Yarger Heather A, Nordahl Christine Wu, Redcay Elizabeth
Department of Psychology, Neuroscience and Cognitive Science Program, College Park, Maryland.
Department of Psychiatry and Behavioral Sciences, UC Davis MIND Institute, Sacramento, California.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Sep;7(9):916-924. doi: 10.1016/j.bpsc.2021.10.010. Epub 2021 Oct 21.
Anxiety is one of the most common co-occurring conditions in people with autism spectrum disorder. The amygdala has been identified as being associated with anxiety in populations with and without autism, yet associations in autism were based on relatively small or developmentally constrained samples, leaving questions as to whether these results hold at different developmental ages and in a larger, more robust sample.
Structural neuroimaging and parent report of anxiety symptoms of children ages 5-13 years with (n = 123) and without (n = 171) a diagnosis of autism were collected from the University of Maryland and three sites from the Autism Brain Imaging Data Exchange. Standardized residuals for bilateral amygdala volumes were computed adjusting for site, hemispheric volumes, and covariates (age, sex, Full Scale IQ).
Clinically significant anxiety symptoms did not differentiate amygdala volumes between groups (i.e., autism and anxiety, autism without anxiety, without autism or anxiety). No significant association between left or right amygdala volumes and anxiety scores was observed among the sample of individuals with autism. Meta-analytic and Bayes factor estimations provided additional support for the null hypothesis. Age, sex, and autism severity did not moderate associations between anxiety and amygdala volumes.
No relation between amygdala volumes and anxiety symptoms in children with autism was observed in the largest sample to investigate this question. We discuss directions for future research to determine whether additional factors including age or method of assessment may contribute to this lack of association.
焦虑是自闭症谱系障碍患者中最常见的并发状况之一。杏仁核已被确定与有或没有自闭症的人群中的焦虑有关，但自闭症患者中的相关研究是基于相对较小或受发育限制的样本，这使得这些结果是否适用于不同发育年龄以及更大、更具代表性的样本存在疑问。
从马里兰大学和自闭症脑成像数据交换中心的三个站点收集了5至13岁被诊断为自闭症（n = 123）和未被诊断为自闭症（n = 171）的儿童的结构神经影像数据以及焦虑症状的家长报告。计算双侧杏仁核体积的标准化残差，并对站点、半球体积和协变量（年龄、性别、全量表智商）进行调整。
临床上显著的焦虑症状并未区分两组之间的杏仁核体积（即自闭症伴焦虑、无焦虑的自闭症、无自闭症或焦虑）。在自闭症个体样本中，未观察到左侧或右侧杏仁核体积与焦虑评分之间存在显著关联。荟萃分析和贝叶斯因子估计为零假设提供了额外支持。年龄、性别和自闭症严重程度并未调节焦虑与杏仁核体积之间的关联。
在调查该问题的最大样本中，未观察到自闭症儿童的杏仁核体积与焦虑症状之间存在关联。我们讨论了未来研究的方向，以确定包括年龄或评估方法在内的其他因素是否可能导致这种缺乏关联的情况。
