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婴儿自闭症:一种自婴儿期起由于辅助运动区突触修剪而导致的慢性精神病。

Infantile autism: a chronic psychosis since infancy due to synaptic pruning of the supplementary motor area.

作者信息

Saugstad Letten F

机构信息

Institute of Neuroscience, University of Oslo.

出版信息

Nutr Health. 2008;19(4):307-17. doi: 10.1177/026010600801900406.

Abstract

The rise in Infantile Autism, learning problems, cognitive decline with age, Alzheimer's, Parkinson's Diseases and the SIDS epidemic, has a common cause in the rising dietary deficit in Omega-3 brain-food. This paper suggests that aside from the wider concept of Autism Spectrum Disorders (ASD) and Pervasive Developmental Disorders (PDD), the rise in Infantile Autism (IA) in the last decade is the effect of deficient brain-food (Omega-3). The consequent delay of development prolongs the 2nd regressive event in infancy to pruning of the centre in the Medial Frontal Lobe System that connects Hippocampus and Cingulum. With a consequently defective Supplementary Motor Area (SMA), the Delayed Response Function is affected leading to persistent psychosis. Post-Pubertal Episodic Psychoses are associated with acute reduction of excitation, a risk of breakdown of circuitry, insufficient fill-in mechanisms, and silent spots. An acute psychosis occurs if the silent spots comprise of SMA. Only two brain areas have continuous neurogenesis, indicating their important functions: the Hippocampus and Olfactory Bulb that belongs to the Lateral Frontal Lobe System essential to survival. Concerned with necessity of action in response to the environment, it relies upon short-term memory and Acute Feedback Mechanisms influenced by emotion and motivation from the external world. In contrast, the Medial Frontal Lobe network is controlled by Feed-Forward Predictive Mechanisms related to storage of information. The Delayed Response Function is mastered at 7 months, when 2nd event occurs with pruning of axons and dendrites. An abolished or defective Delayed Response Function seriously incapacitates an individual: A defective "Social Brain" with an inability for conscious action and to communicate, predominates in IA. There is a near lack of speech, despite normal vision and hearing in the minority without marked adversity in pregnancy, at delivery or in infancy. I propose that the recent rise in IA despite no rise in adversity signifies a rising deficiency in brain-food. That this is so is suggested by a changing clinical picture: no Mental Retardation in an IA majority. Deficit in Olfaction is pathognomonic in schizophrenia since 30 yrs and distinguishes the Asperger Syndrome. If brain-food deficiency alone sufficiently prolongs pruning to cause absent activity in SMA in infancy, less mentally retarded IA from other causes might be observed. Deficit in brain-food was evident in the Sudden Infant Death Syndrome: birthweight averaged 200-300 g lower than sibs, Omega-3 levels in brainstem were lower than controls. Only 20 % SIDS died in first hypoxic episode, suggesting such episodes are more frequent than we imagined. Children with learning-behaviour problems have similarly depressed birthweight. A general deficiency in Omega-3 contributes to the lacking reduction in Schizophrenia, despite early puberty predominates. Olfactory Bulb is first affected in the Alzheimer's and Parkinson's Disease. Cognitive decline with age, Hippocampal dysfunctions rise markedly irrespective of disease, but the major mental illnesses and Infantile Autism in particular, benefit from "brain-food" that might also prevent a development of these disorders. To secure optimal brain function in the coming generations, there is a need to change the diet now from its emphasis on protein for body growth to food for the brain. This means there is a need to increase fish and sea food consumption.

摘要

婴儿孤独症、学习问题、认知能力随年龄衰退、阿尔茨海默病、帕金森病以及婴儿猝死综合征的增多,都有一个共同原因,即ω-3脑营养物质在饮食中的缺乏日益严重。本文指出,除了更广泛的孤独症谱系障碍(ASD)和广泛性发育障碍(PDD)概念之外,过去十年中婴儿孤独症(IA)的增多是脑营养物质(ω-3)缺乏的结果。由此导致的发育延迟将婴儿期的第二次退行性事件延长至内侧额叶系统中连接海马体和扣带的中枢的修剪。由于补充运动区(SMA)因此出现缺陷,延迟反应功能受到影响,导致持续性精神病。青春期后发作性精神病与兴奋的急性减少、神经回路崩溃的风险、填充机制不足以及静区有关。如果静区包括SMA,则会发生急性精神病。只有两个脑区具有持续的神经发生,这表明了它们的重要功能:海马体和嗅球,嗅球属于外侧额叶系统,对生存至关重要。由于涉及对环境做出反应的行动必要性,它依赖于短期记忆以及受外部世界的情感和动机影响的急性反馈机制。相比之下,内侧额叶网络由与信息存储相关的前馈预测机制控制。延迟反应功能在7个月时掌握,此时会发生第二次事件,即轴突和树突的修剪。延迟反应功能的缺失或缺陷会严重削弱个体能力:在婴儿孤独症中,有缺陷的“社交脑”导致无法有意识地行动和交流占主导。少数在孕期、分娩期或婴儿期没有明显不良情况、视力和听力正常的婴儿几乎没有语言能力。我认为,尽管不良情况没有增加,但近期婴儿孤独症的增多表明脑营养物质的缺乏在加剧。不断变化的临床症状表明情况确实如此:大多数婴儿孤独症患者没有智力迟钝。嗅觉缺陷自30年前起就是精神分裂症的特征性表现,也是阿斯伯格综合征的区别特征。如果仅脑营养物质缺乏就足以使修剪过程充分延长,导致婴儿期SMA缺乏活动,那么可能会观察到与其他原因导致的智力迟钝程度较轻的婴儿孤独症。脑营养物质缺乏在婴儿猝死综合征中很明显:出生体重平均比兄弟姐妹低200 - 300克,脑干中的ω-3水平低于对照组。只有20%的婴儿猝死综合征患儿死于首次缺氧发作,这表明此类发作比我们想象的更频繁。有学习行为问题的儿童出生体重同样较低。尽管青春期提前占主导,但ω-3的普遍缺乏导致精神分裂症患者症状减轻不足。嗅球在阿尔茨海默病和帕金森病中首先受到影响。认知能力随年龄衰退,无论是否患病,海马体功能障碍都会显著增加,但主要精神疾病,尤其是婴儿孤独症,受益于“脑营养物质”,这也可能预防这些疾病的发生。为了确保后代的大脑功能达到最佳状态,现在需要改变饮食,从侧重于促进身体生长的蛋白质转向脑营养食物。这意味着需要增加鱼类和海鲜的消费量。

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