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RESEARCH

Autism is Characterized by Dorsal Anterior Cingulate Hyperactivation During Social Target Detection


Gabriel S. Dichter; Jennifer N. Felder; James W. Bodfish Posted: 12/28/2009; Social Cognitive and Affective Neuroscience. 2009;4(3):215-226. © 2009   medscape.com  is.gd/5GKT8

Abstract and Introduction

Abstract


      Though the functional neural correlates of impaired cognitive control and social dysfunction in autism spectrum disorders (ASD) have been delineated, brain regions implicated in poor cognitive control of social information is a novel area of autism research. We recently reported in a non-clinical sample that detection of 'social oddball' targets activated a portion of the dorsal anterior cingulate gyrus and the supracalcarine cortex (Dichter, Felder, Bodfish, Sikich, and Belger, 2009). In the present investigation, we report functional magnetic resonance imaging results from individuals with ASD who completed the same social oddball task. Between-group comparisons revealed generally greater activation in the ASD group to both social and non-social targets. When responses to social and non-social targets were contrasted, the ASD group showed relatively greater activation in the right and middle inferior frontal gyri and a region in dorsomedial prefrontal cortex that abuts the dorsal anterior cingulate (Brodmann's Area 32). Further, dorsal anterior cingulate activation to social targets predicted the severity of social impairments in a subset of the ASD sample. These data suggest that the dorsal anterior cingulate mediates social target detection in neurotypical individuals and is implicated in deficits of cognitive control of social information in ASD.

Introduction
      The purpose of this study was to examine patterns of regional brain activation in individuals with autism spectrum disorders (ASD) during a target detection task that involved both social and non-social components. Whereas previous studies have demonstrated that individuals with ASD show anomalous brain activation during target detection tasks (Gomot et al., 2008; Shafritz et al., 2008), these studies used tasks that involved non-social information. However, the social cognitive deficits that are the sine qua non of autism should produce a unique pattern of responses during tasks that press for cognitive control of social information. Such tasks would represent a reasonable facsimile of everyday social situations wherein successful adaptation requires the identification of relevant and irrelevant social cues as well as the differential processing of social and non-social sources of information.
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• • •

Scientists Discover a Controller of
Brain Circuitry


is.gd/5GKqg

      ScienceDaily — By combining a research technique that dates back 136 years with modern molecular genetics, a Johns Hopkins neuroscientist has been able to see how a mammal's brain shrewdly revisits and reuses the same molecular cues to control the complex design of its circuits.
      Details of the observation in lab mice, published Dec. 24 in Nature, reveal that semaphorin, a protein found in the developing nervous system that guides filament-like processes, called axons, from nerve cells to their appropriate targets during embryonic life, apparently assumes an entirely different role later on, once axons reach their targets. In postnatal development and adulthood, semaphorins appear to be regulating the creation of synapses -- those connections that chemically link nerve cells.
      "With this discovery we're able to understand how semaphorins regulate the number of synapses and their distribution in the part of the brain involved in conscious thought," says David Ginty, Ph.D., a professor in the neuroscience department at the Johns Hopkins University School of Medicine and a Howard Hughes Medical Institute investigator. "It's a major step forward, we believe, in our understanding of the assembly of neural circuits that underlie behavior."
      Because the brain's activity is determined by how and where these connections form, Ginty says that semaphorin's newly defined role could have an impact on how scientists think about the early origins of autism, schizophrenia, epilepsy and other neurological disorders.
      The discovery came as a surprise finding in studies by the Johns Hopkins team to figure out how nerve cells develop axons, which project information from the cells, as well as dendrites, which essentially bring information in. Because earlier work from the Johns Hopkins labs of Ginty and Alex Kolodkin, Ph.D., showed that semaphorins affect axon trajectory and growth, they suspected that perhaps these guidance molecules might have some involvement with dendrites.
      Kolodkin, a professor in the neuroscience department at Johns Hopkins and a Howard Hughes Medical Institute investigator, discovered and cloned the first semaphorin gene in the grasshopper when he was a postdoctoral fellow. Over the past 15 years, numerous animal models, including strains of genetically engineered mice, have been created to study this family of molecules.
      Using two lines of mice -- one missing semaphorin and another missing neuropilin, its receptor -- postdoctoral fellow Tracy Tran used a classic staining method called the Golgi technique to look at the anatomy of nerve cells from mouse brains. (The Golgi technique involves soaking nerve tissue in silver chromate to make cells' inner structures visible under the light microscope; it allowed neuroanatomists in 1891 to determine that the nervous system is interconnected by discrete cells called neurons.)
      
