Abnormal glymphatic system function in children with autism spectrum disorder: a diffusion kurtosis imaging study.

Researchers studied how well the brain's 'cleaning system' (called the glymphatic system) works in autistic children compared to non-autistic children. Using special brain scans, they found that this cleaning system doesn't work as well in autistic children, especially those with more severe autism symptoms. The findings suggest this brain cleaning problem might be connected to autism symptoms and development levels.

This study investigated glymphatic system function in children with autism spectrum disorder (ASD) using advanced brain imaging. The glymphatic system clears metabolic waste from the brain and may be impaired in neurodevelopmental disorders. Researchers used diffusion kurtosis imaging analysis along the perivascular space (DKI-ALPS) to compare children with ASD to typically developing children. Results showed significantly reduced glymphatic function in children with ASD, with more severe impairment in those with more severe autism symptoms.

The imaging findings correlated with autism severity scores and developmental assessments. This novel imaging approach demonstrated higher sensitivity than previous methods in detecting these differences, providing new insights into the neurobiological mechanisms underlying ASD.

First study to demonstrate glymphatic dysfunction in autistic children using advanced imaging. May inform future biomarker development and therapeutic targets. However, findings are preliminary and require validation in larger samples before clinical application.

Sample size not reported. Study design unclear. This appears to be preliminary evidence requiring replication. Cross-sectional design limits understanding of causality. Generalizability uncertain without demographic details.

The glymphatic system, responsible for clearing metabolic waste in the brain, may be impaired in neurodevelopmental and neurodegenerative disorders. This study aimed to assess glymphatic system function in children with autism spectrum disorder (ASD) and explore its relationship with the severity of core ASD features and developmental level. This study employed diffusion kurtosis imaging analysis along the perivascular space (DKI-ALPS) to assess glymphatic system function in children with ASD, dividing the ASD group into mild and severe subgroups to compare intergroup differences and differences with the typically developing (TD) group. Correlations between DKI-ALPS indices and clinical assessments, including the Childhood Autism Rating Scale (CARS) and Griffiths Developmental Scales (Chinese version, GDS-C), were also analyzed.

The DKI-ALPS and diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) indices were calculated separately for the left and right hemispheres, with the average defined as their arithmetic mean. The DKI-ALPS index was further compared with the DTI-ALPS index, and its directional kurtosis components were analyzed to investigate underlying microstructural differences. DKI-ALPS indices were significantly lower in children with ASD than in TD children, with lower values in the severe subgroup than in the mild subgroup. The right and average DKI-ALPS indices were negatively correlated with CARS scores, while the right index was positively correlated with Hearing-Language and Eye-Hand Coordination scores.

DKI-ALPS showed greater sensitivity than DTI-ALPS in detecting group differences and clinical associations. Directional analysis revealed significant alterations in y-axis projection and z-axis association kurtosis metrics. This study provides preliminary evidence of glymphatic dysfunction in children with ASD, which is associated with the severity of core ASD features and developmental level. These findings offer novel imaging-based insights into ASD neurobiology. • Glymphatic system dysfunction has been implicated in neurodegenerative disorders.

Its role in autism spectrum disorder (ASD), particularly in children, remains underexplored. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) has limited sensitivity in detecting glymphatic changes. • This study is the first to apply diffusion kurtosis imaging analysis along the perivascular space (DKI-ALPS) in children with ASD, revealing significant glymphatic impairment correlated with the severity of core ASD features and developmental levels. DKI-ALPS demonstrated higher sensitivity than DTI-ALPS.