelson JE et al. A double blind comparison of clomipramine, desipramine and placebo in the treatment of autistic disorder. Arch Gen Psychiatry 1993;50:441–447.PubMedGoogle Scholar
  24. 24.
    Brasic JR, Barnett JY, Kaplan D et al. Clomipramine ameliorates adventitious movements and compulsions in pre-pubertal boys with autistic disorder and mental retardation. Neurology 1994;44:1309–1312.PubMedGoogle Scholar
  25. 25.
    DeLong GR, Teague LA, McSwain KM. Effects of Fluoxetine treatment in young children with idiopathic autism. Dev Med Child Neurol 1998;40:551–562.PubMedCrossRefGoogle Scholar
  26. 26.
    McDougle CJ, Naylor ST, Cohen DJ, et al. A double-blind, placebo controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry 1996;53:1001–1008.PubMedGoogle Scholar
  27. 27.
    Hollander E, Kaplan A, Catwrite C, Reichman D. Venlafaxine in children, adolescents and young adults with autism spectrum disorders: an open retrospective clinical report. J Child Neurology 2001;14:132–135.Google Scholar
  28. 28.
    McDougle CJ, Holmes JP, Carlson DC et al. A double blind placebo controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psych 1998;55:663–641.CrossRefGoogle Scholar
  29. 29.
    Research Units on Pediatric psychopharmacology autism network. Risperidone in children with autism and serious behavioral problems. N Engl J Med 2002;347(5):314–321.Google Scholar
  30. 30.
    Hollander E, Dolgoff-Kaspar R, Cartwrite C et al. An open trial of divalproex sodium in autism spectrum disorders. J Clin Psychiatry 2001;62:530–534.PubMedCrossRefGoogle Scholar
  31. 31.
    Malone RP, Delaney MA, Luebbert JF, Cater J, Cambell M. A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorders. Arch Gen Psychiatry 2000;57: 649–54.PubMedCrossRefGoogle Scholar
  32. 32.
    Corbett B, Khan K, Czapansky-Beilman D et al. a double blind placebo controlled crossover study investigating the effect of porcine secretin in children with autism. Clin Pediatr 2001;40:327–331.CrossRefGoogle Scholar
  33. 33.
    Kasari C. Assessing Change in early intervention programs for children with autism. J autism Dev Dis 2002;32:447–461CrossRefGoogle Scholar
  34. 34.
    Horner RH, Carr EG, Strain PS, Todd AW, Reed HK. Problem behavior interventions for young children with Autism: A research synthesis. J autism Dev Dis 2002;32:423–446.CrossRefGoogle Scholar
  35. 35.
    Baranek G. Efficacy of sensory and motor interventions for children with autism. J Autism Dev Dis 2002; 32:397–422.CrossRefGoogle Scholar
  36. 36.
    McConnell S. Interventions to facilitate Social Interaction for young children with autism: Review of available research and recommendations for educational intervention and future research. J Autism Dev Dis 2002;32: 351–372.CrossRefGoogle Scholar

Further Reading

  1. Andres C. Molecular Genetics and animal models in autistic disorder. Brain Res Bull 2002;57:109–119.PubMedCrossRefGoogle Scholar
  2. Deuel RK. Autism: A cognitive Developmental Riddle. Pediatr Neurol 2002;26:349–357.PubMedCrossRefGoogle Scholar
  3. Cody H, Pelphrey K, Piven J. Structural and functional magnetic resonance imaging of autism. Int J Devl Neuroscience 2002;20:421–438.CrossRefGoogle Scholar
  4. Schultz R, Klin A. Genetics of childhood disorders: XLIII. Autism, Part 2: Neural foundations. J Am Acad Child Adolesc Psychiatry 2002;41:1259–1262.PubMedCrossRefGoogle Scholar
  5. Klin A, Jones W, Schultz R, Volkmar F, Cohen D. Defining and quantifying the social phenotype in autism. Am J Psych 2002;159:895–908.CrossRefGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2005

Authors and Affiliations

  • Evdokia Anagnostou
    • 1
  • Eric Hollander
    • 1
  1. 1.Seaver and New York Autism Center of Excellence, Department of PsychiatryMount Sinai School of MedicineNew York

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