• • •

TREATMENT

Consumers Get Medical Test Results
Straight From Labs


      By Lee Bowman, Scripps Howard News Service, is.gd/5GKDt

      As Americans struggle to take charge of their health care -- and hold down their medical costs -- a growing number are bypassing the doctor and going right to the source for diagnostic tests.
      Whether through arrangements made online or at one of scores of storefront testing centers around the country, patients are rolling up their sleeves to get screening results about everything from sexually transmitted diseases to cholesterol levels that in many cases leave physicians out of the loop.
      Most of the time, patients pay for the testing out of pocket, with no insurance money involved. And they control who sees the results.
      The concept appeals to patients like 40-year-old Deon Lawson of Abilene, Texas, who went to a new storefront lab "to tell me if my thyroid level is off." She said she had previously been diagnosed with a hyperactive thyroid, but sought the test when she felt her condition might be worsening. "That way, I know if I want to go to the doctor."
      But having patients make the call based on consumer-ordered test results is a major concern for many doctors.
      "There's always the worry that some consumer orders this blood screen on the Web and it comes back with a white count of 150,000 or some other big red flag, and he ignores it and dies. And everyone says consumers can't be trusted with this stuff," said Dr. Bruce Friedman, professor emeritus of pathology at the University of Michigan Medical School who follows consumer-direct-testing issues. "I think the majority of consumers, when given abnormal results, will take it to a physician and ask for interpretation."
      For many clients, the labs are all about sex or drugs -- finding out, as privately as possible, answers about STDs, paternity, even sperm counts. Others want to know, in advance, whether they're likely to pass a pre-employment drug test. Often, the employer may send them back to the same lab for the official check.
      Many of the facilities also report doing basic forensic work for private investigators, such as DNA tests of hair found on a pillow by a suspicious spouse.
      The lab services also market bundles of tests recommended by various experts from diet-book authors to doctors who have researched complex medical conditions such as autism, chronic fatigue and arthritis.
      Simple tests can cost as little as $25 to $49, while more complicated tests can run into hundreds or even thousands of dollars.
      In all, medical testing is a $55 billion-a-year business in the United States. Industry experts say lab tests sold directly to consumers make up only about $100 million of that market, but believe the share will grow as people without insurance or with limited coverage seek lower-cost diagnostic options.
      While there are about 200,000 medical-testing labs registered with the federal government, the vast majority of medical-diagnostic work in the U.S. is actually performed at the collection centers and facilities of two firms -- Quest Diagnostics and Lab Corp. of America.
      So whether a test is ordered through a doctor's office, a retail outlet or online, chances are that the actual work will be done in the same mega-labs.
      A patchwork of state rules covers how the diagnostic tests are done. Although there have been a number of calls to regulate tests offered over the Internet, particularly genetic tests, so far federal health officials haven't moved against consumer-requested lab tests, as long as the labs doing the tests are properly certified.
      State restrictions can range from having no requirement for doctor referral, as in Texas, to a strict interpretation that lab tests have to be ordered by and results returned to a doctor, the situation in California and other states where most companies have been able to meet the requirements by having consumer requests passed through medical directors licensed to practice in those states.
      Most online firms say they flag findings that appear to represent a serious medical threat and also caution patients to consult with a physician about their results. Most storefront centers offer to go over written results with customers.
+ Read more: is.gd/5GKDt
      
• • •

PEOPLE

'He's A Gifted Dancer': Davina Mccall Defends The Decision To Allow An Autistic Boy To Audition For Her New Talent Show


      By Georgina Littlejohn, dailymail.co.uk. is.gd/5GLor

      He's a ten-year-old little boy who fancies his chances on a new reality TV dance show.
      But bosses of Got To Dance, which starts on Sky 1 this Sunday night, have been criticised for allowing James Hobley to audition because he suffers from autism.
      In the aftermath of Britain's Got Talent contestant Susan Boyle's mental breakdown after the stresses brought on by the pressure of the show, there are fears that James may not be able to cope with the spotlight.   


 
      Got To Dance: 10-year-old James Hobley, who suffers from autism, auditions for the new Sky 1 show Got To Dance, which starts this Sunday.  

