(Review fully—correlate issues with other workups and past evaluations)
GLOSSARY
ANA: Antinuclear antibody, an unusual antibody directed against structures within the nucleus of the cell. ANAs are found in patients whose immune system is predisposed to cause inflammation against their own body tissues. Antibodies that are directed against one’s own tissues are referred to as autoantibodies. ANAs indicate the possible presence of autoimmunity.
ASD: Autism spectrum disorders (ASD), also called autism spectrum conditions (ASC) or the autism spectrum, with the word autistic sometimes replacing autism, are a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication, as well as severely restricted interests and highly repetitive behavior.
atrophy: Atrophy is a general physiological process of reabsorption and breakdown of tissues, involving apoptosis on a cellular level. When it occurs as a result of disease or loss of trophic support due to other disease, it is termed pathological atrophy, although it can be a part of normal body development and homeostasis as well.
autoimmunity: The propensity for the immune system to work against its own body is referred to as autoimmunity.
bacteriocidal: An agent that destroys bacteria.
bacteriostatic: An agent, such as a chemical or biological material, that inhibits bacterial growth.
basal ganglia: The thalamus together with other closely related masses of gray matter, situated near the base of the brain.
brain stem: The portion of the brain, consisting of the medulla oblongata, pons Varolii, and midbrain, that connects the spinal cord to the forebrain and cerebrum.
brain tubulins: Tubulin is one of several members of a small family of globular proteins.
calcarine: Pertaining to, or situated near, the calcar of the brain.
CAT: Computed tomography (CT) or computed axial tomography (CAT) scanning uses a series of X-rays of the head taken from many different directions. Typically used for quickly viewing brain injuries, CT scanning uses a computer program that performs a numerical integral calculation on the measured X-ray series to estimate how much of an X-ray beam is absorbed in a small volume of the brain. Typically the information is presented as cross sections of the brain. In approximation, the more dense a material is, the whiter a volume of it will appear on the scan (just as in the more familiar “flat” X-rays). Rhodes Adair (of Harvard Medical School) is working on a new, more efficient version of the traditional CT scan. CT scans are primarily used for evaluating swelling from tissue damage in the brain and in assessment of ventricle size. Modern CT scanning can provide reasonably good images in a matter of minutes.
cerebellum: A region of the brain that plays an important role in the integration of sensory perception and motor control.
CFIDS: Chronic fatigue and immune dysfunction syndrome.
CFS: A condition characterized by disabling fatigue, accompanied by a constellation of symptoms, including muscle pain, multijoint pain without swelling, painful cervical or axillary adenopathy, sore throat, headache, impaired memory or concentration, unrefreshing sleep, and postexertional malaise. This diagnosis requires that a patient have four or more symptoms concurrently that persist for six or more months. The diagnosis is one of exclusion. Also called immune dysfunction syndrome.
cortical layers: Are composed of six somewhat distinct layers; each layer is identified by the nerve cell type and the destination of these nerve cell’s axons (within the brain). The human cortex is a roughly 2.4 mm-thick sheet of neuronal cell bodies.
cytokines: Chemicals made by the cells that act on other cells to stimulate or inhibit their function.
delayed hypersensitivity: A cell-mediated response that occurs in immune people peaking at twenty-four to forty-eight hours after challenge with the same antigen used in an initial challenge. The interaction of T-helper 1 (Th-1) lymphocytes with MHC class II positive antigen-presenting cells initiates the response. This interaction induces the Th-1s and macrophages at the site to secrete cytokines, which are the major factors in the reaction. Called tuberculin-type hypersensitivity. Synonyms: cell-mediated immunity, delayed reaction.
