Emma Duerden’s work employing neuroscience to understand autism is built on collaboration and powered by what she calls some of the best imaging facilities in the country.
It is also inspired by something a whole lot less tangible but equally important.
“This research gives families hope,” said Duerden, a professor in Western’s Faculty of Education and head of the Developing Brain Lab, built to study cognitive development in infants and children through behavioural assessments and brain imaging.
Specifically, Duerden and her team are taking a novel approach to a thorny problem: why anxiety is prevalent among people with neurodevelopmental disorders, and how neuroscience can help decode autism’s many puzzles.
“Autism is a complex, brain-based disorder – not a behavioural disorder as people used to believe – and the diagnosis can be life-changing for families and leave them with a lot of questions,” she said.
“Are there treatments? How will they do at school? Will they make friends? Can they have a job when they’re older?” said Duerden, listing just a few of the issues people worry about. “The parents and children we work with are some of the most resilient people you’ll ever meet. Their energy and their passion are what drives us to want to provide answers.”
For Duerden and her team, some of those answers can be decoded from a closer look at the structure and function of the brain itself.
For that, she works with an extensive, interdisciplinary network of researchers; state-of-the-art brain-scanning technology that includes magnetic resonance imaging (MRI) and functional MRI at the Centre for Functional and Metabolic Imaging, Canada’s only collection of high-field and ultra-high-field magnetic resonance systems; and complementary facilities at Robarts Research Institute that support patients and researchers alike.
The combined impact of these factors is far greater than the sum of their considerable parts, and they give Duerden and her team a unique-in-Canada advantage.
With all of them working together, the team can do one-of-a-kind research in seeking similarities and differences in brains of people with autism: over time and across life’s milestones; under ordinary circumstances; and under stress as children deploy different behavioural and medical strategies.
The endgame: precise therapies as individual as each child or adult, and targeted interventions to help them become their best selves.
Anxiety and autism
Children with autism often find behavioural therapies and medications helpful in developing routines that help them navigate life’s uncertainties and minimize fear of the unknown.
But changes, such as puberty, a new school, exams or a new job, challenge the routines and coping mechanisms they’ve cultivated. This can spur or exacerbate anxiety, depression or even symptoms that range from social stress to debilitating panic attacks, Duerden said.
“About 85 per cent of children with autism spectrum disorder (ASD) have anxiety symptoms – and around 40 per cent of children with ASD also have a diagnosed anxiety disorder. This can be devastating at school, in interacting with others, in issues related to bullying and peer victimization, that also hinder their learning and memory abilities,” she said.
Put simply, a brain that’s continuously wiring itself for anxiety’s fight-or-flight response is less capable of devoting resources to other kinds of learning.
“It’s more than just ‘worrying’ or ‘stress’. In fact, our research shows anxiety is associated with neurological changes in the brain,” she said.
“Our approach is novel in that we use brain imaging to identify the brain regions that are associated with anxiety symptoms and with other factors in the child’s life.
“We’re using MRI and fMRI to track what’s happening in those brain regions over time, and then to understand better what therapies work best, and for whom, in the hopes of improving diagnoses and improving therapeutic interventions.”
They are visualizing the child’s anxiety and targeting its specific sources.
While the research has its “home” in Western’s Faculty of Education, it’s made possible only through countless partnerships with parents, educational institutions and agencies in the region.
Key members include area physicians, psychologists, school boards, London Health Sciences Centre and St. Joseph’s Health Care London, Merrymount Family Support and Crisis Centre, and the Child and Parent Resource Institute and its families of care.
London is large enough to provide opportunities for these intersecting partnerships, and small enough to build trust among people who need and provide service, Duerden said. “Our families have to seek out lots of different questions and answers. And I think that’s why so many of them are motivated to participate in our research.”
Unique Western expertise
The range and scope of expertise at Western is essential to the work, she emphasized.
“There are so few places in Canada where we would be able to conduct this research. We have one of the best imaging facilities in Canada, housed in one building – state-of-the-art MRI scanners at Robarts Research Institute, and scientists who allow us to develop these complex protocols to be able to study the underlying neurobiology in children with autism spectrum disorder.”
For example, child psychiatrist and Schulich Medicine professor Rob Nicolson, a clinical expert in autism, recruits patients for the studies and consults on the behavioural tests and neuro-imaging, Duerden said.
Developmental pediatrician Jacqueline Ogilvie, also a Schulich Medicine professor, brings new insights to developmental assessments. Neuroscience professor Jody Culham provides knowledge on social cognition. Add to them the radiologists who read the scans and computer scientists who then work on complex data analyses of brain and behaviour.
“Here at Western, we have some of the brightest minds in Canada tackling this problem. It really takes a large network of experts in these fields to be able to answer the complex questions we have,” Duerden said.
“Our hope is that this research will inform future clinical trials examining therapies and behavioral interventions that can really help children and their families.”
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