NEURO-DEVELOPMENTAL STRATEGIES IN AUTISM
Traditionally in neurosciences it has been mentioned that brain develops by Wallerian regeneration and it was focused to mainly neurones, but now there is a paradigm shift and the astrocytes and glial cells play an important role in brain plasticity. Doctors can treat all diseases but neurological diseases are a big challenge because of limited capacity of neural tissue to regenerate. Doctors can replace joints, heart, liver, kidney, lungs, pancreas, limbs but cannot replace brain.
CAUSES OF NEURO-DEVELOPMENTAL AND NEURO-DEGENERATIVE DISEASES
Synaptic plasticity is an important neurophysiological process which refers to the ability of the brain to regenerate & neurons to modify the connections and is an activity involved in brain networks development and reorganization after damage from various neuro degenerative diseases and neuro developmental diseases like Autism, Parkinsons disease, Alzheimer’s disease and schizophrenia. Synaptic plasticity is of two types, namely, anti-homeostatic (i.e., Hebbian) and homeostatic plasticity (i.e., synaptic scaling). A delicate and intricate balance between these two forms of synaptic plasticity is important to regulate & maintain a physiological brain network functioning and architecture.
HOW DOES A CHILD PRESENT
Autism is in fact Autism spectrum disorder with children presenting in different clinical presentations for example some children may not speak but some may speak very well. In common children have difficulty in speaking, social communication and social interactions, deficits in cognitive development, repetitive behaviour, hyper-activity, attention deficit, repetition of words or phrases. There are many theories of cause of autism though not proven like genetic factors, environmental factors and perinatal causes .
TREATMENT AND THERAPY
Intervention can be non-pharmacological, pharmacological, life style modification and neurodevelopment through cell based therapies.
Non-pharmacological interventions includes special education, psychoeducational programmes, speech therapy which focusses on psychological, behavioural education. skill-building training may modulate autistic children to learn life skills necessary for living independently and sustain them, as well as to learn social, communication, and language skills. Therapy also aims to reduce challenging behaviors and build upon strengths.
Pharmacological interventions include prescription of drugs like risperidone, aripiperazole and anti-epileptic drugs.
Casein free and gluten free diet is helpful.
Out of all these strategies neurodevelopment through cell based therapies is the most promising way of treatment of such children as other interventions are time consuming and have limited scope and outcome. After cell based therapy like autologous stem cell transplant, non pharmacological and pharmacological approach may be more beneficial.
AUTOLOGOUS STEM CELL THERAPY
Autologous stem cell therapy is quite safe and can be done through autologous bone marrow which is rich in growth factors and haematopoietic cells and
Body fat which is rich in mesenchymal cells.
Both the tissues can be harvested by minimally invasive stitch-less & scarless surgeries with mild anesthesia. After processing in tissue culture labs without manipulating the stem cells, they can be given by IV, intra arterial and intrathecal route. Intrathecal route means giving by spinal route.
This procedure (autologous stem cell therapy) is a day care procedure and the child (including parents) can resume his/her schedule next day. Post transfusion analgesics are also not required. Omega 3 fatty acids given subsequently reduces the pro-inflammatory environment in brain. Stem cell therapy is a ray of hope for all parents who suffers a lot psychologically (fear psychosis) that what would happen to their child after them. This technique had translated from petri dishes to bedside and to a new paradigm. This is the tipping point where race against time for parents and patients stop.
