Autism spectrum disorder, functional MRI and MR spectroscopy: possibilities and challenges

BACKGROUND: In this article we provide an overview of the use of the functional magnetic resonance imaging (fMRI) and MR spectroscopy (MRS) in studies of autism spectrum disorders (ASD). We moreover provide preliminary data using these measures in cases of children with ASD and healthy controls. A hypothesis was that ASD children would show aberrant brain activation in the prefrontal and parietal cortex in an oddball stimulus situation, with predictable and unpredictable deviant tone stimuli, as an index of resistance to change in the ASD children. We also hypothesized that glutamate and GABA metabolite levels would differ between the two groups. METHODS: fMRI images were acquired from a GE Signa HDx 3T MR scanner, as were the MRS data. Behavioral data were acquired as response accuracy to the deviant tone stimulus. The tone stimuli were presented in a standard fMRI ON-OFF box-car paradigim. RESULTS: The fMRI results showed reduced brain activation in the ASD cases compared to the controls, preferably in the inferior and superior frontal gyrus, posterior temporal lobe, and superior and inferior parietal lobule. These areas make up an effort mode network (EMN), being activated in response to cognitive effort. The MRS results also showed differences between the groups. DISCUSSION: The results are discussed in a theoretical framework of resistance to unexpected changes in the environment in ASD children, and how this could have a neurobiological underpinning. The results are also discussed in relation to the brain-gut link, and the possibility that ASD may have a microbial link. A limitation with the study is the few cases reported and the preliminary quality of the results.