QUICKNOTES (3) LIFESCI 3B03
Autism
− Neurodevelopmental disease; highly variable, multiple courses
− Prevalence – 1/88 children; diagnosis made on behaviour alone
− Onset – first 68 months of life = signs of developmental delay; symptoms continue throughout puberty and adulthood; may begin in the womb
− Treatment – early behavioural therapy; intensive tutoring and teaching social integration; few effective drugs
− Several comorbid disorders – mental retardation, epilepsy, anxiety, mood disorders
− Autistic Triad of Symptoms – i) poor social interaction ii) language deficits iii) stereotypical/repetitive behaviours
− Can also have sleep and sensory problems, intellectual disability and seizures
Pervasive Development Dis – family of disorders; Autism, PDDNOS, Asperger’s, Childhood Disintegrative Disorder, Rhett Syndrome
− Childhood Disintegrative Disorder – normal development, followed by regression; low functioning
− Rhett Syndrome – affects females (almost exclusively); normal developmental progress, followed by stagnation and regression
− Autism Spectrum Disorders
o Autism – manifestations cover a wide spectrum (severe impairment to highfunctioning)
o Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) – atypical or incomplete symptoms; considered milder but may be more severe
than typical
o Asperger’s Syndrome – less language and cognitive impairment; “high functioning”
Brain Structure
− Increased total brain volume – disproportionately accounted for by white matte (myelinated area; axons), not grey matter (cell bodies)
o Acceleration of brain growth (510% abnormal increase; age 14); followed by dramatic deceleration ▯volumes roughly equal by puberty
o Deceleration likely due to lack of synaptic pruning
o Enlargements in gray and white matte (largest, most c, temporal and parietal lobe
− Major brain areas implicated in autistic triad – small neurons, closely packed, abnormal neural connectivity
o Social Impairment – i) orbital frontal cortex ii) fusiform gyrus iii) amygdala
Fusiform Gyrus – face recognition area (ASD problems recognizing faces and communicative cues)
Amygdala – emotional response (ASD – trouble empathizing)
o Communication Deficits – i) basal ganglia ii) thalamus iii) cerebellum
Basal Ganglia – movement (PD, HD also has defects)
o Repetitive Behaviours – i) basal ganglia ii) thalamus iii) frontal cortex iv) cerebellum
− Abnormal Neural Connectivity
o Normal brain – strong local connectivity, selectively longrange connectivity between local groups
o Autistic brain – over localc (abnormally intense locaunder longrangeconnectivity;; failure to differentiate signal from noise
Consequence of widespread alterations in synapse elimination and/or formation
− Abnormal Spines
o Changes in spine de (long, skdynamics, stability, function ▯synaptic development and synaptic plasticity ▯abnormal circuit connectivity
Etiology
− Underlying pathogenesis unknown
− Interactions between multiple genes, environment and epigenetics
− Genetic Basis
o Epidemiological studies point to strong genetic basis
o Up to 90% heritability
o > 1000 interacting genes; leads to complex inheritance; does not cause ASD but causes susceptibility; each has less than
~1% risk;
o Susceptibility genes associated with – i) synaptogenesis ii) excitation/inhibition imbalance iii) neurogenesis iv) neurite
outgrowth and guidance v) synaptic plasticity
o Aberrant neurite outgrowth, synapse formation and connectivity during development ▯leads to ASD
o Many genes code for synaptic proteins
structure that receptors bind)aptic density protein; holto actin cytoske(underlying
Neurexi(presynap and neuroli(post syna– hold synapses together
BDNF – important for i) maintenance of synaptic connections ii) dendritic spine maturation iii) spine formation iv) dendritic growth and
branching v) synaptic plasticity
1 QUICKNOTES (3) LIFESCI 3B03
Implicated Pathways
− Regulate neurite outgrowth and synaptic plasticity
− Spine Protein Translation
o TSC1 and 2 – inhibits mTOR; when mutated, too much mTOR activation
Tuberous Sclerosis – unusual brain anatomy; high rates of autism
o PTEN – inhibits P13K; PTEN is active, P13K is inhibited; mTOR activation
ASD
o NF1 (Gap) – inhibits Ras; NF1 KO results in TSC inhibition, too much mTOR activation
Neurofibromatosis Type I
o mTOR has 2 pathways
4EBP – inhibits(protein translation in; too much mTOR inhibits
protein translation
S6K – activates S6 (part of 40S ribosome), which activates eIF; leads to
protein translation
o FMRP – inhibits eIF; FMRP KO results in overactive eIF
Fragile X Syndrome
− Decreased TrkB in Autism (fusiform gyrus) – activated by BDNF
o Causes decreased activation of P13K; 2 pathways are implicated
mTOR pathway – leads to protein translation at spines
Rac pathway – controls spine dynamics and stability
• Eps8 protein is decreased in autism – KO mice i) impaired in sociability test ii) spine abnormalities similar to human autism defects
(increased spine length; increased spine density)
o Decreases PSD95 protein expression
− Decreased SKI1 protease – less cleavage of BDNF isoforms ▯increased
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