Monthly Research Review June 2016

This month there is a novel treatment that is reported – helminth therapy. Helminth is a general term for “worm”. Helminths were common contaminants in the grains that we consumed up until about 100 years ago. They were a harmless contaminant in a wide variety of grains in our food supply. Helminths evoke an immune response which we need as part of our immune conditioning. At the Mindd Forum this year there were a number of case studies presented that utilised helminth therapy with very positive clinical results. More ASD research into supplements and nutritional and biochemical abnormalities in children. And as usual a whole lot more.

Risk factors for ASD

Chemicals, Nutrition, and Autism Spectrum Disorder: A Mini-Review. Full text. “Several chemical exposures such as air pollution (e.g., particular matter 2.5), pesticides, bisphenol A, phthalates, mercury, and nutrition deficiency such as folic acid, vitamin D, or fatty acid may possibly be associated with an increased risk of ASD, whereas other traditional risk factors such as smoking/tobacco, alcohol, or polychlorinated biphenyls are less likely to be associated with ASD.

Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy: A Review of Current Evidence.Exposure to SSRIs in pregnancy has been associated with miscarriage, premature delivery, neonatal complications, birth defects-specifically cardiac defects-and, more recently, neurodevelopmental disorders in childhood, specifically autism spectrum disorders. It is important that every pregnant woman being treated with an SSRI (or considering such treatment) carefully weighs the risks of treatment against the risk of untreated depression for both herself and her child.

Epigenetic Effect of Environmental Factors on Autism Spectrum Disorders. Full text. “findings support the idea that the phenotypes of ASDs caused by epigenetic dysregulation are reversible and thus treatable.

A sexually dichotomous, autistic-like phenotype is induced by Group B Streptococcus maternofetal immune activation...these data show for the first time that gestational exposure to GBS plays an important role in the generation of neurodevelopmental abnormalities reminiscent of human autism spectrum disorders (ASD). These results provide new evidence in favor of the role of a common and modifiable infectious/inflammatory environmental factor in human ASD pathophysiology.

Diet

Iodine Deficiency and Hypothyroidism From Voluntary Diet Restrictions in the US: Case Reports.Recent trends among specific populations of children in the United States include adopting food restrictions, such casein-free and gluten-free diets. We present here 2 cases of iodine deficiency resulting from severe food restriction and associated primary hypothyroidism.” Iodine status should be assessed in all children regardless of diet as iodine deficiency is prevalent in children and pregnant women in Australia.

Nutritional and biochemical abnormalities

Genome-wide association study of serum coenzyme Q10 levels identifies susceptibility loci linked to neuronal diseases.In summary, this study demonstrates that serum CoQ10 levels are associated with common genetic loci that are linked to neuronal diseases [like Alzheimer disease, autism, and schizophrenia].

The landscape of DNA methylation amid a perfect storm of autism aetiologies.The dynamic developmental landscape of DNA methylation is vulnerable to numerous genetic and environmental insults: therefore, understanding pathways that are central to this ‘perfect storm’ will be crucial to improving the diagnosis and treatment of ASD.

DNA methylation: a mechanism linking environmental chemical exposures to risk of autism spectrum disorders?..we describe epidemiological and experimental evidence implicating altered DNA methylation as a potential mechanism by which environmental chemicals confer risk for ASD..

CSF concentrations of 5-methyltetrahydrofolate in a cohort of young children with autism. this study examined CSF 5-methyltetrahydrofolate (5-MTHF) concentrations in a group of young children with autism.” “CSF 5-MTHF levels vary significantly over time in an unpredictable fashion and do not show a significant relationship to typical clinical features of autism. Reduced CSF 5-MTHF levels are a nonspecific finding in autism.” Although this study considers reduced CSF 5-MTHF levels as a “nonspecific finding”, there are other reports that show that this is correlated to cerebral folate deficiency in ASD children.

Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China.These results suggest that reduced macronutrient intakes, severe feeding behavior issues, constipation, and vitamin A deficiency are quite common among children with ASD. Further, a low serum vitamin A level may be a risk factor for symptoms of ASD.” Again we stress the importance of having your child comprehensively evaluated for nutritional deficiencies.

Gastrointestinal issues

Associations between cytokines, endocrine stress response, and gastrointestinal symptoms in autism spectrum disorder.The relationship between cortisol response to stress and GI functioning was greater for children who had a history of regressive autism.

Gut microbiome and psyche: paradigm shift in the concept of brain-gut axis. [German] “a faulty composition of the gut microbiota in childhood influences the maturation of the central nervous system and thus may favor the development of mental disorders such as autism, depression, or other.

Neurochemistry

Brain GABA levels across psychiatric disorders: A systematic literature review and meta-analysis of 1 H-MRS studies.In conclusion, this meta-analysis provided evidence for lower brain GABA levels in ASD……. compared with healthy controls.”

SnapShot: Microglia in Disease.dysregulation of microglia contributes to the pathology of neurodevelopmental disorders such as autism spectrum disorders; neurodegenerative disorders such as Alzheimer’s disease; and schizophrenia

Environmental issues

Mean serum-level of common organic pollutants is predictive of behavioral severity in children with autism spectrum disorders.The ASD cohort displayed greater quantitative variance of analyte concentrations than controls, suggesting a wide range of detoxification functioning in the ASD cohort. This study supports the hypothesis that environmental exposure to organic pollutants may play a significant role in the behavioral presentation of autism.

