Blog Posts

Autism Spectrum Disorder, Neuro-developmental Disorders, Psychiatric Disorders and changing views

8/22/2024

SciShow Video

0:10: Autism Spectrum Disorder is a Diverse Group.

0:41: Historically, Autism was diagnosed in people who were:

especially sensitive to stimuli,
were drawn to routines,
repeated certain words and movements,
get totally consumed with an object,
didn't use language or
didn't use language to communicate with other people.

0:55: 1994 DSM and History of Asperger's Disorder

2:40: Pervasive Developmental Disorders --- had overlapping symptoms with people diagnosed with Autism Disorder

0:10: Autism Spectrum Disorder is a Diverse Group

0:41: Historically, Autism was diagnosed in people who were:

especially sensitive to stimuli,
were drawn to routines,
repeated certain words and movements,
get totally consumed with an object,
didn't use language or
didn't use language to communicate with other people.

0:55: 1994 DSM and History of Asperger's Disorder

2:40: Pervasive Developmental Disorders --- had overlapping symptoms with people diagnosed with Autism Disorder

2:55: 2013 DSM 5 put Autism Disorder and Pervasive Developmental Disorders under Autism Spectum Disorder

4:10: Genetic underpinnings of Autism Spectrum Disorders also appear associated with Schizophrenia and ADHD [See also World Psychiatry: New insights from the last decade of research in psychiatric genetics: discoveries, challenges and clinical implications (2023)].

"Long recognized to be heritable, recent evidence shows that psychiatric disorders are influenced by thousands of genetic variants acting together. Most of these variants are commonly occurring, meaning that every individual has a genetic risk to each psychiatric disorder, from low to high."

[I'm slipping in "Maternal Immune Activation" because I think it is an important part of the story. See Nature Reviews Neurology: Maternal immune activation and neuroinflammation in human neurodevelopmental disorders (2021)

5:10: Epigenetic Changes

5:20: DNA Methylation

6:27: SciShow: "Despite the vast spectrum of autism, these researchers found that different manifestations of the disorder had the same DNA methylation patterns."

7:03: Age of the father -- over 40 [Source of epigenetic changes due to mutations in sperm. Val's Take: I think this includes both chronological age and biological age.]

SciShow
Autism Sprectrum Disorder

Kings College London
Thinking Twice About ADHD and Autism Spectrum Disorder

The King's College London video raises more questions about how distinct some of our categories are. Here, significant overlap is found between ADHD and Autism Spectrum Disorder.

Cont. SciShow Video notes

7:30: Immune System: Mother's Autoimmune Disease [Another source of epigenetic changes]:

Several reports from Europe and North America say that people who developed in the womb of a mother with an auto-immune disease are more likely to be diagnosed with autism, with some specific diseases increasing up to 80%.
Thyroid disease is particularly relevant.
Pregnant women with autoimmune diseases are thought to make more antibodies than pregnant women without autoimmune diseases
Further, pregnant women with autoimmune diseases made different antibodies than pregnant women made without such autoimmune diseases.
The antibodies target proteins in the baby's brain which could make the baby's brain inflamed and change the way it develops.

9:00: Autism is not just a white, male issue.

10:30: One study found that autistic people could communicate information as effectively as non-autistic people, but there is mutual misunderstanding when autistic and non-autistic people try to communicate with people outside their group. [Val's Take: Autism Spectrum Disorder is a BIG Group so I think it might not always breakdown that neatly -- but I do think there are Double Empathy issues].

14:15: Mirror Neurons and adaptability

The energy of anger & Aggression when mitochondria are damaged

8/18/2024

Val's Take/Conjecture
Some of the questions that we are starting to ask:

How much energy does it take to run a human brain?
What are the big energy cost centers? Synapses are arising as an answer.
If you don't have the energy to run all your synapses --- does the body start taking care of that for you? Reducing the number of synapses through auto-immunity or other mechanisms?
Are Thyroid Disorders somehow related to these energy concerns?
Does the body try to help you out with anger and aggression -- that might give you some much needed energy.

So this is painting a complicated picture of people who are struggling with both too little and too much energy.

That is explicitly recognized with regard to Bipolar Disorder and it may be present in other "disorders" as well, especially considering that they are often blurred.

Interestingly, a lot of the research regarding Mitochondrial Dysfunction speaks in terms of Mitochondrial Dysregulation.

I would submit that Mitochondrial Dysregulation is related to Emotional Dysregulation.

To see is to experience: Aggression neurons light up when witnessing a fight. (2023)

"In the current issue of Cell, Yang et al. identified hypothalamic aggression mirror neurons, activated during both physical fighting and witnessing a fight, possibly representing a neural mechanism for understanding social experiences in other minds...."

