UNC Expands Brain Imaging Study of Infants at Risk for Autism

News Release:

UNC expands brain imaging study of infants at risk for autism

CHAPEL HILL – Researchers at the University of North Carolina at Chapel Hill have been awarded an additional $3.25 million in funding to substantially expand an ongoing study that uses infant brain imaging to examine the brain and behavioral changes in very early life that may mark the onset of autistic symptoms.

“This is the first study that will prospectively measure, in the same group of infants, both the onset of autistic symptoms and brain enlargement that co-occurs at the end of the first year of life in children with autism,” said Joseph Piven, M.D., the study’s principal investigator and director of the Carolina Institute for Developmental Disabilities.

“Once these brain and behavioral changes are identified, potential benefits might include the development of early screening measures for autism and a better understanding of the underlying brain mechanisms, which we hope will lead to treatments to prevent or reduce the problems that individuals with autism face,” Piven said.

The Infant Brain Imaging Study at UNC was originally awarded $10 million in funding in 2007 by the National Institutes of Health as an Autism Center of Excellence under the project title "A Longitudinal MRI Study of Infants at Risk for Autism.” Recently the NIH awarded supplemental funding of $500,000 per year for five years and the Simons Foundation Autism Research Initiative provided $150,000 a year for five years.

For the study, UNC heads a network of four data collection sites across the country: at UNC, the University of Washington in Seattle, Washington University in St. Louis and the Children’s Hospital of Philadelphia. There is also a data coordinating center for the network at the Montreal Neurological Institute.

The overarching aim of the study is to examine the brain and behavioral changes in very early life that may mark the onset of autistic symptoms. It will enroll 544 infant siblings of older autistic children, at 6 and 12 months of age, and follow them forward with behavioral assessments and magnetic resonance imaging (MRI) exams at 12 and 24 months of age.

The additional funding will allow researchers to examine all 544 children going forward at all time points instead of focusing only on those that are most likely to develop autism. Also, the additional funding is from a public-private partnership between the NIH and an outside funding agency, and this is a somewhat novel arrangement, Piven said.

The study builds on two key research findings from the researchers involved in the IBIS Network. The first finding, from UNC researchers, is that children with autism have larger brains, from five to 10 percent larger at two years of age than children without autism, and this enlargement or overgrowth of the brain starts around the end of a child’s first year of life.

The second finding, from behavioral researchers led by Lonnie Zwaigenbaum, M.D., from University of Alberta in Edmonton, is that the onset of the social deficits associated with autism does not occur until the end of the first year.

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Autism Causation - Back to Bettelheim?

A recent study of mental illnesses amongst parents of autistic children provides some ominous echos of Bruno Bettelheim. The study, “Parental psychiatric disorders associated with autism spectrum disorders in the offspring,” appears in the May 5, 2008, issue of the journal Pediatrics. The authors gathered data from Swedish medical and hospital registers of children with autism diagnoses before 10 years of age and matched with a control population. Parent diagnoses were based on an inpatient hospital diagnostic evaluation and included schizophrenia, other nonaffective psychoses, affective disorders, neurotic and personality disorders and other nonpsychotic disorders, alcohol and drug addiction and abuse, and autism.

The study found that "for both parents, schizophrenia was associated with autism. For other disorders, such as depression and nonpsychotic personality disorders, the positive association between psychiatric disorders and childhood autism was found only for maternal disorders, not for paternal disorders."

The authors concluded that the study results results ^"support the hypothesis that there is a familial predisposition, perhaps genetic, that presents differently in the parent than in the child and probably requires a constellation of other genetic or environmental factors for expression."

The authors of the study themselves note a number of study design limitations but it should be interesting to see the reaction to the authors' conclusions. In pointing to a connection between autism and parental mental issues, particularly the association between autism and maternal depression and nonpsychotic personality disorders, the authors appear to be retracing the steps taken by Bruno Bettelheim whose "refrigerator mothers" theories of autism causality caused so much harm to families with autistic children. Hopefully this study and the conclusions arising therefrom, will be given as much rigorous study and discussion as others pointing to possible causes of autism.

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