Is deep brain stimulation a new way of treating severe cases of autism?

Rebecca “Becky” Audette is one of five autistic individuals to undergo a treatment called Deep Brain Stimulation (DBS) in an attempt to control repetitive, often self-harming behaviors associated with autism. Becky’s experience with DBS was first discussed on Spectrum News, which we have paraphrased below.

Becky was diagnosed with autism when she was only seven years old. Currently 31, Becky’s brain, function and character development is at the level of a four-year-old child. Living in Massachusetts with her mother, Pamela Peirce, and her brother, Jason Audette, Becky was consumed with obsessive and repetitive behaviors such as keeping the sink running, being overly preoccupied with a video clip, jumping in and out of bed continuously, bathing and flushing the toilet repeatedly, and saying non-words or “gibberish” over and over.

How Does Deep Brain Stimulation Work?

DBS has not been confidently shown to be effective in humans, but it has proven to address injurious repetitive behaviors in lab rats. Doctors tried DBS treatment in five autistic individuals where other treatment options had failed. The main objective was to deal with the repetitive behaviors of autistic children who continuously injure themselves. Since for Becky, there were no other options to pursue, her mother agreed to proceed with the treatment.

DBS works by sending electrical currents to malfunctioning parts of the brain in attempts to get them back to functioning condition. A tiny device that works like a pacemaker is inserted under the patient’s skin, and tiny wires from that device run through the patient’s neck to electrodes inserted on both hemispheres of the individual’s brain. Then, a palm-sized disk is periodically put on the patient’s chest to charge the device’s battery.

Surgeons place the electrodes inside the portion of the brain responsible for natural movements: the basal ganglia. After inserting the electrodes, scientists can modify the amount of current, voltage, frequency and signal pulse specific to that individual’s needs.

Signs of Improvement

The experiment proved effective for Becky over several months, with only a few hiccups, helping Becky tremendously in her daily function. Since the DBS treatment, Becky has been able to take a more active role in life and can enjoy bowling, dancing, singing and making pizza with her mom.

At one point, Becky’s obsessions with inanimate objects surfaced, and she regressed into repetitive behaviors while also suffering from seizures. Neurologist John Gaitanis stabilized her with another operation, activating brain pathway responses to stop uncoordinated activity, using her own inhibitory brain circuitry to help control her compulsive actions.

Risk Versus Benefit

Unfortunately, DBS still has its shortcomings. The battery can die, causing the device to fail, resulting in neurological disturbances such as stroke, vision or speech problems and even loss of balance. Luckily, everything went well for Becky, and when she began to act compulsively again, specialists found that it was because the battery of her device was dying quicker than expected. As soon as this issue was fixed, Becky was back to her normal self.

Medtronic, the supplier of the pacemaker-like device, replaced her original battery, which was expected to last two years, with another that lasts for 15 years at a minimum.

Becky is doing well with the implanted device at the moment, but still not as well as a person her age without autism. In 2013, a genetic test diagnosed the young woman as lacking a line of DNA on a copy of chromosome 9, causing Becky to lack 14 genes, including EHMT1. EHMT1 is a gene is linked to reduced brain development, weak muscle strength, and a rare condition known as Kleefstra syndrome, which presents symptoms including intellectual disability and severe expressive speech delay.

With the correct diagnosis and the help of the brain implant, Becky now has the potential to live a more normal, fulfilling life. Becky’s positive experience with DBS, hopefully, will lead to more successful cases of DBS treatment for autism.