Brain metastases: An update on the multi-disciplinary approach of clinical management.

IMPORTANCE: Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1. OBSERVATIONS: The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. BM should be suspected in any cancer patient who develops new neurological deficits or behavioral abnormalities. Gadolinium enhanced MRI is the preferred imaging technique and BM must be distinguished from other pathologies. Large, symptomatic lesion(s) in patients with good functional status are best treated with surgery and stereotactic radiosurgery (SRS). Due to neurocognitive side effects and improved overall survival of cancer patients, whole brain radiotherapy (WBRT) is reserved as salvage therapy for patients with multiple lesions or as palliation. Newer approaches including multi-lesion stereotactic surgery, targeted therapy, and immunotherapy are also being investigated to improve outcomes while preserving quality of life. CONCLUSION: With the significant advancements in the systemic treatment for cancer patients, addressing BM effectively is critical for overall survival. In addition to patient's performance status, therapeutic approach should be based on the type of primary tumor and associated molecular profile as well as the size, number, and location of metastatic lesion(s).

Poultry Femoral Head Separation and Necrosis: A Review.

Femoral head separation (FHS) is a degenerative skeletal problem in fast-growing poultry wherein the growth plate of the proximal femur separates from its articular cartilage. At its early phase, FHS may remain asymptomatic but lead to epiphyseal breakage, infection, and femoral head necrosis (FHN). Healthy femoral head is viewed as a positive trait for genetic selection. However, the etiology of FHS is poorly understood for use in noninvasive diagnosis and genetic selection. Focal cell death and atrophic changes are likely associated with separation of tissues and necrotic changes. Fibrotic thickening of the articular surface can also impair free movement of the proximal epiphysis in the acetabulum, leading to FHS, under strain. The major limitation to understanding the pathophysiology of FHN is the lack of suitable experimental models and biomarkers to diagnose the problem. In this review, we discuss the possible etiologic factors, anatomic features of the chicken femoral head, biomarkers, and molecular mechanisms relevant to FHN.

Ascorbic Acid Differentially Affects Stress Response and Resistance to Colibacillosis in Turkeys from Genetic Lines Differing in Growth Rate.

Genetic selection for fast growth can affect the ability of male turkeys to cope with stressors, resulting in decreased immunity to opportunistic bacterial infection. The purpose of the current study was to compare the effects of ascorbic acid (AA) on the stress response and resistance to Escherichia coli challenge of birds selected for increased 16-wk body weight (BW; F-line) with their random-bred parent line (RBC2). Male turkeys were raised in duplicate floor pens in a two line×two AA treatment×two stress challenge (SC) design. At 5 wk of age, AA (1200 ppm) was provided in drinking water for a 24-hr period, during which all birds were weighed. After AA treatment, the SC group was subjected to a transport stress protocol. Six hours after the start of transport, SC birds were also inoculated in the thoracic air sac with 1×10(4) colony-forming units of E. coli. The following morning four birds from each pen were bled, and all birds were weighed and necropsied 2 days later. BW and gain after SC were decreased in the F-line but not the RBC2 line, and there were no AA effects on BW. The weight of the bursa of Fabricius relative to BW was higher in the RBC2 line than in the F-line, was decreased by SC, and was not affected by AA. The heterophil∶lymphocyte ratio was higher in the SC F-line as compared to the SC RBC2 and was decreased by AA only in the SC F-line. Corticosterone (C) levels were increased by SC only in the F-line, and AA decreased C levels only in the RBC2 line. Airsacculitis scores were increased in the F-line SC birds. The challenge strain of E. coli was only detected in the air sac and liver of the AA-treated F-line SC birds and in the liver of the no-AA F-line birds. These results suggest that SC at 5 wk of age had a more deleterious effect on the fast-growing F-line than on its parent line and that AA may have increased susceptibility to colibacillosis in the SC F-line birds.

Effect of dexamethasone on bacteriostatic activity of turkey monocytes and implications for food safety.

