Prolonged Auditory Brainstem Response in Universal Hearing Screening of Newborns with Autism Spectrum Disorder

Abstract

Previous studies report prolonged auditory brainstem response (ABR) in children and adults with autism spectrum disorder (ASD). Despite its promise as a biomarker, it is unclear whether healthy newborns who later develop ASD also show ABR abnormalities. In the current study, we extracted ABR data on 139,154 newborns from their Universal Newborn Hearing Screening, including 321 newborns who were later diagnosed with ASD. We found that the ASD newborns had significant prolongations of their ABR phase and V‐negative latency compared with the non‐ASD newborns. Newborns in the ASD group also exhibited greater variance in their latencies compared to previous studies in older ASD samples, likely due in part to the low intensity of the ABR stimulus. These findings suggest that newborns display neurophysiological variation associated with ASD at birth. Future studies with higher‐intensity stimulus ABRs may allow more accurate predictions of ASD risk, which could augment the universal ABR test that currently screens millions of newborns worldwide. Lay Summary Children with autism spectrum disorder (ASD) have slow brain responses to sounds. We examined these brain responses from newborns' hearing tests and found that newborns who were later diagnosed with autism also had slower brain responses to sounds. Future studies might use these findings to better predict autism risk, with a hearing test that is already used on millions of newborns worldwide.

Central Auditory and Vestibular Dysfunction Are Key Features of Autism Spectrum Disorder

“…The ABR has provided the most insight into the function of brainstem centers in ASD. The majority of studies of the ABR in subjects with ASD over the past 40 years provide evidence that subjects with ASD have smaller amplitudes in waves I, II, III, IV, and V (Ornitz et al, 1972 ; Gillberg et al, 1983 ; Martineau et al, 1987 , 1992 ; Klin, 1993 ), longer latencies between waves I-III and waves I-V (Taylor et al, 1982 ), and longer latencies/slower responses (Ornitz, 1969 ; Student and Sohmer, 1978 ; Rosenblum et al, 1980 ; Sohmer, 1982 ; Tanguay et al, 1982 ; Gillberg et al, 1983 ; Sersen et al, 1990 ; Thivierge et al, 1990 ; Wong and Wong, 1991 ; Maziade et al, 2000 ; Kwon et al, 2007 ; Roth et al, 2012 ; Azouz et al, 2014 ; Taş et al, 2017 ; Miron et al, 2018 , 2021 ; Ramezani et al, 2019 ; Delgado et al, 2021 ; reviewed in Talge et al, 2018 ). These longer latency and lower amplitude responses have been attributed to the immaturity of brainstem circuits (Li et al, 2020 ).…”

Optimal time lags from causal prediction model help stratify and forecast nervous system pathology

“…Unlike the vestibular handicap gait issues, the latter are linked to subcortical neurodegeneration rather than higher level sensory perception and integration. Given the current ASD definition relying on higher-level perceptual and sensory issues, and the high prevalence of ear infection and auditory brain stem issues since early infancy 44 , it is possible that their gait problems align with the vestibular integration, rather than the subcortical motor control problems. This hypothesis is addressed below:…”

Optimal Time Lags from Causal Prediction Model Help Stratify and Forecast Nervous System Pathology

“…Given the current ASD definition relying on higher-level perceptual and sensory issues, and the high prevalence of ear infection and auditory brain stem issues since early infancy 44 , it is possible that their gait problems align with the vestibular integration, rather than the subcortical motor control problems. This hypothesis is addressed below: First, we represent the DHI participants in a normalized parameter space spanned by feet causal forces (defined by the ratio of causality divided by the corresponding time lags), and average timings.…”