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Clinical and anatomical heterogeneity in autistic spectrum disorder: a structural MRI study

Published online by Cambridge University Press:  06 November 2009

F. Toal ,
E. M. Daly ,
L. Page ,
Q. Deeley ,
B. Hallahan ,
O. Bloemen ,
W. J. Cutter ,
M. J. Brammer ,
S. Curran  and
D. Robertson
...Show all authors
F. Toal*
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
E. M. Daly
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
L. Page
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
Q. Deeley
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
B. Hallahan
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
O. Bloemen
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
W. J. Cutter
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
M. J. Brammer
Affiliation:
Section of Image Analysis, Centre for Neuroimaging Science, Institute of Psychiatry, King's College, London, UK
S. Curran
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
D. Robertson
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
C. Murphy
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
K. C. Murphy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
D. G. M. Murphy
Affiliation:
Section of Brain Maturation, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
*
*Address for correspondence: Dr F. Toal, MRCPsych, Institute of Forensic Mental Health, Thomas Embling Hospital, Yarra Bend Road, Melbourne, Australia. (Email: ftoal@rcsi.ie)
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Abstract

Background

Autistic spectrum disorder (ASD) is characterized by stereotyped/obsessional behaviours and social and communicative deficits. However, there is significant variability in the clinical phenotype; for example, people with autism exhibit language delay whereas those with Asperger syndrome do not. It remains unclear whether localized differences in brain anatomy are associated with variation in the clinical phenotype.

Method

We used voxel-based morphometry (VBM) to investigate brain anatomy in adults with ASD. We included 65 adults diagnosed with ASD (39 with Asperger syndrome and 26 with autism) and 33 controls who did not differ significantly in age or gender.

Results

VBM revealed that subjects with ASD had a significant reduction in grey-matter volume of medial temporal, fusiform and cerebellar regions, and in white matter of the brainstem and cerebellar regions. Furthermore, within the subjects with ASD, brain anatomy varied with clinical phenotype. Those with autism demonstrated an increase in grey matter in frontal and temporal lobe regions that was not present in those with Asperger syndrome.

Conclusions

Adults with ASD have significant differences from controls in the anatomy of brain regions implicated in behaviours characterizing the disorder, and this differs according to clinical subtype.

Keywords

Asperger syndromeautismbrain anatomyclinical phenotypeneuroimaging
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 7 , July 2010 , pp. 1171 - 1181
Copyright
Copyright © Cambridge University Press 2009

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