Surgery of autism: Is it possible?

Area of Science:

• Neurosurgery
• Neurology
• Developmental Neuroscience

Background:

• Autism spectrum disorder (ASD) is a developmental disability characterized by severe behavioral alterations, including aggression and obsessive-compulsive behaviors.
• Many ASD patients exhibit resistance to conventional pharmacological and behavioral therapies, posing significant social challenges.
• Therapy-resistant symptoms in ASD necessitate the exploration of novel treatment modalities.

Purpose of the Study:

• To evaluate the efficacy and safety of radiofrequency brain lesions combined with Gamma Knife radiosurgery for treating therapy-resistant aggression, obsessive thoughts, and compulsions in ASD patients.
• To assess the impact of the intervention on behavioral symptoms and quality of life.

Main Methods:

• Patients with ASD and therapy-resistant symptoms underwent radiofrequency brain lesions combined with Gamma Knife radiosurgery.
• Symptomatic improvement was assessed using adapted YBOCS, PCQ, and EAE scales.
• Patient safety and neurological status were monitored throughout the treatment period.

Main Results:

• All patients demonstrated a significant reduction in symptoms, with notable decreases in YBOCS, PCQ, and EAE scores.
• Multiple treatment sessions were required for sustained improvement in some patients.
• The procedures were found to be very safe, with no adverse changes in neurological status.

Conclusions:

• Radiofrequency brain lesions and Gamma Knife radiosurgery lead to marked improvements in behavior, quality of life, and environmental interactions for ASD patients.
• The treatment is safe, with no evidence of secondary damage.
• Potential changes in brain connectivity may underlie the observed clinical improvements, warranting further investigation.