Women with autistic-spectrum disorder: magnetic resonance imaging study of brain anatomy.

BACKGROUND: Our understanding of anatomical differences in people with autistic-spectrum disorder, is based on mixed-gender or male samples. AIMS: To study regional grey-matter and white-matter differences in the brains of women with autistic-spectrum disorder. METHOD: We compared the brain anatomy of 14 adult women with autistic-spectrum disorder with 19 controls using volumetric magnetic resonance imaging and voxel-based morphometry. RESULTS: Women with autistic-spectrum disorder had a smaller density bilaterally of grey matter in the fronto-temporal cortices and limbic system, and of white matter in the temporallobes (anterior) and pons. In contrast, they had a larger white-matter density bilaterally in regions of the association and projection fibres of the frontal, parietal, posterior temporal and occipital lobes, in the commissural fibres of the corpus callosum (splenium) and cerebellum (anterior lobe). Further, we found a negative relationship between reduced grey-matter density in right limbic regions and social communication ability. CONCLUSIONS: Women with autistic-spectrum disorder have significant differences in brain anatomy from controls, in brain regions previously reported as abnormal in adult men with the disorder. Some anatomical differences may be related to clinical symptoms.

People with learning disabilities in a low secure in-patient unit: comparison of offenders and non-offenders.

BACKGROUND: People with learning disability who exhibit challenging behaviour are frequently segregated from services and local teams are often reluctant to receive them back into their care. This situation is worse in those whose challenging behaviour includes a forensic history, but the difference between those labelled as challenging and those treated as offenders is not clear, and there is a lack of evidence about treatment effectiveness. AIMS: To test between-group differences in aggression and treatment outcome in people with learning disability and challenging behaviour, with and without a forensic history. METHOD: Clinical records of 86 former in-patients (45 offenders and 41 non-offenders) of a specialist unit were compared on measures of behavioural disturbance and placement outcome. RESULTS: People in the offenders group were significantly less likely to be aggressive to others and to use weapons, but significantly more likely to harm themselves compared with the non-offenders group. Both groups had a significant reduction in their challenging behaviour during admission, and there was no significant difference in treatment outcome. CONCLUSIONS: The negative reputation of people with learning disabilities who offend needs to be reconsidered.