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Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism
Autism Research Institute, 4182 Adams Avenue, San Diego, CA 92116, USA
Division of Endocrinology, Department of Medicine, New York University Medical School, New York, NY 10016, USA
* Author to whom correspondence should be addressed.
Received: 20 September 2013; in revised form: 7 November 2013 / Accepted: 11 November 2013 / Published: 11 December 2013
Abstract: Electrophysiological findings implicate site-specific impairment of the nucleus tractus solitarius (NTS) in autism. This invites hypothetical consideration of a large role for this small brainstem structure as the basis for seemingly disjointed behavioral and somatic features of autism. The NTS is the brain’s point of entry for visceral afference, its relay for vagal reflexes, and its integration center for autonomic control of circulatory, immunological, gastrointestinal, and laryngeal function. The NTS facilitates normal cerebrovascular perfusion, and is the seminal point for an ascending noradrenergic system that modulates many complex behaviors. Microvascular configuration predisposes the NTS to focal hypoxia. A subregion—the “pNTS”—permits exposure to all blood-borne neurotoxins, including those that do not readily transit the blood-brain barrier. Impairment of acetylcholinesterase (mercury and cadmium cations, nitrates/nitrites, organophosphates, monosodium glutamate), competition for hemoglobin (carbon monoxide, nitrates/nitrites), and higher blood viscosity (net systemic oxidative stress) are suggested to potentiate microcirculatory insufficiency of the NTS, and thus autism.
Keywords: autism; nucleus tractus solitarius; blood-brain barrier; autonomic; baroreflex; toxins; hypoxia; perfusion; adrenergic; A2 neurons
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McGinnis, W.R.; Audhya, T.; Edelson, S.M. Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism. Int. J. Environ. Res. Public Health 2013, 10, 6955-7000.
McGinnis WR, Audhya T, Edelson SM. Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism. International Journal of Environmental Research and Public Health. 2013; 10(12):6955-7000.
McGinnis, Woody R.; Audhya, Tapan; Edelson, Stephen M. 2013. "Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism." Int. J. Environ. Res. Public Health 10, no. 12: 6955-7000.