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Towards robust and replicable sex differences in the intrinsic brain function of autism

  • Dorothea L Floris
  • , José O A Filho
  • , Meng-Chuan Lai
  • , Steve Giavasis
  • , Marianne Oldehinkel
  • , Maarten Mennes
  • , Tony Charman
  • , Julian Tillmann
  • , Guillaume Dumas
  • , Christine Ecker
  • , Flavio Dell'Acqua
  • , Tobias Banaschewski
  • , Carolin Moessnang
  • , Simon Baron-Cohen
  • , Sarah Durston
  • , Eva Loth
  • , Declan G M Murphy
  • , Jan K Buitelaar
  • , Christian F Beckmann
  • , Michael P Milham
  • Adriana Di Martino

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Marked sex differences in autism prevalence accentuate the need to understand the role of biological sex-related factors in autism. Efforts to unravel sex differences in the brain organization of autism have, however, been challenged by the limited availability of female data.

METHODS: We addressed this gap by using a large sample of males and females with autism and neurotypical (NT) control individuals (ABIDE; Autism: 362 males, 82 females; NT: 409 males, 166 females; 7-18 years). Discovery analyses examined main effects of diagnosis, sex and their interaction across five resting-state fMRI (R-fMRI) metrics (voxel-level Z > 3.1, cluster-level P < 0.01, gaussian random field corrected). Secondary analyses assessed the robustness of the results to different pre-processing approaches and their replicability in two independent samples: the EU-AIMS Longitudinal European Autism Project (LEAP) and the Gender Explorations of Neurogenetics and Development to Advance Autism Research.

RESULTS: Discovery analyses in ABIDE revealed significant main effects of diagnosis and sex across the intrinsic functional connectivity of the posterior cingulate cortex, regional homogeneity and voxel-mirrored homotopic connectivity (VMHC) in several cortical regions, largely converging in the default network midline. Sex-by-diagnosis interactions were confined to the dorsolateral occipital cortex, with reduced VMHC in females with autism. All findings were robust to different pre-processing steps. Replicability in independent samples varied by R-fMRI measures and effects with the targeted sex-by-diagnosis interaction being replicated in the larger of the two replication samples-EU-AIMS LEAP.

LIMITATIONS: Given the lack of a priori harmonization among the discovery and replication datasets available to date, sample-related variation remained and may have affected replicability.

CONCLUSIONS: Atypical cross-hemispheric interactions are neurobiologically relevant to autism. They likely result from the combination of sex-dependent and sex-independent factors with a differential effect across functional cortical networks. Systematic assessments of the factors contributing to replicability are needed and necessitate coordinated large-scale data collection across studies.

Original languageEnglish
Article number19
JournalMolecular Autism
Volume12
Issue number1
DOIs
Publication statusPublished - 1 Mar 2021

Keywords

  • Autism spectrum disorder
  • Replication
  • Resting-state functional connectivity
  • Robustness
  • Sex differences
  • Voxel-mirrored homotopic connectivity

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