DAN protocol: Defeat Autism Now! which comprises a network of doctors whose goal is to educate parents and clinicians about biomedically based research, appropriate testing, and safe and effective interventions for autism.
dopamine: A monoamine neurotransmitter that is formed during the synthesis of norepinephrine and is essential to the normal functioning of the central nervous system. A reduction of dopamine in the brain is associated with the development of Parkinson’s disease. Chemical formula: C8H11N02.
dopaminergic: Of, relating to, or activated by dopamine or related substances.
erythromycins: A crystalline antibiotic produced by Streptomyces erythreus and used in the treatment of gram-positive bacterial infections. Erythromycin is most effective against gram-positive bacteria such as pneumococci, streptococci, and some staphylococci. The antibiotic also has some effect on gram-negative bacteria and some fungi. Erythromycin inhibits protein synthesis in susceptible microorganisms. It is used to treat such diseases as pneumonia caused by fungi, and streptococcus and syphilis infections, especially where the patient is allergic to penicillin.
fibromyalgia: Fibromyalgia is described as inflammation of the fibrous or connective tissue of the body. Widespread muscle pain, fatigue, and multiple tender points characterize these conditions. Fibrositis, fibromyalgia, and fibromyositis are names given to a set of symptoms believed to be caused by the same general problem.
frontal lobe: The frontal lobe is an area in the brain of mammals. Located at the front of each cerebral hemisphere, frontal lobes are positioned in front of (anterior to) the parietal lobes.
glial cells: Of or relating to neuroglia.
granule cells: Tiny neurons (a type of cell) that are around ten micrometers in diameter. Granule cells are found within the granular layer of the cerebellum.
HBOT: Hyperbaric oxygen therapy.
Herxheimer reaction: The Herxheimer reaction (also known as Jarisch-Herxheimer or herx) occurs when large quantities of toxins are released into the body as bacteria (typically spirochetal bacteria) die, due to antibiotic treatment. Typically the death of these bacteria and the associated release of endotoxins occurs faster than the body can remove the toxins via the natural detoxification process performed by the kidneys and liver. It is manifested by fever, chills, headache, myalgias, and exacerbation of cutaneous lesions. Duration in syphilis is normally only a few hours but can be much longer in other diseases. The intensity of the reaction reflects the intensity of inflammation present. The Herxheimer reaction has shown an increase in inflammatory cytokines during the period of exacerbation.
idiopathic: Relating to or being a disease having no known cause.
interleukins: A generic term for a group of multifunctional cytokines that are produced by a variety of lymphoid and nonlymphoid cells and whose effects occur at least partly within the lymphopoietic system.
Landau-Kleffner: LKS, also called infantile acquired aphasia, acquired epileptic aphasia or aphasia with convulsive disorder, is a rare, childhood neurological syndrome characterized by the sudden or gradual development of aphasia (the inability to understand or express language) and an abnormal electroencephalogram (EEG). LKS affects the parts of the brain that control comprehension and speech. The disorder usually occurs in children between the ages of five and seven years. Typically, children with LKS develop normally but then lose their language skills. While many of the affected individuals have clinical seizures, some only have electrographic seizures, including electrographic status epilepticus of sleep (ESES).
limbic system: Is a term for a set of brain structures including the hippocampus and amygdala and anterior thalamic nuclei and a limbic cortex that support a variety of functions including emotion, behavior, and long-term memory. The structures of the brain described by the limbic system are cl
osely associated with the olfactory structures. The term “limbic” comes from Latin limbus, meaning “border” or “edge.”
macrophages: “Big eaters,” from makros “large” + phagein “eat”) are cells within the tissues that originate from specific white blood cells called monocytes. Monocytes and macrophages are phagocytes, acting in both nonspecific defense (or innate immunity) as well as specific defense (or cell-mediated immunity) of vertebrate animals. Their role is to phagocytose (engulf and then digest) cellular debris and pathogens either as stationary or mobile cells, and to stimulate lymphocytes and other immune cells to respond to the pathogen.