  
      But host Davina McCall defended the decision to let him perform.
      She said: 'If James had been spectacularly bad and he’d been laughed at on stage, then I would have been very upset.
      'But it’s not like that. James is a gifted dancer and, in fact, dancing has helped him in the most amazing way.
      'He hasn’t been put in the firing line to be laughed at. Viewers will love him.
      'I am very protective about anyone who goes onto any of the shows I do, including Big Brother. I would hate the idea that someone would be upset.
      'I want people to enjoy the experience. We go out of our way to make sure the contestants, especially the kids, are looked after.
      'If anyone cried at auditions I would rush out to comfort them or take them to their families.
      Hopeful: James waits for the judges' verdict on his dance routine
      'The judges on our show are also sensitive to the auditionees, especially the kids.'
      And there are high hopes that James will make it through to the finals, after he performed a routine to the Blackout Crew’s BB Bounce and Evanescence’s My Immortal.
      From Redcar in Middlesborough, he is one of three autistic boys in his family, but wasn’t coping very well with the condition and had trouble communicating with others.
      But three years ago, after the splints on his legs were removed, he got a new lease of life when a leaflet dropped through his door about dancing and he decided to take it up.
+ Read more: is.gd/5GLor



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• • •

Maine Hacker Pleads Guilty


      By The Mainebiz News. is.gd/5GM00

      An Aspergers hacker charged with stealing data from major retailers and organizing the Hannaford data breach could spend up to 25 years in jail.
      Albert Gonzalez pled guilty Tuesday at the U.S. District Court in Boston to hacking into the computer servers of Scarborough-based Hannaford Bros. Co. and stealing information on 4.2 million credit and debit cards, according to the Associated Press. The 28-year-old Florida man and former federal informant also pleaded guilty to hacking into 7-Eleven and New Jersey-based credit card processor Heartland Payment Systems Inc., as well as two unnamed companies. In September, Gonzalez pleaded guilty to stealing data from major retailers TJX Cos., BJs Wholesale Club, OfficeMax, BostonMarket, Barnes & Noble and Sports Authority. Gonzalez was indicted for the Hannaford breach in August.
      Gonzalez is scheduled for sentencing in March, and his lawyer plans to argue that he should spend fewer than 25 years in jail considering his prior drug use and a psychiatrist's report that he may have Asperger's syndrome, a form of autism, according to the AP.

• • •

PUBLIC HEALTH

Texas Study Confirms
Lower Autism Rate In Hispanics


      From the postchronicle.com is.gd/5GMGk

      Hispanic kids are less likely than their non-Hispanic white counterparts to be diagnosed with autism, and socioeconomic factors don't seem to explain the difference, according to a new study in Texas schoolchildren.
      "These findings raise questions: Is autism under diagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?" Dr. Raymond F. Palmer of the University of Texas Health Science Center in San Antonio and his colleagues write in the American Journal of Public Health.
      Other research has shown a lower risk of autism among Hispanic individuals, while one study found that Hispanics with autism were typically diagnosed later than autistic children of other ethnic backgrounds. Autism could be under diagnosed among Hispanics, Palmer and his team note, given that these children are less likely to have health insurance and more likely to have trouble accessing medical care.
      To investigate the factors behind the difference in prevalence, the researchers looked at data on 1,184 schools in 254 Texas counties, calculating the number of children in kindergarten through 12th grade in each district who had been diagnosed with autism.
      For every 10 percent increase in Hispanic schoolchildren in a given district, the researchers found, the prevalence of autism decreased by 11 percent, while the prevalence of kids with intellectual disabilities or learning disabilities increased by 8 percent and 2 percent, respectively.
      The reverse was seen as the percentage of non-Hispanic white children in a district increased, with the prevalence of autism rising by 9 percent and the prevalence of intellectual and learning disabilities falling by 11 percent and 2 percent.
      The observed relationships remained for Hispanic children after the researchers accounted for key socioeconomic and health care provider factors, although "urbanicity" of a district, median household income, and number of health care professionals did explain the increased percentage of autism among districts with more non-Hispanic white kids -- a finding the researchers call "curious."
      Whether lower autism prevalence in Hispanics is attributable to other, still-unexamined socioeconomic, health care delivery or biological factors "remains a crucial area for further research," Palmer and colleagues conclude.
      SOURCE: American Journal of Public Health, December 2009.

