TBI Regressive Autism

Ameliorating Hemianopia with Multisensory Training (Rowland et al., 2023)

Quick Summary of paper . An  visual-auditory stimulation therapy was used on two older males  who has loss of vision in the left hemifield (hemianopia). The cause was brain trauma (TBI) rather than lesion.  Prior to joining the study both had been referred to PT and OT as rehabilitation measures. 

• 64 year old JM joined the study 14 months after stroke  (2 infracts)
• 74 year old CW joined the study ~18 months after 1 infract (better sighted field compared to JM). 
• Therapy took place over 8 months /10 sessions 

The results were dramatic. Both patients recovered the ability to detect and describe visual stimuli throughout their formerly blind field within a few weeks. They could also localize these stimuli, identify some features, and perceive multiple visuals simultaneously in both fields. (more detail on paper here link)

Relating all this back to Autism

So impressive about being able to restore sight in a matter of 8 months, given therapy was started 14-18 months after infract and not immediately and it was in older adults. 

Why is regressive autism not thought to be TBI at 18 mo, where there is a sudden loss of learned skills. 

• If TBI --> can those lost skills not be regained through targeted therapy. If you can restore skills in 60-70 yr old, should be able to, in a younger more plastic brain. 
• If TBI -->  is this related to CW & JM having practice with vision for 60-70+ years vs toddlers who only have practice with the skills for 18 mo.

Rethink Traditional Therapies

• CW & JM  had PT/OT for 14-18 mo before joining study; implication these therapies not that useful for regaining lost skills. 
• Autistics kids are in insane amounts of therapy (childhood stuffed with ABA/speech/OT every waking hr with little advances to show for it other than the $$$ spent and lots of career advancement for therapists). 
•  Maybe we need rethink early childhood therapy to be more targeted to restore lost skills. Even regaining that level of lost skills improves quality of life, let alone moving beyond.

One big vagary

Vagaries ubiquitous in autism.
Nothing standard, fractured light in a prism.
Can we conclude then, so far…..
… no evidence in any evidence really
….no clues. What’s going on in this gallery.
inexplicable me. I continue to be one big vagary.

Cellular neuroscience is tough.

Cellular neuroscience  is tough. 

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I'm like a library book, overdue
My brain's so full, it's about to bust in two
I feel like I'm stuck in a never-ending test
Studying so much, I'm starting to feel depressed!
Will it bring success to my quest?



This was the response from my friend in my neuroscience cohort. Thank you for the encouragement and empathy. 

Will it bring success to my quest?
Simply stated, my answer is yes

Battling through the constant stress, through days, months, years of duress
Though now life may seem like a mess, the quest is not to be the best,
Prioritize self-care, remember to rest

Is it worth it, when all I see, are cloudy skies up over me?
Yes I say, the world will see, what's possible with a degree,
The journey to a PhD is sprinkled serendipity,
But even more importantly, be free to show YOU empathy!

Hari,
Above all you are my friend, one that will be there 'til the end,
Remember I am here for you, day in, day out, through and through.

WAIS - Wechsler Adult Intelligence Scale

Lexicon [Measures] - WAIS 

The Wechsler Adult Intelligence Scale (WAIS-IV) is an IQ test used in adults (ages 16-90) to assess cognitive abilities across different domains. It can take around 60-90 minutes to complete

Limitations in the context of autism:

• Language and communication challenges can impact performance on subtests that heavily rely on language abilities.
• Sensory sensitivities and attentional difficulties affect their performance on tasks requiring sustained attention or visual processing.
• Social and contextual factors/aspects of intelligence relevant to autism not considered as the test focuses on cognitive abilities.
• [Also see post on why IQ tests problematic in autistics] 

WAIS-IV has 10 core subtests which are organized into four index scores.

