1
|
Liu M, Yu W, Xu D, Wang M, Peng B, Jiang H, Dai Y. Diagnosis for autism spectrum disorder children using T1-based gray matter and arterial spin labeling-based cerebral blood flow network metrics. Front Neurosci 2024; 18:1356241. [PMID: 38694903 PMCID: PMC11061487 DOI: 10.3389/fnins.2024.1356241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/14/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by impairments in motor skills, communication, emotional expression, and social interaction. Accurate diagnosis of ASD remains challenging due to the reliance on subjective behavioral observations and assessment scales, lacking objective diagnostic indicators. Methods In this study, we introduced a novel approach for diagnosing ASD, leveraging T1-based gray matter and ASL-based cerebral blood flow network metrics. Thirty preschool-aged patients with ASD and twenty-two typically developing (TD) individuals were enrolled. Brain network features, including gray matter and cerebral blood flow metrics, were extracted from both T1-weighted magnetic resonance imaging (MRI) and ASL images. Feature selection was performed using statistical t-tests and Minimum Redundancy Maximum Relevance (mRMR). A machine learning model based on random vector functional link network was constructed for diagnosis. Results The proposed approach demonstrated a classification accuracy of 84.91% in distinguishing ASD from TD. Key discriminating network features were identified in the inferior frontal gyrus and superior occipital gyrus, regions critical for social and executive functions in ASD patients. Discussion Our study presents an objective and effective approach to the clinical diagnosis of ASD, overcoming the limitations of subjective behavioral observations. The identified brain network features provide insights into the neurobiological mechanisms underlying ASD, potentially leading to more targeted interventions.
Collapse
Affiliation(s)
- Mingyang Liu
- School of Electrical and Electronic Engineering, Changchun University of Technology, Changchun, China
| | - Weibo Yu
- School of Electrical and Electronic Engineering, Changchun University of Technology, Changchun, China
| | - Dandan Xu
- Department of Radiology, Affiliated Children’s Hospital of Jiangnan University, Wuxi, China
| | - Miaoyan Wang
- Department of Radiology, Affiliated Children’s Hospital of Jiangnan University, Wuxi, China
| | - Bo Peng
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Haoxiang Jiang
- School of Electrical and Electronic Engineering, Changchun University of Technology, Changchun, China
| | - Yakang Dai
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| |
Collapse
|
2
|
Jiang A, Ma X, Li S, Wang L, Yang B, Wang S, Li M, Dong G. Age-atypical brain functional networks in autism spectrum disorder: a normative modeling approach. Psychol Med 2024:1-12. [PMID: 38563297 DOI: 10.1017/s0033291724000138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Despite extensive research into the neural basis of autism spectrum disorder (ASD), the presence of substantial biological and clinical heterogeneity among diagnosed individuals remains a major barrier. Commonly used case‒control designs assume homogeneity among subjects, which limits their ability to identify biological heterogeneity, while normative modeling pinpoints deviations from typical functional network development at individual level. METHODS Using a world-wide multi-site database known as Autism Brain Imaging Data Exchange, we analyzed individuals with ASD and typically developed (TD) controls (total n = 1218) aged 5-40 years, generating individualized whole-brain network functional connectivity (FC) maps of age-related atypicality in ASD. We then used local polynomial regression to estimate a networkwise normative model of development and explored correlations between ASD symptoms and brain networks. RESULTS We identified a subset exhibiting highly atypical individual-level FC, exceeding 2 standard deviation from the normative value. We also identified clinically relevant networks (mainly default mode network) at cohort level, since the outlier rates decreased with age in TD participants, but increased in those with autism. Moreover, deviations were linked to severity of repetitive behaviors and social communication symptoms. CONCLUSIONS Individuals with ASD exhibit distinct, highly individualized trajectories of brain functional network development. In addition, distinct developmental trajectories were observed among ASD and TD individuals, suggesting that it may be challenging to identify true differences in network characteristics by comparing young children with ASD to their TD peers. This study enhances understanding of the biological heterogeneity of the disorder and can inform precision medicine.
Collapse
Affiliation(s)
- Anhang Jiang
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, P.R. China
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
| | - Xuefeng Ma
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
| | - Shuang Li
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
| | - Lingxiao Wang
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Bo Yang
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, P.R. China
| | - Shizhen Wang
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
| | - Mei Li
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
- Center for Mental Health Education and Counselling, Hangzhou Normal University, Hangzhou, Zhejiang Province, P.R. China
| | - Guangheng Dong
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, P.R. China
| |
Collapse
|
3
|
Bedford SA, Lai MC, Lombardo MV, Chakrabarti B, Ruigrok A, Suckling J, Anagnostou E, Lerch JP, Taylor M, Nicolson R, Stelios G, Crosbie J, Schachar R, Kelley E, Jones J, Arnold PD, Courchesne E, Pierce K, Eyler LT, Campbell K, Barnes CC, Seidlitz J, Alexander-Bloch AF, Bullmore ET, Baron-Cohen S, Bethlehem RA. Brain-charting autism and attention deficit hyperactivity disorder reveals distinct and overlapping neurobiology. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.06.23299587. [PMID: 38106166 PMCID: PMC10723556 DOI: 10.1101/2023.12.06.23299587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Autism and attention deficit hyperactivity disorder (ADHD) are heterogeneous neurodevelopmental conditions with complex underlying neurobiology. Despite overlapping presentation and sex-biased prevalence, autism and ADHD are rarely studied together, and sex differences are often overlooked. Normative modelling provides a unified framework for studying age-specific and sex-specific divergences in neurodivergent brain development. Methods Here we use normative modelling and a large, multi-site neuroimaging dataset to characterise cortical anatomy associated with autism and ADHD, benchmarked against models of typical brain development based on a sample of over 75,000 individuals. We also examined sex and age differences, relationship with autistic traits, and explored the co-occurrence of autism and ADHD (autism+ADHD). Results We observed robust neuroanatomical signatures of both autism and ADHD. Overall, autistic individuals showed greater cortical thickness and volume localised to the superior temporal cortex, whereas individuals with ADHD showed more global effects of cortical thickness increases but lower cortical volume and surface area across much of the cortex. The autism+ADHD group displayed a unique pattern of widespread increases in cortical thickness, and certain decreases in surface area. We also found evidence that sex modulates the neuroanatomy of autism but not ADHD, and an age-by-diagnosis interaction for ADHD only. Conclusions These results indicate distinct cortical differences in autism and ADHD that are differentially impacted by age, sex, and potentially unique patterns related to their co-occurrence.
Collapse
Affiliation(s)
- Saashi A. Bedford
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei 100229, Taiwan
| | - Michael V. Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6ES, UK
| | - Amber Ruigrok
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester
| | - John Suckling
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jason P. Lerch
- Program in Neurosciences and Mental Health, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Margot Taylor
- Program in Neurosciences and Mental Health, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Rob Nicolson
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | | | - Jennifer Crosbie
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Program in Neurosciences and Mental Health, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Russell Schachar
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Program in Neurosciences and Mental Health, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6 Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
- Department of Psychiatry, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Jessica Jones
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6 Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
- Department of Psychiatry, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Paul D. Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Eric Courchesne
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Lisa T. Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kathleen Campbell
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Cynthia Carter Barnes
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Aaron F. Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, The Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Edward T. Bullmore
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Cambridge Lifetime Autism Spectrum Service (CLASS), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Richard A.I. Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
4
|
Lucibello S, Bertè G, Verdolotti T, Lucignani M, Napolitano A, D’Abronzo R, Cicala MG, Pede E, Chieffo D, Mariotti P, Colosimo C, Mercuri E, Battini R. Cortical Thickness and Clinical Findings in Prescholar Children With Autism Spectrum Disorder. Front Neurosci 2022; 15:776860. [PMID: 35197818 PMCID: PMC8858962 DOI: 10.3389/fnins.2021.776860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
The term autism spectrum disorder (ASD) includes a wide variability of clinical presentation, and this clinical heterogeneity seems to reflect a still unclear multifactorial etiopathogenesis, encompassing different genetic risk factors and susceptibility to environmental factors. Several studies and many theories recognize as mechanisms of autism a disruption of brain development and maturation time course, suggesting the existence of common neurobiological substrates, such as defective synaptic structure and aberrant brain connectivity. Magnetic resonance imaging (MRI) plays an important role in both assessment of region-specific structural changes and quantification of specific alterations in gray or white matter, which could lead to the identification of an MRI biomarker. In this study, we performed measurement of cortical thickness in a selected well-known group of preschool ASD subjects with the aim of finding correlation between cortical metrics and clinical scores to understand the underlying mechanism of symptoms and to support early clinical diagnosis. Our results confirm that recent brain MRI techniques combined with clinical data can provide some useful information in defining the cerebral regions involved in ASD although large sample studies with homogeneous analytical and multisite approaches are needed.
Collapse
Affiliation(s)
- Simona Lucibello
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanna Bertè
- Dipartimento di Diagnostica per Immagini, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tommaso Verdolotti
- UOC Radiologia e Neuroradiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Lucignani
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Antonio Napolitano
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Rosa D’Abronzo
- Dipartimento di Diagnostica per Immagini, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria G. Cicala
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisa Pede
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniela Chieffo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Mariotti
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cesare Colosimo
- Dipartimento di Diagnostica per Immagini, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Radiologia e Neuroradiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- *Correspondence: Roberta Battini,
| |
Collapse
|
5
|
Zhao X, Zhu S, Cao Y, Cheng P, Lin Y, Sun Z, Jiang W, Du Y. Abnormalities of Gray Matter Volume and Its Correlation with Clinical Symptoms in Adolescents with High-Functioning Autism Spectrum Disorder. Neuropsychiatr Dis Treat 2022; 18:717-730. [PMID: 35401002 PMCID: PMC8983641 DOI: 10.2147/ndt.s349247] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Previous studies have indicated abnormal gray matter volume (GMV) in individuals with autism spectrum disorder (ASD); however, there is little consistency across the findings within these studies, partly due to small sample size and great heterogeneity among participants between studies. Additionally, few studies have explored the correlation between clinical symptoms and GMV abnormalities in individuals with ASD. Here, the current study examined GMV alterations in whole brain and their correlations with clinical symptoms in a relatively large and homogeneous sample of participants with ASD matched typically developing (TD) controls. METHODS Forty-eight adolescents with high-functioning ASD and 29 group-matched TD controls underwent structural magnetic resonance images. Voxel-based morphometry was applied to investigate regional GMV alterations. The participants with ASD were examined for the severity of clinical symptoms with Autism Behavior Checklist (ABC). The relationship between GMV abnormalities and clinical symptoms was explored in ASD group using voxel-wise correlation analysis within brain regions that showed significant GMV alterations in individuals with ASD compared with TD controls. RESULTS We found increased GMV in multiple brain regions, including the inferior frontal gyrus, medial frontal gyrus, superior frontal gyrus, superior temporal gyrus, occipital pole, anterior cingulate, cerebellum anterior lobe, cerebellum posterior lobe, and midbrain, as well as decreased GMV in cerebellum posterior lobe in individuals with ASD. The correlation analysis showed the GMV in the left fusiform was negatively associated with the scores of sensory factor, and the GMV in the right cerebellum anterior lobe was positively associated with the scores of social self-help factor. CONCLUSION Our results indicated that widespread GMV abnormalities of brain regions occurred in individuals with ASD, suggesting a potential neural basis for the pathogenesis and symptomatology of ASD.
