The very name of ASD (Autistic Spectrum Disorder) shows how varied the characteristics and degrees of alteration in some abilities can be in people so diagnosed.
It is also believed that the causes of ASD are multifactorial, ranging from genetics to the social context.
For all this complexity, any clue about autism coming from science represents a step that can help in the diagnosis and early care of people with autism.
On the 23rd, a team from Yale University, in the United States, presented unprecedented research at the annual congress of the Radiological Society of North America (Radiological Society of North America) demonstrating significant changes in a part of the brain fundamental to its connections , the corpus callosum, in adolescents and young adults with this diagnosis.
The study analyzed MRI scans of 583 people whose medical information is part of a large database for US autism research, the National Database of Autism Research. The authors argue that one of the study’s achievements is considering people of different age groups — from six months of age to 50 years —, while much research on autism focuses only on children.
Although younger people were included in the analysis, changes in the corpus callosum of the brain were observed as age increased, starting in adolescence. The WHO (World Health Organization) works with the estimate that, on the world average, about one in 160 children have some ASD (Autistic Spectrum Disorder).
“Since ASD becomes apparent and is usually diagnosed at the beginning of school age, our results suggest that behavioral changes appear earlier than changes in the white matter of the brain,” physician Clara explained by e-mail to BBC News Brasil. Weber, researcher at Yale University and study leader.
The corpus callosum is made up of white matter — Weber explains that while the brain’s gray matter is like a computer, the white matter is like wires. And the corpus callosum, in particular, is responsible for connecting the two cerebral hemispheres.
“We were unable to detect significant changes in younger children, which gives clues that microstructural changes (in the brain) start later,” says the researcher.
She talks about a microstructure because her team analyzed a very particular mechanism: the displacement of water molecules within the corpus callosum, the so-called fractional anisotropy. Magnetic resonance imaging showed that, in adolescents and young adults with ASD, this shift was smaller compared to a control group.
“A reduction in fractional anisotropy means a change in (brain) connections”, summarizes Clara Weber.
“Different ASD theories consider that many factors contribute to the condition and hypothesize that both poor connectivity and hyperconnectivity of functional connections play a role.”
“Our study basically added another aspect to this, confirming that not only the functional connections are altered, but also the microstructure of the brain.”
The results were presented at the congress of the Society of Radiology of North America but have not yet been published in a scientific journal with the so-called peer review — when experts not involved in that work analyze the content of an article that is candidate for publication. Weber said she and her team will submit the work for publication in a scientific journal in the coming weeks.
Potential for diagnosis and treatment
Weber says he hopes signals in the brain like those seen can help with early diagnosis of ASD and follow-up treatments.
Not involved in the research, Brazilian neuropediatrician Liubiana Arantes de Araújo analyzed the work presented at the congress and also pointed out to BBC News Brasil the potential it has to contribute to the care of people with autism.
The doctor explains that, today, the diagnosis of ASD comes with a combination of several analyses, such as a medical examination, the application of questionnaires and, in some cases, imaging tests (such as magnetic resonance and electroencephalogram).
“Increasingly, we also have studies that help to observe that genetic alterations are related to autism. If there are also imaging tests showing that the more alterations in the corpus callosum, the greater the compromise, it is very interesting for diagnosis and rehabilitation ” says the neuropediatrician, also president of the Scientific Department of Pediatrics for Development and Behavior of the SBP (Brazilian Society of Pediatrics).
“The more changes found that are evidence of autism, the better.”
The doctor emphasizes, however, that not all people with ASD will show changes in the brain or corpus callosum — when they exist, they are usually associated with more severe cases of ASD.
“If you have an alteration in the corpus callosum, there is a condition with more evident symptoms of autism, related to cognitive, language and theory of mind skills, which is the ability to put yourself in someone else’s shoes.”
Araújo also points out that this is not the first study to associate ASD to changes in the brain, corpus callosum and water diffusion, but he claims that it deepens knowledge about these points and reveals how the changes occur during growth.
“In people without autism, the corpus callosum will develop up to around 12 years of age. If you detect that in autism this corpus callosum will have an altered development and especially after that age, this justifies differences in relation to treatment, to changes in behavior throughout the growth of the patient with autism.”
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