Release date: 2017-02-17 By using magnetic resonance imaging (MRI) to study the brains of siblings whose older brothers or sisters have autism, scientists can correctly identify 80% of infants who are subsequently diagnosed with autism at 2 years of age. The study used MRI to measure the brains of “low-risk†infants with no family history of autism, and the brains of “high-risk†infants with at least one autistic relative. Computer algorithms are then used to predict autism prior to clinically diagnosable behavioral settings. The study was completed by researchers at the University of Washington and published in the journal Nature on February 16. For the first time, the study used brain biomarkers to identify babies in high-risk pools, and was able to identify those infants who would be diagnosed with Autism Spectrum Disorder (ASD) at 24 months. “Usually, the earliest age at which we can reliably diagnose autism in children is 2 years. When there is a consistent behavioral symptom, the average age of diagnosis in the United States is actually 4 years due to differences in health visits,†co-author of the study, UW. Annette Estes, professor of speech and hearing science, said, "But in our study, brain imaging biomarkers were able to identify infants who were later diagnosed with ASD at 6 and 12 months." The predictive power discovered by the team may provide information for the development of ASD diagnostic tools that can be used in the first year of life before behavioral symptoms occur. "We don't have such a tool yet," Estes said. "But if we do this, parents of high-risk babies don't need to wait for a 2, 3 or even 4-year-old ASD diagnosis, and researchers can begin to develop interventions to prevent these children from falling behind in social communication skills." ASD patients, including 3 million people in the United States, have unique social communication deficiencies and demonstrate a series of ritual, repetitive and stereotyped behaviors. It is estimated that in the United States, one of 68 infants develops autism. But for babies with autistic brothers or sisters, the risk may be as high as one every five births. The research project includes hundreds of children from across the country and is led by researchers from four clinical sites in the United States: University of North Carolina - Chapel Hill, University of Washington, Washington University in St. Louis, and Children's Hospital of Philadelphia. Other major collaborators are at the Montreal Institute of Neurology, the University of Alberta and the University of New York. "We have wonderful, dedicated families who are involved in this research, and they are willing to come to our research sites from long distances, and then until late at night," said Stephen Dager, Ph.D., professor of radiology at the University of Wisconsin, and professor of radiology at Wisconsin State University. We can collect brain imaging data of the children they sleep with, and the family participates in follow-up visits, so we can measure their children's brains, and without them to participate wholeheartedly, we can't make these findings." MRI technicians Mindy Dixon and Stephen Dager reviewed magnetic resonance spectroscopy images of children's brain chemistry. Source: University of Washington The researchers obtained MRI scans of children at sleep at 6, 12, and 24 months of age. The study also used the criteria developed by Estes and her team to assess the behavior and intelligence of each visit. They found that children with autistic children had excessive brain surface area expansion for 6 to 12 months compared with infants with autistic brothers and sisters who did not show autism for 24 months. The increased surface area growth rate in the first year of life is related to the increased growth rate of the brain volume in the second year of growth. Excessive brain growth is associated with the emergence of a social deficit in autism in the second year. The researchers calculated the 6- and 12-month MRI calculations of brain volume, surface area and cortical thickness, and the gender of the infant into a computer program that required the classification of the most likely ASD-compliant infants at 24 months of age. The program developed the best algorithm to accomplish this, and the researchers applied the algorithm to a separate set of research participants. The researchers found that in infants with ASD brothers and sisters, brain differences at 6 and 12 months of age successfully identified 80% of those diagnosed with autism at 24 months. If these findings can form the basis of a "pre-symptomatic" diagnosis of ASD, health care professionals can intervene earlier. Estes said, “When I diagnosed ASD in 2 to 4 years, children have fallen behind their peers in social skills, communication and language,†Estes pointed out the behavioral assessment of the network. “Once you miss out on the best time for these developments, many people have to work hard to catch up, and some people are almost impossible to do.†The study can then begin to examine interventions in children before the onset of the syndrome and during the most malleable period of the brain. Such interventions may be more likely to improve outcomes than treatments initiated after diagnosis. "Our hope is early intervention, before the age of 2, to change the clinical course of children with brain developmental errors and help them acquire the skills they will strive to achieve," Dager said. The team collected data on other behaviors and brain imaging of these infants and children, such as changes in cerebral blood flow and movement of water along the white matter network to understand brain connectivity and neural activity in high-risk children who are responsible for not developing autism . In a separate study published in the Cerebral Cortex on January 6, the researchers discovered specific brain regions that might be important for early social behavior (called joint attention), after another person pointed to it. Focus your attention on an object. "These longitudinal imaging studies follow the same babies as they grow up and really begin to hone critical brain development processes." “We hope that these ongoing efforts will lead to additional biomarkers that can provide the basis for early, pre-symptomatic diagnosis and can also guide individualized interventions to help these children not fall behind their peers.†Source: Bio 360
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