Introduction to Autism
Autism spectrum disorder (ASD) is a group of various developmental disabilities defined by impaired social interaction and communication, characterized by subjects with narrow interests. However, biological mechanisms were not recognized with Autism until the 1980s, when studies demonstrated the high heritability of ASD and its connection with other genetic conditions. This provided compelling evidence for the role of genetics with Autism, and fueled research up to today on the neurologic causation of this disorder.
Diagnosis
Diagnosis of Autism spectrum disorder is based on the presence of two major symptoms: social-communication deficits and limited and repetitive interests/behaviors. These symptoms must be exhibited in early childhood, but additional symptoms include sensory and motor deficiencies, sleep disturbance, epilepsy, attention deficit/hyperactivity disorder, intellectual disability, anxiety and aggression. Autism prevalence has grown year to year for decades, with a prevalence of 1% worldwide today.
Genetics
It is widely understood ASD contains a huge genetic component. The concordance rates of autism are approximately 90% in monozygotic twins and 10% in dizygotic twins. However, Autism is rarely defined by a single genetic mutation, as these instances only account for 1-2% of Autism cases. Therefore, autism research has focused on genome-wide association studies, accounting for a wide range of genes and how multiple mutations can predispose Autism. Many recent discoveries relating to autism have been titled de novo mutations in genes that encode synaptic proteins and neuroligins. Additionally, several mutations of ASD are indicators for other psychological disorders such as intellectual disability, schizophrenia, childhood absence epilepsy, ADHD and depression.
Neuroanatomical Abnormalities
A common alteration in brain anatomy seen in about 20% of autistic children is macrocephaly, or overgrowth of the brain. Localized overgrowth and over-dendritic development has been identified in the frontrol lobe, parieto-temporal lobe, cerebellum, and subcortical limbic structures. Most notably, the cerebellum has is a main focus of neuroanatomical abnormalities in autistic subjects. Magnetic resonance imaging (MRI) have suggested hypoplasia throughout the cerebellum and most notably a reduction in Purkinje cells. Purkinje cell fibers have a very significant role in regulation of motor movements, helping the fluidity of all physical movement. Therefore, many autistic patients have sensory and motor dysfunctions. It has also been found that cerebellar activation is significantly reduced during selective attention tasks, whereas it is enhanced during a simple motor task in autistic individuals. Cerebellum dysfunction has also been shown to be associated with core symptoms of autism. Recent research has suggested Purkinje cells play a role in social functioning, and neurotransmitter communication throughout the brain. By finding this Purkinje cell role, the mechanism of autism spectrum disorder has further been clarified.
Neurotransmitter Abnormalities
Defects in excitatory/inhibitory balance throughout the brain occurs in patients with autism. Common defects in synaptic proteins in ASD leads to defective transmission in excitatory and inhibitory synapses, damaging the E-I balance throughout structures of the brain. Reduced levels of glutamate, an excitatory neurotransmitter, were observed in the plasma of autistic children, also indicated in post-mortem brains of autistic patients. Decreased levels of rate-limiting enzyme for synthesis of GABA was also observed in autistic brains, suggesting an excess of this inhibitory neurotransmitters.
Serotonin is a neurotransmitter known to play a role in regulating E-I balance. Increased levels of serotonin (5-HT) were observed in blood and urine of autistic individuals. Various genes encoding for serotonergic signaling are linked to autism, like the gene encoding for the serotonin transporter 5-HTT.
Lastly, proteins vital for pre-synaptic release are altered in autistic patients. Neurexins and neuroligins also regulate various aspects of both excitatory and inhibitory synaptic development and function. Many mutations in genes encoding neurexins and neuroligins have been associated with Autistic Spectrum disorder.
Overall, many complex neurological complications are present in autism, often stemming from genetic origin. By better understanding the factors in play in autism, one can better discern the nature of this condition, and become aware of psychological conditions.
Autism Spectrum Disorder
In a study between the years of 2006-2008, it was determined that 1 in 6 American children had a developmental disability ranging from the mild to more severe. These disabilities included anything from speech and language deficits to more serious disabilities like autism. Autism spectrum disorder is a developmental disorder characterized by difficulties in social interactions, communication, repetitive behaviors, motor coordination, and attentiveness.