Stress has been shown to affect the immune system of turkeys making them more susceptible to bacterial infections. Five-week-old male and female turkeys were treated with 3 intra-muscular injections of dexamethasone (Dex) at 0, 0.5 and 2.0mg/kg body weight. Twenty-four hours after the third injection birds were bled and white blood cell (WBC) differentials and bacteriostatic activity of monocytes were measured. Dex at both 0.5 and 2.0mg/kg decreased phagocytic activity in females only. Bacteriostatic activity was decreased at both concentrations of Dex at 8 and 16 h post-infection in both sexes and was lower in males as compared to females. Total WBC counts were increased in females at both concentrations of Dex whereas male total WBC counts were unaffected. Both males and females had an increase in the heterophil to lymphocyte ratio. Within the same study, replicate pens of turkeys were challenged with intra-air sac inoculation of 100 cfu of Escherichia coli. Isolation of E. coli was significantly increased by both Dex and E. coli challenge, but there were no differences between sexes. These results suggest that stress can compromise the bacteriostatic activity of turkey monocytes and increase bacterial colonization of blood and tissues, potentially affecting food safety.

Nutritional effects of egg shell membrane supplements on chicken performance and immunity.

Eggshell membranes (ESM) contain a variety of proteins and peptides which help in the development of embryo and provide protection to it. Many of the peptides and proteins associated with ESM have antimicrobial, immune-modulatory, and adjuvant properties. We hypothesized that the membrane byproducts from egg, provided as posthatch nutritional supplements to chickens, may improve their performance and immunity. To explore its effect, we fed 3 groups of broiler chicks with feed containing 0, 0.2, and 0.4% ESM from d 1 posthatch through 14 d and regular feed thereafter. The birds were individually weighed at the onset of the study and at weekly intervals until the termination at third wk when they were bled and euthanized. The relative weights of liver, spleen, bursa, and heart, hematology profiles, and clinical chemistry variables including serum IgM, IgG, and corticosterone concentrations were measured. The chickens in the ESM treated groups showed a statistically significant increase in BW with no impact on relative organ weights. Compared with controls, the WBC and lymphocyte percentage increased in chickens fed 0.4% ESM whereas the monocyte percentage decreased at both levels of ESM. Except for the serum protein which increased in ESM fed birds no other metabolic clinical chemistry variables showed any significant change. Both IgM and IgG(Y) levels were elevated and corticosterone levels reduced in chickens fed ESM supplemented diets. Our results suggest that ESM supplements during the early phases of growth may improve immunity and stress variables, and enhance their growth performance without any detrimental effect on other physiological parameters.

Efficacy of a novel prebiotic and a commercial probiotic in reducing mortality and production losses due to cold stress and Escherichia coli challenge of broiler chicks 1.

Prebiotics consisting of resistant starch may alter intestinal ecology, thus modulating inflammation and increasing intestinal health through increased cecal production of short-chain fatty acids (SCFA). Probiotics may directly alter the intestinal microbiome, resulting in the same effects. We hypothesize that adding prebiotics and probiotics to feed may protect the gut of young chicks under stress. Studies 1, 2, and 3 evaluated treatments in a cold stress (CS) and Escherichia coli (EC) oral challenge to 430 day-old broiler chicks for 3 wk. In study 1, prebiotics were administered as 15% of the diet during the first week only and consisted of the following: Hi-Maize resistant starch (HM), potato starch (PS), or raw potato (RP). In studies 2 and 3, the PS treatment was identical to study 1, and an additional probiotic treatment (PRO) was administered in feed and water. In study 1, PS protected BW during the first week and decreased the mortality of CS/EC-challenged birds during the first week and wk 3, while RP decreased the mortality of warm-brooded birds challenged with EC during the first week. In study 2, PS decreased and PRO increased the main effect mean (MEM) of the first week BW. PS and PRO numerically decreased the feed conversion ratio (FCR) by 23 and 29 points, respectively, in CS/EC-challenged birds with no effects on mortality. In study 3, PS decreased and PRO increased the first week and wk 3 MEM BW. PS numerically increased FCR by 16 points, while PRO decreased FCR by 2 points. Both PS and PRO tended to increase overall mortality, and PRO significantly increased mortality in the CS/EC challenge. These results suggest that the effects of PS may be too variable in this challenge model for further study; however, the PRO treatment improved production values and may have potential as an alternative to antibiotics during the first weeks after hatch.

Environmental augmentation with bacteriophage prevents colibacillosis in broiler chickens.

