J Psychiatry Neurosci 2011;36(1):32-40
Wouter B. Groen, MD, PhD; Jan K. Buitelaar, MD, PhD; Rutger J. van der Gaag, MD, PhD; Marcel P. Zwiers, PhD
Groen, Buitelaar, van der Gaag — Karakter, Child and Adolescent Psychiatry University Center; Groen, van der Gaag, Zwiers — Department of Psychiatry; Groen, Buitelaar, Zwiers — Donders Institute for Brain, Cognition and Behavior; Buitelaar — Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
Background: Recent studies have reported abnormal functional connectivity patterns in the brains of people with autism that may be accompanied by decreases in white matter integrity. Since autism is a developmental disorder, we aim to investigate the nature and location of decreases in white and grey matter integrity in an adolescent sample while accounting for age.
Methods: We used structural (T1) imaging to study brain volumetrics and diffusion tensor imaging (DTI) to investigate white and grey matter integrity in people with autism. We obtained magnetic resonance images for adolescents aged 12–18 years with high-functioning autism and from matched controls. Fractional anisotropy and mean diffusivity, as well as grey and white matter volumetrics were analyzed.
Results: There were 17 participants with autism and 25 matched controls included in this study. Participants with autism had lower fractional anisotropy in the left and right superior and inferior longitudinal fasciculus, but this effect was not significant after adjusting for age and intelligence quotient (IQ). The kurtosis of the white matter fractional anisotropy probability distribution was higher in this participant group, with and without adjustment for age and IQ. Most notably, however, the mean diffusivity levels were markedly increased in the autism group throughout the brain, and the mean diffusivity probability distributions of both grey and white matter were shifted toward a higher value, particularly with age and IQ adjustment. No volumetric differences in grey and white matter were found.
Limitations: We corrected for age and IQ using a linear model. The study was also limited by its sample size, investigated age range and cross-sectional design.
Conclusion: The findings suggest that autism is characterized by a generalized reduction of white matter integrity that is associated with an increase of interstitial space. The generalized manifestation of the white matter abnormalities provides an important new perspective on autism as a connectivity disorder.
Submitted Aug. 20, 2009; Revised Apr. 23, June 15, 2010; Accepted June 16, 2010.
Competing interests: None declared by Drs. Groen, van der Gaag and Zwiers. Dr. Buitelaar reported being a board member and paid consultant of Janssen Cilag BV and Eli Lilly, receiving a grant from Eli Lilly and being paid for the development of educational presentations by Eli Lilly, Janssen Cilag and Medice.
Contributors: All authors helped design the article, analyzed the data, wrote and reviewed the article and approved its publication. Dr. Groen acquired the data.
Correspondence to: Dr. W.B. Groen, Karakter, Child and Adolescent Psychiatry University Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands; firstname.lastname@example.org