Tuesday, January 12, 2010

Hopeful conjectures about autism

It seems that 25 to 50% of people with the rare disease tuberous sclerosis complex (TSC) have autism. Researchers have found how a mutation in one gene causes TSC. They looked at a well-characterized axon route in mice and found that the growing axons failed to respond to a particular chemical message to stop growing here, please. They suspect other axons than the one they studied also end up in wrong places.

It turns out TSC patients' (well, by the time their brains are being sectioned, they're no longer patients) brains were poorly myelinated. Autistic brains are also poorly myelinated, and there have been suggestions that autism results from miswiring.

They gave a drug called rapamycin to TSC mice and found that it increased myelination.

So here's the hopeful conjecture: If we can diagnose autism at birth with a brain scan, maybe we can give rapamycin or some other drug to autists starting at birth to increase their myelination and maybe ameliorate the problem. Maybe one day we will be able to diagnose it from DNA sequencing of fetal blood cells circulating in maternal blood samples, and introduce myelinating drugs in utero.

But then where will we get our engineers? And that's not just a flippant question. Parents will need to decide, case by case, how bad a kid has to be for them to fix it. Where on the autism spectrum would a kid or fetus have to be to warrant giving them a myelination drug?

And do we want any public discussion of this, or leave it entirely to the parents to figure out?

And if we can do this with autism, can schizophrenia, bipolar, or depression be far behind?

After a while the conjecture gets scary. Maybe I should go read Brave New World again.

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