• • •

Vaccine 'Holy War' - Parents Sue Diocese


       By Dareh Gregorian  is.gd/5GKm2
     
       A devout Rockland County couple is suing the New York Archdiocese for barring their daughter from attending a Catholic preschool because she hasn't been fully vaccinated.
      The couple, who filed the suit anonymously, charges they're being subjected to religious discrimination and are seeking a court order allowing their 4-year-old to attend the St. Margaret School in Pearl River after the archdiocese turned down their request for a religious exemption.
      "Plaintiffs sought the exemption because they hold sincere and genuine religious beliefs, based upon Christian doctrine and Christian teachings that are contrary to vaccinating, that prevent them from injecting diseases into their bodies," the suit says.
      They also cite a moral objection to how the vaccines were created.
      "Jane Doe's" dad said his daughter had received some vaccinations as a baby, but they halted them because it "felt wrong." He said those feelings were borne out when they did more research about vaccines and discovered that many are grown in cell cultures that were obtained from two human fetuses that were aborted in 1964 and 1970.
      In an affidavit, Doe's mom said, "I am pro-life and have sincere and genuine religious beliefs that are contrary to vaccinating because aborted fetal cells are used in vaccinations."
      The couple applied to St. Margaret in January. While other archdioceses around the country allow religious exemptions from vaccinations, the school follows the tenets of the New York Archdiocese, which does not.
      "For the safety and well-being of our students and school communities, we do have a policy that all students receive vaccinations. All of our parents agree to this as a condition to sending their child to one of our schools," said Joe Zwilling, a spokesman for the archdiocese.
      Doe's dad, who said he has no issue with reactive medicine, said clashing with the Archdiocese "has been one of the most stressful things we've ever dealt with in our lives, and I'm a military veteran."

• • •

EVENTS

Registration Continues for Anaheim Autism/Asperger Conference Set for February


      Practical information for children and adults of all ages and abilities

      Join us for this comprehensive Autism conference series in Southern California for parents, teachers, SLPs, other professionals and individuals on the spectrum. This year's event features more than 30 speakers. CEUs for professional development are available.
      When: Saturday & Sunday Feb. 6-7, 2010 Where: Anaheim Convention Center (3rd floor) 800 W. Katella Ave., Anaheim, CA, 92802 Learn more & Register Online is.gd/5GMZ3

• • •

COMMENTARY

Living With Autism - A Mother's Christmas Call
For Compassion


      By Vanessa De La Torre, The Hartford Courant is.gd/5GJGB

      The clop-clop and bells of the horse-drawn carriage were enough to compete with the Christmas carolers, the theater actors in Dickensian costume, even the hefty SpongeBob offering high-fives to passers-by.
      Parents and children buzzed when the carriage traveled down natty Blue Back Square for the holiday stroll this month. Some waved at the riders.
      But not Ben Borré.
      "Look, Benny! Horses!" shouted his mother, Darlene.
      The 8-year-old glanced in the general direction before returning to the cotton candy that tinged his lips blue. Not long ago, Ben tried to eat fiberglass insulation from the basement ceiling panels in his home because it looked like cotton candy.
      The Borrés moved through the crowds that night with the light, grateful step of a family that doesn't get out much. Alex Borré, 45, an attorney for the Social Security Administration, sought hot chocolate and held Benny's hand. Lila, a 2 1/2 -year-old adopted from Guatemala, was ecstatic on Darlene's shoulders.
      Ben followed with worried eyes, often staring into the distance as if hopelessly trapped in a maze.
      'Not Prepared' Christmas is a holiday for children. This year we were not prepared to deal with a children-centered holiday. All year long we all rejoice in Ben's gains, no matter how small. We brainstorm, trying to figure out how best to get through to him. And each month of each year we realize how challenged Ben really is. ...
      No curiosity with the Christmas wrapping, no smiles when he recognizes a favorite stuffed animal. ... No "I love you." No jumping into our bed when he wakes up in the morning. Mostly, he screams. But we don't focus on that.
      — From the Borrés' letter to relatives post-Christmas 2005, explaining why they didn't celebrate the holiday that year.
      Darlene Borré, 42, has curled her hand into a fist and struck her chin again and again, as her son does. With the same hand she has formed an "OK" sign and peered through the "O" while bumping the thumb against her mouth.
      When Benny gazes out the family room window, ignoring a Santa decoration inches from his face, she tries to see what he sees, to feel what he might be feeling.
      The autism that took her son's words as a baby also snatched mastery of his limbs and movements. Ben can't write his own letter to Santa. The second-grader at Whiting Lane Elementary School can't write his name.
      Sometimes, it seems as if his hands are numb. He'll slap his calloused palms together and wring so hard it sounds like chafing rubber.
      "I ache, I bleed for him, because he is in so much discomfort," Darlene said one recent afternoon. Before Ben's diagnosis, she was a lawyer like her husband; now, she works as an insurance adjuster out of the family's two-story colonial on Foot Path Lane.
      Ben was sick with the flu last week and sat crying on the couch, unable to say what pained him.
      He had been a slow talker as a baby. Ben would say a few words — mama, dada, yogurt — but being Alex and Darlene's first child, and the only grandkid in the family, they had no one to compare him with at first.
      Around 15 months is when they noticed a vacuum of language and that Ben no longer looked them in the eye.
      By age 2, it became clear to the Borrés that Ben needed an assessment from an early intervention group. Darlene still believed that the test would reveal her beautiful son was a genius.
      After learning that Ben was probably autistic, Darlene often found herself wanting to throttle people who told her God would not give her more than she could bear.
      Ben soon began applied behavior analysis, the standard method of teaching kids with autism, a mysterious developmental disorder of the brain that ranges in severity and affects more boys than girls. Basic tasks are broken down into minute steps, each followed with a reward — blowing bubbles maybe, or snacking on a small cookie. It took months to teach Ben how to nod his head yes or no.
      Darlene and Alex felt, and still do, that a spark in curiosity could be a gateway for Ben. And so came a false sense of hope in 2004, when Ben became interested in Christmas lights on the family tree. He was 3 and seemed fascinated with the brightness, inching his face closer and closer until, one day, he chomped on the glass.
      He got two bites before his mother reached her finger into his mouth before he bled.
      "I'm right there and I know he does things like this, so you'd think I could anticipate it," Darlene said.
+ Read more: is.gd/5GJGB

