Monday, 25 March 2013

Nela and the Magic Flute

Nela is Monty’s excellent assistant at school, but today, because he is a bit sick, she came to Monty’s house instead.  Nela also has her own theatre school, which she runs in the afternoons.  Monty loves the theatre, and the curtains in particular.

Shortly after Nela arrived at our house, she said “Monty is going to see the Magic Flute”.

So how did Nela know that Monty is going to the opera (albeit the children’s version)?  Well, Monty told her, of course.  Now this might not sound much to you, but for me that is worthy of a big WOW.  Autistic kids are not big conversationalists at the best of times.   Even stranger, said Nela, was that he was really talkative all morning.

Now when his brother Ted is sick, it is about the only time he ever stops talking.

Then I said to Nela, actually it’s not strange at all; it is a proven fact that when autistic kids have a temperature they behave more “normal”.  I said that I would write about in my blog, so now I have to. I was actually saving this for a later post, when I set out the “Peter hypothesis of TRH induced homeostasis in autism”.

The post I originally intended to write

But, first a quick detour.  For those serious scientists among you, there is an excellent blog that you should take a look at.  It is written by a professional autism researcher, Paul Whitely.  The blog is called Questioning-Answers.

Now, late last night I was looking at Paul’s blog and reading all about something called tetrahydrobiopterin (also known as BH4 ,THB, trade name Kuvan, or even sapropterin) and how it might be a useful drug to treat autism.  Then I looked at his links to the research papers and then I looked at the citations listed in those papers; it looked like another long session on Google might lie ahead.  Then, I concluded that since people have been talking about BH4 and autism for 24 years; somebody should have done a serious controlled study by now.  So I will wait until they do, before getting out my textbooks.  Actually, by reading the label (the citations at the bottom of the study) I saw the following at number 53:-
53.  Klaiman C, Huffman L, Elliott GR. Sapropterin as a treatment for Autism Spectrum Disorders: a double-blind, placebo-controlled trial. J Child Adol Psychop 2013 (in press).

So after 24 years, it looks like someone has finally done a serious study.  I expect in a month or so it will appear on Paul’s blog, then I will take a good look.

Back to the Opera

So as not to disappoint Nela, let’s get back to business.  When I started this blog I was going to match my observations of Monty’s quirky behaviours to some solid science.  One observation was that whenever he stayed home sick, he was always great at his piano lesson, and with me on, the maths program, or doing literacy/numeracy with his assistant.

So applying some ANA, I found that the American Academy of Pediatrics (Americans spell it like that) had published a study called:-

They concluded that it is indeed true; a fever makes you less autistic; but why ?

They put forward five possible reasons:- 

(1)  neurobiological effects of selected pro-inflammatory and/or anti-inflammatory cytokines, which have been found to be increased in cerebrospinal fluid (in the absence of fever) and postmortem brain tissue of individuals with autism and may be generated during different phases of responses to fever,  

(2)  modification of neuronal and synaptic function secondary to variations in body temperature that influence neural conduction velocities or synaptic transmission,  

(3)  modification of dynamic neural networks as a result of changes in cellular signal transduction and gene transcription that regulate synapse formation and function, 

(4)  increased production of other stress-related proteins, such as heat-shock proteins, during fever that might modify energy consumption and mitochondrial activity  

(5)  stimulation of the hypothalamic-pituitary-adrenal axis leading to modifications of neurotransmitter production and interaction.
And noted:- 

Should any of these mechanisms be proved to effect behavior changes in individuals with ASDs, this would stimulate research on potential treatments focused on these pathways.

Well this was another of my Eureka moments, since reason (5) fits very neatly with my TRH hypothesis, which was again based on other observations of Monty’s behavior.

For now, at least Paul and Nela will be intrigued; the rest of you may be bemused.  All will be revealed shortly, when my I finish my TRH project.

Now, as Monty would say,  “curtains close”.

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