The Implications of Brain MRI in Autism Spectrum Disorder

Abstract

Our objective was to describe the types of providers who refer children with autism spectrum disorder (ASD) for brain magnetic resonance imaging (MRI), the referral reason, and MRI results. The most common referral reasons were autism spectrum disorder with seizures (33.7%), autism spectrum disorder alone (26.3%), and autism spectrum disorder with abnormal neurologic examination or preexisting finding (24%). Neurology (62.5%), general pediatric (22.3%), and developmental/behavioral practitioners (8.9%) referred the most patients. The prevalence of definite pathology was highest in children referred for autism spectrum disorder with abnormal neurologic examination/preexisting finding (26.2%, 95% CI: 16.8%-36%), headaches (25.7%, 95% CI: 11.2%-40.2%), or seizures (22%, 95% CI: 14.6%-29.5%), and was lowest in children referred for autism spectrum disorder alone (6.5%, 95% CI: 1.5%-11.6%). We concluded that there is a low prevalence of definite pathology in children with autism spectrum disorder undergoing brain MRI. In children with abnormal neurologic examination or preexisting finding, seizures, or headaches, one may consider performing brain MRI given the higher prevalence of pathology.

Procedural sedation in children with autism spectrum disorders: A survey of current practice patterns of the society for pediatric sedation members

“…Despite a majority of the programs performing >1000 sedations per year, only half of the program medical directors believed that their staff felt extremely comfortable with sedating children with autism spectrum disorders. As expected, procedural sedation was needed to accomplish a variety of studies, with most children with autism spectrum disorders undergoing radiologic imaging to evaluate comorbidities, such as seizure disorder and headaches …”

“…As expected, procedural sedation was needed to accomplish a variety of studies, with most children with autism spectrum disorders undergoing radiologic imaging to evaluate comorbidities, such as seizure disorder and headaches. 9 Most of the programs in this survey relied on distraction, the involvement of parents and child life specialists, a higher nurse-topatient ratio, and physical restraint techniques to complete sedation. Counts do not sum to total of completed surveys (N = 47) because more than 1 answer choice could be selected.…”

“…Many medical services such as radiologic imaging, neurophysiologic studies, phlebotomy, and other procedures require procedural sedation . Children with autism spectrum disorders pose challenges for sedationists and anesthesiologists because of a variety of behavioral, sensory, and communication issues . Children with autism spectrum disorders often have comorbidities such as epilepsy that require frequent emergency department visits, hospitalization, radiologic imaging, or blood work .…”

“…[5][6][7] Children with autism spectrum disorders pose challenges for sedationists and anesthesiologists because of a variety of behavioral, sensory, and communication issues. [8][9][10] Children with autism spectrum disorders often have comorbidities such as epilepsy that require frequent emergency department visits, hospitalization, radiologic imaging, or blood work. 11,12 Most procedures, including magnetic resonance imaging, phlebotomy, echocardiogram, and auditory brainstem reflex studies require sedation to provide patient cooperation and immobilization in children with autism spectrum disorders.…”

Brain Magnetic Resonance Findings in 117 Children with Autism Spectrum Disorder under 5 Years Old

“…Indeed, they show a higher prevalence of pathological findings on MRI. However, if the child has isolated ASD, MRI is unlikely to reveal a definite disease [ 69 ].…”