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Increased Extra-axial Cerebrospinal Fluid in High-Risk Infants Who Later Develop Autism

Mark D Shen1, Sun Hyung Kim2, Robert C McKinstry3

  • 1Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina; MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, School of Medicine, Sacramento, California.

Biological Psychiatry
|April 11, 2017
PubMed

Insights

Increased extra-axial cerebrospinal fluid (CSF) in infants at 6 months predicts autism spectrum disorder (ASD) development. This early indicator of ASD is linked to symptom severity and can be detected in high-risk infants.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Autism Spectrum Disorder Research

Background:

  • Previous research indicated elevated extra-axial cerebrospinal fluid (CSF) in infants who later developed autism spectrum disorder (ASD).
  • This study aimed to validate and expand upon these initial findings in a larger, independent cohort.

Purpose of the Study:

  • To confirm and extend the finding of increased extra-axial CSF in infants who develop ASD.
  • To investigate the relationship between extra-axial CSF volume and ASD symptom severity.
  • To assess the predictive value of early extra-axial CSF volume for ASD diagnosis.

Main Methods:

  • A longitudinal neuroimaging study involving 343 infants (221 high-risk, 122 low-risk) was conducted.
  • Infants underwent magnetic resonance imaging (MRI) at 6, 12, and 24 months.
  • Infants diagnosed with ASD at 24 months were compared to control groups.

Main Results:

  • Infants who developed ASD showed significantly greater extra-axial CSF volume at 6 months (18% increase) compared to controls.
  • This elevated extra-axial CSF volume persisted through 24 months.
  • Higher ASD symptom severity correlated with greater extra-axial CSF volume from 6 to 24 months.
  • Extra-axial CSF volume at 6 months accurately predicted ASD diagnosis at 24 months (69% accuracy).

Conclusions:

  • Increased extra-axial CSF is a detectable anomaly at 6 months in infants who develop ASD, confirming prior research.
  • This finding suggests extra-axial CSF may serve as an early risk marker for ASD.
  • Further research is needed to determine if this anomaly contributes to ASD etiology.
Abstract

Keywords:
AutismBrain developmentCSFExtra-axial fluidInfancyMRI

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