Autism is characterized by difficulty communicating and speech disorders. Researchers from Columbia University (USA) have proposed a way to diagnose this mental disorder at an early stage - using MRI analysis of the activity of the speech analyzer in the brain.

Brain tomogram during an audio test; The most active areas are indicated in red, among which the auditory temporal lobes stand out. (Photo by Montreal Neurological Institute.)

According to statistics, autism and related mental disorders At least one child in 110 suffers, but there are still no clear diagnostic criteria that would allow detection of this disease in the early stages. The diagnosis is made based on external manifestations, of which there are many in autism spectrum disorders. Researchers from Columbia University in New York have proposed their own method for unambiguously diagnosing autism, based on the use of functional MRI.

One of characteristic signs of autistic disorders is a difficulty in communication, which sooner or later manifests itself in the child; Such children speak rarely and poorly and often do not seem to hear what others are telling them. The study involved 15 healthy children and 12 with speech impairments and obvious signs of autism; On average, all subjects were slightly older than 12 years. During a brain scan using a tomograph, they were given a recording of their parents speaking as if they were talking to them.

In healthy experimental subjects, in response to parental speech, activity of two brain areas- the primary auditory cortex and the superior temporal gyrus, which is responsible for understanding a sentence as an interconnected sequence of words. U autistic children The activity of the primary auditory cortex was the same as in healthy people, but the activity of the superior temporal gyrus was significantly lower. In other words, autistic people with speech impairments literally do not understand what is being said to them; they hear the sentence as a set of unrelated words. Differed in the same way brain activity in healthy and autistic children after taking sedatives: despite the effect of sedatives, the “language understanding” gyrus worked differently in both groups.

An article by researchers with the results of the experiments is being prepared for publication in the journal Radiology.

Autism Spectrum Disorders can be treated, but the key to success here is early detection of the disease. Perhaps the proposed method will significantly facilitate the diagnosis of autism precisely at the key, early stages of its development.

Researchers from the United States believe that by using brain scans of infants who have older siblings with autism, it is possible to make a fairly accurate prediction of whether the children studied will also develop autism or not.

The results of a recent study give scientists hope that there is a very real possibility of diagnosing children with autism spectrum disorder (ASD) even before they show the first symptoms. Previously, this goal seemed unattainable.

Moreover, the study opens up possibilities and prospects for diagnosing and perhaps even treating autism.

But first, let's figure out why it is so difficult to diagnose autism in children. Typically, a child will begin to show symptoms of autism spectrum disorder (such as difficulty making eye contact) after the age of two. Experts believe that brain changes associated with ASD begin much earlier—perhaps even in the womb.

But various techniques that assess a person's behavior cannot predict who will be diagnosed with autism, said the study's lead author, psychiatrist Joseph Piven of the University of North Carolina at Chapel Hill.

“Children who show signs of autism at age two or three do not appear as if they have autism in their first year of life,” explains Piven.

Many people wonder if there are any genetic “signatures” or biomarkers that could help predict the development of autism. It is noted that there are some rare mutations associated with autism spectrum disorder, but the vast majority of cases cannot be associated with one or even a few genetic risk factors.

Back in the early 1990s, Piven and other researchers noticed that children with autism tend to have slightly larger brains than their peers. This suggested that brain growth may be a biomarker for autism spectrum disorder. But Piven and his colleague Heather Cody Hutzlett, a psychologist at the University of North Carolina at Chapel Hill, note that it's not entirely clear when exactly this overgrowth occurs.

Statistically, autism affects approximately one child in 100 in the general population. But infants who have an older sibling with autism face a greater risk: a 1 in 5 chance of developing ASD.

As part of the National Institutes of Health-funded Infant Brain Imaging Study, Piven and his colleagues scanned the brains of 106 high-risk children. The babies were 6, 12 or 24 months old at the time of the study.

Experts used magnetic resonance imaging (MRI) to see if they could “catch” this brain growth in action. In addition, they studied 42 children from the low-risk group.

Fifteen high-risk children were diagnosed with autism at 24 months of age. MRI scans showed that these children's brain volume increased more rapidly between 12 and 24 months compared to children who had not been diagnosed. Researchers say this increase occurred at the same time that behavioral signs of autism emerged.

Scientists also found changes in the brain at 6 and 12 months of age, even before ASD symptoms appeared. Cortical surface area, a measure of the size of the folds on the outside of the brain, grew faster in infants who were later diagnosed with autism. Again, in comparison with those children who were not given a similar diagnosis.

