Autism is a disorder that is affecting more and more people.
The main cause of autism is not yet known. Some research suggests that autism is a physical problem that affects parts of the brain that process language and information from the five senses. It may be due to an imbalance. Some chemical elements are present in the brain. In some cases, genetic factors have also been involved. In short, autism is actually the result of a combination of several different factors.
Decades ago, it was theorized that autism was caused in children who had been rejected by cold parents (refrigerated parents) and blamed for deviating from normal young children. But family studies did not prove this. It is important to communicate frequently with parents of autistic children.
The cause of autistic disorders is unknown. Theories include pregnancy complications, infections, genetics, and exposure to toxins.
Complications of pregnancy
Complications of pregnancy are associated with an increased risk of autism, but it is not clear whether pregnancy complications cause autism or both.
Infections
An infectious background in some autistic people has suggested that the infection may be the cause of autism, just as rubella epidemics increase the risk of developing autism. These findings suggest that rubella infection makes the fetus vulnerable to autism.
Genetics
A genetic distribution is also known for autism.
Numerous family studies have suggested that there is a genetic component to these families. For example, many studies have shown that some asymptomatic first-degree relatives have abnormal levels of serotonin and other chemicals similar to its precursors. However, a specific autistic person may not display the specific familial trait seen in the autistic population.
Genetic findings of autism are one of the future goals of research. However, the benefits of clinical trials on families of autistic people have not been established.
Toxins
Toxin exposure has been suggested as one of the causes of autism. Although exposure has been identified in some people with autism, a causal role has not been established in all autistic individuals. Certain areas of the earth may be affected by certain toxins, such as "Increased autism in certain areas of Japan is thought to be due to toxins transmitted from fish. However, toxins may play a role in some autistic people in Japan." But in Japan as a whole, this has not been proven to be a common cause, and another reason for the high rate of autism in Japan is the high education and care of Japanese doctors.
The incidence of autism after measles, mumps, and rubella vaccination has led to the theory that autism may be caused by vaccination, but detailed studies have not shown a link between measles, mumps, and rubella vaccination and subsequent autism in the general population.
MRI
Studies are inconsistent, but findings have been made, including overall brain size, overall brain tissue, and the lateral and fourth ventricles of the brain as the midbrain decreases, medulla oblongata, cerebellar hemispheres, and worm-shaped lobes VI and VII.
When hypoplasia was seen in some people with autism, it was seen in a number of others with hyperplasia!
People with autism who hit their heads may have double the size of the space in the parietal and occipital bones by reducing the amount of gray matter close to the bone changes. These findings are similar to those of boxers with encephalopathy and dementia pugilistica.
CT Scan
Studies are inconsistent with each other but can show defects that include ventricular enlargement, hydrocephalus, parenchymal lesions, and reduced caudate nucleus size.
PET
Multiple defects were observed in PET positron emission tomography, but none are seen in all people with autism, and the results vary from person to person.
In 18-fluorine 2-doxy-glucose imaging, the straight anterior groove on the left is larger than on the right, as opposed to the asymmetry found in normal individuals.
In some people, glucose metabolism in the right dorsal calcaneus cortex is increased, while glucose metabolism is decreased in the left dorsal putamen and left internal thalamus.
SPECT
With this method, regional blood flow to the brain is measured with Xenon 133, which has been shown to reduce the metabolism of the left hemisphere in some people.
EEG
Seizure disorder encephalography, acquired seizure aphasia (Landa Kelfner syndrome), biotin-responsive neonatal encephalopathy, and related conditions are evaluated. Consultation with an electroencephalography specialist will help us achieve the right treatment that fits the EEG.
A normal encephalography does not rule out seizure abnormalities
When a routine electroencephalogram does not provide clear evidence of seizures in a patient suspected of having a seizure, such as a partial seizure with complex symptoms, the adoption of specialized methods may help clarify the diagnosis. Electroencephalographic measurements after sleep deprivation and after stimulation with light and sound and the sense of touch using nasopharyngeal leads at the same time as a video monitor may be helpful.
Hospitalization for evaluation with a 24-hour video monitor at the same time as electroencephalography and movement of the child for several days may help diagnose or rule out seizure disorders.
Radioisotope imaging
Examination of local cerebral blood flow with technetium m99 containing hexamethyl oxide Propylene amine (HMPAO), a lipophilic substance, shows a variety of anomalies, including reductions in the vermicelli, cerebellar hemispheres, thalamus, basal ganglia, and parietal and temporal lobes. These findings suggest that a specific abnormality is not seen in all autistic individuals, and that there may be specific biological classes with specific types of cerebral circulatory disorders.
Other experiments
Lead poisoning should be ruled out by appropriate tests
Psycho-physiological assessments
Children are more likely to not show habitual responses during the respiratory period; electrical activity of the skin and vasoconstriction in stimulated peripheral peripheral responses frequently show stimulation in typical children.
Autistic children may have more selective hearing.
Pathophysiology
Research into the pathophysiology of autistic disorders has continued for the past half century, but the underlying cause is still unclear. The three main identified domains include monoamines (serotonin (5-hydroxytryptamine 5 HT, dopamine, norepinephrine) and the aminobutyric acid glutamate and neuropeptides.
