Autistic Spectrum Disorders(ASD’s)

Dr. Aiman Momani

OxyCareTel: +962 79 642 6002

Presentation Outline

Introduction مقدمة Causes of Autism Spectrum Disorders (ASD) أسباب طيف

التوحد Biomedical Dysfunctions in ASD االضطرابات الكيميائية

المصاحبة للتوحد Treatment of ASD عالج أطياف التوحد

Hyperbaric Oxygen in ASD العالج باألوكسجين المضغوط Neurofeedback Therapy عالج االسترجاع العصبي Auditory Integration Therapy عالج التكامل السمعي Vitamins فيتامينات

Introductionمقدمة

ASDs are a group of diseases that are characterized by: A delay in the development of communication skills ( تأشر في

(مهارات التواصل اللغوي Impairment of social interaction (اضطراب المهارات االجتماعية) The use of restrictive, stereotyped behavior patterns ( السلوك

(النمطي التكراري

Prevalence rate today is 1 in every 68 boys and 1 in every 350 girls.

طفلة يعانون 400 طفل من الذكور وطفلة من بين كل 87طفل من بين كل من طيف التوحد

Introductionمقدمة

There are treatments for ASD’s أطياف التوحد يمكن عالجها

Many children who are receiving these treatments are improving, some to the point of functional recovery.

% من األطفال الذين يخضعون للعالج يتحسنون بنسبة 90حوالي مرتفعة

Possible Causes of ASDsأسباب أطياف التوحد

The Metalothionein (MT) Theory

نقص مادة الميتالوثايونين

This theory can explain the difference in prevalence between boys and girls, as estrogen can help in the synthesis of MT.تفسر هذه النظرية الفرق في أعداد المصابين بين األطفال الذكور واالناث

Functions of Metalothionein الوظائف التي تؤديها مادة ميتالوثايونين Control of copper to zinc ratio (نسبة النحاس الى الزنك) GIT maturation (الحفاظ على صحة الجهاز الهضمي) Detoxification (التخلص من المعادن الثقيلة) Antioxidant (مضاد لألكسدة) Boosting the immune system (دعم جهاز المناعة)

The Metalothionein (MT) Theory (Cont.)

نقص مادة الميتالوثايونين

MT deficiency can lead to: نقصان مجاة ميتالوثايونين يؤدي الى Leaky gut (نفاذية عالية للجهاز الهضمي) Sensitive kids: React to things that don’t bother others (Sensory

integration) (التكامل الحسي)

Factors that can suppress the production of MT: أسباب نقصالميتالوثانيونين

Genetic factors (استعداد وراثي) Exposure to heavy metals (تراكم المعادن الثقيلة) Impaired methylation cycle (عدم تفعيل عدد من الفيتامينات)

The Genetic Factors Theoryالوراثة

ASD’s are different in their clinical picture and symptoms. أطياف التوحد هي مجموعة من األمراض وليست مرض واحد

Reported rate of concordance among identical twins (who same genetic make-up) is not 100%.

100نسبة التوافق بين التوائم المتشابهة ليست %

There is an increased incidence of ASD in families that have other auto-immune diseases.

العائالت التي يوجد فيها أمراض المناعة الذاتية يكون احتمال االصابة بطيف التوحد أكبر

The Genetic Factors Theory (Cont.)الوراثة

Many researchers believe that this indicates an underlying dysfunction in the immune system in these families.

The overall rate of increase in the incidence of autism cannot be completely explained by genetics alone

ASD has risen over 1000% in the last 20 years which is not possible if genetic mutation is the only cause.

ال يمكن أن تصل نسبة انتشار مرض وراثي الى مرحلة الوباء العالمي كما هو حاصل بأطياف التوحد

The Immune System Theoryجهاز المناعة

The Immune System Theory (Cont.)

اضطراب جهاز المناعة

The key to balanced immune system function depends upon balanced immune response يجب أن يكون هناك توازن بين Innate cellular immunity (جهاز المناعة األساسي) Learned immunity (جهاز المناعة المكتسب)

T-Helper Cells: Naïve Th-cells

Th 1 (involved in cell-mediated immunity) Th 2 (involved in allergy and autoimmunity)

T-reg

The Immune System Theory (Cont.)

