Dermatoglyphics in infantile autism

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Dermatoglyphics in infantile autism

  1. 1. THE JOURNAL OF PREVENTIVE MEDICINE2003; 11 (1): 11-17 PATHOLOGY OF DERMATOGLYPHICS IN INFANTILE AUTISM Ana Ţarcă1, C. Barabolski2 1. Department of Anthropology - Iaşi Branch of the Romanian Academy 2. ,,Socola” University Clinical Hospital of IaşiAbstract. The authors present the results of a study on digitopalmary dermatoglyphies ofpatients diagnosed with infantile autism. 137 subjects (67 boys and 70 girls) with 274 fingerand palmar prints, residents in country’s eastern territory have been investigated. Thedermatoglyphic digito-palmary picture revealed a broad range of anomalies or distortions(associated with severe clinical features) both as the frequency of some of the digital orpalmary characteristics and their distribution by sex, laterality and fingers, which differentiatesignificantly these people from the normal population. Occurring both in boys and girls, onboth hands but with priority on the left ones, these distortions contribute to a more completeknowledge of the dermatoglyphic nomogram on the basis of which infantile autism could bediagnosed early. The present study is the first one – at national level – devoted to suchaspects.Key words: dermatoglyphics, infantile autism, anomalies or distortionsRezumat. Lucrarea cuprinde un studiu al dermatoglifelor digito-palmare prezente la pacienţicu autism infantil (67 băieţi şi 70 fete) de vârste cuprinse între 2,5 şi 18 ani, de la care s-aurecoltat 274 amprente. Se constată că, tabloul dermatoglific digito-palmar al pacienţilor cuautism infantil prezintă o gamă largă de anomalii sau distorsiuni (cu grave implicaţii clinice),atât sub aspectul frecvenţei unora dintre caracteristicile digitale sau palmare cât şi aldistribuţiei lor în funcţie de sex, lateralitate şi degete, prin care afectaţii se diferenţiazăsemnificativ de populaţia normală din care provin. Prezente atât la băieţi cât şi la fete şi peambele mâini ale afectaţilor dar cu precădere pe cea stângă, distorsiunile evidenţiate sunt ocontribuţie la cunoaşterea nomogramei dermatoglifice de diagnoză a autismului infantil, avândîn vedere că studiul de faţă este primul de acest gen la nivel naţional.Cuvinte cheie: dermatoglife, autism infantil, anomalii sau distorsiuniINTRODUCTION own hermetic world dominated byKnown also as the ,,Kanner’s unreal images, obsessions and feelingsSyndrome”- the name of its discoverer and pronominal reversal, rituals and(1943), the infantile autism is defined compulsive phenomena (1-4).nowadays as a syndrome characterized Once lacking its communicativeby a large spectrum of neuropsychic function, the child’s language becomesdisorders, manifested by: delayed speaking, a soliloquic, talking to himselfincapacity of verbal communication, stereotypically, producing meaninglessinability of establishing and developing sounds and expressions, repeating adcontacts with the other (close persons literam and evoking ceaselessly pastbeing included), the shrink into one’s 11
  2. 2. Ana Ţarcă, C. Barabolskievents, related to nothing, a state chromosome syndrome and withnamed ,,echolalia”. Tuberous sclerosis (2,6).The syndrome, which is usually Taking into consideration the multipleinstalled around the age of 30 months, forms of the manifestations characterizingrarely earlier or later, is in quite the disease, credit has come to bevarious forms, from mild - more or given to the idea that each autisticless similar to a normal child - to very child’s is an unique case, capable ofsevere ones (1,2,4,5). The first providing a multitude of symptoms forcategory includes the Asperger each psychic function, taken separatelySyndrome (2-4), assuming solely the (1,2,7).presence of some autistic elements, As to the etiology of autism, severalsuch as: anxiety, reduced socialization, hypotheses - including multiple causesutilization of the language exclusively of the disease - have been advancedfor personal benefits, child’s intellect (1,4,7,8). The most widely acceptedbeing not affected at all, and the Ret today one supports the organic natureSyndrome (1,2), affecting almost of autism, and assumes certainexclusively little girls. It is structural and functional anomalies atcharacterized, apart from some bony the level of the cerebral hemispheres -distrophies, sight disorders, height and