Collapse
Affiliation(s)
- Xiaoxin Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Shuyi Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yang Cao
- Suzhou Guangji Hospital, Suzhou, People's Republic of China
| | - Peipei Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yuxiong Lin
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhixin Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Wenqing Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yasong Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| |
Collapse
|
6
|
Chien YL, Chen YC, Chiu YN, Tsai WC, Gau SSF. A translational exploration of the effects of WNT2 variants on altered cortical structures in autism spectrum disorder. J Psychiatry Neurosci 2021; 46:E647-E658. [PMID: 34862305 PMCID: PMC8648347 DOI: 10.1503/jpn.210022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/19/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Evidence suggests that cortical anatomy may be aytpical in autism spectrum disorder. The wingless-type MMTV integration site family, member 2 (WNT2), a candidate gene for autism spectrum disorder, may regulate cortical development. However, it is unclear whether WNT2 variants are associated with altered cortical thickness in autism spectrum disorder. METHODS In a sample of 118 people with autism spectrum disorder and 122 typically developing controls, we investigated cortical thickness using FreeSurfer software. We then examined the main effects of the WNT2 variants and the interactions of group × SNP and age × SNP for each hemisphere and brain region that was altered in people with autism spectrum disorder. RESULTS Compared to neurotypical controls, people with autism spectrum disorder showed reduced mean cortical thickness in both hemispheres and 9 cortical regions after false discovery rate correction, including the right cingulate gyrus, the orbital gyrus, the insula, the inferior frontal gyrus (orbital part and triangular part), the lateral occipitotemporal gyrus, the posterior transverse collateral sulcus, the lateral sulcus and the superior temporal sulcus. In the full sample, 2 SNPs of WNT2 (rs6950765 and rs2896218) showed age × SNP interactions for the mean cortical thickness of both hemispheres, the middle-posterior cingulate cortex and the superior temporal cortex. LIMITATIONS We examined the genetic effect for each hemisphere and the 9 regions that were altered in autism spectrum disorder. The age effect we found in this cross-sectional study needs to be examined in longitudinal studies. CONCLUSION Based on neuroimaging and genetic data, our findings suggest that WNT2 variants might be associated with altered cortical thickness in autism spectrum disorder. Whether and how these WNT2 variants might involve cortical thinning requires further investigation. TRIAL REGISTRATION ClinicalTrials.gov no. NCT01582256. PROTOCOL REGISTRATION National Institutes of Health no. NCT00494754.
Collapse
Affiliation(s)
| | | | | | | | - Susan Shur-Fen Gau
- From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan (Chien, Chen, Chiu, Tsai, Gau); and the Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan (Chen, Gau)
| |
Collapse
|
7
|
Ye JY, Qin XJ, Cui JF, Ren Q, Jia LX, Wang Y, Pantelis C, Chan RCK. A Meta-analysis of Mental Time Travel in Individuals with Autism Spectrum Disorders. J Autism Dev Disord 2021; 53:1509-1528. [PMID: 34825295 DOI: 10.1007/s10803-021-05375-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Autism spectrum disorders (ASD) are associated with cognitive dysfunctions, including mental time travel (MTT). However, findings on diminished MTT ability may be confounded by a number of factors, including the individuals' language ability, factors related to the MTT task and the demographic factors of participants. The present study provided a meta-analysis of MTT ability in people with ASD. The results showed significant overall reductions in MTT ability in people with ASD. Moderator analyses revealed that the variables examined did not explain the reduction in MTT ability. These findings suggest that MTT ability is diminished in people with ASD and that the degree of this diminishment may not depend on the characteristics of measures or demographic variables of people with ASD.
Collapse
Affiliation(s)
- Jun-Yan Ye
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiao-Jing Qin
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ji-Fang Cui
- Research Center for Information and Statistics, National Institute of Education Sciences, Beijing, China
| | - Qian Ren
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lu-Xia Jia
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China. .,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia.
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia.,Department of Electrical and Electronic Engineering, The University of Melbourne, Melbourne, Australia.,Florey Institute for Neurosciences and Mental Health, Melbourne, Australia
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
8
|
Alemany S, Blok E, Jansen PR, Muetzel RL, White T. Brain morphology, autistic traits, and polygenic risk for autism: A population-based neuroimaging study. Autism Res 2021; 14:2085-2099. [PMID: 34309210 DOI: 10.1002/aur.2576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/18/2021] [Accepted: 06/27/2021] [Indexed: 12/29/2022]
Abstract
Autism spectrum disorders (ASD) are associated with widespread brain alterations. Previous research in our group linked autistic traits with altered gyrification, but without pronounced differences in cortical thickness. Herein, we aim to replicate and extend these findings using a larger and older sample. Additionally, we examined whether (a) brain correlates of autistic traits were associated with polygenic risk scores (PRS) for ASD, and (b) autistic traits are related with brain morphological changes over time in a subset of children with longitudinal data available. The sample included 2400 children from the Generation R cohort. Autistic traits were measured using the Social Responsiveness Scale (SRS) at age 6 years. Gyrification, cortical thickness, surface area, and global morphological measures were obtained from high-resolution structural MRI scans at ages 9-to-12 years. We performed multiple linear regression analyses on a vertex-wise level. Corresponding regions of interest were tested for association with PRS. Results showed that autistic traits were related to (a) lower gyrification in the lateral occipital and the superior and inferior parietal lobes, (b) lower cortical thickness in the superior frontal region, and (c) lower surface area in inferior temporal and rostral middle frontal regions. PRS for ASD and longitudinal analyses showed significant associations that did not survive correction for multiple testing. Our findings support stability in the relationship between higher autistic symptoms and lower gyrification and smaller surface areas in school-aged children. These relationships remained when excluding ASD cases, providing neurobiological evidence for the extension of autistic traits into the general population. LAY SUMMARY: We found that school-aged children with higher levels of autistic traits had smaller total brain volume, cerebellum, cortical thickness, and surface area. Further, we also found differences in the folding patterns of the brain (gyrification). Overall, genetic susceptibility for autism spectrum disorders was not related to these brain regions suggesting that other factors could be involved in their origin. These results remained significant when excluding children with a diagnosis of ASD, providing support for the extension of the relationship between autistic traits and brain findings into the general population.
Collapse
Affiliation(s)
- Silvia Alemany
- IS Global, Barcelona Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisabet Blok
- The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands
| | - Philip R Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands.,Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Genetics, VU Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| |
Collapse
|
9
|
Zabihi M, Floris DL, Kia SM, Wolfers T, Tillmann J, Arenas AL, Moessnang C, Banaschewski T, Holt R, Baron-Cohen S, Loth E, Charman T, Bourgeron T, Murphy D, Ecker C, Buitelaar JK, Beckmann CF, Marquand A. Fractionating autism based on neuroanatomical normative modeling. Transl Psychiatry 2020; 10:384. [PMID: 33159037 PMCID: PMC7648836 DOI: 10.1038/s41398-020-01057-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 12/25/2022] Open
Abstract
Autism is a complex neurodevelopmental condition with substantial phenotypic, biological, and etiologic heterogeneity. It remains a challenge to identify biomarkers to stratify autism into replicable cognitive or biological subtypes. Here, we aim to introduce a novel methodological framework for parsing neuroanatomical subtypes within a large cohort of individuals with autism. We used cortical thickness (CT) in a large and well-characterized sample of 316 participants with autism (88 female, age mean: 17.2 ± 5.7) and 206 with neurotypical development (79 female, age mean: 17.5 ± 6.1) aged 6-31 years across six sites from the EU-AIMS multi-center Longitudinal European Autism Project. Five biologically based putative subtypes were derived using normative modeling of CT and spectral clustering. Three of these clusters showed relatively widespread decreased CT and two showed relatively increased CT. These subtypes showed morphometric differences from one another, providing a potential explanation for inconsistent case-control findings in autism, and loaded differentially and more strongly onto symptoms and polygenic risk, indicating a dilution of clinical effects across heterogeneous cohorts. Our results provide an important step towards parsing the heterogeneous neurobiology of autism.
Collapse
Affiliation(s)
- Mariam Zabihi
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands. .,Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
| | - Dorothea L. Floris
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Seyed Mostafa Kia
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Thomas Wolfers
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.5510.10000 0004 1936 8921Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research (NORMENT), University of Oslo & Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - Julian Tillmann
- grid.13097.3c0000 0001 2322 6764Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK ,grid.10420.370000 0001 2286 1424Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Alberto Llera Arenas
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Carolin Moessnang
- grid.7700.00000 0001 2190 4373Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Tobias Banaschewski
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Rosemary Holt
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Simon Baron-Cohen
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Eva Loth
- grid.13097.3c0000 0001 2322 6764Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Tony Charman
- grid.13097.3c0000 0001 2322 6764Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, Université de Paris, Paris, France
| | - Declan Murphy
- grid.13097.3c0000 0001 2322 6764Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Christine Ecker
- grid.13097.3c0000 0001 2322 6764Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Jan K. Buitelaar
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands ,grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Christian F. Beckmann
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands ,grid.4991.50000 0004 1936 8948Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Andre Marquand
- grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands ,grid.13097.3c0000 0001 2322 6764Department of Neuroimaging, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
| | | |
Collapse
|
10
|
Zheng W, Zhao Z, Zhang Z, Liu T, Zhang Y, Fan J, Wu D. Developmental pattern of the cortical topology in high-functioning individuals with autism spectrum disorder. Hum Brain Mapp 2020; 42:660-675. [PMID: 33085836 PMCID: PMC7814766 DOI: 10.1002/hbm.25251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/24/2020] [Accepted: 10/07/2020] [Indexed: 12/15/2022] Open
Abstract
A number of studies have indicated alterations of brain morphology in individuals with autism spectrum disorder (ASD); however, how ASD influences the topological organization of the brain cortex at different developmental stages is not yet well characterized. In this study, we used structural images of 492 high‐functioning participants in the Autism Brain Imaging Data Exchange database acquired from 17 international imaging centers, including 75 autistic children (age 7–11 years), 91 adolescents with ASD (age 12–17 years), and 80 young adults with ASD (age 18–29 years), and 246 typically developing controls (TDCs) that were age, gender, handedness, and full‐scale IQ matched. Cortical thickness (CT) and surface area (SA) were extracted and the covariance between cortical regions across participants were treated as a network to examine developmental patterns of the cortical topological organization at different stages. A center‐paired resampling strategy was developed to control the center bias during the permutation test. Compared with the TDCs, network of SA (but not CT) of individuals with ASD showed reduced small‐worldness in childhood, and the network hubs were reorganized in the adulthood such that hubs inclined to connect with nonhub nodes and demonstrated more dispersed spatial distribution. Furthermore, the SA network of the ASD cohort exhibited increased segregation of the inferior parietal lobule and prefrontal cortex, and insular‐opercular cortex in all three age groups, resulting in the emergence of two unique modules in the autistic brain. Our findings suggested that individuals with ASD may undergo remarkable remodeling of the cortical topology from childhood to adulthood, which may be associated with the altered social and cognitive functions in ASD.
Collapse
Affiliation(s)
- Weihao Zheng
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Zhe Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Tingting Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, New York, New York, USA
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| |
Collapse
|
11
|
Mihailov A, Philippe C, Gloaguen A, Grigis A, Laidi C, Piguet C, Houenou J, Frouin V. Cortical signatures in behaviorally clustered autistic traits subgroups: a population-based study. Transl Psychiatry 2020; 10:207. [PMID: 32594096 PMCID: PMC7320967 DOI: 10.1038/s41398-020-00894-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022] Open
Abstract
Extensive heterogeneity in autism spectrum disorder (ASD) has hindered the characterization of consistent biomarkers, which has led to widespread negative results. Isolating homogenized subtypes could provide insight into underlying biological mechanisms and an overall better understanding of ASD. A total of 1093 participants from the population-based "Healthy Brain Network" cohort (Child Mind Institute in the New York City area, USA) were selected based on score availability in behaviors relevant to ASD, aged 6-18 and IQ >= 70. All participants underwent an unsupervised clustering analysis on behavioral dimensions to reveal subgroups with ASD traits, identified by the presence of social deficits. Analysis revealed three socially impaired ASD traits subgroups: (1) high in emotionally dysfunctional traits, (2) high in ADHD-like traits, and (3) high in anxiety and depressive symptoms. 527 subjects had good quality structural MRI T1 data. Site effects on cortical features were adjusted using the ComBat method. Neuroimaging analyses compared cortical thickness, gyrification, and surface area, and were controlled for age, gender, and IQ, and corrected for multiple comparisons. Structural neuroimaging analyses contrasting one combined heterogeneous ASD traits group against controls did not yield any significant differences. Unique cortical signatures, however, were observed within each of the three individual ASD traits subgroups versus controls. These observations provide evidence of ASD traits subtypes, and confirm the necessity of applying dimensional approaches to extract meaningful differences, thus reducing heterogeneity and paving the way to better understanding ASD traits.
