Dhossche Dirk Marcel, Rout Ujjwal
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Int Rev Neurobiol. 2006;72:55-79. doi: 10.1016/S0074-7742(05)72004-3.
Autistic regression seems to occur in about a quarter of children with autism. Its cause is unknown. Late-onset autistic regression, that is, after 2 years of age, shares some features with catatonic regression. A working hypothesis is developed that some children with autistic regression suffer from early-onset catatonic regression. This hypothesis cannot be answered from current data and is difficult to address in clinical studies in the absence of definite markers of autistic and catatonic regression. Treatment implications are theoretical and involve the potential use of anticatatonic treatments for autistic regression. Focus is on electroconvulsive therapy (ECT)--an established but controversial treatment that is viewed by many, but not all, as the most effective treatment for severe, life-threatening catatonic regression. Clinical trials of ECT in early- or late-onset autistic regression in children have not been done yet. The effects of electroconvulsive seizures--the experimental analogue of ECT--should also be tested in gamma-aminobutyric acid-ergic animal models of autistic regression, autism, catatonia, and other neurodevelopmental disorders. Purkinje cell survival and neurogenesis are putative outcome measures in these models.
约四分之一的自闭症儿童似乎会出现自闭症退化现象。其病因不明。迟发性自闭症退化，即两岁之后出现的退化，与紧张性退化有一些共同特征。由此提出一个可行的假设，即一些患有自闭症退化的儿童患有早发性紧张性退化。目前的数据无法回答这个假设，而且在缺乏自闭症和紧张性退化明确标志物的情况下，很难在临床研究中加以探讨。治疗方面只是理论上的，涉及对自闭症退化使用抗紧张性治疗的可能性。重点是电休克疗法（ECT）——一种既定但存在争议的治疗方法，许多人（但不是所有人）认为它是治疗严重的、危及生命的紧张性退化的最有效方法。目前尚未开展针对儿童早发性或迟发性自闭症退化的ECT临床试验。电休克发作（ECT的实验模拟）的效果也应在自闭症退化、自闭症、紧张症及其他神经发育障碍的γ-氨基丁酸能动物模型中进行测试。浦肯野细胞存活和神经发生是这些模型中假定的结果指标。