Powering the social brain: Mitochondria in social behaviour (2023)

"[W]e discuss recent evidence linking mitochondrial functions and dynamics to social behaviour and deficits, including examples in which social behaviours are modulated by stress in the context of mitochondrial changes, as well as potential therapeutic strategies and outstanding questions in the field."

I would submit that the relationship between "mitochondrial dysfunction" and "stress" is complex, dynamic and multi-directional (also including the Immune System, the Endocrine System, the Microbiome, etc.) and at least sometimes involves Maternal Immune Activation.

Topic: Aggressive Behaviors or Intense Energy?

Val's Take: I don't think the question above should be posed as an "either or" question.

I think one could say the Aggressive Behaviors are the result of Intense Energy.

Where is the "Intense Energy" coming from?

ADHD Mood Swings: Symptoms, Causes, and Coping - Verywell Mind (2023)

"People with ADHD often find that their energy levels and ability to concentrate changes throughout the day. Even if they’re on medication, it can be difficult to match their high-energy and high-focus times to the times they need to be most productive. This can be upsetting and frustrating in the moment and cause mood swings."

Mitochondrial heterogeneity and homeostasis through the lens of a neuron (2022)

What are the implications for so-called "Aggression Neurons"?

8 Ways to Channel Your Anger Productively (2022) | Psych Central

Is anger energizing?

"This means anger is energizing. You can sit and seethe or work off your anger in a positive way. Rather than trying to remain calm, you could use your energy for tasks like cleaning, cutting the grass, or anything that requires physical involvement. Anger is an important human emotion."

I posted the article from Psych Central because I think Anger can be Energizing -- the advice above might not always be sufficient.

Ultimately, anger is a complicated and difficult emotion as Aristotle recognized. I think Aristotle probably was a "Neuro-Diverse" guy.

Synapses & Energy

8/17/2024

So one of the big challenges for Neuro-Diverse people is having sufficient energy to run more synapses than the norm --- that were not "pruned" through neuro-typical processes.

Further, Neuro-Diverse people have a complicated relationship with their "synapses" in that they may start out with more and end up with less through:

psychiatric disorders [The synaptic hypothesis of schizophrenia version III: a master mechanism (2023); Synaptic Dysfunction in Depression: Potential Therapeutic Targets (2012)]; Glial-Neuronal Interaction in Synapses: A Possible Mechanism of the Pathophysiology of Bipolar Disorder (2023); Regulatory Molecules of Synaptic Plasticity in Anxiety Disorder (2023)].
auto-immune disorders [Neuropsychiatric Manifestations of Thyroid Diseases (2023); Exploring the Genetic Link Between Thyroid Dysfunction and Common Psychiatric Disorders: A Specific Hormonal or a General Autoimmune Comorbidity (2023); Synapse Dysfunctions in Multiple Sclerosis (2023)].
cancer [Synaptic communication in brain cancer (2023)]
dementia [Human astrocytes and microglia show augmented ingestion of synapses in Alzheimer’s disease via MFG-E8 (2023)].

The Public and Private Sectors are struggling to have the ENERGY to address the Idiosyncratic Strengths and Challenges of Neuro-Diverse people.

Is it worth the ENERGY of the Public and Private Sectors --- it is --- and those Neuro-Diverse folks have a lot to offer the society.

Further, as with so many accommodations for people with disabilities, many other people in the society will likely benefit as well.

Co-occurring Conditions with Adhd & Autism

8/17/2024

UC Davis Health -- Mind Institute

See also Co-Occurring Conditions and Autism (Autism Research Institute) and ADHD and Co-Occuring Conditions (CHADD -- Children & Adults with ADHD).

Neuro-Diversity, energy issues & diet

8/6/2024

Val's Take/Conjecture

The Metabolic Mind folks are pushing a Keto Diet (or more accurately Ketogenic Therapy)
- I don't think it is the answer to everything, but it seems to understand that people with neuro-developmental disorders and/or psychiatric disorders have different energy issues.

Dr. Chris Palmer from about 4 years ago.

Palmer is a psychiatrist and is one of the early promoters of a Ketogenic Diet for Mental Health.

In this video, Palmer recounts impressive results but challenges too.
One of my big concerns is that people, including physicians, are sometimes looking for a hook to blame the individual.

I think Dr. Chris Palmer has gone to great lengths not to do that.

Metabolic Mind
What Is the Difference between a Keto Diet and Ketogenic Therapy? -- with Dr. Bret Scher

Nick Norwitz (2024)

Norwitz recounts a recent small Stanford Study. It was hugely successful in showing the benefits of Ketogenic Therapy for the participants.

Stanford has a significant contingent looking at Metabolic Health and Mental Health [Stanford Metabolic Psychiatry].

Interestingly, Norwitz observes that because this isn't a drug --- it can be hard to find funding to do the research.

