Psychological Medicine

Original Articles

Differential effects on white-matter systems in high-functioning autism and Asperger's syndrome

G. M. McAlonana1a2 c1, C. Cheunga2, V. Cheunga2, N. Wonga2, J. Sucklinga3 and S. E. Chuaa1a2

a1 State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pokfulam, Hong Kong SAR China

a2 Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong SAR China

a3 Cambridge Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK


Background Whether autism spectrum maps onto a spectrum of brain abnormalities and whether Asperger's syndrome (ASP) is distinct from high-functioning autism (HFA) are debated. White-matter maldevelopment is associated with autism and disconnectivity theories of autism are compelling. However, it is unknown whether children with ASP and HFA have distinct white-matter abnormalities.

Method Voxel-based morphometry mapped white-matter volumes across the whole brain in 91 children. Thirty-six had autism spectrum disorder. A history of delay in phrase speech defined half with HFA; those without delay formed the ASP group. The rest were typically developing children, balanced for age, IQ, gender, maternal language and ethnicity. White-matter volumes in HFA and ASP were compared and each contrasted with controls.

Results White-matter volumes around the basal ganglia were higher in the HFA group than ASP and higher in both autism groups than controls. Compared with controls, children with HFA had less frontal and corpus callosal white matter in the left hemisphere; those with ASP had less frontal and corpus callosal white matter in the right hemisphere with more white matter in the left parietal lobe.

Conclusions HFA involved mainly left hemisphere white-matter systems; ASP affected predominantly right hemisphere white-matter systems. The impact of HFA on basal ganglia white matter was greater than ASP. This implies that aetiological factors and management options for autism spectrum disorders may be distinct. History of language acquisition is a potentially valuable marker to refine our search for causes and treatments in autism spectrum.

(Received November 06 2008)

(Revised February 23 2009)

(Accepted March 03 2009)

(Online publication April 09 2009)

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