Mr. Powers started by asking what Dr. Kinsbourne meant in his expert report by “putting TCVs on the agenda” for possible causes of autism.  Dr. Kinsbourne thinks any source of mercury should be on the list of environmental factors to consider as a potential cause of autism.  Do you believe to a reasonable degree of medical certainty that mercury can cause autistic symptoms?  Yes. 

How would you distinguish regressive autism from congenital autism?  There are no real differences in symptoms or outcomes.  But regressive autism is startling and dramatic; it’s unlikely that this was not previously picked up in the literature.  Dr. Kinsbourne estimates that clear-cut cases of regression are low, probably below 20%. 

It’s logical to ask if there’s a real rise in the autism incidence.  While Dr. Kinsbourne said that there is diagnostic substitution and greater recognition, he finds it hard to believe that this accounts for the enormous increase in autism rates.

The next topic of the expert report is gene-environmental causes of autism.  Monozygotic and dyzygotic twin studies show that 10-40% of autism cases are unexplained by genes.  We do know certain specific environmental factors that cause autism:  thalidomide in children if given to the pregnant mother at a particular point; dylantin and rubella exposure of the mother while a child is in utero.  There are prenatal and post-natal exposures.

Then Dr. Kinsbourne described the brain structures that are relevant to his opinion – neurons, astrocytes and microglial cells.  He talked about neurotransmitters that work in the brain synapses, and that an excess of glutamate, an excitatory neurotransmitter, can cause problems.  He then explained gliosis – the death of astrocyte cells -- leading to an increase in microglial cells and a decrease in astrocyte cells as discussed in the 2008 Lopez-Hurtado article on language-related cortex cells in the autopsies of autistic brains.  The article’s findings are consistent with toxicity, oxidative stress and neuroinflammation.  This study shows that neuroinflammation actually happens in the human autistic brain.  We know several different causes of neuroinflammation:  viruses; specific heavy metals; and neurodegenerative diseases.

Is it your belief to a reasonable degree of medical certainty that TCVs deliver inorganic mercury to the brain?  Yes.  Thimerosal is 49% ethylmercury. Some goes to the brain after the vaccine, it becomes inorganic mercury and it stays there indefinitely.  The idea that mercury stays in the brain is not controversial. 

On the relationship between neuroinflammation and autism, Dr. Kinsbourne relies on the Aschner study numbered PMRL 0570 in its list of citations.  This article focuses on how mercury becomes neurotoxic.  Mercury inhibits the uptake of glutamate; the increased glutamate is neurotoxic.  Although Dr. Aschner’s paper is about methylmercury, ethylmercury also converts to inorganic mercury in the brain.  Glutamate is an excitotoxic neurotransmitter.  This description fits a model of autism as an overactivated brain or an “over-arousal” model. 

This is not universally accepted, but there is evidence of over-arousal.  The Goodwin study shows that autistic subjects have higher heart rates; they may have a static state of anxiety or panic.  Using this theory of over-arousal, one would expect that it would affect how autistic people do certain things; where they like to be; and what they do when over-aroused. 

Dr. Kinsbourne notes that as arousal rises, autistic people’s focus shrinks.  He discussed gaze avoidance; difficulty with complex tasks; desire for stability and sameness; and soothing self-stimulatory behaviors as adaptive for an over-aroused brain. 

Is there evidence of neuroinflammation in the autistic individual?  Yes; the 2005 Vargas study is a pioneering finding on autopsied autistic brains, showing that there is active disease continuing over a long time. They found neuroinflammation in 2/3-3/4 of the brains they looked at.  He also pointed to the Pardo 2005 study, showing persistent stimulation of the microglia in autistic patients, again supporting a theory of neuroinflammation.

Cross-examination of Dr. Kinsbourne

Mr. Matanoski asked Dr. Kinsbourne if he had offered his services to Mr. Powers.  Dr. Kinsbourne said no.  Mr. Matanoski then asked when Dr. Kinsbourne had started to work on his testimony.  Dr. Kinsbourne said shortly before he started writing the report. Mr. Matanoski then highlighted that there are no official criteria for regressive autism.

Mr. Matanaoski asked Dr. Kinsbourne about susceptibility to TCVs; Dr. Kinsbourne said we know that some people are sensitive, but we don’t know the mechanism.  Mr. Matanoski asked many questions about the precise time intervals and dose levels of mercury required for Dr. Kinsbourne’s theory; he said these were questions for toxicologists. 

