Perivascular Space Burden in Children With Autism Spectrum Disorder Correlates With Neurodevelopmental Severity.

Researchers used brain scans to study fluid-filled spaces around blood vessels in 66 young children with autism. They found that children with more severe autism symptoms and developmental delays had more of these spaces. The spaces were mostly found in the front part of the brain. This might help us understand how the brain clears waste products in children with autism.

This retrospective MRI study examined perivascular spaces (PVS) in 66 children with autism spectrum disorder (mean age 4.7 years). PVS are fluid-filled spaces around blood vessels involved in brain waste clearance. Researchers found that children with more severe developmental delays and larger extra-axial cerebrospinal fluid volumes had higher PVS counts. PVS were most abundant in frontal brain regions (32%) and least in temporal regions (11%).

The findings suggest a relationship between brain fluid dynamics, PVS burden, and autism severity, potentially indicating altered cerebrospinal fluid circulation in autism.

These findings suggest perivascular spaces may serve as neuroimaging biomarkers for autism severity in young children. The relationship with cerebrospinal fluid dynamics indicates potential targets for understanding brain waste clearance mechanisms in autism, though clinical applications require further validation.

Single-center retrospective study with small sample size (66 children). Cross-sectional design prevents causal inferences. Limited age range (mean 4.7 years) restricts generalizability. Relationship between PVS and functional outcomes unclear.

Cerebral perivascular spaces (PVS) are involved in cerebrospinal fluid (CSF) circulation and clearance of metabolic waste in adult humans. A high number of PVS has been reported in autism spectrum disorder (ASD) but its relationship with CSF and disease severity is unclear. To quantify PVS in children with ASD through MRI. Retrospective.

Sixty six children with ASD (mean age: 4.7 ± 1.5 years; males/females: 59/7). 3T, 3D T1-weighted GRE and 3D T2-weighted turbo spin echo sequences. PVS were segmented using a weakly supervised PVS algorithm. PVS count, white matter-perivascular spaces (WM-PVS) and normalized volume (WM-PVS) were analyzed in the entire white matter. Six regions: frontal, parietal, limbic, occipital, temporal, and deep WM (WM-PVS).

WM, GM, CSF, and extra-axial CSF (eaCSF) volumes were also calculated. Autism Diagnostic Observation Schedule, Wechsler Intelligence Scale, and Griffiths Mental Developmental scales were used to assess clinical severity and developmental quotient (DQ). Kendall correlation analysis (continuous variables) and Friedman (categorical variables) tests were used to compare medians of PVS variables across different WM regions. Post hoc pairwise comparisons with Wilcoxon tests were used to evaluate distributions of PVS in WM regions.

Generalized linear models were employed to assess DQ, clinical severity, age, and eaCSF volume in relation to PVS variables. A p-value < 0.05 indicated statistical significance. Severe DQ (β = 0.0089), mild form of autism (β = -0.0174), and larger eaCSF (β = 0.0082) volume was significantly associated with greater WM-PVScount. WM-PVSwas predominantly affected by normalized eaCSF volume (eaCSF) (β = 0.0242; adjusted for WM volumes).

The percentage of WM-PVSwas higher in the frontal areas (32%) and was lowest in the temporal regions (11%). PVS count and volume in ASD are associated with eaCSF. PVS count is related to clinical severity and DQ. PVS count was higher in frontal regions and lower in temporal regions. 4 Stage 3.