左侧颞叶皮层不能专门用于语言是自闭症的一个早期出现的基本特征。

A failure of left temporal cortex to specialize for language is an early emerging and fundamental property of autism.

机构信息

UCSD Autism Center of Excellence, University of California, San Diego, La Jolla, CA 92037, USA.

出版信息

Brain. 2012 Mar;135(Pt 3):949-60. doi: 10.1093/brain/awr364. Epub 2012 Feb 20.

Abstract

Failure to develop normal language comprehension is an early warning sign of autism, but the neural mechanisms underlying this signature deficit are unknown. This is because of an almost complete absence of functional studies of the autistic brain during early development. Using functional magnetic resonance imaging, we previously observed a trend for abnormally lateralized temporal responses to language (i.e. greater activation on the right, rather than the expected left) in a small sample (n = 12) of sleeping 2-3 year olds with autism in contrast to typically developing children, a finding also reported in autistic adults and adolescents. It was unclear, however, if findings of atypical laterality would be observed in a larger sample, and at even earlier ages in autism, such as around the first birthday. Answers to these questions would provide the foundation for understanding how neurofunctional defects of autism unfold, and provide a foundation for studies using patterns of brain activation as a functional early biomarker of autism. To begin to examine these issues, a prospective, cross-sectional design was used in which brain activity was measured in a large sample of toddlers (n = 80) during the presentation of a bedtime story during natural sleep. Forty toddlers with autism spectrum disorder and 40 typically developing toddlers ranging in age between 12-48 months participated. Any toddler with autism who participated in the imaging experiment prior to final diagnosis was tracked and diagnoses confirmed at a later age. Results indicated that at-risk toddlers later diagnosed as autistic display deficient left hemisphere response to speech sounds and have abnormally right-lateralized temporal cortex response to language; this defect worsens with age, becoming most severe in autistic 3- and 4-year-olds. Typically developing children show opposite developmental trends with a tendency towards greater temporal cortex response with increasing age and maintenance of left-lateralized activation with age. We have now demonstrated lateralized abnormalities of temporal cortex processing of language in autism across two separate samples, including a large sample of young infants who later are diagnosed with autism, suggesting that this pattern may reflect a fundamental early neural developmental pathology in autism.

摘要

无法正常发展语言理解能力是自闭症的早期预警信号,但导致这一特征缺陷的神经机制尚不清楚。这是因为在自闭症儿童早期发育过程中,几乎完全缺乏对自闭症大脑的功能研究。我们之前使用功能磁共振成像技术发现,与正常发育的儿童相比,在一个较小的自闭症儿童样本(n = 12)中,睡眠时对语言的反应存在异常的侧化趋势(即右侧激活增加,而不是预期的左侧),这一发现也在自闭症成人和青少年中得到了报道。然而,在更大的自闭症样本中,是否会观察到异常的偏侧性,以及在自闭症中更早的年龄(例如一岁左右)是否会观察到异常的偏侧性,这一点尚不清楚。回答这些问题将为理解自闭症的神经功能缺陷如何展开提供基础,并为使用大脑激活模式作为自闭症的功能早期生物标志物的研究提供基础。为了开始研究这些问题,我们采用了前瞻性、横断面设计,在自然睡眠期间,通过给 80 名幼儿(年龄在 12-48 个月之间)呈现睡前故事,测量他们的大脑活动。40 名自闭症谱系障碍幼儿和 40 名正常发育的幼儿参与了研究。任何在成像实验前被诊断为自闭症的幼儿都被跟踪,在以后的年龄进行确诊。研究结果表明,有风险的自闭症幼儿表现出对语音的左半球反应不足,并且对语言的颞叶皮层反应异常右偏;这种缺陷随着年龄的增长而恶化,在 3 至 4 岁的自闭症儿童中最为严重。正常发育的儿童表现出相反的发育趋势,即随着年龄的增长,颞叶皮层对语言的反应增强,随着年龄的增长,左半球激活得以维持。我们现在已经在两个独立的样本中证明了自闭症儿童颞叶皮层语言处理的侧化异常,包括一个后来被诊断为自闭症的较大的幼儿样本,这表明这种模式可能反映了自闭症的一种基本的早期神经发育病理学。

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