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J Psychiatr Res. 2019 Apr;111:140-144. doi: 10.1016/j.jpsychires.2019.02.001. Epub 2019 Feb 5.

A pilot investigation of neuroimaging predictors for the benefits from pivotal response treatment for children with autism.

Author information

1
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: hegartyj@stanford.edu.
2
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: ggengoux@stanford.edu.
3
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: kbe@stanford.edu.
4
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: mmillan2@stanford.edu.
5
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, 600 16th Street, San Francisco, CA, 94158, USA. Electronic address: serena.tamura@ucsf.edu.
6
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA; Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Central, WI, 333 Pine Ridge Blvd, Wausau, WI, 54401, USA. Electronic address: skarve@mcw.edu.
7
Department of Human Biology, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA. Electronic address: maggiedr@stanford.edu.
8
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: jenphil@stanford.edu.
9
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA. Electronic address: hardanay@stanford.edu.

Abstract

Children with autism spectrum disorder (ASD) frequently exhibit language delays and functional communication deficits. Pivotal response treatment (PRT) is an effective intervention for targeting these skills; however, similar to other behavioral interventions, response to PRT is variable across individuals. Thus, objective markers capable of predicting treatment response are critically-needed to identify which children are most likely to benefit from this intervention. In this pilot study, we investigated whether structural neuroimaging measures from language regions in the brain are associated with response to PRT. Children with ASD (n = 18) who were receiving PRT to target their language deficits were assessed with MRI at baseline. T1-weighted images were segmented with FreeSurfer and morphometric measures of the primary language regions (inferior frontal (IFG) and superior temporal (STG) gyri) were evaluated. Children with ASD and language deficits did not exhibit the anticipated relationships between baseline structural measures of language regions and baseline language abilities, as assessed by the number of utterances displayed during a structured laboratory observation (SLO). Interestingly, the level of improvement on the SLO was correlated with baseline asymmetry of the IFG, and the size of the left STG at baseline was correlated with the level of improvement on standardized parental questionnaires. Although very preliminary, the observed associations between baseline structural properties of language regions and improvement in language abilities following PRT suggest that neuroimaging measures may be able to help identify which children are most likely to benefit from specific language treatments, which could help improve precision medicine for children with ASD.

KEYWORDS:

Biomarker; Communication; Early intervention; Inferior frontal; Language; Superior temporal

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