Gal Ben-Arie, Ilan Shelef, Gal Meiri, Idan Menashe, Ilan Dinstein, Ayelet Arazi
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EA-CSF volume and total cerebral volume (TCV) were quantified in T2-weighted scans by manual labeling. Measures were compared across groups while stratifying participants by age. Neuroradiologists reported BEH findings in 33% of autistic children scanned before the age of 2 years old (i.e., before autism diagnosis). Quantitative MRI analyses demonstrated that autistic children in this age group exhibited significantly larger EA-CSF volumes relative to controls (<i>t</i>\n <sub>(49)</sub> = 2.89, <i>p</i> = 0.006, Cohen's <i>d</i> = 0.82) with 30% of autistic children and 9.5% of the controls exhibiting EA-CSF/TCV ratios > 0.14, a previously suggested threshold of potential clinical relevance. EA-CSF differences were not apparent in older children. The prevalence of BEH associated with quantifiable EA-CSF enlargements was remarkably high in toddlers who later developed autism, suggesting a specific autism etiology involving early transient CSF circulation problems with potentially long-lasting neurodevelopmental impact.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1796-1804"},"PeriodicalIF":5.6000,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442519/pdf/","citationCount":"0","resultStr":"{\"title\":\"Benign External Hydrocephalus in a Subgroup of Autistic Children Prior to Autism Diagnosis\",\"authors\":\"Gal Ben-Arie, Ilan Shelef, Gal Meiri, Idan Menashe, Ilan Dinstein, Ayelet Arazi\",\"doi\":\"10.1002/aur.70104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Benign external hydrocephalus (BEH) is evident in < 0.6% of births. It is defined by abnormally large cerebrospinal fluid (CSF) volumes in the subarachnoid space (SAS) and otherwise normal neuroimaging findings before 2 years of age. BEH has not been associated with specific developmental disorders and is not treated because it usually resolves spontaneously. However, quantitative MRI studies have reported that some toddlers with autism exhibit enlarged extra-axial CSF (EA-CSF) volumes. Our objective was to determine whether a subgroup of children with autism exhibits both qualitative BEH and quantitative EA-CSF volume enlargements. We analyzed clinical brain MRI scans in a retrospective sample of 136 children, 5–99 months old, 83 with autism, who were assessed for BEH by neuroradiologists. EA-CSF volume and total cerebral volume (TCV) were quantified in T2-weighted scans by manual labeling. Measures were compared across groups while stratifying participants by age. Neuroradiologists reported BEH findings in 33% of autistic children scanned before the age of 2 years old (i.e., before autism diagnosis). Quantitative MRI analyses demonstrated that autistic children in this age group exhibited significantly larger EA-CSF volumes relative to controls (<i>t</i>\\n <sub>(49)</sub> = 2.89, <i>p</i> = 0.006, Cohen's <i>d</i> = 0.82) with 30% of autistic children and 9.5% of the controls exhibiting EA-CSF/TCV ratios > 0.14, a previously suggested threshold of potential clinical relevance. EA-CSF differences were not apparent in older children. 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引用次数: 0
摘要
良性外脑积水(BEH)在(49)= 2.89,p = 0.006, Cohen’s d = 0.82)中很明显,30%的自闭症儿童和9.5%的对照组表现出EA-CSF/TCV比值bb0.14,这是先前建议的潜在临床相关性阈值。EA-CSF差异在年龄较大的儿童中不明显。在后来发展为自闭症的幼儿中,BEH与可量化的EA-CSF增大相关的患病率非常高,这表明自闭症的特定病因涉及早期短暂性CSF循环问题,可能对神经发育产生长期影响。
Benign External Hydrocephalus in a Subgroup of Autistic Children Prior to Autism Diagnosis
Benign external hydrocephalus (BEH) is evident in < 0.6% of births. It is defined by abnormally large cerebrospinal fluid (CSF) volumes in the subarachnoid space (SAS) and otherwise normal neuroimaging findings before 2 years of age. BEH has not been associated with specific developmental disorders and is not treated because it usually resolves spontaneously. However, quantitative MRI studies have reported that some toddlers with autism exhibit enlarged extra-axial CSF (EA-CSF) volumes. Our objective was to determine whether a subgroup of children with autism exhibits both qualitative BEH and quantitative EA-CSF volume enlargements. We analyzed clinical brain MRI scans in a retrospective sample of 136 children, 5–99 months old, 83 with autism, who were assessed for BEH by neuroradiologists. EA-CSF volume and total cerebral volume (TCV) were quantified in T2-weighted scans by manual labeling. Measures were compared across groups while stratifying participants by age. Neuroradiologists reported BEH findings in 33% of autistic children scanned before the age of 2 years old (i.e., before autism diagnosis). Quantitative MRI analyses demonstrated that autistic children in this age group exhibited significantly larger EA-CSF volumes relative to controls (t(49) = 2.89, p = 0.006, Cohen's d = 0.82) with 30% of autistic children and 9.5% of the controls exhibiting EA-CSF/TCV ratios > 0.14, a previously suggested threshold of potential clinical relevance. EA-CSF differences were not apparent in older children. The prevalence of BEH associated with quantifiable EA-CSF enlargements was remarkably high in toddlers who later developed autism, suggesting a specific autism etiology involving early transient CSF circulation problems with potentially long-lasting neurodevelopmental impact.
期刊介绍:
AUTISM RESEARCH will cover the developmental disorders known as Pervasive Developmental Disorders (or autism spectrum disorders – ASDs). The Journal focuses on basic genetic, neurobiological and psychological mechanisms and how these influence developmental processes in ASDs.