Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Monash University and The Alfred, Melbourne, Australia.
Dev Med Child Neurol. 2010 Aug;52(8):e179-83. doi: 10.1111/j.1469-8749.2010.03665.x. Epub 2010 Mar 29.
Controversy surrounds the distinction between high-functioning autism (HFA) and Asperger disorder, but motor abnormalities are associated features of both conditions. This study examined motor cortical inhibition and excitability in HFA and Asperger disorder using transcranial magnetic stimulation (TMS).
Participants were diagnosed by experienced clinicians strictly according to DSM-IV criteria. Participants with HFA (nine males, two females; mean age 16y 8mo, SD 4y 5mo) or Asperger disorder (11 males, three females; mean age 19y 1mo, SD 4y 2mo) and neurotypical participants (eight males, three females; mean age 19y 0mo, SD 3y 1mo) were administered a paired-pulse TMS paradigm intended to assess motor cortical inhibition and excitability. Responses to TMS were recorded by electromyography.
Cortical inhibition was significantly reduced in the HFA group compared with both the Asperger disorder (p<0.001) and neurotypical (p<0.001) groups, suggesting disruption of activity at gamma-aminobutyric acid A (GABA(A)) receptors. There was no group difference in cortical excitability.
Cortical inhibition deficits may underlie motor dysfunction in autism, and perhaps even relate to specific clinical symptoms (e.g. repetitive behaviours). These findings provide novel evidence for a possible neurobiological dissociation between HFA and Asperger disorder based on GABAergic function.
高功能自闭症（HFA）和阿斯伯格综合征之间的区别存在争议，但运动异常是这两种疾病的共同特征。本研究使用经颅磁刺激（TMS）检查 HFA 和阿斯伯格综合征的运动皮质抑制和兴奋性。
经验丰富的临床医生根据 DSM-IV 标准严格诊断参与者。HFA 组（9 名男性，2 名女性；平均年龄 16 岁 8 个月，SD 4 岁 5 个月）或阿斯伯格综合征组（11 名男性，3 名女性；平均年龄 19 岁 1 个月，SD 4 岁 2 个月）和神经典型组（8 名男性，3 名女性；平均年龄 19 岁 0 个月，SD 3 岁 1 个月）接受了旨在评估运动皮质抑制和兴奋性的成对脉冲 TMS 范式。通过肌电图记录 TMS 反应。
与阿斯伯格综合征组（p<0.001）和神经典型组（p<0.001）相比，HFA 组的皮质抑制明显降低，表明γ-氨基丁酸 A（GABA(A)）受体活性中断。皮质兴奋性无组间差异。
皮质抑制缺陷可能是自闭症运动功能障碍的基础，甚至可能与特定的临床症状（例如，重复行为）有关。这些发现为基于 GABA 能功能的 HFA 和阿斯伯格综合征之间可能存在的神经生物学分离提供了新的证据。