اضطراب جهاز المناعة

Neonates have reduced Th1 and need to develop Th2 in order to be able to fight viruses and germs, however:

األطفال حديثي الوالدة بحاجة لتطور جهاز المناعة األساسي بحيث يكون هناك توازن بين شقي جهاز المناعة Vaccines enhance Th2 Heavy metals enhance Th2 by:

Inducing IL-4 Binding to sulfur groups in body proteins, which are then recognized as

foreign bodies (autoimmune)

The Heavy Metals Theoryتراكم المعادن الثقيلة

Blood-Brain Barrier (BBB) Integrity الحاجز الدموي الدماغي The BBB prevents many chemicals and toxins from entering

the brain The fetus does NOT have a BBB

The BBB in neonates is not fully developed, it allows toxins and heavy metals to pass from the mother’s body into the fetus and into the fetal brain

الحاجز الدموي الدماغي عند الجنين يكون غير مكتمل وبالتاي يمكن أن ينفذ المواد الضارة من األم للجنين

The Heavy Metal Theory (Cont.)

تراكم المعادن الثقيلة

Heavy metals in the brain result in chronic “glial reactivity” and consequently chronic inflammation and excitotoxicity تراكم المعادن تحفيز مزمن للخاليا المركزية لجهاز المناعة

Mercury can impair cell-mediated immunity resulting in decreased ability to clear viral and yeast infections.يتسبب الزئبق بخلل في عمل جهاز المناعة

It affects the body’s anti-oxidation ability by depleting intracellular glutathione.

يتسبب الزئبق بنقصان مادة الجلوتاثيون والمسؤولة عن الكثير الوظائف الحيوية

The Heavy Metal Theory (Cont.)

تراكم المعادن الثقيلة

Effects of substances released from astrocytes (a type of glial cells):

Neurovascular communication Mediators of vasodilatation Interaction mechanism with GLUTAMATE

Biomedical Dysfunction in ASDاضطرابات الكيمياء الحيوية

The size of each piece of the pie (impact of ASD on the body physiology) differs one child to the other, and may

change over time within the same kid

Poor Nutrition:vitamin & Mineral Deficiency

Children with ASD are typically very picky eaters, and therefore suffer from: االنتقائية في الطعام تؤدي الى Vitamin deficiency نقص الفيتامينات األساسية لعمل الكثير من األجهزة

وتطور الجهاز العصبي Mineral deficiencies include zinc, selenium, magnesium,

molybdenum, manganese, vanadium and chromium. نقص فيالعناصر األساسية

Oxidative stress تراكم المواد المأكسدة

Leaky Gutالنفاذية العالية للجهاز الهضمي

Children with ASD have abnormal gastrointestinal systems. The reasons for this are varied but include;

أسباب زيادة نفاذية الجهاز الهضمي Abnormal mucosal barriers due to deficiency in metallothionein نقص

الميتالوثايونين Depleted sulfate which prevents normal healing of the mucosal layer خلل في

عملية الكبرته Chronic inflammation from persistent viral infections التهاب مزمن Autoimmune reactions اضطراب المناعة الذاية Abnormal bowel flora اضطراب البيئة الحيوية في األمعاء Abnormal pancreatic digestive function. اضطراب عمل البنكرياس

Leaky Gut (Cont.)النفاذية العالية للجهاز الهضمي

This leads to incomplete breakdown of proteins resulting in partially undigested chains of amino acids “peptides”.هدم هضم البروتينات بشكل كامل

Two of the peptides that are of major concern are gluten and casein. أهم البروتينات التي ال تهضم هي بروتين الجلوتين والكيسين

Decreased functioning of an enzyme called DDP-IV that is responsible for breaking down these particular peptides.

الجلوتين والكيسين“ المسؤول عن هضم 4تظهر األبحاث نقص انزيم ”د ب ب

Yeast & Bacterial Overgrowthالنمو الزائد للبكتيريا والفطريات

Children with ASD may suffer from intestinal dysbiosis (abnormal imbalance of pathogenic gut flora) that is so common in children with ASD due to

Low Th1 Antibiotic overuse Impaired metallothionein function Chronic inflammation with intestinal mucosal damage

Yeast & Bacterial Overgrowth (Cont.)

النمو الزائد للبكتيريا والفطريات

Intestinal dysbiosis can cause symptoms including diarrhea and/or constipation, gas, bloating, abdominal pain and acid reflux.

The organisms can also produce toxic metabolites that enter the bloodstream and affect immunological and neurological function.

Yeast can also contribute to the leaky gut problem by forming spores that further damage the intestinal lining.

