Reduced Volume of the Arcuate Fasciculus in Adults with High-Functioning Autism Spectrum Conditions

Tatton-Brown-Rahman syndrome: Novel pathogenic variants and new neuroimaging findings

Tatton-Brown-Rahman syndrome (TBRS) or DNMT3A-overgrowth syndrome is characterized by overgrowth and intellectual disability associated with minor dysmorphic features, obesity, and behavioral problems. It is caused by variants of the DNMT3A gene. We report four patients with this syndrome due to de novo DNMT3A pathogenic variants, contributing to a deeper understanding of the genetic basis and pathophysiology of this autosomal dominant syndrome. Clinical and magnetic resonance imaging assessments were also performed. All patients showed corpus callosum anomalies, small posterior fossa, and a deep left Sylvian fissure; as well as asymmetry of the uncinate and arcuate fascicles and marked increased cortical thickness. These results suggest that structural neuroimaging anomalies have been previously overlooked, where corpus callosum and brain tract alterations might be unrecognized neuroimaging traits of TBRS syndrome caused by DNMT3A variants.

Developmental prediction modeling based on diffusion tensor imaging uncovering age-dependent heterogeneity in early childhood autistic brain

OBJECTIVE

There has been increasing evidence for atypical white matter (WM) microstructure in autistic people, but findings have been divergent. The development of autistic people in early childhood is clouded by the concurrently rapid brain growth, which might lead to the inconsistent findings of atypical WM microstructure in autism. Here, we aimed to reveal the developmental nature of autistic children and delineate atypical WM microstructure throughout early childhood while taking developmental considerations into account.

METHOD

In this study, diffusion tensor imaging was acquired from two independent cohorts, containing 91 autistic children and 100 typically developing children (TDC), aged 4-7 years. Developmental prediction modeling using support vector regression based on TDC participants was conducted to estimate the WM atypical development index of autistic children. Then, subgroups of autistic children were identified by using the k-means clustering method and were compared to each other on the basis of demographic information, WM atypical development index, and autistic trait by using two-sample t-test. Relationship of the WM atypical development index with age was estimated by using partial correlation. Furthermore, we performed threshold-free cluster enhancement-based two-sample t-test for the group comparison in WM microstructures of each subgroup of autistic children with the rematched subsets of TDC.

RESULTS

We clustered autistic children into two subgroups according to WM atypical development index. The two subgroups exhibited distinct developmental stages and age-dependent diversity. WM atypical development index was found negatively associated with age. Moreover, an inverse pattern of atypical WM microstructures and different clinical manifestations in the two stages, with subgroup 1 showing overgrowth with low level of autistic traits and subgroup 2 exhibiting delayed maturation with high level of autistic traits, were revealed.

CONCLUSION

This study illustrated age-dependent heterogeneity in early childhood autistic children and delineated developmental stage-specific difference that ranged from an overgrowth pattern to a delayed pattern. Trial registration This study has been registered at ClinicalTrials.gov (Identifier: NCT02807766) on June 21, 2016 ( https://clinicaltrials.gov/ct2/show/NCT02807766 ).

Atypical structural connectivity of language networks in autism spectrum disorder: A meta-analysis of diffusion tensor imaging studies

Patients with autism spectrum disorder (ASD) often show pervasive and complex language impairments that are closely associated with aberrant structural connectivity of language networks. However, the characteristics of white matter connectivity in ASD have remained inconclusive in previous diffusion tensor imaging (DTI) studies. The current meta‐analysis aimed to comprehensively elucidate the abnormality in language‐related white matter connectivity in individuals with ASD. We searched PubMed, Web of Science, Scopus, and Medline databases to identify relevant studies. The standardized mean difference was calculated to measure the pooled difference in DTI metrics in each tract between the ASD and typically developing (TD) groups. The moderating effects of age, sex, language ability, and symptom severity were investigated using subgroup and meta‐regression analysis. Thirty‐three DTI studies involving 831 individuals with ASD and 836 TD controls were included in the meta‐analysis. ASD subjects showed significantly lower fractional anisotropy or higher mean diffusivity across language‐associated tracts than TD controls. These abnormalities tended to be more prominent in the left language networks than in the right. In addition, children with ASD exhibit more pronounced and pervasive disturbances in white matter connectivity than adults. These results support the under‐connectivity hypothesis and demonstrate the widespread abnormal microstructure of language‐related tracts in patients with ASD. Otherwise, white matter abnormalities in the autistic brain could vary depending on the developmental stage and hemisphere.

