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Neonatal brain abnormalities associated with autism spectrum disorder in children born very preterm
Alexandra M Ure1,2, Karli Treyvaud1,3, Deanne K Thompson1,3
1Murdoch Childrens Research Institute, Melbourne, Australia.
Insights
Very preterm (VP) children diagnosed with autism spectrum disorder (ASD) showed distinct neonatal brain structures, including more white matter lesions and smaller cerebellums, compared to peers without ASD. These early brain differences may indicate future neurodevelopmental trajectories.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Very preterm (VP) infants face higher risks for autism spectrum disorder (ASD) than term-born infants.
- Neonatal brain development is critical and can be impacted by preterm birth.
- Understanding early brain markers may aid in predicting neurodevelopmental outcomes.
Purpose of the Study:
- To investigate differences in neonatal brain magnetic resonance (MR) imaging features between very preterm (VP) children diagnosed with autism spectrum disorder (ASD) and those without ASD at 7 years of age.
- To correlate early brain structural abnormalities with later ASD diagnosis in VP survivors.
- To identify potential early biomarkers for ASD in the VP population.
Main Methods:
- Structural brain MR scans were performed on 172 VP children (<30 weeks' gestation or <1250 g birth weight) at term equivalent age (TEA).
- Brain abnormalities (white matter, gray matter, cerebellum) and volumes were assessed.
- Children were evaluated for ASD at 7 years using standardized diagnostic interviews and independent assessments.
Main Results:
- Eight VP children (4.7%) were diagnosed with ASD at 7 years.
- VP children with ASD exhibited significantly more cystic lesions in the cortical white matter at TEA (OR 8.7, P=0.02).
- A trend towards smaller cerebellar volumes was observed in VP children with ASD (OR 0.82, P=0.06).
Conclusions:
- Neonatal brain structure differs between VP children with and without ASD.
- Early white matter abnormalities and cerebellar volume may serve as potential indicators for ASD risk in VP survivors.
- These findings highlight the importance of early neuroimaging in understanding ASD development in preterm infants.
Abstract:
Very preterm (VP) survivors are at increased risk of autism spectrum disorder (ASD) compared with term-born children. This study explored whether neonatal magnetic resonance (MR) brain features differed in VP children with and without ASD at 7 years. One hundred and seventy-two VP children (<30 weeks' gestation or <1250 g birth weight) underwent structural brain MR scans at term equivalent age (TEA; 40 weeks' gestation ±2 weeks) and were assessed for ASD at 7 years of age. The presence and severity of white matter, cortical gray matter, deep nuclear gray matter, and cerebellar abnormalities were assessed, and total and regional brain volumes were measured. ASD was diagnosed using a standardized parent report diagnostic interview and confirmed via an independent assessment. Eight VP children (4.7%) were diagnosed with ASD. Children with ASD had more cystic lesions in the cortical white matter at TEA compared with those without ASD (odds ratio [OR] 8.7, 95% confidence interval [CI] 1.5, 51.3, P = 0.02). There was also some evidence for smaller cerebellar volumes in children with ASD compared with those without ASD (OR = 0.82, CI = 0.66, 1.00, P = 0.06). Overall, the results suggest that VP children with ASD have different brain structure in the neonatal period compared with those who do not have ASD. Autism Res 2016, 9: 543-552. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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