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Birth Through Age 2 Years

Heather Cody Hazlett, PhD; Michele Poe, PhD; Guido Gerig, PhD; Rachel Gimpel Smith, BA; James Provenzale, MD; Allison Ross, MD; John Gilmore, MD; Joseph Piven, MD

Arch Gen Psychiatry. 2005;62:1366-1376.

Context  While the neuroanatomical basis of autism is not yet known, evidence suggests that brain enlargement may be characteristic of this disorder. Inferences about the timing of brain enlargement have recently come from studies of head circumference (HC).

Objectives  To examine brain volume and HC in individuals with autism as compared with control individuals.

Design  A cross-sectional study of brain volume was conducted at the first time point in an ongoing longitudinal magnetic resonance imaging study of brain development in autism. Retrospective longitudinal HC measurements were gathered from medical records on a larger sample of individuals with autism and local control individuals.

Setting  Clinical research center.

Participants  The magnetic resonance imaging study included 51 children with autism and 25 control children between 18 and 35 months of age (the latter included both developmentally delayed and typically developing children). Retrospective, longitudinal HC data were examined from birth to age 3 years in 113 children with autism and 189 local control children.

Main Outcome Measures  Cerebral cortical (including cortical lobes) and cerebellar gray and white matter magnetic resonance imaging brain volumes as well as retrospective HC data from medical records were studied.

Results  Significant enlargement was detected in cerebral cortical volumes but not cerebellar volumes in individuals with autism. Enlargement was present in both white and gray matter, and it was generalized throughout the cerebral cortex. Head circumference appears normal at birth, with a significantly increased rate of HC growth appearing to begin around 12 months of age.

Conclusions  Generalized enlargement of gray and white matter cerebral volumes, but not cerebellar volumes, are present at 2 years of age in autism. Indirect evidence suggests that this increased rate of brain growth in autism may have its onset postnatally in the latter part of the first year of life.

Author Affiliations: Neurodevelopmental Disorders Research Center, University of North Carolina, Chapel Hill (Drs Hazlett, Poe, Gerig, Gilmore, and Piven and Ms Smith); and Departments of Radiology (Dr Provenzale) and Anesthesiology (Dr Ross), Duke University Medical Center, Durham, NC.

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