Bacteriophages are viruses that kill bacteria. They are plentiful in nature; are safe, having no known activity to human or animal cells; and are an attractive alternative to antibiotics. The objectives of this research were to establish an experimental model of colibacillosis induced by indirect exposure to Escherichia coli and to determine if bacteriophage could protect the birds from developing colibacillosis. In study 1 there were 6 treatments with 2 replicate pens of 25 birds. The treatments were control warm brooded; control cold stressed; litter inoculated with E. coli, warm brooded; litter inoculated with E. coli, cold stressed; seeder birds (5 per pen) challenged with E. coli, warm brooded; and seeder birds (5 per pen), cold stressed. The study concluded when the birds were 3 wk of age. Body weights at 1, 2, and 3 wk of age were significantly decreased (P ≤ 0.05) by cold stress, decreased at 1 and 2 wk of age by both the litter and seeder bird treatments compared with the control treatment and by the seeder bird treatment at 3 wk of age. Study 2 consisted of 8 treatments with 2 replicate pens of 20 birds per treatment. The treatments were control, warm brooded; control, cold stressed; litter inoculated with E. coli, cold stressed; and seeder birds (5/pen) challenged with E. coli, cold stressed with and without bacteriophage treatment. In the bacteriophage treatments the bacteriophages were sprayed on the litter. The study was concluded at 3 wk of age. Body weights at 1 wk of age were significantly (P ≤ 0.05) decreased from the control treatment by the seeder bird treatment and were significantly (P ≤ 0.05) higher in all the bacteriophage treatments compared with their matched untreated treatments, except in the control cold stressed treatment. Mortality was significantly (P ≤ 0.05) decreased by bacteriophage in the litter challenged treatment. These data suggest that augmentation of the environment with bacteriophage is a practical and efficacious way to prevent colibacillosis in broiler chickens.

Effects of vitamin D and yeast extract supplementation on turkey mortality and clostridial dermatitis incidence in a dexamethasone immunosuppression model.

Clostridial dermatitis (CD) is a production disease of commercial turkeys that is characterized by sudden mortality in market-aged male birds and by lesions that include fluid and air bubbles under the skin of the thigh, breast, and tail area. We have developed a model for CD using dexamethasone (Dex) injection that suggests this disease may be related to stressors during the last stages of turkey production. Male turkeys were provided with control feed and water or with feed supplemented with a commercial yeast extract (YE) product, water supplemented with vitamin D (VD), or the combination. At 6, 11, and 15 wk of age birds were treated with three intramuscular injections of Dex over a 5-day period. Both YE and VD, but not the combination, decreased early mortality. At week 7 mortality was increased by VD, and cellulitis lesions were seen in 7/8 mortalities. Mortality at week 12 was decreased by both YE and the combination of YE and VD, and cellulitis lesions were seen in 8/17 mortalities. There were no significant differences in mortality at week 16. Total mortality was 66 birds, and 23 of these had cellulitis lesions (38%). There were no YE-treated birds with CD lesions; however, 67% of VD-treated birds had CD lesions. This study suggests that feed supplementation with YE may improve the ability of turkeys to withstand the stressors during late production and provide protection against the development of CD; however, high levels of VD supplementation may be detrimental.

Management and outcome of pallidal deep brain stimulation in severe Huntington's disease.

Neurodegenerative movement disorders, such as Huntington's disease (HD), have become a promising field for Deep Brain Stimulation (DBS). This study aims to contribute to the establishment of a well-grounded database including both expected and unexpected effects of pallidal DBS in HD, and to discuss the ethical and legal restrictions of DBS in cognitively limited patients. Evaluation of the outcome data indicates that pallidal DBS exerted an independent effect on motor symptoms but probably also on the patient's cognitive and affective state. The cognitive decline, however, that characterizes the late stage of neurodegenerative disorders implicates ethical and legal problems given the patients' inability to give informed consent to DBS.

Method of administration affects the ability of bacteriophage to prevent colibacillosis in 1-day-old broiler chickens.

Bacteriophages are viruses that kill bacteria. They are plentiful in nature with no known activity in human or animal cells, making them an attractive alternative to antibiotics. The objective of this research was to determine if a coarse or a fine spray of bacteriophage would prevent colibacillosis induced by an intratracheal (IT) challenge with Escherichia coli. Two studies were conducted with 6 treatments: untreated control, birds treated with a spray administration of bacteriophage and not challenged, birds administered bacteriophage IT and not challenged, birds not treated and challenged IT with E. coli, birds sprayed with bacteriophage and IT challenged with E. coli, and birds administered bacteriophage IT and challenged IT with E. coli. There were 3 replicate pens of 10 birds per pen, per treatment, and all treatments were administered at 1 d of age. Study 1 was concluded when the birds were 19 d of age, and study 2 was concluded when the birds were 21 d of age. In both studies, neither a coarse nor a fine spray protected the birds from an IT E. coli challenge; however, when bacteriophage was administered IT there was complete protection. This research demonstrates the necessity for the administration of bacteriophage therapeutics to deliver high bacteriophage titers to the site of a bacterial infection.