While approximately 1 in 68 children are diagnosed with some form of autism spectrum disorder, it still isn’t known exactly what is underlying this condition. Recent research has attempted to compile the best theories on autism spectrum disorder in order to more fully explain how it directly impacts developing brains.
A network of cerebral proteins and substrates that might play a role in the development of autism spectrum disorder (Won et al.)
The most recent theory concerns a problem occurring along the connections between nerves called synapses. In brains of patients with autism spectrum disorder, it was shown that there is over-connectivity of neurons locally with less neurons that stretch between brain regions to aid in communication within the brain. It is hypothesized that an imbalance of excitement and inhibition nerve impulses in the brain could be preventing correct synapse formation leading to autism spectrum disorder.
Dopamine hyperactivity in the synapse could contribute to problems in autism spectrum disorder
Regardless of its cause, genetic or environmental, autism spectrum disorder is becoming more and more common and one thing that can be done is to raise awareness and support for those who are are suffering. Until more is discovered about autism spectrum disorder, the best we can do is offer to help support families and the search for a cure.
Obesity and the Brain
Hypothalamus
It has been recently discovered that unlike inflammation in the in the peripheral tissues, inflammation in the brain due to high fat intake occurs as soon as 1-3 days. In this time following a large fat intake, neuron damage is identified, and inflammatory symptoms spring throughout the hypothalamus. While most alterations are initially reversible, continued fat intake cause permanent damage to many structures like the mediobasal hypothalamus.
While weight gain is delayed, brain damage occurs immediately, shedding light on emerging studies today that portray obesity as a brain disease. Acutely inflamed hypothalamus due to short term over-nutrition or chronic obesity can become dysfunctional. This brain structure, responsible for regulating diet and caloric intake, might disrupt the precise coupling between energy intake and energy expenditure, fostering overeating and further weight gain.
Hippocampus
Recent articles have revealed conditions stemming from obesity-related conditions such as diabetes, hypertension, and cardiovascular disease are proven to adversely influence hippocampal size. High-fat diets induce pro-apoptotic (inflammatory) signaling such as expression of caspase-3 and gliosis throughout structures of the hippocampus. This local signaling of inflammation and cell death ultimately leads to hippocampal tissue loss. The hippocampus, responsible for countless cognitive functions, becomes severely impaired. Studies have shown both obesity and a high BMI in midlife are strong indicators of hippocampal degeneration in late life. Furthermore, factors such as high blood glucose levels have been linked to 10% volume change of the hippocampus within 1 year, regardless of factors such as age, sex, alcohol, and smoking.
Cognitive Decline
Obesity is associated with cognitive decline across the human life span. Often, these cognitive impairments are evident during child or adolescence, where deficits are seen in executive functioning, attention, and decreased intelligence quotient. Many studies have explored the possibility that deficient executive functioning leads to increased appetite, due to a loss of cognitive control of actions such as unhealthy eating.
Even healthy obese people show cognitive deficits in learning, memory, and executive function in contrast to non-obese individuals, which reflects the impacts of obesity. Cognitive performance declines with decreased physical activity and aerobic exercise, which are often linked to increased weight. These cognitive declines occur not only at the rudimentary or elementary level. Scholastic performance at collegiate and graduate levels have decline in response to obesity.
Not all cognitive losses are irreversible, however. Weight loss may result in rapid improvement in some cognitive functions. Studies have revealed improved memory following subjects undergoing bariatric surgery. Weight loss influences many variables, such as blood pressure, arterial flow, sleep quality and nutrition composition which all ultimately contribute to cognitive inclines.
Early Life
Exposure to excessive nutrition during vulnerable pre- and postnatal periods can impair the brain cognitively and disrupt brain-governed feeding behavior. Environments of over-nutrition are mediated many functional alterations which can lead to obesity, dysmetabolism and cognitive disadvantages throughout life.
Although caloric restriction can later reduce body weight gain, early life hypothalamic disposition to hyperphagia is irreversible. Maintaining a healthy diet accompanied by exercise for pregnant mothers is crucial for lifetime eating habits, as this period where feeding behavior is imprinted into the nucleus of the hypothalamus.
What Came First: Obesity or the Brain Disease?
As we all know, obesity is a danger to this country but it may be in more ways than one. There are the physical dangers that come with obesity that are pretty well-know, but thats not all. There are mental effects that will occur with the lifestyle choices of unhealthy people.
There is a lot of different things going on in the brains’ of obese people compared to the brains’ of healthy people. On the right is a picture taken by people who were researching dopaminergic response. Studies show that obese brains have a different response to pictures and smells of foods. They have more of an emotional response and have less control over their choices.
These choices come back to damage the brain in a vicious cycle. A high fat diet can break the blood-brain barrier, the only thing that protects the brain. Researchers believe that the increase in breakdown of the blood brain barrier is due to the circulation of beta amyloid from the high fat diet. Beta amyloid is associated with diseases such as Alzheimer’s.
There are also genes that factor in. Brain derived neurotrophic factor (BDNF) is a protein that fixes neurons. It is activated by many factors and one of them is leptin, which regulates fat storage in the body. Some people have variations of the BDNF gene and others have a genetic leptin deficiency that will cause and decreased amounts of BDNF.
When there isn’t enough BDNF the homeostasis of the brain is upset in. This causes a response of over eating trying to fix the homeostatic problem. The body wants more fat to produce more leptin in order to feel full. Leading the the vicious cycle of a high fat diet.
The question is did are the bad eating habits inevitable and part of a brain disease or did the brain disease stem from the poor habits?
Why do I Keep Getting Fatter?
Obesity is something on everyone’s minds these days. The days of being skinny sort of slipped away, slowly but inevitably. Fatty and sugary foods, expensive (and not as good tasting) vegetables and fruits, lack of time to cook and exercise, and stress are all major reasons for why we continue to gain weight despite small but often inconsistent attempts. Why don’t we have the willpower to just go on a diet and stick with it? Well, it could be that we don’t have the energy to exercise like we once used to have, or maybe it is because we just don’t care anymore. Whatever reason you may have been told via doctors or the internet, it was probably not entirely true.
Weight gain tends to be labeled as a bunch of bad habits, and that is a huge part of it. Lack of strength (laziness) to maintain a fitness and health plan is usually what society tells us is the reason for why we are fat. However, new research is revealing that obesity may be more of a problem of the brain than anything else. In fact, many of us may have been set up to be obese later on in life since growing in our mother’s womb, as there are brain development patterns of the child that change when exposed to high fat and sugar diets that the mother had eaten during pregnancy. This can cause the child to crave those foods more than normal, and develop obesity as well.
The label of “brain disease” could possibly be applied to obesity because there are changes in the brain following poor diet that both harm the brain via inflammation, and change it such that there is an increased craving for fatty and sugary foods. For example, obesity goes hand in hand with insulin resistance, which leads to diabetes and more recently is being linked to Alzheimer’s disease. In addition, obesity is correlated with lower brain volume and diminished cognitive functioning compare, but is reversible with weight loss, depending on the progression of the problem. Obesity also causes leptin resistance in the brain. Leptin is a hormone in the brain that prevents hunger, so being obese turns into downward spiral for the brain because leptin resistance means the effects of leptin in the brain are being prevented and makes obese people more hungry than is necessary. This makes it harder to diet, the main way to fix the problem.
With all of the societal problems, can obesity really be considered a brain disease? It is kind of an arbitrary question, as it is both maintained by brain dysfunction caused by poor diet, but also by society: we have too much easy-to-access and unhealthy food; we also live in a fast-paced time when convenience is necessary to the point that cooking our own food is impossible or just too stressful or rushed. While the negative effects of obesity are far reaching for human health, there are many more problems that could be addressed to prevent obesity in our society.
Whatever we decide to call it, obesity is a problem that reduces our cognitive functioning and even affects our children’s futures. New drugs are being developed to target the new brain pathways discovered in obesity, so it is only a matter of time before we have that on our side.
