Imitation and action understanding in autistic spectrum disorders: how valid is the hypothesis of a deficit in the mirror neuron system?

Inhibition of imitative behaviour and social cognition

There is converging evidence that the observation of an action activates a corresponding motor representation in the observer through a 'mirror-matching' mechanism. However, research on such 'shared representations' of perception and action has widely neglected the question of how we can distinguish our own motor intentions from externally triggered motor representations. By investigating the inhibition of imitative response tendencies, as an index for the control of shared representations, we can show that self-other distinction plays a fundamental role in the control of shared representations. Furthermore, we demonstrate that overlapping brain activations can be found in the anterior fronto-median cortex (aFMC) and the temporo-parietal junction (TPJ) area for the control of shared representations and complex social-cognitive tasks, such as mental state attribution. In a functional magnetic resonance imaging experiment, we functionally dissociate the roles of TPJ and aFMC during the control of shared representations. Finally, we propose a hypothesis stating that the control of shared representations might be the missing link between functions of the mirror system and mental state attribution.

Goals, intentions and mental states: challenges for theories of autism

The ability to understand the goals and intentions behind other people's actions is central to many social interactions. Given the profound social difficulties seen in autism, we might expect goal understanding to be impaired in these individuals. Two influential theories, the 'broken mirror' theory and the mentalising theory, can both predict this result. However, a review of the current data provides little empirical support for goal understanding difficulties; several studies demonstrate normal performance by autistic children on tasks requiring the understanding of goals or intentions. I suggest that this conclusion forces us to reject the basic broken mirror theory and to re-evaluate the breadth of the mentalising theory. More subtle theories which distinguish between different types of mirroring and different types of mentalising may be able to account for the present data, and further research is required to test and refine these theories.

Acting together in and beyond the mirror neuron system

Moving a set dinner table often takes two people, and doing so without spilling the glasses requires the close coordination of the two agents' actions. It has been argued that the mirror neuron system may be the key neural locus of such coordination. Instead, here we show that such coordination recruits two separable sets of areas: one that could translate between motor and visual codes and one that could integrate these information to achieve common goals. The former includes regions of the putative mirror neuron system, the latter, regions of the prefrontal, posterior parietal and temporal lobe adjacent to the putative mirror neuron system. Both networks were more active while participants cooperated with a human agent, responding to their actions, compared to a computer that did not, evidencing their social dimension. This finding shows that although the putative mirror neuron system can play a critical role in joint actions by translating both agents' actions into a common code, the flexible remapping of our own actions with those of others required during joint actions seems to be performed outside of the putative mirror neuron system.

Intention understanding in autism

When we observe a motor act (e.g. grasping a cup) done by another individual, we extract, according to how the motor act is performed and its context, two types of information: the goal (grasping) and the intention underlying it (e.g. grasping for drinking). Here we examined whether children with autistic spectrum disorder (ASD) are able to understand these two aspects of motor acts. Two experiments were carried out. In the first, one group of high-functioning children with ASD and one of typically developing (TD) children were presented with pictures showing hand-object interactions and asked what the individual was doing and why. In half of the "why" trials the observed grip was congruent with the function of the object ("why-use" trials), in the other half it corresponded to the grip typically used to move that object ("why-place" trials). The results showed that children with ASD have no difficulties in reporting the goals of individual motor acts. In contrast they made several errors in the why task with all errors occurring in the "why-place" trials. In the second experiment the same two groups of children saw pictures showing a hand-grip congruent with the object use, but within a context suggesting either the use of the object or its placement into a container. Here children with ASD performed as TD children, correctly indicating the agent's intention. In conclusion, our data show that understanding others' intentions can occur in two ways: by relying on motor information derived from the hand-object interaction, and by using functional information derived from the object's standard use. Children with ASD have no deficit in the second type of understanding, while they have difficulties in understanding others' intentions when they have to rely exclusively on motor cues.

