Normal rates of neuroradiological findings in children with high functioning autism.
Routine MRI is almost always normal in high-functioning kids no matter the diagnosis, so don’t use it as an autism test.
01Research in Context
What this study did
Doctors ordered routine MRI scans for the kids. Thirty had high-functioning autism, 30 had ADHD, and 30 were typically developing.
A radiologist who did not know the diagnoses read every scan. The team counted how many looked normal.
What they found
About 9 out of 10 scans looked normal in every group. Autism, ADHD, and typical kids all had the same low rate of odd findings.
The small number of abnormal scans were minor and did not match any one diagnosis.
How this fits with other research
Eussen et al. (2016) also saw normal routine MRIs in high-functioning youth, but when they used a special DTI sequence the same kids showed wide white-matter gaps. The lesson: standard pictures miss fine wiring problems.
Eussen et al. (2016) found cystic white-matter lesions in babies born very preterm who later got autism. Those lesions are gone by school age, so the 2012 null result in older kids is not a true clash—just a different life stage.
Cox et al. (2017) proved you can teach even kids with autism and ID to lie still for scans without sedation. Together these papers mean MRI is doable, but the read-out is usually boring.
Why it matters
Stop waiting for a brain picture to confirm high-functioning autism. A normal MRI will not rule it in or out, so keep your assessment dollars for gold-standard tools like the ADOS. If parents push for imaging, show them this 90 % normal rate and explain that fancier scans may be needed for research questions only.
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Tell the next parent who asks, “The odds are 9 out of 10 the MRI will look normal—let’s spend our time on direct behavior assessment instead.”
02At a glance
03Original abstract
Magnetic resonance imaging (MRI) has been used to analyze highly specific volumetric and morphological features of the brains of individuals with autism spectrum disorder (ASD). To date, there are few comprehensive studies examining the prevalence of neuroradiologic findings seen on routine MRI scans in children with ASD. This study examined the prevalence of neuroradiologic findings in children with high functioning ASD, and compared these rates to those in children with Attention-Deficit/Hyperactivity Disorder (ADHD) and children who are typically developing (TD). Results showed that approximately 90% of children had normal MRI scans. There was no significant effect of diagnosis on the total number of neuroradiological findings or the number of specific brain findings. Implications and future research directions are discussed.
Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-011-1407-6