Data_Sheet_1_Potential dynamic regional brain biomarkers for early discrimination of autism and language development delay in toddlers.docx

BackgroundThe early diagnosis of autism in children is particularly important. However, there is no obvious objective indices for the diagnosis of autism spectrum disorder (ASD), especially in toddlers aged 1–3 years with language development delay (LDD). The early differential diagnosis of ASD is challenging.
ObjectiveTo examine differences in the dynamic characteristics of regional neural activity in toddlers with ASD and LDD, and whether the differences can be used as an imaging biomarker for the early differential diagnosis of ASD and LDD.
MethodsDynamic regional homogeneity (dReHo) and dynamic amplitude of low-frequency fluctuations (dALFF) in 55 children with ASD and 31 with LDD, aged 1–3 years, were compared. The correlations between ASD symptoms and the values of dReHo/dALFF within regions showing significant between-group differences were analyzed in ASD group. We further assessed the accuracy of dynamic regional neural activity alterations to distinguish ASD from LDD using receiver operating characteristic (ROC) analysis.
ResultsCompared with the LDD group, the ASD group showed increased dReHo in the left cerebellum_8/Crust2 and right cerebellum_Crust2, and decreased dReHo in the right middle frontal gyrus (MFG) and post-central gyrus. Patients with ASD also exhibited decreased dALFF in the right middle temporal gyrus (MFG) and right precuneus. Moreover, the Childhood Autism Rating Scale score was negatively correlated with the dReHo of the left cerebellum_8/crust2 and right cerebellum_crust2. The dReHo value of the right MFG was negatively correlated with social self-help of the Autism Behavior Checklist score.
ConclusionThe pattern of resting-state regional neural activity variability was different between toddlers with ASD and those with LDD. Dynamic regional indices might be novel neuroimaging biomarkers that allow differentiation of ASD from LDD in toddlers.

背景 儿童自闭症的早期诊断尤为关键。然而，自闭症谱系障碍（Autism Spectrum Disorder, ASD）的临床诊断暂无明确客观指标，尤其针对1~3岁伴语言发育迟缓（Language Development Delay, LDD）的幼儿群体，自闭症谱系障碍的早期鉴别诊断极具挑战。
目的 本研究旨在探讨自闭症谱系障碍（ASD）与语言发育迟缓（LDD）幼儿的脑区神经活动动态特征差异，并验证该差异能否作为早期鉴别ASD与LDD的影像学生物标志物。
方法 本研究对55名自闭症谱系障碍（ASD）患儿与31名语言发育迟缓（LDD）幼儿（年龄1~3岁）的动态区域同质性（dynamic regional homogeneity, dReHo）与低频振幅波动动态幅度（dynamic amplitude of low-frequency fluctuations, dALFF）进行了比较。随后，在ASD组中分析了组间差异显著脑区内的dReHo/dALFF值与自闭症症状评分的相关性。此外，本研究通过受试者工作特征（Receiver Operating Characteristic, ROC）分析，评估了动态脑区神经活动异常区分ASD与LDD的诊断准确率。
结果 与LDD组相比，ASD组患儿的左侧小脑_8/Crust2与右侧小脑_Crust2的dReHo值升高，而右侧额中回（middle frontal gyrus, MFG）与中央后回的dReHo值降低。ASD患儿还表现出右侧颞中回（MFG）与右侧楔前叶的dALFF值降低。此外，儿童自闭症评定量表（Childhood Autism Rating Scale, CARS）评分与左侧小脑_8/Crust2、右侧小脑_Crust2的dReHo值呈负相关；自闭症行为检查表（Autism Behavior Checklist, ABC）的社交自理维度得分与右侧额中回的dReHo值呈负相关。
结论 自闭症谱系障碍（ASD）与语言发育迟缓（LDD）幼儿的静息态脑区神经活动变异性模式存在显著差异。动态脑区神经活动指标或可作为新型神经影像学生物标志物，用于鉴别1~3岁幼儿的ASD与LDD。