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Neurogenic atherosclerosis in mentally retarded persons.

The question is raised whether arteriosclerosis (AS) may be induced in man by chronic central nervous system injury. In an institutionalized population of mentally retarded children, more AS than expected was observed. Of 1173 residents with detailed clinical and autopsy records over 40 years, 78 of them, aged 1-21 years, showed mild to moderate coronary or aorta AS. Thirty control subjects without AS, matched for sex, age and IQ, were studied in comparison. In 65 of the probands, the condition could not be explained by predisposing diseases or known risk factors. There were more lesions in those with convulsive disorder; this was felt to reflect arterial changes due to neuronal-sympathoadrenal hyperactivity. In addition, more disease occurred in physically restricted patients; this appeared related to the stress of handicap and inability to respond to psychosocial needs. It is concluded that certain areas of brain defect predispose to atherogenesis. Down's syndrome provides a different set of influences on AS, yet the frequency of AS in these patients was similar to that of non-Down's.