Monthly Research Review May 2016

In the previous April Monthly Research Review, I was surprised to find the number of studies being published on trials of supplements that have been shown to benefit ASD children. This month we have seen yet more studies showing the benefit of nutritional supplements. Parents that have not considered supplements should take note of these research studies, as you certainly will not be hearing about them from your child’s health professionals.

Supplements

The basis for folinic acid treatment in neuro-psychiatric disorders...despite normal systemic levels, folate transport to the brain is impaired in the so-called cerebral folate deficiency (CFD) syndromes presenting as developmental and psychiatric disorders. These include infantile-onset CFD syndrome, infantile autism with or without neurologic deficits..” “Infantile CFD syndrome and autism with neurological deficits tend to be characterized by elevated Folate receptor alpha [FRα] antibody titers and low CSF MTHF.” “..therapeutic regimens using high dose folinic acid, corticosteroids and milk-free diet is presented which has proven to be beneficial in providing adequate folate to the brain and decreasing the FRα autoantibody titer in those positive for the antibody.” For more on Cerebral Folate Deficiency click here.

Sulforaphane treatment of young men with Autism Spectrum Disorder.Sulforaphane, a phytochemical derived from a number of cruciferous vegetables, most notably broccoli sprouts, has metabolic effects that in some ways resemble that of fever. This review paper discusses this “fever effect” and the intracellular effects of sulforaphane as well as the results of our recent clinical trial of sulforaphane in young adults with autism.” For more on sulforaphane click here. At the recent MINDD forum, sulforaphane featured prominently in the biomedical doctors presentations as being beneficial for ASD children.

Biomarker-guided Strategy for Treatment of Autism Spectrum Disorder (ASD).We outline herein, several ASD-associated basic physiological pathways that can be regulated by the small molecule phytochemical sulforaphane, as an example of a druggable small molecule target for which much in vitro, pre-clinical, and clinical evidence already exists.

Effects of yokusankan, a Japanese kampo medicine, for symptoms associated autism spectrum disorder.Yokukansan (YKS), a traditional Japanese medicine, is composed of seven kinds of dried herbs. It is widely prescribed in clinical situation for treating psychiatric disorders by acting on mainly glutamatergic and serotonergic nervous system. In this review, we introduce the ameliorative effects of YKS on ASDs including pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s disorder in the open-label studies, suggesting that YKS is effective and well tolerated for the treatment of severe irritability/agitation and hyperactivity/noncompliance in subjects with ASD.

Serum levels of SOD and risk of autism spectrum disorder: A case-control study.This study examined the clinical significance of serum superoxide dismutase (SOD) level, a marker of oxidative stress, in children with autism spectrum disorder.” “Levels of SOD increased with decreasing severity of ASD ….decreased serum SOD levels could be implicated in the pathophysiology and progression of autism.” Superoxide dismutase is a supplement that is readily available in Australia. Clinically I have seen some children do very well on superoxide dismutase. One of the main advantages of this supplement in clinic, is that it is virtually tasteless. Therefore, no matter how difficult your child may be to supplement, this is one that can be easily given.

Therapeutic potency of bee pollen against biochemical autistic features induced through acute and sub-acute neurotoxicity of orally administered propionic acid.Propionic acid (PA), as a metabolic product of gut microbiota and as a commonly used food additive, has been reported to mediate the effects of autism. Bee pollen was effective in ameliorating the neurotoxic effect of PA.

Gastrointestinal Issues

Regulation of prefrontal cortex myelination by the microbiota.In summary, we believe we demonstrate for the first time that the microbiome is necessary for appropriate and dynamic regulation of myelin-related genes with clear implications for cortical myelination at an ultrastructural level.” 

Dietary / Nutritional Issues

Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder. Full text. “this study is the first of its kind highlighting the importance of a multidisciplinary approach to address pediatric feeding problems. Additionally, nutritional, medical, and oral motor assessments are critical components of a feeding program

Evaluation of whole blood zinc and copper levels in children with autism spectrum disorder.   Zinc (Zn) and copper (Cu) are important trace elements for cognitive development and normal neurological functioning. The results of the present study may be indicative of Zn deficiency in ASD children. Taking into account Zn-mediated up-regulation of metallothionein (MT) gene expression, these findings suggest a possible alteration in the functioning of the neuroprotective MT system.” Zinc is one of the key minerals that ASD children are assessed for. Zinc is such a critical mineral in so many of the body’s biological systems.

Lost at Sea in Search of a Diagnosis: A Case of Unexplained Bleeding.Here, we present a 17-year-old male with autism spectrum disorder and a diet severely deficient in ascorbic acid due to textural aversion and food preferences. He presented with recurrent arthritis, hemarthrosis, bruising, and anemia. His vitamin C level was low, and his symptoms improved promptly after treatment with ascorbic acid.” Parents are often told that gluten and casein free diets are “dangerous”. There is nothing healthy about a child’s diet, where the child has restricted themselves to only a handful of often “white” foods.

