Psychological Medicine

Original Articles

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

B. E. Lahuisa1 c1, S. Durstona1, H. Nederveena1, M. Zeegersa1, S. J. M. C. Palmena1 and H. Van Engelanda1

a1 Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands


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.

(Received November 23 2006)

(Revised June 28 2007)

(Accepted July 02 2007)

(Online publication September 10 2007)

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c1 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: