Abstract
Some children with autism spectrum disorders (ASD; 15% to 30% of patients) show a significant and persistent regression in speech and social function during early childhood. There are no established treatments for the regressive symptoms. However, there are some known causes of this type of regression, such as Rett syndrome and Landau-Kleffner syndrome (LKS). In LKS, steroids have been used as a treatment. Some evidence suggests an autoimmune contribution to the pathophysiology of autism (Chez MG, Guido-Estrada N: Immune therapy in autism: historical experience and future directions with immunomodulatory therapy. Neurotherapeutics 2010, 7:293–301, Wasilewska J, Kaczmarski M, Stasiak-Barmuta A, Tobolczyk J, Kowalewska E: Low serum IgA and increased expression of CD23 on B lymphocytes in peripheral blood in children with regressive autism aged 3-6 years old. Arch Med Sci 2012, 8:324–331, Stefanatos G: Changing perspectives on Landau-Kleffner syndrome. Clin Neuropsychol 2011, 25:963–988), raising the possibility that steroids might be a useful therapy for regression in ASD. A retrospective study published in BMC Neurology by Duffy et al. (Duffy, et al: Corticosteroid therapy in regressive autism: A retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior. BMC Neurol 2014, 14:70) reviewed 20 steroid treated R-ASD (STAR) patients and 24 ASD control patients not treated with steroids (NSA). Improvements in clinical function and in a neurophysiological biomarker were seen in the steroid-treated children pre- to post-prednisolone treatment. This research provides a rationale for a randomized trial with steroid therapy to determine the longer term benefits and complications of steroids in this population.Please see related article http://www.biomedcentral.com/1471-2377/14/70/abstract.
Highlights
Regression is a highly distinctive feature in some patients with autism characterized by sustained loss of normally developing language and social skills around the age of 15 to 30 months [1]
In a retrospective case-control study by Duffy et al [8], the authors summarize their single-center experience with steroid treatment using an innovative EEG/ERP biomarker strategy monitoring the frequency modulated auditory evoked response (FMAER)
Evoked responses in the auditory cortex to rapid auditory stimulus frequency modulation can be used to monitor neurophysiological processes that are important for phoneme detection and language processing
Summary
Regression is a highly distinctive feature in some patients with autism characterized by sustained loss of normally developing language and social skills around the age of 15 to 30 months [1]. Evoked responses in the auditory cortex to rapid auditory stimulus frequency modulation can be used to monitor neurophysiological processes that are important for phoneme detection and language processing It is a promising, objective diagnostic tool for detecting sensory processing abnormalities in the auditory cortex of functional significance, and a potential biomarker for identifying subgroups of patients for novel treatments and for tracking effects of novel therapies. Objective diagnostic tool for detecting sensory processing abnormalities in the auditory cortex of functional significance, and a potential biomarker for identifying subgroups of patients for novel treatments and for tracking effects of novel therapies In this retrospective study, the investigators selected 20 target group children (STAR) with a documented regressive course of autism who had received steroid therapy (prednisolone) and 24 untreated comparison subjects from an existing clinical database [8]. Author details 1Division of Pediatric Neurology, Neurodevelopmental Pediatrics, UT Southwestern and Children's Medical Center at Dallas, Dallas, USA. 2Center for Autism and Developmental Disabilities, UT Southwestern and Children’s Medical Center at Dallas, Dallas, USA
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