HYPOPLASIA OF CEREBELLAR VERMAL LOBULE-VI AND LOBULE-VII IN AUTISM
HYPOPLASIA OF CEREBELLAR VERMAL LOBULE-VI AND LOBULE-VII IN AUTISM
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DOI：
10.1056/nejm198805263182102
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发表时间：
1988-05-26
影响因子：
158.5
通讯作者：
JERNIGAN, TL
中科院分区：
文献类型：
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作者：
COURCHESNE, E;YEUNGCOURCHESNE, R;JERNIGAN, TL
自闭症是一种神经系统紊乱疾病，会严重损害社交、语言和认知能力的发展。自闭症是否涉及神经解剖结构的发育不良尚不清楚。通过磁共振扫描测量自闭症患者小脑蚓部的大小，并与对照组进行比较。发现患者的新小脑蚓部小叶VI和VII明显较小。这似乎是发育不全的结果，而非发育完全后出现的萎缩或退化。相比之下，在个体发生、发育和解剖结构上与小叶VI和VII不同的相邻蚓部小叶I - V大小正常。无论是智力发育迟缓还是无智力发育迟缓的自闭症患者，都存在蚓部新小脑的发育不良。这种局部发育不良可能作为一个时间标记，用于确定在自闭症中损害大脑的事件，以及可能同时受损的其他神经结构。我们的研究结果表明，在自闭症患者中，新小脑异常可能直接损害一些研究人员认为由新小脑所负责的认知功能；可能通过其与脑干、下丘脑和丘脑的连接，间接影响一个或多个涉及认知、感觉、自主神经和运动活动的系统的发育和功能；或者可能与其他神经部位的损伤同时发生，而这些神经部位的功能障碍是自闭症认知缺陷的直接原因。
Autism is a neurologic disorder that severely impairs social, language, and congnitive development. Whether autism involves maldevelopment of neuronantomical structures is not known. The size of the cerebellar vermis in patients with autism was measured on magnetic resonance scans and compared with its size in controls. The neocerebellar vermal lobules VI and VII were found to be significantly smaller in the patients. This appeared to be a result of developmental hypoplasia rather than shrinkage or deterioration after full development had been achieved. In contrast, the adjacent vermal lobules I to V, which are ontogenetically, developmentally, and anatomically distinct from lobules VI and VII, were found to be of normal size. Maldevelopment of the vermal neocerebellum had occurred in both retarded and nonretarded patients with autism. This localized maldevelopment may serve as a temporal marker to identify the events that damage the brain in autism, as well as other neural structures that may be concomitantly damaged. Our findings suggest that in patients with autism, neocerebellar abnormality may directly impair cognitive functions that some investigators have attributed to the neocerebellum; may indirectly affect, through its connections to the brain stem, hypothalamus, and thalamus, the development and functioning of one or more systems involved in cognitive, sensory, autonomic, and motor activities; or may occur concomitantly with damage to other neural sites whose dysfunction directly underlies the cognitive deficits in autism.