Kern Janet Kinnear
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, St. Paul Professional Building I, 5959 Harry Hines Boulevard, Suite 520, Dallas, TX 75390-9101, USA.
Brain Dev. 2003 Sep;25(6):377-82. doi: 10.1016/s0387-7604(03)00056-1.
Autism is a neurological disorder of unknown etiology. The onset of the abnormal growth and development within the brain is also not known. Current thought by experts in autism is that the time of onset is prenatal, occurring prior to 30 weeks gestation. However, autism comprises a heterogeneous population in that parents report either that their child was abnormal from birth, or that their child was developmentally normal until sometime after birth, at which time the child began to regress or deteriorate. Anecdotal reports suggest that some children with autism have significant illness or clinical events prior to the development of autistic symptoms. Conceivably, these children may become autistic from neuronal cell death or brain damage sometime after birth as result of insult. To support this theory is that marked Purkinje cell loss, the most consistent finding in the autistic disorder, can result from insult. Evidence suggests that the Purkinje cell is selectively vulnerable. This article discusses a theory that the selective vulnerability of the Purkinje cell may play a role in the etiology of autism, and suggests that a future direction in autism research may be to investigate the possibility of neuronal cell loss from insult as a cause of autism. Results of a small pilot survey are also discussed.
自闭症是一种病因不明的神经障碍。大脑内异常生长和发育的起始时间也不清楚。目前自闭症专家的观点是发病时间在产前，即在妊娠30周之前。然而，自闭症患者群体具有异质性，因为家长们报告称，他们的孩子要么从出生起就不正常，要么在出生后的一段时间内发育正常，之后才开始出现退化或恶化。轶事报告表明，一些自闭症儿童在出现自闭症症状之前有重大疾病或临床事件。可以想象，这些儿童可能在出生后因受到伤害而导致神经元细胞死亡或脑损伤，进而患上自闭症。支持这一理论的是，自闭症谱系障碍中最一致的发现——显著的浦肯野细胞丢失，可能是由伤害导致的。有证据表明浦肯野细胞具有选择性易损性。本文讨论了一种理论，即浦肯野细胞的选择性易损性可能在自闭症病因中起作用，并表明自闭症研究未来的一个方向可能是调查因伤害导致神经元细胞丢失作为自闭症病因的可能性。还讨论了一项小型初步调查的结果。
