Dysfunction of the Auditory Brainstem as a Neurophysiology Subtype of Autism Spectrum Disorder

Jierong Chen; Zhen Wei; Chun Liang; Binguang Liu; Jimin Guo; Xuejun Kong; Minshi Huang; Ziwen Peng; Guobin Wan

doi:10.3389/fnins.2021.637079

Dysfunction of the Auditory Brainstem as a Neurophysiology Subtype of Autism Spectrum Disorder

Front Neurosci. 2021 Mar 17:15:637079. doi: 10.3389/fnins.2021.637079. eCollection 2021.

Authors

Jierong Chen¹, Zhen Wei¹, Chun Liang¹, Binguang Liu², Jimin Guo², Xuejun Kong³, Minshi Huang¹, Ziwen Peng⁴, Guobin Wan¹

Affiliations

¹ Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
² Department of Radiology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
³ Martinos Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States.
⁴ Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.

Abstract

Autism spectrum disorder (ASD) is very heterogeneous, particularly in language. Studies have suggested that language impairment is linked to auditory-brainstem dysfunction in ASD. However, not all ASD children have these deficits, which suggests potential subtypes of ASD. We classified ASD children into two subtypes according to their speech-evoked auditory brainstem response (speech-ABR) and explored the neural substrates for possible subtypes. Twenty-nine children with ASD and 25 typically developing (TD) peers were enrolled to undergo speech-ABR testing and structural magnetic resonance imaging (sMRI). There were significant differences between the ASD group and TD group in surface area, cortical volume and cortical thickness. According to speech-ABR results, ASD participants were divided into the ASD-typical (ASD-T) group and ASD-atypical (ASD-A) group. Compared with the ASD-T group, the ASD-A group had a lower score in language of the Gesell Developmental Diagnosis Scale (GDDS), increased left rostral middle frontal gyrus (lRMFG) area and decreased local gyrification index of the right superior temporal gyrus. GDDS-language and surface area of lRMFG were correlated to the wave-A amplitude in ASD. Surface area of lRMFG had an indirect effect on language performance via alteration of the wave-V amplitude. Thus, cortical deficits may impair language ability in children with ASD by causing subcortical dysfunction at preschool age. These evidences support dysfunction of the auditory brainstem as a potential subtype of ASD. Besides, this subtype-based method may be useful for various clinical applications.

Keywords: autism spectrum disorder; mediation; neuroimaging; neurophysiology; speech-ABR; subtype.