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The intense world paradigm for understanding autism

James Marroquin, MD
Conditions
January 10, 2014
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Henry Markram is one of the world’s leading neuroscientists.  After a brilliant career of influential research, he has been charged with leading Europe’s Human Brain Project, a $1.3 billion project that aims to build a supercomputer model of the brain.  But Markram is also the father of a boy with autism.  And that has changed everything.

Maia Szalavitz’s poignant article The Boy Whose Brain Could Unlock Autism chronicles Markram’s personal and scientific journey.  From a very early age, his son Kai displayed a variety of unusual behaviors.

“When his parents tried to set limits, there were tantrums — not just the usual kicking and screaming, but biting and spitting, with a disproportionate and uncontrollable ferocity; and not just at age two, but at three, four, five and beyond … Preventing Kai from harming himself by running into the street or following other capricious impulses was a constant challenge. Even just trying to go to the movies became an ordeal: Kai would refuse to enter the cinema or hold his hands tightly over his ears.”

When his son received the diagnosis of autism, Markram read “every study and book he could get his hands on.”  As a visiting professor at the University of California San Francisco, he encountered Michael Merzenich, a neuroscientist who “proposed that autism is caused by an imbalance between inhibitory and excitatory neurons.”

Propelled by this theory, Markram’s lab began studying rats that had been induced to display autism-like behaviors.  To the researchers’ surprise, the excitatory networks of these rats’ brains were hyperactive.  Their brain cells “responded nearly twice as strongly as normal — and they were hyper-connected. If a normal cell had connections to ten other cells, the cell of (autistic rats) connected with twenty.”

They also noted that these rats displayed “high levels of anxiety as compared to normal rats … They were quicker to get frightened, and faster at learning what to fear, but slower to discover that a once-threatening situation was now safe.” The problem with these rats was not that they couldn’t learn.  It was that “they learn too quickly, with too much fear, and irreversibly.”

Based on these findings, Markram developed what he calls the “intense world” model of autism.  He and his fellow researchers hypothesize that autistic behaviors are caused by being overwhelmed by information from the world.  To grasp this idea,

Imagine being world into a world of bewildering, inescapable sensory overload, like a visitor from a much darker, calmer, quieter planet. Your mother’s eyes: a strobe light. Your father’s voice: a growling jackhammer. That cute little onesie everyone thinks is so soft? Sandpaper with diamond grit. And what about all that cooing and affection? A barrage of chaotic, indecipherable input, a cacophony of raw, unfilterable data.

Just to survive, you’d need to be excellent at detecting any pattern you could find in the frightful and oppressive noise. To stay sane, you’d have to control as much as possible, developing a rigid focus on detail, routine and repetition. Systems in which specific inputs produce predictable outputs would be far more attractive than human beings, with their mystifying and inconsistent demands and their haphazard behavior.

This is what Markram believes it is like to be autistic: “Unlike adults, however, babies can’t flee. All they can do is cry and rock, and, later, try to avoid touch, eye contact, and other powerful experiences. Autistic children might revel in patterns and predictability just to make sense of the chaos.”

According to the article, this “intense world” paradigm for understanding autism has been met with some caution and criticism by experts in the field.  Nonetheless, it helps makes sense of what I see in my son with autism.  Indeed, it speaks to my own compulsion to sometimes want to escape from the world in order to process what I’ve experienced.  I wonder if more introverted people have hyperactive brain networks.  Does an onslaught of information from outside compel them to be alone with their thoughts more often?

James Marroquin is an internal medicine physician who blogs at his self-titled site, James Marroquin.

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