Collapse
Affiliation(s)
- Angeline Mihailov
- Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191, France.
| | - Cathy Philippe
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France
| | - Arnaud Gloaguen
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France ,CNRS-Centrale Supélec, 3 rue Joliot-Curie, 91192 Gif-sur-Yvette, France
| | - Antoine Grigis
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France
| | - Charles Laidi
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France ,APHP, Mondor Univ. Hospitals, DMU IMPACT, INSERM, U955, Translational Neuropsychiatry Team, University of Paris-Est Créteil, 94000 Créteil, France
| | - Camille Piguet
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France ,grid.8591.50000 0001 2322 4988Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Josselin Houenou
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France ,APHP, Mondor Univ. Hospitals, DMU IMPACT, INSERM, U955, Translational Neuropsychiatry Team, University of Paris-Est Créteil, 94000 Créteil, France
| | - Vincent Frouin
- grid.460789.40000 0004 4910 6535Neurospin, Institut Joliot, CEA, Université Paris-Saclay, Gif-sur-Yvette, 91191 France
| |
Collapse
|
12
|
Kong D, Fan Y, Hao J, Zhang X, Su Q, Yao T, Zhang C, Xiao L, Wang G. Cortical thickness computation by solving tetrahedron-based harmonic field. Comput Biol Med 2020; 120:103727. [PMID: 32250856 DOI: 10.1016/j.compbiomed.2020.103727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 03/11/2020] [Accepted: 03/21/2020] [Indexed: 11/30/2022]
Abstract
Cortical thickness computation in magnetic resonance imaging (MRI) is an important method to study the brain morphological changes induced by neurodegenerative diseases. This paper presents an algorithm of thickness measurement based on a volumetric Laplacian operator (VLO), which is able to capture accurately the geometric information of brain images. The proposed algorithm is a novel three-step method: 1) The rule of parity and the shrinkage strategy are combined to detect and fix the intersection error regions between the cortical surface meshes separated by FreeSurfer software and the tetrahedral mesh is constructed which reflects the original morphological features of the cerebral cortex, 2) VLO and finite element method are combined to compute the temperature distribution in the cerebral cortex under the Dirichlet boundary conditions, and 3) the thermal gradient line is determined based on the constructed local isothermal surfaces and linear geometric interpolation results. Combined with half-face data storage structure, the cortical thickness can be computed accurately and effectively from the length of each gradient line. With the obtained thickness, we set experiments to study the group differences among groups of Alzheimer's disease (AD, N = 110), mild cognitive impairment (MCI, N = 101) and healthy control people (CTL, N = 128) by statistical analysis. The results show that the q-value associated with the group differences is 0.0458 between AD and CTL, 0.0371 between MCI and CTL, and 0.0044 between AD and MCI. Practical tests demonstrate that the algorithm of thickness measurement has high efficiency and is generic to be applied to various biological structures that have internal and external surfaces.
Collapse
Affiliation(s)
- Deping Kong
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Yonghui Fan
- School of Computing, Informatics, And Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Jinguang Hao
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Xiaofeng Zhang
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Qingtang Su
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Tao Yao
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Caiming Zhang
- Shandong Co-Innovation Center of Future Intelligent Computing, Yantai, China
| | - Liang Xiao
- School of Computer Science and Engineering, Nanjing University of Science & Technology, Nanjing, China
| | - Gang Wang
- School of Information and Electrical Engineering, Ludong University, Yantai, China; School of Computing, Informatics, And Decision Systems Engineering, Arizona State University, Tempe, AZ, USA.
| |
Collapse
|
13
|
Zabihi M, Oldehinkel M, Wolfers T, Frouin V, Goyard D, Loth E, Charman T, Tillmann J, Banaschewski T, Dumas G, Holt R, Baron-Cohen S, Durston S, Bölte S, Murphy D, Ecker C, Buitelaar JK, Beckmann CF, Marquand AF. Dissecting the Heterogeneous Cortical Anatomy of Autism Spectrum Disorder Using Normative Models. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:567-578. [PMID: 30799285 PMCID: PMC6551348 DOI: 10.1016/j.bpsc.2018.11.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The neuroanatomical basis of autism spectrum disorder (ASD) has remained elusive, mostly owing to high biological and clinical heterogeneity among diagnosed individuals. Despite considerable effort toward understanding ASD using neuroimaging biomarkers, heterogeneity remains a barrier, partly because studies mostly employ case-control approaches, which assume that the clinical group is homogeneous. METHODS Here, we used an innovative normative modeling approach to parse biological heterogeneity in ASD. We aimed to dissect the neuroanatomy of ASD by mapping the deviations from a typical pattern of neuroanatomical development at the level of the individual and to show the necessity to look beyond the case-control paradigm to understand the neurobiology of ASD. We first estimated a vertexwise normative model of cortical thickness development using Gaussian process regression, then mapped the deviation of each participant from the typical pattern. For this, we employed a heterogeneous cross-sectional sample of 206 typically developing individuals (127 males) and 321 individuals with ASD (232 males) (6-31 years of age). RESULTS We found few case-control differences, but the ASD cohort showed highly individualized patterns of deviations in cortical thickness that were widespread across the brain. These deviations correlated with severity of repetitive behaviors and social communicative symptoms, although only repetitive behaviors survived corrections for multiple testing. CONCLUSIONS Our results 1) reinforce the notion that individuals with ASD show distinct, highly individualized trajectories of brain development and 2) show that by focusing on common effects (i.e., the "average ASD participant"), the case-control approach disguises considerable interindividual variation crucial for precision medicine.
Collapse
Affiliation(s)
- Mariam Zabihi
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
| | - Marianne Oldehinkel
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Vincent Frouin
- Neurospin, Institut des sciences du vivant Frédéric Joliot, CEA-Université Paris-Saclay, Gif-sur-Yvette, France
| | - David Goyard
- Neurospin, Institut des sciences du vivant Frédéric Joliot, CEA-Université Paris-Saclay, Gif-sur-Yvette, France
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Guillaume Dumas
- Human Genetics and Cognitive Functions Unit, Institut Pasteur, Paris, France
| | - Rosemary Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Durston
- Department of Psychiatry, University Medical Centre, Utrecht, the Netherlands
| | - Sven Bölte
- Center for Neurodevelopmental Disorders, Division of Neuropsychiatry, Department of Women's and Children's Health, Stockholm, Sweden; Child and Adolescent Psychiatry, Centre of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Christine Ecker
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Centre for Functional MRI of the Brain, University of Oxford, Oxford, United Kingdom
| | - Andre F Marquand
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| |
Collapse
|
14
|
Prigge MBD, Bigler ED, Travers BG, Froehlich A, Abildskov T, Anderson JS, Alexander AL, Lange N, Lainhart JE, Zielinski BA. Social Responsiveness Scale (SRS) in Relation to Longitudinal Cortical Thickness Changes in Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:3319-3329. [PMID: 29728946 DOI: 10.1007/s10803-018-3566-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The relationship between brain development and clinical heterogeneity in autism (ASD) is unknown. This study examines the Social Responsiveness Scale (SRS) in relation to the longitudinal development of cortical thickness. Participants (N = 91 ASD, N = 56 TDC; 3-39 years at first scan) were scanned up to three times over a 7-year period. Mixed-effects models examined cortical thickness in relation to SRS score. ASD participants with higher SRS scores showed regionally increased age-related cortical thinning. Regional thickness differences and reduced age-related cortical thinning were found in predominantly right lateralized regions in ASD with decreasing SRS scores over time. Our findings emphasize the importance of examining clinical phenotypes in brain-based studies of ASD.
Collapse
Affiliation(s)
- Molly B D Prigge
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. .,Department of Radiology, University of Utah, Salt Lake City, UT, USA. .,Waisman Center, University of Wisconsin-Madison, Madison, WI, USA. .,University of Utah, 417 Wakara Way, Suite 3111, Salt Lake City, UT, 84108, USA.
| | - Erin D Bigler
- Departments of Psychology and Neuroscience, Brigham Young University, Provo, UT, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.,Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Alyson Froehlich
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Tracy Abildskov
- Departments of Psychology and Neuroscience, Brigham Young University, Provo, UT, USA
| | - Jeffrey S Anderson
- Department of Radiology, University of Utah, Salt Lake City, UT, USA.,Department of Bioengineering, University of Utah, Salt Lake City, UT, USA
| | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Nicholas Lange
- McLean Hospital and Department of Psychiatry, Harvard University, Cambridge, MA, USA
| | - Janet E Lainhart
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Brandon A Zielinski
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.,Department of Neurology, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
15
|
Wei L, Zhong S, Nie S, Gong G. Aberrant development of the asymmetry between hemispheric brain white matter networks in autism spectrum disorder. Eur Neuropsychopharmacol 2018; 28:48-62. [PMID: 29224969 DOI: 10.1016/j.euroneuro.2017.11.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/26/2017] [Accepted: 11/22/2017] [Indexed: 11/30/2022]
Abstract
Atypical brain asymmetry/lateralization has long been hypothesized for autism spectrum disorder (ASD), and this model has been repeatedly supported by various neuroimaging studies. Recently, hemispheric network topologies have been found to be asymmetric, thereby providing a new avenue for investigating brain asymmetries under various conditions. To date, however, how network topological asymmetries are altered in ASD remains largely unexplored. To clarify this, the present study included ASD individuals from the newly released Autism Brain Imaging Data Exchange II database (58 right-handed male ASD individuals aged 5 to 26 years and 70 age- and IQ-matched typically developing (TD) individuals). Diffusion and structural magnetic resonance imaging were used to construct hemispheric white matter networks, and graph-theory approaches were applied to quantify topological efficiencies for hemispheric networks. Statistical analyses revealed a decreased rightward asymmetry of network efficiencies with increasing age in the TD group, but not in the ASD group. More specifically, the TD group did not exhibit an age-related increase in network efficiency in the right hemisphere, but the ASD group did. For the left hemisphere, no difference between the groups was observed for the developmental trajectory of network efficiencies. Intriguingly, within the ASD group, more severe restricted and repetitive behavior in ASD was found to be correlated with less rightward asymmetry of network local efficiency. These findings provide suggestive evidence of atypical network topological asymmetries and offer important insights into the abnormal development of ASD brains.
Collapse
Affiliation(s)
- Long Wei
- Institute of Medical Imaging Engineering, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China; Laiwu Vocational and Technical College, Laiwu, Shandong, China
| | - Suyu Zhong
- State Key Laboratory of Cognitive Neuroscience and Learning &IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Shengdong Nie
- Institute of Medical Imaging Engineering, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China.
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning &IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| |
Collapse
|
16
|
Qin B, Wang L, Zhang Y, Cai J, Chen J, Li T. Enhanced Topological Network Efficiency in Preschool Autism Spectrum Disorder: A Diffusion Tensor Imaging Study. Front Psychiatry 2018; 9:278. [PMID: 29997534 PMCID: PMC6030375 DOI: 10.3389/fpsyt.2018.00278] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/07/2018] [Indexed: 12/27/2022] Open
Abstract
Background: The functional mechanism behind autism spectrum disorder (ASD) is not clear, but it is related to a brain connectivity disorder. Previous studies have found that functional brain connectivity of ASD is linked to both increased connections and weakened connections, and the inconsistencies in functional brain connectivity may be related to age. The functional connectivity in adolescents and adults with ASD is generally less than in age-matched controls; functional connectivity in younger children with the disorder appears to be higher. As the basis of the functional network, the structural network is less studied. This study intends to further study the pathogenesis of ASD by analyzing the white matter network of ASD preschool children. Materials and Methods: In this study, Diffusion Tensor Imaging (DTI) was used to scan preschool children (aged 2-6 years, 39 children with ASD, 19 children as controls), and graph theory was used for analysis. Result: Enhanced topological network efficiency was found in the preschool children with ASD. A higher nodal efficiency was found in the left precuneus, thalamus, and bilateral superior parietal cortex, and the nodal efficiency of the left precuneus was positively associated with the severity of ASD. Conclusion: Our research shows the white matter network efficiency of preschoolers with ASD. It supports the theory of excessive early brain growth in ASD, and it shows left brain lateralization. It opens the way for new research perspectives of children with ASD.
