Analysis of brain functional connectivity in children with autism spectrum disorder and sleep disorders ： A fNIRS observational study

Fengli Bi¹Zhuting Jia²Lin Lv³Yanyan Zhang²Chuanhua Zhu²Chunxiao Wan^1*

• ¹Tianjin Medical University General Hospital, Tianjin, China
• ²Department of Rehabilitation, Affiliated Hospital of Binzhou Medical College, Binzhou, Shandong Province, China
• ³Baotou Central Hospital, Baotou, China

Autism spectrum disorder (ASD) is often associated with sleep disorders but the neurophysiological mechanisms underlying these issues are poorly understood. In this cross-sectional study, functional near-infrared spectroscopy (fNIRS) was used to assess differences in brain functional connectivity (FC) in children with ASD and sleep disorders and those with ASD not complicated by sleep disorders.A total of 88 children were assigned to three groups, namely, those with ASD and sleep disorders (ASD with sleep disorder group; n = 29), those with ASD and no sleep disorders (ASD with no sleep disorder group; n = 29), and those with typical development (TD group; n = 30). All children with ASD met the diagnostic criteria of the DSM-V. The ASD group with sleep disorders exhibited typical sleep disorder symptoms, with a total score on the Children's Sleep Habits Questionnaire ≥41. All children were assessed using theADOS, the VABS-3, the SRS, and the CSHQ. The fNIRS data revealed that under resting-state conditions, the supramarginal gyrus (Cohen's f=0.981(L)f=0.467(R) ) , inferior frontal gyrus ( f=0.415(L)f=0.443(R) ) , frontopolar area ( f=0.620(L)f=0.634(R)), dorsolateral prefrontal cortex ( f=0.593(L)f=0.547(R)) and visual association cortex ( f=0.500(L)f=0.524(R) )of the brain showed lower activity in ASD with sleep disorder group compared with the TD group (P<0.01). The FC values obtained for the SMG ( f=0.981(L)f=0.467(R)), RFPA ( f=0.634), DLPFC ( f=0.593(L)f=0.547(R)), and VAC ( f=0.500(L)f=0.524(R)) were also lower in ASD with sleep disorder group than the ASD without sleep disorder group (P<0.01). The FC values of the LIFG showed a mild negative correlation with social affect scale scores (r=-0.34, P=0.07), while FC values in the RDLPFC were negatively correlated with restricted repetitive behavior (RRB) (r=-0.41, P=0.03). The scores of the CSHQ were positively correlated with FC values in the RIFG region of the brain (r=0.37,P=0.05).supporting that FC in children with ASD complicated with sleep disorders was weaker than that in children with ASD without sleep disorders. Both groups showed weaker FC compared with the TD group. However, due to the limited sample size, the generalizability of the findings requires further validation through multicenter, large-sample studies.