Il ruolo dell’elettroencefalografia nello studio del disturbo dello spettro autistico: un “vecchio” strumento con nuove potenzialità

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that represents a significant public health concern, as it is a lifelong condition, affecting individuals' functioning and autonomy to varying degrees, and which is frequently associated with numerous comorbidities, both somatic and neuropsychiatric. Given the dramatic increase in prevalence since the 2000s, early diagnosis of this disorder represents a significant challenge for the future, for which electroencephalography, despite its introduction in 1924, appears to be a particularly promising resource. In the pediatric autistic population, up to 60.7% of subjects exhibit abnormalities in brain electrical activity, which have attracted the attention of numerous experts in the field of autism. This thesis provides a review of the most recent literature on this topic, which served as the starting point for a retrospective observational study we conducted at the IRCCS Fondazione Stella Maris in Calambrone (PI), which forms the core of this work. The aim of our research was to describe the electroencephalographic findings and phenotypic characteristics of a group of 141 preschool children with autism spectrum disorder, with the aim of identifying a potential association between them. Fifty-five percent of participants, especially the youngest (p = 0.031), showed subclinical electroencephalographic abnormalities, predominantly epileptiform discharges, particularly focal/multifocal (p = 0.010), and predominantly during sleep. Particularly interesting trends suggest that the abnormal brain activity correlates more strongly with the internalizing and externalizing comorbidities of autism spectrum disorder, rather than with its core symptoms. Based on this, we advanced hypotheses on the pathogenetic role of electroencephalographic abnormalities, suggesting directions for future studies in this area