A brain scan that detects autism in adults could mean much more straightforward diagnosis of the condition, scientists say.
Experts at King's College London said the scan - tested on 40 people - identified tiny but crucial signs of autism, only detectable by computer.
Current methods of diagnosis can be lengthy and expensive.But some experts say further research will be needed before the new technique can be widely used.
Autism Spectrum Disorder affects an estimated 1 in every 100 adults in the UK, most of them men. It varies from mild to very severe, and people with the condition can find the world appears chaotic and hard to understand.
Conventional diagnosis involves a team of experts who analyse behaviour and make a complex series of assessments.The Medical Research Council study looked at 20 non-autistic adults and 20 adults with Autism Spectrum Disorder (ASD).
They were initially diagnosed using traditional methods, and then given a 15 minute brain MRI scan. The images were reconstructed into 3D and were fed into a computer, which looked for tiny but significant differences.
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End Quote Dr Christine Ecker Lead researcherIt could help to alleviate the need for the emotional, time consuming and expensive diagnostic process which ASD patients and families currently have to endure”
The researchers detected autism with over 90% accuracy, the Journal of Neuroscience reports.
"What the computer can do very quickly is to see that a patient has autism," said Professor Declan Murphy from the Institute of Psychiatry, who supervised the research, "even though their brain, to the naked eye, looks very normal."Dr Christine Ecker, who led the study, said she hoped the findings might result in a widely available scan to test for autism.
"It could help to alleviate the need for the emotional, time consuming and expensive diagnostic process which ASD patients and families currently have to endure," she said.
Once a patient has a diagnosis, he or she is able to access help and support with managing the condition.
Visible confirmation
Joe Powell was diagnosed with Asperger's syndrome, a form of autism, 14 years ago. Before his diagnosis, he didn't speak at all.
Since then, he says he's made big progress in managing his condition.
His brain scan confirms his ASD. He says seeing his diagnosis charted in black and white made a big difference to him.
"You need to physically see it," he says.
"I know the autism is still there. The progress I've made in managing my condition is real, but it's still there."
The research team is now looking at whether the test would be effective on children.
Nicholas Joy describes what an Asperger's diagnosis meant for his health and treatment
However, they say without more awareness among doctors, it may be of limited use.
"There's still a woeful lack of awareness in GPs' knowledge of autism," said NAS centre director, Carol Povey.
"People with autism are often dismissed when they go to their GPs for help, so we have to make sure front-line professionals have awareness of autism so they can make appropriate referrals."
Professor Uta Frith from UCL Institute of Cognitive Neuroscience, said much more work would be needed before the scans could be used for diagnosis. "This study shows that the subtle brain abnormalities associated with autism show a distinctive pattern," she said. "It is crucial that we learn more about what the brain abnormalities mean."
News highlights
Adult autism diagnosis by brain scan
11 Aug 2010, PR 172/10The team used an MRI scanner to take pictures of the brain’s grey matter. A separate imaging technique was then used to reconstruct these scans into 3D images that could be assessed for structure, shape and thickness – all intricate measurements that reveal Autism Spectrum Disorder (ASD) at its root. By studying the complex and subtle make-up of grey matter in the brain, the scientists can use biological markers, rather than personality traits, to assess whether or not a person has ASD.
ASD is a lifelong and disabling condition caused by abnormalities in brain development. It affects about one per cent of the UK population (half a million people), the majority of these being men (4:1 male to female). Until now, diagnosis has mainly relied on personal accounts from friends or relatives close to the patient – a long and drawn-out process hinged on the reliability of this account and requiring a team of experts to interpret the information.
Dr Christine Ecker, a Lecturer in the Department of Forensic and Neurodevelopmental Sciences from the IoP, who led the study, said: ‘The value of this rapid and accurate tool to diagnose ASD is immense. It could help to alleviate the need for the emotional, time consuming and expensive diagnosis process which ASD patients and families currently have to endure. We now look forward to testing if our methods can also help children.’
Improved quality of life
Professor Declan Murphy, Professor of Psychiatry and Brain Maturation at the IoP, who supervised the research, said: ‘Simply being diagnosed means patients can take the next steps to get help and improve their quality of life. People with autism are affected in different ways; some can lead relatively independent lives while others need specialist support or are so severely affected they cannot communicate their feelings and frustrations at all. Clearly the ethical implications of scanning people who may not suspect they have autism needs to be handled carefully and sensitively as this technique becomes part of clinical practice.’
Professor Christopher Kennard, Chair of the Medical Research Council’s (MRC) Neuroscience and Mental Health funding board, said: ‘Bringing together the knowledge gained from neuroscience in the laboratory and careful clinical and neuropsychological evaluation in the clinic has been key to the success of this new diagnostic tool. In fact, this approach to research is a crucial theme throughout the MRC’s strategy. We know that an investment like this can dramatically affect the quality of life for patients and their families. The more we understand about the biological basis of autism, the better equipped we will be to find new ways of treating those affected in the future.’
The research studied 20 healthy adults, 20 adults with ASD, and 19 adults with ADHD. All participants were males aged between 20 and 68 years. After first being diagnosed by traditional methods (an IQ test, psychiatric interview, physical examination and blood test), scientists used the newly-developed brain scanning technique as a comparison. The brain scan was highly effective in identifying individuals with autism and may therefore provide a rapid diagnostic instrument, using biological signposts, to detect autism in the future.
The research was undertaken using the A.I.M.S. (Autism Imaging Multicentre Study) Consortium, which is funded by the MRC. Support funding was also provided by the Wellcome Trust and National Institute for Health Research (NIHR).
The paper, ‘Describing the brain in autism in five dimensions - MRI-assisted diagnosis using a multi-parameter classification approach’ is published in the Journal of Neuroscience today.
Notes to editors
At present, the Bethlam/ Maudsley Hospital clinic does not offer private assessments or scans. We recommend that people ask their GP or health professional for a referral letter to the Behavioural Genetics Clinic at the Bethlam/Maudsley Hospital, where the patient can then be seen and scanned. More information about the hospital can be found at: www.slam.nhs.uk
King's College London
King's College London is one of the top 25 universities in the world (Times Higher Education 2009) and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,000 students (of whom more than 8,600 are graduate students) from nearly 140 countries, and some 5,500 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.