Impaired Detoxificationعدم القدرة على التخلص من

المعادن الثقيلة

ASD childres have a decreased ability to clear their body of unwanted toxins. Reasons for that include:

Deficiency in a molecule called glutathione due to either oxidative stress or impaired transmethylation.

Impaired Anti-Oxidationتجمع عوامل األكسدة

Oxidation is a biochemical process that generates free radicals (containing an extra oxygen molecule).

These free radicals can be damaging to body tissues especially the gut and the brain.

For a number of reasons, children with ASD have an impaired anti-oxidation system. This results from:

Poor nutrition since many of the vitamins and minerals, such as vitamin C, vitamin B6 and zinc (which are powerful antioxidants) are not consumed.

Low in enzymes that counter oxidative stress (including glutathione, GSH-reductase, lipoic acid, and uric acid).

Low Fatty Acids

Omega-3 fatty acids are naturally-occurring molecules that are highly concentrated in fish oils and flax seed oil.

There is scientific evidence that supports a relationship includes the high rate of inflammatory bowel disease present with ASD and low omega-3 fatty acids.

Impaired Pancreatic Functionاضطراب عمل البنكرياس

Children with ASD are deficient in “Secretin”, which is responsible for stimulating the pancreas.

نقصان انزيم ”السكريتين المسؤؤول عن تفعيل البنرياس “

Secretin receptors have also been found in an area of the brain called the amygdala. Functions of the amygdala include face recognition, emotion, fear, anxiety and stress response.

“السكريتين له وظائف حيوية من ضمنها فهم تعابير الوجه “

Decreased Immune Function

Th1 lymphocytes that are responsible for combating viruses and fungal infections.

Th2 lymphocytes are responsible for producing immunoglobulins (antibodies) and responding to allergies.

These are normally controlled and balanced very closely by a complex network of messengers called cytokines (IL-4, IL-12) and Lymphocytes (Th-reg).

Decreased Immune Function (Cont.)

Children with ASD have an imbalance of these two types of T-lymphocytes with a predominance of Th2 and a deficit of Th1 functioning.

This predisposes them to increased amount of allergic and autoimmune disorders and a decreased ability to fight off viral and fungal infections.

Dr. V Singh has done extensive research in this area, and found that some ASD children have antibodies directed against the myelin sheath in their own brain cells.

If this sheath is destroyed, it would slow down brain processing time.

Biomedical Treatment

Hyperbaric Oxygen for ASD

Hyperbaric Oxygen Therapy (HBOT)

Research (using SPECT scans) has shown that children with ASD have bilateral temporal hypoperfusion .

Decreased cerebral blood flow (rCBF) in the left superior temporal gyrus is correlated with severity of symptoms.

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy (HBOT)

Area of Hypoperfusion Clinical CorrelationThalamus Repetitive, self-stimulatory and

unusual behaviors

Temporal Lobes Desire for sameness and social/communication impairment

Temporal Lobes and Amygdala Impairments in processing of facial expressions/emotions

Fusiform Gyrus Difficulty recognizing familiar faces

Wernicke’s & Brodmann’s Areas Decreased language development, and auditory processing problems

Temporal and Frontal Lobes Decreased IQ and learning difficulties

Selected areas of hypoperfusion in ASD and clinical correlation

Benefits :Hyperbaric Oxygen Therapy

(HBOT)

HBOT and Inflammation Several studies have shown that children with

ASD have both neuro-inflammation and gastrointestinal inflammation

Studies have shown that HBOT has potent anti-inflammatory effect

HBOT and Oxidative Stress Research has shown that HBOT help the body

make “glutathione”

HBOT and Detoxification HBOT increases cell membrane permeability HBOT help with the manufacturing of “glutathione”

Benefits:Hyperbaric Oxygen Therapy

(HBOT)

HBOT and Brain Hypo-Perfusion Increased brain perfusion and therefore alleviating the

effects of hypo-perfusion (language delay, repetitive behavior, concentration, information processing, overall awareness, & expression of emotions)

Lower ABC (aberrant behavior checklist) score (lower score denotes improvement).

Lower ATEC (autism treatment evaluation checklist) score (lower score denotes improvement).

Neurofeedback Therapy

A technique that is used to train the brain to use appropriate brain waves.

Used to improve symptoms, including: Hyperactivity Attention deficit Verbal communication Cognitive skills Executive functioning Learning ability Auditory processing

www.oxycare-jo.com

Tel: 00962 79 6426002