BRAIN and NERVE－神経研究の進歩64巻7号

2012年07月発行

増大特集 顔認知の脳内機構

自閉症スペクトラム障害の顔認知

著者： 北洋輔¹² 稲垣真澄¹

所属機関： ¹国立精神・神経医療研究センター精神保健研究所知的障害研究部 ²日本学術振興会

ページ範囲：P.821 - P.830

文献概要

Ⅰ．自閉症スペクトラム障害とは

　自閉症スペクトラム障害（autism spectrum disorders：ASD）という用語は，世界保健機関の国際疾病分類第10版（International Classification of Diseases：ICD-10)¹⁾における小児自閉症（childhood autism），非定型自閉症（atypical autism），アスペルガー症候群（Asperger's syndrome）などを含む「心理的発達の障害」に分類された疾患である広汎性発達障害（pervasive developmental disorders；F84）や，米国精神医学会の精神疾患の診断・統計マニュアル（Diagnostic and Statistical Manual of Mental Disorders Forth Edition Text Revision：DSM-IV-TR)²⁾にて使用されている広汎性発達障害（自閉性障害；autistic disorder，アスペルガー障害；Asperger's disorderと特定不能の広汎性発達障害；pervasive developmental disorder not otherwise specified）を細分化することなく，すべてを一つのつながりとして，あるいは「連続体」として捉えようとする概念を示す。

　ASDに共通する特徴は，①対人的相互反応の質的障害，②言語的および非言語的コミュニケーションの障害，③想像力の障害および限定的な範囲での反復的・常同的活動の3点が挙げられており^3,4)，知的機能障害の有無や程度は問わない。現在広く使用されている診断基準では，正式な診断名としてASDを用いることはない^1,2)。しかしながら，診断基準の改訂（例えばICD-11やDSM-5)^5,6)が近々予定されており，その中でASDが診断名として採用される可能性が強いことや，現在の自閉症研究の潮流を踏まえて，本稿ではASDという概念を使用することとしたい。ASDの有病率は，0.3～0.9％などと報告するもの^7,8)もあるが，診断基準の変遷や障害の周知度の変化によって変動している。ASDの病因は，中枢神経系の機能障害と推測されているが，その特定には至っておらず，精力的な研究が世界的に続けられている。

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