Preliminary evidence for deficits in multisensory integration in autism spectrum disorders: the mirror neuron hypothesis

Autism is a complex disorder, characterized by social, cognitive, communicative, and motor symptoms. One suggestion, proposed in the current study, to explain the spectrum of symptoms is an underlying impairment in multisensory integration (MSI) systems such as a mirror neuron-like system. The mirror neuron system, thought to play a critical role in skills such as imitation, empathy, and language can be thought of as a multisensory system, converting sensory stimuli into motor representations. Consistent with this, we report preliminary evidence for deficits in a task thought to tap into MSI--"the bouba-kiki task" in children with ASD. The bouba-kiki effect is produced when subjects are asked to pair nonsense shapes with nonsense "words". We found that neurotypical children chose the nonsense "word" whose phonemic structure corresponded with the visual shape of the stimuli 88% of the time. This is presumably because of mirror neuron-like multisensory systems that integrate the visual shape with the corresponding motor gestures used to pronounce the nonsense word. Surprisingly, individuals with ASD only chose the corresponding name 56% of the time. The poor performance by the ASD group on this task suggests a deficit in MSI, perhaps related to impaired MSI brain systems. Though this is a behavioral study, it provides a testable hypothesis for the communication impairments in children with ASD that implicates a specific neural system and fits well with the current findings suggesting an impairment in the mirror systems in individuals with ASD.

Befunde zum menschlichen Spiegelneuronensystem bei Autismus: Eine kritische Übersicht funktioneller Bildgebungsstudien

Es mehren sich Hinweise, dass Menschen über ein Spiegelneuronensystem verfügen, das für das Verständnis von Handlungen, für Imitation und für Empathie von großer Bedeutung sein könnte. Autistische Störungen gehen mit Beeinträchtigungen in der Imitation und Empathie einher. Die Annahme, dass diesen Beeinträchtigungen defizitäre Spiegelneuronenmechanismen zugrunde liegen könnten, hat eine Reihe von Untersuchungen angeregt, die mittels bildgebender Methoden die Funktion des Spiegelneuronensystems bei Personen mit Autismus überprüft haben. Basierend auf Annahmen und Erkenntnissen zu Spiegelneuronenmechanismen bei gesunden Kindern und Erwachsenen werden in der vorliegenden Arbeit die Ergebnisse dieser Studien zusammengefasst und kritisch diskutiert. Zudem werden mögliche klinische Implikationen der Befunde dargestellt.

A failure to grasp the affective meaning of actions in autism spectrum disorder subjects

The ability to grasp emotional messages in everyday gestures and respond to them is at the core of successful social communication. The hypothesis that abnormalities in socio-emotional behavior in people with autism are linked to a failure to grasp emotional significance conveyed by gestures was explored. We measured brain activity using fMRI during perception of fearful or neutral actions and showed that whereas similar activation of brain regions known to play a role in action perception was revealed in both autistics and controls, autistics failed to activate amygdala, inferior frontal gyrus and premotor cortex when viewing gestures expressing fear. Our results support the notion that dysfunctions in this network may contribute significantly to the characteristic communicative impairments documented in autism.

Autismo: uma avaliação transdisciplinar baseada no programa TEACCH

OBJETIVO: apresentar protocolo de avaliação transdisciplinar no autismo baseado no programa denominado Treatment and Education of Autistic and related Communicattion handicapped Children - TEACCH e sua aplicação no programa desenvolvido na Organização Não -Governamental Centro de Referência e Apoio às Desordens do Desenvolvimento - CRADD. MÉTODOS: foram escolhidos seis indivíduos, entre sete e doze anos, com diagnóstico de autismo que frequentam o programa da referida e que foram avaliados em três momentos durante o ano (janeiro, junho e dezembro). RESULTADOS: foram verificados os progressos de cada um deles nas áreas de interação social, comportamento, aspecto cognitivo e linguagem. CONCLUSÃO: independente do grau e do tipo de autismo, a aplicação da abordagem transdisciplinar nos sujeitos, demonstrou que existe desenvolvimento em todas as áreas avaliadas, proporcionando o efetivo estabelecimento das suas funções comunicativas.

Sensorimotor cortex as a critical component of an 'extended' mirror neuron system: Does it solve the development, correspondence, and control problems in mirroring?