The time-locked neurodynamics of semantic processing in autism spectrum disorder: an EEG study

Language processing is often an area of difficulty in Autism Spectrum Disorder (ASD). Semantic processing-the ability to add meaning to a stimulus-is thought to be especially affected in ASD. However, the neurological origin of these deficits, both structurally and temporally, have yet to be discovered. To further previous behavioral findings on language differences in ASD, the present study used an implicit semantic priming paradigm and electroencephalography (EEG) to compare the level of theta coherence throughout semantic processing, between typically developing (TD) and ASD participants. Theta coherence is an indication of synchronous EEG oscillations and was of particular interest due to its previous links with semantic processing. Theta coherence was analyzed in response to semantically related or unrelated pairs of words and pictures across bilateral short, medium, and long electrode connections. We found significant results across a variety of conditions, but most notably, we observed reduced coherence for language stimuli in the ASD group at a left fronto-parietal connection from 100 to 300 ms. This replicates previous findings of underconnectivity in left fronto-parietal language networks in ASD. Critically, the early time window of this underconnectivity, from 100 to 300 ms, suggests that impaired semantic processing of language in ASD may arise during pre-semantic processing, during the initial communication between lower-level linguistic processing and higher-level semantic processing. Our results suggest that language processing functions are unique in ASD compared to TD, and that subjects with ASD might rely on a temporally different language processing loop altogether.

Imagination in Autism: A Chance to Improve Early Language Therapy

Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children.

Age of Speech Onset in Autism Relates to Structural Connectivity in the Language Network

Speech onset delays (SOD) and language atypicalities are central aspects of the autism spectrum (AS), despite not being included in the categorical diagnosis of AS. Previous studies separating participants according to speech onset history have shown distinct patterns of brain organization and activation in perceptual tasks. One major white matter tract, the arcuate fasciculus (AF), connects the posterior temporal and left frontal language regions. Here, we used anatomical brain imaging to investigate the properties of the AF in adolescent and adult autistic individuals with typical levels of intelligence who differed by age of speech onset. The left AF of the AS group showed a significantly smaller volume than that of the nonautistic group. Such a reduction in volume was only present in the younger group. This result was driven by the autistic group without SOD (SOD−), despite their typical age of speech onset. The autistic group with SOD (SOD+) showed a more typical AF as adults relative to matched controls. This suggests that, along with multiple studies in AS-SOD+ individuals, atypical brain reorganization is observable in the 2 major AS subgroups and that such reorganization applies mostly to the language regions in SOD− and perceptual regions in SOD+ individuals.

Altered structural brain connectivity involving the dorsal and ventral language pathways in 16p11.2 deletion syndrome

Copy number variants at the chromosomal locus 16p11.2 contribute to neurodevelopmental disorders such as autism spectrum disorders, epilepsy, schizophrenia, and language and articulation disorders. Here, we provide detailed findings on the disrupted structural brain connectivity in 16p11.2 deletion syndrome (patients: N = 21, age range: 8-16 years; typically developing (TD) controls: 18, 9-16 years) using structural and diffusion MRI. We performed global short-, middle-, long-range, and interhemispheric connectivity analysis in the whole brain using gyral topology-based cortical parcellation. Using region of interest analysis, we studied bilateral dorsal (3 segments of arcuate fasciculus (AF)) and ventral (inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF)) language pathways. Our results showed significantly increased axial (AD) and radial (RD) diffusivities in bilateral anterior AF, decreased volume for left long AF, increased mean diffusivity (MD) and RD for right long AF, and increased AD for bilateral UF in the 16p11.2 deletion group in the absence of significant abnormalities in the whole-brain gyral and interhemispheric connectivity. The selective involvement of the language networks may aid in understanding effects of altered white matter connectivity on neurodevelopmental outcomes in 16p11.2 deletion.

The language network in autism: Atypical functional connectivity with default mode and visual regions

Autism spectrum disorders (ASDs) are neurodevelopmental disorders associated with atypical brain connectivity. Although language abilities vary widely, they are impaired or atypical in most children with ASDs. Underlying brain mechanisms, however, are not fully understood. The present study examined intrinsic functional connectivity (iFC) of the extended language network in a cohort of 52 children and adolescents with ASDs (ages 8-18 years), using resting-state functional magnetic resonance imaging. We found that, in comparison to typically developing peers (n = 50), children with ASDs showed increased connectivity between some language regions. In addition, seed-to-whole brain analyses revealed increased connectivity of language regions with posterior cingulate cortex (PCC) and visual regions in the ASD group. Post hoc effective connectivity analyses revealed a mediation effect of PCC on the iFC between bilateral inferior frontal and visual regions in an ASD subgroup. This finding qualifies and expands on previous reports of recruitment of visual areas in language processing in ASDs. In addition, increased iFC between PCC and visual regions was linked to lower language scores in this ASD subgroup, suggesting that increased connectivity with visual cortices, mediated by default mode regions, may be detrimental to language abilities. Autism Res 2019, 12: 1344-1355. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We examined the functional connectivity between regions of the language network in children with autism spectrum disorders (ASDs) compared to typically developing peers. We found connectivity to be intact between core language in the ASD group, but also showed abnormally increased connectivity between regions of an extended language network. Additionally, connectivity was increased with regions associated with brain networks responsible for self-reflection and visual processing.

