15. Neuropathology
1 - Creak (1963) and Williams et al. (1980)
2 - Rodier et al. (1996) and Coleman et al. (1985)
3 - Ritvo et al. (1986)
4 - Bailey et al. (1998) and Kemper & Bauman (1998)
5 - Brain size and fetal alcohol syndrome
6 - Magnetic resonance imaging (MRI)
7 - Functional magnetic resonance imaging (fMRI)
No consistent visible neuropathology has been found in brains of children or adults
with autism. Brain impairment in autism is likely most often submicroscopic and due
to metabolic derangements. Visible signs of damage to-date have been primarily
found inbrainstem nuclei and the cerebellum. Magnetic resonance imaging (MRI)
scans indicate decreased brainstem size and cerebellar abnormalities in many
cases. Therefore both neuropathology and MRI tend to indicate a brainstem
(rather than cortical) pattern of involvement in autistic disorder.
Notes on individual cases:
The pathological and clinical findings in the individual cases of Creak (1963), Williams et al.
(1980), Bauman and Kemper (1985), Ritvo et al. (1986), and Bailey et al. (1998) are briefly
summarized in the sections above; the original papers should be consulted for full details. The
case reports indicate potential compromise at birth in some cases, mild to moderate
developmental delay in most cases, incidence of seizure disorder, and similar developmental
problems in siblings. The most consistent neuropathological finding is decreased numbers of
Purkinje cells in the cerebellum. The single case of Coleman et al. (1985), and Rodier et al.
(1996, 1997b) is also summarized, and would seem to represent autism caused by prenatal
exposure to alcohol. Some of the cases of Bailey et al. would also appear to involve exposure to
alcohol during gestation.