Gait function in high-functioning autism and Asperger's disorder : evidence for basal-ganglia and cerebellar involvement?

Gait abnormalities have been widely reported in individuals with autism and Asperger's disorder. There is controversy as to whether the cerebellum or the basal-ganglia frontostriatal regions underpin these abnormalities. This is the first direct comparison of gait and upper-body postural features in autism and Asperger's disorder. Clinical and control groups were matched according to age, height, weight, performance, and full scale IQ. Consistent with Hallet's (1993) cerebellar-gait hypothesis, the autistic group showed significantly increased stride-length variability in their gait in comparison to control and Asperger's disorder participants. No quantitative gait deficits were found for the Asperger's disorder group. In support of Damasio and Maurer's (1982) basal-ganglia frontostriatal-gait hypothesis, both clinical groups were rated as showing abnormal arm posturing, however, only the Asperger's group were rated as significantly different from controls in terms of head and trunk posturing. While DSM-IV-TR suggests that Asperger's disorder, but not autism, is associated with motoric clumsiness, our data suggest that both clinical groups are uncoordinated and lacking in motor smoothness. Gait differences in autism and Asperger's disorder were suggested to reflect differential involvement of the cerebellum, with commonalities reflecting similar involvement of the basal-ganglia frontostriatal region.