Neuroanatomical Cerebellar Patterns in Autism Spectrum Disorder

This study aimed to investigate cerebellar volumetric and cortical-thickness differences in adults with autism spectrum disorder (ASD) using automated segmentation techniques, with a particular focus on sex-based anatomical patterns.

A total of 100 participants from the Autism Brain Imaging Data Exchange database were included, comprising 48 adults with ASD (20 females, 28 males) and 52 healthy controls (23 females, 29 males). T1-weighted structural magnetic resonance imaging scans were processed using the CERES (CEREbellum Segmentation) module of volBrain to obtain lobule-specific cerebellar volume and thickness measures. Group comparisons were performed separately for males and females using non-parametric statistical tests.

Adults with ASD exhibited global cerebellar volumetric enlargement alongside lobule-specific reductions and altered pseudo-cortical thickness (PCT) across multiple lobules, most prominently within anterior sensorimotor and posterior cognitive regions. Several lobules demonstrated reversed asymmetry patterns relative to controls. Sex-stratified analyses suggested differential morphometric patterns between females and males with ASD; however, these findings should be interpreted as exploratory given subgroup sample sizes.

These findings demonstrate distinct cerebellar morphometric alterations in adults with ASD and support the utility of automated cerebellar segmentation for region-specific anatomical characterization. The results indicate group-level neuroanatomical differences involving the cerebellum, while emphasizing cautious interpretation regarding clinical or group-level distinguishing feature implications. Cite this article as: Karakaş AB, Akbulut Y. Neuroanatomical cerebellar patterns in autism spectrum disorder. Eurasian J Med. 2026, 58(4), 1008, doi: 10.5152/eurasianjmed.2026.251008.