Perhaps the main question arises: is it possible to focus on these brain changes and use them to predict autism in children? Hutzlett and Piven's team then entered the MRI scan data (changes in brain volume, surface area and cortical thickness at 6 and 12 months of age), as well as the children's sex, into a computer program. The goal is to find out which babies are most likely to have autism at 24 months of age.

It turned out that brain changes recorded at 6 and 12 months (among children who had older siblings with autism) successfully identified 80 percent of all babies diagnosed with ASD at 24 months.

In other words, the researchers were able to correctly determine which infants were diagnosed with autism at age two in 80 percent of cases.

The authors clarify that their results still need to be confirmed in subsequent scientific work and with a larger number of high-risk newborns. In addition, they intend to use other imaging techniques to help detect early brain changes.

Other experts note that even if the results are reliable, the clinical application of such a technique may be quite limited. Specialist Cynthia Schumann of the University of California, Davis, says the findings only apply to high-risk infants, not the general population. She notes that other studies will be needed to test whether autism can be predicted in non-at-risk children.

How is everything going?

I am describing personal experience. At some point you “lose” your child. For us, this happened in the classic 1.5 years. Sasha, from a healthy baby and a well-known “my” child, turns into something completely different, into a “stranger” - he stopped doing everything.

The child began to: NOT eat, DO NOT play, DO NOT understand requests, DO NOT hear (although his hearing is fine), DO NOT do anything he did before.

The rush to see doctors, specialists, neurologists, psychologists, and defectologists began. Then, who will “reanimate” the child in what ways.

And now a “new” life is being reborn: learning new skills, a new diet, those who can speak will be potty trained, new games, new activities, NEW EVERYTHING.

And you are happy, extremely happy about new words, songs, that you no longer need diapers, that you begin to say or show what you want... Each of you, parents, has your own joys... and then... OPA!..

....he started peeing again, is silent again, doesn’t want much again, and even hysterics may appear..

The first time it was a real disaster for me:

Was everything I did in vain?

Has a year of my labors been in vain?

Will my child never get better?

Have you ever had this?? As far as I have studied the topic, many have. If not everyone.

And how should we feel about this?

I liked the idea of ​​Stephen Cowan, a pediatrician with 25 years of experience, here’s what he says (even though he’s talking about neurotypical children, but I remember his words when Sasha has another “kickback”):

“Each child’s life has its own rhythm and rhythm - sometimes fast and loud, sometimes slow and quiet. And just as each spring brings us a renewed sense of the value of our lives, each new life stage brings new discoveries and wonders to the child. After all, learning something new is far from just a process of accumulating information. This is a process of rethinking it, a process of turning our knowledge into something new, and sometimes in order to look at something with fresh eyes, we must forget about it. This is why some children sometimes need to step back a little in order to make a huge leap forward.

Our life goes in a spiral, and this, first of all, means that we have more than one chance to learn something. With each new stage of life, we encounter the same lessons in new guises - again and again.

One must accept the idea that, in contrast to the perfect soul, the physical being is an imperfect entity, the progress of which is determined by mistakes and failures. It is the conflicts born of mistakes that provide energy for the continuation of evolution.»

There is also such a thing in sports. How do bodybuilders grow muscles? Micro-tears occur in muscle tissue due to strong tension. These micro-tears trigger the mechanism of muscle growth.

The exact causes of autism are unknown, but one of them may be due to organic changes in the patient's brain. To determine the cause of a brain development disorder, your doctor may order an MRI. Whether autism is visible on MRI, and in what cases this diagnostic method can be useful, read our article.

MRI for autism

In diagnosing autism, MRI is used to exclude organic causes of the disorder. If, as a result of the data obtained, it turns out that autism is not caused by structural (organic) changes in the brain, the attending physician will be able to turn to other diagnostic methods.

Autism of organic origin is accompanied by changes in areas of the brain that are clearly visualized on MRI. For example, difficulty or lack of communication skills may be caused by changes in the frontal and temporal lobes of the brain. With organic damage to the brain, asymmetry of the lateral ventricles can be observed.

How is MRI useful for brain developmental disorders?

In some cases, autism may have clinical symptoms similar to other diseases. Thus, MRI scans can detect hydrocephalus, encephalopathy, hemorrhage, abnormalities in brain development, smoothness of the cerebral cortex and increased intracranial pressure characteristic of other pathologies. In addition, MRI reveals ischemic brain damage. Timely diagnosis of these pathologies will allow prescribing the most effective treatment.

One possible reason for the development of autism may be the presence of a tumor in the patient’s brain. MRI is the most effective diagnostic method for detecting neoplasms, regardless of their location and degree. It is important to note that during the diagnosis there is no harmful radiation that can cause the growth of tumor cells.