1. Verbal Comprehension Index (VCI):
• Similarities: verbal reasoning and concept formation.
• Vocabulary: ability to define words and understand their meaning.
2. Perceptual Reasoning Index (PRI):
• Block Design: visual-motor coordination and spatial perception.
• Matrix Reasoning: non-verbal reasoning and problem-solving skills.
• Visual Puzzles: ability to analyze and synthesize visual information.
• Picture Completion: visual perception and attention to detail. Presented with incomplete pictures and are required to identify the missing part or detail.
3. Working Memory Index (WMI):
• Digit Span: attention, concentration, and working memory by assessing the ability to repeat a series of digits forward and backward.
• Arithmetic: mental arithmetic skills and working memory.
4. Processing Speed Index (PSI):
• Symbol Search: visual scanning speed and processing speed.
• Coding:motor speed, attention, and visual-motor coordination.

Scoring and interpretation

Index scores are derived from specific combinations of subtests and provide an overall assessment of an individual's cognitive strengths and weaknesses in those domains.

The Full-Scale IQ (FSIQ) is the combination of the index scores. It represents overall intellectual functioning and is calculated based on the combined performance across all subtests.

Interpretation involves comparing an individual's performance to normative data (percentile ranks, confidence intervals, and descriptive categories), considering the person's age and the index and subtest scores obtained. 

History
WAIS was first developed by David Wechsler as an adaptation of his earlier intelligence tests, the Wechsler-Bellevue Intelligence Scale (1st Ed 1955, 4th Ed 2008).

Equanimity is the steady hand that guides us through life's ups and downs

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

The Neurotransmitter Showdown: GABA v Glutamate in the Courtroom.

The Neurotransmitter Showdown: GABA v Glutamate in the Courtroom.

GABA: Good day, Glutamate. How do you plead today?

Glutamate: Not guilty Your Honor. My actions were justified.

GABA: Oh, please. You know that you always overexcite the receptors and cause chaos in the brain.

Glutamate: That's simply untrue. I only activate the NMDA, AMPA, and kainate receptors as needed.

GABA: Needed? 

Your excessive activation of those receptors leads to seizures and neurotoxicity and not to mention hyperactivity, mood swings, social communication challenges, and sensory dysfunction in autistics. 

You are totally implicated in the Excitatory-Inhibition Imbalance theory in autism.

Hari: You Said It, GABA!! Tell it like it is. 

Judge (pounding table with mallet): Order in the court! The audience is not allowed to speak. 

Hari: Your Honor, I was not speaking out loud. It was all in my mind. 

Judge: But we are in your mind so everyone here can hear you. 

Hari: Oh, Ok. Then I'll go off and take a nap. 

Judge. Thank you Hari. 

(Pounding with mallet) Order! Order!I call order in the courtroom!

Executive and Contextual Control Theory (ECCT)

 

While no single theory fully explains all aspects of autism, each attempts to provide insights into different cognitive and behavioral characteristics.

• ECCT posits that individuals with autism have difficulties with contextual control, which is the ability to modulate behavior based on the context. This can be related to challenges in executive function and flexibility.
• Implications: Difficulty in adjusting behavior to suit different social contexts, rigidity in thought processes, and a tendency toward repetitive behaviors.

Read more on [ECCT Theory]

Posts on other [Theories of Autism]

27 Genetic Variants Linked to ADHD

 https://neurosciencenews.com/genetics-adhd-22476/

"imbalance in dopamine in the brains of people with ADHD is partly attributable to genetic risk factors"

"7,300 common genetic variants that increase the risk of ADHD. It is particularly interesting that the vast majority of these variants—84-98 percent—also have an influence on other mental disorders, e.g. autism, depression and schizophrenia"

Serenity is the harmony that comes with being in balance.

Informal Removals

This is so deja vu for me. 

Never mind even the struggles involved in getting access to general ed classrooms, 

even special education classrooms only want the Good Patients. 

