Leveraging AI-Driven Neuroimaging Biomarkers for Early Detection and Social Function Prediction in Autism Spectrum Disorders: A Systematic Review

Background: This systematic review examines artificial intelligence (AI) applications in neuroimaging for autism spectrum disorder (ASD), addressing six research questions regarding biomarker optimization, modality integration, social function prediction, developmental trajectories, clinical translation challenges, and multimodal data enhancement for earlier detection and improved outcomes. Methods: Following PRISMA guidelines, we conducted a comprehensive literature search across 8 databases, yielding 146 studies from an initial 1872 records. These studies were systematically analyzed to address key questions regarding AI neuroimaging approaches in ASD detection and prognosis. Results: Neuroimaging combined with AI algorithms demonstrated significant potential for early ASD detection, with electroencephalography (EEG) showing promise. Machine learning classifiers achieved high diagnostic accuracy (85–99%) using features derived from neural oscillatory patterns, connectivity measures, and signal complexity metrics. Studies of infant populations have identified the 9–12-month developmental window as critical for biomarker detection and the onset of behavioral symptoms. Multimodal approaches that integrate various imaging techniques have substantially enhanced predictive capabilities, while longitudinal analyses have shown potential for tracking developmental trajectories and treatment responses. Conclusions: AI-driven neuroimaging biomarkers represent a promising frontier in ASD research, potentially enabling the detection of symptoms before they manifest behaviorally and providing objective measures of intervention efficacy. While technical and methodological challenges remain, advancements in standardization, diverse sampling, and clinical validation could facilitate the translation of findings into practice, ultimately supporting earlier intervention during critical developmental periods and improving outcomes for individuals with ASD. Future research should prioritize large-scale validation studies and standardized protocols to realize the full potential of precision medicine in ASD.