Head circumference is an independent clinical finding associated
with autism.
Miles JH, Hadden LL, Takahashi TN, Hillman RE.
Division of Medical Genetics, The Children's Hospital, University of
Missouri-Columbia, 65212, USA. milesjh@missouri.edu
Occipitofrontal circumference (OFC) is one of the few physical findings in
autism that varies significantly from the norm and is distinct and measurable.
As part of a study of genetic heterogeneity of autism, we scrutinized data from
a large sample of patients with idiopathic autism (N = 137), using OFC as the
categorizing variable. The OFC standard deviation (OFCSD) values of the autistic
propositi (0.61+/-1.6) varied significantly from that of the normal population
(0.0+/-1.0), (P<0.001). Comparison of the macrocephalic (OFCSD > 2.0, N = 32)
with the normocephalic individuals (-2 SD < OFCSD < +2 SD, N = 95) showed no
significant differences in sex ratio, morphological status, IQ, seizure
prevalence, or recurrence risks. The macrocephalic individuals were slightly
less apt than those with normocephaly to have a family history of Attention
Deficit Hyperactivity Disorder (ADHD) (P<0.05). Each clinical subgroup of autism
propositi, defined on the basis of phenotypic status, type of onset, seizure
history, or IQ, had a higher than normal mean OFC indicating that macrocephaly
is an independent clinical trait in autism. As in the non-autistic population,
macrocephaly was highly familial with 45% of the macrocephalic and 37% of the
normocephalic propositi having at least one macrocephalic parent. Microcephaly,
however, was an independent significant variable that predicted the presence of
other phenotypic or genetic traits and outcome. The microcephalic patients were
more likely to have abnormal physical morphology, structural brain
malformations, lower IQ, and seizures. Their sex ratio was closer to normal, and
their relatives had a higher incidence of seizures.
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