Case study: Rapid recovery from autism after treatment of aspergillus (2020) | Hacker News Reader

Case study: Rapid recovery from autism after treatment of aspergillus (2020)

pubmed.ncbi.nlm.nih.gov

77 pointsoldschoolib60 comments

If you’re inclined to take this paper seriously, or if you feel like reading a very badly produced article, I recommend reading the full paper. It’s just a few pages, and a light read.

Also, you’ll get to ponder how in the “List of abnormal clinical symptoms of the child with an autism spectrum disorder prior to antifungal therapy”, the first entry is “Silly”.

No standardized assessments of autism (e.g. the ADOS) are mentioned. While there are other genuine autism symptoms mentioned, it’s unclear if any other professional assessed the child, or if both the diagnosis and subsequent statement of cure were done by this guy with his pet theories.

I honestly thought you were joking or at least over exaggerating. You aren’t, haha.

Some others from that list:

- Curious/into things

- Likes fans

- Farting (stinky)

- Looks sick

Amazing criteria.

If this is for children I think we get a clinical diagnosis of 150% autism amongst the 3-5 cohort.

Today I learned I have autism, according to this list at least

This makes me wonder if there is research on pathways that 'cause' autism, or perhaps how we can find the 'vulnerability' which then is 'exploited' by something using those pathways.

I'm using a bunch of quotes in there because I'm not well-versed enough in medicine terminology to know what the correct wording would be (and as such I also haven't had much luck in searching PubMed or NIH for that matter).

I would imagine that much like other complex systems, there are many similar outcomes that emerge from different chain reactions, and understanding one precursor is only a small part of the first link in a rather complicated chain.

As far as I'm aware, the autistic neurotype is caused by a different distribution of connections in the brain, caused by a deficiency of some chemical that I can't seem to find the name of (I swear I saw it somewhere, but there's too much SEO garbage for anything to find things other than vitamins and anti-vax propaganda). ASD is diagnosed by disordered symptoms that are consistent with autism, and can sometimes occur in people who do not possess the actual neurotype, but still have something else that causes those symptoms. (What the "something else" might be is something I do not know.)

If you ever find out the name of that chemical, I hope you'll post it on the chance I'll see your reply. I'm very curious to know more.

https://www.spectrumnews.org/news/connectivity-theory-autism...

> Some of this work indicates that autism is characterized by underconnectivity between distant brain regions and overconnectivity between neighboring ones; others show differences in connectivity within certain brain networks. In one study, connections within the default mode, or ‘daydreaming,’ network of autism brains looked especially weak.

> For example, mutations in the autism-linked genes MET and CNTNAP2 produce patterns that differ from those in people without these mutations.

https://www.spectrumnews.org/news/cntnap2-variants-alter-bra...

> Ashley Scott, a graduate student in Geschwind’s lab, scanned the brains of 16 high-functioning boys with autism and 16 age-, sex- and IQ-matched healthy controls during a difficult memory task that requires activity in that brain circuit. She also collected saliva samples from the children to see which ones carry the CNTNAP2 variants.

> Because the variants are common in the population, most participants — 11 of the children with autism and 12 of the controls — have at least one copy.

> Scott found that these children have increased connectivity among local areas of the prefrontal cortex. In contrast, long-range connections between the prefrontal cortex and the posterior cingulate cortex — a region toward the back of the brain that’s part of the frontal-striatal loop — are significantly stronger in the children who do not carry the risk allele.

I don't remember if this is it or not, but there's something that stimulates the generation of long neural connections, and a deficiency in something can cause those connections to be shorter on average - you end up with the same amount, but they are distributed differently and more localized, which is what causes the "attention to detail" effect (as well as underutilization of potential connections, and connections between unwanted areas).

Still trying to find the original source where I heard that, though. Sucks that I do so many of my impulse searches in incognito mode.

Appreciate the info and links!

The paper is dated August 2020. Does anyone know a follow up study done?

https://www.youtube.com/live/qw_tta3W7Rk

Authors are discussing this anecdotal paper here.

