Neuroimmunology, XMRV, and The Myth of Autism

I had recently finished The Myth of Autism by Michael Goldberg, M.D., who presents anecdotal observations that support the idea that some cognitive defects currently diagnosed under the umbrella of autism spectrum disorder is a result of pathology, not a genetically based, developmental defect. This is a crucial distinction, as a pathology suggests a disease state that is, in theory, treatable, even if we lack a cure now.

In the book, Dr. Goldberg goes further and suggests that a broad class of autistic patients suffer from a neuroimmunological disorder, and only a small fraction of autistic patients suffer from classical autism (considered a developmental condition.) He brings enough observations to bear on the idea that an aberrant immunological response may underlie cognitive deficits, that I’ve begun looking at neuroimmunology related research (partly out of personal interest, but also because I am in the middle of identifying a research agenda for a 1-D imaging cytometer my lab has developed.).

From a presentation perspective, I was disappointed that Dr. Goldberg does not present a systematic study of his patients and treatments. Instead, he gives an appendix of patient testimonies. The omission of a study is glaring, given his access to patient data and outcome: symptoms (cognitive impairments),  biomarker status (elevated immune system and inflammation responses), and long-term observation.

Again, I think his arguments are compelling, and he cites existing research (including a recently, formally retracted paper on a retrovirus as a cause of chronic fatigue syndrome*) that supports his thesis, which makes follow up easy. Given the element of self-promotion and the lack of a clear scientific consensus, one can be forgiven for  withholding judgment on the veracity of his claims until a  deeper reading into the primary research. But one might do worse than to use this book as a guide into subsequent research.

*John Timmer, at Ars Technica, has written some articles (here and here) regarding the controversy surrounding the idea that a retrovirus causes chronic fatigue syndrome.