Amygdala Enlargement in Toddlers with Autism Related to Severity of Social and Communication Impairments
Amygdala Enlargement in Toddlers with Autism Related to Severity of Social and Communication Impairments
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DOI：
10.1016/j.biopsych.2009.07.007
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发表时间：
2009-11-15
影响因子：
10.6
通讯作者：
Courchesne, Eric
中科院分区：
文献类型：
--
作者：
Schumann, Cynthia Mills;Barnes, Cynthia Carter;Courchesne, Eric
背景：自闭症是一种病因不明的异质神经发育障碍。考虑到杏仁核在情绪和社会行为中的作用，长期以来，杏仁核一直是自闭症神经病理学研究中备受关注的一个部位。一个有趣的假设出现了：自闭症患者的杏仁核经历了一个异常的发育轨迹，在早期有一段过度生长的时期；然而，这一发现并没有很好地建立在年轻的年龄，也没有单独分析男孩和女孩。方法：对89名1-5岁幼儿（平均3岁）的杏仁核体积进行磁共振成像扫描。每个孩子在大约5岁时返回进行最后的临床评估。结果：与正常发育的幼儿（28名男孩，11名女孩）相比，后来确诊为自闭症的幼儿（32名男孩，9名女孩）的右杏仁核和左杏仁核更大（p < 0.01），总脑容量有或没有共变。自闭症谱系障碍幼儿的杏仁核大小与他们的社交和沟通障碍的严重程度相关，这是通过自闭症诊断访谈和Vineland量表测量的。引人注目的是，女孩的杏仁核体积与典型的差异更大，而男孩的杏仁核大小与临床损伤的严重程度有显著关系。结论：本研究提供了自闭症儿童杏仁核增大的证据；过度生长必须在3岁之前开始，并且与临床损伤的严重程度有关。然而，神经解剖表型在男性和女性之间存在差异，这严重影响了自闭症遗传学和病因学的未来研究。
Background: Autism is a heterogeneous neurodevelopmental disorder of unknown etiology. The amygdala has long been a site of intense interest in the search for neuropathology in autism, given its role in emotional and social behavior. An interesting hypothesis has emerged that the amygdala undergoes an abnormal developmental trajectory with a period of early overgrowth in autism; however this finding has not been well established at young ages nor analyzed with boys and girls independently.Methods: We measured amygdala volumes on magnetic resonance imaging scans from 89 toddlers at 1-5 years of age (mean = 3 years). Each child returned at similar to 5 years of age for final clinical evaluation.Results: Toddlers who later received a confirmed autism diagnosis (32 boys, 9 girls) had a larger right (p < .01) and left (p < .05) amygdala compared with typically developing toddlers (28 boys, 11 girls) with and without covarying for total cerebral volume. Amygdala size in toddlers with autism spectrum disorder correlated with the severity of their social and communication impairments as measured on the Autism Diagnostic Interview and Vineland scale. Strikingly, girls differed more robustly from typical in amygdala volume, whereas boys accounted for the significant relationship of amygdala size with severity of clinical impairment.Conclusions: This study provides evidence that the amygdala is enlarged in young children with autism; the overgrowth must begin before 3 years of age and is associated with the severity of clinical impairments. However, neuroanatomic phenotypic profiles differ between males and females, which critically affects future studies on the genetics and etiology of autism.