Sleep in subjects with autistic disorder: a neurophysiological and psychological study.

Polysomnography (EOG, EEG, EMG) was carried out in 17 male children and adolescents with autistic disorder, in seven patients with mental retardation and fragile X syndrome, and in five age- and sex-matched normal male subjects. Density of rapid eye movements was not significantly different in the three groups of subjects; however, some sleep parameters such as time in bed, sleep period time, and total sleep time were significantly lower in subjects with autistic disorder than in normal controls; moreover, patients with autistic disorder showed values of sleep period time, first REM latency and percent (%) sleep stage 1 lower than those of patients with fragile X syndrome with mental retardation. Density of muscle twitches was significantly higher in patients with autistic disorder than in normal controls. In contrast only minor differences were observed between patients with autistic disorder and those with fragile X syndrome with mental retardation. Furthermore, some psychoeducational profile-revised items such as perception and eye-hand coordination, showed significant correlation with some sleep parameters (time in bed, sleep latency, stage shifts, first REM latency and wakefulness after sleep onset). Childhood Autism Rating Scale (CARS) scores to visual response and non-verbal communication showed significant correlation with some tonic sleep parameters, such as sleep period time, wakefulness after sleep onset, and total sleep time. Relating to people and activity level items were found to be significantly correlated with rapid eye movement density. Our results suggest the existence of a sleep pattern in autistic patients different from that observed in subjects with mental retardation and from that of normal controls. In addition, these findings indicate that sleep parameters in these patients are correlated with some psychological indices generally used for the diagnosis of autistic disorder; for this reason, polysomnographies might be useful in the comprehension of the neurophysiological mechanisms underlying this condition.

Chronological age and receptive vocabulary of persons with Down syndrome.

The Test de Vocabulaire en Images (the French version of the Peabody Picture Vocabulary Test) and the Columbia Mental Maturity Scale were administered to 29 participants with Down syndrome aged 6.1 yr. to 13.0 yr. Analysis indicated a significant association between chronological age and the Test de Vocabulaire en Images mental age. This finding seems to suggest that the relationship between chronological age and the receptive vocabulary of persons with mental retardation is not specific to etiology.

Epileptic drivers--a study of 1,089 patients.

A longitudinal study of 1,089 epileptic patients followed up by the same specialist between 1965-1991, allowed close observation of the seizures occurring to the patient at the wheel and their consequences and to relate them to detailed epileptological criteria. The results show road accidents caused by epileptic seizures are few and most of them are minor. The repatriation of risks between patients is very uneven. The quality of the neuro-psychic inter-critical state as well as the patients' degree of compliance seem to be more reliable risk indicators than some more traditional criteria like the length of remission between seizures. Although seizures occur more frequently in patients suffering from Complex Partial seizures as opposed to other forms of epileptic seizures, the differences between patients with epilepsy lies mostly in their behaviour and in their own representation of the risks. There is a need for a body of rules and regulations serving as an official framework regulating the driving test. This widely circulated document should take into account the multiplicity of cases, including the small number of patients thought to be dangerous. Its mode of application should allow doctors as well as patients to opt for a realistic attitude based on decision-making criteria involving a thorough knowledge of epilepsy as well as a thorough knowledge of the psychological characteristics of the patient concerned.

Long-term administration of butoctamide hydrogen succinate on nocturnal sleep of mentally retarded subjects: a polygraphic study versus placebo.

Butoctamide hydrogen succinate (BAHS) has been proved to increase REM sleep in patients with reduced REM sleep. Following previous experiments on the effects of BAHS on nocturnal sleep of mentally retarded (MR) subjects, a polygraphic study was conducted on 20 MR subjects (age 8-14 years) to verify the effects of BAHS, 1) after long-term administration and 2) in different etiologies of MR. Subjects were divided into two balanced groups receiving placebo or 400 mg BAHS before sleep for a 6-month period. Basal sleep did not differ substantially in the two groups, both presenting reduced REM sleep. Low amounts of REM sleep were partially reversed by BAHS administration, which caused a significant increase in the REM sleep stage. Post-treatment sleep modifications found in the experimental group were not observed in the control group. BAHS produced its effects on REM sleep immediately after the first administration of the drug, but they became more apparent after long-term treatment. Our findings indicate that long-term administration of BAHS at low dosage maintains its effects on REM sleep of mentally retarded children, causing modifications similar to those previously obtained with single administration at higher dosages in cats, in healthy young and elderly volunteers and in Down's syndrome children. In addition, our observations demonstrate the effectiveness of BAHS on REM sleep, when utilized in mental retardation of etiologies other than Down's syndrome.

