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Low-dose venlafaxine in three adolescents and young adults with autistic disorder improves self-injurious behavior and attention deficit/hyperactivity disorders (ADHD)-like symptoms.

In our clinical practice, we have had good experiences with venlafaxine in the treatment of self-injurious behavior (SIB) and attention deficit/hyperactivity disorders (ADHD)-like symptoms in patients with pervasive developmental disorders (PDD), and we report here three cases of possible therapeutic response: (A) a 17-year-old boy with autism and severe behavioral symptoms, including aggression toward self or property, SIB and hyperactivity, who appeared to respond to low-dose venlafaxine (18.75 mg/day); (B) a 23-year-old woman with autism hyperactivity who appeared to respond to low-dose venlafaxine (18.75 mg/day); (C) a 17-year-old girl with autism hyperactivity who appeared to respond to low-dose venlafaxine (18.75 mg/day). Follow-ups occurred respectively 18, 36 and 6 months after treatment initiation, making it possible to observe the stability of the clinical improvement in these cases.

Adolescent↗

A prospective, open-label trial of galantamine in autistic disorder.

OBJECTIVE: Post-mortem studies have reported abnormalities of the cholinergic system in autism. The purpose of this study was to assess the use of galantamine, an acetylcholinesterase inhibitor and nicotinic receptor modulator, in the treatment of interfering behaviors in children with autism. METHODS: Thirteen medication-free children with autism (mean age, 8.8 +/- 3.5 years) participated in a 12-week, open-label trial of galantamine. Patients were rated monthly by parents on the Aberrant Behavior Checklist (ABC) and the Conners' Parent Rating Scale-Revised, and by a physician using the Children's Psychiatric Rating Scale and the Clinical Global Impressions scale. RESULTS: Patients showed a significant reduction in parent-rated irritability and social withdrawal on the ABC as well as significant improvements in emotional lability and inattention on the Conners' Parent Rating Scale--Revised. Similarly, clinician ratings showed reductions in the anger subscale of the Children's Psychiatric Rating Scale. Eight of 13 participants were rated as responders on the basis of their improvement scores on the Clinical Global Impressions scale. Overall, galantamine was well-tolerated, with no significant adverse effects apart from headaches in one patient. CONCLUSION: In this open trial, galantamine was well-tolerated and appeared to be beneficial for the treatment of interfering behaviors in children with autism, particularly aggression, behavioral dyscontrol, and inattention. Further controlled trials are warranted.

Adolescent↗

Chromosomal abnormalities in a clinic sample of individuals with autistic disorder.

We examined data from the largest reported sample of autistic individuals who have been karyotyped with the aim of providing additional information in the search for autism disease genes. Individuals seen in the University of Iowa's Child and Adolescent Psychiatry Clinic since 1980 who had been diagnosed with autism were cross-referenced with the University of Iowa's Cytogenetics Laboratory database. We determined the number of individuals referred for cytogenetic testing and, of these, the number found to have gross cytological abnormalities. Medical records were reviewed for all cases with such abnormalities. Between 1980 and 1998, 898 subjects seen in the clinic were diagnosed with autism. Of these, 278 (30.1%) were referred for cytological studies; 25 (9.0%) of these were found to have chromosomal abnormalities. The most common chromosomal abnormalities were Fragile X, other sex chromosome anomalies, and chromosome 15 abnormalities. These data support the contribution of chromosomal abnormalities to a small but significant number of cases of autism, and highlight the involvement of chromosome 15 and the sex chromosomes.

Abnormalities, Multiple↗

Hand preferences in sign-learning students with autistic disorder.

The purpose of the study was fourfold: (a) to document the hand preferences of nonspeaking individuals with autism as they produced signs and nonsign actions; (b) to find out if sign-language proficiency in such individuals is associated with directionality or consistency of signing hand preference; (c) to explore the link between hand preference for signing and standardised measures of cognitive and motor development; (d) to compare the hand preferences (sign and nonsign actions) of such individuals to sign-learning children with normal cognitive functioning. In this study, the hand preferences of 14 nonspeaking students with autistic disorder were determined from videotape records of their sign production and nonsign actions. In their sign production, four students strongly favoured their right hands, four had a distinct left-hand preference, and six did not significantly favour either hand. There was little evidence linking sign-language proficiency, cognitive maturity, or motor development to strongly lateralised signing or handedness in general in these students. Compared with the hand preferences of the children in the two comparison groups, the autistic students were markedly less lateralised with respect to signing, but not nonsign actions.

Journal Article↗

High blood monocyte counts and neopterin levels in children with autistic disorder.

OBJECTIVE: Leukocyte counts and plasma neopterin levels were determined in autistic children and matched healthy comparison subjects. METHOD: Blood from 31 autistic children and 28 age- and gender-matched healthy comparison subjects was analyzed for numbers of neutrophils, eosinophils, basophils, lymphocytes, monocytes, and total leukocytes and for plasma neopterin levels. RESULTS: The monocyte count and neopterin level were significantly higher in the autistic children than in the comparison subjects. CONCLUSIONS: These results suggest that the immune system may be activated in some children with autism.

Autistic Disorder↗

Psychophysiological aspects of autistic disorders: overview.

The neurological, neurochemical, and neurotransmitter level differences as well as genetic influences associated with autism have been studied extensively in the last two decades. The varied findings from research offer hope for better understanding, effective treatment, and, perhaps, cure of this pervasive developmental disorder.

Adolescent↗

Migration abnormality in the left cingulate gyrus presenting with autistic disorder.

Autism, characterized by an impairment in communication, including language, narrowly focused interests, and poor sociability, is a neurodevelopmental disorder of still largely unknown pathogenesis. In children with autistic symptomatology, the most consistent functional or anatomic abnormalities are found in the cingulate gyrus, particularly in the anterior regions. Neuronal migration malformations caused by incomplete neuronal migration and characterized by loss of the normal gyral patterns in the cerebral hemispheres and prominent disorganization of the cerebral cortical cytoarchitecture are generally associated with profound neurologic deficits, epilepsy, and autism. In this report, we present a case with an isolated migration abnormality located in the anterior part of the left cingulate gyrus who was admitted with the complaints of epileptic seizures and autism. In addition, the role of the localization of the migration abnormality in the appearance of autistic symptomatology is discussed.

Autistic Disorder↗

[Intervention in autistic disorders: status quo, evidence-based, questionable and doubtful techniques].

OBJECTIVE: We describe and critically discuss intervention methods that have been used to modify autistic behaviors. METHODS: Early intervention methods, training of social skills, pharmacological treatment and alternative approaches are reviewed in the light of the empirical evidence. RESULTS: Autism is a persistent and phenotypically heterogeneous disorder for which no cure has been found to date. However, individually composed care and therapies can lead to remarkable quantitative improvement. CONCLUSIONS: Further research is needed to evaluate the true impact of psychological and biological intervention techniques in autistic disorders. Among other things, the therapy studies carried out up to now often lack an adequate diagnostic assessment.

Autistic Disorder↗