Brain imaging may help diagnose autism

Philadelphia 08 January 2010Children with autism spectrum disorders (ASDs) process sound and language a fraction of a second slower than children without ASDs, and measuring magnetic signals that mark this delay may become a standardized way to diagnose autism. Researchers at the Children's Hospital of Philadelphia report their findings in an on-line article in the journal Autism Research.

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"More work needs to be done before this can become a standard tool, but this pattern of delayed brain response may be refined into the first imaging biomarker for autism", stated study leader Timothy P.L. Roberts, Ph.D., vice chair of Radiology Research at Children's Hospital.

ASDs are a group of childhood neurodevelopmental disorders that cause impairments in verbal communication, social interaction and behaviour. ASDs are currently estimated to affect as many as one percent of United States children, according to a recent CDC report.

Like many neurodevelopmental disorders, in the absence of objective biological measurements, psychologists and other caregivers rely on clinical judgments such as observations of behaviour to diagnose ASDs, often not until a child reaches school age. If researchers can develop imaging results into standardized diagnostic tests, they may be able to diagnose ASDs as early as infancy, permitting possible earlier intervention with treatments. They also may be able to differentiate types of ASDs - classic autism, Asperger's syndrome or other types - in individual patients.

In the current study, Timothy P.L. Roberts and colleagues used magneto-encephalography (MEG), which detects magnetic fields in the brain, similar to the way electro-encephalography (EEG) detects electrical fields. Using a helmet that surrounds the child's head, the team presents a series of recorded beeps, vowels and sentences. As the child's brain responds to each sound, non-invasive detectors in the MEG machine analyze the brain's changing magnetic fields.

The researchers compared 25 children with ASDs, having a mean age of 10 years, to 17 age-matched typically developing children. The children with ASDs had an average delay of 11 milliseconds (about 1/100 of a second) in their brain responses to sounds, compared to the control children. Among the group with ASDs, the delays were similar, whether or not the children had language impairments.

"This delayed response suggests that the auditory system may be slower to develop and mature in children with ASDs", stated Timothy P.L. Roberts. An 11-millisecond delay is brief, but it means, for instance, that a child with ASD, on hearing the word 'elephant' is still processing the 'el' sound while other children have moved on. The delays may cascade as a conversation progresses, and the child may lag behind typically developing peers."

A 2009 study by Timothy P.L. Roberts and colleagues sheds light on how changes in brain anatomy may account for the delays in sound processing. The study team used MEG to analyze the development of white matter in the brains of 26 typically developing children and adolescents. Because white matter carries electrical signals in the brain, signaling speed improves when neurons are better protected with an insulating sheath of a membrane material called myelin.

In this previous study, the researchers showed that normal age-related development of greater myelination corresponds with faster auditory responses in the brain. "The delayed auditory response that we find in children with ASDs may reflect delayed white matter development in these children", stated Timothy P.L. Roberts. Timothy P.L. Roberts said his team's further studies will seek to refine their imaging techniques to determine that their biomarker is specific to ASDs, and will investigate other MEG patterns found in children with ASDs in addition to auditory delays.

Grants from the National Institute of Health, the Nancy Lurie Marks Family Foundation, Autism Speaks, and the Pennsylvania Department of Health supported this research. In addition, Timothy P.L. Roberts holds an endowed chair, the Oberkircher Family Chair in Paediatric Radiology at the Children's Hospital of Philadelphia. Timothy P.L. Roberts' co-authors were from Children's Hospital, including the Hospital's Center for Autism Research.

The Children's Hospital of Philadelphia was founded in 1855 as the United States' first paediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of paediatric health care professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its paediatric research programme is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centred care and public service programmes have brought the 441-bed hospital recognition as a leading advocate for children and adolescents.


Source: Children's Hospital of Philadelphia

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