Autism is different in girls' brains

A study has found differences in brain connectivity patterns in boys and girls with autism

Boys and girls with autism have different brain organization, according to a new study from Stanford University School of Medicine

The difference, discovered by artificial intelligence techniques analyzing hundreds of brain scans, is unique to people with autism and not found in normally developing boys and girls

Autism is a developmental disorder of varying severity

The study's lead author, Kaustubh Supekar, PhD, a clinical assistant professor of psychiatry and behavioral sciences, said: "When a disorder is described in a biased way, the diagnostic approach is also biased

The study was published online Feb.

"We found significant differences in the brains of boys and girls with autism and obtained individualized predictions of clinical symptoms in girls," said the study's senior author Vinod Menon, Ph.

Girls with autism typically have less pronounced repetitive behaviors than boys, which can lead to delays in diagnosis, the researchers said

"It's very compelling to know that men and women behave differently and neurologically," said Lawrence Fung, MD, assistant professor of psychiatry and behavioral sciences

Fung treats people with autism, including girls and women with delayed diagnosis, at Stanford Children's Health

"If therapy can be done at the right time, it makes a big difference: for example, children with autism who receive early language intervention will have a better chance of developing language than others, without continuing to catch up as they grow older ," Fung said

New statistical method eliminates variance

The study analyzed fMRI brain scans of 773 children with autism (637 boys and 136 girls)

The dominance of boys in the brain scan database also presents a mathematical challenge: Standard statistical methods for finding differences between groups require groups to be roughly equal in size

"When I try to identify the differences (with traditional methods), the algorithm tells me that every brain is a male with autism," Supekar said

Supekar discussed the issue with Tengyu Ma, Ph.

"We are fortunate that this new statistical method was developed at Stanford University," Supekar said
.

What's the difference?

Using brain scans of 678 children with autism, researchers developed an algorithm that can distinguish boys from girls with 86 percent accuracy
.
When they were validated against the remaining 95 brain scans of children with autism, the algorithm maintained the same accuracy in distinguishing between boys and girls
.

The scientists also tested the algorithm on 976 brain scans of normally developing boys and girls
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The algorithm couldn't tell them apart, confirming that the gender differences the scientists found were unique to autism
.

Among children with autism, girls differed from boys in connectivity patterns in several brain centers, including motor, language, and visuospatial attention systems
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Differences were greatest between sexes in a set of motor regions—including primary motor cortex, supplementary motor cortex, parietal and lateral occipital cortex, and middle and superior temporal gyrus
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Among girls with autism, differences in motor centers correlated with the severity of their motor symptoms, meaning those girls whose brain patterns were most similar to boys with autism tended to have the most pronounced motor symptoms
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The researchers also found different language areas between boys and girls with autism, noting that previous studies have found more severe language impairments in boys
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"It seems more true when you see differences in areas of the brain that are associated with autism clinical symptoms," Supekar said
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Taken together, the findings should be used to guide future efforts to improve diagnosis and treatment of girls, the researchers said
.

"Our study advances the precision psychiatry application of AI-based technologies in people with autism," Menon said
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"We may need different tests for women and men
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The AI ​​algorithm we developed may help improve the diagnosis of autism in girls," Supekar said
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At a therapeutic level, girls could be intervened earlier, he added
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