Response of restraint stress-selected lines of Japanese quail to heat stress and Escherichia coli challenge.

Japanese quail selected for divergent corticosterone response to restraint stress were evaluated for their susceptibility to heat stress and challenge with Escherichia coli. These quail lines are designated as high stress (HS), low stress (LS), and the random-bred control (CS) lines. Heat stress (35°C, 8 h/d) began at 24 d until the end of the study at 39 d. Birds were challenged with an aerosol spray containing 2 × 10(9) cfu of E. coli at 25 and 32 d. At 38 d, the surviving birds were necropsied and the intestinal tract was screened for both Salmonella and Campylobacter. Body weights of the CS birds were higher than both HS and LS at 17, 25, and 32 d. At 32 d, there was no difference in mortality between males and females and the CS line had higher mortality compared with the LS line with the HS line being intermediate. At 38 d, females of the CS line that were both heat stressed and challenged had a mortality incidence of 25%, which was significantly higher than male birds of the same line and treatment (5.3%). There was an increased incidence in Salmonella enterica serotype Agona isolation after heat stress, with the LS birds having less isolation than the HS birds. Mean corticosterone levels of male birds were not significantly affected by line, heat stress, or E. coli challenge; however, the LS line subjected to heat stress had one-third the level of the HS line, a difference identical to that seen in the original selection for response to restraint stress.

The effects of yeast feed supplementation on turkey performance and pathogen colonization in a transport stress/Escherichia coli challenge.

A commercial yeast culture feed supplement (YC; Celmanax SCP, Vi-COR, Mason City, IA) was provided to turkeys throughout a 16-wk grow-out to determine if it would prevent the effects of stress on production and pathogen colonization. The YC was provided either continuously at 100 g/t (YC-CS) or intermittently during times of stress at 200 g/t (YC-IS). Birds were stressed with an environmental challenge of Escherichia coli and by transporting them in a vehicle for 3 h after which they were penned in new social groups, without feed or water, for an additional 9 h. Turkeys were transported and challenged at 6, 12, and 16 wk of age to model the movement of birds within a 3-stage housing system. The YC-IS was provided only for the first week after hatch and for a 1-wk period encompassing each challenge. At wk 7 and 9, a decrease in BW of challenged birds was prevented by YC-IS but not YC-CS. There were no significant differences in BW due to either challenge or YC during wk 11 and 13. At wk 16, the challenge decreased BW, but there was no improvement in either of the YC treatments. Overall feed conversion ratio (FCR) was increased by transport/E. coli (P < 0.0001). The YC-CS improved FCR of challenged birds by 21 points, whereas YC-IS improved FCR by 36 points and this effect was significant (P = 0.013). The YC-CS tended to decrease both Salmonella and Campylobacter isolation from the ceca of stressed birds (P > 0.05). The YC-IS also tended to decrease Salmonella isolation (P > 0.05) with no effect on Campylobacter isolation. These data suggest that the practice of transporting turkeys decreases performance and that YC-IS may be more effective than YC-CS for alleviating the effects of this stressor on feed efficiency.

Comparison of hematologic and serologic profiles of broiler birds with normal and severe degrees of white striping in breast fillets.

White striping is the white striation occasionally observed parallel to the direction of muscle fibers in broiler breast fillets and thighs at the processing plant. Broiler breast fillets can be categorized as normal (NORM), moderate (MOD), or severe (SEV) based on the degree of white striping. Histologically, SEV fillets are characterized by the highest degree of degeneration of muscle fibers along with fibrosis and lipidosis when compared with NORM. The present study was undertaken to compare the hematologic and serologic profiles of broilers with NORM and SEV degrees of white striping to get more information on the systemic changes associated with the condition. Day-old male broiler chicks of a commercial strain were grown on the same diet in 6 replicate pens (n = 32 birds/pen). Blood samples (5 mL) were collected from the wing vein of each bird on the day before processing for analyzing hematologic and serologic profiles. At 63 d, the birds were weighed and processed in a commercial inline processing system. Weight of the butterfly fillets, liver, and abdominal fat pad were recorded. Left-side fillets were scored to obtain the degree of white striping for each bird. Representative samples for NORM (n = 24) and SEV (n = 17) categories were selected to compare the hematologic and serologic profiles. The SEV birds had greater (P < 0.05) live, fillet, and liver weights, as well as fillet yield, compared with the NORM birds, but the abdominal fat yield was less (P < 0.05) in SEV birds. The NORM and SEV birds did not show any differences in various hematological parameters, including the differential leukocyte count. Conversely, SEV birds had elevated (P < 0.05) serum levels of creatine kinase, alanine transaminase, aspartate aminotransferase, and lactate dehydrogenase. These results suggest that there is no systemic infectious or inflammatory condition associated with a SEV degree of white striping. The elevated serum enzyme levels confirm the muscle damage associated with the degenerative myopathy in SEV birds.