Collapse
Affiliation(s)
- Bin Qin
- Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Longlun Wang
- Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yun Zhang
- Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jinhua Cai
- Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Chen
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Tingyu Li
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| |
Collapse
|
17
|
Kouklari EC, Tsermentseli S, Monks CP. Hot and cool executive function in children and adolescents with autism spectrum disorder: Cross-sectional developmental trajectories. Child Neuropsychol 2017; 24:1088-1114. [PMID: 29052463 DOI: 10.1080/09297049.2017.1391190] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The development of executive function (EF) in autism spectrum disorder (ASD) has only been investigated using "cool"-cognitive-EF tasks. Little is known about the development of "hot"-affective-EF and whether it follows a similar developmental pathway. This study employed a cross-sectional developmental trajectories approach to examine the developmental changes in cool (working memory, inhibition, and planning) and hot EF (delay discounting and affective decision-making) of ASD participants (n = 79) and controls (n = 91) relative to age and IQ, shedding more light on the hot-cool EF organization. The developmental trajectories of some aspects of cool EF (working memory and planning) differed significantly as a function of age in ASD participants relative to controls. For both hot EFs, no significant age-related changes were found in either group. These findings extend our understanding regarding the maturation of EF from childhood through adolescence in ASD.
Collapse
Affiliation(s)
| | - Stella Tsermentseli
- a Department of Psychology, Social Work and Counselling , University of Greenwich , London , UK
| | - Claire P Monks
- a Department of Psychology, Social Work and Counselling , University of Greenwich , London , UK
| |
Collapse
|
18
|
Ecker C, Schmeisser MJ, Loth E, Murphy DG. Neuroanatomy and Neuropathology of Autism Spectrum Disorder in Humans. ADVANCES IN ANATOMY, EMBRYOLOGY, AND CELL BIOLOGY 2017; 224:27-48. [PMID: 28551749 DOI: 10.1007/978-3-319-52498-6_2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Autism spectrum disorder (ASD) is a lifelong heterogeneous neurodevelopmental condition that is associated with differences in brain anatomy and connectivity. Yet, the molecular and cellular mechanisms that underpin the atypical developmental of the brain in ASD remain poorly understood. Here, we review the findings of in vivo neuroimaging studies examining the time course of atypical brain development in ASD and relate the different neurodevelopmental stages that are atypical in ASD to the known neurobiological mechanisms that drive the maturation of the typically developing brain. In particular, we focus on the notion of 'early brain overgrowth' in ASD, which may lead to differences in the formation of the brain's micro- and macro-circuitry. Moreover, we attempt to link the in vivo reports describing differences in brain anatomy and connectivity on the macroscopic level to the increasing number of post-mortem studies examining the neural architecture of the brain in ASD on the microscopic level. In addition, we discuss future directions and outstanding questions in this particular field of research and highlight the need for establishing the link between micro- and macro-pathology in the same set of individuals with ASD based on advances in genetic, molecular and imaging techniques. In combination, these may proof to be invaluable for patient stratification and the development of novel pharmacotherapies in the future.
Collapse
Affiliation(s)
- Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany.
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
| | - Michael J Schmeisser
- Institute for Anatomy and Cell Biology, Ulm University, Ulm, Germany
- Division of Neuroanatomy, Institute of Anatomy, Otto-von-Guericke University, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| |
Collapse
|
19
|
Abstract
A suite of recent studies has reported positive genetic correlations between autism risk and measures of mental ability. These findings indicate that alleles for autism overlap broadly with alleles for high intelligence, which appears paradoxical given that autism is characterized, overall, by below-average IQ. This paradox can be resolved under the hypothesis that autism etiology commonly involves enhanced, but imbalanced, components of intelligence. This hypothesis is supported by convergent evidence showing that autism and high IQ share a diverse set of convergent correlates, including large brain size, fast brain growth, increased sensory and visual-spatial abilities, enhanced synaptic functions, increased attentional focus, high socioeconomic status, more deliberative decision-making, profession and occupational interests in engineering and physical sciences, and high levels of positive assortative mating. These findings help to provide an evolutionary basis to understanding autism risk as underlain in part by dysregulation of intelligence, a core human-specific adaptation. In turn, integration of studies on intelligence with studies of autism should provide novel insights into the neurological and genetic causes of high mental abilities, with important implications for cognitive enhancement, artificial intelligence, the relationship of autism with schizophrenia, and the treatment of both autism and intellectual disability.
Collapse
Affiliation(s)
- Bernard J Crespi
- Department of Biological Sciences and Human Evolutionary Studies Program, Simon Fraser University Burnaby, BC, Canada
| |
Collapse
|
20
|
Eilam-Stock T, Wu T, Spagna A, Egan LJ, Fan J. Neuroanatomical Alterations in High-Functioning Adults with Autism Spectrum Disorder. Front Neurosci 2016; 10:237. [PMID: 27313505 PMCID: PMC4889574 DOI: 10.3389/fnins.2016.00237] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/12/2016] [Indexed: 12/14/2022] Open
Abstract
Autism spectrum disorder (ASD) is a pervasive neurodevelopmental condition, affecting cognition and behavior throughout the life span. With recent advances in neuroimaging techniques and analytical approaches, a considerable effort has been directed toward identifying the neuroanatomical underpinnings of ASD. While gray-matter abnormalities have been found throughout cortical, subcortical, and cerebellar regions of affected individuals, there is currently little consistency across findings, partly due to small sample-sizes and great heterogeneity among participants in previous studies. Here, we report voxel-based morphometry of structural magnetic resonance images in a relatively large sample of high-functioning adults with ASD (n = 66) and matched typically-developing controls (n = 66) drawn from multiple studies. We found decreased gray-matter volume in posterior brain regions, including the posterior hippocampus and cuneus, as well as increased gray-matter volume in frontal brain regions, including the medial prefrontal cortex, superior and inferior frontal gyri, and middle temporal gyrus in individuals with ASD. We discuss our results in relation to findings obtained in previous studies, as well as their potential clinical implications.
Collapse
Affiliation(s)
- Tehila Eilam-Stock
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, NY, USA; Department of Psychology, Queens College, City University of New YorkFlushing, NY, USA; The Graduate Center, City University of New YorkNew York, NY, USA
| | - Tingting Wu
- Department of Psychology, Queens College, City University of New York Flushing, NY, USA
| | - Alfredo Spagna
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, NY, USA; Department of Psychology, Queens College, City University of New YorkFlushing, NY, USA
| | - Laura J Egan
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, NY, USA; Department of Psychology, Queens College, City University of New YorkFlushing, NY, USA
| | - Jin Fan
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, NY, USA; Department of Psychology, Queens College, City University of New YorkFlushing, NY, USA; The Graduate Center, City University of New YorkNew York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount SinaiNew York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| |
Collapse
|
21
|
Jumah F, Ghannam M, Jaber M, Adeeb N, Tubbs RS. Neuroanatomical variation in autism spectrum disorder: A comprehensive review. Clin Anat 2016; 29:454-65. [PMID: 27004599 DOI: 10.1002/ca.22717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 01/27/2023]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in socialization, communication, and behavior. Many investigators have described the anatomical abnormalities in autistic brains, in an attempt to correlate them with the manifestations of ASD. Herein, we reviewed all the available literature about the neuroanatomical findings in ASD available via "PubMed" and "Google Scholar." References found in review articles were also searched manually. There was substantial discrepancy throughout the literature regarding the reported presence and significance of neuroanatomical findings in ASD, and this is thoroughly discussed in the present review.
Collapse
Affiliation(s)
- Fareed Jumah
- Department of Neuroscience, an-Najah National University Hospital, Nablus, Palestine
| | - Malik Ghannam
- Department of Neuroscience, an-Najah National University Hospital, Nablus, Palestine
| | - Mohammad Jaber
- Department of Neuroscience, an-Najah National University Hospital, Nablus, Palestine
| | - Nimer Adeeb
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, Grenada.,Seattle Science Foundation, Seattle, Washington
| |
Collapse
|
22
|
Smith E, Thurm A, Greenstein D, Farmer C, Swedo S, Giedd J, Raznahan A. Cortical thickness change in autism during early childhood. Hum Brain Mapp 2016; 37:2616-29. [PMID: 27061356 DOI: 10.1002/hbm.23195] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/25/2016] [Accepted: 03/16/2016] [Indexed: 11/11/2022] Open
Abstract
Structural magnetic resonance imaging (MRI) scans at high spatial resolution can detect potential foci of early brain dysmaturation in children with autism spectrum disorders (ASD). In addition, comparison between MRI and behavior measures over time can identify patterns of brain change accompanying specific outcomes. We report structural MRI data from two time points for a total of 84 scans in children with ASD and 30 scans in typical controls (mean age time one = 4.1 years, mean age at time two = 6.6 years). Surface-based cortical morphometry and linear mixed effects models were used to link changes in cortical anatomy to both diagnostic status and individual differences in changes in language and autism severity. Compared with controls, children with ASD showed accelerated gray matter volume gain with age, which was driven by a lack of typical age-related cortical thickness (CT) decrease within 10 cortical regions involved in language, social cognition, and behavioral control. Greater expressive communication gains with age in children with ASD were associated with greater CT gains in a set of right hemisphere homologues to dominant language cortices, potentially identifying a compensatory system for closer translational study. Hum Brain Mapp 37:2616-2629, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Elizabeth Smith
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Audrey Thurm
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Deanna Greenstein
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Cristan Farmer
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Susan Swedo
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Jay Giedd
- Department of Psychiatry at University of California, San Diego, California
| | - Armin Raznahan
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland
| |
Collapse
|
23
|
Lischinsky JE, Skocic J, Clairman H, Rovet J. Preliminary Findings Show Maternal Hypothyroidism May Contribute to Abnormal Cortical Morphology in Offspring. Front Endocrinol (Lausanne) 2016; 7:16. [PMID: 26941710 PMCID: PMC4766309 DOI: 10.3389/fendo.2016.00016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/11/2016] [Indexed: 12/18/2022] Open
Abstract
In rodents, insufficient thyroid hormone (TH) gestationally has adverse effects on cerebral cortex development. Comparable studies of humans examining how TH insufficiency affects cortical morphology are limited to children with congenital hypothyroidism or offspring of hypothyroxinemic women; effects on cortex of children born to women with clinically diagnosed hypothyroidism are not known. We studied archived MRI scans from 22 children aged 10-12 years born to women treated for preexisting or de novo hypothyroidism in pregnancy (HYPO) and 24 similar age and sex controls from euthyroid women. FreeSurfer Image Analysis Suite software was used to measure cortical thickness (CT) and a vertex-based approach served to compare HYPO versus control groups and Severe versus Mild HYPO subgroups as well as to perform regression analyses examining effects of trimester-specific maternal TSH on CT. Results showed that relative to controls, HYPO had multiple regions of both cortical thinning and thickening, which differed for left and right hemispheres. In HYPO, thinning was confined to medial and mid-lateral regions of each hemisphere and thickening to superior regions (primarily frontal) of the left hemisphere and inferior regions (particularly occipital and temporal) of the right. The Severe HYPO subgroup showed more thinning than Mild in frontal and temporal regions and more thickening in bilateral posterior and frontal regions. Maternal TSH values predicted degree of thinning and thickening within multiple brain regions, with the pattern and direction of correlations differing by trimester. Notably, some correlations remained when cases born to women with severe hypothyroidism were removed from the analyses, suggesting that mild variations of maternal TH may permanently affect offspring cortex. We conclude that maternal hypothyroidism during pregnancy has long-lasting manifestations on the cortical morphology of their offspring with specific effects reflecting both severity and timing of maternal TH insufficiency.
