Friday, 6 January 2012

Where is autism research heading in 2012?

To quote everyone's favourite breakdown truck Mater, 'Ain't no need to watch where I'm goin'; just need to know where I've been'. In answer to the title of this post, I don't exactly know where autism research is heading in 2012 but if the previous trends are anything to go by, I might be able to provide you with a few possible clues.

Vasilopita (New Years Day bread) @ Paul Whiteley
The biggest clue comes from this review paper* published in December 2011 by Dan Rossignol and Richard Frye (open-access). Viewers of my recent post on 'I am a HBOT' will have seen the name Rossignol there. The more science-y types out there who enjoy reading the odd edition of Molecular Psychiatry will also remember Dr Rossignol for his quite comprehensive review of possible mitochondrial involvement in some cases of autism (open-access here).

The author's review of autism research is again open-access so no need for me to go into too much detail (what a cop-out!). Comprehensive... well, yes; as with many reviews and meta-analyses, which can often involve more work than writing 'go out there and collect data' experimental papers up. A few points worth mentioning:

  • The rise of research into immune issues and autism spectrum conditions, inflammation, mitochondrial dysfunction and environmental exposures was a key point noted in this search of the PubMed literature on autism between 1971 and 2010.
  • Moving from a period before 1986 where such factors were only discussed in a handful of papers, the 1990s were a growth time for such biological research and the past 5 years have truly witnessed an explosion in these research areas. Importantly the strength of the evidence, based on how studies were done, is encouragingly quite resilient.
  • Genetic research still holds the Lion's share in terms of numbers of papers produced, probably as a result of the pretty large sums of money being pumped into things like genome-wide analysis studies and also accounting for the very complicated genetics paper and database discussed in a recent post.
  • Pity the poor Theory of Mind (ToM). From autism research superstar in the 1980s to that unloved embarrassing 1985 Christmas jumper kept at the back of the wardrobe. Even one of ToM's main proponents has decided to head the 'metabolomics' way**. I don't want to be mean to ToM but lets face it, the writing has been on the wall for some time for ToM being the be-all-and-end-all of autism research. I'm thinking last years Nature series on autism...

I have to say that with my research hat on, I am pretty buoyed by the results of this current research review paper. By saying this I am not trying to belittle the reality of what autism means to many, many people on a day-to-day basis or anything like that. Nor do I want to be seen as just another researcher sat in their ivory tower shouting about things which ultimately still do very little to help improve quality of life for many people on the spectrum. It is heartening however to see that research does seem to be going in one of the directions which quite a few parents of, and people with autism have thought and been saying for a long time. Importantly also realising that the behavioural presentation of autism may be but one facet of a complex and heterogeneous condition.

I did say that I would give you clues (plural) as to where I thought autism research was heading in 2012 and beyond. A final clue harks back to another recent post on the study of biological phenotypes in autism; that is, looking at slightly more homogeneous sub-groups outside of just a group of children/adults 'with autism'. If it is somehow possible that autism research can look at the strong evidence findings isolated in the Rossignol and other reviews, source a decent enough sized participant group and apply some of the phenotypic overlay, thinking of the Nordahl study....

I end with an ode to ToM by a person whose life has probably changed beyond all recognition after singing a song... I dreamed a dream in time gone by...

* Rossignol DA. & Frye RE. A review of research trends in physiological abnormalities in autism spectrum disorders: immune dysregulation, inflammation, oxidative stress, mitochondrial dysfunction and environmental toxicant exposures. Molecular Psychiatry. December 2011.

** Schwarz E. et al. Sex-specific serum biomarker patterns in adults with Asperger's syndrome. Molecular Psychiatry. December 2011.