What’s the Goal of it All?
Cognitive Dysfunction Reversed in Mouse Model of Down Syndrome was the headline for a new study by researchers from the Stanford University School of Medicine and Lucile Packard Children's Hospital, as reported in yesterday's Science Daily. The actual Science Translational Medicine study is about how giving norepinephrine, a neurotransmitter the helps cells communicate, to mice with brains "genetically engineered to mimic Down syndrome" improves some of their cognitive functioning. Specifically (and noting I do not know much about Down syndrome):
…..people with Down syndrome struggle to use spatial and contextual information to form new memories, a function that depends on the hippocampus part of the brain. As a result, they have trouble with learning to navigate complex environments such as a new neighborhood or a shopping mall. But they're much better at remembering information linked to colors, sounds or other sensory cues because such sensory memories are coordinated by a different brain structure, the amygdala.
Salehi and his colleagues looked at what could be causing the problems in the hippocampus. Normally, as contextual or relational memories are formed, hippocampal neurons receive norepinephrine from neurons in another part of the brain, the locus coeruleus. The researchers showed that, like humans with Down syndrome, the mice in their experiments experienced early degeneration of the locus coeruleus.
When the locus coeruleus broke down in the study's mice, the animals failed at simple cognitive tests that required them to be aware of changes in the milieu: For instance, the genetically engineered mice, when placed in the strange environment of an unknown cage, did not build nests. That contrasts with normal mice, which typically build nests in such circumstances.
However, by giving norepinephrine precursors to the mice with the Down-syndrome-like condition, the researchers could fix the problem. Only a few hours after they got the drugs, which were converted to norepinephrine in the brain, these mice were just as good at nest-building and related cognitive tests as normal mice. Direct examination of neurons in the hippocampus of the genetically altered mice showed that these cells responded well to norepinephrine.
Norepinephrine improved—helped—the cognitive ability of the mice, an improvement that was also noted at the cellular level. The "reversing deficits" headline is not exactly misleading, but a bit of a hasty over-generalization familiar to anyone who follows reporting about "the latest" in research, science, and anything biomedical about autism.
Having rather often weighed in on the problems of referring to autism as "reversible," I'm not inclined to turn this post, let alone this blog, into a space for discussions of the cans and can't-do-its of various "interventions" and "treatments" and understandings of autism. We certainly tried a number of such biomedical "treatments" for Charlie when he was much younger. Charlie gluten-free and casein-free (and supplement-filled) for some years and the mark of his being the former can be seen in his disinclination to eat many of the foods in the BAC cafeteria: Cereal and milk. French toast sticks. Mashed potatoes (with the off-limits butter!).
When I picked Charlie up, his teacher noted to me that he asked for corn and liked that, and that he's been asking for an apple, and wanting it to be sliced (as I do with his apples at home, only it's been a while since Charlie wanted to eat an apple at home). Thursday, "day 4," was–she noted—an "awesome" day. Around 11.30am, the classroom staff didn't place any new demands on Charlie. He's been requesting breaks and walks frequently after working at his desk; his teacher noted that she thinks this is a sign of his "awareness" that he can request such breaks when the room gets too loud or Charlie himself is frustrated.
I felt an internal "wow" on reading that in his notebook. Charlie was 7 when a speech therapist and his teacher first tried to teach him to ask for a "break" to leave the room when, well, it got too noisy and he got frustrated. He might ask for such a "break" once or twice successfully, but never consistently. We'd note that he would often ask when he was already so agitated that, even when outside the room, he was already very, very upset. Over time, the very word "break" started to acquire negative connotations for Charlie.
And it seems that, five years later, Charlie's learned to ask for that "break." And because the BAC is, well, big, there's always space for him to walk around in. There is a gym with a basketball court and, on the top level, a track. You can get a pretty good, short walk just by walking around the BAC grounds too, as Charlie and I did before school started; we've been leaving early and arriving up to 30 minutes before school starts—Charlie's been eager to get out and go, though he still had an initial frisson of hesitance getting out of the car.
As I was signing him out in the main office yesterday afternoon, I overheard a man asking about the BAC and if it was public. He noted that he had visited a certain private autism school (I had too). He asked a few more questions in an intense tone of voice, and with a similarly intense set to his jaw and shoulders.
Yeah, I think I know what he was feeling, that the best school for his child has to be found and his child has to have a place now and immediately, to give her or him the best chance possible for…..recovery?
The good life?
A place to feel a bit more……at home—or just a place to get a new start?