Evidence of Cortical Disorganization in Autism: Comparing Transcranial Ultrasound (TUS) to Microstructure; with Thoughts on Enhanced Means to Restore the Autism Brain.
May 5, 2015 Leave a comment
Shortly after Marco Ruggiero, Stefania Pacini and I published our findings using a novel method of transcranial ultrasonographic imaging (TUS) to image the autism brain and surrounding structures, Eric Courchesne, the noted neuroscientist from UCSD, published their findings of cortical (higher brain) defects which seems very similar in nature and which may be related to our own observations. The Courchesne team did their work with autopsy brains, so the obvious intrigue here is whether we are now able to use our ultrasound methods to visualize these defects. Since we both published our data at nearly the same time we were unaware of the each others’ observations. Now, and for the first time, I will compare what we saw with ultrasound and termed cortical abnormalities (and possibly dysplasia) to what Courchesne refers to as “patches” based on RNA expression and microstructure on tissue evaluations. This post is lengthy, rather technical and regrettably complex, but are of extreme importance. Herein, I will describe the combined transcranial technologies: pulsed magnetic (see prior posts), low level laser and focused ultrasound, which are presently in routine use at our facility in the Atlanta area. Let’s explore why this is all so important to autism.
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We start here with the observations from UCSD which tell us that “patches” of disorganization exist in areas of the autism brain which correspond with the observed language, social and repetitive abnormalities.
NOW LET’S CONTRAST THESE FINDINGS WITH WHAT I SEE IN SOME CHILDREN WITH AUTISM WHEN I VIEW THE BRAIN WITH ULTRASONOGRAPHY.
As a quick background on TUS, it functions much like sonar an sends out high frequency vibrations which reflect off the tissues based on the density of the structures.
More density means more reflection or a whiter looking signal. Less density is darker.
THE IMAGE BELOW IS WHAT WE SEE IN HEALTHY CHILDREN WITHOUT AUTISM. NOTE THE SMOOTH, LAYERED AND HOMOGENOUS REFLECTION FROM THE TUS
Now look at this pattern (below).
As we magnify the TUS images (as seen in the images above) we see focal “patches” where the reflection is decreased (this means decreased reflective density of tissue). It is generally subtle and takes a careful look to actual see, but we don’t see these types of images in healthy children. We cannot be certain, but its tempting to speculate that these hyporeflective “patches” correspond to the same “patches”described by Courchesne’s UCSD team.
NOW THE BIG QUESTION: WHAT CAN WE DO ABOUT IT?
Before I attempt to answer that, allow me to share 20 years of observations regarding autism. Over and over again parents tell me their child is really smart in many ways. Based on typical measurements of “smart” that observation is hard to support. However, we now have windows into their smart brain via facilitated communication and rapid prompting methods, which allow the children to tell their own stories. In all the cases I am aware of, they are processing many things at full proficiency, and yet find it nearly impossible to talk effectively. Both my son’s own autism symptoms and those of my stepson, are very much the same. I can best describe it as “focal” meaning there are asymmetrical strengths and weaknesses which don’t fit the typical model of autism neurodevelopment as either genetic or from within the womb, since these areas develop at differing times in the child’s life.
NOW FOR MY ATTEMPTS AT SOLUTIONS
We know MRT (see prior posts on this blog) is a very effect way if improving harmonics, behavior, socialization and cognition in children. What we have started doing is combining the known effect on the brain’s physics with healing of the structures of the brain using stem cells, TUS, or more specifically focused sonication, and low level lasers. Stem cells are not practical for many patients, but if you are interested in this method, explore my published research with my team members from EmCell and Italy (article below):
When Marco Ruggiero and I originally discussed the TUS project he had two interests: the first was to look and describe the observations, while the second was to treat the brain with TUS. He, in fact, was already doing that with ME/CFS patients and felt it could be helpful in ASD. Stuart Hameroff at the University of Arizona had just explored the possible application of TUS (sonication) of the brain as a therapy for pain states. See Below:
Six months after our TUS paper was published, a team from Harvard and Korea also proposed the therapeutic use of TUS as a non-invasive form of brain stimulation. They stated this in their paper (excerpted below): “The demand for methods enabling non-invasive brain stimulation with superior spatial specificity and penetration depth, therefore, has been warranted, and focused ultrasound (FUS) has emerged as a new modality that shows exceptional promise in the field of brain stimulation and subsequent functional brain mapping.” So we have both TUS as a diagnostic consideration and FUS as a therapeutic potential in ASD.
Next we can add in the observations from Harvard on the use of transcranial lasers to repair the brain.
IMAGEs FROM: J Biophotonics. 2012 Nov;5(11-12):827-37. doi: 10.1002/jbio.201200077. Epub 2012 Jul 17.
Transcranial low level laser (light) therapy for traumatic brain injury.
Huang YY1, Gupta A, Vecchio D, de Arce VJ, Huang SF, Xuan W, Hamblin MR.
- 1Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.
It therefore seems, that LLLT (known as photobiomodulation) has the therapeutic potential to stimulate existing stem cells to repair the brain (to the extent that is possible) and at the same time enhance the synaptic connections, reduce inflammation and correct mitochondrial dysfunction (pretty much the whole list of issues for autism apart from the physics component). Marco Ruggiero and I speculated that the decrease in the reflections noted via TUS results from the decrease in synaptic connections, but this has not been established through other means of testing. So, LLLT may be able to stimulate restoration in “patches” described by the UCSD team and what we believe we are observing on TUS. Add to this the effects of FUS (sonic stimulation) and we seem to have the basis of potential hardware repair. Once the mechanical restoration is in place the potential for MRT can be enhanced.
Pulling this all together, it appears the brain in ASD has structural abnormalities which are not going to be easily overcome. However, enhances in our understanding of LLLT and TUS/FUS when combined with powerful tools like MRT, creates renewed hope for true restoration in ASD. These points will be further explained in my lectures at Autism One in a few weeks.