Dexamethasone immunosuppression resulting in turkey clostridial dermatitis: a retrospective analysis of seven studies, 1998-2009.

We have studied the etiology of turkey osteomyelitis complex (TOC) for the past 20 yr and have determined that this syndrome is caused by the inability of some fast-growing male turkeys to cope with production stressors. Although immunosuppressive viruses have often been associated with susceptibility to gangrenous dermatitis (cellulitis), we hypothesize that production stressors alone can also undermine resistance to opportunistic pathogens by both increasing bacterial translocation from the intestine and disrupting the skin's antimicrobial barrier, resulting in subcutaneous lesions referred to as cellulitis and recently named turkey clostridial dermatitis (CD). Some common characteristics between TOC and CD are that they are both caused by opportunistic bacterial species that are prevalent in the environment and are both most common in adolescent male birds. In both diseases the affected birds are often large, healthy, and from the best-performing flocks. Our TOC studies using dexamethasone immunosuppression result in a high incidence of cellulitis lesions in dead turkeys that were given either Escherichia coli or Staphylococcus aureus respiratory challenges. The natural presence of Clostridium spp. in the poultry intestine and environment suggests that they may also have been concomitant pathogens. We suggest that a useful and repeatable model for CD can be developed by focusing on the ability of stress to increase diuresis and wet litter conditions and undermine both intestinal and cutaneous bacterial resistance in fast-growing male turkeys.

Effects of high fat diets or prednisolone treatment on femoral head separation in chickens.

1. The effects of high fat diets and prednisolone treatment were studied to understand the etiology of femoral head separation (FHS) in fast growing broiler chickens. Dietary effects on production parameters such as growth, feed conversion ratio (FCR) and blood chemistry were also measured. 2. Three groups of chickens, consisting of 30 birds each, in two replicate pens, were fed isonitrogenous diets containing 40 (control), 60, or 80 g poultry fat supplements per kg feed. The birds were fed a starter diet containing the fat supplements for the first three weeks, then switched to a grower diet containing the same supplements for the rest of the experimental period. Two groups of birds were also raised with the control diets, but were administered either cholesterol or prednisolone intramuscularly at 30 and 32 days of age to evaluate their effects on FHS incidences. 3. The chickens were euthanised and necropsied at 37 d of age. The presence of femoral head weakness was determined by applying mild pressure on the pelvic joint to cause the growth plate to become detached from its articular cartilage in affected cases. 4. High fat diets did not change FHS incidences, but increased 28 d body weights (BW) and FCR. At 37 d of age the BW differences were not significant but the FCR (gain: feed ratio) remained higher in high fat fed groups. Prednisolone treatment, by contrast, resulted in decreased BW, decreased feed efficiency, increased FHS index, and elevated blood lipid levels. 5. The results suggest that high dietary fats do not affect FHS incidence in broilers. Prednisolone treatment causes hyperlipidaemia and increases FHS index, and may therefore provide a suitable experimental model of FHS pathogenesis in growing chickens.

Pharmacological treatment of deep brain stimulation-induced hypomania leads to clinical remission while preserving motor benefits.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for Parkinson's disease, but can lead to adverse effects including psychiatric disturbance. Little is known about the risk factors and treatment options for such effects. Here, we describe a patient who reproducibly developed stimulation-induced hypomania when using ventrally located electrodes and responded well to pharmacological intervention while leaving the stimulation parameters unchanged to preserve motor benefits. In spite of clinical remission, [¹5O]-positron-emission-tomography (PET) demonstrated activation patterns similar to those reported during mania. This case, therefore, highlights an important treatment option of adverse effects of DBS, but also points toward the need for investigations of its risk factors and their underlying neurobiological mechanisms.

[Deep brain stimulation for psychiatric disorders: historical basis]. / Die tiefe Hirnstimulation bei psychiatrischen Erkrankungen : Historische Grundlagen.

