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Today in Your Health, scientists say they are finally beginning to understand what's different about the brains of people with autism. There's growing evidence that the difference involves the fibers that carry information from one part of the brain to another. NPR's Jon Hamilton reports on two people in Pittsburgh who have played key roles in this discovery. One is a scientist. The other is a man with autism.
JON HAMILTON, BYLINE: Like a lot of people with autism, Jeff Hudale has a brain that's really good at some things.
JEFF HUDALE: I have an unusual aptitude for numbers, namely math computations.
HAMILTON: Hudale can do triple-digit multiplication in his head. That sort of ability helped him get a degree in engineering at the University of Pittsburgh. But Hudale says his brain struggles with other subjects.
HUDALE: Abstract thinking like literature and philosophy and those sort of things. I like where(ph) things are rather concrete and structured and - yeah, I like things that have some logic and some rules to it.
HAMILTON: So Hudale, who's 40, does fine at his job at the bank. But he doesn't do so well with social interactions, where logic and rules aren't so obvious.
HUDALE: Most people my age are nowadays married. But me, not only am I totally single, I mean I've never even had a date.
HAMILTON: What Hudale has done for the past 25 years is help scientists understand autism by letting them study his brain. His career as a research subject began in 1985. Hudale was 13 and had just been committed to Western Psychiatric Institute at the University of Pittsburgh.
HUDALE: I was actually diagnosed as a schizophrenic. And that's a common misdiagnosis, at least back then it was, anyway.
HAMILTON: During his stay, a neurologist named Nancy Minshew ran some tests on Hudale and realized that his real problem wasn't schizophrenia. It was autism. She also realized that even though Hudale was still a teenager, his intelligence and curiosity about what was going on in his own brain made him a great candidate for research studies. So not long after Hudale returned home, Minshew and other researchers began asking him if he'd be willing to take part in some experiments. Hudale says he didn't hesitate.
HUDALE: When I first started learning what this is really about, I thought if I can get some benefit to help my health out, that would be great. But now I realize this not only helps me but it can help other people with similar troubles, and I'm all for it.
HAMILTON: So Hudale said yes to just about every scientist who asked him to participate in an autism study. That was back in the mid-1980s, when researchers still considered the human brain a sort of black box because there was no way to watch the activity going on inside. Marcel Just, a brain scientist at Carnegie Mellon University, says researchers everywhere seem to be asking the same questions.
MARCEL JUST: How do you open that black box? How do you know what a person's thinking? How do you do it? It was just not approachable. And then the magic happened. In the late '80s and early '90s it became possible to image brain activity.
HAMILTON: So-called functional MRI scans and PET scans began to show which parts of the brain become active when people see pictures or read words or think about certain things.
But scientists didn't start applying these technologies to autism until the late 1990s. That's when the National Institutes of Health began pouring tens of millions of dollars into autism research. By this time, Marcel Just had teamed up with Nancy Minshew, the neurologist who'd helped diagnose Jeff Hudale more than a decade earlier. The two researchers suspected that new imaging technologies could show how the brain of a person with autism is different.
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HAMILTON: But to find out they needed lots of people with autism who would be willing to lie in the noisy tunnel of an MRI scanner and perform mental tasks over and over. And that's where people like Jeff Hudale became really important. He and many other people with autism agreed to come to basement rooms like this one at Carnegie Mellon University. A wall of thick glass separates researchers from the enormous magnet of this state-of-the-art scanner. Inside the tube is a young woman named Chelsea McGrath.
KARA COHEN: Chelsea, are you still doing okay in there?
CHELSEA MCGRATH: (Unintelligible)
HAMILTON: McGrath doesn't have autism. She's a research associate with a typical brain. But scans of brains like hers offer a way to see what's different about the brains of people with autism. Kara Cohen, the research coordinator, tells McGrath what to expect.
COHEN: We're going to get started in just a moment. And please remember that when you see two faces in a row that are the same, just press the button in your right hand.
HAMILTON: Marcel Just says scans like this one showed him that in a typical brain, the activity in areas near the front is synchronized with the activity in certain areas toward the back.
JUST: It was obvious that they were working together. I mean we all knew in some vague way that the different parts of the brain would work together, but to find this, sort of this beautiful rhythmic dance together, it was a very eye-opening moment.
HAMILTON: And when he began to study the brains of people with autism, he realized that beautiful rhythm wasn't always there.
JUST: There was this lack of synchrony between the frontal areas and posterior areas.
HAMILTON: And the lack of synchrony became quite clear when people with autism did mental tasks like the one Chelsea McGrath is doing in the scanner. It's an exercise that requires her to remember faces. Marcel Just says that process usually involves many parts of the brain working together.
JUST: It's one thing to recognize the visual pattern, it's another, for example, to associate the emotional response to a face. Is it a pleasant one? Is it somebody you know and like, and so on and so forth.
HAMILTON: Combining visual and emotional information requires areas in the front of the brain to communicate instantly with areas in the back of the brain. And that's what you see in someone with a typical brain, like McGrath. But Marcel Just says that in the brain of someone like Jeff Hudale, there would be less communication and coordination.
JUST: Even in this brief little study, you put someone in the scanner and you have them look at a face and you can see that the thought of the face is somewhat altered in autism.
HAMILTON: That makes sense, given the research showing that people with autism often pay less attention to faces and have difficulty reading emotions in them.
Marcel Just and his colleagues soon came to believe that the problem could be traced to fiber tracts that connect key areas in the front of the brain to key areas in the back. The connections just weren't good enough. He says it helps to think of the brain as being a bit like the Internet.
JUST: The Internet would be nothing without cabling and Wi-Fi. It's the fact that we have this fabulous connectivity that lets our smartphones and computers connect to each other and get information back and forth quickly.
HAMILTON: Jeff Hudale has a more succinct version of what's become known as the under connectivity theory of autism.
HUDALE: Well, I put this to you simply. Like, if I'm somewhat messed up it's because my wires are messed up.
HAMILTON: When Marcel Just and Nancy Minshew first proposed the underconnectivity theory a few years ago, it attracted some skepticism. But recent evidence supports the theory.
For example, a new type of scan that shows the fiber tracts connecting various parts of the brain confirms that some of them are less robust in people with autism.
And if connections in the brain really are the problem, there are tantalizing hints of a partial solution. A study of dyslexia has shown that when people do mental exercises that use certain fiber tracts, the connections get stronger.
Jeff Hudale says he's not sure whether mental exercises can help people with autism. But he says he'll keep volunteering for autism studies until something does.
HUDALE: I don't want to quit until they finally can get this set right and make this - get this thing eradicated. I'd like to finally have some semblance of - well, finally just be a regular person like everybody else.
Jon Hamilton, NPR News.
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