Yield of brain MRI in children with autism spectrum disorder.
ASD
Autism
MRI
Neurodevelopment
Neuroimaging
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
20
11
2022
accepted:
28
04
2023
revised:
18
03
2023
medline:
28
8
2023
pubmed:
25
5
2023
entrez:
25
5
2023
Statut:
ppublish
Résumé
Autism spectrum disorder (ASD) is a common neurodevelopmental condition. The American Academy of Paediatrics and American Academy of Neurology do not recommend routine brain magnetic resonance imaging (MRI) in the assessment of ASD. The need for a brain MRI should be decided on atypical features in the clinical history and examination. However, many physicians continue to use brain MRI routinely in the assessment process. We performed a retrospective review of indications for requesting brain MRI in our institution over a 5-year period. The aim was to identify the yield of MRI in children with ASD and calculate the prevalence of significant neuroimaging abnormalities in children with ASD and identify clinical indications for neuroimaging. One hundred eighty-one participants were analysed. An abnormal brain MRI was identified in 7.2% (13/181). Abnormal brain MRI was more likely with an abnormal neurological examination (OR 33.1, p = 0.001) or genetic/metabolic abnormality (OR 20, p = 0.02). In contrast, abnormal MRI was not shown to be more likely in children with a variety of other indications such as behavioural issues and developmental delay. Conclusion: Thus, our findings support that MRI should not be a routine investigation in ASD, without additional findings. The decision to arrange brain MRI should be made on a case-by-case basis following careful evaluation of potential risks and benefits. The impact of any findings on the management course of the child should be considered prior to arranging imaging. What is Known: • Incidental brain MRI findings are common in children with and without ASD. • Many children with ASD undergo brain MRI in the absence of neurological comorbidities. What is New: • Brain MRI abnormalities in ASD are more likely with an abnormal neurological examination and genetic or metabolic conditions. • Prevalence of significant brain MRI abnormalities in ASD alone is low.
Identifiants
pubmed: 37227501
doi: 10.1007/s00431-023-05011-2
pii: 10.1007/s00431-023-05011-2
pmc: PMC10460367
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3603-3609Informations de copyright
© 2023. The Author(s).
Références
Association AP (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed
Roman-Urrestarazu A et al (2021) Association of race/ethnicity and social disadvantage with autism prevalence in 7 million school children in England. JAMA Pediatr 175(6):e210054–e210054
doi: 10.1001/jamapediatrics.2021.0054
pubmed: 33779707
pmcid: 8008434
Amiri M et al (2020) Environment-wide association study (EnWAS) of prenatal and perinatal factors associated with autistic traits: a population-based study. Autism Res 13(9):1582–1600
doi: 10.1002/aur.2372
pubmed: 32830427
pmcid: 7540497
An Roinn Slainte (Department of Health, Ireland) (2018) Estimating prevalence of autism spectrum disorder (ASD) in the Irish population: a review of data sources and epidemiological studies
Boilson AM et al (2016) Operationalisation of the European Protocol for Autism Prevalence (EPAP) for autism spectrum disorder prevalence measurement in Ireland. J Autism Dev Disord 46(9):3054–3067
doi: 10.1007/s10803-016-2837-y
pubmed: 27364514
Hyman SL et al (2020) Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics 145(1)
Filipek PA et al (2000) Practice parameter: screening and diagnosis of autism: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology 55(4):468–479
doi: 10.1212/WNL.55.4.468
pubmed: 10953176
Ming X et al (2016) The utility of MRI in children with autism spectrum disorder. Autism Open Access 164
Cooper AS et al (2016) The implications of brain MRI in autism spectrum disorder. J Child Neurol 31(14):1611–1616
doi: 10.1177/0883073816665548
pubmed: 27629267
Dangouloff-Ros V et al (2019) Incidental brain MRI findings in children: a systematic review and meta-analysis. AJNR Am J Neuroradiol 40(11):1818–1823
pubmed: 31624116
pmcid: 6975122
Rochat MJ et al (2020) Brain magnetic resonance findings in 117 children with autism spectrum disorder under 5 years old. Brain Sci 10(10):741
doi: 10.3390/brainsci10100741
pubmed: 33081247
pmcid: 7602717
Jansen PR et al (2017) Incidental findings on brain imaging in the general pediatric population. N Engl J Med 377(16):1593–1595
doi: 10.1056/NEJMc1710724
pubmed: 29045203
Biebl A et al (2015) Prospective analysis on brain magnetic resonance imaging in children. Eur J Paediatr Neurol 19(3):349–353
doi: 10.1016/j.ejpn.2015.01.008
pubmed: 25683784
Gupta S, Kanamalla U, Gupta V (2010) Are incidental findings on brain magnetic resonance images in children merely incidental? J Child Neurol 25(12):1511–1516
doi: 10.1177/0883073810370622
pubmed: 20558674
Vasa RA et al (2012) Normal rates of neuroradiological findings in children with high functioning autism. J Autism Dev Disord 42(8):1662–1670
doi: 10.1007/s10803-011-1407-6
pubmed: 22105143
pmcid: 3999957
Monterrey JC et al (2017) Incidental brain MRI findings in an autism twin study. Autism Res 10(1):113–120
doi: 10.1002/aur.1720
pubmed: 27874265
Boddaert N et al (2009) MRI findings in 77 children with non-syndromic autistic disorder. PLoS ONE 4(2):e4415
doi: 10.1371/journal.pone.0004415
pubmed: 19204795
pmcid: 2635956
Zeegers M et al (2006) Radiological findings in autistic and developmentally delayed children. Brain Dev 28(8):495–499
doi: 10.1016/j.braindev.2006.02.006
pubmed: 16616445
Aoki Y et al (2017) Association of white matter structure with autism spectrum disorder and attention-deficit/hyperactivity disorder. JAMA Psychiat 74(11):1120–1128
doi: 10.1001/jamapsychiatry.2017.2573
Li X et al (2021) Structural, functional, and molecular imaging of autism spectrum disorder. Neurosci Bull 37(7):1051–1071
doi: 10.1007/s12264-021-00673-0
pubmed: 33779890
pmcid: 8275699
Autism spectrum disorder in under 19s: recognition, referral and diagnosis. London: National Institute for Health and Care Excellence (NICE); December 2017. https://pubmed.ncbi.nlm.nih.gov/31999412/
de Graaff JC et al (2021) Best practice & research clinical anesthesiology: safety and quality in perioperative anesthesia care. Update on safety in pediatric anesthesia. Best Practice & Research Clinical Anaesthesiology 35(1):27–39