local interview

[Sophist]

http://www.wdrb.com/story/16103395/doct ... ltrasounds

Tell me whatcha guys think.

(And, yes, I couldn't resist and posted a comment below. I'm "flibbit". Probably a bit of a cheat considering I'm the first author on all these papers, but I wasn't the one interviewed. )

[Aspen]

It's interesting, but I only had two ultrasounds and my daughter is autistic.

How strong is the correlation, if you know?

[goddessoflubbock]

Sadly I had a ton with DS. Only two with my oldest and one with kiddo number 2. Oldest had no prenatal care whatsoever with DD which may explain some things...

[renaeden]

I can only add my experience here: I didn't experience ultrasound as it was uncommon in the 1970s. But I was x-rayed twice before I was born. My mum still has the x-ray films. I have a twin, she is not autistic.

All my nieces and nephews experienced ultrasound before they were born but I don't know how much. My twin's youngest son probably had the most as he had a tumour on his lung (benign) that was monitored closely before he was born. He is not autistic. I don't believe autism runs in my family.

[Sophist]

It's interesting, but I only had two ultrasounds and my daughter is autistic.

How strong is the correlation, if you know?

At present, there has only been one study that's looked at correlation between number of ultrasounds and autism and it returned null results. However, it's really difficult to look at a variable that may act differently on different subpopulations. While there may be some risk associated with timing and/or number/duration, it may also heavily rely on factors innate to the developing fetus.

Ultrasound and autism may not be related in the slightest. But the biggest problem that I see, and which Manny occasionally touches on amidst all his fervor, is that we just don't know. Originally, when Manny came to me with the idea to write an article proposing a potential link, I thought it sounded kinda crazy. Let's face it, at face value it sounds like yet one more causal Holy Grail that the pro-cure groups would latch onto: something environmental to blame. And the crazier-sounding the better.

BUT, I gotta be honest, as I went deeper and deeper into the literature, I've realized how potentially dangerous a tool this is and how lightly it's treated by both the medical and lay communities. Ultrasound isn't a camera and this is anything but a picture. It seems to do a number of things to a cell. For one, the force it creates actually promotes the production of free radicals and those free radicals trigger lipid peroxidation. High levels of free radicals are dangerous because they are highly reactive substances that are short of one or more electrons. So in order to fill up their outer valence and find a more homeostatic state, they steal electrons from other compounds. Usually, they do this from the molecules that are the weakest and easiest to steal from. In the case of a cell, this usually means the polyunsaturated lipids (yup, polyunsaturated fats that you see listed on the backs of food products, the "good fats" as they say) because they have a double-carbon bond which, compared to the rest of the atoms in the lipid, is a really weak bond and easy to break. Other lipids, like monounsaturated and especially saturated fats are more resistant to the effects of free radicals. The problem with this is that lipids make up the cell membrane. So ultrasound initially targets polyunsaturated lipids within the membrane, free radicals stealing electrons from these lipids, which in turn turns the fats into a proxy radical which then starts a chain reaction of electron-stealing throughout the membrane. After a brief period pores appear in the membrane which can let in a number of molecules that, under most conditions, are normally kept out except under certain circumstances, like the firing of a neuron. Free radicals can also attack the membrane that surrounds the DNA (the nuclear envelope), causing problems. In addition, they can make difficulties for the mitochondria because the mitochrondrion uses oxygen (a potential initiator of free radicals) to produce ATP, which is the energy source of the cell. And last but not least, free radicals can actually act as transmitters and trigger a whole host of communicative changes within the cell, basically sending it the wrong message. What this can do, if the cell itself is not damaged (which usually it isn't to any considerable extent under diagnostic intensities) this can instead redirect the cell towards an alternate development. Cells are highly reliant on timing and location for their cues as to what to develop into, and so ultrasound has great potential to communicate to the cell incorrectly and put a cell onto the wrong developmental track.

Now, just picture you're shooting all this at your baby. Even though I'm the one doing most of this research, I'm not quite sure if it's involved in autism. But the important thing in my mind is simply that we don't understand ultrasound enough and we're subjecting our kids to it. That's pretty scary. And so in the meantime, I definitely recommend extreme caution to anyone who's pregnant or considering getting pregnant. Don't use it unless you really need it.

[adhocisadirtyword]

I had two ultrasounds with each of my children - both to check for genetic conditions. Since I only know 1/2 of my family history, I thought it was important. But with Elliot, it was after months of researching ultrasounds and their harmful affects on the fetus.

