Autism and the Brain

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2 Autism and the Brain

3

4 Tatyana B. Glezerman Autism and the Brain Neurophenomenological Interpretation

5 Tatyana B. Glezerman Independent Practitioner New York, NY, USA ISBN ISBN (ebook) DOI / Springer New York Heidelberg Dordrecht London Library of Congress Control Number: Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

6 For Ilya, Oliver and Abigail and in honor of my parents, Boris and Maria Altschuler

7 wwwwwwwwwww

8 Preface Autism and the Brain is an interdisciplinary study that provides neurophenomenological analysis of autism. It hypothesizes the brain networks involved in autism allowing a new understanding of why symptoms of autism go together and how they are connected to one another in a complex pattern that repeats itself in each autistic child. In this book, introspections of high functioning autistic individuals (HFA), products of autistic savants (as a means of inferring their subjective experience), and behavioral descriptions of low functioning autistic individuals (LFA) are analyzed in connection with the function of various cortical and subcortical regions (and the networks they belong to). The speci fi c function of each particular region (network) is considered within the conceptual frame of human brain three-dimensional differentiation: hierarchical (low order higher order function); Left Right Brain (analytic holistic information processing); Posterior Anterior Brain (spatial temporal organization of information). Considering general principles of brain organization, together with the speci fi c functions of the separate regions while explaining symptoms of autism, this work strives to overcome reductionism of modern neuroscience and arrive to a new cooperation linking phenomenology, psychopathology, and neuroscience. The conducted neurophenomenological analysis gives rise to a new hypothesis of the brain pattern that underlies clinical manifestation of autism. The pattern includes the primary, fundamental brain abnormality, and secondary changes resulting from reorganization of brain functional systems in response to the primary deficit. The book tracks the fundamental problem to part of the left hemisphere which is responsible for awareness of personal identity, self as one and apart from others. In this connection, the primary problem of autism is the problem of consciousness, of the self, not of cognition. Self as an agent is missing or underdeveloped. This book offers a unique and original approach. It gives a panoramic view of autistic brain s functioning. It de fi nes the brain networks that explain the diversity vii

9 viii Preface of the clinical manifestation of autism: from the low functioning autists to high functioning autists to autistic savants. On the other hand, it delineates autistic clinical-brain model what is necessary and suf fi cient for diagnosis. This is important as at present we witness unjusti fi ed broadening of autistic-spectrum-disorder boundaries. New York, NY, USA Tatyana B. Glezerman

10 Acknowledgments I am grateful to Dr. Natalia Novinskaya for critical comments and important suggestions. I am indebted to Dr. Amanda Moberg Wilson for her invaluable help with editing and preparation of the manuscript. Her sense of responsibility and devotion cannot be exaggerated. ix

11

12 Contents 1 Introduction Prelude Current Approach to Autism: Emphasizing Trees and Losing The Forest? Clinical Neurophenomenological Approach to Autism The Three-Dimensional Brain Organization as Conceptual Framework for Neurophenomenological Analysis of Autism Bernstein s Levels and Modern Neuroscience Patterns of Connectivity in the Brain as Widely Distributed Networks How Autistic Persons Understand Words (Cerebral Organization of Word Meaning and Autism) The What System and Its Major Player, BA Object Recognition, Topological Scheme of the Object, and Empirical Component of Word Meaning Topological Scheme Is the Base for Object Action Topological Scheme of an Object Is the Basis for Communicative Gestures Topological Scheme of an Object Is the Basis for the Empirical Component of Word Meaning Categorical Classification, Categorical Component of Word Meaning and Left BA Word Meaning and the Right BA RH Visual Situational Level and Word Meaning RH Symbolic Level and Word Meaning Model of Cerebral Organization of Word Meaning xi

