sensory integration problems in autism may 24, 2009 manuel f. casanova, m.d

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Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D.

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Page 1: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Sensory Integration Problems in AutismMay 24, 2009

Manuel F. Casanova, M.D.

Page 2: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Temple GrandinTemple Grandin

• In an interview with Temple Grandin (2008) when asked where the federal government should spend their research money, she answered: “…I would spend it on…really figuring out what causes all the sensory problems. I realize it’s not the core deficit in autism, but it something that makes it extremely difficult for persons with autism

to function.”

Page 3: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Properties of SystemsProperties of Systems

A system has: 1) properties that are emergent, if not intrinsically found in any of its parts, 2) phase transitions; the capacity to change from one defined state to another at a critical juncture, and 3) a high degree of internal interdependence.

Page 4: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Orientation Preference of ColumnsOrientation Preference of Columns

Proposed emergent properties: Thresholding, amplification, derivative functions, feature convergence, distribution functions, coincidence detection, pattern generation, etc. Mountcastle, 1998.

Page 5: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Minicolumns in Autism and ControlsMinicolumns in Autism and Controls

Casanova et al., 2002

Page 6: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Gray Level Index OverlayGray Level Index Overlay

Casanova, 2007, in press

Page 7: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Rett Syndrome

Page 8: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Minicolumns in AutismMinicolumns in Autism

Page 9: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Shower Curtain of InhibitionShower Curtain of Inhibition

Page 10: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Minicolumnar activity patterns generated by Favorov and Kelly (1994) in response to spatially defined patterns in a shape of letters H and U.

Page 11: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Predictability: Quantitative Sensory Predictability: Quantitative Sensory Testing in AutismTesting in Autism

Radial histogram of SI cortical → activity (Squirrel monkeys, n=5). Cortical activity measured as light absorbance.

←Spatial localization under two conditions of adapting stimulus duration.

Page 12: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Minicolumnar activity patterns generated by Favorov and Kelly (1994) in response to spatially defined patterns in a shape of letters H and U.

Page 13: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Inhibitory Deficit in AutismInhibitory Deficit in Autism

Casanova, 2006

Page 14: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Information (Neuronal Activity) and BackgroundInformation (Neuronal Activity) and Background

Page 15: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

The Noisy Brain: Part 1The Noisy Brain: Part 1

• 1) “What researchers found was that in fact stimulus overload is devastating to the brain’s- to the self’s- capacity to maintain itself. Entirely normal people who are severely overloaded, especially by unpredictable and uncontrollable stimuli, can show impaired functioning, raised physiological stress, internal chaos. Impulsive actions, and a “lower level of adaptation: to life’s challenges.”

• 2) “Because research shows that prolonged states of sensory overload (or noise) are actually traumatizing, we can conclude that patients suffering from severe mental disorders are actually being traumatized by their own brains.”

Ratey JJ. Shadow Syndromes, page 29, 1997

Page 16: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

The Noisy Brain: Part 2The Noisy Brain: Part 2

• 1) “Noise affects this top level, causing a person afflicted to fall back to a more primitive, “lower” level of brain functioning that corresponds to the social strategies of the adolescent or child. (Or lower still…where we respond reflexively instead of thoughtfully.”

• 2) “Finally, beyond both of these difficulties, intense physiological arousal also impairs reasoning ability, a phenomenon psychiatrists describe as becoming concrete. Once we have become concrete, we take things at face value; we are no longer responding to the subtle clues and subtext of social interactions…But what happens when people become concrete is that they have no way of gauging the depth, the possible subtexts, of any particular exchange.”

Ratey JJ. Shadow Syndromes, page 29, 1997

Page 17: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Inhibitory Surround of MinicolumnsInhibitory Surround of Minicolumns

Page 19: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Precise Targeting of Specific Cortical Precise Targeting of Specific Cortical Regions: Frameless StereotaxyRegions: Frameless Stereotaxy

Brainsight-Rogue Research, Inc

Page 20: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Diagnostic Characterization of Neural Circuitry: Modulation of Modulation of Activity in a Distributed NetworkActivity in a Distributed Network

Valero-Cabre et al., Exp Brain Res 2005, 2006

Page 22: Sensory Integration Problems in Autism May 24, 2009 Manuel F. Casanova, M.D

Induced Gamma Frequency OscillationsInduced Gamma Frequency Oscillations