title: Poor Brain Growth in Extremely Preterm Neonates Long Before the Onset of Autism Spectrum Disorder Symptoms.
abstract: Preterm infants face an increased risk of autism spectrum disorder (ASD). The relationship between autism during childhood and early brain development remains unexplored. We studied 84 preterm children born at <27 weeks of gestation, who underwent neonatal magnetic resonance imaging (MRI) at term and were screened for ASD at 6.5 years. Full-scale intelligence quotient was measured and neonatal morbidities were recorded. Structural brain morphometric studies were performed in 33 infants with high-quality MRI and no evidence of focal brain lesions. Twenty-three (27.4%) of the children tested ASD positive and 61 (72.6%) tested ASD negative. The ASD-positive group had a significantly higher frequency of neonatal complications than the ASD-negative group. In the subgroup of 33 children, the ASD infants had reduced volumes in the temporal, occipital, insular, and limbic regions and in the brain areas involved in social/behavior and salience integration. This study shows that the neonatal MRI scans of extremely preterm children, subsequently diagnosed with ASD at 6.5 years, showed brain structural alterations, localized in the regions that play a key role in the core features of autism. Early detection of these structural alterations may allow the early identification and intervention of children at risk of ASD.
authors.affiliation: Department of Women's and Children's Health.
authors.forename: Nelly
authors.initials: N
authors.lastname: Padilla
authors.affiliation: Department of Women's and Children's Health.
authors.forename: Eva
authors.initials: E
authors.lastname: Eklöf
authors.affiliation: Department of Women's and Children's Health.
authors.forename: Gustaf E
authors.initials: GE
authors.lastname: Mårtensson
authors.affiliation: Department of Women's and Children's Health.|Division of Child and Adolescent Psychiatry, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sven
authors.initials: S
authors.lastname: Bölte
authors.affiliation: Department of Women's and Children's Health.|Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Lagercrantz
authors.affiliation: Department of Women's and Children's Health.|Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Ådén
mesh_terms: D000328:Adult; D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000473:pathology*; D001921:Brain / Q000254:growth & development / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000254:growth & development; D007360:Intelligence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012919:Social Behavior; D055815:Young Adult
keywords: autism; brain development; extreme prematurity; structural MRI