especially in the parietal zoneweight hypotrophy, or cortical (responsible for hearing, speaking andanthropies, by certain autistic language) in the temporal zonemanifestations, such as: slow diction, (known as regulating the formation ofabsence of social communication, social and emotional habits), as well asrepeated stereotype movements. The at the level of the Calous Body,severe forms of infantile autism are through which the nervous impulsesassociated - in most cases - with are transmitted from one cerebralsevere or moderate mental retardation, hemisphere to another. Actually, bywith epilepsy, dislexy, alalia, hearing magnetic nuclear resonance (MRI) atless, enuresis or double incontinence, brain level (1) a low nervous activitysometimes with the Fragil - X in the above mentioned regions havechromosome syndrome or Martin Bell’s been detected. Such anomalies presentdisease, or with a very rare genetic at the level of autistic brain may bedisease - namely, tuberous sclerosis. inherited (especially in the case ofConsequently, it is appreciated family forms of autism), or they maynowadays that about 75% of autistic appear either during prenatalpersons evidence mental retardation, development (more exactly, in the firstof which 15%-20% with very severe three months of embrionary life, whenforms (IQ - below 34); almost 1 of 3 epidermal papillary ridges are alsopersons are stricken by epileptic forming), being provoked by viral orcrises, while, for about 10% of them bacterian infections, metabolic(boys, especially) the disease is disorders etc., or in perinatal periods.associated with the Fragil - X 12
  3. 3. PATHOLOGY OF DERMATOGLYPHICS IN INFANTILE AUTISMAs to autism’s substrate and genetic anxiety, dislexy, double incontinency.mechanism research is in progress In the most of cases (52.55%) the(2,4,5,9), sustained efforts being made disease was accompanied by moderateby specialists for discovering the mental deficiency, alalie, enuresis,genes responsible for the disease, in hypoacusy. Some patients hadview of a possible, future elimination epilepsy (10.95%). Over 75% offrom the genetic code. Until then, people have been considered withhowever, it is absolutely necessary to disability of first degree, whichestablish some methods and assumes an advanced stage oftechniques for an early identification neuropsychic and physiologicalof children in danger of autism, so that degeneration, suggestively illustrated -an adequate therapy should be applied as we shall see in the following - byprior to the manifestation of any the broad pathological charge of theirsymptoms. As the dermatoglyphic dermatoglyphic picture, too.studies, performed on patients suffering For all indicators of dermatoglyphicfrom Down syndrome, congenital pathology put into evidence, sexualdeafness, or with heart congenital dimorphism and bilateral differencesmalformations, severe ophtalmologic had been also considered, the resultsdisorders or epilepsy (9-13) put into being compared with those of controlsevidence the importance of (normal population) from the samedermatoglyphic indicators for an early region (a group of 200 subjects: 100diagnosis, their application had been men and 100 women).considered as beneficial also in The working methods have been thoseinfantile autism. currently employed in studies ofConsequently, a dermatoglyphic study pathologic dermatoglyphy (9,11,14).on a group of autistic patients,residents in eastern territory, has been RESULTS AND DISCUSSIONdeveloped. The analysis and statistic processing of the dermatoglyphic data of theMATERIAL AND METHODS patients with infantile autism have137 patients with infantile autism (67 shown that both their finger andboys and 70 girls) aged between 2.5 palmary picture show an ample andand 18 years, all residents in eastern strong pathological charge,territory of Romania, have been suggestively illustrated by a multitudeinvestigated in the Mental Health of distortions with deep clinicalLaboratory of Iassy. significance, being an expression ofThe medical records of the patients - their advanced degree of neuropsychicwhose disease began to manifest and physiological degeneration.around the age of 2 years - showed At the level of the whole sample, suchthat, in 36.50% of the cases, autism anomalies are deviations in thewas associated with a severe mental frequency of some of the finger ordeficiency (IQ below 34), with palmar dermatoglyphic characteristics 13