Dr. Kinsbourne’s expert report concludes that TCVs may cause regressive autism in a susceptible population. What information were you relying on that the TCVs constitute a sufficient dose?  Dr. Kinsbourne bases his idea of toxic sufficiency on Dr. Aposhian’s report, the Burbacher articles, the Charleston studies, the Aschner articles.

Do you know whether one vaccine will cause autistic symptoms? A single atom won’t cause autism and a huge amount would put everybody at risk.  We know that mercury can cause neuroinflammation.  I would rely on a toxicologist to determine whether a particular amount is sufficient to cause inflammation.  How much mercury does it take to cause astrocyte death?  I don’t know and it doesn’t matter to my opinion.   

Mr. Matanoski asked questions about Purkinje cells in the brain and autism and whether Dr. Kinsbourne’s theory took this literature into account.  Dr. Kinsbourne said his model does not depend on Purkinje cells, but that Purkinje cell death is probably related to a threshold toxicity level.

In further discussion of toxic dose, Dr. Kinsbourne relied on the Burbacher study’s use of mercury doses to simulate the human infant vaccine schedule.  Dr. Kinsbourne said that if the Burbacher studies were incompetently done, then his conclusions would differ. 

How much excess glutamate is necessary for astrocyte death?  I cannot tell you quantities, but it doesn’t impact my opinion.  Is excess glutamate known to be a cause of autism?  It’s not known to be, but when you look at the Vargas findings, you become very suspicious.  The role of neuroinflammation is being studied in autism; there is a project now on microglial activation that’s being funded by NIH.

Mr. Matanoski asked questions to clarify that Dr. Kinsbourne has not had a clinical practice in 18 years and that he has published two articles on autism in the last 20 years. 

Then questions were about the similarity of this opinion to the opinion Dr. Kinsbourne gave in the Cedillo hearing on the measles virus and neuroinflammation.  Dr. Kinsbourne said that the mechanism of neuroinflammation is the same.  Mr. Matanoski asked whether Dr. Kinsbourne’s level of confidence was the same as to both cases.  Dr. Kinsbourne said that he is very confident that mercury can cause neuroinflammation.  He said that he is not confident that the amount of mercury in vaccines is enough to cause this reaction, but that the Burbacher studies, and the view of toxicologists, supports this case. 

Mr. Matanoski asked questions about Dr. Kinsbourne’s expert reports in several of the autism test cases and about how each opinion was similar and different.  Dr. Kinsbourne said that TCVs and the measles virus do work in virtually identical ways to cause neuroinflammation. 

Mr. Matanoski asked questions to establish that Dr. Kinsbourne has testified in about 130 vaccine injury cases, and has found that vaccines cause a number of different injuries, including encephalitis, seizure disorders, ADEM, septicemia and autism. 

Mr. Matanoski reviewed an episode in Dr. Kinsbourne’s career of many years ago where he filed a grievance against the institution he was working.  Mr. Matanoski asked whether Dr. Kinsbourne was fired for reasons of ethics.  Dr. Kinsbourne said that there were accusations; he filed a grievance; he won the grievance procedure, resigned and moved.

Redirect Examination of Dr. Kinsbourne   

Mr. Powers asked questions to show that Dr. Kinsbourne’s recent chapter in Pediatric Neurology which was published in 2005 had to be completed more than a year before publication.  Many of the new advances on the TCV theory have developed since then.  Mr. Powers pointed out that 22 articles in Dr. Kinsbourne’s report were published after 2005.  Mr. Powers clarified certain of Dr. Kinsbourne’s references to the scientific literature.  Going back to the Burbacher study, they clarified that the 2005 Burbacher study only mimicked the first 6 months of the vaccine schedule.  A child’s vaccine schedule goes out to two years, so mercury exposures increases.  Autopsies show that neuroinflammation continues over time.

Direct Examination of George Mead

Petitioner William Mead’s father testified.  He is an attorney, now doing construction and real estate law.  He did medical malpractice defense for ten years. 

He reviewed that William was a full term, healthy baby born May 5, 1998.  There had been an uneventful pregnancy; his wife has no dental amalgams and she ate no fish during pregnancy.  William’s general health was good, although he had ear and bronchial infections.  William had an older sister.  His development was normal through the first year, with eye contact, verbalization, interest in play, engagement.  He was even a model for “Pottery Barn” at around 14 months. 

