Proceedings: Comparison of slow cerebral potentials evoked by sensory stimuli and by the ankle jerk in children and in adults.
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Biomedical subjects
Publications and source records attributed to N Bruneau.
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Auditory evoked potentials (AEPs) were studied from scalp locations Cz and Oz on 37 adults aged 20-22 years during sensori-sensorial association of a weak sound (S) and a strong flash of light (L). After sound alone repetition (habituation), S-L association modified AEP: first, it caused a generalized orienting response expressed as increasing of Cz and Oz amplitude AEPs. Then, this pattern gave way to an activation limited to the Oz lead: the increase of amplitude was then concomitant with shortened latencies when compared to sound-alone-habituated responses. Inter-individual differences were observed since these occipital modifications were recorded only on 26 subjects. The other 11 subjects did not exhibit any occipital modifications following S-L association. For them, the main modification was a strong decrease of Cz AEP induced by S-L association. These two groups also differed in their capacity to ignore irrelevant stimuli which is higher in the first group (AEP amplitude habituation with sound-alone repetition) than in the second one (no AEP habituation).
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Childhood autism is not usually considered as a neurological disease although frequent antecedents of ante, peri and postnatal injuries are found in its antecedents. Several symptoms of autism particularly in the early development, resemble the signs observed in frontal, temporal, striatal and brainstem dysfunctioning. These cerebral structures are connected with the central dopaminergic system which may be disturbed in autistic children. Such hypotheses suggest the necessary elaboration of an infant and child "behavioral neurology".
Infantile autism is a behaviorally defined syndrome. Many investigators suggest that it is probably related to a brain dysfunctioning in which catecholamine metabolism is involved. The aim of the following paper is to study the validity of different clinical and biological markers of this syndrome: 1. clinical scores using a behavioral rating scale, 2. amplitude and variability of conditioned auditory evoked potentials, 3. urinary levels of homovanillic acid. The response of these markers in autistic children treated with vitamin B6 and magnesium have been assessed. The relationships found between clinical and biological data are discussed. It can be expected that such an approach would contribute to a better understanding of the underlying mechanism of autism.
Since the first description of infantile autism by Kanner, many physiopathological hypotheses have been suggested to explain this syndrome. In order to confirm these hypotheses, a lot of biological technics have been used among which the cerebral electroencephalography plays a leading part. The authors describe the main electroencephalographical technics used in autistic children. For each sort of examination, the physiopathological contribution has been studied. Then, these electrophysiological data have been confronted with neuroanatomical hypotheses (temporal, frontal, mesencephalic functional troubles) or neurobiochemical hypotheses (dysfunctioning of the corresponding dopaminergic systems).
As childhood autism is usually considered as a developmental disorder, complete assessment of each patient requires non only clinical examination but various biological investigations: EEG and evoked potentials recordings, biochemical dosages and sometimes, cerebral blood flow measures, molecular biologic explorations.... These investigations help to understand neurophysiological dysfunctionings which underly different autistic syndromes. It therefore seems necessary to develop quantified clinical tools which could allow closer matching between clinical evaluations and biological numerical data. These complementary evaluations must be both simple and quick to perform in medical practice, as they are added to an already heavy clinical examination. The main tools used in our bioclinical Department are described here. For each child, psychiatric, pediatric and neurological examination was performed. Different scales were progressively elaborated and validated to complete and precise behavioral parameters. Attention and perception were evaluated by a Behavior Summarized Evaluation (BSE) scale, association and imitation by appropriate scales, language by the Pre-Verbal Behavior Summarized Evaluation (PV-BSE) scale, early symptoms by the Infant Behavior Summarized Evaluation (t-BSE) scale. The main neurophysiological dysfunctionings were grouped in a Behavioral Functional Inventory (BFI). Clinical genetic data were scored in a summarized assessment carrying both on the antecedents and on the somatic abnormalities. The completed clinical data were gathered in a Quantified Multidimensional Assessment (QMA), with four axes: socialization, communication, cognition and neurological observation. These clinical evaluations provide behavioral details that can be integrated into a bioclinical database and give an objective approach to the heterogeneity of autism. They invite both clinicians and biologists to deepen the description of individual profiles which allow better understanding of physiopathological mechanisms in autistic children.