Biostatistics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK.
Mol Autism. 2017 Sep 22;8:49. doi: 10.1186/s13229-017-0167-3. eCollection 2017.
Prospective studies of infants at high familial risk for autism spectrum disorder (ASD) have identified a number of putative early markers that are associated with ASD outcome at 3 years of age. However, some diagnostic changes occur between toddlerhood and mid-childhood, which raises the question of whether infant markers remain associated with diagnosis into mid-childhood.
First, we tested whether infant neurocognitive markers (7-month neural response to eye gaze shifts and 14-month visual disengagement latencies) as well as an observational marker of emerging ASD behaviours (the Autism Observation Scale for Infants; AOSI) predicted ASD outcome in high-risk (HR) 7-year-olds with and without an ASD diagnosis (HR-ASD and HR-No ASD) and low risk (LR) controls. Second, we tested whether the neurocognitive markers offer predictive power over and above the AOSI.
Both neurocognitive markers distinguished children with an ASD diagnosis at 7 years of age from those in the HR-No ASD and LR groups. Exploratory analysis suggested that neurocognitive markers may further differentiate stable versus lost/late diagnosis across the 3 to 7 year period, which will need to be tested in larger samples. At both 7 and 14 months, combining the neurocognitive marker with the AOSI offered a significantly improved model fit over the AOSI alone.
Infant neurocognitive markers relate to ASD in mid-childhood, improving predictive power over and above an early observational marker. The findings have implications for understanding the neurodevelopmental mechanisms that lead from risk to disorder and for identification of potential targets of pre-emptive intervention.
对高家族性自闭症谱系障碍（ASD）风险的婴儿进行的前瞻性研究已经确定了许多与 3 岁时 ASD 结果相关的潜在早期标志物。然而，在幼儿期和儿童中期之间会发生一些诊断变化，这就提出了一个问题，即婴儿期标志物是否仍然与儿童中期的诊断相关。
首先，我们测试了婴儿神经认知标志物（7 个月时对眼球转移的神经反应和 14 个月时的视觉脱离潜伏期）以及新兴 ASD 行为的观察性标志物（婴儿自闭症观察量表；AOSI）是否可以预测有和无 ASD 诊断的高风险（HR）7 岁儿童的 ASD 结局（HR-ASD 和 HR-No ASD）和低风险（LR）对照组。其次，我们测试了神经认知标志物是否提供了超越 AOSI 的预测能力。
这两个神经认知标志物都将 7 岁时患有 ASD 诊断的儿童与 HR-No ASD 和 LR 组的儿童区分开来。探索性分析表明，神经认知标志物可能在 3 到 7 岁期间进一步区分稳定与丧失/延迟诊断，这需要在更大的样本中进行测试。在 7 个月和 14 个月时，将神经认知标志物与 AOSI 相结合提供了比单独使用 AOSI 更好的模型拟合度。
婴儿神经认知标志物与儿童中期的 ASD 相关，提高了对早期观察性标志物的预测能力。这些发现对于理解导致风险向障碍发展的神经发育机制以及确定潜在的预防性干预目标具有重要意义。
