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October 1985, Vol 42, No. 10 >
Article | October 1985

Brain-stem Dysfunction in Autism: Title and subTitle BreakResults of Vestibular Stimulation

Edward M. Ornitz, MD; Constance W. Atwell, PhD; Andrea R. Kaplan; Joan R. Westlake, PhD
[+] Author Affiliations

Accepted for publication April 17, 1984.

Reprint requests to Department of Psychiatry, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024 (Dr Ornitz).


Arch Gen Psychiatry. 1985;42(10):1018-1025. doi:10.1001/archpsyc.1985.01790330102012
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Article
References
Comments

• Responses to vestibular stimulation can, under well-controlled experimental conditions, provide a measure of brainstem function. Autistic children had significantly longer time constants during the primary nystagmus response and significantly fewer beats during the secondary response than normal children when stimulated with constant angular acceleration in complete darkness. These findings could not be attributed to gross differences in arousal, to developmental retardation, to associated clinical conditions, or to either the influence of vision or habituation. Rather, they are suggestive of a neurophysiologic dysfunction, perhaps involving the brain stem, and may be an expression of the process that underlies those autistic behaviors that suggest faulty modulation of sensory input and motor output. Brain-stem centers moduate both general sensory input and motor excitation and may play a role in the elaboration of the more complex adaptive and motivated behaviors that are also disturbed in autism.

