Children with an autism spectrum disorder (ASD) have difficulties communicating and relating to others, their interests are restricted, and they show repetitive behaviors, but this developmental disorder affects each individual differently and with a different degree of intensity. . In 1943 Dr. Leo Kanner published the original description of autism, which was biased towards male patients, to which is added that four times more boys than girls are diagnosed with autism, so most studies have focused in males.
New research by scientists at Stanford University (California, USA) has now found differences in the brains of girls with autism compared to boys with the disorder, suggesting that the sex when making a diagnosis. The differences, which have been identified thanks to the analysis of hundreds of brain scans with artificial intelligence techniques, were exclusive to autism, since they were not present in children with typical development.
The results of the study, which have been published in The British Journal of Psychiatry, help explain why autism symptoms are different depending on gender, and may contribute to improving ASD diagnoses in girls. “When a condition is described in a biased way, diagnostic methods are biased,” said the study’s lead author, Dr. Kaustubh Supekar, clinical assistant professor of psychiatry and behavioral sciences. “This study suggests we need to think differently.”
Improving diagnosis and treatment of autism in girls
The research analyzed the fMRI brain scans of 773 children with autism: 637 boys and 136 girls. Drawing on data collected at Stanford and public databases containing brain scans from research sites around the globe, the study authors developed an algorithm capable of distinguishing between boys and girls with 86% accuracy. When they tested the algorithm on the remaining 95 brain scans of children with autism, its accuracy in differentiating boys from girls held up. It was also tested on 976 brain scans of boys and girls without ASD and the algorithm was unable to distinguish between them, confirming that the sex differences these scientists found were unique to autism.
In the case of children with autism, it was observed that girls presented different patterns of connectivity than boys in several centers of the brain, including the motor, language and visuospatial attention systems. Differences in a group of motor areas, including the primary motor cortex, the supplementary motor area, the parietal and lateral occipital cortex, and the middle and superior temporal gyri, were the greatest between sexes.
Girls had different patterns of connectivity than boys in various brain centers, including motor, language and visuospatial attention systems
Among girls with autism, differences in motor centers were associated with the severity of their motor symptoms, meaning that girls whose brain patterns were most similar to those of boys with autism tended to have the most pronounced motor symptoms. Areas of language that differed between boys and girls with autism were also identified, and the researchers noted that earlier studies had found greater language problems in boys.
The findings, according to the study authors, should be used to improve the diagnosis and treatment of girls with ASD. “We may need different tests for women compared to men. The artificial intelligence algorithms we developed can help improve autism diagnosis in girls,” said Kaustubh Supekar, Clinical Assistant Professor of Psychiatry and Behavioral Sciences, who concludes that interventions for girls could start earlier.
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