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<front>
<journal-meta>
<journal-id journal-id-type="issn">1043-3155</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Neurol Briefs</journal-id>
<journal-id journal-id-type="pmc">pedneurbriefs</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr Neurol Briefs</journal-id>
<journal-title-group>
<journal-title>Pediatric Neurology Briefs</journal-title>
<abbrev-journal-title>Pediatr Neurol Briefs</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2166-6482</issn>
<issn pub-type="ppub">1043-3155</issn>
<issn-l>2166-3155</issn-l>
<publisher>
<publisher-name>Pediatric Neurology Briefs Publishers</publisher-name>
<publisher-loc>Chicago, IL, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">PNB-2013-27-10-1</article-id>
<article-id pub-id-type="doi">10.15844/pedneurbriefs-27-10-1</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Autism Spectrum Disorder</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Neurology</subject>
<subject>Pediatrics</subject>
<subject>Nervous System Diseases</subject>
<subject>Child Development</subject>
<subject>Brain Diseases</subject>
<subject>Neurosurgery</subject>
<subject>Child</subject>
<subject>Infant</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>MRI Biomarker for Early Diagnosis of Autism</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0173-7931</contrib-id>
<name>
<surname>Millichap</surname>
<given-names>J. Gordon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="corresp" rid="cor1">&#x002A;</xref>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>Division of Neurology, Ann &#x0026; Robert H. Lurie Children&#x0027;s Hospital of Chicago, Chicago, IL</aff>
<aff id="AF0002">
<label>2</label>Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL</aff>
<author-notes>
<corresp id="cor1">
<label>&#x002A;</label>Correspondence: Dr. J. Gordon Millichap, E-mail: <email xlink:href="jgmillichap@northwestern.edu">jgmillichap@northwestern.edu</email>
</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="print">
<month>10</month>
<year>2013</year>
</pub-date>
<pub-date date-type="pub" publication-format="electronic">
<day>15</day>
<month>10</month>
<year>2015</year>
</pub-date>
<volume>27</volume>
<issue>10</issue>
<fpage>73</fpage>
<lpage>74</lpage>
<permissions>
<copyright-statement>Copyright: &#x00A9; 2013 The Author(s)</copyright-statement>
<copyright-year>2013</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This work is licensed under the <uri xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</uri>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<related-article id="R1" related-article-type="commentary-article" ext-link-type="doi" xlink:href="10.1093/brain/awt166" vol="136" page="2825">
<article-title>Early brain enlargement and elevated extra-axial fluid in infants who develop autism spectrum disorder</article-title>
</related-article>
<abstract abstract-type="web-summary" specific-use="electronic-only">
<p>In order to identify early risk markers for autism spectrum disorder (ASD), investigators at University of California Davis School of Medicine and Davis Children&#x2019;s Hospital conducted a longitudinal brain MRI study of infant siblings in conjunction with behavioral assessments leading to an outcome classification at 24 months or later (mean age 32.5 months).</p>
</abstract>
<kwd-group>
<kwd>Autism Spectrum Disorder</kwd>
<kwd>MRI Biomarker</kwd>
<kwd>Eyeblink Conditioning</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<p>In order to identify early risk markers for autism spectrum disorder (ASD), investigators at University of California Davis School of Medicine and Davis Children&#x2019;s Hospital conducted a longitudinal brain MRI study of infant siblings in conjunction with behavioral assessments leading to an outcome classification at 24 months or later (mean age 32.5 months). Fifty-five infants (33 &#x2018;high-risk&#x2019; infants having an older sibling with ASD and 22 &#x2018;low-risk&#x2019; infants having no relatives with ASD) were imaged at three time points: 6-9 months, 12-15 months, and 18-24 months of age. Compared to infants classified as developmental delay or typical development, 10 infants who developed ASD had significantly greater extra-axial fluid at 6-9 months, which remained elevated at 12-15 and 18-24 months. The amount of extra-axial fluid detected at 6 months was predictive of more severe ASD symptoms at time of outcome. Infants who developed ASD also had significantly larger total cerebral volumes at both 12-15 and 18-24 months of age. These novel findings raise the potential for use of structural MRI to aid in early detection (6-9 months of age) of children at risk for ASD. [<xref ref-type="bibr" rid="CIT0001">1</xref>]</p>
<p>COMMENT. The clinical diagnosis of ASD is usually delayed until at least 18 months of age. This study provides a potential brain MRI biomarker for the earlier diagnosis and treatment of ASD in at risk infants.</p>
<p>Extra-axial fluid accumulation (communicating hydrocephalus) with rapid head growth in the first year of life typically resolves without intervention, but it may be associated with seizures and motor delays [<xref ref-type="bibr" rid="CIT0002">2</xref>] and now is associated with development of ASD. Extra-axial fluid and rapid head growth in infancy is not always a benign reversible disorder.</p>
<sec id="s0001">
<title>Neurobiological abnormalities in infants who later develop ASD</title>
<p>Studies since 2009 showing abnormalities in head circumference, electrophysiological markers and interhemispheric synchronization and differences in various brain regions (amygdala, cerebellum, frontal and temporal cortex) are reviewed by investigators at the University of Glasgow, Scotland. Cross-disciplinary approaches are essential to elucidate sequence of developmental abnormalities during early infancy leading to ASD. [<xref ref-type="bibr" rid="CIT0003">3</xref>]</p>
<p><bold>Eyeblink conditioning (EBC)</bold> is proposed as a non-invasive biomarker for ASD that can be employed shortly after birth [<xref ref-type="bibr" rid="CIT0004">4</xref>]. The neural circuitry for EBC involves sensory information from the cornea to the trigeminal nucleus, the interpositus nucleus and cerebellar cortex.</p>
</sec>
</body>
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