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Living with Autism

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August 15, 2013

Self-Injurious Behavior in Autism: Where it may Start in the Brain


Award Winning Non-Fiction Blogs - BlogCatalog Blog DirectoryMight Deep Brain Stimulation Targeting Specific Areas of Brain, Help Autistic People Plagued by Self-injurious Behavior?


Doctors at University Hospital in Cologne Germany wanted to help an autistic boy who couldn’t stop hurting himself. The 13 yr old non-verbal, autistic boy was suffering from life-threatening self-injurious behavior (SIB). Doctors treated him with deep brain stimulation (DBS) targeting the amygdaloid complex of his brain, says a 2012 Frontiers in Human Neuroscience Report.

Results were surprising. 

And may give new hope to finding a cure to chronic self-injurious behavior in autistic patients.

When doctors positioned electrodes in various parts of the autistic boy’s brain, they noted only electrodes positioned to stimulate a specific part of amygdala, the basolateral (BL) area of amygdala, improved both SIB and autism related symptoms.


Stimulation of only the basolateral area with electrodes not only radically reduced SIB, but improved socialization, nocturnal sleep and sparked rudimentary speech. Conversely, stimulating other areas of brain made SIB and autism related symptoms worse.
The basolateral amygdala is located in the limbic related area of brain. 

Stimulating other brain areas had no effect or worsened self-injurious behaviors.  

According to the Journal of Neuroscience, the basolateral amygdala controls emotions, learning and memory.

What’s more, after 8 weeks of continuous electrical stimulation of the basolateral region, the autistic boy became higher functioning. Going from severely autistic to moderately autistic. 

44 weeks into this implanted deep brain stimulation treatment, the battery on device malfunctioned, and during the month long lull in treatment, the boy’s self-injurious behavior exploded. Imagine the parents despair. Once battery was replaced his symptoms improved.

Scientists caution more studies are needed to validate DBS as a treatment for chronic self-injurious behavior in children and adults with autism. 

However, this case is “intriguing and promising,” said Ali Rezai of the Ohio State University Wexner Medical Center.

Of interest: 

·         This part of the brain called amygdala is involved in the etiopathogenesis (where it's speculated self-abuse stems from) of autism and self-injurious behavior.
·         DBS in the basolateral amygdala was effective and did not evoke side-effects, thus having potential for treatment of patients with severe autism and related SIB.

In our autistic son's case, I've noticed something interesting. When he's given Ativan for seizures, it's effective, but if you give him Ativan for self-injurious behavior, it worsens his behavior. Why? One possible reason is that Ativan deactivates parts of the brain that need to be activated to control self-injurious behavior. 

Another thing I've noticed is certain epilepsy drugs seem to increase his self-injurious behavior, even if they're effectively controlling seizures. For instance, Topamax (topiramate). Why is this? One reason could be that Topamax reduces excitability in the basolateral amygdala. If the study using DBS says activating this region reduces SIB, then it would make sense that deactivating this brain area would increase SIB. 

Clearly, pharmaceutical and autism research studying autistic people who have both seizures and self-injurious behavior is lacking. 

The development of a drug that activates the basolateral amygdala, while also deactivating parts of brain involved in seizure spread, would be helpful. Or the development of a drug that activates basolateral amygdala, so it could be an adjunct to work synergistically with seizure medication.  Currently, it doesn't seem there are pharmaceutical drugs that activate this region. 

Sources:http://www.sciencenews.org/view/generic/id/347854/description/Deep_brain_stimulation_improves_autistic_boys_symptoms

  • Representing 19 San Diego County children diagnosed with Autism Spectrum Disorder (ASD) in their appeal of the San Diego Regional Center's termination of funding for a crucial therapy. The victory resulted in a complete reinstatement of funding and set a precedent that allows other children to obtain the treatments they need.

2 comments:

Anonymous said...
This comment has been removed by a blog administrator.
Kim Oakley said...

Wir wissen jetzt, WER das geschrieben hat. Schade. Wie sadistisch und grausam. Möge Gott schmach und schande beteiligten.

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