Original Article

Citation: Translational Psychiatry (2016) 6, e948; doi:10.1038/tp.2016.213
Published online 15 November 2016

Brain responses to biological motion predict treatment outcome in young children with autism
Open

D Yang1,2, K A Pelphrey1, D G Sukhodolsky2, M J Crowley2, E Dayan3, N C Dvornek2, A Venkataraman4, J Duncan5,6, L Staib5,6 and P Ventola2

  1. 1Autism and Neurodevelopmental Disorders Institute, The George Washington University and Children’s National Health System, Washington, DC, USA
  2. 2Child Study Center, Yale University School of Medicine, New Haven, CT, USA
  3. 3Department of Radiology and Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  4. 4Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
  5. 5Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
  6. 6Department of Biomedical Engineering, Yale University, New Haven, CT, USA

Correspondence: Dr D Yang, Autism and Neurodevelopmental Disorders Institute, The George Washington University and Children's National Health System, 2300 I St NW, Washington, DC 20052, USA, or Dr P Ventola, Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA. E-mail danielyang@gwu.edu or pamela.ventola@yale.edu

Received 11 April 2016; Revised 26 July 2016; Accepted 27 September 2016

Top

Abstract

Autism spectrum disorders (ASDs) are common yet complex neurodevelopmental disorders, characterized by social, communication and behavioral deficits. Behavioral interventions have shown favorable results—however, the promise of precision medicine in ASD is hampered by a lack of sensitive, objective neurobiological markers (neurobiomarkers) to identify subgroups of young children likely to respond to specific treatments. Such neurobiomarkers are essential because early childhood provides a sensitive window of opportunity for intervention, while unsuccessful intervention is costly to children, families and society. In young children with ASD, we show that functional magnetic resonance imaging-based stratification neurobiomarkers accurately predict responses to an evidence-based behavioral treatment—pivotal response treatment. Neural predictors were identified in the pretreatment levels of activity in response to biological vs scrambled motion in the neural circuits that support social information processing (superior temporal sulcus, fusiform gyrus, amygdala, inferior parietal cortex and superior parietal lobule) and social motivation/reward (orbitofrontal cortex, insula, putamen, pallidum and ventral striatum). The predictive value of our findings for individual children with ASD was supported by a multivariate pattern analysis with cross validation. Predicting who will respond to a particular treatment for ASD, we believe the current findings mark the very first evidence of prediction/stratification biomarkers in young children with ASD. The implications of the findings are far reaching and should greatly accelerate progress toward more precise and effective treatments for core deficits in ASD.