magnetic resonance imaging (MRI): Uses magnetic fields and radio waves to produce high quality two- or three-dimensional images of brain structures without use of ionizing radiation (X-rays) or radioactive tracers. During an MRI, a large cylindrical magnet creates a magnetic field around the head of the patient through which radio waves are sent. When the magnetic field is imposed, each point in space has a unique radio frequency at which the signal is received and transmitted (Preuss). Sensors read the frequencies, and a computer uses the information to construct an image. The detection mechanisms are so precise that changes in structures over time can be detected. Using MRI, scientists can create images of both surface and subsurface structures with a high degree of anatomical detail. MRI scans can produce cross-sectional images in any direction from top to bottom, side to side, or front to back. The problem with original MRI technology was that while it provides a detailed assessment of the physical appearance, water content, and many kinds of subtle derangements of structure of the brain (such as inflammation or bleeding), it fails to provide information about the metabolism of the brain (how actively it is functioning) at the time of imaging. A distinction is therefore made between “MRI imaging” and “functional MRI imaging” (fMRI), where MRI provides only structural information on the brain while fMRI yields both structural and functional data.
multiplesclerosis (MS): A chronic autoimmune disorder affecting movement, sensation, and bodily functions. It is caused by destruction of the myelin insulation covering nerve fibers (neurons) in the central nervous system (brain and spinal cord).
neuronal loss: Loss of neurons (also known as neurones and nerve cells), which are electrically excitable cells in the nervous system that process and transmit information.
neurons (also known as neurones and nerve cells): Electrically excitable cells in the nervous system that process and transmit information. In vertebrate animals, neurons are the core components of the brain, spinal cord, and peripheral nerves.
NIDS: Neuro immune dysfunction syndromes, a set of related disorders characterized by complex interactions between the nervous system and the immune system.
norepinephrine: A hormone secreted by the adrenal medulla that is released into the bloodstream in response to physical or mental stress, as from fear or injury. It initiates many bodily responses, including the stimulation of heart action and an increase in blood pressure, metabolic rate, and blood glucose concentration. Also called adrenaline.
PANDAS: An abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.
pathophysiology: The study of the biologic and physical manifestations of disease as they correlate with the underlying abnormalities and physiologic disturbances. Pathophysiology does not deal directly with the treatment of disease. Rather, it explains the processes within the body that result in the signs and symptoms of a disease.
PET scan: Positron–emission tomography (PET) measures emissions from radioactively labeled metabolically active chemicals that have been injected into the bloodstream. The emission data are computer-processed to produce two- or three-dimensional images of the distribution of the chemicals throughout the brain (Nilsson 57). The positron-emitting radioisotopes used are produced by a cyclotron, and chemicals are labelled with these radioactive atoms. The labeled compound, called a radiotracer, is injected into the bloodstream and eventually makes its way to the brain. Sensors in the PET scanner detect the radioactivity as the compound accumulates in various regions of the brain. A computer uses the data gathered by the sensors to create multicolored two- or three-dimensional images that show where the compound acts in the brain. Especially useful are a wide array of ligands used to map different aspects of neurotransmitter activity, with by far the most commonly used PET tracer being a labeled form of glucose (see FDG).
Purkinje cells: A class of GABAergic neurons located in the cerebellar cortex. They are named after their discoverer, Czech anatomist Jan Evangelista Purkyně.
retroviruses: A retrovirus is an RNA virus that is replicated in a host cell via the enzyme reverse transcriptase to produce DNA from its RNA genome. The DNA is then incorporated into the host’s genome by an integrase enzyme. The virus thereafter replicates as part of the host cell’s DNA. They are enveloped viruses possessing an RNA genome, and replicate via a DNA intermediate.
RhoGam injections: A medicine given by intermuscular injection that is used to prevent the immunological condition known as Rhesus disease (or hemolytic disease of newborn). It can prevent maternal sensitization by Rh D antigens on the surface of blood cells from a Rhesus positive fetus in a Rhesus negative mother. The medicine is a solution of IgG anti-D (anti-RhD) antibodies which binds and destroys fetal Rh D positive red blood cells that have passed through the placenta from the fetus to the maternal circulation. This prevents maternal B-cell activation and memory cell formation. With the widespread use Rho(D) immune globulin Rh disease of the fetus and newborn has almost disappeared.
