The neuroanatomy of autism spectrum disorder: An overview of structural neuroimaging findings and their translatability to the clinical setting.
Brain scans show reliable but still useless autism signatures.
01Research in Context
What this study did
Ecker (2017) gathered every structural MRI paper on autism. She wanted to see which brain shapes keep showing up in ASD. The review covers kids and adults, but does not run new scans.
What they found
The same differences appear again and again. Brains are a little larger in some areas, a little smaller in others. White-matter tracts look patchy. These patterns are real, but still too messy for a lab test.
How this fits with other research
Fitzgerald et al. (2019) later counted the white-matter damage and linked it to social scores. Their data back up the patchy picture Christine described.
Cai et al. (2021) zoomed out to whole-brain networks. They showed the patchy wiring reaches peak strength seven years later in ASD, giving a timeline Christine did not have.
Amaral et al. (2017) narrowed the lens to one clear subtype: fifteen percent of boys with ASD also have big brains. This fits Christine’s call for smaller, cleaner groups before any scan becomes a clinic tool.
Wang et al. (2025) swept up every biomarker study through 2017, including Christine’s. They agree: keep using behavioral tests; the brain pictures are still research toys.
Why it matters
You will not order an MRI to diagnose autism after reading this. You will keep doing ADOS and interviews. But when a parent asks why scans are not ready, you can explain the consistent yet blurry patterns. Track head growth and watch for megalencephaly in severe boys. Expect white-matter findings to stay experimental for years.
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02At a glance
03Original abstract
Autism spectrum disorder is a complex neurodevelopmental disorder, which is accompanied by differences in brain anatomy, functioning and brain connectivity. Due to its neurodevelopmental character, and the large phenotypic heterogeneity among individuals on the autism spectrum, the neurobiology of autism spectrum disorder is inherently difficult to describe. Nevertheless, significant progress has been made in characterizing the neuroanatomical underpinnings of autism spectrum disorder across the human life span, and in identifying the molecular pathways that may be affected in autism spectrum disorder. Moreover, novel methodological frameworks for analyzing neuroimaging data are emerging that make it possible to characterize the neuroanatomy of autism spectrum disorder on the case level, and to stratify individuals based on their individual phenotypic make up. While these approaches are increasingly more often employed in the research setting, their applicability in the clinical setting remains a vision for the future. The aim of the current review is to (1) provide a general overview of recent structural neuroimaging findings examining the neuroanatomy of autism spectrum disorder across the human life span, and in males and females with the condition, (2) highlight potential neuroimaging (bio)markers that may in the future be used for the stratification of autism spectrum disorder individuals into biologically homogeneous subgroups and (3) inform treatment and intervention strategies.
Autism : the international journal of research and practice, 2017 · doi:10.1177/1362361315627136