Evidence map›Paper›PMID 41540340›Full record

ArticleJournal of neurodevelopmental disorders2026

Extra-axial cerebrospinal fluid volumes from 6 to 24 months of age are associated with poorer executive function at school-age in children with and without autism.

Yichi Zhang, Joshua Rutsohn, Sun Hyung Kim, Juhi Pandey, Robert T Schultz, Lonnie Zwaigenbaum, Catherine Burrows, Stephen R Dager, Tanya St John, Annette M Estes and 8 more

Abstract read
In one paragraph

Article in Journal of neurodevelopmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Yichi ZhangCarolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Joshua RutsohnCarolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Sun Hyung KimDepartment of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Juhi PandeyCenter for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
Robert T SchultzCenter for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
Lonnie ZwaigenbaumDepartment of Pediatrics, University of Alberta, Edmonton, AB, T6G 2R3, Canada.
Catherine BurrowsDepartment of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, 55455, USA.
Stephen R DagerDepartment of Radiology, University of Washington, Seattle, WA, 53792, USA.
Tanya St JohnDepartment of Speech and Hearing Sciences, University of Washington, Seattle, WA, 98105, USA.
Annette M EstesDepartment of Speech and Hearing Sciences, University of Washington, Seattle, WA, 98105, USA.
Robert C McKinstryMallinckrodt Institute of Radiology, Washington University in Saint Louis School of Medicine, St. Louis, MO, 63110, USA.
Natasha MarrusDepartment of Psychiatry, Washington University in Saint Louis School of Medicine, St. Louis, MO, 63110, USA.
John R PruettDepartment of Psychiatry, Washington University in Saint Louis School of Medicine, St. Louis, MO, 63110, USA.
Martin StynerDepartment of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Heather C HazlettCarolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Joseph PivenCarolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Mark D Shen *Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Dea Garic *Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA. dea_garic@med.unc.edu.

Funding

Cellular and molecular mechanisms governing cortical surface area overgrowth in iPSC-derived neural cells from longitudinally characterized individuals with autismR01HD055741 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Joseph Piven · 2007 to 2026
$52.6M
UNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Hazel B Nichols · 2001 to 2026
$36.3M
WUIDDRC Supplement-Supporting the health and well-being of children with intellectual and developmental disability during COVID-19 pandemicP50HD103525 · NICHD · WASHINGTON UNIVERSITY · PI JEFFREY D MILBRANDT · 2020 to 2026
$15.5M
Postdoctoral Research in Neurodevelopmental DisordersT32HD040127 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BENJAMIN D PHILPOT, Mark D Shen · 2001 to 2026
$8.5M
The Role of CSF Dynamics in Infant Brain and Behavioral Development in Down Syndrome and Related Neurodevelopmental DisordersK01HD109445 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Dea Garic · 2022 to 2026
$739k
Eunice Kennedy Shriver National Institute of Child Health and Human Development K01- HD109445Eunice Kennedy Shriver National Institute of Child Health and Human Development R01-HD055741Eunice Kennedy Shriver National Institute of Child Health and Human Development T32-HD040127NICHD NIH HHS K01 HD109445NICHD NIH HHS P50 HD103525NICHD NIH HHS R01 HD055741NICHD NIH HHS T32 HD040127NIEHS NIH HHS P30 ES010126
6 · The paper itself

Abstract

backgroundAbnormally increased extra-axial cerebrospinal fluid (EA-CSF) volume is present as early as 6 months in infants later diagnosed with autism and is associated with symptom severity at the age of diagnosis, but it is unknown whether early EA-CSF enlargement has long-term impacts on other clinical domains. Executive function (EF) deficits are frequently observed in children with autism and are linked with worse academic outcomes, higher anxiety, and lower adaptive functioning. The current study examines the association between EA-CSF volume at infancy and EF at school age in a longitudinally phenotyped cohort of children with either high (HL) or low (LL) familial likelihood for autism.

methodsIn this prospective study, 239 infants underwent MRI scans during natural sleep at 6, 12, and 24 months of age. HL was defined as having an older sibling with autism. The sample was divided into three diagnostic groups: HL infants who were diagnosed with autism at 24 months (HL+, n = 34), HL infants not diagnosed with autism (HL-, n = 131), and LL infants without autism (LL-, n = 74). Two parent-rating scales of EF were collected at the school-age follow-up (Mage= 10.4 years ± 1.34): the Behavior Rating Inventory of Executive Function (BRIEF) and Conners Parent Short Form. ANOVA was used to test for diagnostic group differences in EF. Longitudinal mixed-effects models utilized EA-CSF volumes in infancy to predict EF at school-age, while controlling for IQ, sex, total cerebral volume, and diagnostic group.

resultsConsistent with previous literature, HL + participants had greater EF deficits than both HL- and LL- on the BRIEF (F = 18.46, p < .0001) and greater EF deficits than LL- on the Conners (F = 8.55, p < .001). Further, higher EA-CSF volumes during infancy were associated with poorer executive function eight years later on both BRIEF (ß=0.18, p < .001) and Conners (ß=0.18, p < .001). This association between EA-CSF and executive function was observed across familial likelihood and diagnostic groups.

conclusionsOur study indicates that elevations in EA-CSF volumes during infancy, even in those who do not have autism, have long-term associations beyond autism symptomatology. These findings underscore the potential link between infant CSF physiology and future behavioral domains such as executive function at school age.

Indexed as

Autistic DisorderCerebrospinal FluidExecutive FunctionChild, PreschoolFemaleHumansInfantLongitudinal StudiesMagnetic Resonance ImagingMaleProspective StudiesAutismExecutive functionExtra-axial cerebrospinal fluidMRI

Identifiers

PMID41540340
PMCPMC12892752

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.