Notes on postmortem findings of Ritvo et al. (1986)
Case 1 – Male, age 10
Brain: Bilateral ventricular enlargement on CAT scan. Slight indentation of the left
posterior lobe and microgyria of left occipital and temporal lobes; asymmetry of
ventral-medial temporal lobes, with right uncus and parahippocampal gyrus twice as
large as the left; asymmetry of the cerebellar tonsils, with the right tonsil projecting
farther posteriorly. Purkinje cell counts 414 hemisphere, 297 vermis.
Clinical: Motor milestones within normal limits, but awkward gait. Poor gross and fine
motor coordination. Hyperactive. No smiling response or eye contact. Speech and
language normal until 18 months, then regressed. No seizures. IQ 20.
Case 2 – Male, age 19
Brain: No visible pathology. Purkinje cell counts 394 hemisphere, 440 vermis.
Clinical: Slow learning to walk, other gross and fine motor milestones within normal
limits. First words at 45 months and sentences at 50 months (age 4), then
progressed rapidly to stilted but near normal speech. Keenly aware of his peculiar
manner. IQ 103 verbal, 97 performance. Oversensitive to sounds. Normal EEG.
Clinical depression at age 15. Death by suicide.
Case 3 – Male, age 19
Brain: No visible pathology. Purkinje cell counts 362 hemisphere, 405 vermis.
Clinical: Motor milestones within normal limits. Poor fine motor coordination. No
smiling response or eye contact. Spoke isolated words until 36 months, then became
echolalic and remained so. Variable sensitivity to sounds. No seizures. IQ 40.
Case 4 – Male, age 22
Brain: No visible pathology. Purkinje cell counts 342 hemisphere, 262 vermis.
Clinical: Walked at 20 months. Poor fine motor coordination. Hyperactive. No
smiling response or eye contact. Single words by 18 months and phrases at 48
months, then became echolalic with pronoun reversal. No seizures. IQ 40.
Comparison subjects without CNS pathology:
Purkinje cell counts 510, 567, 454 hemisphere; 469, 696, 621 vermis.
Comparison subject with phenytoin toxicity:
Purkinje cell counts 797 hemisphere, 606 vermis.
3 - Ritvo et al. (1986)
Ritvo et al (1986) examined the brains of four autistic
subjects, all male [1]. One would now be classified as
having Asperger syndrome. He was described as
acutely aware of his differences, and he committed
suicide at the age of nineteen. The youngest subject
died at ten years of age; dilated cerebral ventricles
had been noted on an earlier CAT scan. No visible
pathology was found in the other cases, and the only
consistent abnormality was decreased Purkinje cells in
all four cases.
- Ritvo ER et al. (1986) Lower
Purkinje cell counts in the
cerebella of four autistic
subjects: initial findings of
the UCLA-NSAC Autopsy
Research Report.
- Ritvo ER, Freeman BJ, Scheibel AB, Duong T, Robinson H, Guthrie D, Ritvo A (1986) Lower
Purkinje cell counts in the cerebella of four autistic subjects: initial findings of the UCLA-
NSAC Autopsy Research Report. American Journal of Psychiatry 143:862-6.