Autism / TND Diagnosis: A Revolutionary Ultrasound Scanner?

Diagnosing a neurodevelopmental disorder from the cradle is what functional ultrasound, developed by a French start-up and a cohort of scientists, promises. A first clinical trial is scheduled for early 2023.

At first glance, the Iconsus machine looks like an XXL printer, mounted on wheels. In reality, in the belly of this 100% made in France innovation, there is not paper and ink but a new cutting-edge imaging method that allows us to observe the human brain in action. This “Focus ultrasonic system” technology, also called “Functional ultrasound imaging”, looks promising for the hyper-early diagnosis of neurodevelopmental disorders (NDD). While the fourth plan for autism (2018-2022) will end at the end of the year (linked article below), the observation of scientists remains the same: too many patients with TND or autism (ASD) experience medical wandering. “If in 2015 the average age of diagnosis was six and a half years, today we are less than five years old”, acknowledges Claire Compagnon, inter-ministerial delegate for the national strategy for autism and TND. Gold, “The earlier we take the children, the more chance we have of recovering a trajectory”, she says. The ideal according to scientists? Detect a TND from the crib, in the first six to twelve months of the baby’s life.

Neuroimaging at the bedside of the child

So far, only MRI was able to do this. But the Iconaus ultrasound system has an additional advantage: its maneuverability (it is portable) and its ease of use, essential in perinatal care. “Neuroimaging at the baby’s bedside: we are the only ones in the world to have done it”, boasts Mickaël Tanter, research director of Inserm and CNRS (National Center for Scientific Research), who collaborated on the project. Thanks to its ultra-fast speed, the instrument can visualize the blood in every vessel in the brain and then analyze brain activity in real time, which is undetectable using a conventional ultrasound scanner. In fact, when an area of ​​the brain is activated, it draws a rush of blood to deliver oxygen to the neurons. It is this movement or its alteration, imperceptible on clinical examination, that can guide doctors on the trail of a neurodevelopmental disorder or not.

A clinical study at the Robert-Debré hospital

“Let’s try to see the invisible”, continues Mickaël Tanter. Tested for the first time in the preclinical and experimental phase on rodents, this device will be tested on the first newborns in early 2023, at the Robert-Debré hospital in Paris. With prematurity being one of the risk factors, the study will initially focus on preterm births only. The clinical trial will last three years, with the first concrete results within five to ten years. In addition to its sensitivity and the relative speed of treatment, the ultrasound technique is not irradiating and therefore “painless and non-invasive”, reassure researchers.

The “MR” : what evaluation for 3 years?

Other devices, which are beginning to bear fruit, have emerged during this fourth autism plan. Starting with the network of dedicated scientific interest groups (GIS), the first of which will blow out its third candle on November 10, 2022. 650 French researchers from different specialties (from fundamental biology to human and social sciences) work side by side for three years with families and associations to carry out research and propose an innovative methodology. The eye-tracking process is one of them. Easily used even on infants from six months of age, this computerized gaze tracking technique could enable ASD to be identified by simple eye movement.

Renewal of the autism strategy in 2023

Another proof of scientific enthusiasm for this topic: National funding for TND by the National Research Agency (ANR) has jumped 180% in the past five years. Next goals: “intensify international actions”, admits Claire Compagnon, or even “to improve training, particularly in psychology universities”, adds Catherine Barthélémy, child psychiatrist, member of the National Academy of Medicine. Recall that the autism and TND strategy comes to an end on December 31, 2022. During the Interministerial Disability Committee (CIH), Prime Minister Elisabeth Borne announced its renewal starting in 2023 (linked article below).

© Clotilde Costil

“All reproduction and representation rights reserved. © This article was written by Clotilde Costil, journalist”

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