Context
Autism is an etiologically heterogeneous neurodevelopmental disorder for which there is no known unifying etiology or pathogenesis. Many conditions of atypical development can lead to autism, including fragile X syndrome (FXS), which is presently the most common known single gene cause of autism.
Objective
To examine whole-brain morphometric patterns that discriminate young boys with FXS from those with idiopathic autism (iAUT), as well as control participants.
Design
Cross sectional, in-vivo neuroimaging study.
Setting
Academic medical centers.
Patients
Young boys (n=165, 1.57-4.15 years) diagnosed as FXS or iAUT as well as typically developing (TD) and idiopathic developmentally delayed (DD) controls.
Main Outcome measures
Univariate voxel-based morphometric (VBM) analyses, VBM multivariate pattern classification (linear support vector machine) and clustering analyses (self organizing map).
Results
We found that frontal and temporal grey and white matter regions often implicated in social cognition, including the medial prefrontal cortex, orbitofrontal cortex, superior temporal region, temporal pole, amygdala, insula, and dorsal cingulum, were aberrant in FXS and iAUT as compared to controls. However, these differences were in opposite directions for FXS and iAUT relative to controls; in general, greater volume was seen in iAUT compared to controls, who in turn had greater volume than FXS. Multivariate analysis showed that the overall pattern of brain structure in iAUT generally resembled that of the controls more than FXS, both with and without AUT (FXS+A, FXS-A, respectively).
Conclusions
Our findings demonstrate that FXS and iAUT are associated with distinct neuroanatomical patterns, and further underscores the neurobiological heterogeneity of iAUT.