HECKENLIVELY ON THE OMNIBUS AUTISM PROCEEDING: 5/21

Dr. Rust is a little “Rusty” about What Causes Autism – The Omnibus Autism Proceeding – Second Set of Hearings (Thimerosal & Autism) – Day Eight – May 21, 2008

By Kent Heckenlively, Esq.

There are times when I can’t help but observe that on many issues that both sides are seeing something similar, but the pro-vaccine side can’t see how many indicators point to vaccines as a possible cause of autism.

Direct Examination of Dr. Rust (Witness for the Government)

Dr. Rust is a pediatric neurologist, has numerous peer-reviewed articles, book chapters, has his own clinical practice, and is a professor at the University of Virginia Medical School, but what does he know about autism?

He knows how to describe autism.  And he knows that there are some prenatal factors such as exposure to the rubella virus.

Beyond that he can’t really seem to say much definitive about autism.  He thinks about 80% of the children with autism in his practice showed abnormalities in their first year, but he hasn’t published such data and can’t verify it from any other source.

He likens autism to Rett’s Syndrome, but in that malady there is a clear genetic abnormality.  Nothing similar has been observed in autism.  There is a high concordance between twins, but less than the 100% which would be expected.  He can’t explain that difference.

Dr. Rust believes both William Mead and Jordan King have autism, but it couldn’t have come from thimerosal-containing vaccines.  Of great importance to his theory is the increase in the percentile change in head size for William Mead (60th to 96th percentile) and the early loss of words for Jordan King.

As far as Dr. Kinsbourne’s theory of over-excitation he refers to it as nothing more than speculation.

Cross-Examination of Dr. Rust (Witness for the Government)

Even under Dr. Rust’s claim that 80% of his cases show abnormalities in their first year, he agrees that at least 20% show no abnormalities during their first year.

Although he places a great deal of weight on family history, he was not in the courtroom for the testimony of the parents of William Mead and Jordan King.

Dr. Rust acknowledges that in the families of these two boys there is no history of autism
spectrum disorder.  He also acknowledges his claim that 90% of autism is based on some genetic contribution remains to be proven.  In fact, Dr. Rust agrees that only 8-12% of autism cases have identifiable genetic causes.

Dr. Rust believes there are genetic switches that can be turned on and off during development and as a general proposition these can be influenced by environmental factors.

Dr. Rust agreed that there are differences in the brains of normally developing children and those with autism, particularly in the area of activation and blood flow.  There was some controversy over whether William Mead’s earlier head circumference was at the 60th or 80th percentile.  This did not get resolved.

The concept of prenatal virus exposure resulting in autism is something that Dr. Rust agrees with.  He does not believe it can happen after birth.

He is aware that the Institute of Medicine in 2007 had a meeting on the environment and autism, but did not review the published volume.

Dr. Rust acknowledges the 2005 Burbacher monkey study which showed that the mercury depoited inorganic mercury into the brains of infant monkeys at twice the expected amount of mercury.  He also is aware that the mercury accumulated in the microglia and astrocytes rather than the neurons.

Dr. Rust was unaware that the authors of the 2005 monkey study were getting ready to publish the second part of their study, showing that the increased mercury was associated with neural inflammation.

Redirect Examination of Dr. Rust (Expert Witness for the Government)

It is Dr. Rust’s recollection that the amount of mercury given to the monkeys in the study was abnormally large.

Concluding Thoughts on this Day of Testimony

What gives here? 

It’s inconceivable to me that a clinician of Dr. Rust’s experience wouldn’t be present, or at least review the parent testimony regarding William Mead and Jordan King.  There’s a principle in the law that you can’t testify about information you don’t know.  Or as Abe Lincoln once observed, “Sometimes it’s better to remain quiet and be thought a fool, rather than open your mouth and remove all doubt.”

That’s the only explanation I have for why Dr. Rust didn’t testify about the parent history.  It also explains why he didn’t read the IOM report on autism and the environment.  I have read a good deal of it and the thrust of it is looking at environmental exposures.  It makes the point very well that autism is unlikely to be solely genetic.

