Differences cérébrales liées au sexe dans le trouble du spectre de l'autisme tout au long de la vie : revue systématique des résultats de l'IRM structurelle, de l'IRMf et de l'ITD
Titre original en anglais : Brain-based sex differences in autism spectrum disorder across the lifespan: A systematic review of structural MRI, fMRI, and DTI findings
Walsh, M. J., Wallace, G. L., Gallegos, S. M., & Braden, B. B. (2021). Brain-based sex differences in autism spectrum disorder across the lifespan: A systematic review of structural MRI, fMRI, and DTI findings. NeuroImage: Clinical, 31, 102719. https://doi.org/10.1016/j.nicl.2021.102719
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Résumé
Les femmes présentant un trouble du spectre de l'autisme (TSA) ont longtemps été négligées dans la recherche en neurosciences, mais des données émergentes suggèrent qu'elles présentent des trajectoires phénotypiques distinctes et des différences cérébrales liées à l'âge. Des facteurs biologiques liés au sexe (p. ex., hormones, gènes) pourraient jouer un rôle dans l'étiologie du TSA et il a été montré qu'ils influencent les trajectoires du neurodéveloppement. Ainsi, une approche couvrant l'ensemble de la vie est justifiée pour comprendre les différences cérébrales liées au sexe dans le TSA. Cette revue systématique des différences liées au sexe dans le TSA fondées sur l'IRM a été menée afin d'élucider les variations tout au long de la vie et d'éclairer la découverte de biomarqueurs du TSA chez les femmes. Nous avons identifié des articles au moyen de deux recherches dans des bases de données. Cinquante études répondaient aux critères et ont fait l'objet d'une revue intégrative. Nous avons constaté que les régions présentant, d'une étude à l'autre, des différences reproductibles d'interaction sexe-par-diagnostic chevauchaient les régions montrant des différences sexuelles dans des cohortes neurotypiques. En outre, les études examinant les différences cérébrales liées à l'âge sur une large tranche d'âge suggèrent des profils neurodéveloppementaux distincts chez les femmes présentant un TSA. La comparaison qualitative des études chez les jeunes et chez les adultes a également étayé cette hypothèse. Toutefois, de nombreuses études ont regroupé les participants indépendamment de l'âge, ce qui peut masquer des différences. En outre, l'accumulation de données étaye l'effet protecteur féminin dans le TSA, bien qu'une seule étude ait examiné les circuits cérébraux impliqués dans la « protection ». Lorsqu'elles sont synthétisées avec la littérature plus large, les différences cérébrales liées au sexe dans le TSA peuvent provenir de diverses sources, notamment de processus génétiques et endocriniens impliqués dans la « masculinisation » et la « féminisation » du cerveau au cours du développement précoce, de la puberté et d'autres périodes de transition hormonale tout au long de la vie. En outre, la biologie liée au sexe peut interagir avec des processus périphériques, en particulier l'axe du stress et le système d'éveil cérébral, pour produire des profils neurodéveloppementaux distincts chez les hommes et les femmes présentant un TSA. Les recherches futures sur les différences liées au sexe dans le TSA fondées sur la neuroimagerie bénéficieraient d'une approche couvrant l'ensemble de la vie dans le cadre d'études bien contrôlées et multivariées. Les relations possibles entre le comportement, les hormones sexuelles et le développement cérébral dans le TSA restent largement non examinées.
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