summary: New research identifies specific brain network hotspots associated with autism, aggression, and various other social behavior problems. The findings reveal that ASD patients with low scores on the facial handling test are more likely to have more severe symptoms of autism, particularly problems with social behavior. , reports that treatments such as tRMS may offer hope for people on the autism spectrum.
sauce: Children’s Hospital Boston
What if doctors could break down a condition like autism into its core symptoms, map these symptoms to “hot spots” in the brain, and treat those areas directly with brain stimulation? , such an approach could transform the treatment of neurological and developmental disorders by focusing on symptoms common to multiple conditions.
This is the vision of Dr. Alexander Lee Cohen, pediatric neurologist and researcher who heads the Translational Neuroimaging Institute and is a member of Boston Children’s Autism Spectrum Center. “What we’ve seen is that individual parts of human behavior are mapped to different brain networks,” he says.
Facial Blindness: A Window to Understanding Autism
Dr. Cohen started by studying the common problem of autism. It is facial blindness, or the inability to recognize faces. He cannot even recognize the faces of his loved ones. A study of people with autism spectrum disorder found that those who scored poorly on tests of facial processing had more severe symptoms, particularly social impairments. can provide a way to understand autism?
To answer this question, he first studied people who developed facial blindness after stroke. I have found that I am receiving Others had no direct damage there, but damage to parts of the brain that connect to that area, as shown by a technique called damage network mapping.
“Sometimes you need a whole-brain network to trigger symptoms,” Dr. Cohen explains.
Tuberous Sclerosis, Fusiform Facial Area, and Autism
To connect Dot to autism, he next examined patients with tuberous sclerosis. In this rare genetic condition, abnormal growths called tubers form in the brain and other organs. His 40% of affected children develop autism.
“We wanted to know if tuber patterns in the brain influence the incidence of autism,” Dr. Cohen says.
It certainly was. An analysis of her 115 infants with tuberous sclerosis found that children with nodules on or near the fusiform facial area were 3.7 times more likely than her to develop autism. .The research is published in the journal Neurological Annals.
Dr. Cohen now wants to see if children with autism who do not have tuberous sclerosis have abnormalities in this area or the brain networks connected to it. To that end, he and his colleagues recruited his teenagers, aged 15 to 18, for a study comparing his MRIs of the brains of people with and without autism. It was started. The team assessed each participant on their ability to process faces, social impairment, and the severity of their autism symptoms to see how these correlated with brain imaging findings.
Brain stimulation for autism?
Do differences in facial processing cause autism, or are they a result of it? This is another question that Dr. Cohen hopes to answer. He suspects that people with autism rely too much on specific brain networks to process faces.
“That’s something children with autism can have a very hard time with,” he says.
If we could treat facial blindness in children with autism, would that also improve their social functioning?
Dr. Cohen envisions non-invasive treatments like transcranial magnetic stimulation (TMS). In TMS, tiny electromagnets induce electrical currents at specific locations on the surface of the brain. TMS has been found to be safe and is approved for the treatment of depression and obsessive-compulsive disorder in adults. Researchers at Boston Children are currently testing it in children with epilepsy that cannot be effectively treated with drugs or surgery.
Addressing agitation and aggression in autism and beyond
Ultimately, Dr. Cohen hopes to identify brain hotspots and networks that drive various symptoms and behaviors of autism, not just facial processing. At the top of his list are aggression and agitation, which can create difficult situations for children with autism and their families. have been treated with drugs that have serious side effects and are not always effective.
Dr. Cohen hopes new research can help change this. We use brain-mapping data from different groups at risk of aggressive behavior to look for ‘hotspots’ of aggression. ” To date, we have collected data from over 1,200 children and adults.
“You can sort people by the most aggressive and the least aggressive and ask, ‘What’s different about their brains?'” Dr. Cohen explains.
“You can try to find what people with aggression have in common and see if there are any that might be targeted for treatment. I might be able to help you go down a different path.”
About this Autism Research News
author: Nancy Freisler
sauce: Children’s Hospital Boston
contact: Nancy Fliesler – Children’s Hospital Boston
image: image credit is Chronology Neurology/ researcher
Original research: open access.
“Tubers affecting the fusiform facial region are associated with the diagnosis of autismby Alexander Lee Cohen et al. Neurological Annals
overview
Tubers affecting the fusiform facial region are associated with the diagnosis of autism
the purpose
Tuberous sclerosis complex (TSC) is associated with a high incidence of focal brain “nodules” and autism spectrum disorders (ASD). The location of brain nodules associated with autism may provide insight into the neuroanatomical underpinnings of ASD symptoms.
method
Tuber location of 115 TSC participants with ASD (n = 31) and without ASD (n = 84) from the Tuberous Sclerosis Combined Autism Center of Excellence Research Network was shown. We tested the association between ASD diagnosis and nodal burden in the whole brain, specific lobes, and eight regions of interest derived from the ASD neuroimaging literature. sulcus, amygdala, and supplementary motor cortex. We then performed an unbiased, data-driven, voxel-wise lesion-symptom mapping (VLSM) analysis. Finally, we calculated her risk of ASD associated with the positive results obtained from the above analysis.
result
There were no significant ASD-related differences across the brain, within specific lobes, or within a priori regions derived from the ASD literature. However, using VLSM analysis, we found that tubers containing the right fusiform facial area (FFA) were associated with a 3.7-fold increased risk of developing ASD.
interpretation
Although TSC is a rare cause of ASD, there is a strong association between nodal involvement of the right FFA and ASD diagnosis. This highlights a potential causative mechanism to develop autism in TSC, which may guide the study of more common ASD symptoms. Ann Neurol 2023;93:577–590
