A Protocol for Sedation Free MRI and PET Imaging in Adults with Autism Spectrum Disorder


Imaging technologies such as positron emission tomography (PET) and magnetic resonance imaging (MRI) present unparalleled opportunities to investigate the neural basis of autism spectrum disorder (ASD). However, challenges such as deficits in social interaction, anxiety around new experiences, impaired language abilities, and hypersensitivity to sensory stimuli make participating in neuroimaging studies challenging for individuals with ASD. In this commentary, we describe the existent training protocols for preparing individuals with ASD for PET/MRI scans and our own experience developing a training protocol to facilitate the inclusion of low-functioning adults with ASD in PET-MRI studies. We hope to raise awareness of the need for more information exchange between research groups about lessons learned in this context in order to include the entire disease spectrum in neuroimaging studies.

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We wish to thank Gregory Hren (Greg Hren Photography Inc.) for producing all the videos and DVDs, Regan Butterfield for helpful discussions, coordinating the video recordings and for radiotracer injection, Dr. Michael Placzek and Shirley Hsu for participating in the videos, as well as Jonathan Kent for working on an earlier version of this manuscript. We would like to thank Dr. Chieh-En (Jane) Tseng and Thomas Morin for assistance with motion estimation, Dr. Ciprian Catana, Dr. Daniel Chonde and Dr. David Izquierdo-Garcia for assistance with PET data reconstruction, Dr. Marco Loggia and Dr. Hsiao-Ying Wey for assistance with PET data analysis, and Dr. Nouchine Hadjikhani, Christine Wu, Baileigh Hightower, Lauren Richey and Anjali Parmar for help with data acquisition. We thank the physicians Dr. Christopher Keary and Dr. Michelle Palumbo for obtaining informed consent, Dr. Lisa Nowinski for neuropsychological assessments, the nurse practitioners Marlene Wentworth, Amy Kendall and Natacha Nortelus for medical coverage and nuclear medicine technologists Shirley Hsu and Grae Arabasz for radiotracer injection and assistance with PET-MRI scans, as well as Judit Sore and the radiopharmacy team for radioligand production.


Funding for this study was provided by the Robert E. and Donna Landreth Fund for the Study of Neuroinflammation in Autism, the Nancy Lurie Marks Family Foundation, and the Meixner Translational Postdoctoral Fellowship # 9258 from Autism Speaks awarded to Nicole R. Zürcher as well as the Transatlantic Research Scholar awarded to Nicole R. Zürcher.

Author information

CJS, AB, and EN performed literature search; EN, JEM, CJM, NRZ, and JMH designed and developed the training protocol; AB, JEM, and NRZ implemented the training protocol and acquired data; NRZ analyzed data; CJS, SDB, CJM, NRZ, and JMH conceived of the commentary; CJS and NRZ wrote the manuscript. All authors edited the manuscript.

Correspondence to J. M. Hooker.

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Conflict of interest

Author J. M. Hooker is a co-founder of Eikonizo Therapeutics and serves on the scientific advisory board of Psy Therapeutics. Within the past 12 months, J.M.H. has consulted for Psy Therapeutics, Rodin Therapeutics, Evelo Biosciences, Denali Therapeutics and Vertex and has received honoraria for grant review or speaking from Alzheimer’s Drug Discovery Foundation, Lawrence Berkeley National Lab, and Cure Alzheimer’s Fund. Authors C. J. Smith, A. Bhanot, E. Norman, J. E. Mullett, S. D. Bilbo, C. J. McDougle and N. R. Zürcher have no conflicts of interest to declare.

Ethical Approval

This study referenced in this commentary was approved by the Institutional Review Board (IRB) of Partners Healthcare and the radioactive drug research committee (RDRC) at Massachusetts General Hospital.

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Smith, C.J., Bhanot, A., Norman, E. et al. A Protocol for Sedation Free MRI and PET Imaging in Adults with Autism Spectrum Disorder. J Autism Dev Disord 49, 3036–3044 (2019) doi:10.1007/s10803-019-04010-3

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  • Autism spectrum disorder
  • Neuroimaging
  • Positron emission tomography
  • Magnetic resonance imaging
  • Training protocols