Overconnectivity of the right Heschl's and inferior temporal gyrus correlates with symptom severity in preschoolers with autism spectrum disorder

Previous studies have reported varying findings regarding the association of brain connectivity in autism spectrum disorder (ASD) with overconnectivity, underconnectivity, or both. Despite the emerging understanding that ASD is a developmental disconnection syndrome, very little is known about structural brain networks in preschool-aged children with low-functioning ASD. We aimed to investigate the structural brain connectivity of low-functioning ASD using diffusion magnetic resonance imaging and graph theory to examine alterations in different brain network topologies and identify any correlations with the clinical severity of ASD in preschool-aged children. Fifty-two preschool-aged children (28 with ASD and 24 with typical development) were included in the analysis. Graph-based network analysis was performed to examine the global and local structural brain networks. Nodal network measures exhibited increased nodal strength in the right Heschl's gyrus, which was positively associated with all autistic clinical symptoms (Autism Diagnostic Observation Schedule and Childhood Autism Rating Scale [CARS]). The nodal strength of the right inferior temporal gyrus showed a moderate correlation with the CARS score. Using network-based statistics, we identified a subnetwork with increased connections encompassing the right Heschl's gyrus and the right inferior temporal gyrus in preschool-aged children with ASD. The asymmetric value in the inferior temporal gyrus exhibited right dominance of nodal strength in children with ASD compared to that in typically developing children. Our findings support the theory of aberrant brain growth and overconnectivity as the underlying mechanism of ASD and provides new insights into potential regional biomarkers that can detect low-functioning ASD in preschool-aged children.