Collapse
Affiliation(s)
- Julieta E. Lischinsky
- Institute for Biomedical Sciences, The George Washington University, Washington, DC, USA
- Center for Neuroscience Research, Children’s National Medical Center, Washington, DC, USA
| | - Jovanka Skocic
- Neuroscience and Mental Health Program, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - Hayyah Clairman
- Neuroscience and Mental Health Program, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - Joanne Rovet
- Neuroscience and Mental Health Program, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
24
|
van Belle J, van Hulst BM, Durston S. Developmental differences in intra-individual variability in children with ADHD and ASD. J Child Psychol Psychiatry 2015; 56:1316-26. [PMID: 25871802 DOI: 10.1111/jcpp.12417] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Intra-individual variability reflects temporal variation within an individual's performance on a cognitive task. Children with developmental disorders, such as ADHD and ASD show increased levels of intra-individual variability. In typical development, intra-individual variability decreases sharply between the ages 6 and 20. The tight link between intra-individual variability and age has led to the suggestion that it may be marker of neural development. As there is accumulating evidence that ADHD and ASD are characterised by atypical neurodevelopmental trajectories, we set out to explore developmental changes in intra-individual variability in subjects with ADHD and ASD. METHOD We used propensity score matching to match a cross-sectional sample of children with ADHD, ASD and control subjects (N = 405, aged 6-19 years old) for age, IQ and gender. We used ex-Gaussian distribution parameters to characterise intra-individual variability on fast responses (sigma) and slow responses (tau). RESULT Results showed that there was a similar decrease in mean response times with age across groups, and an interaction between age and group for measures of variability, where there was a much lower rate of change in the variability parameters (sigma and tau) for subjects with ASD compared with the other two groups. Subjects with ADHD had higher intra-individual variability, reflected by both sigma and tau, but the rate of decrease in variability with age was similar to that of the controls. CONCLUSION These results suggest that subjects with ADHD, ASD and controls differ in the rate at which intra-individual variability decreases during development, and support the idea that intra-individual variability may be a marker of neural development, mimicking the neurodevelopmental changes in these disorders.
Collapse
Affiliation(s)
- Janna van Belle
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Branko M van Hulst
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
25
|
Richter J, Henze R, Vomstein K, Stieltjes B, Parzer P, Haffner J, Brandeis D, Poustka L. Reduced cortical thickness and its association with social reactivity in children with autism spectrum disorder. Psychiatry Res 2015; 234:15-24. [PMID: 26329119 DOI: 10.1016/j.pscychresns.2015.06.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/19/2015] [Accepted: 06/25/2015] [Indexed: 01/30/2023]
Abstract
Symptomatology and behavioral characteristics in autism spectrum disorders (ASD) have increasingly been linked to abnormalities in early brain growth patterns of affected children. Studies investigating specific components of gray matter structure, such as cortical thickness (CT), have produced conflicting results, and have rarely included additional measures of social impairment. In the present study, we applied a surface-based whole brain analysis to investigate CT in a sample of 36 pre-adolescent children [18 subjects with ASD (IQ mean: 111) and 18 healthy controls (IQ mean: 112.8), age range 6-12 years]. The CT analysis revealed widespread, but mostly left-hemispheric thinning in frontal, temporal, parietal and occipital brain areas related to the theory-of-mind network and the heteromodal association cortex. In an exploratory analysis, CT was observed to be differently associated with social impairment in children with ASD compared with typically developing children. The affected neuroanatomical regions are related to characteristic deficits in language, cognition and behavior that are often observed in the disorder. The relationship between social impairment and CT in children with ASD and controls seems to indicate aberrant developmental trajectories in ASD emerging early in life.
Collapse
Affiliation(s)
- Julia Richter
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Romy Henze
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
| | - Kilian Vomstein
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bram Stieltjes
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Johann Haffner
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| |
Collapse
|
26
|
Foster NEV, Doyle-Thomas KAR, Tryfon A, Ouimet T, Anagnostou E, Evans AC, Zwaigenbaum L, Lerch JP, Lewis JD, Hyde KL. Structural Gray Matter Differences During Childhood Development in Autism Spectrum Disorder: A Multimetric Approach. Pediatr Neurol 2015; 53:350-9. [PMID: 26231265 DOI: 10.1016/j.pediatrneurol.2015.06.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Autism spectrum disorder is a complex neurodevelopmental disorder characterized by impaired social interaction and communication, repetitive behaviors, and restricted interests. Gray matter differences linked to autism spectrum disorder have been studied using a variety of structural imaging methods, but yielded little consensus; the extent to which disparate results reflect differences in methodology or heterogeneity within autism spectrum disorder is not yet clear. Moreover, very few studies have examined gray matter changes as a function of age in autism spectrum disorder. METHOD A detailed investigation of gray matter structural development was performed via voxel-based morphometry, cortical thickness, and cortical surface area analyses in 38 autism spectrum disorder versus 46 typically developing children. RESULTS Relative to typically developing children, the autism spectrum disorder group showed gray matter increases most prominently in the frontal and temporal lobes (including regions such as medial frontal gyrus, Broca's area and posterior temporal cortex), as well as certain parietal and occipital subcortical regions. Gray matter decreases were found only near the temporoparietal junction. Subcortical gray matter increases were found in the putamen and caudate nucleus, while decreases were found in cerebellum. There were age-dependent GM differences in distributed regions including prefrontal cortex, primary sensorimotor cortex, and temporoparietal junction. CONCLUSION The results underline the distributed nature of gray matter structural differences in autism spectrum disorder and provide a more comprehensive characterization of autism spectrum disorder-related cortical and subcortical gray matter structural differences during childhood and adolescent development.
Collapse
Affiliation(s)
- Nicholas E V Foster
- International Laboratory for Brain Music and Sound Research (BRAMS), FAS, Université de Montréal, Montréal, Quebec, Canada; Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Krissy A R Doyle-Thomas
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Ana Tryfon
- International Laboratory for Brain Music and Sound Research (BRAMS), FAS, Université de Montréal, Montréal, Quebec, Canada; Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Tia Ouimet
- International Laboratory for Brain Music and Sound Research (BRAMS), FAS, Université de Montréal, Montréal, Quebec, Canada; Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alan C Evans
- Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Jason P Lerch
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - John D Lewis
- Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Krista L Hyde
- International Laboratory for Brain Music and Sound Research (BRAMS), FAS, Université de Montréal, Montréal, Quebec, Canada; Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | |
Collapse
|
27
|
Do children with congenital hypothyroidism exhibit abnormal cortical morphology? Pediatr Res 2015; 78:286-97. [PMID: 25978801 DOI: 10.1038/pr.2015.93] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 02/03/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Given thyroid hormone (TH)'s essential role in multiple aspects of early brain development, children with congenital hypothyroidism (CH) detected and treated early may still display subtle cognitive and behavioral impairments as well as brain abnormalities. However, effects on their cortical development are not yet known. We used an automated neuroimaging technique to determine if these children differ in cortical thickness (CT) from typically developing controls (TDC) and if the regions showing CT differences reflect severity of initial hypothyroidism and predict later neuropsychological functioning. METHODS FreeSurfer Image Analysis Suite was used on archived MRI scans from 41 CH and 42 TDC children aged 9-16 y. Vertex-based procedures were used to compare groups and perform correlations between CT and indices of disease severity and neuropsychological outcome. RESULTS The CH group showed multiple regions of cortical thinning or cortical thickening within right and left hemispheres relative to TDC. CT values were significantly correlated with early T4 and thyroid-stimulating hormone (TSH) levels and current neuropsychological test indices. CONCLUSION The developing cortex is sensitive to early TH loss in CH. Different patterns of cortical thinning or cortical thickening among brain regions may reflect timing of TH deficiency relative to timing of cortical development.
Collapse
|
28
|
Tu PC, Hsu JW, Lan CC, Liu CC, Su TP, Chen YS. Structural and functional correlates of a quantitative autistic trait measured using the social responsive scale in neurotypical male adolescents. Autism Res 2015; 9:570-8. [DOI: 10.1002/aur.1535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/28/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research; Taipei Veterans General Hospital; Taipei 112 Taiwan
- Department of Psychiatry; Taipei Veterans General Hospital; Taipei 112 Taiwan
- Institute of Philosophy of Mind and Cognition, National Yang-Ming University; Taipei Taiwan
- Department of Psychiatry, Faculty of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry; Taipei Veterans General Hospital; Taipei 112 Taiwan
- Department of Psychiatry, Faculty of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Chen-Chia Lan
- Department of Psychiatry; Taipei Municipal Gandau Hospital; Taipei Taiwan
| | - Chia-Chien Liu
- Department of Psychiatry; National Yang-Ming University Hospital; Yi-Lan Taiwan
| | - Tung-Ping Su
- Department of Psychiatry; Taipei Veterans General Hospital; Taipei 112 Taiwan
- Department of Psychiatry, Faculty of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Ying-Sheue Chen
- Department of Psychiatry; Taipei Veterans General Hospital; Taipei 112 Taiwan
- Department of Psychiatry, Faculty of Medicine; National Yang-Ming University; Taipei Taiwan
| |
Collapse
|
29
|
Ohta H, Nordahl CW, Iosif AM, Lee A, Rogers S, Amaral DG. Increased Surface Area, but not Cortical Thickness, in a Subset of Young Boys With Autism Spectrum Disorder. Autism Res 2015; 9:232-48. [PMID: 26184828 DOI: 10.1002/aur.1520] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/22/2015] [Indexed: 01/22/2023]
Abstract
The Autism Phenome Project is the largest, single site, longitudinal magnetic resonance imaging (MRI) study of young children with autism spectrum disorder (ASD). Previous analyses from this cohort have shown that the children with autism have a total brain volume at time 1 (∼3 years of age) that is 6% larger than typically developing (TD) children. This finding is driven primarily by 15% of the boys with ASD that have disproportionate megalencephaly (ASD-DM) or brain size that is 1.5 standard deviations above what would be expected for the child's height. In the current study, cerebral cortical grey matter volume, thickness, and surface area were assayed from MRI scans of 112, 3-year-old boys with ASD and 50 age-matched TD boys. The boys with ASD-DM (n = 17) were analyzed separately from the boys with normal brain size (ASD-N, n = 95). Previous studies of cortical thickness and surface area for ASD children in this age range have come to diametrically different conclusions concerning the significance of cortical thickness vs. surface area. Current analyses indicate that cortical thickness was comparable across the ASD and TD groups. However, surface area was significantly greater in the ASD group compared to the TD group. This result was driven largely by the children with ASD-DM. Even in the ASD-DM group, not all cortical regions demonstrated increased surface area. These results provide strong evidence that the early cortical overgrowth associated with ASD is due primarily to increased surface area and not to increased cortical thickness.
Collapse
Affiliation(s)
- Haruhisa Ohta
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, California
- Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan
| | - Christine Wu Nordahl
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, California
| | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, California
| | - Aaron Lee
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, California
| | - Sally Rogers
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, California
| | - David G Amaral
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, California
| |
Collapse
|
30
|
Examination of Local Functional Homogeneity in Autism. BIOMED RESEARCH INTERNATIONAL 2015; 2015:174371. [PMID: 26180782 PMCID: PMC4477064 DOI: 10.1155/2015/174371] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/09/2014] [Indexed: 01/07/2023]
Abstract
Increasing neuroimaging evidence suggests that autism patients exhibit abnormal brain structure and function. We used the Autism Brain Imaging Data Exchange (ABIDE) sample to analyze locally focal (~8 mm) functional connectivity of 223 autism patients and 285 normal controls from 15 international sites using a recently developed surface-based approach. We observed enhanced local connectivity in the middle frontal cortex, left precuneus, and right superior temporal sulcus, and reduced local connectivity in the right insular cortex. The local connectivity in the right middle frontal gyrus was positively correlated with the total score of the autism diagnostic observation schedule whereas the local connectivity within the right superior temporal sulcus was positively correlated with total subscores of both the communication and the stereotyped behaviors and restricted interests of the schedule. Finally, significant interactions between age and clinical diagnosis were detected in the left precuneus. These findings replicated previous observations that used a volume-based approach and suggested possible neuropathological impairments of local information processing in the frontal, temporal, parietal, and insular cortices. Novel site-variability analysis demonstrated high reproducibility of our findings across the 15 international sites. The age-disease interaction provides a potential target region for future studies to further elucidate the neurodevelopmental mechanisms of autism.
