Neuroimaging Cannot Detect Autism by Itself

A biostatistician is warning against advocating the use of brain imaging scans to diagnose autism and emphasized more concentration on performing larger, long-term multicenter studies to identify the biologic mechanisms of the disorder.

The report was published in the November 1, 2012, issue of the journal Nature. “Several studies in the past two years have claimed that brain scans can diagnose autism, but this assertion is deeply flawed,” said Dr. Lange, an associate professor of psychiatry and biostatistics at Harvard Medical School (Boston, MA, USA). “To diagnose autism reliably, we need to better understand what goes awry in people with the disorder. Until its solid biological basis is found, any attempt to use brain imaging to diagnose autism will be futile.”

While advising against current use of brain imaging as a diagnostic approach, Dr. Lange is a strong supporter of using this technology in helping researchers to better clarify autism’s workings. Through the use of several brain imaging modalities, including functional magnetic resonance imaging (MRI), positron emission tomography (PET), and volumetric MRI, Dr. Lange noted that investigators have made significant findings about early brain enlargement in the illness, the role of serotonin in someone with autism, and how individuals with autism focus during social interaction.

“Brain scans have led to these extremely valuable advances, and, with each discovery, we are getting closer to solving the autism pathology puzzle,” said Dr. Lange. “What individuals with autism and their parents urgently need is for us to carry out large-scale studies that lead us to find reliable, sensitive, and specific biological markers of autism with high predictive value that allow clinicians to identify interventions that will improve the lives of people with the disorder.”

Autism and autism spectrum disorder (ASD) are terms typically employed to define a group of complex disorders of brain development. This spectrum characterized, in varying levels, by problems in social interaction, repetitive behaviors, and verbal and nonverbal communication, whose criteria have been revised in the newly proposed Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The occurrence of ASD in the United States has risen 78% in the last 10 years, with the US Centers for Disease Control (Atlanta, GA, USA) estimating that one in 88 children has ASD.

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