Obesity as a Brain Disease – A Public Wakeup Call
It’s a weird thought – an obese person being at the mercy of his or her brain – but recent research suggests this may be the case. According to a study done by Shefer et al., a diet high in calorie intake is linked to various negative neurological qualities such as a cognitive decline and reduced brain volume. This high calorie diet the researchers are attributing to these diminished qualities works via the blood brain barrier – they breakdown the proteins responsible for constructing the barrier, which then hinders the brain’s ability to protect from pathogens in the blood. Furthermore, this destruction can lead to devastating inflammation in the brain, which leads to even further consequences for the high-calorie-consumer’s brain.
For example, the researchers showed that the resulting inflammation can damage various sensitive areas of the brain such as the hypothalamus, the amygdala, and the hippocampus. All of these areas are not only to crucial to everyday functioning, but they also contain signaling pathways important for learning and emotional processing. Because of this, behaviors like overeating can eventually transition into a learned behavior – a development very similar to that of addiction. In addition, the research showed that the chemical reward pathway in the brains of obese people is severely changed when exposed to food after fasting. These findings suggest that, maybe, obesity is actually a neurological disease. Is there merit to this claim? Or is it simply an opinionated, open-ended discussion topic that will be debated for a long time?
In my opinion, either way, this research should draw attention to a novel way to approach tackling obesity. And here in America, it seems that we should take any new approach we can get to make our nation healthier, right? In addition, these findings just further push me to believe how pertinent it is that our country becomes more educated on not only our brains, but what our lifestyles do to them. If we can actually understand what is happening when we eat a lot of calories instead of just knowing that eating unhealthy makes us fat, I firmly believe things may change. And in the case of this topic, the brain is a great place to start.
It’s time to educate the public on this topic – what we eat doesn’t just make our stomachs big and our bodies unhealthy, but it literally changes our brains. We begin to change the way we think about food and the decisions we make about our diets in response to overconsuming calories. It’s crazy. But it’s also reality.
Obesity: Social Issue or Brain Disease?
Defined as the excessive amount of body fat, obesity has historically been described as a physiological disease. However, recent research has challenged this classical idea by looking into the neurological degenerative nature of this condition.
While the accumulation of body fat occurs through the excessive intake of fatty foods and extreme caloric consumption, the mechanisms of hunger and food satisfaction in the brain have been further studied in recent research.
One such studied focused on the brain signaling pathways found throughout the prefrontal cortex of the brain in the postprandial state. They chose to target this portion of the brain since the prefrontal cortex is the control center for decision making and executive function. The postprandial state means that they conducted imaging tests on individuals after they had had a full meal. This was done to see how different individuals reacted to the consumption of food.
Following the study, researchers were able to determine that obese individuals were less satisfied by standard caloric intake and had showed less inhibitory control in the prefrontal cortex. More or less, it took more food for these people to be satisfied and even then it was more difficult to resist eating more. They attributed these behaviors to a difference in the neuronal activity of the posterior cingulate, which is a portion of the prefrontal cortex, between obese and lean individuals.
While this information may suggest that obesity may be attributed to an innate chemical imbalance or inability to control executive function, individuals that had previously been obese that lost weight and remained at a normal BMI for three years showed similar neuronal activity to lean individuals. This would suggest that neurological disfunction found in the brain may be due to a physiological factors rather than innate conditions.
The question of whether obesity is dependent on social factors such as diet and exercise or on the genetic composition of the brain remains unanswered. However, I think it is safe to say that the neurological function of our brains is dependent on the way we take care of our bodies and the physiological health of our bodies is dependent on the condition of our brains. At the end of the day I guess the real question is, which came first, the chicken or the egg?
Obesity in the Brain
According to multiple studies that I have read, obesity is of great concern in all societies. In every state at least 20-35% of their individuals are considered obese. These numbers continue to rise every day due to the lack of exercise and easy accessibility of unhealthy food.
Throughout class we discovered the impact food can have on the brain and how alterations are made to the brain from the food we eat.