REFERENCES

1 +
Ornitz EM:  Childhood autism: A review of the clinical and experimental literature . Calif Med 1973;;118:21-47.
2 +
Ornitz EM, Ritvo ER:  The syndrome of autism: A critical review . Am J Psychiatry 1976;;133:609-621.
3 +
American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
4 +
Ornitz EM, Guthrie D, Farley AJ:  The early symptoms of childhood autism , in Serban G (ed): Cognitive Defects in the Development of Mental Illness . New York, Brunner-Mazel, 1978;, pp 24-42.
5 +
Ornitz EM, Guthrie D, Farley AJ:  The early development of autistic children . J Autism Dev Disord 1977;;7:207-229.
6 +
Kanner L:  Autistic disturbances of affective contact . Nerv Child 1943;;2:217-250.
7 +
Kanner L:  Problems of nosology and psychodynamics of early infantile autism . Am J Orthopsychiatry 1949;;19:416-426.
8 +
Rutter M:  The development of infantile autism . Psychol Med 1974;;4:147-163.
9 +
Hutt SJ, Hutt C, Lee D, Ounsted C:  A behavioural and electroencephalographic study of autistic children . J Psychiatr Res 1965;;3:181-197.
10 +
Hutt C, Forrest SJ, Richer J:  Cardiac arrhythmia and behaviour in autistic children . Acta Psychiatr Scand 1975;;51:361-372.
11 +
Ornitz EM, Ritvo ER:  Perceptual inconstancy in early infantile autism . Arch Gen Psychiatry 1968;;18:76-98.
12 +
Reichler RJ, Schopler E:  Observations on the nature of human relatedness . J Autism Dev Disord 1971;;1:283-296.
13 +
Ornitz EM:  The disorders of perception common to early infantile autism and schizophrenia . Compr Psychiatry 1969;;10:259-274.
14 +
Ornitz EM:  Vestibular dysfunction in schizophrenia and childhood autism . Compr Psychiatry 1970;;11:159-173.
15 +
Ornitz EM:  The modulation of sensory input and motor output in autistic children . J Autism Dev Disord 1974;;4:197-215.
16 +
Ornitz EM:  The functional neuroanatomy of infantile autism . Int J Neurosci 1983;;19:85-124.
17 +
Hermelin B, O'Connor N: Psychological Experiments With Autistic Children . New York, Pergamon Press, 1970;.
18 +
MacCulloch MJ, Williams C:  On the nature of infantile autism . Acta Psychiatr Scand 1971;;47:295-314.
19 +
Ornitz EM, Forsythe AB, de la Peña A:  Effect of vestibular and auditory stimulation on the REMs of REM sleep in autistic children . Arch Gen Psychiatry 1973;;29:786-791.
20 +
Colbert EG, Koegler RR, Markham CH:  Vestibular dysfunction in childhood schizophrenia . Arch Gen Psychiatry 1959;;1:600-617.
21 +
Ritvo ER, Ornitz EM, Eviatar A, Markham CH, Brown M, Mason A:  Decreased post-rotatory nystagmus in early infantile autism . Neurology 1969;;19:653-658.
22 +
Ornitz EM, Brown MB, Mason A, Putnam N:  Effect of visual input on vestibular nystagmus in autistic children . Arch Gen Psychiatry 1974;;31:369-375.
23 +
Ornitz EM:  Neurophysiologic studies , in Rutter M, Schopler E (eds): Autism: A Reappraisal of Concepts and Treatment . New York, Plenum Press, 1978;, pp 117-139.
24 +
Pollack M, Krieger HP:  Oculomotor and postural patterns in schizophrenic children . Arch Neurol Psychiatry 1958;;79:720-726.
25 +
Zlotnik G, Iversen PB, Tolstrup K, Zilstorff K:  Vestibular function of patients in a child psychiatric department . Dan Med Bull 1971;;18:152-156.
26 +
Piggott L, Purcell G, Cummings G, Caldwell D:  Vestibular dysfunction in emotionally disturbed children . Biol Psychiatry 1976;;11:719-729.
27 +
Baloh R, Honrubia V: Clinical Neurophysiology of the Vestibular System . Philadelphia, FA Davis Co, 1979;.
28 +
Robinson DA:  The use of control systems analysis in the neurophysiology of eye movements . Ann Rev Neurosci 1981;;4:463-503.
29 +
Honrubia V, Jenkins A, Baloh RW, Lav GYL:  Evaluation of rotatory vestibular tests in peripheral labyrinthine lesions , in Honrubia V, Brazier MAB (eds): Nystagmus and Vertigo: Clinical Approaches to the Patient With Dizziness . New York, Academic Press Inc, 1982;, pp 57-77.
30 +
Miles RA, Lisberger SG:  Plasticity in the vestibulo-ocular reflex: A new hypothesis . Ann Rev Neurosci 1981;;4:273-299.
31 +
Koenig E, Dichgans J:  Aftereffects of vestibular and optokinetic stimulation and their interaction . Ann NY Acad Sci 1981;;374:434-445.
32 +
Blair S, Gavin M:  Modifications of vestibulo-ocular reflex induced by diazepam . Arch Otolaryngol 1979;;105:698-701.
33 +