Supplements and novel therapies

Mass spectrometric evaluation of neurotransmitter levels in IMR 32 cell line in response to Ayurvedic medicines.Herbal medicines given as part of ayurvedic medicine increased the neurotransmitter levels ……… these ayurvedic medicines when prescribed to children with ASD might alleviate the abnormal behavioral symptoms by maintaining neurotransmitter homeostasis.” Herbal medicine can be very useful in the treatment of ASD children.

A comparative consecutive case series of 20 children with a diagnosis of ADHD receiving homeopathic treatment, compared with 10 children receiving usual care.In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD.”

Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review.Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.” It is unfortunate that complimentary medicines that have been shown to be effective are reported as “potentially harmful”, yet pharmacological medications like atomexatine (the study appears in the Pharmaceutical section below) are reported as appearing to be “safe and effective”.

Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls. Full text. “Children with ADHD and ASD had low levels of EPA, DHA and AA and high ratio of n-6/n-3 PUFAs and these correlated significantly with symptoms.” Research on omega-3 supplements show inconsistent results. Unfortunately no one actually tests the quality of omega-3 supplements used in the majority of studies. The few studies done on omega-3 supplements have shown that most are of very poor quality.

Practices and outcomes of self-treatment with helminths based on physicians’ observations.The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug.

Pharmaceuticals

Risperidone-Induced Acute Respiratory Distress in an Adolescent with Autism. No abstract available. However, it is a reminder that pharmaceutical medications can have serious side effects.

Effects of Atomoxetine in Individuals with Attention-Deficit/Hyperactivity Disorder and Low-Functioning Autism Spectrum Disorder. “ATX [atomoxetine] appears to be safe and effective for social withdrawal and ADHD symptoms in children with ASD and ID.” Out of 37 patients 16 (43,2%) were considered responders, 5 (13.5%) stopped medication due to either increased motor activity and talkativeness, irritability, temper outbursts, or increased blood pressure. This is only within 12 weeks. Long-term side effects?  Better outcomes can be achieved with dietary modification or targeted supplements, with minimal side effects.

Curcumin in depressive disorders: an overview of potential mechanisms, preclinical and clinical findings.Despite the limited number of reports, preclinical models investigated the potential role for curcumin in anxiety, bipolar disorder, post-traumatic stress disorder and autism spectrum disorders.

Antipsychotic Use Trends in Youth With Autism Spectrum Disorder and/or Intellectual Disability: A Meta-Analysis.1 in 6 youth with ASD received antipsychotics. Both proportions increased in later years; however, clinical reasons and outcomes of antipsychotic use in ASD/ID require further study.

Self-injury behaviour

Cataract secondary to self-inflicted blunt trauma in children with autism spectrum disorder.We report 3 cases of bilateral cataract secondary to self-inflicted blunt eye trauma in children with autism spectrum disorder (ASD). All 3 children hit their foreheads, orbits, or globes repeatedly for long periods of time and developed cataracts.” This case report is so sad in that NO ONE investigated WHY these three children were self-injuring themselves. The most common reason is underlying PAIN.

Persistence of self-injurious behaviour in autism spectrum disorder over 3 years: a prospective cohort study of risk markers.Behavioural correlates of being non-verbal, having lower ability and higher levels of overactivity, impulsivity and repetitive behaviour, were associated with self-injury..” Sad that 3 years of research was done on 67 ASD individuals with self-injury but no evaluation for PAIN as the driver for the self-injury.

Neuropsychiatric issues

Preschool to School in Autism: Neuropsychiatric Problems 8 Years After Diagnosis at 3 Years of Age.More than 90 % of children with a preschool diagnosis of ASD have remaining neuropsychiatric problems at 11, despite early intervention.” The statistics speak for themselves. ASD children need more than just behavioural therapy.

Quality of life of ASD individuals and their family

Asperger syndrome in males over two decades: Quality of life in relation to diagnostic stability and psychiatric comorbidity.The subsample that no longer fulfilled an autism spectrum disorder had full-time jobs or studies (10/11), independent living (100%), and reported having two or more friends (100%). In the stable autism spectrum disorder group, 41% had full-time job or studies, 51% lived independently, and 33% reported two or more friends, and a significant minority had specialized employments, lived with support from the government, or had no friends.” I have written previously about the sad outcomes and quality of life of ASD individuals as they enter adulthood previously. We need to do so more to help children reach their optimal potential.

Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders.Autism spectrum disorders were also associated with schizophrenia spectrum disorders, affective disorders, anxiety disorders, and other neurotic and personality disorders among siblings.

A Comparison Between Caregiver-Reported Anxiety and Other Emotional and Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorders Attending Specialist or Mainstream Schools.Increasing numbers of students with Autism Spectrum Disorder (ASD) are attending mainstream schools. Nonetheless, concerns about their emotional well-being and mental health in these settings have also been raised. Students with ASD attending mainstream schools experienced higher levels of social anxiety symptoms compared to their specialist school counterparts.

For more research into ASD that your medical professional is not reading. Just follow the link to my Autism page, and scroll down to Current Research – Selected research articles of interest.

Be informed, NOT misinformed!