I was specifically interested in leptin receptors and their effect on the brain. Leptin is released into the brain proportionately to body weight. Therefore if someone consumes food that is higher calorically they tend to produce more leptin.
Leptin is then released into the brain where it binds to leptin receptors in the hypothalamus, the region that controls hunger and thirst. In a normal body when leptin binds to the receptors in the hypothalamus the feeling of fullness is triggered causing individuals to stop eating. But in individuals who are overweight leptin receptors fail to work. When the receptors become resistant it takes a lot more leptin to trigger the individual that they are full causing them to consume more food. This is why individuals who are overweight have such a hard time reducing the amount of food they eat and why losing weight can be difficult.
For further information about how obesity is a brain disease the paper we read in class is very helpful.
Knowing that obesity isn’t necessarily an individuals choice but rather is a brain disorder is alarming. This encourages us all to educate our communities about the impact unhealthy food can have on our bodies.
It's More than Morals: A Look at Obesity and the Brain
As most people know, obesity has impacted the lives of many people in western society. Everywhere you turn, there is a fast-food building, a convenience store with cheap, sugary snacks, and fewer places with accessible health foods.
Reading blogs and watching you-tube videos about explanations to this, people tend to lean more towards the “moral judgement” explanation. Some people say that obesity happens when people lack will power, and some people say that it’s because of the parents. However, the explanation that isn’t talked about as much is the idea the increase in high caloric diet could be because of brain dysfunction.
According to a paper that we read in class, cognitive impairments and hormone regulation were affected by obesity. It seems to be an endless cycle.
High caloric diets can lead to the breakdown of the Blood Brain Barrier, which can have detrimental effects (i.e. toxins can potentially enter the brain) itself. It also leads to inflammation, which will affect areas of the brain that are susceptible to damage such as the amygdala (emotions), hypothalamus (hormones), and hippocampus (memory).
Overeating can become a learned behavior in result of the effects on emotions, hormones, and memory. In a way, the brain acts as if it is an addiction because of how reinforcing it is. The changes can also result in detrimental effects such as oxidative stress and Insulin-receptor signaling breakdown. All of these can result in cognitive impairment, and more of high-caloric diets.
Although obesity can result in changes to the brain, thus resulting further as more of a brain disease, it is also important to look at what initially starts the high-caloric diets. This is where most people think it’s a matter of moral decisions. However, studies show that genetics and environment (socioeconomic status, fresh food availability, etc.) can also play a very large role in obesity. It is not just a matter of moral decision, although that does play a role as well.
Furthermore, more research needs to go to into this topic in order to fully understand obesity, what causes it, and how we can help alleviate it as much as possible.
Obesity: A rising problem?
Obesity is a disorder when a person has an excessive amount of body fat. It is estimated one-third of adults in the U.S. is obese. Obesity can also lead to other unwanted health problems, such as heart disease, diabetes, and high blood pressure.
It sounds easy to fight obesity by having a healthy diet and exercise, but it might be more complicated than that.
Obesity can be labeled as a brain disease due to the changes in brain structures. Overnutrition will cause a breakdown of the blood-brain barrier. Another problem caused by overnutrition is the increase of inflammation in different brain structures. The hippocampus, which is important for memory, has seen lost in size due to a high-fat diet or obesity. The reduction in the size of the hippocampus will cause memory and cognitive defects.
The hypothalamus is another structure affected by overnutrition. The hypothalamus helps regulate body temperature, hunger, and sleep. The increase in inflammation within the brain will cause the hypothalamus to affect insulin resistance too. The change in structure due to obesity will impair insulin secretion. This will result in glucose building up, and lead to type 2 diabetes.
While obesity can be labeled as a brain disease, some might not consider it as so. People who are obese had a choice in their life to become obese. People with other brain diseases, such as Parkinson’s and Alzheimer’s Disease, didn’t choose to obtain a brain disease. The change in brain structure in obese patients can’t be denied, but the aspect of placing it in the categories with “true” brain diseases is still questionable for me.
Regardless, obesity is still a problem and needs to be tackled with steps to help patients improve their life. By figuring out the parts of the obese brain is a possibility in treating obesity.