Comparison of nutritional status between children with autism spectrum disorder and typically developing children in the Mediterranean Region (Valencia, Spain).Autism spectrum disorder group failed to meet dietary recommendations for thiamin, riboflavin, vitamin C, or calcium. Risk of inadequate intake of fiber, vitamin E, and sodium was lower in children with autism spectrum disorder than typically developing children.” This confirms our concern about the nutritional status of ASD children. Anything we can do to raise their nutritional status via diet or nutritional supplements, will only benefit them in the long-term.

Bread and Other Edible Agents of Mental Disease.Full text. “Perhaps because gastroenterology, immunology, toxicology, and the nutrition and agricultural sciences are outside of their competence and responsibility, psychologists and psychiatrists typically fail to appreciate the impact that food can have on their patients’ condition.

Behaviour

What Happened to Paul? Manifestation of Abnormal Pain Response for Individuals With Autism Spectrum Disorder.This article concludes by arguing that professionals across all domains of health care need to begin to see behavior as communicative for those with ASD. This is particularly true of changes in behavior, which can be significant indicators of health care problems rather than something to be dismissed as another manifestation of the condition.

The Relationship Between Pain, Self-Injury, and Other Problem Behaviors in Young Children With Autism and Other Developmental Disabilities. Research has suggested that individuals who engage in self-injurious behavior may have enhanced expressions of pain ……These results continue to support that individuals with self-injury may have enhanced expressions of pain.” I continuously try to get the message across to parents, health professionals and anyone else that will listen, to look beyond the difficult behaviour that these children often exhibit. They may be expressions of pain or discomfort that needs to be identified and treated. Unfortunately, many end up being medicated with drugs that have not been approved for use in children. Let alone being checked for side-effects and safety in the pediatric population.

Pharmaceutical Prescribing

Weight Gain and Metabolic Consequences of Risperidone in Young Children With Autism Spectrum Disorder.Rapid weight gain with risperidone treatment may promote the cascade of biochemical indices associated with insulin resistance and metabolic syndrome. Appetite, weight, waist circumference, liver function tests, blood lipids, and glucose warrant monitoring.” Risperidone is one of the few drugs that has been approved for use in ASD. However, it does have adverse side-effects that can impair health. If your child is on this medication, MAKE SURE that they have baseline and regular pathology testing done to ensure they are not being set up with a lifetime of adverse health problems.

Minocycline as Adjunctive Treatment to Risperidone in Children with Autistic Disorder: A Randomized, Double-Blind Placebo-Controlled Trial.Forty-six children with diagnosis of autistic disorder …… participated in a randomized controlled trial and underwent 10 weeks of treatment with either minocycline (50 mg twice per day) or placebo in addition to risperidone titrated up to 2 mg/day (based on bodyweight). By week 10, 21 (91.3%) patients in the minocycline group and 15 (65.5%) patients in the placebo group achieved at least partial response. Minocycline seems to be a safe and effective adjuvant in management of patients with autistic disorder.” So this seems to be safe and effective, but dietary intervention is not proven and “dangerous”!

Oxytocin – the research continues to be positive

The Potential of Nasal Oxytocin Administration for Remediation of Autism Spectrum Disorders.Administration of oxytocin has been proposed as a treatment for the core symptoms of autism spectrum disorder (ASD), including social-communicative deficit.

Plasma Oxytocin in Children with Autism and Its Correlations with Behavioral Parameters in Children and Parents.Oxytocin (OT) has been implicated to play an important role in autism spectrum disorders (ASD) etiology. Our results support the hypothesis of OT deficiency in autism. The “paradoxical” associations of OT levels and social skills in children with autism indicate disturbances at various levels of OT system.

More research

Analysing change in music therapy interactions of children with communication difficulties. Full text. “Music therapy has been found to improve communicative behaviours and joint attention in children with autism…” Yet another study indicating the positive benefit of music therapy.

Case 2: Persistent skin discolouration in a child with autism spectrum disorder. Full text. A 3-year old ASD boy described as a “picky eater” presented with orange discolouration of his entire body. He drank 1.36 litres per day of a commercial fruit juice. The diagnosis was hypercarotenemia (elevated serum beta-carotene). Of note was his overall carbohydrate intake of 158 grams per day from juice (130 grams per day is recommended for children). At the MINDD Forum this year, a case study was presented of an infant with an orange complexion due to beta-carotenemia (high beta-carotene). This was due to a failure to convert beta-carotene to vitamin A due to low thyroid hormone (hypothyroidism).

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

Be informed, NOT misinformed!