Brain scan could aid diagnosis in adults with autism
11 August 2010
Autism spectrum disorders (ASDs) are lifelong and disabling conditions caused by abnormalities in brain development. They affect about 1 per cent of the UK population - just over half a million people - the majority of these being men, with the disorder affecting around four males to every female affected.
Until now, diagnosis has mainly relied on personal accounts from friends or relatives close to the patient. A team of experts is required to interpret this information, leading to a lengthy and drawn-out process that hinges on the reliability of their accounts.
Scientists at the Institute of Psychiatry (IoP), King's College London, used an MRI scanner to take pictures of the brain's grey matter in adults with ASD. A separate imaging technique reconstructs these scans into three-dimensional images that a computer algorithm can assess for structure, shape and thickness - all intricate measurements that reveal symptoms of the disorder at its root. The computer can then quickly pinpoint biological markers, rather than personality traits, to assess whether or not a person has ASD. Their findings are published today in the Journal of Neuroscience.
Dr Christine Ecker, a Lecturer in the Department of Forensic and Neurodevelopmental Sciences at the IoP, who led the study, said: "The value of this rapid and accurate tool to diagnose ASD is immense. It could help to alleviate the need for the emotional, time-consuming and expensive diagnosis process which ASD patients and families currently have to endure. We now look forward to testing if our methods can also help children."
Professor Declan Murphy, Professor of Psychiatry and Brain Maturation at the IoP, who supervised the research, said: "Simply being diagnosed means patients can take the next steps to get help and improve their quality of life. People with autism are affected in different ways; some can lead relatively independent lives while others need specialist support or are so severely affected they cannot communicate their feelings and frustrations at all. Clearly the ethical implications of scanning people who may not suspect they have autism needs to be handled carefully and sensitively as this technique becomes part of clinical practice."
The research studied 20 adults with ASD, 19 adults with attention deficit hyperactivity disorder (ADHD) and 20 control. All participants were males aged between 20 and 68 years. After first diagnosing the patients with traditional methods - an IQ test, psychiatric interview, physical examination and blood test - scientists used the newly-developed brain scanning technique as a comparison.Individuals with autism were correctly diagnosed with the condition in 90 per cent of cases. The researchers believe this may therefore provide a rapid diagnostic instrument using biological signposts to detect autism in the future.
The research was undertaken using the AIMS Consortium (Autism Imaging Multicentre Study), which is funded by the Medical Research Council (MRC), the Wellcome Trust and the National Institute for Health Research.
Professor Christopher Kennard, Chair of the MRC's Neuroscience and Mental Health funding board, said: "Bringing together the knowledge gained from neuroscience in the laboratory and careful clinical and neuropsychological evaluation in the clinic has been key to the success of this new diagnostic tool. In fact, this approach to research is a crucial theme throughout the MRC's strategy. We know that an investment like this can dramatically affect the quality of life for patients and their families. The more we understand about the biological basis of autism, the better equipped we will be to find new ways of treating those affected in the future."
Reference
Ecker C et al. Describing the brain in autism in five dimensions - magnetic resonance imaging-assisted diagnosis using a multi-parameter classification approach. J Neurosci 2010.
