[Autism and the pervasive developmental disorders].
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Biomedical subjects
Publications and source records attributed to Marcos T Mercadante.
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The category "Pervasive Developmental Disorders" includes autistic disorder, Asperger's syndrome, Rett's syndrome, childhood disintegrative disorder, and a residual category, named pervasive developmental disorder not otherwise specified. In this review, Rett's syndrome and childhood disintegrative disorder, which are well-defined categories, will be discussed, as well as the not well defined categories that have been included in the Pervasive Developmental Disorder Not Otherwise Specified group. Different proposals of categorization have been created, some of which based on descriptive phenomenological approach, and others based upon other theoretical perspectives, such as neuropsychology. Current proposals are presented and discussed, followed by critical appraisals on the clinical advantages and disadvantages of these concepts.
By comparing 51 heart disease patients with history of rheumatic fever and 46 heart disease patients with no rheumatic fever history, the authors found a higher prevalence of obsessive-compulsive symptoms in rheumatic fever subjects. This suggests that rheumatic fever activity is not a necessary condition for the expression of neuropsychiatric symptoms.
OBJECTIVE: To verify differences in the visual scanning strategies between pervasive developmental disorders (PDD) and controls when they are observing social and non-social pictures. METHOD: PDD group (PDDG) comprised by 10 non-retarded subjects (age from 4 to 41) and age-matched control group (CG). Nine social pictures with human beings (including two pictures of cat mask), and 3 nonsocial pictures of objects were presented for 5 seconds. Saccadic movements and fixation were recorded with equipment EyeGaze (LC Technologies Inc.). RESULTS: PDDG (mean=292.73, SE=67.62) presented longer duration of saccadic movements for social pictures compared to CG (mean=136.06, SE=14.01) (p=0.04). The CG showed a higher number of fixations in the picture 7 (a women using a cat mask, with the eyes erased) (CG: mean=3.40; PDDG: mean=1.80; p=0.007). CONCLUSION: The results suggest differences in strategies that PDD explore human picture. Moreover, these strategies seem not to be affected by the lack of expected part of the face (the eyes).
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This study details a case of Rett Syndrome where the patient's respiratory dysfunction was improved after buspirone was administered. Polygraphic studies in the waking state, before and after treatment with 5 mg of buspirone twice a day, were obtained. Breathing movements, oxygen saturation and end-tidal carbon were monitored. Average oxygen saturation increased from 86.9 to 91%, and the period of saturation below 90% was reduced by 42.2%. The oxygen saturation improvement observed in this case suggests that buspirone might be useful in treating respiratory dysfunction associated with Rett Syndrome. Controlled clinical trials are needed to provide more evidence.
Based on five cases of obsessive-compulsive spectrum disorders in rheumatic fever patients, the authors discuss the range of psychiatric disorders associated with poststreptococcal autoimmune reactions and its implications for immunology/CNS interaction.
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OBJECTIVE: To describe and discuss evidence-based articles on the neurobiology of obsessive-compulsive disorder and Tourette syndrome. SOURCES OF DATA: A review of the most relevant papers on the phenomenology, neuroanatomy, neuroimaging, genetic and immunological aspects of these two disorders was performed. SUMMARY OF THE FINDINGS: Ritualistic behaviors and repetitive thoughts have been extensively studied in the last years. The definitions of obsessive-compulsive disorder and Tourette syndrome emphasize the existence of a continuum of symptoms, with high prevalence in the general population. Neurobiological findings have implicated genetic and immunological factors in the etiology of these two disorders. CONCLUSIONS: Advances in neuroscience triggered genetic and immunological research studies, allowing new perspectives on the treatment of obsessive-compulsive disorder and Tourette syndrome patients.
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OBJECTIVE: An animal model was used to investigate an autoimmune etiology for some cases of Tourette's syndrome. METHOD: Sera from 12 patients with Tourette's syndrome with high levels of antineural or antinuclear antibodies were infused bilaterally into the ventrolateral striatum of rats. Sera from 12 additional Tourette's syndrome patients and 12 normal subjects (both groups with low levels of autoantibodies) were infused for comparison. Rates of oral stereotypies were recorded by observers who were blind to the origin of the infused sera. RESULTS: Oral stereotypies significantly increased in the rats infused with sera from the patients with high levels of autoantibodies. CONCLUSIONS: The results are consistent with an autoimmune etiology in a subset of cases of Tourette's syndrome.