Bjørklund Geir, Kern Janet K, Urbina Mauricio A, Saad Khaled, El-Houfey Amira A, Geier David A, Chirumbolo Salvatore, Geier Mark R, Mehta Jyutika A, Aaseth Jan
Council for Nutritional and Environmental Medicine, Mo i Rana, Norway,
Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA; CONEM US Autism Research Group, Allen, TX, USA.
Acta Neurobiol Exp (Wars). 2018;78(1):21-29.
Cerebral hypoperfusion, or insufficient blood flow in the brain, occurs in many areas of the brain in patients diagnosed with autism spectrum disorder (ASD). Hypoperfusion was demonstrated in the brains of individuals with ASD when compared to normal healthy control brains either using positron emission tomography (PET) or single‑photon emission computed tomography (SPECT). The affected areas include, but are not limited to the: prefrontal, frontal, temporal, occipital, and parietal cortices; thalami; basal ganglia; cingulate cortex; caudate nucleus; the limbic system including the hippocampal area; putamen; substantia nigra; cerebellum; and associative cortices. Moreover, correlations between symptom scores and hypoperfusion in the brains of individuals diagnosed with an ASD were found indicating that the greater the autism symptom pathology, the more significant the cerebral hypoperfusion or vascular pathology in the brain. Evidence suggests that brain inflammation and vascular inflammation may explain a part of the hypoperfusion. There is also evidence of a lack of normal compensatory increase in blood flow when the subjects are challenged with a task. Some studies propose treatments that can address the hypoperfusion found among individuals diagnosed with an ASD, bringing symptom relief to some extent. This review will explore the evidence that indicates cerebral hypoperfusion in ASD, as well as the possible etiological aspects, complications, and treatments.
脑灌注不足，即大脑血流量不足，在被诊断为自闭症谱系障碍（ASD）的患者大脑的许多区域都会出现。与正常健康对照者的大脑相比，无论是使用正电子发射断层扫描（PET）还是单光子发射计算机断层扫描（SPECT），都证实了ASD患者大脑存在灌注不足。受影响的区域包括但不限于：前额叶、额叶、颞叶、枕叶和顶叶皮质；丘脑；基底神经节；扣带回皮质；尾状核；包括海马区在内的边缘系统；壳核；黑质；小脑；以及联合皮质。此外，在被诊断为ASD的个体大脑中发现症状评分与灌注不足之间存在相关性，这表明自闭症症状病理越严重，大脑中的脑灌注不足或血管病理就越明显。有证据表明，脑部炎症和血管炎症可能是灌注不足的部分原因。也有证据表明，当受试者面对一项任务时，缺乏正常的血流代偿性增加。一些研究提出了可以解决被诊断为ASD的个体中发现的灌注不足问题的治疗方法，在一定程度上缓解了症状。这篇综述将探讨表明ASD中脑灌注不足的证据，以及可能的病因、并发症和治疗方法。