The role of chemical mediators in the development of autism
Monoamines
1-Serotonin
Early research measured total serotonin levels in the blood, suggesting that serotonin levels in autistic people were higher than normal, but later found that these measurements were higher than usual, perhaps due to lack of racial control. It has been puberty, but most subsequent studies have shown that high baseline serotonin levels in autistic children tend to remain high as they grow, while in normal children they tend to decrease with age. This could indicate an abnormal maturation of the serotonin system in autistic children. However, urinary excretion of 5-hydroxy-indole acetic acid (5HIAA), the primary metabolite of 5-hydroxytryptamine (5HT), and tryptophan blood concentrations in autistic and normal children were not significantly different.
2-Dopamine
Dopamine (DA) release in the brain is associated with motor and cognitive effects. The role of dopamine has been determined based on the effects of D2 receptor antagonists in the treatment of this group of patients. This group of drugs is effective in treating these patients with its effectiveness on autism symptoms such as aggression, self-harming behaviors, and hyperactivity. Some genetic studies have been performed on dopamine receptors. A study by comings and colleagues on a number of patients, especially autistic patients, found that the dopamine D2 receptor A1 receptor allele was significantly increased.
3- Norepinephrine (NE)
Epinephrine light is associated with arousal, memory, anxiety, and autonomic activity. This neurotransmitter is made of dopamine and is converted to vanilla mendelic acid VMA in the environment and to 3 methoxy 4 hydroxyphenyl glycol MHPG in cerebrospinal fluid.
Blood levels of norepinephrine and its metabolites correspond to levels in cerebrospinal fluid. Studies in autistic children measuring light epinephrine metabolites MHPG and VMA have not shown a clear difference between autistic and normal children.
The conclusion is that measurements of peripheral blood amino acids have not been consistent and can not be cited, and the reasons for this can be a small number of measured samples and different methods of measurement and possibly "drug therapy" in patients before the test.
Neuropeptides
Oxytocin and vasopressin
The 9 amino acids peptides oxytocin (OT) and vasopressin (AVP) are involved in the development of social behaviors in mammals. These neuropeptides are made in the hypothalamus and are secreted from the back of the pituitary gland and are found only in mammals and differ only in two amino acids. Receptors for these peptides are found throughout the limbic apparatus and anterior part of the brain and in the brainstem at autonomic centers.
Evaluations of adverse social behaviors in people with ASD are not yet supported by epidemiological, neurochemical, therapeutic, and genetic evidence gathered from the effects of oxytocin and vasopressin. Future studies should focus on the blood level of this substance in the brain and focus on finding the different effects of these substances on the sex of lower level mammals.
Opioids
Several studies have been performed on autistic children on the dysregulation of opioids as the etiology of the disease in people with ASD. Symptoms of this disorder include increased pain threshold, low interest in social interactions, and episodes of hyperactivity. These findings are seen in children of animals that have received opioids. The human opioid system is associated with the hypothalamic-pituitary-adrenal axis and other neuropeptides. Because beta-endorphins are released at the same time as corticotropin (ACTH) is released from the anterior pituitary gland. This is because these peptide hormones are primarily part of the same pre-hormone.
Evaluation of these peptides in the blood and cerebrospinal fluid and urine of ASD patients has had different results. Some results were increased and some decreased and some were unchanged compared to the control group.
Studies of the effects of naltrexone, an opioid antagonist, on children with ASD have had conflicting results, and measurements of beta-endorphins have not yielded similar results.
The conclusion is that the endogenous and exogenous opioid systems in ASD patients need further study, suggesting that blood levels of beta-endorphin alone may not cause disease, but that opioids interact with other neurotransmitters such as 5HT, DA, norepinephrine, and glutamate, or The GABA system causes symptoms Behavior of people becomes ASD. The final behavior of opioids in the pathophysiology of ASDs may be due to inhibition of oxytocin activity as seen in mice. Finally, much study is needed to understand the interaction of the opioid system with conventional neurotransmitters and other neurotransmitters.
Melatonin
It has previously been suggested that excessive melatonin secretion from the pineal gland may be responsible for the effect on the HPA axis, which may therefore lead to an autistic pseudo-autistic behavioral phenotype. Elevated melatonin reduces the secretion of the corticotropin-releasing hormone CRP, which in turn decreases the secretion of ACTH and beta-endorphins, while by an unknown mechanism increases 5HT in the whole brain. Its median level has not changed from that of normal individuals but tends to decrease in nocturnal peaks in autistic patients.The exact role of melatonin remains unknown and there is evidence of early melatonin deficiency.
Secrets
Although the role of secretin in the digestive system is well known, its role as a neuropeptide is still unclear. Although initial reports of the hormone's effectiveness in treating autistic patients, controlled studies have not confirmed its effectiveness.
Thyroid hormone
Thyroid-stimulating hormone secreted by the pituitary gland has been measured in several people with autism but has not changed compared to normal people.
Other pituitary hormones
Growth hormone, prolactin, LH and FSH in autistic children were no different from normal people.
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