Deep brain stimulation (DBS), which is already established as an effective treatment for movement disorders, such as Parkinson's disease, is increasingly being considered as a therapy option for mental diseases. Due to the increasing number of successful applications of DBS for otherwise therapy-resistant psychiatric diseases, DBS is becoming more and more of interest in fields of fundamental research as well as clinical care. However, the stimulation system is a medical product which has to be neurosurgically implanted and this fact is often used to draw certain analogies to earlier psychosurgical approaches in the era of Freeman. But, looking at the historical development of DBS, as is the aim of the present systematic and literature-based overview, it becomes obvious that DBS did not arise exclusively from the inglorious period of psychosurgery. In fact, two partly in parallel evolving lines of medical progress have contributed to the development of DBS as it is applied today. One of these lines is the use of lesional neurosurgical procedures, such as incision of capsules and cingulotomy, which in contrast to psychosurgical interventions in the era of Freeman, is aimed at subcortical structures and provides important basic knowledge for the choice of target points. In addition DBS is rooted in the application of an electrical charge with the goal to stimulate neuronal networks.

Effects of dietary yeast extract on turkey stress response and heterophil oxidative burst activity.

1. Effective nutritional approaches to counteract the negative effects of stress may provide food animal producers with useful alternatives to antibiotics. In this study, turkeys were fed on a standard diet, or the same diet supplemented with yeast extract (YE), to determine if YE would improve disease resistance in a stress model. 2. At 16 weeks of age, half of the birds were exposed to a bacterial challenge using a coarse spray of the pen environment. A subset of control and challenged birds was also treated with dexamethasone (Dex) prior to challenge (Dex/challenge). At 18 weeks, another subset was subjected to a 12?h transport stress protocol (Challenge/transport). All birds were bled and necropsied the morning after transport. The numbers and proportions of blood cells and the heterophil oxidative burst activity (OBA) were determined. Serum corticosterone (Cort) levels of male birds were measured using a commercial ELISA kit. Body weight and gain were increased by YE during week 1. 3. YE decreased mortality and bacterial isolation following Dex/challenge only in females. Cort levels in male turkeys were decreased by YE and Dex treatment. OBA was higher in males and in birds given YE and was reduced by challenge and transport. 4. These results suggest there may be gender differences in the turkey stress response and that dietary YE has potential for modulating the impact of stress on innate immunity of turkeys.

[Autism spectrum disorders in adulthood: clinical and neuropsychological findings of Aspergers syndrome diagnosed late in life]. / Autismus-Spektrum-Störungen im Erwachsenenalter: Klinische und Neuropsychologische Befunde Spätdiagnostizierter Asperger-Syndrome.

INTRODUCTION: High-functioning autism (HFA) and Aspergers syndrome (AS) are autism spectrum disorders (ASD) characterised by disturbances in social interaction, both verbal and non-verbal communication and repetitive and/or restrictive behaviour since early childhood. Symptoms appear generally during early childhood and adolescence. The increasing need to clarify diagnostic queries in advanced age led to the constitution of specialised outpatient clinics for adults involving a growing amount of HFA/AS subjects diagnosed late in life. However, thus far neuropsychological data about this group are scarce. METHODS: We present a subgroup of 39 patients with HFA/AS (mean age at diagnosis 31.1 ± 8.9 years) who were consecutively diagnosed at the autism outpatient clinic at the Department of Psychiatry at the University Hospital Cologne. Autistic symptoms (autism spectrum quotient; AQ), depressive symptoms (Beck depression inventory; BDI), general intelligence (HAWIE-R), social cognition ("theory of mind", ToM) and executive functioning (COWAT) were systematically studied in comparison to a control group matched for age, education, gender and intelligence (n = 39). RESULTS: HFA/AS subjects presented higher AQ scores (40.4 ± 5.2) as opposed to the healthy controls (13.5 ± 4.8). Neuropsychologically, patients showed deficits in social cognition, executive functions and in subtests of HAWIE-R related to verbal comprehension and perceptual organisation as opposed to the healthy control group. DISCUSSION: The diagnosis of autistic disorders in adulthood basically relies on the clinical assessment of autistic core symptoms which were corroborated by high AQ values. The self-rating instrument AQ was found to be highly discriminative between the HFA/AS group and the healthy control group. The neuropsychological profile of adult HFA/AS patients diagnosed late in life is compatible with that of previously investigated HFA/AS populations. These findings show that such basic autism-associated deficits persist until adulthood, although patients are able to learn social rules.