  4. 4. Ana Ţarcă, C. Barabolskifrom the values of normal population on the right hand of both sexes havingfrom which the subjects come, and its major incidence on fingers IV and V.also upsetting from their classical • Palmary dermatoglyphicdistribution line, as a function of sex, distortionslaterality or fingers. A large part of A broad range of distortions, quitesuch distortions had been reported severe as to their pathologicalalso, for other European groups of significance (9,11,12,13); has beenautistic patients (6,8,10), as well as in provided by palmary picture. The firstother severe genetic disorders one, refers to the modification of the(7,9,10,12) - in different ratios – fact classical sequence of the truewhich explains their large clinical patterns’ frequency in palm’s fiveimplications. compartments, that is IV > Hp > III >• Digital dermatoglyphic distortions Th/I > II instead of IV > III > Hp >Patients with infantile autism show a Th/I > II which is the normal case.significantly higher frequency for Such a situation is induced by thearches (A) and a lower one for loops substantial reduction of pattern’s(L) on all fingers, comparatively with percentages in the interdigital spacethe control group (table 1). If, for the III, up to 24.09%, comparatively withnormal population, the two main 36.09% - recorded on the controlpatterns are predominant at girls and group, the difference beingon the left hand, in these patients they statistically significant (p < 0.02). Thiswere more frequently at boys and on anomaly, associated with the otherthe right hand (the last one, for loops, two, equally important as to theirexclusively). malformative effects, consists in theThe arches, usually present on the increase (over two fold) of partial andsecond and third finger, and very total supression of C line (Cx andrarely represented on the others, Co, respectively) compared with therecords quite high percentages on the controls. Cx was more frequent infourth and fifth finger, and especially boys, while Co in girls; both prevailedon the first finger of the left hand on left palms, the tendencies being(15.7% for girls and 10.45% for boys); similar to those of the control groupmany of them had here a radial instead (table 1).of an ulnar orientation - a peculiarity Significantly higher frequencies haveconsidered as a strong ,,malformative been found also for: the presence ofstigmate” for carriers (9,11). the loop with ulnar orientation (LU)A last dermatoglyphic anomaly at the and of 2, 3 or 4 triradia in the samedigital level refers to the significant palm (tt’, tt’t’’, etc); the absence ofincrease of raketoid loops ratio, the axial triradius t in the palm (tΟ)through which the patients of the both and finishing of line T’s course insexes are considerably differential from fields 11 and 12 instead of 13 (all ofthe control group (p < 0.01); it is a them at the level of palm’sdistortion more frequent in girls and Hypothenary); for the arrangement 14
  5. 5. PATHOLOGY OF DERMATOGLYPHICS IN INFANTILE AUTISMof the papillary ridges as a dense and or the Simian Line. The differencesvery dense network in the Thenar/I; between the two groups concerningfor reducing the distance between the mentioned distortions aretriradia a and b, limiting the supported statistically by a p value ofinterdigital space II, much lower than < 0.05, especially when consideringthe normal average value of 21 mm - the male and female series, on wholefor women and, of 24 mm - for men, (table 1).and for the transverse palmary sulcus Table 1. Frequencies of digital and palmary distortions in infantile autism group comparatively with normal population Digital and Infantile autism (137) Control (200) p value palmary Boys Girls Boys + Boys Girls Boys + Boys Girls Boys + distortions (%) Girls Girls Girls A on all fingers 10.60 10.00 10.29 2.50 6. 