Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-18T08:45:50.037Z Has data issue: false hasContentIssue false

MRI-based morphometry in children with multiple complex developmental disorder, a phenotypically defined subtype of pervasive developmental disorder not otherwise specified

Published online by Cambridge University Press:  10 September 2007

B. E. Lahuis*
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
S. Durston
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
H. Nederveen
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
M. Zeegers
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
S. J. M. C. Palmen
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
H. Van Engeland
Affiliation:
Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
*
*Address for correspondence: B. E. Lahuis, M.D., University Medical Centre Utrecht, Department of Child and Adolescent Psychiatry, B 01.201, PO Box 85500, Utrecht, The Netherlands. (Email: b.e.lahuis@umcutrecht.nl)

Abstract

Background

The DSM-IV-R classification Pervasive Developmental Disorder – Not otherwise Specified (PDD-NOS) is based on the symptoms for autism and includes a wide variety of phenotypes that do not meet full criteria for autism. As such, PDD-NOS is a broad and poorly defined residual category of the autism spectrum disorders. In order to address the heterogeneity in this residual category it may be helpful to define clinical and neurobiological subtypes. Multiple complex developmental disorder (MCDD) may constitute such a subtype. In order to study the neurobiological specificity of MCDD in comparison with other autism spectrum disorders, we investigated brain morphology in children (age 7–15 years) with MCDD compared to children with autism and typically developing controls.

Method

Structural MRI measures were compared between 22 high-functioning subjects with MCDD and 21 high-functioning subjects with autism, and 21 matched controls.

Results

Subjects with MCDD showed an enlarged cerebellum and a trend towards larger grey-matter volume compared to control subjects. Compared to subjects with autism, subjects with MCDD had smaller intracranial volume.

Conclusions

We report a pattern of volumetric changes in the brains of subjects with MCDD, similar to that seen in autism. However, no enlargement in head size was found. This suggests that although some of the neurobiological changes associated with MCDD overlap with those in autism, others do not. These neurobiological changes may reflect differences in the developmental trajectories associated with these two subtypes of autism spectrum disorders.

