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2016 ; 10
(ä): 192
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Neuropathological Mechanisms of Seizures in Autism Spectrum Disorder
#MMPMID27242398
Frye RE
; Casanova MF
; Fatemi SH
; Folsom TD
; Reutiman TJ
; Brown GL
; Edelson SM
; Slattery JC
; Adams JB
Front Neurosci
2016[]; 10
(ä): 192
PMID27242398
show ga
This manuscript reviews biological abnormalities shared by autism spectrum
disorder (ASD) and epilepsy. Two neuropathological findings are shared by ASD and
epilepsy: abnormalities in minicolumn architecture and ?-aminobutyric acid (GABA)
neurotransmission. The peripheral neuropil, which is the region that contains the
inhibition circuits of the minicolumns, has been found to be decreased in the
post-mortem ASD brain. ASD and epilepsy are associated with inhibitory GABA
neurotransmission abnormalities including reduced GABAA and GABAB subunit
expression. These abnormalities can elevate the excitation-to-inhibition balance,
resulting in hyperexcitablity of the cortex and, in turn, increase the risk of
seizures. Medical abnormalities associated with both epilepsy and ASD are
discussed. These include specific genetic syndromes, specific metabolic disorders
including disorders of energy metabolism and GABA and glutamate
neurotransmission, mineral and vitamin deficiencies, heavy metal exposures and
immune dysfunction. Many of these medical abnormalities can result in an
elevation of the excitatory-to-inhibitory balance. Fragile X is linked to
dysfunction of the mGluR5 receptor and Fragile X, Angelman and Rett syndromes are
linked to a reduction in GABAA receptor expression. Defects in energy metabolism
can reduce GABA interneuron function. Both pyridoxine dependent seizures and
succinic semialdehyde dehydrogenase deficiency cause GABA deficiencies while urea
cycle defects and phenylketonuria cause abnormalities in glutamate
neurotransmission. Mineral deficiencies can cause glutamate and GABA
neurotransmission abnormalities and heavy metals can cause mitochondrial
dysfunction which disrupts GABA metabolism. Thus, both ASD and epilepsy are
associated with similar abnormalities that may alter the excitatory-to-inhibitory
balance of the cortex. These parallels may explain the high prevalence of
epilepsy in ASD and the elevated prevalence of ASD features in individuals with
epilepsy.