Towards a neuroanatomy of autism: A systematic review and meta-analysis of structural magnetic resonance imaging studies

Background. - Structural brain abnormalities have been described in autism but studies are often small and contradictory. We aimed to identify which brain regions can reliably be regarded as different in autism compared to healthy controls. Method. - A systematic search was conducted for magnetic resonance imaging studies of regional brain size in autism. Data were extracted and combined using random effects meta-analysis. The modifying effects of age and IQ were investigated using meta-regression. Results. - The total brain, cerebral hemispheres, cerebellum and caudate nucleus were increased in volume, whereas the corpus callosurn area was reduced. There was evidence for a modifying effect of age and IQ on the cerebellar vermal lobules VI-VII and for age on the arnygdala. Conclusions. - Autism may result from abnormalities in specific brain regions and a global lack of integration due to brain enlargement. Inconsistencies in the literature partly relate to differences in the age and IQ of study populations. Some regions may show abnormal growth trajectories. (c) 2007 Elsevier Masson SAS. All rights reserved.