Abstract:
Tentative results from feasibility analyses are critical for planning future randomized control trials (RCTs) in the emerging field of neural biomarkers of behavioral interventions. The current feasibility study used MRI-derived diffusion imaging data to investigate whether it would be possible to identify neural biomarkers of a behavioral intervention among people diagnosed with autism spectrum disorder (ASD). The corpus callosum has been linked to cognitive processing and callosal abnormalities have been previously found in people diagnosed with ASD. We used a case-control design to evaluate the association between the type of intervention people diagnosed with ASD had previously received and their current white matter integrity in the corpus callosum. Twenty-six children and adolescents with ASD, with and without a history of parent-managed behavioral intervention, underwent an MRI scan with a diffusion data acquisition sequence. We conducted tract-based spatial statistics and a region of interest analysis. The fractional anisotropy values (believed to indicate white matter integrity) in the posterior corpus callosum was significantly different across cases (exposed to parent-managed behavioral intervention) and controls (not exposed to parent-managed behavioral intervention). The effect was modulated by the intensity of the behavioral intervention according to a dose-response relationship. The current feasibility case-control study provides the basis for estimating the statistical power required for future RCTs in this field. In addition, the study demonstrated the effectiveness of purposely-developed motion control protocols and helped to identify regions of interest candidates. Potential clinical applications of diffusion tensor imaging in the evaluation of treatment outcomes in ASD are discussed.
摘要:
可行性分析的初步结果对于在行为干预的神经生物标志物的新兴领域规划未来的随机对照试验(RCT)至关重要。当前的可行性研究使用MRI衍生的扩散成像数据来研究是否有可能在被诊断为自闭症谱系障碍(ASD)的人群中识别行为干预的神经生物标志物。call体与认知过程有关,并且先前在被诊断为ASD的人中发现了call体异常。我们使用病例对照设计来评估先前被诊断为ASD的干预者的类型与他们当前的call体白质完整性之间的关联。26名患有ASD的儿童和青少年,有或没有父母管理的行为干预史,用扩散数据采集序列进行MRI扫描.我们进行了基于道的空间统计和感兴趣区域分析。在病例(暴露于父母管理的行为干预)和对照(未暴露于父母管理的行为干预)之间,call体后部的各向异性值(被认为表明白质完整性)显着不同。根据剂量反应关系,通过行为干预的强度来调节效果。当前的可行性案例对照研究为估算该领域未来RCT所需的统计能力提供了基础。此外,该研究证明了有目的地制定的运动控制方案的有效性,并有助于确定感兴趣的候选区域.讨论了扩散张量成像在评估ASD治疗结果中的潜在临床应用。