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自闭症谱系障碍的结构神经影像学和遗传学研究结果综述——临床视角

Review of structural neuroimaging and genetic findings in autism spectrum disorder - a clinical perspective.

作者信息

Budisteanu Magdalena, Papuc Sorina Mihaela, Erbescu Alina, Glangher Adelina, Andrei Emanuela, Rad Florina, Hinescu Mihail Eugen, Arghir Aurora

机构信息

Alexandru Obregia Clinical Hospital of Psychiatry, 041914, Soseaua Berceni 10, Bucharest, Romania.

Victor Babes National Institute of Pathology, 050096, Splaiul Independentei 99-101, Bucharest, Romania.

出版信息

Rev Neurosci. 2024 Nov 19;36(3):295-314. doi: 10.1515/revneuro-2024-0106. Print 2025 Apr 28.

Abstract

Autism spectrum disorders (ASDs) are neurodevelopmental conditions characterized by deficits in social relationships and communication and restrictive, repetitive behaviors and interests. ASDs form a heterogeneous group from a clinical and genetic perspective. Currently, ASDs diagnosis is based on the clinical observation of the individual's behavior. The subjective nature of behavioral diagnoses, in the context of ASDs heterogeneity, contributes to significant variation in the age at ASD diagnosis. Early detection has been proved to be critical in ASDs, as early start of appropriate therapeutic interventions greatly improve the outcome for some children. Structural magnetic resonance imaging (MRI) is widely used in the diagnostic work-up of neurodevelopmental conditions, including ASDs, mostly for brain malformations detection. Recently, the focus of brain imaging shifted towards quantitative MRI parameters, aiming to identify subtle changes that may establish early detection biomarkers. ASDs have a strong genetic component; deletions and duplications of several genomic loci have been strongly associated with ASDs risk. Consequently, a multitude of neuroimaging and genetic findings emerged in ASDs in the recent years. The association of gross or subtle changes in brain morphometry and volumes with different genetic defects has the potential to bring new insights regarding normal development and pathomechanisms of various disorders affecting the brain. Still, the clinical implications of these discoveries and the impact of genetic abnormalities on brain structure and function are unclear. Here we review the literature on brain imaging correlated with the most prevalent genomic imbalances in ASD, and discuss the potential clinical impact.

摘要

自闭症谱系障碍(ASD)是一种神经发育疾病,其特征为社交关系和沟通能力缺陷,以及存在局限、重复的行为和兴趣。从临床和遗传学角度来看,ASD是一个异质性群体。目前,ASD的诊断基于对个体行为的临床观察。在ASD异质性的背景下,行为诊断的主观性导致ASD诊断年龄存在显著差异。事实证明,早期检测在ASD中至关重要,因为尽早开始适当的治疗干预可显著改善部分儿童的预后。结构磁共振成像(MRI)广泛应用于包括ASD在内的神经发育疾病的诊断检查,主要用于检测脑畸形。最近,脑成像的重点转向定量MRI参数,旨在识别可能成为早期检测生物标志物的细微变化。ASD具有很强的遗传成分;多个基因组位点的缺失和重复与ASD风险密切相关。因此,近年来在ASD领域出现了大量神经影像学和遗传学研究结果。脑形态测量和体积的明显或细微变化与不同遗传缺陷之间的关联,有可能为影响大脑的各种疾病的正常发育和发病机制带来新的见解。然而,这些发现的临床意义以及基因异常对脑结构和功能产生的影响仍不明确。在此,我们综述了与ASD中最常见的基因组失衡相关的脑成像文献,并讨论了其潜在的临床影响。

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