Thursday, June 8, 2017

Could a Single Brain Scan Predict Which Infants Will Eventually be Diagnosed with Autism?

Differences in a baby’s brain activity patterns at 6 months of age can predict which children will develop autism at 2 years of age, according to a study published this week by the NIH- funded, multi-site Infant Brain Imaging Study (IBIS) network, which includes CHOP’s Center for Autism Research.

CHOP researchers are part of a national network using brain imaging
to detect the earliest signs of autism in infants.
Using a safe brain imaging procedure called functional connectivity magnetic resonance imaging (fcMRI), the research team studied brain activity during waking tasks and natural sleep in 59 six-month-old infants who were at high risk for autism spectrum disorder (ASD). They then applied a computer algorithm to analyze the pattern of activity across tens of thousands of neural signals across the entire brain. This combination of techniques allowed scientists to identify with more than 96% accuracy which children would go on to be diagnosed with the neurodevelopmental condition by two years of age, and which would not.  The study is the fourth in a series of findings published this year by the IBIS researchers.

“2017 has been a breakthrough year for decades of research aimed at detecting the earliest changes in the brain that are associated with autism,” said Robert T. Schultz, Ph.D., who leads the CHOP research site. “This current study reveals the foundational patterns of brain function at age 6 months, which set in motion developmental processes that yield behavioral symptoms of autism by age 24 months.  This is an astounding observation that could fundamentally change clinical practice.”

Robert T. Schultz, PhD, directs
the CHOP study site for the NIH
multi-site infant brain imaging study.
All of the science to date shows that early diagnosis and intervention for autism is the best way to reduce the severity of symptoms over the course of a lifetime. However, until now, clinicians have not had rigorous ways to diagnose children before the behaviors of autism emerge, typically between ages 2 and 4- and even this requires a highly specialized clinician and can involve long wait times.

Although this latest study was a small one, researchers are encouraged that this growing body of evidence will mean that in the future, neuroimaging may be a useful tool to diagnose autism or help health care providers evaluate a child’s risk of developing the disorder. “The ability to detect who will develop autism before there are any clear outward manifestations should enable earlier diagnoses and better long term outcomes for scores of children who develop autism,” said Dr. Schultz.

The authors propose that a neuroimaging scan at age 6 months can accurately predict autism among high-risk infants, but caution that the findings need to be replicated in a larger group. 

The results were published in the June 7th issue of Science Translational Medicine, and the study’s lead author was Dr. Robert Emerson at University of North Carolina, Chapel Hill.

Learn more about the study results from the NIH press release and Spectrum article.