A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Winter 2024 | Number 1, Volume 38

Perivascular spaces, cerebral spinal fluid volume in infancy may play a role in ASD and sleep

The brain contains fluid-filled compartments called perivascular spaces that surround blood vessels and allow cerebral spinal fluid (CSF) to flush out neuroinflammatory chemicals and other waste. A new study suggests that infants with abnormally large perivascular spaces have a significantly elevated likelihood of developing autism spectrum disorders (ASD).

Dea Garic and colleagues, who conducted the study, collected data from three groups of infants:

The researchers analyzed 870 magnetic resonance imaging (MRI) scans of the infants’ brains to measure their perivascular space size and CSF volume at six, 12, and 24 months of age. They found that 30% of the infants who later developed ASD had they were 12 months of age, and nearly half of the infants diagnosed with ASD had enlarged perivascular spaces by 24 months of age. Infants with elevated odds for ASD who had enlarged perivascular spaces at 24 months had a 2.2 times greater likelihood of being diagnosed with ASD compared to other children with elevated odds for ASD.

The researchers found that Infants with elevated odds for ASD who had enlarged perivascular spaces at 24 months of age had 2.2 times greater odds of developing ASD compared to other children with elevated odds for ASD.

“Our findings were striking, given that neuroradiologists typically view enlarged perivascular spaces as a sign of neurodegeneration in adults, but this study reported it in toddlers,” Garic says. “This is an important aspect of brain development in the first years of life that should be monitored.”

In addition, the researchers found that excess CSF volume at six months of age was associated with enlarged perivascular spaces at 24 months. This suggests, the researchers hypothesize, that impaired CSF circulation may lead to an accumulation of CSF and to enlarged perivascular spaces.

Because research suggests a link between enlarged perivascular spaces and sleep problems, Garic and colleagues examined data collected on a subset of the children approximately eight years after their initial evaluations. The results suggest, they say, that having enlarged perivascular spaces at 24 months of age “was associated with more frequent night disturbances regardless of familial likelihood or diagnosis of autism.”

Garic comments, “Since autism is so highly linked with sleep problems, we were in this unique position to examine CSF dynamics and sleep. It was really striking to observe such a strong association separated by such a long period of time over childhood. But it really shows how perivascular spaces not only have an effect early in life, but they can have long-term effects, too.”


Citations

“Enlarged perivascular spaces in infancy and autism diagnosis, cerebrospinal fluid volume, and later sleep problems,” Dea Garic, Robert C. McKinstry, Joshua Rutsohn, Rebecca Slomowitz, Jason Wolff, Leigh C. MacIntyre, Leigh Anne H. Weisenfeld, Sun Hyung Kim, Juhi Pandey, Tanya St. John, Annette M. Estes, Robert T. Schultz, Heather C. Hazlett, Stephen R. Dager, Kelly N. Botteron, Martin Styner, Joseph Piven, and Mark D. Shen, JAMA Network Open, December 19, 2023 (free online). Address: Dea Garic, Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, 101 Renee Lynne Ct, Carrboro, NC 27510, [email protected].

—and—

“Enlarged spaces in infant brains linked to higher risk of autism, sleep problems,” news release, Kendall Daniels, University of North Carolina at Chapel Hill School of Medicine, December 19, 2023.