| Objectives This study aimed to identify the prenatal,perinatal risk factors for ASD(autism spectrum disorder),explore intelligetual profile of Chinese school-aged boys with ASD and investigate its neurobases.Methods 1.Three hundred and fifty children with ASD(aged 2-16 years old,mean age 6.52±3.06,the ratio of boy to girl is 5.78:1)and age,gender matched typically developing(TD)children participated in this study.Data were collected based on a retrospective report by parents that included demographic information,prenatal,perinatal impact factors.Descriptive and linear regression analyses were used to summarize potential risk factors.2.Sixty-five boys diagnosed ASD using DSM-5(Diagnostic and Statistical manual of Mental illness-5)and 48 TD boys(aged 6-16 years old,mean age 11.19±2.58)were all administered WISC-IV(Wechsler Intelligence Scale for Children,the fourth edition,Chinese version),and parents of ASD were interviewed ADI-R(Autism Diagnostic Interview-Revised).The ASD group was divided into two groups based on the FSIQ(Full Scale IQ=70): the HFASD(high functioning ASD,n=36,mean age 10.47±3.19)group and LFASD(low functioning ASD,n=29,mean age 9.79±3.11)group.3.Forty-six boys with ASD aged 6 to 16 years old and 15 typically developing boys(6-16 years old,mean age 10.80±2.96)were scanned the structure MRI,24 boys with ASD were in the HFASD(mean age 11.33±3.16)and 22 in the LFASD(mean age 9.14 ± 3.15)groups,the correlation between the grey matter volume and intelligence was explored.Resting state f MRI of 33 boys in the ASD group(16 with HFASD,mean age 11.81±2.61;and 17 with LFASD,mean age 9.23±3.40)and 15 in the TD(mean age 10.80±2.96)group was also collected to investigate the association of intelligence and the values of ALFF,Re Ho.The grey matter volume,ALFF,Re Ho and FC(functional connectivity)of DLPFC was also examined.Results Part One The difference were observed between the ASD and TD groups on family history of psychiatric disorders(P < 0.001),maternal abortion history(P = 0.013),infection during mother's pregnancy(P < 0.001),birth weight(P < 0.018),neonatal jaundice(P < 0.001)and breast feeding(P < 0.001).The linear regression model showed that family history of psychiatric disorders,maternal abortion history,infection during mother's pregnancy,and neonatal jaundice and breast feeding were related with autism(P = 0.026~0.001).Part Two The VCI(Verbal Comprehension Index),PSI(Processing Speed Index)and FSIQ were significantly lower in the HFASD group compared to the TD group(P < 0.05),while the PRI(Perceptual Reasoning Index)and WMI(Working Memory Index)were equivalent with the TD group(P < 0.05).The IQ index scores and subtests in the LFASD group were all significantly lower than the TD and HFASD groups(P < 0.001).For the VIQ-/NVIQ split,difference was found between the HFASD and TD,also for the LFASD and TD group(P = 0.01).All the IQ index scores were correlated with the scores of Level & Consistency of Intellectual Response,General Impression of CARS(Childhood Autism Rating Scale)(r =-0.563~0.433,P < 0.01;r =-0.319~0.391,P < 0.05).VCI,PRI,WMI and FSIQ was also negatively correlated with the total CARS and the Taste,Smell,Touch score(r =-0.336~-0.299,P < 0.05;r =-0.447~-0.405,P < 0.05);the VCI,PSI,and FSIQ scores were negatively correlated with the Fear or Nervous score(r =-0.329~-0.301,P < 0.05).Part Three The grey matter volume of the BA 4,6,9,11,18,39 in the HFASD group was smaller than the LFASD group.The grey matter volume of the DLPFC was negatively correlated with the FSIQ and PRI,the PSI was negatively correlated with the right DLPFC in the LFASD group(P < 0.01,Alphasim correction),while the correlation was not found for the HFASD and TDgroups.The ALFF score of BA6,7,9,11,13,37,39,40;the ReHo score of the BA6,9 is higher in the HFASD group;while the ALFF score of the BA1,18,the Re Ho score of BA4,5,18,19 is lower than the LFASD group(P < 0.01,Alphasim correction).The functional connectivity of left DLPFC and BA 6,7,13,37,40,44 and 46 is higher than the LFASD group,the functional connectivity of left DLPFC and BA 18,38 is lower than the LFASD group(P < 0.01,Alphasim correction).The ALFF score of right DLPFC was positively correlated with the PRI and PSI HFASD group;that of the left DLPFC was positively correlated with the VCI in the LFASD group.However,the correlation between the ALFF/Re Ho score and IQ scores was not observed in the TD group.In the HFASD group,the functional connectivity of right DLPFC and middle-occipital gyrus was positively correlated with the VCI,which of the inferior parietal lobule was negatively correlated with the FSIQ,PRI and WMI in the LFASD group.In addition,the correlation of functional connectivity of right DLPFC and IQ scores was observed in the TD group.Conclusions According to our results,family history of psychiatric disorders,mother's history of abortion,infection during pregnancy,neonatal jaundice were potential risk factors,while breast feeding were potential protective factors,indicating that ASD is neurodevelopmental disorder.Chinese school-aged boys with HFASD showed impaired VCI,PSI and FSIQ,while the PRI and WMI were comparable with the TD boys.All the IQ index scores were lower in the boys with LFASD.The VIQ-/NVIQ split was different between the HFASD and TD groups,also for the LFASD and TD.The grey matter volume of DLPFC was negatively correlated with the IQ scores in the LFASD group.The ALFF score of DLPFC was positively correlated with IQ scores in the HFASD and LFASD groups.For the functional connectivity of DLPFC and IQ index scores,in the HFASD group,the functional connectivity of right DLPFC and middle-occipital gyrus was positively correlated with the VCI,which of the inferior parietal lobule was negatively correlated with the FSIQ,PRI and WMI in the LFASD group.The lower IQs in the LFASD was correlated with the grey matter volume,ALFF and functional connectivity of right DLPFC. |
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