Aberration central nervous system and Disorders Autistik

Autistik interference is not only due to psychological factors, but also biologically. Research on brain structure in the brain surgery autis have died and the brain with pencitraan Magnetic resonance imaging imaging (MRI), single photon Emission Computed Tomography (SPECT), or Positron Emission Tomography (PET) shows almost all the difference in brain structure. Among others in the cerebellum (serebelum), cortex of the brain (korteks serebri), the system limbik (emotions regulator), connecting the left and right brain (corpuscle kalosum), ganglia basalis, and the brain stem.

Central nervous system disturbances that can trigger the symptoms autis discussed in the National Conference Autisme I themed "Towards a Better Life for Autistic individuals" who held 2-4 July 2003.

Autisme in boyhood marked by disturbances in social interaction, the ability to communicate, and fearless activity. Behavior that often accompany autisme among other hiperaktivitas, agresivitas, stereotipik word and movement, self-harm, secession, and sleep disturbances (insomnia).

According to dr Chatijah Satrio Wibowo SpKJ from the disease Life Sciences Faculty of Medicine, Columbia University, Bandung, the brain autis have intelligence that shows the world and manage their physical health. However, they have a problem with the weight of the ability to care, learn and examine the action, set themselves, and the perceptions and reactions to what happened or what other people felt. It is caused by abnormalities in certain parts of the brain that is responsible for the emotional, control, coordination and movement.

Another speaker, and Hardiono D Pusponegoro SpA (K) from the Children's Health Sciences Faculty of Medicine, University of Indonesia (FKUI), describes the growth of brain regard, interference with the emergence of symptoms autis.

According to Hardiono, on autis there are patterns of brain growth that is different from normal children. In the period before birth until the age of two to three years, the accelerated growth of brain function with the rocker in the rocker. However, the rapid growth of the brain that can not be maintained. Start the age of six years up to teenagers, the slowing growth of the brain so that the volume of the brain in adolescents and adults is smaller than normal brain.

This is evidenced from research that involves 67 cases autis and 83 control (normal individuals) aged eight to 46 years old through MRI examination. However, autis children under the age of 12 years shows a greater volume of the brain. However, the difference lost on the age of 12 years.

Other studies have brain volume in 45 cases autisme greater compared with 26 normal children and 14 children with delayed development but not autis.

In addition, research autisme in 60 cases and 52 controls aged 2-26 years showed results more precise. When born, all cases of controller indicates autisme and head circumference that is not different. At the age of 2-4 years, 90 percent of cases autisme show greater volume of the brain, even 37 percent of them have a head circumference that can be classified as makrosefali.

Enlarging the volume of the brain are not evenly distributed, but only in certain parts of the excess white substance on the brain and cerebellum and the gray substance of the brain, but less gray substance in the brain and a small part of the brain called lobulus small vermis VI-VII.

The growth of brain nerve

Tuesday nerve brain (neurons) consists of body cells and fibers impulse to drain electricity (akson) and fiber to receive the electrical impulse (dendrit). Tuesday there were nerves in the brain cortex of gray (korteks). Akson wrapped film called mielin, located in the brain white. Tuesday nerves related to one another through sinaps.

Tuesday nerve at the age of the content of three to seven months. In the third trimester, the formation of nerve cells stop and start the formation of akson, dendrit, and sinaps which continues until the child aged around two years.

After the child was born, the process occurred setting the form of increased growth of brain structure and less akson, dendrit, and sinaps. This process is influenced by genetic through a number of chemical substances known as Factor Brain growth and learning of children.

"The more sinaps formed, the more intelligent children. Forming akson, dendrit, and sinaps very dependent on stimulation from the environment. The brain used in the study showed growing akson, dendrit, and sinaps. While the brain is not used indicates the death of cells, decreasing akson, dendrit, and sinaps, "said Hardiono.

From the blood-baby newborn, known morbid growth on autis triggered by berlebihnya neurotropin and neuropeptida brain (Brain-derived neurotrophic factor, neurotrophin-4, vasoactive intestinal peptide, calcitonin-related peptide life.txt), a brain chemical substances that responsible for managing the addition of nerve cells, migration, differentiation, growth, development bonds, and nerve cells. Factors Brain growth is important for brain growth.

"Increasing neurokimia brain caused by morbid morbid growth in certain regions. Autistik In the interference conditions of growth occurred without Guidance, in which parts of the brain grow and die not in uniform," said Hardiono.