=================

https://www.nytimes.com/2023/02/09/us/students-disabilities-informal-removal.html?fbclid=IwAR36fyuIXrWPV7QZMxdeHt_HPxYJy9___BwxYS0k7YIEKBarCdHdrxEAW4U


"During her son’s elementary years, Ms. LaVigne was called almost daily to pick him up hours early because he was having “a bad day.” By middle school, he was only attending an hour a day..."

"...tactic that schools... use to remove challenging students with disabilities from class. The removals — which can include repeated dismissals in the middle of the day or shortening students’ education to a few hours a week."

"In a report last year, the National Disability Rights Network, a national nonprofit established by Congress more than four decades ago, found informal removals occurring hundreds and perhaps thousands of times per year as “off-the-book suspensions.” The report said the removals also included “transfers to nowhere,” when students are involuntarily sent to programs that do not exist."

"The removals largely escape scrutiny because schools are not required to report them in the same manner as formal suspensions and expulsions, making them difficult to track and their impact hard to measure."

"continuation of the practice sends a terrible message to students and to school communities about which students deserve an education.”

Cellular Neuroscience

Last semester was systems neuroscience, this semester is cellular neuroscience. 

What's interesting is the way the course is organized. It's very different from what I'm used to. Every week we get a different professor teaching the class on a different topic followed by a Friday quiz on that topic. Of course the other parts are there like a midterm, final and a class presentation. While the class feels a bit disjointed with a new professor this week (autism & change are not the best of bedfellows), its also kinda cool to be taught a topic by a someone researching that area specifically. They know the topic absolutely inside out. But the quizzes are tough!!

Wk 5: Synaptic Plasticity with Prof Roger Colbran (Molecular Physiology and Biophysics)

Wk4:  Voltage Gated Ion Channels and Presynaptic Calcium Channels. If last week was glutamate receptors, this week its GABA receptors with Prof David Jacobson (Molecular Physiology & Biophysics). 

Wk2-3 Presynaptic & Postsynaptic specialization: Prof Ege Kavalali (Pharmacology) and Prof Teru Nakagawa (Molecular Physiology and Biophysics)

Wk1:  Electrophysiology : This week was Bioelectricity of Neurons with Jerod Denton (Anesthesiology). After all, electrophysiology forms the basis of how the nervous system works, it determines how we interact with our environment, how we process that information in the nervous system and how we respond (hopefully appropriately?). And I loved how he said we should be so comfortable with it that we can strike up a casual conversation on the topic at the next VBI (Vanderbilt Brain Institute) meet. 

A lot of material is covered in each class. Interesting, a maze and tough all at once. 

Some poems being inspired by the neuroscience I'm learning. 

Woody Vine Dance

Woody Vine Dance

Gale tosses the woody vines of tall trees.

Strong wind and rustling leaves.

Nature roars, unrelenting crescendo 

Rustic music and Woody Vine dance.

Equanimity is the gentle acceptance of ourselves and others

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the non-judgmental awareness of our thoughts and emotions

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

16 of 118

 16 of the 118 elements. Go Bears!! I have the Berkelium t-shirt. 

I laughed when i saw the last hashtag. Cal and Stanford have this friendly rivalry going on which is most evident at Big Game (annual football game). Like a former therapist (had been a student at Stanford when working with me), was overjoyed that I got into Cal, with the caveat of "except during Big Game."

Seatbelt? What is that

Seatbelts? What is that. 

This is the way to ride to school. Students in school uniform on the back of an auto. Carefree joy!! 

Photo taken during a 2018 India trip in North India. 

Equanimity is the acceptance that all things pass in due time

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the inner strength that allows us to face life's challenges

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Equanimity is the clarity that helps us see things as they are.

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Twinkling Tree Canopy

Glass trees sweat in the winter sun

Refraction bends with ice melts.

Twinkling treetops in a blue sky

Canopy of stars in the daytime light.

The photo does not capture it but the tops of the trees were twinkling as the melting frost was refracted by the sunlight. It was like seeing stars in daytime.