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. 2024 May;39(5-6):178-189.
doi: 10.1177/08830738241248685. Epub 2024 May 15.

Abnormality of Early White Matter Development in Tuberous Sclerosis Complex and Autism Spectrum Disorder: Longitudinal Analysis of Diffusion Tensor Imaging Measures

Affiliations

Abnormality of Early White Matter Development in Tuberous Sclerosis Complex and Autism Spectrum Disorder: Longitudinal Analysis of Diffusion Tensor Imaging Measures

Siddharth Srivastava et al. J Child Neurol. 2024 May.

Abstract

Background: Abnormalities in white matter development may influence development of autism spectrum disorder in tuberous sclerosis complex (TSC). Our goals for this study were as follows: (1) use data from a longitudinal neuroimaging study of tuberous sclerosis complex (TACERN) to develop optimized linear mixed effects models for analyzing longitudinal, repeated diffusion tensor imaging metrics (fractional anisotropy, mean diffusivity) pertaining to select white matter tracts, in relation to positive Autism Diagnostic Observation Schedule-Second Edition classification at 36 months, and (2) perform an exploratory analysis using optimized models applied to all white matter tracts from these data. Methods: Eligible participants (3-12 months) underwent brain magnetic resonance imaging (MRI) at repeated time points from ages 3 to 36 months. Positive Autism Diagnostic Observation Schedule-Second Edition classification at 36 months was used. Linear mixed effects models were fine-tuned separately for fractional anisotropy values (using fractional anisotropy corpus callosum as test outcome) and mean diffusivity values (using mean diffusivity right posterior limb internal capsule as test outcome). Fixed effects included participant age, within-participant longitudinal age, and autism spectrum disorder diagnosis. Results: Analysis included data from n = 78. After selecting separate optimal models for fractional anisotropy and mean diffusivity values, we applied these models to fractional anisotropy and mean diffusivity of all 27 white matter tracts. Fractional anisotropy corpus callosum was related to positive Autism Diagnostic Observation Schedule-Second Edition classification (coefficient = 0.0093, P = .0612), and mean diffusivity right inferior cerebellar peduncle was related to positive Autism Diagnostic Observation Schedule-Second Edition classification (coefficient = -0.00002071, P = .0445), though these findings were not statistically significant after multiple comparisons correction. Conclusion: These optimized linear mixed effects models possibly implicate corpus callosum and cerebellar pathology in development of autism spectrum disorder in tuberous sclerosis complex, but future studies are needed to replicate these findings and explore contributors of heterogeneity in these models.

Keywords: MRI; autism; tuberous sclerosis complex.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Depiction of longitudinal brain magnetic resonance imaging (MRI) scans from participants in the TACERN study included in our analysis. Each point represents an MRI scan. A horizontal line connecting multiple points represents repeated MRI scans for a single participant.
Figure 2.
Figure 2.
Nonparametric locally weighted scatterplot smoothing (LOWESS) estimates for linearity assessment of corpus callosum FA (CC_FA) versus (A) age and (B) natural logarithm of age. FA, fractional anisotropy.
Figure 3.
Figure 3.
Nonparametric locally weighted scatterplot smoothing (LOWESS) estimates for linearity assessment of right posterior limb internal capsule MD (PLIC_R_MD) versus (A) age and (B) natural logarithm of age. MD, mean diffusivity.
Figure 4.
Figure 4.
Residual plots of selected best models for the outcome measures (A) FA_CC (model 4) and (B) MD_PLIC_R (model 6). FA, fractional anisotropy; MD, mean diffusivity.

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