Neural reuse of action perception circuits for language, concepts and communication

Neurocognitive and neurolinguistics theories make explicit statements relating specialized cognitive and linguistic processes to specific brain loci. These linking hypotheses are in need of neurobiological justification and explanation. Recent mathematical models of human language mechanisms constrained by fundamental neuroscience principles and established knowledge about comparative neuroanatomy offer explanations for where, when and how language is processed in the human brain. In these models, network structure and connectivity along with action- and perception-induced correlation of neuronal activity co-determine neurocognitive mechanisms. Language learning leads to the formation of action perception circuits (APCs) with specific distributions across cortical areas. Cognitive and linguistic processes such as speech production, comprehension, verbal working memory and prediction are modelled by activity dynamics in these APCs, and combinatorial and communicative-interactive knowledge is organized in the dynamics within, and connections between APCs. The network models and, in particular, the concept of distributionally-specific circuits, can account for some previously not well understood facts about the cortical 'hubs' for semantic processing and the motor system's role in language understanding and speech sound recognition. A review of experimental data evaluates predictions of the APC model and alternative theories, also providing detailed discussion of some seemingly contradictory findings. Throughout, recent disputes about the role of mirror neurons and grounded cognition in language and communication are assessed critically.

White Matter Integrity and Treatment-Based Change in Speech Performance in Minimally Verbal Children with Autism Spectrum Disorder

We investigated the relationship between imaging variables for two language/speech-motor tracts and speech fluency variables in 10 minimally verbal (MV) children with autism. Specifically, we tested whether measures of white matter integrity—fractional anisotropy (FA) of the arcuate fasciculus (AF) and frontal aslant tract (FAT)—were related to change in percent syllable-initial consonants correct, percent items responded to, and percent syllable insertion errors (from best baseline to post 25 treatment sessions). Twenty-three MV children with autism spectrum disorder (ASD) received Auditory-Motor Mapping Training (AMMT), an intonation-based treatment to improve fluency in spoken output, and we report on seven who received a matched control treatment. Ten of the AMMT participants were able to undergo a magnetic resonance imaging study at baseline; their performance on baseline speech production measures is compared to that of the other two groups. No baseline differences were found between groups. A canonical correlation analysis (CCA) relating FA values for left- and right-hemisphere AF and FAT to speech production measures showed that FA of the left AF and right FAT were the largest contributors to the synthetic independent imaging-related variable. Change in percent syllable-initial consonants correct and percent syllable-insertion errors were the largest contributors to the synthetic dependent fluency-related variable. Regression analyses showed that FA values in left AF significantly predicted change in percent syllable-initial consonants correct, no FA variables significantly predicted change in percent items responded to, and FA of right FAT significantly predicted change in percent syllable-insertion errors. Results are consistent with previously identified roles for the AF in mediating bidirectional mapping between articulation and acoustics, and the FAT in its relationship to speech initiation and fluency. They further suggest a division of labor between the hemispheres, implicating the left hemisphere in accuracy of speech production and the right hemisphere in fluency in this population. Changes in response rate are interpreted as stemming from factors other than the integrity of these two fiber tracts. This study is the first to document the existence of a subgroup of MV children who experience increases in syllable- insertion errors as their speech develops in response to therapy.

White Matter Diffusion of Major Fiber Tracts Implicated in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder found to have widespread alterations in the function and synchrony of brain regions. These differences may underlie alterations in microstructural organization, such as in white matter pathways. To investigate the diffusion of major white matter tracts, the current study examined multiple indices of white matter diffusion in 42 children and adults with ASD and 44 typically developing (TD) age- and IQ-matched peers using diffusion tensor imaging. Diffusivity measures were compared between groups for the following tracts: bilateral cingulum bundle, corpus callosum, inferior longitudinal fasciculus, superior longitudinal fasciculus, and uncinate fasciculus. Results indicate a significant reduction in fractional anisotropy (FA) for the left superior longitudinal fasciculus (LSLF) in ASD children and adults compared with TD peers. A significant increase in radial diffusivity for ASD participants was also found in the same cluster along the LSLF. In addition, a significant positive correlation emerged for all subjects between FA for the LSLF and age, with FA increasing with age. These findings point to a significant alteration in long-distance white matter connectivity in children and adults with ASD, potentially underscoring the relationship between alterations in white matter diffusion and the ASD phenotype. These results also suggest that the white matter alterations in autism may be subtle and related to the developmental trajectory.