Date of Award
Doctor of Philosophy in Biomedical Engineering - (Ph.D.)
Tara L. Alvarez
Michael William Cole
Autism Spectrum Disorder (ASD) was first described in 1943 by Dr. Leo Kranner in a case study published in The Nervous Child. It is a neurodevelopment disorder, with a range of clinical symptoms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), used by clinicians to diagnose mental disorders, a child needs to have persistent social deficits, language impairments, and repetitive behaviors, that cannot be explained by neurological damage or intellectual disability. It is known that children diagnosed with ASD are often are developmentally delayed therefore alterations in the typical developmental trajectory should be a major factor in consideration when studying ASD. As of 2016, 1 in 68 children in the USA is diagnosed with ASD, of those diagnosed young males are four times more likely to be diagnosed than their female peers. Although genetic and behavioral theories exist to explain these differences, the cause for the disparity is still unknown.
This Dissertation presents a unique opportunity to understand the intersection of altered neurodevelopment and the alarming sex disparities in patients with ASD from a neuroimaging perspective. The hypothesis is that there exist differences due to development and sex in with ASD. Access to ABIDE (Autism Brain Imaging Data Exchange), a open source large scale data sharing consortium of functional and anatomical MR data. Analyzing MR data for alterations due to ASD, developmental trajectory, and sex as well as the intersection of these factors. Theses modulations are observed in three Project Aims that employ various analytical approaches: (1) Structural Morphology, (2) Resting-state Functional Connectivity, and (3) Graph Theory.
The major findings lie at the interaction of these three factors; developmental stage-by-diagnosis-by-sex. Structural Morphological Analyses of anatomical data show differences in cortical thickness, on the left rostral middle frontal gyrus and surface area in along the sensory motor strip, of the left paracentral gyrus and right precentral gyrus. Resting-state Functional Connectivity analyzed in multiple data driven approaches, and altered resting state connectivity patterns between the left frontal parietal network and the left parahippcampal gyrus are reported. The regions found in the Morphological Analyses are used as seeds for a priori connectivity analysis, connectivity between the left rostral middle frontal cortex and bilateral superior temporal gyrus as well as the right precentral gyrus and right middle frontal gyrus and left inferior frontal gyrus are described. Finally using Graph Theory analysis, which quantifies a whole brain connectivity matrix to calculate metrics such as path length, cluster coefficient, local efficiency, and betweeness centrality all of which are altered by the interaction of all three factors. The last investigation is an attempt to correlate the behavioral assessments, conducted by clinicians with theses neuroimaging findings to determine if there exist a relationship between them.
Significant interaction effects of sex and development on ASD diagnosis are observed. The goal of the Study is to provide more information on the disorder that is by nature highly heterogeneous in symptomatology. Studying these interactions, may be key to better understand a disorder that was introduced into the medical literature 75 years ago.
Azeez, Azeezat, "Developmental and sex modulated neurological alterations in autism spectrum disorder" (2019). Dissertations. 1418.