Early brain development in infants at high risk for autism spectrum disorder.
Early brain development in infants at high risk for autism spectrum disorder.
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DOI：
10.1038/nature21369
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发表时间：
2017-02-15
期刊：
影响因子：
64.8
通讯作者：
Statistical Analysis
中科院分区：
文献类型：
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作者：
Hazlett HC;Gu H;Munsell BC;Kim SH;Styner M;Wolff JJ;Elison JT;Swanson MR;Zhu H;Botteron KN;Collins DL;Constantino JN;Dager SR;Estes AM;Evans AC;Fonov VS;Gerig G;Kostopoulos P;McKinstry RC;Pandey J;Paterson S;Pruett JR;Schultz RT;Shaw DW;Zwaigenbaum L;Piven J;IBIS Network;Clinical Sites;Data Coordinating Center;Image Processing Core;Statistical Analysis
在患有自闭症谱系障碍(ASD)的儿童中观察到了脑增大，但这种现象的发生时间及其与行为症状出现的关系尚不清楚。对2岁儿童的回溯性头围和纵向脑体积研究在4岁时进行了跟踪，提供了脑体积增加可能出现在发育早期的证据。对自闭症高家庭风险婴儿的研究可以提供对自闭症早期发展的洞察，并发现自闭症的特征社交缺陷出现在生命的第一年和第二年的后期。这些观察表明，对ASD家族高危婴儿的前瞻性脑成像研究可能会发现，在ASD诊断出现之前，出生后早期脑体积的变化就已经发生了。在这项前瞻性的神经影像研究中，106名ASD高危婴儿和42名低风险婴儿在24个月时被诊断为自闭症的15名高危婴儿中，6-12个月时皮质表面积过度扩张先于12-24个月时观察到的脑体积过度增长。大脑体积的过度增长与自闭症社会缺陷的出现和严重程度有关。深度学习算法主要使用6个月和12个月大的大脑MRI的表面积信息，预测24个月大的高危儿童个体诊断为自闭症(阳性预测值为81%，敏感度为88%)。这些发现表明，早期的大脑变化发生在自闭症行为首次出现的时期。
Brain enlargement has been observed in children with Autism Spectrum Disorder (ASD), but the timing of this phenomenon and its relationship to the appearance of behavioral symptoms is unknown. Retrospective head circumference and longitudinal brain volume studies of 2 year olds followed up at age 4 years, have provided evidence that increased brain volume may emerge early in development. Studies of infants at high familial risk for autism can provide insight into the early development of autism and have found that characteristic social deficits in ASD emerge during the latter part of the first and in the second year of life. These observations suggest that prospective brain imaging studies of infants at high familial risk for ASD might identify early post-natal changes in brain volume occurring before the emergence of an ASD diagnosis. In this prospective neuroimaging study of 106 infants at high familial risk of ASD and 42 low-risk infants, we show that cortical surface area hyper-expansion between 6-12 months of age precedes brain volume overgrowth observed between 12-24 months in the 15 high-risk infants diagnosed with autism at 24 months. Brain volume overgrowth was linked to the emergence and severity of autistic social deficits. A deep learning algorithm primarily using surface area information from brain MRI at 6 and 12 months of age predicted the diagnosis of autism in individual high-risk children at 24 months (with a positive predictive value of 81%, sensitivity of 88%). These findings demonstrate that early brain changes unfold during the period in which autistic behaviors are first emerging.