Neuropsychiatric Disorder Tackled by Innovative Cell Therapy-A Case Report in Autism

Case Report

J Stem Cell Res Transplant. 2014;1(1): 1004.

Neuropsychiatric Disorder Tackled by Innovative Cell Therapy-A Case Report in Autism

Sharma A1, Gokulchandran N1, Shetty A3, Kulkarni P2*, Sane H2 and Badhe P1

1Department of Medical Services and Clinical research, NeuroGen Brain and Spine Institute, India

2Department of Research & Development, NeuroGen Brain and Spine Institute, India

3Department of NeuroRehabilitation, NeuroGen Brain and Spine Institute, India

*Corresponding author: Kulkarni P, Department of Research & Development, NeuroGen Brain and Spine Institute-StemAsia Hospital and Research Centre. Plot 19, Sector 40, Nerul, Next to Seawood Station (W), Off Palm Beach Road, Navi Mumbai-400706, India

Received: June 28, 2014; Accepted: Aug 04, 2014; Published: Aug 06, 2014


Autism is a pervasive developmental disorder affecting socialization, communication and behavior. Neuropathology of autism spectrum disorders is poorly understood and may involve impaired connectivity in the brain, selectively affecting parts of the brain forming circuits supporting social behavior. The currently available treatment options do not address the core neuropathology of autism. Hence, it is important to develop a treatment modality for autism at the earliest. Cell therapy is recently emerging as a potential treatment option for autism. We hypothesize that it may assist in the repair of the disrupted neuronal circuit. The neural repair may take place not only by cellular restoration but also by paracrine and immunomodulatory effects. Cellular therapy has shown promising results for various other neurological disorders. We administered autologous bone marrow mononuclear cells, intrathecally in an 11 year old boy diagnosed with autism. He was assessed for a follow up period of eight months wherein his autistic features had reduced. This was objectively supported by improvement in scores of CARS (31 to 25), ISAA (130 to 98), CGI-I (6 to 5) and FIM (104 to 110). This case study may hint towards exploring cell therapy as a potential treatment alternative for autism, in addition to standard approach. A longer period of follow up along with functional imaging may further help us understand the repair of the impaired neuronal circuit at cellular level.

Keywords: Autism; Cellular therapy; Autologous; Bone marrow; Mononuclear cells


CARS: Childhood Autism Rating Scale; ISAA: Indian Scale for Assessment of Autism; CGI: Clinical Global Impression; FIM: Functional Independence Measure; PET CT: Positron Emission Tomography; FDG: Fluorodeoxyglucose; G-CSF: Granulocyte-colony stimulating factor; MNCs: Mononuclear cells; STS: Superior temporal sulcus, FFG: Fusiform gyrus, OFC: Orbital frontal cortex

Case Report

Case Presentation

Herein, we present a case of an 11 year old boy with autism. Mother reported emotional stress throughout the pregnancy and had hypertension in the last 2 months of pregnancy. He was born at full term by normal delivery, cried immediately after birth, with normal birth weight and had no neonatal complications. The motor milestones development was normal, however his speech was delayed.

At the age of 2 years, he was diagnosed with autism as parents noticed poor eye contact along with attention and concentration deficit Over the period of 9 years, the parents observed increased level of hyperactivity, presence of stereotypical and self stimulatory behavior like hand flapping and jumping. Social interaction was poor, presence of odd play behavior, emotional responses were inappropriate to the situation (like he laughed without any reason) and the behavioral issues increased when there was a change in routine. His responses were delayed and the questions needed to be repeated a couple of times for understanding. There was presence of aggressive behaviour like spitting on others or saying foul words. Along with echolalia, his speech was stereotypical and repetitive. He made unusual noises and used meaningless words while talking. Had difficulty in performing fine motor activities and following simple commands. In most of the daily activities of living, he was independent but required assistance in fine motor activities. In spite of regular standard rehabilitation he showed no improvements with respect to eye contact, behavior and social interaction and his autistic symptoms persisted.

Childhood Autism Rating Scale (CARS) score was 31 which are categorized as mild to moderate autism. We also assessed the case on Indian Scale for Assessment of Autism (ISAA). This scale, based on CARS, has domains such as social relationship and reciprocity; emotional responsiveness; speech, language and communication; behavior patterns; sensory aspects and cognitive component. The items are rated from 1 to 5, increasing score indicating increasing severity of the problem. The content, construct and concurrent validity, internal consistency and test-retest reliability, and sensitivity and specificity of ISAA were studied by the members of the expert committee for the development of assessment tool for autism. ISAA was thus found to be a valid tool, with good reliability and high sensitivity and specificity [1]. On ISAA his score was 130 which is categorized as moderate autism. On Clinical Global Impression (CGI) the severity of index (CGI-I) was 6 which is severely ill. On Functional Independence Measure (FIM) his score was 104. The PET CT scan of the brain showed reduction of FDG uptake in the left cerebellar hemisphere, bilateral amygdale and hippocampi (Figure 1).

Citation: Sharma A, Gokulchandran N, Shetty A, Kulkarni P, Sane H and Badhe P. Neuropsychiatric Disorder Tackled by Innovative Cell Therapy-A Case Report in Autism. J Stem Cell Res Transplant. 2014;1(1): 1004. ISSN:2381-9065