I will say this - it was difficult to find anything at all on the internet - even just 3 years ago. And what you've written above, Sophist, is more than I ever saw. Most of the concern was about sound waves stressing the baby out.

If we were to have a third child, I don't think I would do it again. After 2 kids who are really healthy, I'm liking the track record. But I doubt that kid wouldn't be on the spectrum considering that the 2 I have now already seem to be. Ava just took longer to show it.

As for the trend, when I was doing the research with Elliot, I found many sites talking about how women are getting 7+ ultrasounds during their pregnancies mostly due to amniotic fluid issues. I believe we're over-thinking this whole amniotic fluid thing though (it can vary greatly based on what you're drinking) and *most* of those were unnecessary.

[Sophist]

The strange thing about ultrasound research is that it's divided into sects. Most of the work I've managed to dig up (which took some time and learning what to keyword) has not been focused on prenatal ultrasound. Instead, I've looked through numerous articles focusing on ultrasound's use for medication delivery with the added enhancement of "microbubbles" (this effect mainly through what I spoke about with sonoporation of the cell membrane), for transfection of viral DNA into the cell which is popular in research, for US' use in the study of the cardiovascular system in that not only does it provide an image but it also triggers vassodilation, it's use (at super-high intensities) as a tool for neurosurgery not unlike laser and can be utilized to remove damaged tissue, and finally, from looking at what is known of ultrasound in the field of physics and how it's used in such things as food preparation, e.g., it can be used to "clean" some grains and nuts.

I suspect the reason that there isn't more caution with the method in prenatal care is that the researchers who've done more basic research on ultrasound biophysics are not in healthcare research and so their publications have not tended that way.

[SomethingElse]

Couldn't low rats of autism within the Amish community be a sort of illusion due to their lifestyle? Lots of routine, the same rules for everyone, and close communities, that kind of thing?

In fact, on watching a programme about the Amish, R commented that she thought that lots of the people on the programme seemed to have autistic traits, despite probably not being autistic (she thought it was probably because of the nature of their lifestyle and beliefs), which made me wonder whether an autistic person would go undetected in that environment.

[Sophist]

That's possible. Or it could also be due to other factors in their lifestyle. They seem to focus more on farming; I doubt they use things like pesticides. Most of their food is probably pretty simple and fresh. And they don't live in the city.

The more I learn about epigenetics, the more I start thinking that our chemical environment has really changed and that's altered aspects of our development.

[adhocisadirtyword]

I agree. The more thinking I do on this, the more I want to live in an environment without any extra chemical influence, although that is becoming more and more difficult. Even the amish have cars driving through their areas - sometimes quite a few cars. When I was in Maryland, my mom took us to an Amish community with a huge buffet-style restaurant and an enormous grocery store. I'm sure the profits from these places went to the community, but they were far from amish outside of some handmade gift items. And the parking lot was packed.

I feel like people look at me like I'm the unabomber though whenever I say that I'd like to be self-sustained and off the grid.

It just seems to me that if I agree with certain scientific principles, it would be weird to think that humans evolved to require all this technology and advancement. Plus - medical advances are quickly leading to vast over-population. Humans are supposed to die. Much earlier than they do today. Not that I want to kick off very soon, but I also don't want to be on 30 pills a day when I'm 80. There's a balance. Although, when I'm 80, I may have a different opinion.

I wanted to add that none of this was meant to offend... just my own personal ramblings. I re-read and realized that I came off as somewhat callous which was never my intention. When I'm talking about over-population, it's due to things like major surgery or chemotherapy on a 90 year old. This also affects healthcare costs.

My grandfather was 95 before he needed anything major done to him, besides some skin cancer treatments and a prostrate surgery a decade ago. But when he needed the major stuff, they started spending hundreds of thousands of dollars to extend his life. Why? He was 95. No - I wouldn't want to lose him any earlier and I absolutely adored every minute with him. But 95 is not the time to try to start extending someone's life.

[Sophist]

On a related topic, since I just happened to run across it. Apparently the pores created in a cell membrane by ultrasound are not simply from oxidation-reduction (redox) mechanisms but are from the hydrophobic effect. Water is pushed towards the membrane, the latter which is highly hydrophobic at its core but hydrophilic at the portions that face outward and inward. Ultrasound forces the water into the membrane, which ultimately disrupts the membrane for a brief period of time. (Picture that the membrane isn't a solid but a liquid viscous fat.)

http://physics.aps.org/story/v26/st2

So, it creates holes in cell membranes and floods the cell briefly with free radicals.

I seem to recall we were somewhat careless with radiation in the early days too...