Blair SM, Gavin M:  Brainstem commissures and control of time constant of vestibular nystagmus . Acta Otolaryngol 1981;;91:1-8.
34 +
Henn V, Cohen B, Young LR:  Visual-vestibular interaction in motion perception and the generation of nystagmus . Neurosci Res Program Bull 1980;;18:459-651.
35 +
Crampton GH:  Certain single cell responses within the vestibular nuclei of cat have characteristics which may be related to secondary nystagmus , in Hood JD (ed): Vestibular Mechanisms in Health and Disease . New York, Academic Press Inc, 1978;, pp 59-65.
36 +
Sills AW, Honrubia V, Baloh RW:  Is the adaptation model a valid description of the vestibulo-ocular reflex? Biol Cybern 1978;;30:209-220.
37 +
Ornitz EM, Atwell CW, Walter DO, Hartmann EE, Kaplan AR:  The maturation of vestibular nystagmus in infancy and childhood . Acta Otolaryngol 1979;;88:244-256.
38 +
Ron S, Robinson DA, Skavenski AA:  Saccades and the quick phase of nystagmus . Vision Res 1972;;12:2015-2022.
39 +
Nakao S, Markham CH, Curthoys IS:  Modification of single neural elements in vestibular nystagmus by anesthesia . Acta Otolaryngol 1980;;89:121-134.
40 +
Barr CC, Schultheis LW, Robinson DA:  Voluntary, non-visual control of the human vestibulo-ocular reflex . Acta Otolaryngol 1976;;81:365-375.
41 +
Buettner UW, Henn V, Young LR:  Frequency response of the vestibulo-ocular reflex (VOR) in the monkey . Aviat Space Environ Med 1981;;52:73-77.
42 +
Jäger J, Henn V:  Vestibular habituation in man and monkey during sinusoidal rotation . Ann NY Acad Sci 1981;;374:330-339.
43 +
Gavin M, Blair S:  Modification of the macaque's vestibulo-ocular reflex by picrotoxin . Arch Otolaryngol 1981;;107:372-376.
44 +
Buettner UW, Büttner U, Henn V:  Transfer characteristics of neurons in vestibular nuclei of the alert monkey . J Neurophysiol 1978;;41:1614-1628.
45 +
Cohen B:  Origin of quick phases of nystagmus . Prog Brain Res 1972;;37:544-545.
46 +
Nakao S, Curthoys IS, Markham CH:  Direct inhibitory projection of pause neurons to nystagmus-related pontomedullary reticular burst neurons in the cat . Exp Brain Res 1980;;40:283-293.
47 +
James AL, Barry RJ:  Respiratory and vascular responses to simple visual stimuli in autistics, retardates, and normals . Psychophysiology 1980;;17:541-547.
48 +
Kootz JP, Cohen HF:  Modulation of sensory intake in autistic children . J Am Acad Child Psychiatry 1981;;20:692-701.
49 +
Skoff BF, Mirsky AF, Turner D:  Prolonged brainstem transmission time in autism . Psychiatr Res 1980;;2:157-166.
50 +
Rosenblum SM, Arick JR, Krug DA, Stubbs EG, Young NB, Pelson RO:  Auditory brainstem evoked responses in autistic children . J Autism Dev Disord 1980;;10:215-225.
51 +
Taylor MJ, Rosenblatt B, Linschoten L:  Auditory brainstem response abnormalities in autistic children . Can J Neurol Sci 1982;;9:429-433.
52 +
Ornitz EM, Walter DO:  The effect of sound pressure waveform on human brain stem auditory evoked responses . Brain Res 1975;;92:490-498.
53 +
Ornitz EM, Mo A, Olson ST, Walter DO:  Influence of click sound pressure direction on brain stem responses in children . Audiology 1980;;19:245-254.
54 +
Student M, Sohmer H:  Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits . J Autism Dev Disord 1978;;8:13-20.
55 +
Student M, Sohmer H:  Erratum: Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits  [J Autism Dev Disord 1978;;8:13-20].
56 +
J Autism Dev Disord 1979;;9:309.
57 +
Novick B, Vaughn HG Jr, Kurtzberg D, Simson R:  An electrophysiologic indication of auditory processing defects in autism . Psychiatr Res 1980;;3:107-114.
58 +
Tanguay PE, Edwards RM, Buchwald J, Schwafel J, Allen V:  Auditory brainstem evoked responses in autistic children . Arch Gen Psychiatry 1982;;39:174-188.
59 +
Fein D, Skoff B, Mirsky AF:  Clinical correlates of brainstem dysfunction in autistic children . J Autism Dev Disord 1981;;11:303-315.
60 +
Gillberg C, Rosenhall U, Johansson E:  Auditory brainstem responses in childhood psychosis . J Autism Dev Disord 1983;;13:181-195.
61 +
Berntson GG, Micco DJ:  Organization of brainstem behavioral systems . Brain Res Bull 1976;;1:471-483.
62 +
Scheibel ME, Scheibel AB:  The anatomy of constancy . Ann NY Acad Sci 1977;;290:421-435.
63 +
Simon N:  Echolalic speech in childhood autism . Arch Gen Psychiatry 1975;;32:1439-1446.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Ornitz EM:  Childhood autism: A review of the clinical and experimental literature . Calif Med 1973;;118:21-47.