The child and/or his mother would have been in each newspaper and late night shows at this time telling everybody his history. As that didn't happened in three years, the recovery seems either temporary or fake, unfortunately

Autism diagnosis are based on nothing more than behavior. The facts here are that one child behaved in a manner consistent (enough) with the criteria for ASD. After treating a fungal infection, the child’s behavior changed. I think it’s a stretch to associate fungal infections with autism. There are probably many ailments that could trigger typical ASD behaviors.

You are correct. The autistic neurotype is a different pattern of brain development that cannot be cured in this way; nonetheless, a diagnosis of ASD can be assigned to anyone who shows disordered symptoms consistent with being autistic. Therefore, there are certainly people out there, diagnosed with ASD, but who do not possess the autistic neurotype, and who thus may be treatable.

> I think it’s a stretch to associate fungal infections with autism.

I think this tends to discount the emerging narratives about the link between gut microbiome and neurotransmitters.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504309/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234057/

https://www.frontiersin.org/articles/10.3389/fcell.2021.6491...

https://www.theatlantic.com/health/archive/2015/06/gut-bacte...

People are not used to this idea that what happens in your microfauna may play this super important role in what happens in your head, but there are already links to things like parkinsons and anxiety/depression.

To me it's not a stretch to associate fungal infections with a neurological disorder or symptom presentation at all, it's a pretty natural extension of the research that's happened over the last 10-15 years. And in several (human) case studies and research scenarios (mice), there is evidence for an actual causal link and not just "people with neurodivergence have fucked up microbiomes" too - treat the microbiome and you treat the parkinsons, or the ASD, and you can induce autism-like symptoms in mice by infecting their microbiome with B. fragilis.

Not a doctor but this does seem like probably the biggest thing people have tended to ignore (studiously, in some cases), that microbiome might play this huge role in things like weight or mental health. 100 years later, we are going to look back at this as an obvious case of science more or less ignoring what was right in front of our faces because it wasn't medicalized yet.

Another comment about this got flagged for tone/snark, but I think the Wikipedia link for one of the coauthors is actually really valuable information, so posting without the snark:

https://en.m.wikipedia.org/wiki/William_Shaw_(laboratory_own...

Now, does this work with adults too?

Maybe highly functioning autists are what recovery looks like.

Might be a quack, but I would not put it past the idea that fungi can act in different ways within our bodies, especially if our immune system is weak where it might be more opportunistic rather than non harmful for healthy immune systems.

Paul Offit also has a great book on the other topic of what to look out for when it comes to quackery called "Do You Believe in Magic?" where he talks about Jenny McCarthy and various doctors who tried to support that movement.

They give a 6-year old 600 mg of itaconazole per day when the adult dose is 400 mg/day and there is a risk for liver damage because he is "silly", "jumps", "shrieks" and has "foul stool odour"?

This kind of quackery has crossed into abusive territory, and heavy flogging as seen as in the Passion of the Christ would be appropiate for the physician and the parents.

Wow, thats kind of mind blowing. If the cause has been as simple as fungus this entire time. Looking forward to seeing more research on this.

It's likely that there are many causes of autism. For example, there have been successful results of giving stool transplants to children with resolution of symptoms.

Which also indicates a bacteria cause, no?

ASD is a set of symptoms. There’s likely many causes. If it were commonly caused by infections of the gut people would have noticed more prevalently as anti fungal and antibiotic treatments aren’t uncommon.

Not if you're missing microorganisms. In fact, antibiotics may damage your gut microbiota even further.

The above is just playing with an hypothesis, but there is evidence (unrelated to this case or autism) that gut microbiota is related to psychiatric/personality/mental disorders and stool transplants may help in those cases.

Yeah, probably related to gut microbiota.

Yes, stool transplants attempt to reset the gut to a normal set of flora. The hypothesis is that something upset the flora in the gut of kids with ASD and resetting it resolves the symptoms. When I did research in the field, the thought at the time was that various Clostridia species may be the cause. They are known to produce toxins that can act on neurological cells (think Clostridum botulinum). The thought was these bacteria were more prevalent in kids, and their presence released toxins causing the symptoms. By resetting the gut and getting rid of these bacteria, the toxins disappeared and so did the symptoms. I haven't look at the literature in quite a while so things could have changed.

Amazing! Note that ASD is not necessarily indicative of actual neurodivergence, as you don't have to possess the autistic neurotype to show autistic symptoms. Autistic symptoms, if not arising from actual neurodivergence, can potentially be treated, and I love that there is ongoing research into this.

