PEDIATRICS Vol. 87 No. 5 May 1991, pp. 774-780
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Indices of Neural Function in Autism: Clinical and Biologic Implications

Nancy J. Minshew MD1

1 From the Western Psychiatric Institute and Clinic, University of Pittsburgh, Pennsylvania

In contrast to neuroanatomic and neuroimaging studies, which have identified abnormalities in the limbic system and cerebellum in autism, physiologic studies have revealed abnormalities of the cerebral cortex and, in particular, of association cortex. Electroencephalogrphic studies in the autistic population have reported a significant incidence of abnormalities involving the cerebral cortex. More specific studies of neural function using evoked potentials, positron emission tomography (PET), and 31P nuclear magnetic resonance (NMR) spectroscopy have identified abnormalities involving association cortex.

ELECTROENCEPHALOGRAPHY

Electroencephalography (EEG) was one of the earliest techniques used to investigate the neurobiology of autism. The recognition of a high incidence of EEG abnormalities and of seizure disorders in the autistic population was among the earliest evidence of a biologic basis for this disorder. One of the first of these studies appeared in 19641 and reported EEG abnormalities in 58% and epilepsy in 19% of the 58 young autistic children in their series. The EEG abnormalities consisted of generalized paroxysmal spike and wave activity in the majority of cases, with the remainder having a spike or slow wave focus. In the ensuing decade, the incidence of abnormal EEGs in various series ranged from 10% to 83%, depending on the method of subject selection and the criteria for interpretation of the EEGs.1-8 The seizure frequency ranged from 19% to 25% in these studies.

In 1975, Small9 reported paroxysmal EEG abnormalities (focal spike, paroxysmal spike and wave, and multifocal spike activity) in 65% of 147 autistic children studied with repeated EEGs. Two technical factors were found to be significant in the EEG status of these cases, the most important of which was the number of recordings.




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