Unusual brain growth patterns in early life in patients with autistic disorder

TLDR

The study aimed to quantify developmental abnormalities in cerebral and cerebellar volume in autism. The authors performed MRI scans on 60 autistic and 52 normal boys aged 2–16, with half scanned before diagnosis and half after, and also examined neonatal head circumferences. Autistic boys showed early brain overgrowth, with 90 % of 2–4‑year‑olds having larger volumes and 37 % meeting macrencephaly criteria, and increased cerebral and cerebellar white and gray matter, but this overgrowth was not seen in older children, indicating abnormal growth regulation that later slows.

Abstract

To quantify developmental abnormalities in cerebral and cerebellar volume in autism.The authors studied 60 autistic and 52 normal boys (age, 2 to 16 years) using MRI. Thirty autistic boys were diagnosed and scanned when 5 years or older. The other 30 were scanned when 2 through 4 years of age and then diagnosed with autism at least 2.5 years later, at an age when the diagnosis of autism is more reliable.Neonatal head circumferences from clinical records were available for 14 of 15 autistic 2- to 5-year-olds and, on average, were normal (35.1 +/- 1.3 cm versus clinical norms: 34.6 +/- 1.6 cm), indicative of normal overall brain volume at birth; one measure was above the 95th percentile. By ages 2 to 4 years, 90% of autistic boys had a brain volume larger than normal average, and 37% met criteria for developmental macrencephaly. Autistic 2- to 3-year-olds had more cerebral (18%) and cerebellar (39%) white matter, and more cerebral cortical gray matter (12%) than normal, whereas older autistic children and adolescents did not have such enlarged gray and white matter volumes. In the cerebellum, autistic boys had less gray matter, smaller ratio of gray to white matter, and smaller vermis lobules VI-VII than normal controls.Abnormal regulation of brain growth in autism results in early overgrowth followed by abnormally slowed growth. Hyperplasia was present in cerebral gray matter and cerebral and cerebellar white matter in early life in patients with autism.