Lesion Network Mapping of Cognitive Decline in Three Cases of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is characterized by diverse neurological and cognitive profiles, with cognitive decline observed in some individuals over time. This study employs lesion network mapping to investigate the neural correlates of cognitive decline in three individuals with ASD. Using high-resolution neuroimaging data, we mapped lesion-like abnormalities in brain connectivity and correlated these with longitudinal cognitive assessments. The cases, spanning distinct age groups and ASD severity levels, revealed disruptions in key networks, including the default mode network (DMN) and frontoparietal network (FPN), associated with cognitive functions such as memory, executive function, and social cognition. Specifically, altered connectivity in the DMN was linked to declines in verbal and non-verbal reasoning, while FPN disruptions correlated with impaired executive control. These findings suggest that cognitive decline in ASD may stem from individualized patterns of network dysfunction, highlighting the utility of lesion network mapping in elucidating the neuropathological underpinnings of ASD-related cognitive changes. This study underscores the need for personalized interventions targeting specific neural networks to mitigate cognitive decline in ASD and calls for larger-scale studies to validate these preliminary findings.