20 4.35 < 0.03 NS 0.03 L>R L>R L>R L>R L>R L>R L on all fingers 61.19 59.71 60.44 67.00 75.20 71.10 NS < 0.03 0.04 R>L R>L R>L L>R L>R L>R Raketoid type 8.65 9.71 9.10 R - - - 0.01 0.01 < 0.01 loops R>L R>L >L LU in Hp 11.95 7.86 9.85 3.90 2.63 3.26 0.05 NS < 0.02 L>R L>R L>R L>R L>R L>R tt’, tt’t’’, etc. 27.62 36.42 32.11 15.80 17.92 16.86 NS < 0.01 0.01 R>L R>L R>L R>L R>L R>L t0 2.24 7.14 4.75 - - - NS < 0.01 < 0.01 L>R L>R L>R T11 and T12 32.09 28.57 30.30 2.80 3.51 3.15 < 0.01 < 0.01 < 0.01 instead of T13 L>R L>R L>R L>R L>R L>R Dense and very dense 29.85 58.57 44.52 10.90 16.91 13.95 0.01 < 0.01 < 0.01 network in Th/I L=R L>R L>R L>R L>R L>R a-b < than 24 mm 58.39 62.04 60.22 9.80 7.20 8.50 L in M R>L R>L R>L L>R L>R >R < 0.01 <0.01 < 0.01 21 mm in F Cx 36.56 30.30 33.21 16.90 14.50 15.70 0.01 0.02 0.01 L>R L>R L>R L>R L>R L>R Co 5.22 10.00 7.66 2.10 3.20 2.60 NS 0.05 0.05 L>R L>R L>R L>R L>R L>R Transverse 11.94 6.43 9.12 4.10 2.30 3.20 0.05 NS 0.03 palmary Sulcus L=R L>R L>R L>R L>R L>RTable 1 data show that, out of the 9 network from Th/I, Co and the muchpalmary distortions occurring in more reduced a-b distance areinfantile autism, LU from Hp, T11 and present to girls - a dimorphic tendencyT12, Cx and the palmar Sulcus are which, apart from some insignificantmore frequent to boys, while tt’t’’, exceptions, was present in the controletc, t0, the dense and very dense group, as well. 15
  6. 6. Ana Ţarcă, C. BarabolskiOf the two hands, most of the palmary maintain the tendencies occurringanomalies of patients with autism were in the normal population.more frequent on the left palm (with 4. These results could be of use for anthe exception of tt’t’’, etc., and of the early identification of infantilemuch lower a-b distance), being autism in order to establish anrecognized as carriers of the majority adequate therapy.of ,,malformative stigmata” in othermaladies, too (8,9,11,14). With the REFERENCESonly one exception (the reduced a-b 1. xxx: American Psychiatric Associationdistance) these bimanual differences (APA): Diagnostic and Statisticalagree, with those of the control group, Manual of Mental Disorders, Fourthtoo (table 1). Edition, Washington D.C., 1994. 2. Meilă P, Milea Şt: Textbook of pediatrics, Med. Publ. House Bucureşti,CONCLUSIONS 1988, 6: 340-346 (in Romanian).1. The dermatoglyphic investigations 3. Uta F: Autism and Asperger performed on patients with infantile Syndrome. Cambridge Univ. Press, autism, have put into evidence 1997, 37-183. multiple modifications (either 4. xxx: World Health Organization anomalies or distortions) with deep (WHO): International Classification pathological significance, both in of Diseases, Chapt. V, Mental and the digital and - especially - in the Behavioural Disorders. Geneva, palmary picture (up to eight for 1990, 270-287. each patient) being present - in 5. Bowman EP: Asperger’s Syndrome and Autism. British Journal of most cases - on carriers’ both Psychiatry, 1983, 143: 261-265. hands. 6. Langenbeck W, Varga I, Hausman I:2. On the whole group, for all The Predictive Value of Dermato- distortions put into the light, glyphics in the Diagnosis of FRA (X)- significantly higher ratios have Positive Martin Bell Syndrome been found comparatively with the (MBS), American Journal of Med. control group suggesting that the Genet., 1988, 169-175. causal factors involved in the 7. Wing L: Language, Social and development of autistic manifestations Cognitive Impairments in Autism and had been active during the first Severe Mental Retardation. Journal of three or four months of intrauterine Autism and Development Disorders, 1981, 11: 31-44. life, when the epidermal papillary 8. Sank D, Sank BD: Finger Prints and ridges were finished up. Laterality Preferences of Early Onset3. The digital anomalies are mostly Autism. Birth Defects, Original accompanied by some significant Article Series, 1979, XV, 6: 678-695. deviations from the classical line of 9. Schauman B, Alter M: Dermatoglyphics the sexual dimorphism, of the in Medical Disorders. Springer Verlag, bilateral differences, or distribution New-York-Heidelberg-Berlin, 1976, 253. on fingers; the palmary ones 16
  7. 7. PATHOLOGY OF DERMATOGLYPHICS IN INFANTILE AUTISM10. Ţarcă A: The population dermatogyiphics 13. Ţarcă A, Barabolski C: Contributions to in three Romanian provinces. Thesis, the Dermatoglyphic Diagnosis of Univ. of Iaşi 1995, 171-217 (in Epilepsy. Journal of Preventive Romanian). Medicine, 2002, 10 (2): 28-35.11. Ţarcă Ana: La valeur diagnostique 14. Loesch DZ: Dermatoglyphics Methods des dermatoglyphes. Jurnal de in other Types of Malformations and Medicină Preventivă, Iaşi, 1998, 6 (1): Diseases. Quantitative Dermatoglyphics, 11-24 (in Romanian). Oxford Univ. Press, 1983, 315-331.12. Ţarcă A: Contribution a l’étude de la pathologie des dermatoglyphes. Anthropo, 2001 b, 51-60. 17

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