Asperger syndrome: a simple matter of white matter?

Asperger syndrome, one of the Pervasive Developmental Disorders, is formally diagnosed on the basis of a cluster of cognitive, social and motor signs. It is also associated with poor visuo-spatial skills, good verbal performance, gauche social behaviour and clumsiness. Many of the difficulties evident in those with Asperger syndrome are closely associated with right-hemisphere dysfunction. In this respect they also resemble signs used to diagnose what has been labelled Nonverbal Learning Disorder. Here, these are treated as being the same or closely-related disorders with a possible common underlying aetiology; that is, a neurodevelopmental abnormality affecting white matter. This review examines the ability of this approach to account for a wide range of characteristics of the Asperger syndrome, and contrasts this with a theory-of-mind approach, which, although able to account for the primary features of Asperger syndrome, is less successful at explaining some of its secondary features.