A core assumption of how humans understand and infer the intentions and beliefs of others is the existence of a functional self-other distinction. At least two neural systems have been proposed to manage such a critical distinction. One system, part of the classic motor system, is specialized for the preparation and execution of motor actions that are self realized and voluntary, while the other appears primarily involved in capturing and understanding the actions of non-self or others. The latter system, of which the mirror neuron system is part, is the canonical action 'resonance' system in the brain that has evolved to share many of the same circuits involved in motor control. Mirroring or 'shared circuit systems' are assumed to be involved in resonating, imitating, and/or simulating the actions of others. A number of researchers have proposed that shared representations of motor actions may form a foundational cornerstone for higher order social processes, such as motor learning, action understanding, imitation, perspective taking, understanding facial emotions, and empathy. However, mirroring systems that evolve from the classic motor system present at least three problems: a development, a correspondence, and a control problem. Developmentally, the question is how does a mirroring system arise? How do humans acquire the ability to simulate through mapping observed onto executed actions? Are mirror neurons innate and therefore genetically programmed? To what extent is learning necessary? In terms of the correspondence problem, the question is how does the observer agent know what the observed agent's resonance activation pattern is? How does the matching of motor activation patterns occur? Finally, in terms of the control problem, the issue is how to efficiently control a mirroring system when it is turned on automatically through observation? Or, as others have stated the problem more succinctly: "Why don't we imitate all the time?" In this review, we argue from an anatomical, physiological, modeling, and functional perspectives that a critical component of the human mirror neuron system is sensorimotor cortex. Not only are sensorimotor transformations necessary for computing the patterns of muscle activation and kinematics during action observation but they provide potential answers to the development, correspondence and control problems.

From emotion resonance to empathic understanding: A social developmental neuroscience account

The psychological construct of empathy refers to an intersubjective induction process by which positive and negative emotions are shared, without losing sight of whose feelings belong to whom. Empathy can lead to personal distress or to empathic concern (sympathy). The goal of this paper is to address the underlying cognitive processes and their neural underpinnings that constitute empathy within a developmental neuroscience perspective. In addition, we focus on how these processes go awry in developmental disorders marked by impairments in social cognition, such as autism spectrum disorder, and conduct disorder. We argue that empathy involves both bottom-up and top-down information processing, underpinned by specific and interacting neural systems. We discuss data from developmental psychology as well as cognitive neuroscience in support of such a model, and highlight the impact of neural dysfunctions on social cognitive developmental behavior. Altogether, bridging developmental science and cognitive neuroscience helps approach a more complete understanding of social cognition. Synthesizing these two domains also contributes to a better characterization of developmental psychopathologies that impacts the development of effective treatment strategies.

Planning actions in autism

It has been suggested that the deficit in understanding others' intention in autism depends on a malfunctioning of the mirror system. This malfunction could be due either to a deficit of the basic mirror mechanism or to a disorganization of chained action organization on which the mirror understanding of others' intention is based. Here we tested this last hypothesis investigating the kinematics of intentional actions. Children with autism and typically developing children (TD) were asked to execute two actions consisting each of three motor acts: the first was identical in both actions while the last varied for its difficulty. The result showed that, unlike in TD children, in children with autism the kinematics of the first motor act was not modulated by the task difficulty. This finding strongly supports the notion that children with autism have a deficit in chaining motor acts into a global action.

Psychosis and autism as diametrical disorders of the social brain

Autistic-spectrum conditions and psychotic-spectrum conditions (mainly schizophrenia, bipolar disorder, and major depression) represent two major suites of disorders of human cognition, affect, and behavior that involve altered development and function of the social brain. We describe evidence that a large set of phenotypic traits exhibit diametrically opposite phenotypes in autistic-spectrum versus psychotic-spectrum conditions, with a focus on schizophrenia. This suite of traits is inter-correlated, in that autism involves a general pattern of constrained overgrowth, whereas schizophrenia involves undergrowth. These disorders also exhibit diametric patterns for traits related to social brain development, including aspects of gaze, agency, social cognition, local versus global processing, language, and behavior. Social cognition is thus underdeveloped in autistic-spectrum conditions and hyper-developed on the psychotic spectrum.;>We propose and evaluate a novel hypothesis that may help to explain these diametric phenotypes: that the development of these two sets of conditions is mediated in part by alterations of genomic imprinting. Evidence regarding the genetic, physiological, neurological, and psychological underpinnings of psychotic-spectrum conditions supports the hypothesis that the etiologies of these conditions involve biases towards increased relative effects from imprinted genes with maternal expression, which engender a general pattern of undergrowth. By contrast, autistic-spectrum conditions appear to involve increased relative bias towards effects of paternally expressed genes, which mediate overgrowth. This hypothesis provides a simple yet comprehensive theory, grounded in evolutionary biology and genetics, for understanding the causes and phenotypes of autistic-spectrum and psychotic-spectrum conditions.

