مقاله انگلیسی رایگان در مورد ذهن انگیزی اوتیسم و اختلال بیش فعالی-کم توجهی – الزویر 2024

Abstract

Background
Autism and attention-deficit/hyperactivity disorder (ADHD) are heterogeneous neurodevelopmental conditions with complex underlying neurobiology that is still poorly understood. Despite overlapping presentation and sex-biased prevalence, autism and ADHD are rarely studied together and sex differences are often overlooked. Population modeling, often referred to as normative modeling, provides a unified framework for studying age-specific and sex-specific divergences in brain development.

Methods
Here, we used population modeling and a large, multisite neuroimaging dataset (N = 4255 after quality control) to characterize cortical anatomy associated with autism and ADHD, benchmarked against models of average brain development based on a sample of more than 75,000 individuals. We also examined sex and age differences and relationship with autistic traits and explored the co-occurrence of autism and ADHD.

Results
We observed robust neuroanatomical signatures of both autism and ADHD. Overall, autistic individuals showed greater cortical thickness and volume that was localized to the superior temporal cortex, whereas individuals with ADHD showed more global increases in cortical thickness but lower cortical volume and surface area across much of the cortex. The co-occurring autism+ADHD group showed a unique pattern of widespread increases in cortical thickness and certain decreases in surface area. We also found that sex modulated the neuroanatomy of autism but not ADHD, and there was an age-by-diagnosis interaction for ADHD only.

Conclusions
These results indicate distinct cortical differences in autism and ADHD that are differentially affected by age and sex as well as potentially unique patterns related to their co-occurrence.

Introduction

Neurodevelopmental conditions such as autism and attention deficit hyperactivity disorder (ADHD) are the products of altered neurodevelopmental trajectories (1), but their specific neurobiological underpinnings remain poorly understood. Both display significant variability in trajectory, associated traits, and neurobiology (2–8), which can hamper efforts to better understand these conditions. Sex and gender modulations of presentation, prevalence and neuroanatomy (9–15), and clinical and aetiological overlap (16–19), add complexity. Importantly, most studies have been based on male-dominant samples and might not be representative (15).

One of the most commonly reported findings is increased total brain volume in young autistic children (20–22), although evidence suggests this might only hold true for a subset (23–25), and for boys (26,27). Increased cortical thickness is often associated with autism (28–31), although reductions have been reported (32,33), as well as alterations in cortical surface area and volume (34–36). Alterations, including both increases and decreases, have been reported in the superior temporal gyrus, inferior and prefrontal cortex, sensory and motor regions (29–38), cerebellum, and subcortex (39–42), and appear to be moderated by age, sex, and co-occurring conditions or traits (31,43–48). Complementary work has suggested that multiple subgroups with distinct patterns of neuroanatomical alterations and clinical characteristics exist (40,48–50). Sex differences, in particular, have been reported in multiple cortical measures and associations (31,44, 51, 52, 53–57).

Results

We observed robust neuroanatomical signatures of both autism and ADHD. Overall, autistic individuals showed greater cortical thickness and volume that was localized to the superior temporal cortex, whereas individuals with ADHD showed more global increases in cortical thickness but lower cortical volume and surface area across much of the cortex. The co-occurring autism+ADHD group showed a unique pattern of widespread increases in cortical thickness and certain decreases in surface area. We also found that sex modulated the neuroanatomy of autism but not ADHD, and there was an age-by-diagnosis interaction for ADHD only.