Perivascular Space Burden in Children With Autism Spectrum Disorder Correlates With Neurodevelopmental Severity

Area of Science:

• Neuroimaging
• Developmental Neuroscience
• Autism Spectrum Disorder Research

Background:

• Cerebral perivascular spaces (PVS) facilitate cerebrospinal fluid (CSF) circulation and waste clearance in adults.
• Increased PVS have been observed in autism spectrum disorder (ASD), but their association with CSF dynamics and disease severity remains unclear.

Purpose of the Study:

• To quantitatively assess PVS in children diagnosed with ASD using magnetic resonance imaging (MRI).

Main Methods:

• A retrospective analysis of 66 children with ASD (mean age 4.7 years) using 3T MRI with 3D T1-weighted GRE and 3D T2-weighted turbo spin echo sequences.
• PVS were segmented using a weakly supervised algorithm, analyzing total count (WM-PVS_tot) and normalized volume (WM-PVS_voln) across white matter regions.
• Statistical analyses included Kendall correlation and Friedman tests, with generalized linear models assessing relationships between PVS, developmental quotient (DQ), clinical severity, and extra-axial CSF (eaCSF) volume.

Main Results:

• Higher WM-PVS_tot counts were significantly associated with severe DQ, milder ASD forms, and larger eaCSF volumes.
• WM-PVS_voln was primarily influenced by normalized eaCSF volume (eaCSF_voln).
• The percentage of segmented white matter PVS (WM-PVS_sr) was highest in frontal regions (32%) and lowest in temporal regions (11%).

Conclusions:

• PVS count and volume in children with ASD correlate with eaCSF volume, clinical severity, and DQ.
• PVS distribution varies regionally, with greater prevalence in frontal white matter and lower prevalence in temporal regions.