June 19th, 2007 at 9:56 am
Friday’s testimony was given by Dr. Marcel Kinsbourne, Professor of Psychology in the New School University of New York. Dr. Kinsbourne has spent years studying child neurology.
He discovered a syndrome, Kinsbourne Syndrome, where infants between nine months and two years unexpectedly and abruptly have a constant twitching of muscles in the body while maintaining their mental abilities. The syndrome turned out to be immune mediated.
Kinsbourne described autism as children with abnormalities in three domains: speech, social difficulties, and repetitive characteristic movements. The movements come when the child is overexcited, and they are tactics to calm down. Kinsbourne has been published on this feature. Children with autism like to play with practical things, and they like closed sets of items or complete bodies of knowledge they can master.
Most people working in the autism field recognize that there are many causes. Often there are disorders that have a “functional convergence” where the symptoms are the same though the causes differ: cerebral palsy, epilepsy, for starters. The number of people with autism that also have other clear medical abnormalities are only 10-20% of all children diagnosed with autism.
Where there does not seem to be a single genetic abnormality in autistic children, it is generally believed that multiple genes are involved and it is inherited. Genetics confers a susceptibility but does not confer autism on its own. Some children may avoid a triggering encounter. Some identical twins exist where one is autistic and one isn’t. In others, one is more severe than the other.
About 20 percent of autistic children start out seemingly normal and then regress into autism within two years. Unfortunately there are no studies which study a child with regressive autism during the regression.
Epidemiology is the study of possible things that can cause a condition. Once a possible cause comes up, then normal studies can be conducted as to whether there is a cause. There is nothing in the literature that evaluated whether thimerosal and MMR could cause or is associated with autism.
Kinsbourne notes that from the video evidence Michelle did not demonstrate any autistic behavior before the MMR, and afterwards she displayed classic symptoms: nonresponsiveness to her name being called, aversion of new people, repetitive behavior, lack of affection, etc.
There are physiological studies on how the brain looks in a case of autism. In many cases the cells in the hippocampus, the cerebellum, and the medulla are disorganized. The white matter in the brain seems to be enlarged in may patients, but the cause is unknown. Recent autopsies of people with autism have shown areas of inflammation. The inflammation is consistent that cells may be responding to a foreign agent.
The nervous system can be underexcited, such as in a seizure, or overexcited. There are papers which suggest many symptoms of autism can be explained by overactivation. Dr. Kinsbourne theorizes that this causes an autistic person to be more concerned about what they are feeling rather than the world around them, and thus they can be withdrawn and perform repetitive behaviors.
Dr. Kinsbourne vouched for the reputations of over 40 scientists who are working with autism and various specialties such as neuropsychology and immunology, including Dr. Byers. Kinsbourne didn’t start out with his opinion, but it took 3½ years and cooperation among the disciplines for him to be convinced that MMR could cause autism.
Cross began in the afternoon, asking Kinsbourne to go through the causal chain and indicate how confident he was in each step. Kinsbourne relied on Dr. Aposhian for the role of thimerosal, but he was fairly confident in the pathology of the measles virus causing Michelle’s autism. Cross asked what was the weakest link in the chain of the theory, and Dr. Kinsbourne said that the overexcitation hypothesis in the cells was the weakest.
Dr. Kinsbourne noted that the Petitioner had provided three questions of causation: did thimerosal cause autism, did MMR cause autism, and did the collaboration of thimerosal and MMR cause autism? Kinsbourne was affirmative about MMR causing autism but would not conjecture about the role of thimerosal.
Cross then continued with hypothetical questions; if this weren’t in the evidence, would it change your diagnosis? The witness remarked that some of the questions were a little improbable. Kinsbourne’s confidence remains the same because of the presence of the persistent and neuropathic measles virus. If there were no measles virus recovery, it would shake the Dr. Kinsbourne’s confidence.
There were further inquiries of cooperation between the experts of the Petitioner and the Respondent. Kinsbourne said that he had met with the defendant’s experts but did not see their reports.