And amazingly, he says that prenatal exposure to rubella increases the rate of autism.  I’m sure it doesn’t escape the attention of the judges that the MMR shot is really measles, mumps, and rubella.  These viruses are linked together because of their similarities.

Let’s review Dr. Rust’s appearance.

He’s a really smart guy.  But he didn’t listen to the parent testimony in this case, even though that’s a big part of his clinical practice.  And he didn’t review the IOM meeting on autism and the environment.

But nothing in the environment could cause autism, at least not after birth.

However the rubella virus can cause autism before birth.

Oh, and the type of mercury used in the vaccines is deposited at twice the expected rate in infant monkeys.  And those same researchers are getting ready to publish findings which show that the increased mercury is linked to neural inflammation.

Could neural inflammation cause those “big heads” Dr. Rust talks about and some of the behavioral hallmarks of autism?  Dr. Rust says he hasn’t identified any such encephalopathy in his patients.

One wonders if he has even looked.

Kent Heckenlively is Legal Editor for Age of Autism.

Comments

[Angel Ford]

Hi Kent, Well I think your report was very good. I mean, I dont nothen about your subject but it is nice to learn. I am leaving a comment cause I noticed you have the same last name as my maiden name and I was told if your a Heckenlively then your related and I am just trying to find all the family. I can understand how you are a writer cause I love doing the same. But not so lucky in writing for a paper. Anyway, email me sometime.

[Marilyn Abdilla]

Thanks to Kent for great reporting. I must say this 'expert' Dr. Rust talks with fork tongue. Does he actually know anything? Does the CDC or Mr. Offit consider him an expert? If so, I can understand their thinking..all are on his level. It does seem that the respondent's KNOW that the jig is over. The lawyer's have hit them with questions, with facts, and all they can say is 'I don't know'. Rett is not the same as autism. Rett is not caused by vaccines. Why would this expert dwell on Rett in testimony on mercury and autism? I know a female child with Rett and my grandson has autism...big difference. Some symptoms may be similiar in some cases but the cause is completely different. I agree with Jeanne, these experts are making this real easy in these cases. I have always believed that the piece of the puzzle missing in autism would be found, we just had to open the right door to find it. The truth has been known a long time, just hiden from the public for profits. And the CDC should quit acting as agents for the pHARMa companies..conflict of interest big time..along with alot of other agencies and 'government workers.' Hiding data from petitioners only shows 'quilt' and strong distrust from citizens of this country. I have no respect for any of these agencies or companies. Do I care if drug companies fold? Of course not. And we have good reason to feel this way.

[Garbo]

This testimony is so lame that I can't help wondering if the government is choosing to throw the "thimerosal" test cases for a reason: They know the jig is up, and it's the easiest theory for them to control in the aftermath. The CDC, HHS, Pharma, etc. can limit compensation to those families whose injured kids got a particular level of thimerosal in vaccines. It allows them to belatedly remove thimerosal and continue to claim that vaccines are safe without ever having to address the possibility of the numerous viral components being part of the problem. If it's thimerosal, they can address the problem without losing the vaccine program as a whole. If it's viral/genetic/environmental interaction, there is no easy solution.

[Brian]

"He likens autism to Rett’s Syndrome, but in that malady there is a clear genetic abnormality. Nothing similar has been observed in autism. There is a high concordance between twins, but less than the 100% which would be expected. He can’t explain that difference."

Apparently Dr. Rust doesn't know or wasn't able to say much about the genetics of Rett syndrome. The genetic picture for Rett syndrome is actually pretty clear: the profound postnatal neurodevelopmental problems that arise after an apparently normal infancy are associated with mutations that affect the structure or alter the expression of a particular regulatory protein and/or alter the expression of genes regulated by that protein.

How is this related to autism?

First, of course, Rett syndrome demonstrates that a genetic switch (of the type mentioned by Dr. Rust) can allow apparently normal postnatal development for a period and then produce profound changes. (In Rett syndrome, typical early development is followed by loss of social, cognitive, and language skills at around 6 to 18 months of age.)