What is new in autism?

PURPOSE OF REVIEW

Autism is now recognized in one out of 150 children. This review highlights the topics within the growing autism literature that are shaping current thinking on autism and advancing research and clinical understanding of autism spectrum disorders.

RECENT FINDINGS

The role of single-stranded microdeletions and epigenetic influences on brain development has dramatically altered our understanding of the etiology of the autisms. Recent research has focused on the role of synapse structure and function as central to the development of autism and suggests possible targets of interventions. Brain underconnectivity has been a focus in recent imaging studies and has become a central theme in conceptualizing autism. Despite increased awareness of autism there is no 'epidemic' and no one cause for autism. Data from the sibling studies are identifying early markers of autism and defining the broader autism phenotype.

SUMMARY

Larger datasets in genetics, a focus on the early signs of autism, and increased recognition of the importance of defining subgroups of children with autism are leading to a greater understanding of the etiologies of autism. A growing interest in defining the molecular biology of social cognition, which is at the core of autism, will lead to expansion of our presently limited choices of mechanistically based interventions.

Gender differences in brain networks supporting empathy

Females frequently score higher on standard tests of empathy, social sensitivity, and emotion recognition than do males. It remains to be clarified, however, whether these gender differences are associated with gender specific neural mechanisms of emotional social cognition. We investigated gender differences in an emotion attribution task using functional magnetic resonance imaging. Subjects either focused on their own emotional response to emotion expressing faces (SELF-task) or evaluated the emotional state expressed by the faces (OTHER-task). Behaviorally, females rated SELF-related emotions significantly stronger than males. Across the sexes, SELF- and OTHER-related processing of facial expressions activated a network of medial and lateral prefrontal, temporal, and parietal brain regions involved in emotional perspective taking. During SELF-related processing, females recruited the right inferior frontal cortex and superior temporal sulcus stronger than males. In contrast, there was increased neural activity in the left temporoparietal junction in males (relative to females). When performing the OTHER-task, females showed increased activation of the right inferior frontal cortex while there were no differential activations in males. The data suggest that females recruit areas containing mirror neurons to a higher degree than males during both SELF- and OTHER-related processing in empathic face-to-face interactions. This may underlie facilitated emotional "contagion" in females. Together with the observation that males differentially rely on the left temporoparietal junction (an area mediating the distinction between the SELF and OTHERS) the data suggest that females and males rely on different strategies when assessing their own emotions in response to other people.

Why Does Joint Attention Look Atypical in Autism?

This essay answers the question of why autistic children are less likely to initiate joint attention (e.g., use their index finger to point to indicate interest in something) and why they are less likely to respond to bids for their joint attention (e.g., turn their heads to look at something to which another person points). It reviews empirical evidence that autistic toddlers, children, adolescents, and adults can attend covertly, even to social stimuli, such as the direction in which another person's eyes are gazing. It also reviews empirical evidence that autistics of various ages understand the intentionality of other persons' actions. The essay suggests that autistics' atypical resistance to distraction, atypical skill at parallel perception, and atypical execution of volitional actions underlie their atypical manifestations of joint attention.