2 +
Ornitz EM, Ritvo ER:  The syndrome of autism: A critical review . Am J Psychiatry 1976;;133:609-621.
3 +
American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
4 +
Ornitz EM, Guthrie D, Farley AJ:  The early symptoms of childhood autism , in Serban G (ed): Cognitive Defects in the Development of Mental Illness . New York, Brunner-Mazel, 1978;, pp 24-42.
5 +
Ornitz EM, Guthrie D, Farley AJ:  The early development of autistic children . J Autism Dev Disord 1977;;7:207-229.
6 +
Kanner L:  Autistic disturbances of affective contact . Nerv Child 1943;;2:217-250.
7 +
Kanner L:  Problems of nosology and psychodynamics of early infantile autism . Am J Orthopsychiatry 1949;;19:416-426.
8 +
Rutter M:  The development of infantile autism . Psychol Med 1974;;4:147-163.
9 +
Hutt SJ, Hutt C, Lee D, Ounsted C:  A behavioural and electroencephalographic study of autistic children . J Psychiatr Res 1965;;3:181-197.
10 +
Hutt C, Forrest SJ, Richer J:  Cardiac arrhythmia and behaviour in autistic children . Acta Psychiatr Scand 1975;;51:361-372.
11 +
Ornitz EM, Ritvo ER:  Perceptual inconstancy in early infantile autism . Arch Gen Psychiatry 1968;;18:76-98.
12 +
Reichler RJ, Schopler E:  Observations on the nature of human relatedness . J Autism Dev Disord 1971;;1:283-296.
13 +
Ornitz EM:  The disorders of perception common to early infantile autism and schizophrenia . Compr Psychiatry 1969;;10:259-274.
14 +
Ornitz EM:  Vestibular dysfunction in schizophrenia and childhood autism . Compr Psychiatry 1970;;11:159-173.
15 +
Ornitz EM:  The modulation of sensory input and motor output in autistic children . J Autism Dev Disord 1974;;4:197-215.
16 +
Ornitz EM:  The functional neuroanatomy of infantile autism . Int J Neurosci 1983;;19:85-124.
17 +
Hermelin B, O'Connor N: Psychological Experiments With Autistic Children . New York, Pergamon Press, 1970;.
18 +
MacCulloch MJ, Williams C:  On the nature of infantile autism . Acta Psychiatr Scand 1971;;47:295-314.
19 +
Ornitz EM, Forsythe AB, de la Peña A:  Effect of vestibular and auditory stimulation on the REMs of REM sleep in autistic children . Arch Gen Psychiatry 1973;;29:786-791.
20 +
Colbert EG, Koegler RR, Markham CH:  Vestibular dysfunction in childhood schizophrenia . Arch Gen Psychiatry 1959;;1:600-617.
21 +
Ritvo ER, Ornitz EM, Eviatar A, Markham CH, Brown M, Mason A:  Decreased post-rotatory nystagmus in early infantile autism . Neurology 1969;;19:653-658.
22 +
Ornitz EM, Brown MB, Mason A, Putnam N:  Effect of visual input on vestibular nystagmus in autistic children . Arch Gen Psychiatry 1974;;31:369-375.
23 +
Ornitz EM:  Neurophysiologic studies , in Rutter M, Schopler E (eds): Autism: A Reappraisal of Concepts and Treatment . New York, Plenum Press, 1978;, pp 117-139.
24 +
Pollack M, Krieger HP:  Oculomotor and postural patterns in schizophrenic children . Arch Neurol Psychiatry 1958;;79:720-726.
25 +
Zlotnik G, Iversen PB, Tolstrup K, Zilstorff K:  Vestibular function of patients in a child psychiatric department . Dan Med Bull 1971;;18:152-156.
26 +
Piggott L, Purcell G, Cummings G, Caldwell D:  Vestibular dysfunction in emotionally disturbed children . Biol Psychiatry 1976;;11:719-729.
27 +
Baloh R, Honrubia V: Clinical Neurophysiology of the Vestibular System . Philadelphia, FA Davis Co, 1979;.
28 +
Robinson DA:  The use of control systems analysis in the neurophysiology of eye movements . Ann Rev Neurosci 1981;;4:463-503.
29 +
Honrubia V, Jenkins A, Baloh RW, Lav GYL:  Evaluation of rotatory vestibular tests in peripheral labyrinthine lesions , in Honrubia V, Brazier MAB (eds): Nystagmus and Vertigo: Clinical Approaches to the Patient With Dizziness . New York, Academic Press Inc, 1982;, pp 57-77.
30 +
Miles RA, Lisberger SG:  Plasticity in the vestibulo-ocular reflex: A new hypothesis . Ann Rev Neurosci 1981;;4:273-299.
31 +
Koenig E, Dichgans J:  Aftereffects of vestibular and optokinetic stimulation and their interaction . Ann NY Acad Sci 1981;;374:434-445.
32 +
Blair S, Gavin M:  Modifications of vestibulo-ocular reflex induced by diazepam . Arch Otolaryngol 1979;;105:698-701.
33 +
