| Backgroud Autism Spectrum Disorders (ASD) is a developmental disorder which begins at infancy or toddler age(<3 years old). The cause of autism remains unclear whereas the incidence is increasing. More and more energy has been put into the brain research while the knowledge is increasing. The abnormalities of ASD, in complete agreement, mainly involve in the macro and micro structure of the brain and the network function. It is possible to use MRI/fMRI/MRS to detect the change of the brain in vivo. Those provide a way to find the change of the diseases in the early stage and monitor the conversion. Autistic children and the unexplained develop delay children belong to the developmental disorder spectrum. On the early stage, the core symptoms of autism, most of time, are not obvious and the patients are too young to determine accurately, so it is quite easy to treat the autism symptoms just as develop delay and led the autistic patients miss the best treatment period. And more, most of autistic children are associated with mild or moderate mental retardation phenomenon. The autism will be misdiagnosed as the mental retardation if without detailed history and close follow-up. Therefore, it is emergent to find a measure to distinguish the autism and the unresolved develop delay.Methods Thirteen children with autism, 2 to 6 years old, and fifty age-matched unexplained delay subjects were detected by 1H-MRSI (1.5T) on bilateral basal ganglia with PRESS sequence (TR/TE=1500/30ms). Quantitative levels of N-acetyl compounds (NAA), creatine (Cr), glyceryl phosphoryl choline (GPC), inositol (Ins), glutamine complex (Glx) would be available assessed by LCmodel. Mean±SD represents the concentration of the metabolisms. The differences of all the metabolisms between the two diseases were statistically detectable by ANOVA (analysis of variance) and Fisher test. The data was deal with the software SPSS 17.0, P<0.05 was accepted. Results1. (2-6 year-male group) On the right basal ganglia, the concentration of Glu in autistic children(Mean±SD=7.453±0.901) was lower than that in the unexplained develop delay children (Mean±SD=8.875±1.749) ,and it was significant difference(F=4.789,P=0.046).2. (2-6 year-male group) Unexplained develop delay children: the concentration of Glx on the right basal ganglia (Mean±SD=11.949±0.656)was higher than that on the left(Mean±SD=10.539±0.696),and it was significant difference(F=10.861, P=0.011).3. (2-6 year-female group) Autistic children: the concentration of Glx was lower on the right basal ganglia (Mean±SD=10.920±0.105)than that on the left(Mean±SD=12.449±0.059), and it was significant difference(F=324.567 , P=0.003).4. (2-6 year-male group versus less than 2 year-male group) Unexplained develop delay children: on the right basal ganglia, the concentration of NAA in 2-6 year-male group (Mean±SD=7.126±0.666) was higher than that in the less than 2 years old group (Mean±SD=5.674±0.700), and it was significant difference( F=11.284,P=0.01 ) , and showed positive correlation with age( CC=0.756,P=0.011 ).5. (2-6 year-male group versus less than 2 year-male group) Unexplained develop delay children: on the left basal ganglia, the concentration of GPC+PCh in 2-6years-male-Group (Mean±SD=1.618±0.116) was lower than that in the less than 2 years-old-group (Mean±SD=1.900±0.129) ,and it was significant difference( F=13.158,P=0.007 ) , and showed negative correlation with age ( CC= -0.872,P=0.001 ).Conclusion The differences of the metabolisms (including the neurotransmitters) on bilateral basal ganglia between autistic children and unexplained develop delay children aged less than 2 years old were not obvious. But with age, the pathological differences become more and more significant. Therefore, on the early stage, comparing the metabolism changes by follow-up testing can offer a significant mean to indentify autistic children and the unexplained develop delay children. |
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