Explore This Lab

Overview

Autism Spectrum Disorders (ASDs) are rapidly reaching epidemic proportions in the United States and throughout the world. While there is evidence that some of those on the autism spectrum show abnormalities in their genetic make-up, it is becoming clear that other factors are involved in the burgeoning number of cases we see each year.

By providing an integrated stream of brain and body laboratory studies, TRANSCEND aims to systematically turn clinical assessment and treatment into data for research that will maximize the help we can give to each patient.

We believe that every individual with autism experiences social, emotional and medical challenges that deserve assessment and study to uncover every possible avenue of assistance, both for that individual and for those with similar difficulties. At the same time, each individual with autism is unique, and deserves personalized care.

Our Collaborators

With our growing network of collaborators we “transcend” the separation between isolated silos of knowledge and integrate together the many levels of autism into a coherent and synergistic framework.

  • Affective Computing Research Group (AFRG), MIT Media lab
  • Ames Laboratory, Children's Hospital Oakland Research Institute (CHORI), Oakland, CA
  • Anderson Laboratory at Beth Israel Deaconess Medical Center (BIDMC)
  • Autism Society of America (ASA)
  • Kilee Patchell-Evans Autism Research Group
  • I.N.D. Institute (Medical Investigation of Neurodevelopmental Disorders), UC Davis Medial Center, Sacramento, CA
  • Perinatal Research Laboratory, Columbia University College of Physicians and Surgeons

Diagnosis and Treatment Goals

Integration of brain and body with genetic biomarkers to allow an individualized understanding of autism is a totally unique approach to diagnosis, research and treatment. When we place this model into a clinical setting it allows us to treat each facet of autism in its own terms, and at the same time learn how these interventions impact the whole person. This approach goes straight to the “biological ground zero” of the everyday reality of autism. It represents a model for truly effective 21st century systems clinical science for ASD.

TRANSCEND is approaching the diagnosis and treatment of ASD and developmental disabilities with the intent to:

  • Optimize profiles of brain and body measures that are sensitive to abnormal function in autism spectrum disorders
  • Develop profiles of measures for early identification of a disorder
  • Using these multidisciplinary measures to maximize our chances of identifying biologically distinct autism subgroups
  • Track how brain and body metabolism (chemistry, immune) challenges relate to each other in people with autism
  • Use animal models of the brain and metabolic abnormalities measured in autism to study how best to improve brain and body function and track brain and body impacts of treatments
  • Use measurement profiles to track change through development and response to treatment

About Us

The TRANSCEND program is based at the Massachusetts General Hospital in Boston, the Martinos Center for Biomedical Imaging in Charlestown, and in Lexington. The path-breaking Lurie Center for Autism—part of the MassGeneral Hospital for Children—has an office in the same building. Established under the leadership of Dr. Martha Herbert, the TRANSCEND program was initiated to explore possible abnormalities in the brains and bodies of children and adults with Autism Spectrum Disorders (ASD).

TRANSCEND is unique because:

  • We study not just what is different in these conditions, but how things change in development and with treatment
  • We integrate brain and body, and we integrate behavior with underlying biology
  • We pool the thinking and resources of like-minded researchers and clinicians to make a whole that is greater than the sum of its parts

Our program includes:

  • TRANSCEND Brain Research Program
  • TRANSCEND Multisystem At-Risk Infant Siblings Program
  • TRANSCEND Body Biomarker Program
  • TRANSCEND Treatment Research Program
  • TRANSCEND Translational Research Program

Mission

TRANSCEND’s mission is to improve outcomes in autism and other neurodevelopmental disorders (NDDs) by using sophisticated and coordinated objective measures to characterize what can be changed in these conditions.

By looking at brain problems at several integrated levels and in a whole-body systems context, we aim to maximize understanding and maximize our ability to find ways to help.

By applying cutting-edge science, measurement technologies and informatics to treatment research and clinical-behavioral practice, TRANSCEND aims to minimize suffering, optimize quality of life for individuals and families, and maximize chances for individuals to reach their full potential - now.

Unique, Whole Body Approach

TRANSCEND’s partners work from a model of autism that describes a complex whole-body condition with many treatable facets.

Brain as part of the body

We look at the brain not just as an information-processing computer but also as a physical organ that is part of the body.

We think that the way the brain processes sensory, emotional and social information is related to the health of the cells of the brain, which can be related to the health of cells in the body.

We think that changes in the way the brain processes sensory, emotional and social information might come from physical changes in the cells of the brain related to some kinds of physical illness in the body (especially immune problems), and not just from the brain developing differently before a baby is born.

