Assessment & Research

Incidental brain MRI findings in an autism twin study.

Monterrey et al. (2017) · Autism research : official journal of the International Society for Autism Research 2017
★ The Verdict

Autism twins carry the same number of brain MRI surprises as typical twins, but their surprises more often need medical action.

✓ Read this if BCBAs who work with twins or children already booked for neurologist visits.
✗ Skip if Clinicians only doing functional assessments with no medical work-up role.

01Research in Context

01

What this study did

Scientists scanned the brains of 80 twin pairs. Half of the pairs had autism. Half did not.

They read every MRI like a radiologist would. They wrote down any surprise finding that showed up.

The goal was simple: do kids with autism have more unexpected brain spots than kids without?

02

What they found

Both groups had surprise spots at the same rate. About one in every four scans.

But the autism twins were three times more likely to need a doctor follow-up. Their spots looked more serious.

In numbers: same total findings, different clinical weight.

03

How this fits with other research

Ellegood et al. (2011) saw smaller white-matter in autism mice. The twin study shows the same thing can sit silent in human brains.

Shields et al. (2013) found a gene chunk that almost always brings autism. The twin study adds that when autism is already there, the brain may hide extra surprises.

Ptomey et al. (2021) linked chemical tags on the oxytocin gene to social trouble. The MRI study gives a second layer: structure and chemistry both flag risk, just in different languages.

04

Why it matters

You can’t see an MRI, but you can ask the family. If parents mention past neurologist visits or strange test results, dig deeper. A clean autism label doesn’t rule out other brain issues that still need care.

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02At a glance

Intervention
not applicable
Design
other
Sample size
164
Population
autism spectrum disorder, neurotypical
Finding
null

03Original abstract

Brain magnetic resonance imaging (MRI) studies suggest the prevalence of asymptomatic "incidental" findings (IF) in autism spectrum disorder (ASD) is similar to that of neurotypically developing (NT) controls. However, given the causes of IF may include both genetic and environmental factors, a twin study would facilitate comparing brain IF between ASD and NT subjects. MRI scans were examined to assess the prevalence of brain IF in twin "case pairs" (at least one twin with diagnosis of ASD) and twin "control pairs" (NT). Fifty case pairs and thirty-two control pairs were analyzed. IF were found in 68% of subjects with ASD, 71% of unaffected ASD siblings, and in 58% of control subjects (P = 0.4). IF requiring clinical follow-up occurred more frequently in subjects with ASD compared to NT controls (17% vs. 5%, respectively; P = 0.02). The concordance rate of IF in twins was 83%. A mixed effects model found younger age, male sex, and "family environment" to be significantly associated with IF. There was no difference in the prevalence rate of IF between ASD subjects and NT controls. More IF required clinical follow-up in ASD subjects compared to NT controls. The prevalence rate of IF observed in this twin study was higher than rates previously reported in singleton studies. Our results suggest the shared environment of twins - perhaps in utero - increases the risk of brain IF. Brain MRI in the initial work-up of ASD may be indicated in twins, especially in males. Autism Res 2017, 10: 113-120. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1720