Overestimation of mentally retarded persons' IQs using the PPVT: a re-analysis and some implications for future research.

Numerous validity studies have shown that the PPVT consistently overestimates mentally retarded persons' IQs. One possible interpretation is that this phenomenon is an outcome of the dissociation between their cognitive level and their experience. Indeed, compared to intellectually average subjects of the same mental age, they have had more learning opportunities, simply because they have lived longer. In order to validate this hypothesis, the French version of the PPVT, Raven's Coloured Progressive Matrices (RCPM), and the 1966 version of the Binet-Simon were administered to 90 subjects of various chronological ages matched on mental age (30 nonretarded 5 year olds and two groups of 30 retarded subjects aged 10 and 16 years, respectively). The results indicate that CA exerts a strong effect on vocabulary, but not on RCPM performance. The research implications of this finding are discussed.

Butoctamide hydrogen succinate and intensive learning sessions: effects on night sleep of Down's syndrome patients.

Mentally retarded children present a reduction in percentage of REM sleep and of oculomotor frequencies. These sleep patterns are probably relevant for their cognitive activities. The effects of butoctamide hydrogen succinate and intensive learning sessions on the night sleep of five Down's syndrome patients was studied by the authors. They found an increase in percentage of REM sleep after pharmacological treatment and an increase in oculomotor frequencies after learning sessions. The authors' hypotheses of REM sleep as a neurophysiological indicator of cerebral "plasticity" and of oculomotor frequencies as an indicator of "organization" abilities are discussed in this article. Pedagogical implications and therapeutical perspectives are also outlined.

Sleep patterns of Down's syndrome children: effects of butoctamide hydrogen succinate (BAHS) administration.

Several investigators have described the altered sleep patterns in Down's syndrome subjects. The most relevant findings have been a reduction in percentage of REM sleep, a prolonged latency to the first REM episode, an increase in undifferentiated sleep, and a reduced ratio of the oculomotor frequencies. Because it is of interest to identify new drugs able to increase the percentage of REM sleep in mentally retarded subjects, we studied the effects of butoctamide hydrogen succinate (BAHS) on nocturnal sleep in eight young institutionalized Down's syndrome subjects. BAHS produced a significant increase in the percentage of REM sleep as well as a decrease in undifferentiated sleep and latency to the first REM.

Sleep and mental deficiency.

The nocturnal sleep of 54 young, organic and functional, institutionalized mentally deficients was recorded and analyzed according to Rechtschaffen and Kales (1968) and compared to that of 17 normal subjects of the same age. The paradoxical sleep (PS) rate of mental deficients is significantly lower than that of normals, as is the number of PS phases. On the other hand, the rate of intermediary sleep (IS) is increased, as is the latency of the first PS phases. The analysis of intervals between consecutive horizontal eye movements showed that intervals less than 1 sec (I less than 1 sec) are shorter in mental deficients. The ratio between high frequency (I less than 1 sec) and low frequency intervals (I greater than or equal to 2 sec) increases with age in normals and remains at a constant low level in mental deficients.

Spontaneous electrodermal activity during sleep in man: an intranight study.

This study was designed to examine the intranight evolution of spontaneous electrodermal activity (EDA). Eight paid volunteer male students were recorded for 3 complete nights (after a habituation night). The results show that: during the first sleep cycle, EDA is significantly lower than during the rest of the night; rapid eye movement sleep evolves in a particular manner, which emphasizes the specificity of this sleep stage; and there is no internight habituation effect.