Collapse
|
31
|
Wallace GL, Eisenberg IW, Robustelli B, Dankner N, Kenworthy L, Giedd JN, Martin A. Longitudinal cortical development during adolescence and young adulthood in autism spectrum disorder: increased cortical thinning but comparable surface area changes. J Am Acad Child Adolesc Psychiatry 2015; 54:464-9. [PMID: 26004661 PMCID: PMC4540060 DOI: 10.1016/j.jaac.2015.03.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 02/23/2015] [Accepted: 03/13/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Prior reports suggest that autism spectrum disorder (ASD) is associated with atypically excessive early brain growth. Recent cross-sectional studies suggest that later cortical development during adolescence/adulthood might also be aberrant, although longitudinal designs are required to evaluate atypical growth trajectories. The present study sought to examine longitudinal changes in cortical thickness and surface area among adolescents and young adults with ASD. METHOD Two high-resolution anatomic magnetic resonance imaging scans approximately 2 years apart were acquired from 17 adolescents with ASD and 18 typically developing (TD) adolescents, matched on age (range = 14-24 years), IQ, sex ratio, and handedness (70 scans total). The FreeSurfer image analysis suite was used to quantify longitudinal changes in cortical thickness and surface area. RESULTS Accelerated cortical thinning for the ASD group as compared to the TD group was found in 2 areas in the left hemisphere, the posterior portion of ventral temporal cortex and superior parietal cortex (cluster corrected p < .01). For ventral temporal cortex, cortical thinning was associated with everyday executive function impairments, and thinner cortex at time 2 was correlated with ASD social symptoms. Differences in surface area changes were not detected. CONCLUSION The present longitudinal study extends prior cross-sectional research by demonstrating increased cortical thinning (in portions of temporal and parietal cortex) but comparable surface area growth rates in participants with ASD compared to TD controls during adolescence and into young adulthood. These findings provide further evidence for atypical cortical development beyond the early years in ASD, marked by increased cortical thinning in late adolescence/young adulthood.
Collapse
Affiliation(s)
- Gregory L Wallace
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD; George Washington University, Washington, DC.
| | - Ian W Eisenberg
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD
| | - Briana Robustelli
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD
| | - Nathan Dankner
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD
| | - Lauren Kenworthy
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD
| | | | - Alex Martin
- Laboratory of Brain and Cognition, National Institute of Mental Health (NIMH), Bethesda, MD
| |
Collapse
|
32
|
Saleh M, Nashaat NH, Fahim C, Ibrahim AS, Meguid N. MRI Surface-Based Brain Morphometry in Egyptian Autistic and Typically Developing Children. Folia Phoniatr Logop 2015; 67:29-35. [PMID: 25967922 DOI: 10.1159/000368962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The verbal abilities of autistic children differ from those of typically developing ones and they also differ among autistic children themselves. Neuroanatomical changes and an abnormal organization of functional networks are expected to accompany such a neurodevelopmental disorder. The aim of this study was to delineate the brain neuroanatomical changes in Egyptian children with autism and to compare them with previous studies in order to add more insight into the global brain imaging deviations linked to autism. PATIENTS AND METHODS Twenty-five autistic children and 25 typically developing children underwent MRI. Further analysis was performed using surface-based morphometry to obtain cortical thickness, brain volume, and cortical complexity. RESULTS MRI analysis results revealed significantly greater cortical thickness, cortical complexity, and gray matter volume in the autistic as compared to the control group. On the other hand, the white matter volume was significantly smaller. CONCLUSION These findings generally align with findings in previous studies, except for occasional differences.
Collapse
Affiliation(s)
- Marwa Saleh
- Unit of Phoniatrics, Department of Otolaryngology, Ain Shams University, Cairo, Egypt
| | | | | | | | | |
Collapse
|
33
|
Wang G, Zhang X, Su Q, Shi J, Caselli RJ, Wang Y. A novel cortical thickness estimation method based on volumetric Laplace-Beltrami operator and heat kernel. Med Image Anal 2015; 22:1-20. [PMID: 25700360 PMCID: PMC4405465 DOI: 10.1016/j.media.2015.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 12/31/2022]
Abstract
Cortical thickness estimation in magnetic resonance imaging (MRI) is an important technique for research on brain development and neurodegenerative diseases. This paper presents a heat kernel based cortical thickness estimation algorithm, which is driven by the graph spectrum and the heat kernel theory, to capture the gray matter geometry information from the in vivo brain magnetic resonance (MR) images. First, we construct a tetrahedral mesh that matches the MR images and reflects the inherent geometric characteristics. Second, the harmonic field is computed by the volumetric Laplace-Beltrami operator and the direction of the steamline is obtained by tracing the maximum heat transfer probability based on the heat kernel diffusion. Thereby we can calculate the cortical thickness information between the point on the pial and white matter surfaces. The new method relies on intrinsic brain geometry structure and the computation is robust and accurate. To validate our algorithm, we apply it to study the thickness differences associated with Alzheimer's disease (AD) and mild cognitive impairment (MCI) on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Our preliminary experimental results on 151 subjects (51 AD, 45 MCI, 55 controls) show that the new algorithm may successfully detect statistically significant difference among patients of AD, MCI and healthy control subjects. Our computational framework is efficient and very general. It has the potential to be used for thickness estimation on any biological structures with clearly defined inner and outer surfaces.
Collapse
Affiliation(s)
- Gang Wang
- School of Information and Electrical Engineering, Ludong University, Yantai, China; School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Xiaofeng Zhang
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Qingtang Su
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Jie Shi
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Richard J Caselli
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA.
| |
Collapse
|
34
|
McKavanagh R, Buckley E, Chance SA. Wider minicolumns in autism: a neural basis for altered processing? Brain 2015; 138:2034-45. [PMID: 25935724 DOI: 10.1093/brain/awv110] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/28/2015] [Indexed: 01/09/2023] Open
Abstract
Previous studies have found alterations in the columnar organization of the cortex in autism spectrum disorders. Such changes have been suggested to be limited to higher order association areas and to spare primary sensory areas. In addition, evidence from gene-expression studies have suggested that there may be an attenuation of cortical differentiation in autism spectrum disorders. The present study specifically assessed the minicolumns of cells that span the depth of the cortex in a larger sample of autism spectrum disorder cases than have been studied previously, and across a broad age range. The cortical regions to be investigated were carefully chosen to enable hypotheses about cortical differentiation and the vulnerability of association cortex to be tested. Measures of the minicolumnar arrangement of the cortex (minicolumn width, spacing and width of the associated axon bundles) were made in four regions of cortex (primary auditory cortex, auditory association cortex, orbital frontal cortex and inferior parietal lobe) for 28 subjects with autism spectrum disorder and 25 typically developing control subjects. The present study found wider minicolumns in autism spectrum disorder [F(1,28) = 8.098, P = 0.008], which was particularly pronounced at younger ages, providing evidence for an altered developmental trajectory at the microstructural level. In addition, altered minicolumn width was not restricted to higher order association areas, but was also seen in the primary sensory region investigated. Finally, this study found evidence that cortical regional differentiation was still present in autism spectrum disorder [F(3,39) = 5.486, P = 0.003], although attenuated compared to typically developing subjects [F(3,45) = 18.615, P < 0.001]. It is suggested that wider spacing of the minicolumns may relate to the enhanced discrimination seen in some individuals with autism spectrum disorders.
Collapse
Affiliation(s)
- Rebecca McKavanagh
- 1 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK 2 Neuroscience and Mental Health Research Institute, University of Cardiff, CF24 4HQ, UK
| | - Eleanor Buckley
- 1 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Steven A Chance
- 1 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| |
Collapse
|
35
|
Neuroimaging in autism spectrum disorder: brain structure and function across the lifespan. Lancet Neurol 2015; 14:1121-34. [PMID: 25891007 DOI: 10.1016/s1474-4422(15)00050-2] [Citation(s) in RCA: 268] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/25/2015] [Accepted: 04/13/2015] [Indexed: 12/22/2022]
Abstract
Over the past decade, in-vivo MRI studies have provided many invaluable insights into the neural substrates underlying autism spectrum disorder (ASD), which is now known to be associated with neurodevelopmental variations in brain anatomy, functioning, and connectivity. These systems-level features of ASD pathology seem to develop differentially across the human lifespan so that the cortical abnormalities that occur in children with ASD differ from those noted at other stages of life. Thus, investigation of the brain in ASD poses particular methodological challenges, which must be addressed to enable the comparison of results across studies. Novel analytical approaches are also being developed to facilitate the translation of findings from the research to the clinical setting. In the future, the insights provided by human neuroimaging studies could contribute to biomarker development for ASD and other neurodevelopmental disorders, and to new approaches to diagnosis and treatment.
Collapse
|
36
|
Libero LE, DeRamus TP, Lahti AC, Deshpande G, Kana RK. Multimodal neuroimaging based classification of autism spectrum disorder using anatomical, neurochemical, and white matter correlates. Cortex 2015; 66:46-59. [PMID: 25797658 DOI: 10.1016/j.cortex.2015.02.008] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/13/2014] [Accepted: 02/23/2015] [Indexed: 01/22/2023]
Abstract
Neuroimaging techniques, such as fMRI, structural MRI, diffusion tensor imaging (DTI), and proton magnetic resonance spectroscopy (1H-MRS) have uncovered evidence for widespread functional and anatomical brain abnormalities in autism spectrum disorder (ASD) suggesting it to be a system-wide neural systems disorder. Nevertheless, most previous studies have focused on examining one index of neuropathology through a single neuroimaging modality, and seldom using multiple modalities to examine the same cohort of individuals. The current study aims to bring together multiple brain imaging modalities (structural MRI, DTI, and 1H-MRS) to investigate the neural architecture in the same set of individuals (19 high-functioning adults with ASD and 18 typically developing (TD) peers). Morphometry analysis revealed increased cortical thickness in ASD participants, relative to typical controls, across the left cingulate, left pars opercularis of the inferior frontal gyrus, left inferior temporal cortex, and right precuneus, and reduced cortical thickness in right cuneus and right precentral gyrus. ASD adults also had reduced fractional anisotropy (FA) and increased radial diffusivity (RD) for two clusters on the forceps minor of the corpus callosum, revealed by DTI analyses. 1H-MRS results showed a reduction in the N-acetylaspartate/Creatine ratio in dorsal anterior cingulate cortex (dACC) in ASD participants. A decision tree classification analysis across the three modalities resulted in classification accuracy of 91.9% with FA, RD, and cortical thickness as key predictors. Examining the same cohort of adults with ASD and their TD peers, this study found alterations in cortical thickness, white matter (WM) connectivity, and neurochemical concentration in ASD. These findings underscore the potential for multimodal imaging to better inform on the neural characteristics most relevant to the disorder.
Collapse
Affiliation(s)
- Lauren E Libero
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas P DeRamus
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gopikrishna Deshpande
- Auburn University MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA; Department of Psychology, Auburn University, Auburn, AL, USA
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
37
|
Valk SL, Di Martino A, Milham MP, Bernhardt BC. Multicenter mapping of structural network alterations in autism. Hum Brain Mapp 2015; 36:2364-73. [PMID: 25727858 DOI: 10.1002/hbm.22776] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/10/2015] [Accepted: 02/13/2015] [Indexed: 01/28/2023] Open
Abstract
Autism spectrum disorders (ASD) are a group of neurodevelopmental conditions primarily characterized by abnormalities in social cognition. Abundant previous functional MRI studies have shown atypical activity in networks encompassing medial prefrontal cortex (mPFC) and medial parietal regions corresponding to posterior cingulate cortex and precuneus (PCC/PCU). Conversely, studies assessing structural brain anomalies in ASD have been rather inconsistent. The current work evaluated whether structural changes in ASD can be reliability detected in a large multicenter dataset. Our comprehensive structural MRI framework encompassed cortical thickness mapping and structural covariance analysis based on three independent samples comprising individuals with ASD and controls (n = 220), selected from the Autism Brain Imaging Data Exchange open-access database. Surface-based analysis revealed increased cortical thickness in ASD relative to controls in mPFC and lateral prefrontal cortex. Clusters encompassing mPFC were embedded in altered inter-regional covariance networks, showing decreased covariance in ASD relative to controls primarily to PCC/PCU and inferior parietal regions. Cortical thickness increases and covariance reductions in ASD were consistent, yet of variable effect size, across the different sites evaluated and measurable both in children and adults. Our multisite study shows regional and network-level structural alterations in mPFC in ASD that, possibly, relate to atypical socio-cognitive functions in this condition.
