Key Players in Autism: IV. The Brainstem

The reaction to this blog about the role of the brainstem in autism was a complete surprise to me. It has received over 2,000 views in less than a year of its being published. The only other blog that has received more publicity relates to ultrasound. Since I wrote the blog not much has changed. Jerzy Wegiel should have an article published on the neuropathology of the brainstem in autism some time in the near future. Otherwise the only clarification that I would like to make is the fact that Patricia Rodier’s initial case history may have been one of syndromic autism rather than idiopathic autism. The fact that her patient had missing cranial nerve nuclei suggests a Moebius sequence (see ).

Cortical Chauvinism

In the central nervous system the brainstem links the brain to the spinal cord. This anatomical structure is usually divided into different portions, from top to bottom, these are the midbrain, pons (meaning bridge), and medulla. Though small, relative to the size of the brain, the brainstem provides a conduit to sensory and motor projections, and to the majority of cranial nerves. In terms of function, the brainstem serves to modulate vegetative aspects of the body such as breathing, sleeping, and heart rate.


Many core symptoms of autism involve the person’s ability to process thoughts (so-called higher cognitive functions) and probably stem from deficits of the cerebral cortex. However, other symptoms such as diminished facial expression, hypersensitivity to sound and touch, and sleep disturbances could have an origin within the brainstem. In effect, a rare birth defect caused by the underdevelopment or absence of cranial nerves, Moebius syndrome, is usually…

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