MRI in early diagnosis of autism

In the journal Nature in February 2017, American scientists published the results of a study on early MRI diagnostics in children with autism. The researchers concluded that early MRI diagnosis opens up the possibility of surgical intervention and treatment, which may be more effective at the initial stage. For example, in children with suspected autism aged 6-12 months, expansion of the surface of the brain (an increase in its area and volume) was discovered. In this case, an atypical brain structure, as a rule, is formed by two years. According to scientists, timely diagnosis makes it possible to begin treatment immediately.

From a medical point of view, autism is a complex medical condition with unclear etiology (i.e., causes). In my practice, I try to learn as much as possible about each patient. This requires a thorough examination of the child himself, detailed communication with parents about the medical history, as well as extensive laboratory tests.

Here's where I start my research:

• The actual reception of the patient: the standard ten minutes that the pediatrician graciously grants to the patient is completely insufficient here. Among other things, the conversation should include a detailed description of the medications taken during pregnancy, a description of the food the child took, and a story about older relatives: do grandparents and older parents have any quirks?
• Audiology: I had a patient from Canada whose hearing was not tested. The boy was deaf, but not autistic.
• MRI: I'm not a big fan of this procedure. First of all, you need to take into account the risks that general anesthesia creates (this study will not be possible without it, since the child must be completely immobile). The main practical value of MRI often comes down to the fact that parents are a little reassured: according to external signs, everything is in order with the brain.
• EEG: often the child does not show any visible seizures of epilepsy (loss of consciousness or muscle tremors). However, prominent autism doctors believe that checking brain rhythms (especially if done during sleep as well) can go a long way toward identifying spikes in activity that may be harming the brain.
  And now the fun begins: You need to somehow convince the child to cooperate with you during the procedure. Then you need to find a good pediatric neurologist who will help decipher the data obtained. Next, you need to decide whether to treat areas of increased electrical excitability, since no anticonvulsant drug is completely safe. A very difficult and time-consuming process.
• Detailed blood test: very often pediatricians ignore this simple test. If we strive to ensure that the brain is sufficiently saturated with oxygen, we first need to understand whether the child is suffering from anemia.
  
• Assessing lead and mercury levels in a patient's blood: The theory that heavy metals may somehow be “locked” in the brain is controversial and has generated considerable debate in the medical community. But such a check often helps reassure worried parents. I oppose the introduction of a special provocateur into the body, which will cause the release of heavy metals, without first determining their basic level.
• Other metals: Magnesium, calcium and zinc are very important for many chemical reactions in the body. Children who are picky eaters often don't get enough essential nutrients. Micronutrient deficiencies can lead to skin rashes and digestive problems.
• Thyroid function assessment: I offer you a logical construction. We have a patient who demonstrates hyperactivity or, on the contrary, lethargy and loss of strength. How can we know that this condition is not related to thyroid health unless we get it checked? Correct answer: no way.
• Chromosomal analysis: Traditional school doctors too often tell parents that autism is a genetic disorder and there is no use in treating it with anything other than classes like ABA. So why not check the chromosomes themselves? If everything is in order with them (at least to the extent that modern genetics can confirm this), then, obviously, biomedical intervention has a significantly higher chance of success than is commonly believed.
• Gastrointestinal health: I prefer to see a detailed coprogram and check the stool for dysbiosis in order to know for sure whether there is a pathological proliferation of pathogenic microorganisms (including yeast) in the intestines, and how the process of digesting proteins, fats and carbohydrates is going. By the way, potty training a child will be much easier when intestinal health is restored.
• Food allergies: when the body reacts to an agent coming from the external environment by releasing immunoglobulins, an inflammatory process occurs, which undermines the overall energy of the body. Eliminating foods to which you are hypersensitive will help clear the fog and improve eye contact and communication.
  A gluten- and casein-free diet usually doesn't work in two cases: 1) The patient is not allergic to either gluten or casein; 2) The child continues to receive some third (fourth, fifth...) product to which he has an allergic reaction.
  We check children for sensitivity to a very wide range of foods and we advise not some general diet, but a diet specially selected for a particular patient. You should also test your urine for traces of opiate-like substances, which have been linked to poor absorption of gluten and casein in the intestines.
• Vitamin levels: It is especially important to know whether the patient is getting enough vitamins A and D from food. This is easy to find out and just as easy to solve with the help of multivitamin supplements.
• Metabolism knowledge: information about how well the patient's kidneys and liver are functioning should be familiar to the attending physician, since this determines the tolerability of many medications.
• Lipid panel: Both high and low cholesterol can lead to health problems. If cholesterol is very low, this can easily be corrected with medication, often resulting in improvements in eye contact and communication. This information may also influence the composition of the diet used.