The Intense World Syndrome – an alternative hypothesis for autism

Autism is a devastating neurodevelopmental disorder with a polygenetic predisposition that seems to be triggered by multiple environmental factors during embryonic and/or early postnatal life. While significant advances have been made in identifying the neuronal structures and cells affected, a unifying theory that could explain the manifold autistic symptoms has still not emerged. Based on recent synaptic, cellular, molecular, microcircuit, and behavioral results obtained with the valproic acid (VPA) rat model of autism, we propose here a unifying hypothesis where the core pathology of the autistic brain is hyper-reactivity and hyper-plasticity of local neuronal circuits.

Such excessive neuronal processing in circumscribed circuits is suggested to lead to hyper-perception, hyper-attention, and hyper-memory, which may lie at the heart of most autistic symptoms. In this view, the autistic spectrum are disorders of hyper-functionality, which turns debilitating, as opposed to disorders of hypo-functionality, as is often assumed. We discuss how excessive neuronal processing may render the world painfully intense when the neocortex is affected and even aversive when the amygdala is affected, leading to social and environmental withdrawal. Excessive neuronal learning is also hypothesized to rapidly lock down the individual into a small repertoire of secure behavioral routines that are obsessively repeated.

We further discuss the key autistic neuropathologies and several of the main theories of autism and re-interpret them in the light of the hypothesized Intense World Syndrome.


Conclusion

While many of the neuropathologies and symptoms observed in autism seem to resemble pieces of information in a scrambled puzzle, we proposed here a unifying hypothesis, which makes the first attempt to assemble the pieces into a coherent picture centered on excessive local circuit functionality. It has already been proposed that the autistic brain may be hyper-excitable due to excessive excitation or reduced inhibition (Hussman, 2001 ; Rubenstein and Merzenich, 2003 ), but our findings suggest that a more fundamental pathology is hype-reactivity which may be caused in a number of different ways.

We reviewed here experimental findings obtained on the VPA rat model of autism that provide the first direct evidence for a unifying hypothesis. We propose that the core pathology of the autistic brain may be hyper-reactivity and hyper-plasticity of local neuronal circuits. On a perceptual and cognitive level, this excessive functioning of neuronal circuits may lead to an intensely perceived world, which may turn aversive if the amygdaloid complex is also affected. Many of the observed neuropathologies can be viewed as a consequence of hyper-reactive and hyper-plastic neural circuits, while many of the autistic symptoms may be re-interpreted in the light of an aversively intense world.

The Intense World Syndrome suggests that the autistic person is an individual with remarkable and far above average capabilities due to greatly enhanced perception, attention and memory. In fact it is this hyper-functionality, which could render the individual debilitated. This perspective of hyper-functionality offers new hope for pharmacological as well as behavioral treatments. For example, while most the commonly prescribed medication try to increase neuronal and cognitive functioning, we conclude that the autistic brain needs to be calmed down, learning needs to be slowed, and cognitive functions need to be diminished in order to re-instate proper functionality.

In terms of behavioral treatments, the hyper-plasticity offers an immense scope for rehabilitation therapies that are based on excessive positive reward and comforting approaches and that avoid direct punishment, which may lead to a lockdown of behavioral routines. It may well turn out that successful treatments could expose truly capable and highly gifted individuals.

Link zur Hypothese

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https://www.spektrum.de/news/autismus-ma...-theory/1689476