Department of Economics and Business Economics

Co-occurring hydrocephalus in autism spectrum disorder: a Danish population-based cohort study

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  • Tina Nørgaard Munch, Statens Serum Institut, Rigshospitalet, University of Copenhagen
  • ,
  • Paula Louise Hedley, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)
  • ,
  • Christian Munch Hagen, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)
  • ,
  • Marie Bækvad-Hansen, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)
  • ,
  • Jonas Bybjerg-Grauholm, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)
  • ,
  • Jakob Grove
  • Merete Nordentoft, iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Psykiatrien i Region Hovedstaden
  • ,
  • Anders Dupont Børglum
  • Preben Bo Mortensen
  • Thomas Mears Werge, iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Psykiatrien i Region Hovedstaden
  • ,
  • Mads Melbye, Stanford University School of Medicine
  • ,
  • David Michael Hougaard, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)
  • ,
  • Michael Christiansen, Statens Serum Institut, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), University of Copenhagen

BACKGROUND: The association between autism spectrum disorder and hydrocephalus is not well understood, despite demonstrated links between autism spectrum disorder and cerebrospinal fluid abnormalities. Based on the hypothesis that autism spectrum disorder and hydrocephalus may, at least in some cases, be two manifestations of a shared congenital brain pathology, we investigated the potential association between autism spectrum disorder and hydrocephalus in a large Danish population-based cohort.

METHODS: Patients and controls were obtained from the Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH2012 case-cohort, which includes all patients with selected psychiatric disorders born in Denmark 1981-2005 along with randomly selected population controls (end of follow-up, December 31, 2016). The associations between individual psychiatric disorders and hydrocephalus were estimated using binary logistic regression with adjustment for age and sex.

RESULTS: The cohort consisted of 86,571 individuals, of which 14,654 were diagnosed with autism spectrum disorder, 28,606 were population controls, and the remaining were diagnosed with other psychiatric disorders. We identified 201 hydrocephalus cases; 68 among autism spectrum disorder patients and 40 among controls (OR 3.77, 95% CI 2.48-5.78), which corresponds to an absolute risk of 0.46 % (i.e. approximately one in 217 children with autism spectrum disorder had co-occurring hydrocephalus). The autism spectrum disorder-hydrocephalus association was significant over the entire subgroup spectrum of autism spectrum disorder.

CONCLUSIONS: Given the considerable risk of hydrocephalus among patients with autism spectrum disorder, we suggest that patients with autism spectrum disorder should be evaluated for co-occurring hydrocephalus on a routine basis as timely neurosurgical intervention is important. Likewise, attention must be paid to traits of autism spectrum disorder in children with hydrocephalus. The results of this study call for future investigations on a potential shared aetiology between hydrocephalus and autism spectrum disorder, including the role abnormal CSF dynamics in the pathogenesis of autism spectrum disorder.

Original languageEnglish
JournalJournal of neurodevelopmental disorders
Volume13
Pages (from-to)19
Number of pages9
ISSN1866-1947
DOIs
Publication statusPublished - 2021

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