13 xii Contents 2.6 Cerebral Organization of Word Meaning and Autism RH Situational Level and Word Meaning in Autism Is the Empirical Component of Word Meaning Impaired in Autism? Is the Categorical Component of Word Meaning Impaired in Autism? Cerebral Organization of Metaphors and Autism Metaphorical Language of Children with Autism Is of RH Origin Cerebral Organization of Metaphors in the Norm Autistic Children Create Metaphors but do not Understand Them Uniqueness of Right-Hemispheric Prevalence for Language in Autism Conclusion How Autistic Persons Perceive the World (Sensory-Motor Function Level in the Brain and Autism) Right-Hemispheric Situational Level and Autist s Fear of and Fascination with Moving Objects RH Disorders of Time and Autism STG, Detection of Change and Autism RH Situational Level in Autistic Savant Drawing Preoccupation with Parts of Objects in Autistic Savant Drawing The Right-Hemispheric Situational Level and Autist s Hypersensitivity/Hyporeactivity to Sensory Stimuli Right-Hemispheric Situational Level and Autist s Insistence on Sameness Conclusion How Autistic Persons Perceive Faces (Cerebral Organization of Face Recognition and Autism) Research in Fusiform Face Area and Autism The FFA, the Distributed Network of Face Processing and Autism Damage to the FFA and Its Left Hemispheric Counterpart Are Autistic People Prosopagnostic? Do Children with Developmental Prosopagnosia Become Autistic? Face as Right Hemispheric Gestalt: Face Is Holistic Form Face as RH Gestalt: What Is Familiar Face?... 75

14 Contents xiii Disinhibited Right Hemispheric Processing of Faces Social Knowledge and Sense of Knowing The Left Amygdala Role in Face Processing Network The STS Area Role in Face Processing Network The STS and Autists Lip Reading Versus Eye Tracking Conclusion How Autistic Persons Act in the World (Cerebral Organization of Movements and Autism) Hierarchical Organization of Movements in the Brain Bernstein s Levels Different Space of Bernstein s Levels Determined by the Intended Action s Meaning Walking as an Example of Bernstein Level s Integration Object Actions and Their Topological Schemes The Making of Automatisms and Pathological Stereotypy Pathological Stereotypy The Drive Behind Stereotypical Behaviors Autist s Nonrhythmical Stereotypical Movements: Role of the Striatum Autist s Preoccupation with Parts of Objects and Its Underlying Brain Network Autist s Sameness Behavior and Its Underlying Brain Network Repetitive Behavior in Autism and Compulsions in Obsessive Compulsive Disorder Autist s Rhythmical Stereotypical Movements: Role of the Thalamo-pallidum System Conclusion How Autistic Persons Perceive Space and Spatial Relations ( Where System in the Brain and Autism) The Right Parietal-Occipital Region, Topographical Memory, and Autism The Thalamus, Intrapersonal Space, and Autism Returning to the Right Parietal-Occipital Region: Thalamo-Parietal System and Integration of I-Space and Non-I-Space Spatial Representations and Qualitative Quantity The Left Parietal-Occipital Region, Grammatical Constructions in Language and Autism

15 xiv Contents 6.6 More About the Left Parietal-Occipital Region and Autism: Numbers and Calculation Numbers for Autistic Individuals Are Qualitative Quantities: They Are of Right-Hemispheric Origin Exceptional Calculating Ability, Autism, and the Right Hemisphere Autistic Calculators: How Do They Do It? Autistic Calculators: What Are They Doing? Autistic Calendar Calculators and the Right Hemisphere: Soul in Numbers and Memory Without Consciousness The Right Inferior Temporal Region (BA37), Autistic People s Memory, and Autistic Savant s Calendar Calculation The Right Inferior Parietal Region (BA39 and 40), Archetypal Calendar, and Autistic Savant s Calendar Calculation Contribution of the Right DLPC to Autistic Savant Calendar Calculation Contribution of the Striatum to Autistic Savant Calendar Calculation Contribution of the Inner Rhythm to Autistic Savant Calendar Calculation Endnotes How Autistic Persons Feel (Cerebral Organization of Limbic Emotion and Autism) The Amygdala and Its Connectivity Pattern Limbic Emotion: Emotional Experience Limbic Emotion: Emotional Expression Interhemispheric Differences in Amygdala-Related Emotion FMRI Studies of Emotion Recognition by the Left and Right Amygdala Do Autistic People Recognize Emotion? Which Hemisphere Do Autistic People Use to Recognize Emotion? Do Autistic People Express Emotions? Facial Expression in Autistic Children Prosody in Autistic Children Laughter in Autistic Children Viscero-Motor Expression of Emotion in Autistic People Do Autistic People Feel? Amygdala Temporal Cortex Functional Network, Penfield s Brain Archive and Memory of Autistic People

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