Towards robust and replicable sex differences in the intrinsic brain function of autism.
Dorothea L Floris, José O A Filho, Meng-Chuan Lai and 18 others
PMID 33648569WHAT IT FOUND
Brain scans in autism showed that females with autism had lower left-right visual connectivity than neurotypical females.
Males with autism showed a slight opposite pattern. No therapy outcome was tested.
Key findings
01In one cluster for left-right visual connectivity, neurotypical females had higher values than the other groups, and females with autism had lower values than the other groups.
02That cluster overlapped with maps for higher-order visual, oculomotor, cognitive flexibility and language-related processes.
03The autism-by-sex interaction pattern replicated in EU-AIMS LEAP but not in GENDAAR.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study looked at brain scans only. It did not test therapy, communication outcomes, or functional change. Participants were aged 7 to 18, and the authors had no direct measure of puberty, so it is unclear how development affects the finding. The brain-behaviour link with social affect in females did not survive the authors' strict correction for multiple tests. The autism-by-sex interaction replicated in EU-AIMS LEAP but not in GENDAAR, so it is not consistent across independent samples. The authors could not separate sex effects from gender effects, and they did not have detailed cognitive tests to explain the visual connectivity result.
Declared interests
The work was supported by the National Institute of Mental Health, NIH Clinical Center, Ontario Brain Institute, autism research awards, foundations, Canadian Institutes of Health Research, Innovative Medicines Initiative, and named donors. The supplied text does not give author conflict declarations.
The easy way to misread this
Do not use these brain scan sex differences to decide autism therapy. The autism-by-sex result was one left-right visual connectivity cluster, the social-affect link did not survive strict correction, and the pattern did not replicate in GENDAAR.