language regression in ASD

March 20, 2006

Brain Endothelial Antibodies in Children with Language Regression

A. McVicar, rio Valicenti-McDermott, L. Moshe, Shlomo

Shinnar, Bronx, NY

OBJECTIVE: Characterize frequency of serum brain endothelial antibodies in

children with language regression (LR). BACKGROUND: Brain endothelial antibodies

have been reported in children with both autistic spectrum disorders (ASD) and

Landau Kleffner syndrome (LKS). The reported frequency has been variable, but

higher than that seen in children with other neurological conditions.

DESIGN/METHODS: Subjects were 31 children with LR who underwent overnight video

EEG monitoring at Montefiore Medical Center. Children with LR had a documented

LR (loss of 5 previously acquired words) with or without associated autistic

regression. ASD was diagnosed using DSM IV criteria. Serum samples were analysed

for brain endothelial antibodies, IgG and IgM, at Dr Connollys laboratory at

Washington University, St. Louis. RESULTS: Of 31 subjects, 24 (77%) were boys,

21 (68%) also met criteria for ASD, 14 (45%) had epileptiform EEGs and 10 (32%)

had a history of clinical seizures. Of the 31 children, 24 (77%) had brain

endothelial antibodies in serum, with 21 (68%) having positive IgG and 15 (48%)

having positive IgM antibodies. Brain endothelial antibodies were somewhat more

frequent in boys than girls (83% vs 50 %; p=0.12). Freuqncy was similar in those

with ASD (81%) and those with isolated LR (70%). It was also similar in those

with epileptiform EEG (71%) and nonepileptiform EEGs (82%).

CONCLUSIONS/RELEVANCE: Children with language regression have a high rate of

brain endothelial autoantibodies even though they are not being measured at

regression. The rates in this study are much higher than in other studies that

have examined all children with autism. The high rate observed in this populaion

suggests autoimmune mechanisms may be involved in the pathophysiology of this

devastating disorder. If confirmed, this has implications for novel therapeutic

approaches and pathophysiology. Supported by: NIH grant RR-17672-01 (KM).

Category - Child Neurology/Developmental Neurobiology

SubCategory - Other

Thursday, April 6, 2006 7:30 AM

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