At 18 months, a developmental regression started.  He started playing by himself, speaking less and making sounds like “taca taca taca.”  By two, he and his wife were worried about hearing problems.  A little before his second birthday, he got vaccinated in April and again 6 weeks later.  After May 2000, things changed extremely dramatically.  Within a few weeks, he’d lost all the language he had; he didn’t recognize us; his “taca taca taca” sounds increased; we went to the audiologist in September.  But then he started to have diarrhea, vomiting, unexplained welts.  He was getting very sick.  From mid-July 2000, there was a serious deterioration and behavioral decline.  He was grinding his teeth, squinting, hand flapping, toe walking, basically acting like he was on a different planet. 

His physical condition was not improving at all; his stomach was bloating.  At the audiology visit in September, they said he had no hearing problem, but that he should be seen for autism; the first available visit was in December.  William’s mother attended a conference in October on autism and learned about the casein-free and gluten-free diet and mercury as a possible cause.  They put William on the CFGFdiet; they got him into Early Intervention.  He tested with an IQ of 55, 5 points above retarded.  The evaluators said he’d need to be institutionalized.  Will had lost everything he’d once had.  Tory said we need to videotape him to remember what he was like.  [Mr. Mead needs to stop talking for a bit.]

Everyone was telling him that this is a lifelong condition; no one understands it; it’s mysterious and there’s no cure; nothing can be done and pay no attention to the fact that the diet seemed to improve everything.  Through the Oasis conference they found Dr. John Green and got a new pediatrician.  Dr. Green did blood, stool and urine tests; they were shocking.  They showed that William had extreme immune problems, like those of an AIDS patient, with no IgA; massive yeast overgrowth and leaky gut syndrome.  In addition to Williams’s neurological problems, he was a very sick little boy. 

In January 2001, they started the journey they’ve been on for six years.  They cautiously started chelation, pulling mercury out of him; he had 7 times the reference range.  This was shocking – they did not live near a coal-fired plant; the mother had no amalgams.  So with Dr. Green, they did a variety of treatments – chelation, transfer factor, supplements.  They also went to see Dr. Tim Buie at Massachusetts General Hospital; William was diagnosed with lymphoid hyperplasia of his intestines.  They also looked at his pancreatic sufficiency – William had almost no gut enzymes.  They have continued with chelation, supplementation and anti-inflammatory treatment.

Where is William now?  William talks; he plays with his sister; his language is emerging; he’s in 2nd grade with an aide; he’s doing math at a 1st grade level.  He’s made huge gains.  He’s regained gross motor coordination.  Through chelation, the mercury excreted is now at barely detectible levels. He’s doing well and surprises us every day.

Cross Examination of Mr. Mead

Ms. Esposito first wanted to acknowledge the journey that Mr. Mead has been on and how clear it is that he and William’s mother care for and love William.

What was the first thing that indicated a developmental problem?  We thought he had a hearing problem.  What were other words he had before the decline?  “Bath time,” bed time,” “pajamas.” 

When did you first think that vaccines contributed to his autism?  In January 2001, when William had 7 times the reference range for mercury, that’s when we wondered why he had the second most toxic substance on the planet in his body.  But the first order of business was getting the mercury out.

How did you get to Dr. Green?  Through a pediatrician we were referred to at the October conference.  Did William have intravenous IVIG?  Yes, but only once; William was not sedated and it was a horrible experience.  He got secretin twice; it did help.  We’ve done chelation with Dr. Green, with DMSA, DMPS and EDTA.  William had ABA therapy for thirty hours per week at one point.

Did you keep careful records under Dr. Green’s care? Yes; we kept a chart.  We would follow a protocol for a few months and then assess. 

Redirect Examination of Mr. Mead

Mr. Mead talked more about the care and treatment Dr. Green gave.  He said that as a former medical malpractice lawyer, he would not take his son to someone who was a “quack.”  Everything that’s happened has been done safely.  William has never had an adverse reaction.  We owe William to Dr. Green. 

Is William better off than when he started with Dr. Green?  My kid jumped in to bed with me and asked to read with me; they said this kid would never talk and would be institutionalized.  Without doubt, Dr. Green has contributed to where William is now.   Mr. Mead answered several specific questions from the Special Masters about his testimony. 

Mary Holland teaches at New York University Law School and may be contacted HERE. Thank you to A-CHAMP for providing this important service.