Autism: A Neurodevelopmental Disorder and a Stratum for Comorbidities

M. Saleh, A. Adel
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Abstract

Autism is a neurodevelopmental disorder which is more common in males than females. It is characterized by social communication disorders and restricted repetitive behaviors. There is wide heterogeneity in its etiology, clinical presenta-tions, management and consequently prognosis. Although the etiology of autism remains unclear, the most currently proven theory is that it is a complex neurodevelopmental disorder that displays “brain network abnormalities”. fMRI studies have shown decreased brain connectivity or functional synchronization between frontal and more posterior cortical regions. Dynamic brain activity through high resolution electroencephalograghy (EEG) has revealed local overconnectivity and long-range underconnectivity. This disrupted connectivity pattern would involve connectivity between hemispheres (corpus callosum), together with axonal and synaptic connectivity within each hemisphere. Inconsistent morphometric changes involving both gray and white matter structure also exist. Clinically, autism is associated with multiple comorbidities (somatic, neurologic and psychiatric); some of which are attention deficit hyperactivity disorder, dyspraxia, and sensory processing disorders.
自闭症:一种神经发育障碍和共病的一个阶层
自闭症是一种神经发育障碍,男性比女性更常见。它的特点是社会沟通障碍和限制性重复行为。在其病因、临床表现、治疗和预后方面存在广泛的异质性。虽然自闭症的病因尚不清楚,但目前最被证实的理论是,这是一种复杂的神经发育障碍,表现出“大脑网络异常”。功能磁共振成像研究显示,大脑前额和后部皮层区域之间的连通性或功能同步下降。通过高分辨率脑电图(EEG)的动态脑活动揭示了局部过度连接和远距离连接不足。这种中断的连接模式可能涉及两个半球(胼胝体)之间的连接,以及每个半球内的轴突和突触连接。涉及灰质和白质结构的不一致的形态学变化也存在。在临床上,自闭症与多种合并症(躯体、神经和精神)有关;其中一些是注意缺陷多动障碍,运动障碍和感觉处理障碍。
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