Imaging: A New Way to Diagnose Autism?Apr 30, 2014
An autism diagnosis typically comes from a child’s primary care physician, but there might be a new way to tell if a child has autism. Dr. Jeffrey Anderson says this new method of looking at the brain could be up to 90 percent accurate. He’ll tell you how an MRI can detect autism in the brain, and its pros and cons compared to a diagnosis by a physician.
Host: Most people believe that autism is diagnosed in the clinic, but there might be a new way to tell if somebody has autism. That's coming up next on The Scope.
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Host: We're talking with Dr. Jeff Anderson, Associate Professor of Neuroradiology at the University of Utah. Dr. Anderson, what are some of the more traditional ways of diagnosing autism?
Dr. Jeff Anderson: Well autism has always been diagnosed by a physician, so this is either a psychiatrist, or a pediatrician who interviews the child and interviews the parents. And sometimes these interviews can take several hours as the physician gets to know the child. And it can be a time-consuming process and there are also a number of questionnaires. And all of that data together comes to a diagnosis of autism or not, or some other condition.
Host: And so your researching a new way of possibly diagnosing autism, is that correct?
Dr. Jeff Anderson: Well we would love to have a way of looking at the brain to determine if someone has autism rather than the more time consuming process of...
Host: ...the clinics.
Dr. Jeff Anderson: Yes, exactly. So yes, we and others have been working on MRI tests. One of the tests that we did was with a new type of MRI scan called Functional Connectivity.
Host: Explain a little bit what that is.
Dr. Jeff Anderson: Well functional connectivity is a way of looking at which regions of the brain are connected or wired together. It's like looking at a wiring diagram of the brain, and we use the same type of MRI scanner that's used for other types of MRI images. And we've found in one study that we can be about 80% to 90% accurate on whether a child has autism or not, once they're old enough to be imaged in the MRI scanner.
Host: Would this be something that maybe a parent is aware that something might be going on with their child and they choose to do the imaging, or would it be something that the physicians say, okay, clinically let's prove it this way, but maybe let's have a second opinion?
Dr. Jeff Anderson: Well right now we're still in the research domain with our technique, and all of the MRI tests for autism are research procedures; they are not ready to diagnose clinically yet. And one of the reasons is that when you want to diagnose autism it's usually when the child is two or three years old...
Host: Quite young.
Dr. Jeff Anderson: Yes. Usually by the time a child is three you can make a diagnosis. For us, we usually scan children and young adults that are much older, and it's not as helpful to make a diagnosis in a 14-year-old.
Host: Why would it be beneficial to diagnose using imaging at an older age?
Dr. Jeff Anderson: That's the first step in the research; it's studying patient populations that can go in the MRI scanner and where we have more data about what each one is like. It's more difficult when they're younger and we still need to work towards that.
Host: Are there different things that you're looking for in these images versus older adults and then the younger adults rather than the two year old?
Dr. Jeff Anderson: We have the idea that autism is not one disease or one condition. But it may be many different conditions, and they may differ. And it has different types of symptoms in some individuals compared to others. And so what we would love to do is be able to find specific types of autism that may respond to different treatments. And to be able to do that with brain imaging is really attractive, because that way we're actually measuring what's happening in their brain, which is more specific perhaps than what we can get just using questionnaires or watching children.
Host: What are you actually looking for in these imaging, because with clinics, like you said before, the physicians are looking for maybe communication or speech or social interaction with others. But what are you looking for in the imaging?
Dr. Jeff Anderson: Well that's what we're trying to find out. See we are actually doing the MRI scans between individuals with autism and individuals that don't have autism and we're able to find the differences. And then we see our certain subsets of those differences associated with for example poor language, or difficulty with social interaction, or with kids who have more restricted or repetitive behaviors. And if we can find those different subsets of brain findings that are associated with specific types of symptoms, then we have a marker or what's called a biomarker for finding those specific types of autism.
Host: And you cons to imaging versus clinical diagnosis?
Dr. Jeff Anderson: Well an MRI scan can be expensive, and so we're mindful of that. And we're hopeful that once we find the brain differences we can push towards less expensive means of diagnosis, like headsets or EEG or other things that may be cheaper and easier to obtain as a screening method.
Host: How long do you think this research is going to take?
Dr. Jeff Anderson: Right now I think the main issue that we are facing is that we need to push this to younger and younger age subjects that may have a harder time being in an MRI scanner.
Host: Okay, how young do you think; two?
Dr. Jeff Anderson: Well that would be great. The trouble with 1 to 7-year-olds is that they move a lot. They crawl out of the scanner; they're hard to keep in, and that's one of the biggest pitfalls. I would just hope that people realize that our tools are still a little bit limited and it's not always easy to make a diagnosis of autism. The best tools that we have right now are experienced physicians.
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