Brain and body problems in autism and other neurodevelopmental disorders and how they develop

  • We suspect that the relationship of health problems and brain/behavior problems may develop in close relationship to each other.
  • Therefore we look at how brain and body problems develop early in autism and how these brain and body problems may relate to each other early on

Unique Approach to What We Measure

TRANSCEND partners believe that while genes, brain and behavior are important in autism, if we want to help people now we need a more complete model.

  • Even though we recognize autism by behaviors and language disorders by language problems, we think that underneath there are biological issues in brain and body.
  • Therefore we measure what we consider to be core biological features (like changes in sensory processing, brain electrical properties, brain tissue and whole body metabolism and immune function).
  • We also test behavioral, language and communication function.
  • Then we work on how the physical changes relate to the behavioral, language and communication problems.

From Research to Treatment

TRANSCEND focuses on the relationships of brain and body because we believe that this will help us move more quickly to finding more ways to help people have better quality of life. Observant clinicians know that if we can make our “body machine” work better, behavior and cognition often improve along the way.

Our Measurements

What we measure:

  • Brain structure and tissue (MRI – Magnetic Resonance Imaging)
  • Brain function –fMRI (functional Magnetic Resonance Imaging)
  • Brain function (MEG – MagnetoEncephaloGraphy and Magnetic Evoked Potentials)
  • Brain function (EEG – ElectroEncephaloGraphy and Electrical Evoked Potentials))

Where we measure it:

  • At the imaging facilities of the Martinos Center for Biomedical Imaging of Massachusetts General Hospital-Charlestown
  • In Lexington, Massachusetts at the Autism Center facility that also houses the Lurie Center for Autism

Our Core Focus on What is Happening

The TRANSCEND trademark is to integrate these measures and root them in a practical approach to the whole person.

  • Most other groups start with genes or brain and work out to behaviors
  • We are interested in the mechanisms, the biology, of what is going on. We focus on that biology in the whole person, not just the brain
  • We are interested in genetic AND environmental influences. But what is centralis their IMPACT
  • We therefore start with the brain and body experience of living with autism; and work to understand it in depth
  • From the foundation of what is actually going onwith each person, we work outwards to consider causal mechanisms (e.g. genes and environment) and consequences (medical and behavioral problems)
  • We choose this focus because it is closest to what we need to know to be able to offer intelligent help
  • Our goal is to find treatment targets and measure treatment outcomes sensitively

Research Projects

The goal of TRANSCEND is to give every patient the opportunity to teach us important things about their ASD. We offer each patient the opportunity to participate in clinical research and will make every effort to offer patients who come through the Lurie Center for Autism an opportunity for available assessments that are appropriate for them.

For More Information

If you would like to learn more about our studies, please call our Study Intake Coordinator at 617-966-9766 or email TRANSCEND@partners.org.

Location of Studies

MRI, and MEG studies take place at the Charlestown Navy Yard (Massachusetts General Hospital’s research campus). The EEG studies take place at our Lexington site, which also houses the Lurie Center for Autism and Spaulding Rehabilitation Hospital programs. Screening visits usually take place at our Charlestown Site but sometimes take place in Lexington.

Charlestown site:
149 13th Street
Charlestown, MA 02129

Lexington site:
1 Maguire Road
Lexington, MA 02421

 

Study Descriptions

To take part in our studies you need to be screened to see if you or your child qualifies. Here are the steps in our research studies:

Step one: Screening

Step two: Evaluation (more detailed than screening)

Step three: Enrollment in appropriate imaging studies, which include:

MRI (Magnetic Resonance Imaging: pictures of the brain)

MEG MagnetoEncephaloGraphy: tracking brain signals magnetically)

EEG ElectroEncephaloGraphy: tracking brain signals electrically)

These methods are considered entirely safe technologies. Risks may include boredom or restlessness. People who experience claustrophobia should not volunteer for the MRI study. There are no known side effects of the MRI, MEG, or EEG.

We also have a BIOMARKERS study, to measure metabolism, immune function and other systemic biology. We have received funding to do a multisystem (behavior, medical, nervous system) study of infants at high risk for autism (if they have an older sibling with autism). Please stay tuned for further information.

 

Eligibility Screening

The purpose of the screening visit is to determine which of our studies may be appropriate for your child. Your child will be evaluated by an examiner with special experience with children. There will also be questionnaires for the parent or legal guardians. The results of the screening will allow us to tell you what studies might be appropriate for your child.

Neurobehavioral Evaluation

Once your child is found to be eligible to be in one or more of our studies we will perform more evaluations, depending on the needs of the specific study. These further evaluations will be to get to know your child better, which will help us answer our research questions. The results will tell us about your child’s reasoning, language, motor, and play skills. The visit may last about 2 hours (or more for some studies). If your child needs more time to finish, you can come back for an extra visit.