Blair SM, Gavin M:  Brainstem commissures and control of time constant of vestibular nystagmus . Acta Otolaryngol 1981;;91:1-8.
34 +
Henn V, Cohen B, Young LR:  Visual-vestibular interaction in motion perception and the generation of nystagmus . Neurosci Res Program Bull 1980;;18:459-651.
35 +
Crampton GH:  Certain single cell responses within the vestibular nuclei of cat have characteristics which may be related to secondary nystagmus , in Hood JD (ed): Vestibular Mechanisms in Health and Disease . New York, Academic Press Inc, 1978;, pp 59-65.
36 +
Sills AW, Honrubia V, Baloh RW:  Is the adaptation model a valid description of the vestibulo-ocular reflex? Biol Cybern 1978;;30:209-220.
37 +
Ornitz EM, Atwell CW, Walter DO, Hartmann EE, Kaplan AR:  The maturation of vestibular nystagmus in infancy and childhood . Acta Otolaryngol 1979;;88:244-256.
38 +
Ron S, Robinson DA, Skavenski AA:  Saccades and the quick phase of nystagmus . Vision Res 1972;;12:2015-2022.
39 +
Nakao S, Markham CH, Curthoys IS:  Modification of single neural elements in vestibular nystagmus by anesthesia . Acta Otolaryngol 1980;;89:121-134.
40 +
Barr CC, Schultheis LW, Robinson DA:  Voluntary, non-visual control of the human vestibulo-ocular reflex . Acta Otolaryngol 1976;;81:365-375.
41 +
Buettner UW, Henn V, Young LR:  Frequency response of the vestibulo-ocular reflex (VOR) in the monkey . Aviat Space Environ Med 1981;;52:73-77.
42 +
Jäger J, Henn V:  Vestibular habituation in man and monkey during sinusoidal rotation . Ann NY Acad Sci 1981;;374:330-339.
43 +
Gavin M, Blair S:  Modification of the macaque's vestibulo-ocular reflex by picrotoxin . Arch Otolaryngol 1981;;107:372-376.
44 +
Buettner UW, Büttner U, Henn V:  Transfer characteristics of neurons in vestibular nuclei of the alert monkey . J Neurophysiol 1978;;41:1614-1628.
45 +
Cohen B:  Origin of quick phases of nystagmus . Prog Brain Res 1972;;37:544-545.
46 +
Nakao S, Curthoys IS, Markham CH:  Direct inhibitory projection of pause neurons to nystagmus-related pontomedullary reticular burst neurons in the cat . Exp Brain Res 1980;;40:283-293.
47 +
James AL, Barry RJ:  Respiratory and vascular responses to simple visual stimuli in autistics, retardates, and normals . Psychophysiology 1980;;17:541-547.
48 +
Kootz JP, Cohen HF:  Modulation of sensory intake in autistic children . J Am Acad Child Psychiatry 1981;;20:692-701.
49 +
Skoff BF, Mirsky AF, Turner D:  Prolonged brainstem transmission time in autism . Psychiatr Res 1980;;2:157-166.
50 +
Rosenblum SM, Arick JR, Krug DA, Stubbs EG, Young NB, Pelson RO:  Auditory brainstem evoked responses in autistic children . J Autism Dev Disord 1980;;10:215-225.
51 +
Taylor MJ, Rosenblatt B, Linschoten L:  Auditory brainstem response abnormalities in autistic children . Can J Neurol Sci 1982;;9:429-433.
52 +
Ornitz EM, Walter DO:  The effect of sound pressure waveform on human brain stem auditory evoked responses . Brain Res 1975;;92:490-498.
53 +
Ornitz EM, Mo A, Olson ST, Walter DO:  Influence of click sound pressure direction on brain stem responses in children . Audiology 1980;;19:245-254.
54 +
Student M, Sohmer H:  Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits . J Autism Dev Disord 1978;;8:13-20.
55 +
Student M, Sohmer H:  Erratum: Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits  [J Autism Dev Disord 1978;;8:13-20].
56 +
J Autism Dev Disord 1979;;9:309.
57 +
Novick B, Vaughn HG Jr, Kurtzberg D, Simson R:  An electrophysiologic indication of auditory processing defects in autism . Psychiatr Res 1980;;3:107-114.
58 +
Tanguay PE, Edwards RM, Buchwald J, Schwafel J, Allen V:  Auditory brainstem evoked responses in autistic children . Arch Gen Psychiatry 1982;;39:174-188.
59 +
Fein D, Skoff B, Mirsky AF:  Clinical correlates of brainstem dysfunction in autistic children . J Autism Dev Disord 1981;;11:303-315.
60 +
Gillberg C, Rosenhall U, Johansson E:  Auditory brainstem responses in childhood psychosis . J Autism Dev Disord 1983;;13:181-195.
61 +
Berntson GG, Micco DJ:  Organization of brainstem behavioral systems . Brain Res Bull 1976;;1:471-483.
62 +
Scheibel ME, Scheibel AB:  The anatomy of constancy . Ann NY Acad Sci 1977;;290:421-435.
63 +
Simon N:  Echolalic speech in childhood autism . Arch Gen Psychiatry 1975;;32:1439-1446.

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