Auditory brainstem response in infants and children with autism spectrum disorder: A meta‐analysis of wave V

Abstract

Infants with autism spectrum disorder (ASD) were recently found to have prolonged auditory brainstem response (ABR); however, at older ages, findings are contradictory. We compared ABR differences between participants with ASD and controls with respect to age using a meta‐analysis. Data sources included MEDLINE, EMBASE, Web of Science, Google Scholar, HOLLIS, and ScienceDirect from their inception to June 2016. The 25 studies that were included had a total of 1349 participants (727 participants with ASD and 622 controls) and an age range of 0–40 years. Prolongation of the absolute latency of wave V in ASD had a significant negative correlation with age (R2 = 0.23; P = 0.01). The 22 studies below age 18 years showed a significantly prolonged wave V in ASD (Standard Mean Difference = 0.6 [95% CI, 0.5–0.8]; P < 0.001). The 3 studies above 18 years of age showed a significantly shorter wave V in ASD (SMD = −0.6 [95% CI, −1.0 to −0.2]; P = 0.004). Prolonged ABR was consistent in infants and children with ASD, suggesting it can serve as an ASD biomarker at infancy. As the ABR is routinely used to screen infants for hearing impairment, the opportunity for replication studies is extensive. Autism Res 2018, 11: 355–363. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.Lay SummaryOur analysis of previous studies showed that infants and children with autism spectrum disorder (ASD) have a slower brain response to sound, while adults have a faster brain response to sound. This suggests that slower brain response in infants may predict ASD risk. Brain response to sound is routinely tested on newborns to screen hearing impairment, which has created large data sets to afford replication of these results.

Evidence for Brainstem Contributions to Autism Spectrum Disorders

“…Third, it is the spontaneous activity of the brainstem (discussed in the section “Neurocircuitry Maturation”) that is thought to attune the auditory system long before the first auditory stimulus is propagated (reviewed in Friauf and Lohmann, 1999 ). The disruption of this developmental program may result in atypical auditory function, a behavior exhibited by many individuals with ASD ( Rosenhall et al, 1999 ; Khalfa et al, 2004 ; Miron et al, 2018 ; Otto-Meyer et al, 2018 ) and associated with autism severity ( Brandwein et al, 2015 ; Donkers et al, 2015 ). Overall, the principal role of the brainstem in hierarchical brain development suggests this region may have a major impact on how the symptoms of ASD unfold.…”

“…According to a recent meta-analysis, an increased ABR latency in youth with ASD changes into a decreased ABR latency in adults, which is indicative of an unusually fast developmental trajectory of ABR in ASD ( Miron et al, 2018 ). The rapid progression of ABR with age ( Cohen et al, 2013 ; Miron et al, 2018 ) suggests that the neurobiology supporting ASD symptoms may be highly malleable during specific periods, opening a possibility for time-sensitive interventions. In the future, longitudinal studies investigating age-related specificity of brainstem-based behaviors in ASD may help identify vulnerable developmental stages when intervention would be able to re-wire emerging neurocircuitry.…”

Atypical longitudinal development of speech‐evoked auditory brainstem response in preschool children with autism spectrum disorders

“…The amplitude of wave I was larger than that of wave V in more children (2-6 years of age) with ASD than in the age-matched TD controls [Santos et al, 2017]. Miron and his colleagues performed a meta-analysis on the recent literature regarding age-related changes in the latencies of ABR waves and reported that wave V latency was significantly prolonged across studies in children with ASD and was correlated negatively with age in ASD patients [Miron, Beam, & Kohane, 2017]. Taken together, the previous findings on the latency and amplitude abnormalities in the click-ABR indicate aberrant brainstem processing of the click sound in ASD.…”

An Exploratory Study of Imagining Sounds and “Hearing” Music in Autism

“…Contradictory findings have also been observed in neurophysiological and event-related potential (ERP) studies of pitch processing in ASD. A recent meta-analysis of results using these techniques suggests that infants and children (but not adults) with ASD have impaired auditory brainstem response to sound (Miron et al 2018). There are mixed reports regarding cortical sound encoding (P1-N1-P2), with enhanced (Ferri et al 2003), normal (Čeponienė et al 2003), and impaired patterns (Roberts et al 2011;Whitehouse and Bishop 2008) all reported.…”