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial (2024)

"ADHD" and Epigenetics

8/4/2024

Val's Take

Epigenetics is more and more seen as a crucial player in Auto-Immune Diseases.
When we talk about Neuro-Developmental Disorders, they often begin with Maternal Immune Activation (MIA).
That MIA can result from many things, including infection, obesity, smoking, auto-immune disease, etc.
Since Epigenetics plays a large role in Auto-Immune and Inflammatory Diseases, it not surprising that Epigenetics would also play a large role in Neuro-Developmental Disorders.
Frontiers in Neuroscience: The Epigenome in Neurodevelopmental Disorders (2021)

"There is increasing evidence that dysregulated epigenetic mechanisms of gene expression are involved in the pathogenesis of attention deficit hyperactivity disorder (ADHD)."

The Role of Epigenetics in the Pathogenesis and Potential Treatment of Attention Deficit Hyperactivity Disorder (2022)

Recent Research on Cognitive Disability

8/2/2024

Conduct Disorder Linked to Widespread Brain Structure Changes (2024)

Val's Take/Conjecture

The Criminal Law has at least to some extent dealt with the Defendant with an IQ under 70.
Further, we do have supports for people with an IQ under 70 and Developmental Disabilities.
The challenge in 2024, is the Defendant with an IQ over 70 and Developmental Disabilities.
- They may be tagged with ADHD, Autism, Conduct Disorder, and/or Anti-Social Personality Disorder, etc.
Further, people with ADHD are more likely to incur a brain injury (2015 study supports link between ADHD and traumatic brain injury)
People with brain injury make-up generally over 50% of the justice-involved population, with some estimates at 80%.
The Council of State Governments Justice Center found that the prevalence of brain injury in the criminal justice population was around 60%. (2024)

University of Southern California

Enigma Working Groups Around the World

The ENIGMA Consortium has grown to include over 1400 participating scientists from over 200 institutions, across 43 countries worldwide. ENIGMA is organized as a set of 50 WGs [Working Groups], studying 26 major brain diseases (see color key).

Each group works closely with the others and consists of worldwide teams of experts in each brain disorder as well as experts in the major methods used to study each disorder.

The diseases studied include major depressive disorder, bipolar disorder, schizophrenia, substance use disorder, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and autism spectrum disorder, and several neurological disorders, including Parkinson's disease, epilepsy, ataxia, and stroke.

In recent years, new WGs were created that grew into worldwide consortia on epilepsy (Whelan et al. 9 ), eating disorders (King et al. 104 ), anxiety disorders (Groenewold et al. 107 ), antisocial behavior, and infant neuroimaging.

"ADHD" and "ANTI-SOCial Personality Disorder"

8/2/2024

Val's Take/Conjecture

So "ADHD" is a Neuro-Developmental Disorder
It is part of a Neuro-Developmental/Psychiatric Continuum in which Epigenetics is playing a large role.
It is important to understand the "Generational" aspects to ADHD which often involve some type of maternal auto-immunity.
Additionally, this is often going back more than one generation.
In the case of "smoking," that can go back to the 3rd Generation (maybe more) --- so if your maternal grandmother smoked, you have a higher risk for ADHD.
ADHD, Autism and other Psychiatric Disorders are much more FULL BODY DISORDERS than we generally appreciate.
The Immune System is important as one might expect if ADHD is often seen with maternal auto-immunity and maternal immune activation during pregnancy.
As psychiatry and psychology slowly move to biomarkers --- that will bring a dimension of clarity that we just haven't had in mental health.
Further, the assumption was often that to get those biomarkers one essentially needed brain surgery.
Now, researchers are more and more finding biomarkers in the blood.

THIS IS SERIOUS STUFF

The rates of ADHD and Autism are increasing --- and if one appreciates the many causes of Maternal Immune Activation that is not surprising.
Boys and Men with ADHD, of color and poor are highly represented in Jails and Prisons in Colorado, the US and Countries around the world.
This is a Disability Rights Issue --- it's also a competent assessment and care issue .
Nobody's for sacrificing safety --- but we can't keep punishing a neuro-developmental disorder.

Does ADHD Cause Antisocial Personality Disorder? - WebMD

Studies suggest that as many as 90% of adults with ADHD have other mental health disorders. ASPD is one of the most common mental disorders that happens with ADHD. One study showed that men with ADHD were more likely to have antisocial personality disorder than women with ADHD.

Autoimmune Diseases and ADHD: Is There a Link?

The risk for attention-deficit/hyperactivity disorder is increased with a personal or maternal history of autoimmune disease, particularly with type 1 diabetes and parental autoimmune diseases.

Mitochondrial DNA Copy Number is Associated with Attention Deficit Hyperactivity Disorder. (2020)

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children. ...Mitochondrial dysfunction (MD) is suggested to be one of the causes of Attention Deficit Hyperactivity …

Hofbauer cells and fetal brain microglia share transcriptional profiles and responses to maternal diet-induced obesity (2024)

Single-cell RNA-seq identified common alterations in fetal microglial and Hofbauer cell gene expression induced by maternal obesity, as well as sex differences in these alterations.