MRI Study

For this study, we will be using an MRI scanner to take pictures of the brain. An MRI (Magnetic Resonance Imaging) is a safe, non-invasive method that uses the strength of a magnetic field to obtain pictures from the inside of body. People who take part in this study need to be able to stay still for about half an hour to an hour (with some breaks if necessary).

We will help prepare you or your child for the MRI by some combination of listening to the sounds it produces, practicing being in a model of a scanner, and playing games that are about being in the scanner.

MEG Study

For this study, we will use the MEG machine (MagnetoEncephaloGram) to measure the magnetic brain waves your child’s brain creates as it works. We will present your child with sounds through earphones, with things to look at on a screen, or with taps on the fingers. We will learn a lot by seeing how your child’s brain responds to these kinds of stimulations.

An MEG is a safe, non-invasive method used to measure brain waves. It does not emit any magnetic fields, it only measures them.

EEG Study

An EEG (ElectroEncephaloGram) helps us learn about how your child’s brain works by measuring the tiny electrical signals that come through the scalp to the outside of the head. EEG is safe and very commonly used in small children and even newborn babies. We use an EEG net because it is easy to put on. This makes it more comfortable, greatly reduces the time we need to to place the electrodes and enhances localization of brainwave activity.

During the EEG, your child will watch a muted video, and then look at other things on a computer screen, such as light flashes and images. Your child will also hear various sounds from speakers. While this is going on, your child needs to sit still as much as possible. We will ask them to be still if they are old enough to understand and able to try to cooperate. If they are small they can sit in the parent’s lap.

Biomarker Study

TRANSCEND is starting a biomarker program to measure metabolic and immune markers in blood and urine to learn about the relationship between body changes and the brain changes we are studying. Participants in some of our brain studies will have the opportunity to contribute to this innovative and integrative line of research.

Selected Publications

Full PubMed publication list.

Herbert MR. Autism: The centrality of active pathophysiology and the shift from static to chronic dynamic encephalopathy. Chapter 18 in: Chauhan A, Chauhan V, Brown T. Autism: Oxidative stress, inflammation and immune abnormalities. Taylor & Francis / CRC Press, 2009.

Herbert MR, Anderson MP. An Expanding Spectrum of Autism Models: From Fixed Developmental Defects to Reversible Functional Impairments . Zimmerman A ed. Autism: Current Theories and Evidence. Humana Press, 2008: 429-63.

Anderson MP, Hooker BS, Herbert MR. Bridging from Cells to Cognition in Autism Pathophysiology: Biological Pathways to Defective Brain Function and Plasticity. American Journal of Biochemistry and Biotechnology 2008; 4(2):167-76 http://www.scipub.org/fulltext/ajbb/ajbb42167-176.pdf .

Herbert MR, Kenet T. Brain Abnormalities in Language Disorders and in Autism. Pediatr Clin North Am 2007; 54(3):563-83.

Herbert MR, Caviness VS. Neuroanatomy and Imaging Studies. in: Tuchman R, Rapin I eds. Autism: A neurobiological disorder of early brain development. Mac Keith Press, 2006: Chapter 8 pp. 115-140.

Herbert MR. Large brains in autism: the challenge of pervasive abnormality. Neuroscientist 2005; 11(5 ):417-40.

Herbert MR, Ziegler DA, Deutsch CK et al. Brain asymmetries in autism and developmental language disorder: a nested whole-brain analysis. Brain 2005; 128(Pt 1):213-26.

Herbert MR, Russo JR, Yang S et al. Autism and Environmental Genomics. IMFAR 2005; Poster:P4A.1.9.

Herbert MR, Ziegler DA. Volumetric Neuroimaging and Low-Dose Early-Life exposures: Loose Coupling of Pathogenesis-Brain-Behavior Links. Neurotoxicology 2005; 26(4):565-72.

Herbert MR. Autism: A Brain disorder or a disorder that affects the brain? Clinical Neuropsychiatry 2005; 2(6):354-79.

Herbert MR. Neuroimaging in disorders of social and emotional functioning: what is the question? J Child Neurol 2004; 19(10):772-84.

Herbert MR, Ziegler DA, Makris N et al. Localization of white matter volume increase in autism and developmental language disorder. Ann Neurol 2004; 55(4):530-40.

Herbert MR, Ziegler DA, Makris N et al. Larger Brain and White Matter Volumes in Children With Developmental Language Disorder. Developmental Science 2003; 6(4):F11-F22.

Herbert MR, Ziegler DA, Deutsch CK et al. Dissociations of cerebral cortex, subcortical and cerebral white matter volumes in autistic boys. Brain 2003; 126(Pt 5):1182-92.

Herbert MR, Harris GJ, Adrien KT et al. Abnormal asymmetry in language association cortex in autism. Ann Neurol 2002; 52(5):588-96.