Solving the mystery of autism

It doesn't sound like much: A tiny bit of skin, plucked from the arm of a child and placed in a dish. But in a Houston lab, the skin cells in that dish may be key pieces to solving the puzzle of autism - what causes it, how to diagnose it and, eventually, how to treat it.

At the Neurological Research Institute at Texas Children's Hospital, Dr. Mirjana Maletic-Savatic and a team of colleagues are finding new ways to explore the mysteries of autism, which affects one in 88 kids. Studying brain disorders can be tricky - after all, you can't cut into the brain and examine it directly. But now, from their 12th-floor lab in the heart of the Texas Medical Center, this team is using a patient's own cells to re-create human neurons outside the body.

"This is the closest that we can get to the human model of disease," Maletic-Savatic said. "It's a human disease in a dish."

Maletic-Savatic is an assistant professor in pediatrics in the division of child neurology at Baylor College of Medicine and the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital. She's part of an interdisciplinary team working together on the autism puzzle from several angles.

She and her colleagues have two goals: They're looking for ways to diagnose autism much earlier in a child's life, which will help kids get earlier therapy. They also want to learn why autism develops in the first place - a discovery that should lead to better therapy.

Early diagnosis will come first. Maletic-Savatic wants to move up the timeline for diagnosing autism, using brain scans to detect the disorder in a baby's earliest days.

Her lab - which includes, among others, a chemist, a statistician, a cell biologist and an electrophysiologist - does brain imaging, using MRI and magnetic resonance spectroscopy to observe the connections between parts of the brain, map the flow of water molecules and determine the composition of small molecules in different parts of the brain.

"We are trying to generate a composite biomarker that can help us diagnose autism earlier," she said.

How could it make a difference if a child is diagnosed a few months earlier? The earlier therapists can intervene, the more good they can do. The brain has more plasticity in the first two years of life than it ever will have again. "The earlier you start to do therapy," Maletic-Savatic said, "the more flexible they'll be."

Immediate therapy can help a baby develop better speech and communication. It could also give that child a chance to develop what is missing in many kids with autism: A capacity for imaginative play.

"In this early stage of development, with appropriate intervention, you can really do a lot," she said.

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