The Inflamed Brain

 

Obsessive-compulsive disorder is defined by the Mayo Clinic website as a common condition affecting more than 200,000 people in the U.S. per year. Those with OCD, as it is more commonly known, tend to focus on thoughts and fears that become obsessions and then attempt to deal with these upsetting thoughts by engaging in compulsive behaviors.  Statistics indicate that OCD affects approximately two percent of the general population. However, various studies show that the rate of OCD ranges from eight to thirty-three percent of those with autism––much higher than the general population.

When Alex was eleven, he was diagnosed with OCD and began taking the SSRI medication Prozac to alleviate the symptoms. In his late teens, Prozac suddenly stopped addressing his OCD symptoms, leading to extreme anxiety, and he was placed on another SSRI, Zoloft, which he currently takes daily. His primary obsession is time, and he needs to know what time it is at all times and requires a watch and schedule and calendar to keep track of time. Although medication and behavioral therapy have helped ease some of the symptoms of OCD, such as frantically searching for a clock every few minutes, he still can become unnerved if his schedule changes or if he can’t find his wristwatch.

Because of the link between autism and OCD, I found a recent article on OCD especially interesting: “Brain Inflammation Discovered in Those With OCD” published online in Neuroscience News.com on June 21, 2017. [To read this article, please click here.] This article focuses upon research published on the same date in the journal JAMA Psychiatry. The senior author of the study, Dr. Jeffrey Meyer, is the Head of the Neuroimaging Program in Mood and Anxiety at the Centre for Addiction and Mental Health (CAMH) Campbell Family Mental Health Research Institute in Canada.

This study used PET scans of the areas of the brain known to function differently in OCD, and dye was used to measure the activity of immune cells (microglia) found in inflammation. This research discovered for the first time that brain inflammation is much higher in people with OCD than in those who do not have OCD. Specifically, those with OCD had greater than 30% higher brain inflammation. Noting the significance of this novel research, Dr. Meyer stated: “This finding represents one of the biggest breakthroughs in understanding the biology of OCD and may lead to the development of new treatments.”

While inflammation and swelling help the body to heal from infection and injury, this immune system response can also be harmful. In addition to discovering the link between brain inflammation and OCD, Dr. Meyer also found in an earlier study that brain inflammation is elevated in people with depression. Moreover, some researchers have suggested that autism is linked to inflammation of the brain and nervous system. Consequently, the link between mental health disorders and brain inflammation indicates the need for new methods and medications to treat these conditions.

Currently, the most commonly used medications for OCD include SSRI medications to ease depressed mood and anxiety, anxiolytic medications to relieve anxiety and tension, and antidepressant medications to prevent and relieve depression and elevate mood. However, these current medications do not help one third of those dealing with OCD. This study indicates that additional research needs to be done to develop low-cost tests, perhaps in blood markers, to identify those OCD patients with brain inflammation who would respond to treatment addressing the inflammation. Additionally, the study suggests that medications used in other disorders for brain inflammation might be helpful in treating OCD.

Another important discovery in this research is the connection between brain inflammation and stress response. Approximately ninety percent of those with OCD engage in compulsive behaviors in attempts to lessen their obsessions. Those who tried to avoid engaging in compulsions experienced great anxiety and were found to have the highest levels of inflammation in one brain area. Consequently, stress appears to play a role in brain inflammation. As Dr. Meyer notes, “Work needs to be done to uncover the specific factors that contribute to brain inflammation.”

Although more research needs to uncover sources and potential treatments for brain inflammation, this groundbreaking work by Dr. Meyer and his associates gives real hope for those struggling with OCD, depression, and other conditions impacted by neuroinflammation, such as autism. Not only might they find better ways to treat the inflammation in the brain that impacts thoughts and behaviors, but they also may be getting close to finding the causes of the inflammation, which may eventually lead to a cure. As I follow research like this and continue to pray for a cure for autism, I wait with anticipation for the day that Alex will be completely healed.

“Lord, my God, I called to You for help, and You healed me.” Psalm 30:2

Brain Anatomy and Autism

Last week, I had the opportunity to watch a fascinating free webinar about brain anatomy. Sponsored the Great Plains Laboratory, Dr. Kurt Woeller offers monthly online lectures about topics typically related to autism. Although I majored in English in college, I’ve always had an interest in medicine and psychology, two of the areas I’ve researched intensively since Alex was diagnosed with autism. This month’s online seminar, entitled “Brain Regions and Their Dysfunction in Autism—Clinical Correlations for Behavior, Language, and Cognitive Problems,” provided a clear description of the anatomy of the brain along with an explanation of how autism symptoms can manifest if inflammation exists in certain regions. Dr. Woeller asserts that brain inflammation is a major contributing and causative factor in autism. Moreover, he cites various sources of neurological inflammation in autism: glutens and caseins from foods, heavy metal toxicity, and infections from bacteria, viruses, and/or fungi, such as yeast. Since we have treated Alex for heavy metal toxicity and yeast overgrowth as well as kept him on a gluten-free and casein-free diet upon discovering he has sensitivities to both, I strongly suspect that many of his issues are directly related to inflammation of his nervous system.

Dr. Woeller’s webinar focused upon regions of the brain and explained how inflammation in these regions can affect behavior and function. A summary of the function of each area and how dysfunction manifests follows.

The frontal lobe of the brain deals with understanding the connection between actions and consequences and making decisions. Those who have inflammation of this lobe tend to have no sense of danger, engaging in risky behavior, such as climbing and fleeing. Problems with this lobe can also lead to a loss of smell and taste. Fortunately, Alex does not exhibit problems with the frontal lobe as he tends to be quite cautious and possesses a keen sense of smell and taste.

The parietal lobe is involved with sensory information and the ability to read and solve math problems. Since Alex is quite strong in his sensory processing, reading, and math skills, I suspect that his parietal lobe has not been affected.

The temporal lobe is responsible for many areas related to language processing, including grammar and word production, semantics of speech, and functions of language, all of which are problematic for Alex. In addition, facial recognition occurs in the temporal lobe, and Alex has some trouble recognizing people’s faces, often confusing his cousins who are siblings. While I think Alex understands what is being said to him fairly easily, he has always had difficulty producing speech. Consequently, his temporal lobe has likely been impacted by neurological inflammation.

The occipital lobe, which receives information from the eyes, processes visual input. Those with problems in this area often cannot identify colors even though they can see them. Alex’s strengths lie in his visual processing because he is quite visually perceptive, noticing small details most people would miss. Hence, he probably doesn’t have issues with his occipital lobe.

The cerebellum, a common site of abnormality in autism, according to Dr. Woeller, coordinates smooth body movement. Symptoms of problems in the cerebellum include hypotonia, or low muscle tone, balance issues, awkward gait, difficulty with speech articulation, and trouble with planned movements. Alex has had problems with all of these areas, which we have addressed with speech therapy and occupational therapy. However, he still struggles with motor issues, which makes self-care tasks difficult for him. Therefore, Alex likely has inflammation of his cerebellum, evidenced by his difficulties with fine and gross motor skills.

For me, gaining understanding about what each lobe of the brain controls and how inflammation can disrupt specific critical processes helped me realize why certain tasks are so difficult for Alex. As we continue to seek ways to help his nervous system heal, we pray that eventually all those tasks that frustrate him will eventually come easily so that he can reach his full potential.

“O Lord, listen to my cry; give me the discerning mind You promised.” Psalm 119:169