Collapse
Affiliation(s)
- Sofie L Valk
- Department of Social Neuroscience, Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | | | | |
Collapse
|
38
|
Osipowicz K, Bosenbark DD, Patrick KE. Cortical Changes Across the Autism Lifespan. Autism Res 2015; 8:379-85. [DOI: 10.1002/aur.1453] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 11/25/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Karol Osipowicz
- Department of Psychology, 3201 Chestnut Street; Drexel University; Philadelphia Pennsylvania 19104
| | - Danielle D. Bosenbark
- Department of Psychology, 3201 Chestnut Street; Drexel University; Philadelphia Pennsylvania 19104
| | - Kristina E. Patrick
- Department of Psychology, 3201 Chestnut Street; Drexel University; Philadelphia Pennsylvania 19104
| |
Collapse
|
39
|
Libero LE, DeRamus TP, Deshpande HD, Kana RK. Surface-based morphometry of the cortical architecture of autism spectrum disorders: volume, thickness, area, and gyrification. Neuropsychologia 2014; 62:1-10. [PMID: 25019362 DOI: 10.1016/j.neuropsychologia.2014.07.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/25/2014] [Accepted: 07/05/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Lauren E Libero
- Department of Psychology, University of Alabama at Birmingham, CIRC 235G, 1719 6th Avenue South, Birmingham, AL 35294-0021, USA
| | - Thomas P DeRamus
- Department of Psychology, University of Alabama at Birmingham, CIRC 235G, 1719 6th Avenue South, Birmingham, AL 35294-0021, USA
| | | | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham, CIRC 235G, 1719 6th Avenue South, Birmingham, AL 35294-0021, USA.
| |
Collapse
|
40
|
Vogan VM, Morgan BR, Lee W, Powell TL, Smith ML, Taylor MJ. The neural correlates of visuo-spatial working memory in children with autism spectrum disorder: effects of cognitive load. J Neurodev Disord 2014; 6:19. [PMID: 25057329 PMCID: PMC4107490 DOI: 10.1186/1866-1955-6-19] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/29/2014] [Indexed: 11/16/2022] Open
Abstract
Background Research on the neural bases of cognitive deficits in autism spectrum disorder (ASD) has shown that working memory (WM) difficulties are associated with abnormalities in the prefrontal cortex. However, cognitive load impacts these findings, and no studies have examined the relation between WM load and neural underpinnings in children with ASD. Thus, the current study determined the effects of cognitive load on WM, using a visuo-spatial WM capacity task in children with and without ASD with functional magnetic resonance imaging (fMRI). Methods We used fMRI and a 1-back colour matching task (CMT) task with four levels of difficulty to compare the cortical activation patterns associated with WM in children (7–13 years old) with high functioning autism (N = 19) and matched controls (N = 17) across cognitive load. Results Performance on CMT was comparable between groups, with the exception of one difficulty level. Using linear trend analyses, the control group showed increasing activation as a function of difficulty level in frontal and parietal lobes, particularly between the highest difficulty levels, and decreasing activation as a function of difficulty level in the posterior cingulate and medial frontal gyri. In contrast, children with ASD showed increasing activation only in posterior brain regions and decreasing activation in the posterior cingulate and medial frontal gyri, as a function of difficulty level. Significant differences were found in the precuneus, dorsolateral prefrontal cortex and medial premotor cortex, where control children showed greater positive linear relations between cortical activity and task difficulty level, particularly at the highest difficulty levels, but children with ASD did not show these trends. Conclusions Children with ASD showed differences in activation in the frontal and parietal lobes—both critical substrates for visuo-spatial WM. Our data suggest that children with ASD rely mainly on posterior brain regions associated with visual and lower level processing, whereas controls showed activity in frontal lobes related to the classic WM network. Findings will help guide future work by localizing areas of vulnerability to developmental disturbances.
Collapse
Affiliation(s)
- Vanessa M Vogan
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.,Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S 1V6, Canada
| | - Benjamin R Morgan
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Wayne Lee
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Tamara L Powell
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Mary Lou Smith
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.,Department of Psychology, University of Toronto, Toronto, ON M5S 1V6, Canada
| | - Margot J Taylor
- Diagnostic Imaging and Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.,Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S 1V6, Canada.,Department of Psychology, University of Toronto, Toronto, ON M5S 1V6, Canada
| |
Collapse
|
41
|
Taylor MJ, Doesburg SM, Pang EW. Neuromagnetic vistas into typical and atypical development of frontal lobe functions. Front Hum Neurosci 2014; 8:453. [PMID: 24994980 PMCID: PMC4061489 DOI: 10.3389/fnhum.2014.00453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/03/2014] [Indexed: 11/24/2022] Open
Abstract
The frontal lobes are involved in many higher-order cognitive functions such as social cognition executive functions and language and speech. These functions are complex and follow a prolonged developmental course from childhood through to early adulthood. Magnetoencephalography (MEG) is ideal for the study of development of these functions, due to its combination of temporal and spatial resolution which allows the determination of age-related changes in both neural timing and location. There are several challenges for MEG developmental studies: to design tasks appropriate to capture the neurodevelopmental trajectory of these cognitive functions, and to develop appropriate analysis strategies to capture various aspects of neuromagnetic frontal lobe activity. Here, we review our MEG research on social and executive functions, and speech in typically developing children and in two clinical groups – children with autism spectrum disorder and children born very preterm. The studies include facial emotional processing, inhibition, visual short-term memory, speech production, and resting-state networks. We present data from event-related analyses as well as on oscillations and connectivity analyses and review their contributions to understanding frontal lobe cognitive development. We also discuss the challenges of testing young children in the MEG and the development of age-appropriate technologies and paradigms.
Collapse
Affiliation(s)
- Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada
| | - Sam M Doesburg
- Department of Diagnostic Imaging, Hospital for Sick Children , Toronto, ON , Canada ; Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Medical Imaging, University of Toronto , Toronto, ON , Canada ; Department of Psychology, University of Toronto , Toronto, ON , Canada
| | - Elizabeth W Pang
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute , Toronto, ON , Canada ; Department of Paediatrics, University of Toronto , Toronto, ON , Canada ; Division of Neurology, Hospital for Sick Children , Toronto, ON , Canada
| |
Collapse
|
42
|
The effect of age, diagnosis, and their interaction on vertex-based measures of cortical thickness and surface area in autism spectrum disorder. J Neural Transm (Vienna) 2014; 121:1157-70. [PMID: 24752753 DOI: 10.1007/s00702-014-1207-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/26/2014] [Indexed: 12/26/2022]
Abstract
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition that is accompanied by an atypical development of brain maturation. So far, brain development has mainly been studied during early childhood in ASD, and using measures of total or lobular brain volume. However, cortical volumetric measures are a product of two distinct biological neuroanatomical features, cortical thickness, and surface area, which most likely also have different neurodevelopmental trajectories in ASD. Here, we therefore examined age-related differences in cortical thickness and surface area in a cross-sectional sample of 77 male individuals with ASD ranging from 7 to 25 years of age, and 77 male neurotypical controls matched for age and FSIQ. Surface-based measures were analyzed using a general linear model (GLM) including linear, quadratic, and cubic age terms, as well as their interactions with the main effect of group. When controlling for the effects of age, individuals with ASD had spatially distributed reductions in cortical thickness relative to controls, particularly in fronto-temporal regions, and also showed significantly reduced surface area in the prefrontal cortex and the anterior temporal lobe. We also observed significant group × age interactions for both measures. However, while cortical thickness was best predicted by a quadratic age term, the neurodevelopmental trajectory for measures of surface area was mostly linear. Our findings suggest that ASD is accompanied by age-related and region-specific reductions in cortical thickness and surface area during childhood and early adulthood. Thus, differences in the neurodevelopmental trajectory of maturation for both measures need to be taken into account when interpreting between-group differences overall.
Collapse
|
43
|
Zielinski BA, Prigge MBD, Nielsen JA, Froehlich AL, Abildskov TJ, Anderson JS, Fletcher PT, Zygmunt KM, Travers BG, Lange N, Alexander AL, Bigler ED, Lainhart JE. Longitudinal changes in cortical thickness in autism and typical development. ACTA ACUST UNITED AC 2014; 137:1799-812. [PMID: 24755274 DOI: 10.1093/brain/awu083] [Citation(s) in RCA: 262] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The natural history of brain growth in autism spectrum disorders remains unclear. Cross-sectional studies have identified regional abnormalities in brain volume and cortical thickness in autism, although substantial discrepancies have been reported. Preliminary longitudinal studies using two time points and small samples have identified specific regional differences in cortical thickness in the disorder. To clarify age-related trajectories of cortical development, we examined longitudinal changes in cortical thickness within a large mixed cross-sectional and longitudinal sample of autistic subjects and age- and gender-matched typically developing controls. Three hundred and forty-five magnetic resonance imaging scans were examined from 97 males with autism (mean age = 16.8 years; range 3-36 years) and 60 males with typical development (mean age = 18 years; range 4-39 years), with an average interscan interval of 2.6 years. FreeSurfer image analysis software was used to parcellate the cortex into 34 regions of interest per hemisphere and to calculate mean cortical thickness for each region. Longitudinal linear mixed effects models were used to further characterize these findings and identify regions with between-group differences in longitudinal age-related trajectories. Using mean age at time of first scan as a reference (15 years), differences were observed in bilateral inferior frontal gyrus, pars opercularis and pars triangularis, right caudal middle frontal and left rostral middle frontal regions, and left frontal pole. However, group differences in cortical thickness varied by developmental stage, and were influenced by IQ. Differences in age-related trajectories emerged in bilateral parietal and occipital regions (postcentral gyrus, cuneus, lingual gyrus, pericalcarine cortex), left frontal regions (pars opercularis, rostral middle frontal and frontal pole), left supramarginal gyrus, and right transverse temporal gyrus, superior parietal lobule, and paracentral, lateral orbitofrontal, and lateral occipital regions. We suggest that abnormal cortical development in autism spectrum disorders undergoes three distinct phases: accelerated expansion in early childhood, accelerated thinning in later childhood and adolescence, and decelerated thinning in early adulthood. Moreover, cortical thickness abnormalities in autism spectrum disorders are region-specific, vary with age, and may remain dynamic well into adulthood.
Collapse
Affiliation(s)
- Brandon A Zielinski
- 1 Department of Pediatrics, University of Utah, Salt Lake City, UT, USA2 Department of Neurology, University of Utah, Salt Lake City, UT, USA3 Primary Children's Medical Centre, Salt Lake City, UT, USA
| | - Molly B D Prigge
- 1 Department of Pediatrics, University of Utah, Salt Lake City, UT, USA4 Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Jared A Nielsen
- 4 Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | | | | | - Jeffrey S Anderson
- 4 Department of Radiology, University of Utah, Salt Lake City, UT, USA7 Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA
| | - P Thomas Fletcher
- 8 Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA9 School of Computing, University of Utah, Salt Lake City, UT, USA
| | - Kristen M Zygmunt
- 8 Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Brittany G Travers
- 10 Waisman Laboratory for Brain Imaging and Behaviour, University of Wisconsin, Madison, WI, USA
| | - Nicholas Lange
- 11 Department of Psychiatry, Harvard Medical School, Boston, MA, USA12 Department of Biostatistics, Harvard Medical School, Boston, MA, USA13 Neurostatistics Laboratory, McLean Hospital, Belmont, MA, USA
| | - Andrew L Alexander
- 10 Waisman Laboratory for Brain Imaging and Behaviour, University of Wisconsin, Madison, WI, USA14 Department of Medical Physics, University of Wisconsin, Madison, WI, USA15 Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Erin D Bigler
- 6 Neuroscience Centre, Brigham Young University, Provo, UT, USA16 Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Janet E Lainhart
- 10 Waisman Laboratory for Brain Imaging and Behaviour, University of Wisconsin, Madison, WI, USA15 Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
44
|
Mills BD, Lai J, Brown TT, Erhart M, Halgren E, Reilly J, Appelbaum M, Moses P. Gray matter structure and morphosyntax within a spoken narrative in typically developing children and children with high functioning autism. Dev Neuropsychol 2014; 38:461-80. [PMID: 24138216 DOI: 10.1080/87565641.2013.820306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined the relationship between magnetic resonance imaging (MRI)-based measures of gray matter structure and morphosyntax production in a spoken narrative in 17 typical children (TD) and 11 children with high functioning autism (HFA) between 6 and 13 years of age. In the TD group, cortical structure was related to narrative performance in the left inferior frontal gyrus (Broca's area), the right middle frontal sulcus, and the right inferior temporal sulcus. No associations were found in children with HFA. These findings suggest a systematic coupling between brain structure and spontaneous language in TD children and a disruption of these relationships in children with HFA.