SPECT: Single photon emission computed tomography (SPECT) is similar to PET and uses gamma ray emitting radioisotopes and a gamma camera to record data that a computer uses to construct two- or three-dimensional images of active brain regions (ball). SPECT relies on an injection of radioactive tracer, which is rapidly taken up by the brain but does not redistribute. Uptake of SPECT agent is nearly 100 percent complete within 30—60s, reflecting cerebral blood flow (CBF) at the time of injection. These properties of SPECT make it particularly well suited for epilepsy imaging, which is usually made difficult by problems with patient movement and variable seizure types. SPECT provides a “snapshot” of cerebral blood flow since scans can be acquired after seizure termination (so long as the radioactive tracer was injected at the time of the seizure). A significant limitation of SPECT is its poor resolution (about 1 cm) compared to that of MRI.
temporal lobes: The temporal lobes are parts of the cerebrum that are involved in speech, memory, and hearing. They lie at the sides of the brain, beneath the lateral or Sylvian fissure.
thimerosal: A mercury-based crystalline powder with antibacterial and antifungal properties, used as a local antiseptic and preservative in vaccines and other drugs.
Tourette’s: Tourette’s syndrome (TS) is an inherited disorder of the nervous system, characterized by a variable expression of unwanted movements and noises (tics).
virus: a minute infectious agent which, with certain exceptions, is not resolved by the light microscope, lacks independent metabolism and is able to replicate only within a living host cell; the individual particle (virion) consists of nucleic acid (nucleoid)—DNA or RNA (but not both)—and a protein shell (capsid), which contains and protects the nucleic acid and which may be multilayered.
NOTES
Foreword
1 Goldstein, J. The Pathophysiology and Treatment of Chronic Fatigue Syndrome and Other Neurosomatic Disorders: Cognitive Therapy in a Pill. Alasbimn Journal2(7): April 2000. Article N° AJ07-5. http://www.alasbimnjournal.cl/revistas/7/goldstein.html
2 Goldberg, M. Mena I and Miller B. Frontal and Temporal Lobe Dysfunction in autism and Other Related Disorders: ADHD and OCD. Alasbimn Journal1(4): July 1999. http://www.alasbimnjournal.cl/revistas/4/goldberg.htm
3 Roca Bielsa, I. ; Mena, I.; García-Burillo, A. et al. SPET cerebral cuantificado en el Síndrome de Fatiga Crónica: comparación de los es
tudios basal y post-esfuerzo. Alasbimn Journal 8(31): January 2006.
4 Mena G., Ismael. Neurospect applications in Psychiatry. Alasbimn Journal 11 (45):July 2009. Article N° AJ45-1.http://www.alasbimnjournal.cl/
5 Mountz J., Tolbert L., Lill D., Katholi C., and Liu H. Functional Deficit in Autistic Disorder< Characterization by Tc99m HMPAO and SPECT. J.Nuc.Med.1995, 36, 1156/1162
Introduction
1 Klotter, Jule. (2002) Hepatitis B Vaccine TownsendLetter (In the case of the hepatitis B vaccine, Samuel L. Katz, MD, who was ACIP chairman when the hepatitis B recommendations were made in 1991, admitted that no peer-reviewed, published studies supported giving the vaccine to newborns. Mr . Belkin says that over . . . In the case of the hepatitis B vaccine, Samuel L. Katz, MD, who was ACIP chairman when the hepatitis B recommendations were made in 1991, admitted that no peer-reviewed, published studies supported giving the vaccine to newborns. Mr . Belkin says that over 36,000 adverse reactions and 440 deaths involving the hepatitis B vaccine have been reported to the Vaccine Adverse Event Reporting System.)
The Myth of Autism Page 24