Second, the regulatory protein (MeCP2) is frequently aberrantly expressed in the brains of autistic subjects, as are the products of several genes regulated by MeCP2. Although mutations in the MECP2 gene are apparently a rare cause of autism, the levels of the protein MeCP2 are abnormal due to factors related to expression of that gene. For example, while 9 of 9 brains from individuals with Rett syndrome showed aberrant levels of MeCP2 protein, 11 of 14 brains from individuals with autism showed significantly decreased MeCP2 levels compared to age-matched controls.

Third, despite the clear genetic picture, Rett syndrome--like autism--can still be discordantly expressed in monozygotic twins. This illustrates that monozygotic twins are not genetically identical, a point that has been repeatedly and convincingly demonstrated in genetic studies.

[Craig (And the Pessimist Wins by a Knockout!)]

The problem with neurologists is that they pretend to know a lot, but the truth of the matter is that no one truly understands the inner workings of the human mind with 100% certainty. This is doubly so for autistic children. So, they come off as pretending to know, when all they do is make themselves look stupid. Yes, I know that this could apply to Dr. Poling, but he knows enough to say, "I'm not sure" when he gives a statement, so he is the exception to the rule. The optimist in me wants to say that these doctors really do want to help people out, that they have a mental block when it comes to the fact that they could possibly have damaged our children through poisonous chemicals in a program that they have learned is life saving. But then, the pessimist in me goes after the optimist with a baseball bat and says, "They are all pHARMa shills...get your story straight!" and then proceeds to beat the optimist into a bloody pulp.

Someone brought up a very good point (sorry, I don't remember who), and it really makes me wonder. What if pHARMa wants to lose in these proceedings? $250,000 is a lot less to pay than the billions of dollars they might have to pay if this goes to a criminal court.

[Not bad, useless]

"For autism, Ped Neuorlogists here are a waste of time and money."

We have seen 3 for my son and each one said that they did not really understand why the seizures occurred and there was nothing they could do about it. All they did was push pills. One even said that my son's blanking out stares were possibly behavioral. Behavioral?? It was excessive ammonia, viruses, and gut issues. Something you can improve with treatment of the bio-medical kind.

You are right, they are a waste of time and money. We need to see them so they can eyeball your child for half an hour and write the next Rx. Or maybe recommend a blood draw and see levels of the meds circulating in your child's blood. Long-term perspective, completely and utterly useless. I, as a parent, knew more about how to *treat* my son's seizures.

[Keith]

I do not think all are "bad". I would refer to Jon Poling. I do wonder what his perspective would be had Hannah not expereinced what she experienced.

I hate to seem so cynical but:

It has been our experience, in our city, that ped neurologists are very limited in what they know and/or communicate to parents. The ones here certainly do little to help other than to confirm a dx. As a rescue angel many of the calls I get are from parents who have just seen one and are looking for help or the "next steps". The ped neurologists "next steps" around here are towards the cashier and out the door. This is very sad as many parents had to wait more than 6 months to be told so very little. They could have just as easily gone through the regional center, received a dx and begun the various therapies and services available sooner (or I should say get on the state services wait list sooner).

For autism, Ped Neuorlogists here are a waste of time and money.

[jeanne]

Kent, thank you (again) for reporting to us. I've noticed a theme with the governments "expert" witnesses... they don't seem to be reviewing research, looking at information, or listening to (or reviewing) previous testimony. It appears to me the government's goal is to come across as if these cases are a total waste of time - not even worthy of review. If they MUST be involved, they'll make sure everyone knows they think it is a waste of time. What they are missing... and I can't believe they don't see it happening right under their noses, is that they are coming across as a bunch of morons. I don't care how big of a waste of time you think it is, you better read everything you can and know it, so that when it is your turn to open your mouth and give your "expert opinion," you sound like one. So on that note, let me just go ahead and thank the government, their lawyers, and all the "experts" who can't seem to tell their a$$ from a hole in the wall.. thanks guys! You're making this REAL easy.