Growth morbid part the growth of certain brain nerve cells other. Almost all the researchers reported slackening Purkinye cells (nerve cells where the results of exit and processing sensory nerve impulse) in the cerebellum in the autisme. Declining Purkinye alleged to stimulate cell growth akson, glia (support network in the central nervous system), and so mielin brain growth occurs in a morbid or otherwise, the growth akson a morbid turn off cell Purkinye. What is clear, the increase Brain derived neurotrophic factor and neurotrophin-4 cells causes the death Purkinye.

Purkinye interference in the cell can occur in primary or secondary. When autisme caused by genetic factors, disruption of cells Purkinye interference is a primary that occurred since the beginning of the pregnancy.

Secondary degeneration occurs when cells Purkinye have been developed, then interference occurs that causes damage to cells Purkinye. Damage occurred in the pregnancy if the mother drinking excessive alcohol or drugs such as thalidomide.

Research with the MRI shows, a small children's normal brain activation experienced during the movement motor, motor-learning Sensorineural, atensi, given the process, and language activities. Disturbances in the brain causes a small reaction atensi more slow, difficult process of perception or to distinguish the target, overselektivitas, and the failure of exploring the environment.

Brain enlargement in rocker occur also in the front part of the brain known as lobus frontalis. Bauman and Kemper found the decreasing size of neurons in cell hipokampus (the front of the brain that play a role in the process and noble function of memory) and amigdala (the front side of the brain that play a role in the process of memory).

Research on monkeys with hipokampus damage and lead to baby monkeys amigdala aged two months shows passive-aggressive behavior. They did not start the social contact, but do not reject it. However, at the age of six months behavior changed. They reject the approach other social monkeys, withdraw, start showing movement stereotipik and hiperaktivitas similar to the autisme. In addition, they showed cognitive interference.

According to Hardiono, the environmental factors that determine the development of the brain, among others, the adequacy of oxygen, protein, energy, and micro-nutrient substances such as iron, zinc, iodine, hormone tiroid, essential fatty acid, and acid folat.

The things that damage or disrupt brain development, among others, alcohol, lead poisoning in black, and metilmerkuri aluminum, which suffer maternal infections during pregnancy, radiation, and it cloth.

Therapy

Chatijah states, the brain chemical that measure rocker on the autis is the serotonin 5-hydroxytryptamine (5-HT), which manages the neurotransmiter or signals in nerve cells. Around 30-50 percent of the autis have a high rate of serotonin in the blood.

Norepinefrin rate, dopamin, and serotonin 5-HT in normal children in stable condition and each other. However, this is not the case in the autis.

Psikofarmakologi therapy does not change history or circumstances autistik trip interruption, but effective to reduce the behavior autistik as hiperaktivitas, secession, stereotipik, hurt themselves, agresivitas and sleep disturbances.

A number of states observation, manipulation of the system dopamin and serotonin can be beneficial for patients autis. Antipsikotik new generation, namely antipsikotik atipikal, is strong on the internet reseptor serotonin 5-HT and dopamin type 2 (D2).

Chatijah out, risperidone worked as internet reseptor dopamin D2 and serotonin 5-HT to reduce agresivitas, hiperaktivitas, behavior and self-harm.

Meanwhile, olanzapine, which is used for schizophrenia, recently spread to the use autisme. Because able to hamper the widely varied reseptor, olanzapine can reduce hiperaktivitas, socializing interference, interference reaction afektual (natural feelings), Sensorineural interference response, the use of language interference, the behavior of self-harm, aggression, iritabilitas emotional or dander, and the state of panic and depression.

To improve social skills and daily activities, the autis need diterapi in nonmedikamentosa that involve various science disciplines. By JEFF Widyawati SpKJ off from the Life Sciences FKUI disease, among other educational therapy to improve social interaction and communication, behavior therapy to control the behavior that disrupt / dangerous, wicara therapy, occupation therapy / physical, Sensorineural-integration of information through the organization all the senses , Auditory integration training (AIT) to reduce the hipersensitivitas voice, family intervention, and so forth.

To improve digestion channel interference that can aggravate the condition and symptoms autis, conducted Biomedical therapy. Therapy that includes the settings to avoid dietary substances-substances that cause allergic (casein and gluten), provision of vitamin and mineral supplements, and treatment against fungi and bacteria that bercokol in the intestinal wall.

With the various therapies, the autis can be expected to live as other children grow and become independent adults and achievement.