Autism, Brain, and Environment
Autism, Brain, and Environment
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自闭症、大脑和环境
DOI：
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发表时间：
2006
影响因子：
10.4
通讯作者：
G. Windham
中科院分区：
文献类型：
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作者：
G. Windham
正如我们从媒体报道中听到的那样，自闭症的发病率已经上升到“流行病”的程度。然而，到目前为止，理解为什么还很难，已经提出了无数的理论，从改变诊断标准到提高对疫苗的认识，再到不同的交配模式增加了家族遗传的可能性。在这本书中，理查德·莱瑟（Richard Lathe）采用学术方法来探索各种可能的联系，以解释自闭症，汇集来自众多研究领域的证据，包括神经科学，毒理学，遗传学，内分泌学和免疫学。自闭症或自闭症谱系障碍（ASD）是一种毁灭性的残疾，对所有人都有终身影响，但只有轻度影响。在1940年代首次描述时被认为是罕见的，现在据报道每166名新生儿中就有1名发生。自闭症没有医学测试，但其诊断是基于三个方面的行为障碍：沟通，社交互动和重复或限制活动。Lathe写了一本非常全面和清晰的书来描述自闭症，整合了导致他得出结论的证据，即它是一种边缘系统的疾病，对环境毒物非常敏感，同时也认识到遗传的贡献。Lathe描述了他的意图，即为研究人员和非专业人员提供材料，包括家庭、医生、教师、心理学家和倡导者，他已经在合理的范围内这样做了。每一章都以一个简单有趣的介绍开始，并以5-10个关键要点结束。章节材料布局清晰，但大部分都是相当技术性的。每一章都广泛引用了最新的文献。因此，这本书提供了丰富的材料，以新的研究人员在该领域，一定会提供一些感兴趣的经验丰富的调查人员，因为涵盖的广度。其中一些证据并未经过严格审查，因此，例如，关于某个主题的一项研究有时会作为结论性证据提供。但读者可以查看原始参考文献，得出自己的结论。车床不是来自自闭症领域，而是来自神经科学。在见到一个受影响的孩子时，他被自闭症患者的行为与大脑特定区域海马体和杏仁核受伤的人的行为所震惊，这指导了他的调查。这本书从ASD及其诊断的描述开始，然后涵盖了强大的遗传成分，甚至触及表观遗传学，并得出结论，“两次打击”机制是可能的-遗传易感性和暴露于环境因素。在回顾了发病率增加的证据后，Lathe得出结论，ASD病例数量的增加可能是真实的;他将最近的这一趋势称为“新阶段自闭症”，它涉及比经典自闭症更强的环境因素。虽然大多数自闭症研究者会同意这一比率有所增加，但可能不知道为什么或增加了多少，但Lathe务实地建议，在这一点上，原因可能并不重要-ASD是如此重要，以至于无论如何都需要理解。环境因素的探讨强调重金属和大脑功能;虽然一些相互矛盾的证据过于简单化，车床确实避免煽动到目前为止未经证实的担忧疫苗。他谈到了免疫和激素因素的作用，但只是轻描淡写。许多其他的生理问题诊断ASD的儿童进行了描述，与精神方面的结论是，远远没有分开，这些生理问题可能会产生和加剧的条件。通过这些或遗传因素进行分型可以集中研究以阐明特定的机制，并导致最有效的生化治疗或预防。车床完成采取更广泛的观点自闭症，提请平行的其他多因素的条件，如阿尔茨海默病。
Autism rates have risen to “epidemic” proportions, as we hear from media reports. Yet understanding why has so far been elusive, and a myriad of theories have been proposed, from changing diagnostic criteria to increased awareness to vaccines to different mating patterns increasing the likelihood of familial inheritance. In this book, Richard Lathe takes a scholarly approach to exploring a variety of possible links in order to explain autism, pulling together evidence from numerous fields of study including, among others, neuroscience, toxicology, genetics, endocrinology, and immunology. Autism or autistic spectrum disorder (ASD) is a devasting disability, with lifelong implications for all but those only mildly affected. Thought to be rare when first described in the 1940s, it is now reported to occur in 1 of every 166 births. There is no medical test for autism, but its diagnosis is based on behavioral impairments in three areas: communication, social interactions, and repetitive or restricted activities. Lathe has written a very thorough and clear book describing autism, integrating the evidence that has led him to conclude that it is a disorder of the limbic brain, which is very sensitive to environmental toxicants, while recognizing the genetic contribution as well. Lathe describes his intent to provide material accessible to researchers as well as nonspecialists, including families, medical practitioners, teachers, psychologists, and advocates, and he has done so to a reasonable extent. Each chapter begins with a simple, interesting introduction and ends with 5–10 key take-home points. The chapter material is clearly laid out, but of a fairly technical nature for the most part. Each chapter is extensively referenced with the latest literature. Thus the book provides a wealth of material to new researchers in the field and is bound to provide something of interest to experienced investigators because of the breadth covered. Some of this evidence is not very critically reviewed, so that, for example, one study on a topic is offered as conclusive evidence at times. But readers can look at the original references to draw their own conclusions. Lathe came not from the field of autism, but rather neuroscience. On meeting an affected child, he was struck by how autistic behavior resembled that of people with injuries to specific areas of the brain—the hippocampus and amygdala—which guided his investigation. The book begins with a description of ASD and its diagnosis, and then covers the strong genetic component, even touching on epigenetics, and concluding that a “two-hit” mechanism is likely— genetic susceptibility and exposure to an environmental factor. After reviewing the evidence for increased rates, Lathe concludes that the rise in number of ASD cases may be real; he terms this recent trend “new phase autism,” which involves a much stronger environmental component than classic autism. Whereas most autism researchers would agree that the rate has increased, but perhaps not why or how much, Lathe pragmatically suggests that the reasons may not matter at this point—ASDs are of such major concern that they demand understanding regardless. Environmental factors are explored with a strong emphasis on heavy metals and brain function; although some conflicting evidence is oversimplified, Lathe does avoid fanning so far unsubstantiated concerns about vaccines. He touches on the roles of immune and hormone factors, but only lightly. The numerous other physiologic problems diagnosed in children with ASD are described, with the conclusion that far from being separate from the psychiatric aspects, these physiologic problems may produce and exacerbate the condition. Subtyping by these or genetic factors may focus research to elucidate specific mechanisms and lead to the most efficacious biochemical treatments or prevention. Lathe finishes by taking a wider of view of autism, drawing parallels to other multifactorial conditions, such as Alzheimer disease.