Lombardo Michael V, Pierce Karen, Eyler Lisa T, Carter Barnes Cindy, Ahrens-Barbeau Clelia, Solso Stephanie, Campbell Kathleen, Courchesne Eric
Department of Psychology, University of Cyprus, 1 Panepistimiou Avenue, Aglantzia, Nicosia 1678, Cyprus; Center for Applied Neuroscience, University of Cyprus, 1 Panepistimiou Avenue, Aglantzia, Nicosia 1678, Cyprus; Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK.
Autism Center of Excellence, Department of Neuroscience, University of California, San Diego, 8110 La Jolla Shores Drive, Suite 201, La Jolla, CA 92093, USA.
Neuron. 2015 Apr 22;86(2):567-77. doi: 10.1016/j.neuron.2015.03.023. Epub 2015 Apr 9.
Autism (ASD) is vastly heterogeneous, particularly in early language development. While ASD language trajectories in the first years of life are highly unstable, by early childhood these trajectories stabilize and are predictive of longer-term outcome. Early neural substrates that predict/precede such outcomes are largely unknown, but could have considerable translational and clinical impact. Pre-diagnosis fMRI response to speech in ASD toddlers with relatively good language outcome was highly similar to non-ASD comparison groups and robustly recruited language-sensitive superior temporal cortices. In contrast, language-sensitive superior temporal cortices were hypoactive in ASD toddlers with poor language outcome. Brain-behavioral relationships were atypically reversed in ASD, and a multimodal combination of pre-diagnostic clinical behavioral measures and speech-related fMRI response showed the most promise as an ASD prognosis classifier. Thus, before ASD diagnoses and outcome become clinically clear, distinct functional neuroimaging phenotypes are already present that can shed insight on an ASD toddler's later outcome. VIDEO ABSTRACT.
自闭症谱系障碍（ASD）具有极大的异质性，尤其是在早期语言发展方面。虽然ASD在生命最初几年的语言发展轨迹极不稳定，但到幼儿期这些轨迹会趋于稳定，并能预测长期预后。目前很大程度上尚不清楚预测此类预后的早期神经基础，但它们可能具有相当大的转化和临床意义。在语言发育相对良好的ASD幼儿中，诊断前对言语的功能磁共振成像（fMRI）反应与非ASD对照组高度相似，并且有力地激活了对语言敏感的颞上叶皮质。相比之下，在语言发育不良的ASD幼儿中，对语言敏感的颞上叶皮质活动不足。在ASD中，脑与行为的关系出现了非典型的反转，诊断前临床行为测量与言语相关fMRI反应的多模态组合作为ASD预后分类器显示出最大的前景。因此，在ASD的诊断和预后在临床上明确之前，就已经存在不同的功能性神经影像表型，这些表型可以为ASD幼儿的后期预后提供见解。视频摘要。
