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Sleep Onset Problems and Subcortical Development in Infants Later Diagnosed With Autism Spectrum Disorder
Katherine E MacDuffie1, Mark D Shen1, Stephen R Dager1
1Department of Speech and Hearing Sciences (MacDuffie, St. John, Estes), and Department of Radiology (Dager), University of Washington, Seattle; Department of Psychiatry (Shen, Styner, Kim), Biomedical Research Imaging Center (Styner), and Neurodevelopmental Research Center (Piven), University of North Carolina Chapel Hill; Department of Psychology, Temple University, Philadelphia (Paterson); Department of Child Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia (Pandey); Institute of Child Development (Elison), Department of Educational Psychology (Wolff), University of Minnesota, Minneapolis; Department of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson); Department of Child Psychiatry, Washington University School of Medicine in St. Louis (Botteron); and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada (Zwaigenbaum).
Insights
Infants later diagnosed with autism spectrum disorder (ASD) show more sleep onset issues in their first year. These sleep problems are linked to changes in the hippocampus, suggesting a role in early neurodevelopment for ASD.
Area of Science:
- Neurodevelopmental disorders
- Pediatric sleep medicine
- Autism spectrum disorder (ASD) research
Background:
- Sleep problems are common in children with autism spectrum disorder (ASD), often emerging around 2-3 years of age.
- Limited research exists on sleep issues in infants who later develop ASD and their impact on early brain development.
Purpose of the Study:
- To investigate sleep onset problems in infants at high and low familial risk for ASD.
- To examine the relationship between early sleep problems and subcortical brain volumes in the first two years of life.
Main Methods:
- Longitudinal neuroimaging study of 432 infants (high ASD risk, high non-ASD risk, low risk).
- Parent-reported sleep onset problem scores assessed using an infant temperament measure.
- High-resolution structural MRI (T1 and T2) acquired at 6, 12, and 24 months.
Main Results:
- Infants who later developed ASD exhibited more sleep onset problems at 6-12 months.
- Sleep onset problems were associated with hippocampal volume trajectories (6-24 months) exclusively in high-risk infants who developed ASD.
- No significant brain-sleep relationships were found for other subcortical structures (amygdala, caudate, etc.).
Conclusions:
- Early sleep onset problems in the first year precede ASD diagnosis.
- These sleep difficulties are linked to altered neurodevelopmental trajectories in infants who develop ASD.
- Findings suggest a potential role for sleep disturbances in the developmental pathways of ASD.
Objective:
Sleep patterns in children with autism spectrum disorder (ASD) appear to diverge from typical development in the second or third year of life. Little is known, however, about the occurrence of sleep problems in infants who later develop ASD and possible effects on early brain development. In a longitudinal neuroimaging study of infants at familial high or low risk for ASD, parent-reported sleep onset problems were examined in relation to subcortical brain volumes in the first 2 years of life.
Methods:
A total of 432 infants were included across three study groups: infants at high risk who developed ASD (N=71), infants at high risk who did not develop ASD (N=234), and infants at low risk (N=127). Sleep onset problem scores (derived from an infant temperament measure) were evaluated in relation to longitudinal high-resolution T1 and T2 structural imaging data acquired at 6, 12, and 24 months of age.
Results:
Sleep onset problems were more common at 6-12 months among infants who later developed ASD. Infant sleep onset problems were related to hippocampal volume trajectories from 6 to 24 months only for infants at high risk who developed ASD. Brain-sleep relationships were specific to the hippocampus; no significant relationships were found with volume trajectories of other subcortical structures examined (the amygdala, caudate, globus pallidus, putamen, and thalamus).
Conclusions:
These findings provide initial evidence that sleep onset problems in the first year of life precede ASD diagnosis and are associated with altered neurodevelopmental trajectories in infants at high familial risk who go on to develop ASD. If replicated, these findings could provide new insights into a potential role of sleep difficulties in the development of ASD.
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