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Poor Brain Growth in Extremely Preterm Neonates Long Before the Onset of Autism Spectrum Disorder Symptoms
Nelly Padilla1, Eva Eklöf1, Gustaf E Mårtensson1
1Department of Women's and Children's Health.
Insights
Extremely preterm infants diagnosed with autism spectrum disorder (ASD) show early brain structural alterations. Neonatal MRI scans can identify these changes, aiding early intervention for at-risk children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Autism Research
Background:
- Preterm infants, particularly those born extremely early, have a higher risk of developing autism spectrum disorder (ASD).
- The connection between early brain development in preterm infants and later ASD diagnosis is not well understood.
- Neonatal brain imaging may offer insights into the neurobiological underpinnings of ASD in this vulnerable population.
Purpose of the Study:
- To investigate early brain structural differences in extremely preterm infants who later develop autism spectrum disorder (ASD).
- To explore the relationship between neonatal brain morphometry and ASD diagnosis at 6.5 years of age.
- To determine if neonatal MRI can aid in the early identification of preterm infants at risk for ASD.
Main Methods:
- Studied 84 preterm infants (<27 weeks gestation) with neonatal MRI at term, screened for ASD at 6.5 years.
- Performed structural brain morphometric analysis on MRI scans from 33 infants without focal brain lesions.
- Recorded neonatal morbidities and measured full-scale intelligence quotient.
Main Results:
- 27.4% of preterm children were diagnosed with ASD.
- ASD-positive infants had significantly more neonatal complications.
- In the MRI subgroup, ASD infants showed reduced brain volumes in temporal, occipital, insular, limbic, and social/salience integration regions.
Conclusions:
- Neonatal MRI reveals structural brain alterations in extremely preterm children later diagnosed with ASD.
- These alterations are localized in brain regions critical for core autism features.
- Early detection of these neonatal brain changes may facilitate timely intervention for preterm infants at risk of ASD.
Abstract:
Preterm infants face an increased risk of autism spectrum disorder (ASD). The relationship between autism during childhood and early brain development remains unexplored. We studied 84 preterm children born at <27 weeks of gestation, who underwent neonatal magnetic resonance imaging (MRI) at term and were screened for ASD at 6.5 years. Full-scale intelligence quotient was measured and neonatal morbidities were recorded. Structural brain morphometric studies were performed in 33 infants with high-quality MRI and no evidence of focal brain lesions. Twenty-three (27.4%) of the children tested ASD positive and 61 (72.6%) tested ASD negative. The ASD-positive group had a significantly higher frequency of neonatal complications than the ASD-negative group. In the subgroup of 33 children, the ASD infants had reduced volumes in the temporal, occipital, insular, and limbic regions and in the brain areas involved in social/behavior and salience integration. This study shows that the neonatal MRI scans of extremely preterm children, subsequently diagnosed with ASD at 6.5 years, showed brain structural alterations, localized in the regions that play a key role in the core features of autism. Early detection of these structural alterations may allow the early identification and intervention of children at risk of ASD.
