Increased extra-axial cerebrospinal fluid and benign external hydrocephalus in early autism
Bibliographic record
Abstract
Abstract Previous studies have reported that some children with Autism Spectrum Disorder (ASD) below the age of 3-years-old exhibit increased extra-axial cerebrospinal fluid (EA-CSF) volumes, suggesting that transient early CSF circulation abnormalities may characterize a unique etiology in a sub-group of ASD children. Specifically, this sub-group was proposed to exhibit an EA-CSF to total brain volume (TBV) ratio >0.14. It is unknown whether such findings may correspond to an early radiological diagnosis of Benign external hydrocephalus (BEH), which is defined as an enlargement of CSF volumes within the subarachnoid space (SAS) during the first two years of life. Here we examined a retrospective clinical sample extracted from the National Autism Database of Israel. In 2020, ∼14% of ASD children in the database (n= 102) had completed clinical brain MRI scans at different ages before or after ASD diagnosis. Scans of 83 ASD children fulfilled quality control criteria and were compared to those of 53 age and sex matched typicality developing (TD) children who were referred to the same clinical center for similar clinical reasons. EA-CSF volume and total brain volume (TBV) were quantified from T2-weighted scans using manual labeling and compared across groups. The results revealed that ASD children scanned before the age of 2-years-old (i.e., before ASD diagnosis) exhibited significantly larger EA-CSF volumes when compared to controls (t(49)=2.89, p=0.006, Cohen’s d=0.82). No significant differences were apparent across groups at older ages. Of those scanned before the age of 2-years-old, ∼16% of the ASD children, and none of the control children, exhibited EA-CSF/TBV ratios >0.14, thereby replicating previous findings from prospective research samples. In addition, retrospective examination of the neuroradiology assessments revealed a BEH prevalence of 33% in the ASD children scanned before the age of 2-years-old, with 80% of these children exhibiting EA-CSF/TBV ratios >0.11. These findings reveal a clear relationship between quantitative EA-CSF volume analyses and qualitative BEH radiological findings, which characterize a considerable sub-group of ASD children. Accumulating evidence, therefore, suggests that BEH diagnosis in conjunction with a high EA-CSF/TBV ratio by the age of 2-years-old may be indicative of a specific ASD etiology that warrants further research and may offer unique opportunities for intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".