Type
Original Articles
Copyright
Copyright © 2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ad-Dab'bagh, Y, Greenfield, B (2001). Multiple Complex Developmental Disorder: the ‘Multiple and Complex’ evolution of the ‘Childhood Borderline Syndrome’ construct. Journal of the American Academy of Child and Adolescent Psychiatry 40, 954964.Google Scholar
Akshoomoff, N, Pierce, K, Courchesne, E (2002). The neurobiological basis of autism from a developmental perspective. Development and Psychopathology 14, 613634.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn). American Psychiatric Association: Washington, DC.Google Scholar
Aylward, EH, Minshew, NJ, Field, K, Sparks, BF, Singh, N (2002). Effects of age on brain volume and head circumference in autism. Neurology 23, 175183.Google Scholar
Buitelaar, JK, Van der Gaag, RJ (1998). Diagnostic rules for children with PDD-NOS and Multiple Complex Developmental Disorder. Journal of Child Psychology and Psychiatry and allied disciplines 39, 911918.Google ScholarPubMed
Cody, H, Pelphrey, K, Piven, J (2002). Structural and functional magnetic resonance imaging of autism. International Journal of Developmental Neuroscience 20, 421438.CrossRefGoogle ScholarPubMed
Cohen, DJ, Paul, R, Volkmar, FR (1986). Issues in the classification of pervasive and other developmental disorders: toward DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry 25, 213220.Google ScholarPubMed
Cohen, DJ, Paul, R, Volkmar, FR (1987). Issues in the classification of pervasive and other developmental disorders and associated conditions. In Handbook of Autism and Pervasive Developmental Disorders (ed. Cohen, D. J., Donnellan, A. M. and Pauls, R.), pp. 2039. Wiley & Sons: New York.Google Scholar
Courchesne, E, Karns, C, Davis, HR, Ziccardi, R, Carper, RA, Tique, ZD, Chisum, HJ, Moses, P, Pierce, K, Lord, C, Lincoln, AJ, Pizzo, S, Schreibman, L, Haas, RH, Akshoomhoff, NA, Courchesne, RY (2001). Unusual brain growth patterns in early life in patients with autistic disorder: an MRI study. Neurology 57, 245254.CrossRefGoogle ScholarPubMed
Cox, A, Klein, K, Charman, T, Baird, G, Baron-Cohen, S, Swettenham, J, Drew, A, Wheelwright, S (1999). Autism spectrum disorders at 20 and 42 months of age: stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry and Allied Disciplines 40, 719732.Google Scholar
Durston, S, Hulshoff Pol, HE, Casey, BJ, Giedd, JN, Buitelaar, JK, Van Engeland, H (2001). Anatomical MRI of the developing human brain: what have we learned? Journal of the American Academy of Child and Adolescent Psychiatry 40, 10121020.CrossRefGoogle ScholarPubMed
Durston, S, Hulshoff Pol, HE, Schnack, HG, Buitelaar, JK, Steenhuis, MP, Minderaa, RB, Kahn, RS, Van Engeland, H (2004). Magnetic Resonance Imaging of boys with Attention Deficit Hyperactivity Disorder and their unaffected siblings. Journal of the American Academy of Child and Adolescent Psychiatry 43, 332340.CrossRefGoogle ScholarPubMed
Fombonne, E (2003). Epidemiological surveys of autism and other pervasive developmental disorders: an update. Journal of Autism and Developmental Disorders 33, 365382.Google Scholar
Fombonne, E (2005). Epidemiology of autistic disorder and other developmental disorders. Journal of Clinical Psychiatry 66, 38.Google Scholar
Jansen, LM, Gispen-de Wied, CC, Van der Gaag, RJ, Van Engeland, H (2003). Differentiation between autism and multiple complex developmental disorder in response to psychosocial stress. Neuropsychopharmacology 28, 582590.CrossRefGoogle ScholarPubMed
Kemner, C, Van der Gaag, RJ, Verbaten, M, Van Engeland, H (1999). ERP differences among subtypes of pervasive developmental disorders. Biological Psychiatry 46, 781789.CrossRefGoogle ScholarPubMed
Lainhart, JE, Bigler, ED, Bocian, M, Coon, H, Dinh, E, Dawson, G, Deutsch, CK, Dunn, M, Estes, A, Tager-Flusberg, H, Folstein, S, Hepburn, S, Hyman, S, McMahon, W, Minshew, N, Munson, J, Osann, K, Ozonoff, S, Rodier, P, Rogers, S, Sigman, M, Spence, MA, Stodgell, CJ, Volkmar, F (2006). Head circumference and height in autism: a study by the collaborative program of excellence in autism. American Journal of Medical Genetics, Part A 140, 22572274.Google Scholar
LeCouteur, A, Rutter, M, Lord, C, Rios, P, Robertson, S, Holdgrafer, M, McLennan, J (1989). Autism diagnostic interview: a standardized investigator-based instrument. Journal of Autism and Developmental Disorders 19, 363387.CrossRefGoogle Scholar
Lord, C, Rutter, M, Le Couteur, A (1994). Autism Diagnostic Interview – Revised. Journal of Autism and Developmental Disorders 24, 659686.Google Scholar
Palmen, SJ, Hulshoff Pol, HE, Kemner, C, Schnack, HG, Durston, S, Lahuis, BE, Kahn, RS, Van Engeland, H (2005). Increased gray-matter volume in medication-naive high-functioning children with autism spectrum disorder. Psychological Medicine 35, 561570.Google Scholar
Palmen, SJ, Van Engeland, H (2004). Review on structural neuroimaging findings in autism. Journal of Neural Transmission 111, 903929.CrossRefGoogle ScholarPubMed
Sparks, BF, Friedman, SD, Shaw, DW, Aylward, EH, Echelard, D, Artru, AA, Maravilla, AR, Giedd, JN, Munson, J, Dawson, G, Dager, SR (2002). Brain structural abnormalities in young children with autism spectrum disorder. Neurology 59, 184192.Google Scholar
Towbin, KE, Duykens, EM, Pearson, GS, Cohen, DJ (1993). Conceptualizing ‘borderline syndrome of childhood’ and ‘childhood schizophrenia’ as a developmental disorder. Journal of the American Academy of Child and Adolescent Psychiatry 32, 775782.Google Scholar
Van der Gaag, RJ (1993). Multiplex development disorder: an exploration of borderlines on the autistic spectrum. Thesis, University of Utrecht, Netherlands.Google Scholar
Van der Gaag, RJ, Buitelaar, J, van den Ban, E, Bezemer, M, Njio, L, Van Engeland, H (1995). A controlled multivariate chart review of multiple complex developmental disorder. Journal of the American Academy of Child and Adolescent Psychiatry 34, 109–106.Google Scholar
Van Engeland, H, Van der Gaag, RJ (1994). MCDD in childhood: a precursor of schizophrenic spectrum disorders. Schizophrenia Research 11, 197.Google Scholar
Vandersteene, G, Van Haassen, PP, De Bruyn, EEJ, Coetsier, P, Pijl, YL, Poortinga, YH, Lutje Spelberg, HC, Spoelders-Claes, R, Stinissen, J (1986). WISC-R, Wechsler Intelligence Scale for Children – Revised. Nederlandstalige uitgave. Swets and Zeitlinger: Lisse.Google Scholar
Wing, L, Gould, J (1979). Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Developmental Disorders 9, 1129.CrossRefGoogle ScholarPubMed