Electroencephalographic measures of the neurophysiological dysfunction underlying autism have been nonspecific and incomplete. Studies using electroencephalographic methods have been fraught with subject sampling bias, a lack of standardized techniques and measures, and a lack of appropriate control groups. Low-functioning autistic children with age-matched normals, age-matched mentally handicapped, and mentally age-matched normal toddlers were tested using a computerized electroencephalographic technique. The autistic children showed significantly more slow wave activity and less alpha, as well as less inter- and intrahemispheric asymmetry than either normal or mentally handicapped children. In general, electroencephalographic features of autistic children closely resembled those of the toddlers, supporting a model of maturational lag as the key descriptor for autistic CNS functioning. A model of diminished cortical differentiation is proposed to account for the low level of intellectual functioning.

A comprehensive diagnostic evaluation was administered to 162 closed head-injured patients within 1 to 21 days (mean, 7.5 days) after injury. Each evaluation consisted of (1) power spectral analyses of electroencephalogram (EEG) recorded from 19 scalp locations referenced to age-matched norms, (2) brainstem auditory evoked potentials, (3) computed tomography (CT)-scan, and (4) Glasgow Coma Score (GCS) at time of admission (GCS-A) and at time of EEG test (GCS-T). Functional outcome at one year following injury was assessed using the Rappaport Disability Rating Scale (DRS), which measures the level of disability in the six diagnostic categories of (1) eye opening, (2) best verbal response, (3) best motor response, (4) self-care ability for feeding, grooming, and toileting, (5) level of cognitive functioning, and (6) employability. The ability of the different diagnostic measures to predict outcome at one year following injury was assessed using stepwise discriminant analyses to identify patients in the extreme outcome categories of complete recovery versus death and multivariate regression analyses to predict patients with intermediate outcome scores. The best combination of predictor variables was EEG and GCS-T, which accounted for 74.6% of the variance in the multivariate regression analysis of intermediate outcome scores and 95.8% discriminant accuracy between good outcome and death. The best single predictors of outcome in both the discriminant analyses and the regression analyses were EEG coherence and phase. A gradient of prognostic strength of diagnostic measures was EEG phase greater than EEG coherence greater than GCS-T greater than CT-scan greater than EEG relative power. The value of EEG coherence and phase in the assessment of diffuse axonal injury was discussed.

A B S T R A C T The intestinal absorption of [3H ]-pteroylmonoglutamate (simple folic acid) and pteroyl-,u[14C]glutamyl-y-hexaglutamate ([14C]PG-7, conjugated folic acid) was assessed by the method ofjejunal perfusion in five patients with proven celiac sprue who were studied after a gluten-containing or a gluten-free diet, and in nine normal subjects. The luminal disappearance of each folate was markedly impaired after exposure of the patients to dietary gluten and improved by gluten restriction, but not to within the range found in the normal subjects. In each experiment, column chromatography ofthe luminal aspirates revealed similar spectra ofhydrolytic products of [ sults of in vivo hydrolysis suggests that measurement of the enzyme in whole mucosal homogenates overestimates its significant digestive activity. The present studies indicate that (a) the mucosal lesion of celiac sprue significantly limits the intestinal absorption of both simple and conjugated folate, and (b) malabsorption of conjugated folate results from a combination of impaired hydrolysis and decreased mucosal uptake of hydrolytic product.

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