INSIGHTS | 20. The Link Between Autism & Inflammation
Neuroimaging allows us to look inside that infinitely complex structure we call the brain. Unfortunately, this isn't routinely done for those with Autism.
In recent years, people have become justifiably skeptical about Big Pharma and vaccines. With recent covid policies, the definition of “anti-vaxxer” has expanded as well.
When I was in school, an anti-vaxxer was often characterized as someone who thought the MMR vaccine (amongst others) caused autism. But recently, our regulators have expanded this definition to include anyone opposed to vaccine mandates.
Quite the range of beliefs for one derogatory term.
But, this piece is not about vaccines causing autism.
This piece is about the role of inflammation in neurological disease, with attention on autism.
What is Autism?
The definition and diagnostic criteria for autism should help illustrate how incomplete and uncertain a condition it really is. Initially, people would refer to those with difficulties in language & social interaction as autistic.
Now, we refer to it as autism spectrum disorder (ASD) because, over time we learned that it wasn’t as simple as we thought.
The most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has very elaborate diagnostic criteria:
Persistent deficits in social communication and interaction
Restricted or repetitive patterns of behavior, interest or activities
Symptoms must be present in early developmental period
Symptoms cause impairment in social, occupational, and life settings
Not better explained by intellectual disability or global developmental delay…
But, intellectual disability frequently co-occurs with ASD (go figure)
The DSM goes on to state that the doctor must specify if there is:
Developmental, mental, or behavioral disorders
Catatonia - abnormal muscle tone
Associated with medical or environmental factors
It’s all a bit complicated.
What is Autism, really?
One of the best descriptions I have come across was from Karl Deisseroth, who was a guest on the Lex Fridman podcast not too long ago. Karl is best known for his pioneering work on optogenetics, but is also a psychiatrist.
In Karl’s view, autism is an inability to appropriately process new information.
You may be wondering ‘what is the connection between social interactions and processing new information?’
As Karl points out, since autistic people have difficulty processing novel information, the domain within which that would manifest the greatest is social dynamics. There is nothing as unpredictable, chaotic and idiosyncratic as interactions with other humans.
Thus, it would make sense for the most apparent ‘deficiency’ within autism to be social interaction. A natural extension of this would be language fluency and intellectual disability.
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