Collapse
Affiliation(s)
- Brian D Mills
- a Department of Psychology , San Diego State University , San Diego , California
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Auzias G, Viellard M, Takerkart S, Villeneuve N, Poinso F, Fonséca DD, Girard N, Deruelle C. Atypical sulcal anatomy in young children with autism spectrum disorder. NEUROIMAGE-CLINICAL 2014; 4:593-603. [PMID: 24936410 PMCID: PMC4053636 DOI: 10.1016/j.nicl.2014.03.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 11/23/2022]
Abstract
Autism spectrum disorder is associated with an altered early brain development. However, the specific cortical structure abnormalities underlying this disorder remain largely unknown. Nonetheless, atypical cortical folding provides lingering evidence of early disruptions in neurodevelopmental processes and identifying changes in the geometry of cortical sulci is of primary interest for characterizing these structural abnormalities in autism and their evolution over the first stages of brain development. Here, we applied state-of-the-art sulcus-based morphometry methods to a large highly-selective cohort of 73 young male children of age spanning from 18 to 108 months. Moreover, such large cohort was selected through extensive behavioral assessments and stringent inclusion criteria for the group of 59 children with autism. After manual labeling of 59 different sulci in each hemisphere, we computed multiple shape descriptors for each single sulcus element, hereby separating the folding measurement into distinct factors such as the length and depth of the sulcus. We demonstrated that the central, intraparietal and frontal medial sulci showed a significant and consistent pattern of abnormalities across our different geometrical indices. We also found that autistic and control children exhibited strikingly different relationships between age and structural changes in brain morphology. Lastly, the different measures of sulcus shapes were correlated with the CARS and ADOS scores that are specific to the autistic pathology and indices of symptom severity. Inherently, these structural abnormalities are confined to regions that are functionally relevant with respect to cognitive disorders in ASD. In contrast to those previously reported in adults, it is very unlikely that these abnormalities originate from general compensatory mechanisms unrelated to the primary pathology. Rather, they most probably reflect an early disruption on developmental trajectory that could be part of the primary pathology. A new single-site cohort of 73 young children (1.5–11 years) with autism and controls State-of-the-art methodology used to compare geometrical attributes of sulci Combination of automatic extraction of descriptors with manual identification of sulci Clearly evidence localized sulcal shape abnormalities in the autism group Different relationships between age and structural changes in brain morphology
Collapse
Affiliation(s)
- G. Auzias
- INT UMR 7289, Aix-Marseille Université, CNRS, France
- Corresponding author at: Institut de Neurosciences de la Timone, Faculté de Médecine, 27, Boulevard Jean Moulin, 13385 cedex 5 Marseille, France.
| | - M. Viellard
- INT UMR 7289, Aix-Marseille Université, CNRS, France
- Centre de Ressources Autisme, Service de Pédopsychiatrie, APHM, Hôpital Ste Marguerite, Marseille, France
| | - S. Takerkart
- INT UMR 7289, Aix-Marseille Université, CNRS, France
| | - N. Villeneuve
- Centre de Ressources Autisme, Service de Pédopsychiatrie, APHM, Hôpital Ste Marguerite, Marseille, France
| | - F. Poinso
- INT UMR 7289, Aix-Marseille Université, CNRS, France
- Centre de Ressources Autisme, Service de Pédopsychiatrie, APHM, Hôpital Ste Marguerite, Marseille, France
| | - D. Da Fonséca
- INT UMR 7289, Aix-Marseille Université, CNRS, France
- Service de Pédopsychiatrie, APHM, Hôpital Salvator, France
| | - N. Girard
- CRMBM UMR 7339, Aix-Marseille Université, CNRS, France
- APHM Timone, Service de Neuroradiologie Diagnostique et Interventionnelle, Marseille, France
| | - C. Deruelle
- INT UMR 7289, Aix-Marseille Université, CNRS, France
| |
Collapse
|
46
|
Lyall AE, Shi F, Geng X, Woolson S, Li G, Wang L, Hamer RM, Shen D, Gilmore JH. Dynamic Development of Regional Cortical Thickness and Surface Area in Early Childhood. Cereb Cortex 2014; 25:2204-12. [PMID: 24591525 DOI: 10.1093/cercor/bhu027] [Citation(s) in RCA: 255] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cortical thickness (CT) and surface area (SA) are altered in many neuropsychiatric disorders and are correlated with cognitive functioning. Little is known about how these components of cortical gray matter develop in the first years of life. We studied the longitudinal development of regional CT and SA expansion in healthy infants from birth to 2 years. CT and SA have distinct and heterogeneous patterns of development that are exceptionally dynamic; overall CT increases by an average of 36.1%, while cortical SA increases 114.6%. By age 2, CT is on average 97% of adult values, compared with SA, which is 69%. This suggests that early identification, prevention, and intervention strategies for neuropsychiatric illness need to be targeted to this period of rapid postnatal brain development, and that SA expansion is the principal driving factor in cortical volume after 2 years of age.
Collapse
Affiliation(s)
| | - Feng Shi
- Biomedical Research Imaging Center Department of Radiology
| | | | | | - Gang Li
- Biomedical Research Imaging Center Department of Radiology
| | - Li Wang
- Biomedical Research Imaging Center Department of Radiology
| | - Robert M Hamer
- Department of Psychiatry Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA
| | - Dinggang Shen
- Biomedical Research Imaging Center Department of Radiology
| | - John H Gilmore
- Department of Psychiatry Biomedical Research Imaging Center
| |
Collapse
|
47
|
Abstract
Over the past decade, human neuroimaging studies have provided invaluable insights into the neural substrates that underlie autism spectrum disorder (ASD). Although observations from multiple neuroimaging approaches converge in suggesting that changes in brain structure, functioning and connectivity are associated with ASD, the neurobiology of this disorder is complex, and considerable aetiological and phenotypic heterogeneity exists among individuals on the autism spectrum. Characterization of the neurobiological alterations that underlie ASD and development of novel pharmacotherapies for ASD, therefore, requires multidisciplinary collaboration. Consequently, pressure is growing to combine neuroimaging data with information provided by other disciplines to translate research findings into clinically useful biomarkers. So far, however, neuroimaging studies in patients with ASD have mainly been conducted in isolation, and the low specificity of neuroimaging measures has hindered the development of biomarkers that could aid clinical trials and/or facilitate patient identification. Novel approaches to acquiring and analysing data on brain characteristics are currently being developed to overcome these inherent limitations, and to integrate neuroimaging into translational research. Here, we discuss promising new studies of cortical pathology in patients with ASD, and outline how the novel insights thereby obtained could inform diagnosis and treatment of ASD in the future.
Collapse
|
48
|
Baribeau DA, Anagnostou E. A comparison of neuroimaging findings in childhood onset schizophrenia and autism spectrum disorder: a review of the literature. Front Psychiatry 2013; 4:175. [PMID: 24391605 PMCID: PMC3869044 DOI: 10.3389/fpsyt.2013.00175] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 12/09/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) and childhood onset schizophrenia (COS) are pediatric neurodevelopmental disorders associated with significant morbidity. Both conditions are thought to share an underlying genetic architecture. A comparison of neuroimaging findings across ASD and COS with a focus on altered neurodevelopmental trajectories can shed light on potential clinical biomarkers and may highlight an underlying etiopathogenesis. METHODS A comprehensive review of the medical literature was conducted to summarize neuroimaging data with respect to both conditions in terms of structural imaging (including volumetric analysis, cortical thickness and morphology, and region of interest studies), white matter analysis (include volumetric analysis and diffusion tensor imaging) and functional connectivity. RESULTS In ASD, a pattern of early brain overgrowth in the first few years of life is followed by dysmaturation in adolescence. Functional analyses have suggested impaired long-range connectivity as well as increased local and/or subcortical connectivity in this condition. In COS, deficits in cerebral volume, cortical thickness, and white matter maturation seem most pronounced in childhood and adolescence, and may level off in adulthood. Deficits in local connectivity, with increased long-range connectivity have been proposed, in keeping with exaggerated cortical thinning. CONCLUSION The neuroimaging literature supports a neurodevelopmental origin of both ASD and COS and provides evidence for dynamic changes in both conditions that vary across space and time in the developing brain. Looking forward, imaging studies which capture the early post natal period, which are longitudinal and prospective, and which maximize the signal to noise ratio across heterogeneous conditions will be required to translate research findings into a clinical environment.
Collapse
Affiliation(s)
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, University of Toronto , Toronto, ON , Canada
| |
Collapse
|
49
|
Schaer M, Ottet MC, Scariati E, Dukes D, Franchini M, Eliez S, Glaser B. Decreased frontal gyrification correlates with altered connectivity in children with autism. Front Hum Neurosci 2013; 7:750. [PMID: 24265612 PMCID: PMC3820980 DOI: 10.3389/fnhum.2013.00750] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 10/20/2013] [Indexed: 01/11/2023] Open
Abstract
The structural correlates of functional dysconnectivity in autism spectrum disorders (ASD) have been seldom explored, despite the fact that altered functional connectivity is one of the most frequent neuropathological observations in the disorder. We analyzed cerebral morphometry and structural connectivity using multi-modal imaging for 11 children/adolescents with ASD and 11 matched controls. We estimated regional cortical and white matter volumes, as well as vertex-wise measures of cortical thickness and local Gyrification Index (lGI). Diffusion Tensor Images (DTI) were used to measure Fractional Anisotropy (FA) and tractography estimates of short- and long-range connectivity. We observed four clusters of lGI reduction in patients with ASD, three were located in the right inferior frontal region extending to the inferior parietal lobe, and one was in the right medial parieto-occipital region. Reduced volume was found in the anterior corpus callosum, along with fewer inter-hemispheric frontal streamlines. Despite the spatial correspondence of decreased gyrification and reduced long connectivity, we did not observe any significant relationship between the two. However, a positive correlation between lGI and local connectivity was present in all four clusters in patients with ASD. Reduced gyrification in the inferior fronto-parietal and posterior medial cortical regions lends support for early-disrupted cortical growth in both the mirror neuron system and midline structures responsible for social cognition. Early impaired neurodevelopment in these regions may represent an initial substrate for altered maturation in the cerebral networks that support complex social skills. We also demonstrate that gyrification changes are related to connectivity. This supports the idea that an imbalance between short- and long-range white matter tracts not only impairs the integration of information from multiple neural systems, but also alters the shape of the brain early on in autism.
Collapse
Affiliation(s)
- Marie Schaer
- Stanford Cognitive and Systems Neuroscience Laboratory, Stanford University School of Medicine, Palo Alto CA, USA ; Office Médico-Pédagogique, Department of Psychiatry, University of Geneva School of Medicine Geneva, Switzerland
| | | | | | | | | | | | | |
Collapse
|
50
|
Doyle-Thomas KAR, Kushki A, Duerden EG, Taylor MJ, Lerch JP, Soorya LV, Wang AT, Fan J, Anagnostou E. The effect of diagnosis, age, and symptom severity on cortical surface area in the cingulate cortex and insula in autism spectrum disorders. J Child Neurol 2013; 28:732-9. [PMID: 22832774 DOI: 10.1177/0883073812451496] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Functional activity in the anterior cingulate cortex and insula has been reported to be abnormal during social tasks in autism spectrum disorders. However, few studies have examined surface morphometry in these regions and how this may be related to autism spectrum disorder symptomatology. In this study, 27 individuals with autism spectrum disorders and 25 controls between the ages of 7 to 39 years underwent structural magnetic resonance imaging. Our primary analysis examined differences in surface area in the cingulate and insula, between individuals with and without autism spectrum disorders, as well as age-related changes and associations with social impairments. Surface area in the right cingulate was significantly different between groups and decreased more rapidly with age in autism spectrum disorder participants. In addition, greater surface area in the insula and isthmus was associated with poorer social behaviors. Results suggest atypical surface morphometry in brain regions involved in social function, which appeared to be related to poorer social ability scores.
Collapse
Affiliation(s)
- Krissy A R Doyle-Thomas
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|