The problem is that autism is a vague term. There are likely multiple conditions that can cause behaviors that lead to an autism diagnosis. For this kid, they have a fungal infection. For others, there can be lots of things.

Come on people, one case? Was he really properly diagnosed of ASD? How did this get so front page up after all covid and colloidal silver, MMS or hydroxychloroquine

Autism spectrum disorder isn’t a disease like COVID with a known cause. There are likely many things that lead to symptoms consistent with ASD. According to the link the mold infection has biomarkers, and presumably it’s possible that some people who have this infection and ASD can be treated for the infection and might see improvement. However I don’t think the article implies in any way that ASD is caused by mold infections, just that some with ASD AND the mold infection might be treated for ASD when the mold infection is treated.

What I find interesting if other cases are found is the incredible influence our intestines have on our personality and mental processes.

everything is connected, my mom believed my brother's ASD was because of vaccines, I didn't have much of an opinion till I researched it years later and learned it was based on one cooks theories, but this seems like a more sound research study, albeit a small sample size. I'm self diagnosed (3 of my friends with ASD told me I'm probably am on spectrum, because I over share and don't shut up about a subject I like.), my brother's an easier more detectable case. I had to be a lot more independent so learned masking and taught myself coping skills...

This however, seems more reasonable than the vaccines theory because the gut also has some gray matter and our digestive system I think plays some role in our consciousness system, along with neurons, and all the hormones and chemicals that our body uses to transmit signals and all the electricity running through our neural network, etc...

I'm pretty sure an uptick in ASD could very well correlate with environmental conditions considering we all have forever chemicals and micro plastics in our blood and those probably have some effect on hormones and internal body chemistry.

Another explanation could be found in the DNA where siblings share the same traits even at a family distance > 3.

I would guess microbiome over any chemical or plastics being a major factor.

If you refer to 1 case as "small sample size" you need to review all the research process in order to even start building your own opinion.

When my son was diagnosed with autism a quarter century or so ago, we would see claims like this popping up now and again. At first we would get excited, but over time we learned to ignore them. Desperate parents make easy targets for grifters and quacks so you have to expect this kind of thing. The worst part is when well-meaning family and friends keep excitedly sending you articles or giving advising you on these exciting new treatments.

My special needs brother predates autism. I was always annoyed with the question 'what's wrong with your brother' as if slapping a label on him would fix things. And big picture there isn't anything wrong with him other than a few deep deficits which no ones going to be able to undo.

My brother has a few friends with similar deficits, just different ones. That makes me dubious of the idea of autism as a particular 'disease'. In fact I find the disease model insulting.

I think current approach of neurodiversity agrees with you.

Nowhere the article claims that such infections are the only cause for autism.

It’s just one datapoint, but it’s an _interesting_ datapoint nevertheless, because it seems so unrelated. A good starting point for an investigation, I’d say.

> Integr Med (Encinitas)

Don't trust anything at face value because it's written in an article, specially if it's published in a terrible journal.

But we need replication, replication is the way! Feynman wrote something about this, I recall. Someone proposes that the moon is made from Wensleydale, and NASA goes up and brings back some rocks. "It's made from rock", you say, but someone else says "it's actually made from Gouda, but some rock has fallen onto it". So the Russians go up and return more rock, and another proposes it's made out of Limburger. And so on.

n=1.

I keep warning Hackernews not to trust fungi, and people downvoted me for it. But I keep getting proved right. Don't trust those spores. They're everywhere: in the trees, in the breeze, even our cheese.

don't forget beer and bread! it's EVERYWHERE

Fungi is way too broad a category to "be suspicious of", there's lots of harmless fungi that are basically ubiquitous. And as you note, lots of it in food, often with supposed benefits.

Lol

https://en.m.wikipedia.org/wiki/William_Shaw_(laboratory_own...

Leave it to HN to fall for grifters, but then again I suppose this must just probably just a massive conspiracy by the big bad Illuminati or something to profit off mainstream understanding of autism and we should trust the “science” this time. (To be fair, I can’t find anything that points to the main author being nearly on the same level of quackery, but having this guy on there hardly instills faith)

Just because someone has a history of being deceitful and making up things to further their own agenda, that doesn't mean we should discount everything they say - especially when it's an extraordinary, n=1 result in the case of a complex disorder.