       [Thanks to Karen Lepak.]

• • •

Carmel Wakefield Speaks Out on
Pending GMC Decision


      Below is an excerpt from Autism File magazine by Carrmel Wakefield, wife of Dr. Andrew Wakefield.  Read Mrs. Wakefield's complete, heartfelt message here.

      By Carmel Wakefield ...To get us in the mood for Christmas we have just been told that the longest GMC hearing in history is grinding towards a decision on the facts - the GMC’s complaint against my husband Andy Wakefield and his two colleagues Professors Walker Smith and Murch. The sixth anniversary of the complaint being made by the freelance reporter, Brian Deer, will be in February; the GMC hearing itself has lasted over 2 and a half years. At the time of writing, the date for a verdict to be “handed down” has been set for January 29th 2010 but that date has shifted three times in less than 10 days.
      It is very sad on so many levels. Obviously on a highly personal level, we have had to live with the shadow of the sword for a ridiculously long time but it goes much further than that. Think of the financial cost of this travesty of an inquiry: three barristers for the GMC, two barristers for each of the three defendants, at least one solicitor per defendant and a couple for the GMC for good measure. Add to the mix the cost of the panel’s remittance and their expenses - six lots of them - and of course the GMC administrative staff assigned to this case, both in Manchester and London; heat, light - the show goes on and on and multiplying that, brings a mind boggling total in the millions of Great British Pounds.
      It may console you to know that the dosh is out of the pockets of doctors, rather than yourselves, which in this context, would make it totally unbearable. Nonetheless it is hard earned money, which has been poured straight down the drain. Money, which if used for research might have delivered critical results that could already be impacting on your children’s lives. What a waste of time, emotion, effort and money.
      Whatever the verdict in this case, there will be no winners: not a single one...
+ Read more: www.rescuepost.com/files/carmelwakefield1.pdf

      Note: The opinions expressed in COMMENTARY are those of the author and do not necessarily represent the views of the Schafer Autism Report.


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In This Issue:


 




































RESEARCH
Autism is Characterized by Dorsal Anterior Cingulate Hyperactivation During Social Target Detection
Scientists Discover a Controller of Brain Circuitry

TREATMENT
Consumers Get Medical Test Results Straight From Labs

PEOPLE
'He's A Gifted Dancer'
Maine Hacker Pleads Guilty

PUBLIC HEALTH
Texas Study Confirms Lower Autism Rate In Hispanics
Vaccine 'Holy War' - Parents Sue Diocese

EVENTS
Anaheim Autism/Asperger Conference Set for February

COMMENTARY
Living With Autism - A Mother's Christmas Call For Compassion
Carmel Wakefield Speaks Out on Pending GMC Decision








            

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