We propose that Hofbauer cells, which are easily accessible at birth, provide insights into fetal brain microglial programs and may facilitate the early identification of offspring vulnerable to neurodevelopmental disorders.

Recognizing and treating obesity as a disease | 60 Minutes

We have a long tradition of wanting to blame Mom --- and Maternal Immune Activation is often a key precursor to neuro-developmental disorders.

We need to strenuously resist the temptation to scapegoat Mom or anyone else as we work for more comprehensive understandings and treatments.

Policy Challenges & the complicated intersection between Developmental & Psychiatric disorders

7/11/2024

Val's Take/Conjecture

I am supportive of the State's desire to reserve premium ABTU space to those who really need it.
We do have some categories that we have traditionally thought of as quite distinct and most research in 2024 would identify a Neuro-Developmental / Psychiatric Continuum.
There are specialists, but many mental health professionals are not competent to address Neuro-Developmental Disorders, and if these kids, adolescents, adults have an IQ over 70 --- they are ironically quite at risk.
Historically, a lot of kids and adults with neuro-developmental disorders have ended up in the Juvenile Justice System and the Adult Justice System.
So where in the "rich, abundant resources in the community" are these kids with neuro-developmental disorders going?

The influence of neurodevelopmental impairment on youth crime. (2017)

"The disproportionately high prevalence of neurodevelopmental disorders among young people in custody in numerous countries suggests a heightened vulnerability to serious and/or persistent offending coupled with a failure of various policy and practice systems to address complex needs in seeking to prevent offending and re-offending."

Updated adolescent admissions to the Colorado Mental Health Hospital in Pueblo
June 27, 2024

Good afternoon,
I am writing to inform you of the updated admissions policy and procedures for the adolescent behavioral treatment unit (ABTU) at the Colorado Mental Health Hospital in Pueblo (CMHHIP).

Review of recent admissions to ABTU show that many of the youth ordered to inpatient competency restoration are not in need of inpatient psychiatric care and that the factors impacting competency are often related to learning or developmental disorders, young age, and/or attentional problems, for example, rather than a psychiatric illness.

Youth without a need for intensive/inpatient psychiatric treatment would be best served, and have their developmental needs best met, in settings where there are more opportunities for these youth to develop their skills and abilities socially, academically, and recreationally while continuing treatment in a safe and secure environment.

Jill Marshall
Chief Executive Officer
Colorado Mental Health Hospital in Pueblo (CMHHIP)

Higher levels of Bioactive Lipids are arising as another biomarker of mental Disorders

7/2/2024

Val's Take, Conjecture

Illness is a scary thing --- especially when there are a lot of unknowns. With something like "Mental Illness," the symptoms can be very subtle until they are not.
We are constantly telling ourselves stories about how the world works --- until we have the basis for a new story.
"Mental Disorders" do involve the brain --- but they involve a lot more and often have prenatal origins.
We are starting to be able to see this in the Circulatory System in the Blood and the Mitochondria and in the Lymphatic System with Increased levels of Bioactive Lipids.
We're maybe not that far from getting a more comprehensive understanding of neuro-developmental and psychiatric disorders . Given the level of human suffering --- that would be a very good thing.
A lot of Energy in this society is going to trying to understand these issues and integrate the understandings we do have.
Better understandings (and treatments) will almost assuredly improve the "dynamics" of how we handle neuro-developmental and psychiatric disorders in the society.

University of Cologne in Germany

Lipid Signaling in Brain Linked to Mental Disorders (June 6, 2024)

"Increased levels of bioactive lipids produced naturally in the body, which affect excitatory transmission between brain cells, promote mental disorders."

Autotaxin activates the lipids.

Autotaxin is also recognized as a factor in heart disease and stroke, cancer, immune regulation, and autoimmune disorders.

[Val's Take: Mental Health has gone a long time without biomarkers. Things are breaking. We will likely have many biomarkers in the next 30 years]

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Translational Medicine Friday

Autism Spectrum Disorder, Neuro-developmental Disorders, Psychiatric Disorders and changing views

The energy of anger & Aggression when mitochondria are damaged

Synapses & Energy

Co-occurring Conditions with Adhd & Autism

Neuro-Diversity, energy issues & diet

"ADHD" and Epigenetics

Recent Research on Cognitive Disability

Conduct Disorder Linked to Widespread Brain Structure Changes (2024)

"ADHD" and "ANTI-SOCial Personality Disorder"

Policy Challenges & the complicated intersection between Developmental & Psychiatric disorders

Higher levels of Bioactive Lipids are arising as another biomarker of mental Disorders

Translational Medicine Friday

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