Improvement of Language in Children with Autism with Combined Donepezil and Choline Treatment.

The safety and efficacy of a novel combination treatment of AChE inhibitors and choline supplement was initiated and evaluated in children and adolescents with autism spectrum disorder (ASD). Safety and efficacy were evaluated on 60 children and adolescents with ASD during a 9-month randomized, double-blind, placebo-controlled trial comprising 12 weeks of treatment preceded by baseline evaluation, and followed by 6 months of washout, with subsequent follow-up evaluations. The primary exploratory measure was language, and secondary measures included core autism symptoms, sleep and behavior. Significant improvement was found in receptive language skills 6 months after the end of treatment as compared to placebo. The percentage of gastrointestinal disturbance reported as a side effect during treatment was higher in the treatment group as compared to placebo. The treatment effect was enhanced in the younger subgroup (younger than 10 years), occurred already at the end of the treatment phase, and was sustained at 6 months post treatment. No significant side effects were found in the younger subgroup. In the adolescent subgroup, no significant improvement was found, and irritability was reported statistically more often in the adolescent subgroup as compared to placebo. Combined treatment of donepezil hydrochloride with choline supplement demonstrates a sustainable effect on receptive language skills in children with ASD for 6 months after treatment, with a more significant effect in those under the age of 10 years.

The medial prefrontal cortex and integration in autism.

This article offers a unifying theoretical interpretation of known abnormalities in people with autism spectrum disorders (ASDs) in four psychological domains, namely emotion, memory, sensation-perception, and motor skills. It proposes that in all four domains three levels of processing can be identified: a basic level, an integrative level, and a "logical" or higher-order level. It also notes that in typically developing people, there is evidence that the integrative level is subserved by subregions of the medial prefrontal cortex. The major argument of the article is to propose and argue that the integrative level in all four domains is responsible for common atypicalities in people with ASDs.

Functional anatomic models of language: assembling the pieces.

In the past few years, a series of influential review articles have summarized the state of the art with respect to cortical models of language organization. The present article is a mini-review and conceptual meta-analysis of several of the most prominent recent contributions. Based on the models, the authors extract some generalizations to arrive at a more robust model that 1) does justice to the range of neurological data, 2) is more connected to research in linguistics and psycholinguistics, and 3) stimulates hypothesis-driven research in this domain. In particular, the article attempts to unify a few of the current large-scale models of the functional neuroanatomy of language in a more principled manner. First, the authors argue that the relevant type of processing in a given cortical area, that is, memorizing (temporal cortex) versus analyzing (parietal) versus synthesizing (frontal), lies at the basis of local neuronal structure and function. Second, from an anatomic perspective, more dorsal regions within each of these (temporal, parietal, and frontal) systems specialize more in phonological processing, middle areas in syntactic processing, and more ventral areas in semantic processing.