Potentially Inappropriate Medication Use in Older Adults: Concordance Among the Chinese and AGS/Beers and STOPP Criteria.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by impairments in social communication, repetitive and stereotyped behaviors, restricted interests, and sensory abnormalities. ASD is known to have inherent patterns of atypical brain development (; ). Over the past decade, neuroimaging studies have identified relatively consistent abnormalities in brain structure and development in children and adolescents with ASD (; ; ). In contrast, structural neuroimaging investigations focusing on adults with ASD remain comparatively limited. As noted in comprehensive reviews and diagnostic guidelines, adult ASD research faces persistent bottlenecks in recruitment and diagnostic characterization due to complex co-occurring psychiatric conditions and varied intervention backgrounds (; ; ). Given the lifelong nature of ASD, examining brain structure in adulthood is critical for understanding whether early neurodevelopmental alterations translate into atypical brain aging or altered maturation trajectories later in life (). Social impairment represents a core clinical feature of ASD and is central to its diagnostic criteria (). Deficits in social communication and interaction in ASD are associated with to underlying neurodevelopmental alterations and are strongly associated with long-term functional outcomes, representing a major determinant of adaptive functioning across the lifespan (; ). Examining the relationship between neuroimaging-derived metrics and social-domain measures may help characterize potential brain–behavior associations in adults with ASD. These social impairments have been associated with large-scale structural brain differences, and several studies have reported widespread neuroanatomical in large-scale brain structural alterations, several studies have reported widespread neuroanatomical differences in adults with ASD, including regional increases in gray matter volume (GMV) in temporal and frontal cortices, as well as widespread white matter abnormalities associated with core autistic traits and behavior (; ; ). Conversely, other voxel-based morphometry (VBM) studies have identified reduced gray matter in regions implicated in social cognition, such as the fusiform gyrus, amygdala, and prefrontal areas in adult ASD (). However, meta-analytic evidence indicates that these findings are heterogeneous. Both increases and decreases in GMV have been reported across temporal, parietal, and frontal regions, as well as in the anterior cingulate cortex and cerebellum, underscoring the inconsistency of macrostructural results in adult ASD (; ). For example, region-specific volumetric alterations have been documented in the posterior hippocampus, cuneus, and various prefrontal subregions in high-functioning adult ASD cohorts, yet these patterns are not consistently replicated across studies (). A recent large-sample neuroimaging study further reported heterogeneous and region-specific structural patterns across adulthood in individuals with ASD (). Collectively, these findings suggest that investigations of brain aging in ASD should incorporate both whole-brain and region-specific assessments.