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Neuropathological observations in a case of autism presenting with self-injury behavior

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Summary

We report the neuropathological evaluation of a 24-year-old autistic woman suffering from a residual state of infantile autism and presenting with self-injury behavior since childhood. Her behavior included head-banging, eye-gouging and self-biting. All intended therapeutic measures remained without effect, including high doses of psychotropic drugs. At autopsy, numerous neurofibrillary tangles were found in the perirhinal and entorhinal cortex where they were frequently grouped in nests or clusters. A few neurofibrillary tangles were also observed in the amygdala and in the prepiriform and orbito-frontal cortex. In the cortex, tangles were located in both layers II and III. There were no neuritic plaques or amyloid deposits. Interestingly, neurofibrillary tangles have been described in brains of individuals who had experienced repeated head injuries such as boxers (dementia pugilistica) and soccer players, suggesting that in our case a similar mechanism induced tangle formation and resulted in the loss of selective neuronal populations.

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References

  1. Aggleton JP, Burton MJ, Passingham RE (1980) Cortical and subcortical afferents to the amygdala of the rhesus monkey (Macaca mulatta). Brain Res 190: 347–368

    Google Scholar 

  2. Behrouz N, Défossez A, Delacourte A, Hublau P, Mazzuca M (1989) Alzheimer's disease: glycolytic pretreatment dramatically enhances immunolabeling of senile plaques and cerebrovascular amyloid substance. Lab Invest 61: 576–583

    Google Scholar 

  3. Bouras C, Hof PR, Guntern R, Morrison JH (1990) Down's syndrome (DS), dementia pugilistica (DP), and Alzheimer's disease (AD): a quantitative neuropathologic comparison. Soc Neurosci Abstr 16: 1264

    Google Scholar 

  4. Braak H (1980) Architectonics of the human telencephalic cortex. Springer, Berlin

    Google Scholar 

  5. Campbell MJ, Morrison JH (1989) A monoclonal antibody to neurofilament protein (SMI-32) labels a subpopulation of pyramidal neurons in the human and monkey neocortex. J Comp Neurol 282: 191–205

    Google Scholar 

  6. Corsellis JAN, Bruton CJ, Freeman-Browne D (1973) The aftermath of boxing. Psychol Med 3: 270–303

    Google Scholar 

  7. Frankel F, Simmons III JQ (1976) Self-injurious behavior in schizophrenic and retarded children. Am J Ment Defic 80: 512–522

    Google Scholar 

  8. Gallyas F (1971) Silver staining of Alzheimer's neurofibrillary changes by means of physical development. Acta Morphol Acad Sci Hung 19: 1–8

    Google Scholar 

  9. Globus JH (1927) The Cajal and Hortega glia staining methods. A new step in the preparation of fomaldehyde-fixed material. Arch Neurol Psychiatry 18: 263–71

    Google Scholar 

  10. Green AH (1967) Self-mutilation in schizophrenic children. Arch Gen Psychiatry 17: 234–244

    Google Scholar 

  11. Guntern R, Bouras C, Hof PR (1989) An improved staining method for senile plaques and neurofibrillary tangles in Alzheimer's disease: quantitative comparison with other techniques. Soc Neurosci Abstr 15: 1038

    Google Scholar 

  12. Hedreen JC, Kraskin LS, Struble RG, Price DL (1988) Selective silver impregnation of senile plaques: a method useful for computer imaging. J Neurosci Methods 25: 151–158

    Google Scholar 

  13. Hof PR, Morrison JH (1990) Quantitative analysis of a vulnerable subset of pyramidal neurons in Alzheimer's disease: II. Primary and secondary visual cortex. J Comp Neurol 301: 55–64

    Google Scholar 

  14. Hof PR, Morrison JH (1991) Neocortical neuronal subpopulations labeled by a monoclonal antibody to calbindin exhibit differential vulnerability in Alzheimer's disease. Exp Neurol 111: 293–301

    Google Scholar 

  15. Hof PR, Bouras C, Constantinidis J, Morrison JH (1990) Selective disconnection of specific visual association pathways in cases of Alzheimer's disease combined with Balint's syndrome. J Neuropathol Exp Neurol 49: 168–184

