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Publication
Neuroimagem nas Perturbações de Espetro de Autismo
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Authors
Abstract(s)
Introdução: As Perturbações de Espetro de Autismo (PEA) são um grupo de síndromes
que têm em comum uma deficiente interação social, comunicação, comportamentos
estereotipados e/ou interesses restritos e défice cognitivo. As PEA afetam atualmente
cerca de 0,5-1 a cada 1000 crianças com prevalência no sexo masculino. As atuais
diretrizes indicam que o diagnóstico das PEA deve ser maioritariamente clínico, sem
recurso regular a meios complementares de diagnóstico (MCD) imagiológicos. A
significativa afetação das atividades da vida diária e qualidade de vida de indivíduos com
PEA, origina a premência de um diagnóstico precoce e preciso, culminando numa ação
terapêutica atempada.
Objetivos: Demonstrar qual o papel dos MCD de neuroimagem como Ressonância
Magnética (RM), Tomografia Computorizada (TC) e exames de Medicina Nuclear (MN),
no diagnóstico de PEA.
Materiais e Métodos: Para a realização desta revisão sistemática, foram utilizados
motores de busca para a obtenção de artigos datados entre 01 de janeiro de 2013 e 31 de
dezembro de 2023. Foi utilizada a metodologia PRISMA-P 2015 e a aplicação da
ferramenta Robins Tool-I para avaliação de presença de viés.
Resultados: Após análise dos artigos selecionados, sublinho que a maioria dos estudos
foram efetuados em adultos do sexo masculino. Nestes constataram-se alterações
funcionais e/ou anatómicas, contudo nem sempre concordantes aquando comparação.
Importa também, salientar a ausência de estudos na área da Tomografia computorizada
por emissão de fotão único (SPECT-CT) no período de pesquisa, comparativamente com
a variedade de estudos de Tomografia de Emissão de Positrões (PET), TC, e com enfoque
na RM.
Conclusões: Conclui-se que a investigação, os estudos efetuados e respetivos
resultados/conclusões obtidos na área de PEA têm vindo a aumentar e esta é, sem
dúvida, uma área de interesse e promissora. Contudo, num futuro próximo, será
necessário que a investigação abranja a idade pediátrica, bem como indivíduos do sexo
feminino. A melhoria destas lacunas poderá expandir o conhecimento e obter resultados
de maior robustez, neste grupo de síndromes. Para além do exposto, acresce a
necessidade de um maior número de estudos por forma a constatar o benefício do uso de MCD imagiológicos, no algoritmo diagnóstico de PEA. Paralelamente, deverão ser
realizadas análises socio-económicas e logísticas acerca dos benefícios da sua utilização.
Introduction: Autism Spectrum Disorder (ASD) is a group of diseases with some characteristics in common, such as deficient social interaction, communication skills, stereotyped behaviors and/or restricted interests and cognitive impairment. ASD has a prevalence of 0,5 – 1 in 1000 children, mostly boys. State of the art guidelines recommend that the diagnosis of ASD should be mostly clinical, without the use of imaging. Day to day activities are largely affected by ASD and so is the quality of life of the individual. For this reason, an early and precise diagnosis is crucial since it will contribute to an adequate treatment response. Objectives: Demonstrate the role of neuroimaging such as Magnetic Resonance (MR), Computerized Tomography (CT) and Nuclear Medicine imaging in the diagnosis of ASD. Methods: For the elaboration of this systematic review, several search tools were used for obtaining articles from 1st January of 2013 until 31st of December of 2023. The Prisma-P 2015 tool and Robins Tool-I for estimating the presence of bias in each article were also used. Results: After analyzing the selected articles, it is relevant to highlight the fact that most studies were performed on male subjects. These, have shown functional and/or anatomical abnormalities, however, not always in line with other findings. Also relevant, is the fact that there is a lack of Single Photon Emission Computed Tomography (SPECTCT) studies for the time frame defined, when comparing to the number of studies performed using Positron Emission Tomography (PET), CT and MR. Conclusion: In conclusion, the number of studies regarding ASD, have increased, which translates into this being a very promising field of study. Nevertheless, in a near future, further investigation is required, specially studies on pediatrics individuals and females. The improvement of these aspects will allow the expansion of knowledge and the access to more robust results regarding ASD. Furthermore, there is still a need of more studies that focus on the use of imaging in ASD diagnosis algorithm. Additionally, socio-economical and logistic analyses must be done on the benefits of the use of neuroimaging in the diagnosis of ASD.
Introduction: Autism Spectrum Disorder (ASD) is a group of diseases with some characteristics in common, such as deficient social interaction, communication skills, stereotyped behaviors and/or restricted interests and cognitive impairment. ASD has a prevalence of 0,5 – 1 in 1000 children, mostly boys. State of the art guidelines recommend that the diagnosis of ASD should be mostly clinical, without the use of imaging. Day to day activities are largely affected by ASD and so is the quality of life of the individual. For this reason, an early and precise diagnosis is crucial since it will contribute to an adequate treatment response. Objectives: Demonstrate the role of neuroimaging such as Magnetic Resonance (MR), Computerized Tomography (CT) and Nuclear Medicine imaging in the diagnosis of ASD. Methods: For the elaboration of this systematic review, several search tools were used for obtaining articles from 1st January of 2013 until 31st of December of 2023. The Prisma-P 2015 tool and Robins Tool-I for estimating the presence of bias in each article were also used. Results: After analyzing the selected articles, it is relevant to highlight the fact that most studies were performed on male subjects. These, have shown functional and/or anatomical abnormalities, however, not always in line with other findings. Also relevant, is the fact that there is a lack of Single Photon Emission Computed Tomography (SPECTCT) studies for the time frame defined, when comparing to the number of studies performed using Positron Emission Tomography (PET), CT and MR. Conclusion: In conclusion, the number of studies regarding ASD, have increased, which translates into this being a very promising field of study. Nevertheless, in a near future, further investigation is required, specially studies on pediatrics individuals and females. The improvement of these aspects will allow the expansion of knowledge and the access to more robust results regarding ASD. Furthermore, there is still a need of more studies that focus on the use of imaging in ASD diagnosis algorithm. Additionally, socio-economical and logistic analyses must be done on the benefits of the use of neuroimaging in the diagnosis of ASD.
Description
Keywords
Autismo Imagiologia Neuroimagiologia Perturbação de Espetro de Autismo Radiofármaco Ressonância Magnética Tomografia
Computorizada por Emissão de Fotão Único Tomografia Computorizada Tomografia de Emissão de
Positrões