And honestly, it's kind of disrespectful to bring up someone's history of grifting in this context. We should trust each other more, not less, and that starts with believing people who suggest suspiciously easy answers to questions that have hitherto resisted easy answers.

Are you serious? That is literally exactly what we should.

Can decide if I should upvote this because it's great satire, or downvote it because these days it feels like half the arguments you see online are proposed sincerely but they sound like sarcasm to me.

Yes, because the hallmark of great satire is that you cannot tell.

Agree with what you've said, but I think this post is also a lesson in how grifters try to "legitimize" their schemes. Look, this paper comes from "nih.gov". I mean, the National Institutes of Health is surely a reputable source! Point being it's not immediately apparent that pretty much anyone can get a case report published like this. If the report was instead posted a on Great Plains Laboratory blog, I think folks would have been more critical. Obscuring the origin of dubious reports is a classic technique that you see in Snopes entries all the time: eventually something gets repeated enough that it is taken as fact even if nobody can remember where it came from in the first place (e.g. "you should drink 8 glasses of water a day" is made up bullshit).

Not an expert but the wiki article says he proposed a link with acetaminophen, which has recently been demonstrated by papers and spawned a lawsuit: https://www.spectrumnews.org/news/acetaminophen-on-trial-ove...

Two points:

1. Lawsuits are completely irrelevant to what is actually causative. E.g. there is essentially no evidence silicone breast implants are carcinogenic, but that didn't prevent implant manufacturers from going bankrupt due to legal judgments.

2. From your own link: "The studies in people are observational. Some conditions that might prompt acetaminophen use during pregnancy, such as fever and severe infection, are themselves associated with autism and ADHD in children." Observational studies may be a good point to start further investigation, but given how many observational studies have been thoroughly debunked from a causative point of view, they should be completely ignored as evidence IMO.

Oops I got curious and went down a big rabbit hole.

There’s a lot of interesting observational research on this topic, and in particular I found this paper[1] interesting because it shows a similar link with Tylenol and autism in young infants, but did not find the same effect for ibuprofen, which to me almost rules out fever/infection as the root cause.

There was another paper I saw that even suggested the anti-vaxxer conspiracies may stem from the fact that doctors and parents give Tylenol to their kids to manage the side effect of some vaccines.

Interestingly, there is also a separate body of research[2] that has shown experimentally that acetaminophen causes emotional blunting and reduced empathy in adults - could be related?

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044872/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455058/

Can you please make your substantive points without snark or (to use the wording from https://news.ycombinator.com/newsguidelines.html) sneering at the community?

It's human nature to make ourselves feel superior by putting down others, but it skews discussion in a way that goes against what we're trying to optimize for here (https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor...).

Edit: it looks like you've unfortunately been breaking the site guidelines in a lot of what you've been posting here. Can you please review them and stick to them? I don't want to ban you but we end up not having much choice if an account keeps posting in this low-quality way.

This is the second terrible autism fake science article on the front page today after https://news.ycombinator.com/item?id=37716167

As someone who was diagnosed with ASD, I wish William Shaw a very merry lengthy prison sentence for a career of fraud, theft, misrepresentation, and maybe even a dash of practice of medicine without a license.

The guy is a menace, and is Facebook Karen Mom bait to the highest degree. He has done more to harm research into ASD than almost anyone, being second to only Andrew Wakefield (the only man ever to get a straight up middle finger from The Lancet for managing to slip one pass them, and getting a front page retraction for his trouble).

ASD exists, its real, it is a collection of symptoms that likely have multiple causes, and we know why that is likely true (immune system cross-reactivity in the parts of the immune system we don't understand well, and is also likely the root cause of a lot of poorly understood conditions; this is why there is also a high rate of ADHD comorbidity in ASD people).

The gut most likely is the "culprit" in the sense that the gut bacteria is no longer sending the correct chemical signals to engage the immune system, and the immune system gets confused and thinks we're stuck in some sort of Cold War with an Unseen Enemy, and just slowly fucks you up, but we simply don't understand this well enough for anyone to even consider something as a possible "cure". William Shaw is undermining the process and making it harder for actual researchers to research a possible cure.

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