    Google Scholar 

  16. Hof PR, Cox K, Morrison JH (1990) Quantitative analysis of a vulnerable subset of pyramidal neurons in Alzheimer's disease: I. Superior and inferior temporal cortex. J Comp Neurol 301: 44–54

    Google Scholar 

  17. Hyman BT, Van Hoesen GW, Kromer LJ, Damasio AR (1986) Perforant pathway changes and the memory impairment of Alzheimer's disease. Ann Neurol 20: 472–481

    Google Scholar 

  18. Kitamoto T, Ogomori K, Tateishi J, Prusiner SB (1987) Formic acid pretreatment enhances immunostaining of cerebral and systemic amyloid. Lab Invest 57: 230–236

    Google Scholar 

  19. Lampert PW, Hardman JM (1984) Morphological changes in brains of boxers. J Am Med Assoc 251: 2676–2679

    Google Scholar 

  20. Lewis DA, Campbell MJ, Terry TD, Morrison JH (1987) Laminar and regional distribution of neurofibrillary tangles and neuritic plaques in Alzheimer's disease: a quantitative study of visual and auditory cortices. J Neurosci 7: 1799–1808

    Google Scholar 

  21. Morrison JH, Hof PR, Campbell MJ, De Lima AD, Voigt T, Bouras C, Cox K, Young WG (1990) Cellular pathology in Alzheimer's disease: implications of corticocortical disconnection and differential vulnerability. In: Rapoport SR, Petit H, Leys D, Christen Y (eds) Imaging, cerebral topography and Alzheimer's disease. Springer, Berlin, pp 19–40

    Google Scholar 

  22. Nieuwenhuys R, Voogd J, van Huijzen C (1988) The human central nervous system, 3rd edn. Springer, Berlin

    Google Scholar 

  23. Pearson RCA, Esiri MM, Hiorns RW, Wilcock GK, Powell TPS (1985) Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease. Proc Natl Acad Sci USA 82: 4531–4534

    Google Scholar 

  24. Perl DP, Good PF (1987) Uptake of aluminium into central nervous system along nasal-olfactory pathways. Lancet I: 1028

    Google Scholar 

  25. Potter H, Nauta WJH (1979) A note on the problem of olfactory associations of the orbitofrontal cortex in the monkey. Neuroscience 4: 361–367

    Google Scholar 

  26. Reyes PF, Golden GT, Fagel PL, Fariello RG, Katz L, Carner E (1987) The prepiriform cortex in dementia of the Alzheimer type. Arch Neurol 44: 644–645

    Google Scholar 

  27. Roberts GW, Allsop D, Bruton C (1990) The occult aftermath of boxing. J Neurol Neurosurg Psychiatry 53: 373–378

    Google Scholar 

  28. Shodell MJ, Reiter HH (1968) Self-mutilative behavior in verbal and nonverbal schizophrenic children. Arch Gen Psychiatry 19: 453–455

    Google Scholar 

  29. Suzuki WA, Amaral DG (1990) Cortical inputs to the CA1 field of the monkey hippocampus originate from the perirhinal and parahippocampal cortex but not from area TE. Neurosci Lett 115: 43–48

    Google Scholar 

  30. Talamo bR, Rudel RA, Kosik KS, Lee VMY, Neff S, Adelman L, Kauer JS (1989) Pathological changes in olfactory neurons in patients with Alzheimer's disease. Nature 337: 736–739

    Google Scholar 

  31. Turner BH, Gupta KC, Mishkin M (1978) The locus and cytoarchitecture of the projection areas of the olfactory bulb in Macaca mulatta. J Comp Neurol 177: 381–396

    Google Scholar 

  32. Van Hoesen GW, Pandya DP (1975) Some connections of the entorhinal (area 28) and perirhinal (area 35) cortices of the rhesus monkey. III. Efferent connections. Brain Res 95: 39–59

    Google Scholar 

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Supported in part by the Brookdale Foundation (to PRH)

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Hof, P.R., Knabe, R., Bovier, P. et al. Neuropathological observations in a case of autism presenting with self-injury behavior. Acta Neuropathol 82, 321–326 (1991). https://doi.org/10.1007/BF00308819

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  • DOI: https://doi.org/10.1007/BF00308819

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