Intact automatic imitation of human and robot actions in autism spectrum disorders

The existence of a specialized imitation module in humans is hotly debated. Studies suggesting a specific imitation impairment in individuals with autism spectrum disorders (ASD) support a modular view. However, the voluntary imitation tasks used in these studies (which require socio-cognitive abilities in addition to imitation for successful performance) cannot support claims of a specific impairment. Accordingly, an automatic imitation paradigm (a 'cleaner' measure of imitative ability) was used to assess the imitative ability of 16 adults with ASD and 16 non-autistic matched control participants. Participants performed a prespecified hand action in response to observed hand actions performed either by a human or a robotic hand. On compatible trials the stimulus and response actions matched, while on incompatible trials the two actions did not match. Replicating previous findings, the Control group showed an automatic imitation effect: responses on compatible trials were faster than those on incompatible trials. This effect was greater when responses were made to human than to robotic actions ('animacy bias'). The ASD group also showed an automatic imitation effect and a larger animacy bias than the Control group. We discuss these findings with reference to the literature on imitation in ASD and theories of imitation.

A new way to quantify the fidelity of imitation: preliminary results with gesture sequences

Imitation is a common and effective way for humans to learn new behaviors. Until now, the study of imitation has been hampered by the challenge of measuring how well an attempted imitation corresponds to its stimulus model. We describe a new method for quantifying the fidelity with which observers imitate complex series of gestures. Wearing a data glove that transduced movements of their digits, subjects viewed and then reproduced a sequence of gestures from memory. The velocity profile of each digit's flexion or extension was used to segment movements made during an imitation into gestures that can be compared against corresponding gestures in the stimulus model. The outcome is a multivariate description of each imitation, including its temporal characteristics, as well as spatial errors (in individual gestures and in the ordering of those gestures). As a demonstration, we applied this method to data from an imitation learning experiment with gesture sequences. With repetition, overall fidelity of imitation improved, with various aspects of the imitation improving at different rates. Confirming the approach's usefulness, when we varied the complexity associated with imitation, that variation was robustly reflected in our measures of imitation quality. Finally, we describe a simple way to extend our methods to make them useful not only in assessing imitation and imitation learning, but also in various settings in which the detection and characterization of subtle abnormalities in movement production is paramount.

Emulation and Mimicry for Social Interaction: A Theoretical Approach to Imitation in Autism

The “broken-mirror” theory of autism argues that dysfunction of the “mirror neuron system” is a root cause of social disability in autism. The present paper aims to scrutinize this theory and, when it breaks down, to provide an alternative. Current evidence suggests that children with autism are able to understand and emulate goal-directed actions, but may have specific impairments in automatic mimicry of actions without goals. These data are not compatible with the broken-mirror theory, but can be accounted for by a new model called EP-M. The EP-M model segments the mirror neuron system into an indirect, parietal route for goal emulation and planning (EP) and a direct occipital-frontal route for mimicry (M). This fractionation is consistent with neuroimaging and behavioural studies of the mirror neuron system in typical children and adults. I suggest that top-down modulation of the direct M route may be dysfunctional in individuals with autism, leading to abnormal behaviours on mimicry tasks as well as other social disabilities.

Movement interference in autism-spectrum disorder

Movement interference occurs when concurrently observing and executing incompatible actions and is believed to be due to co-activation of conflicting populations of mirror neurons. It has also been suggested that mirror neurons contribute towards the imitation of observed actions. However, the exact neural substrate of imitation may depend on task demands: a processing route for goal-directed meaningful actions may be distinct from one for non-goal-directed actions. A more controversial role proposed for these neurons is in theory of mind processing, along with the subsequent suggestion that impairment in the mirror neuron circuit can contribute to autism-spectrum disorder (ASD) where individuals have theory of mind deficits. We have therefore examined movement interference in nine ASD participants and nine matched controls while performing actions congruent and incongruent with observed meaningless arm movements. We hypothesised that if the mirror neuron system was impaired, reduced interference should be observed in the ASD group. However, control and ASD participants demonstrated an equivalent interference effect in an interpersonal condition, with greater movement variability in the incongruent compared to the congruent condition. A component of movement interference which is independent of congruency did differ between groups: ASD participants made generally more variable movements for the interpersonal task than for biological dot-motion task, while the reverse was true for the control participants. We interpret these results as evidence that the ASD participant group either rely to a greater extent on the goal-directed imitation pathway, supporting claims that they have a specific deficit of the non-goal-directed imitation pathway, or exhibit reduced visuomotor integration.

Impairment of actions chains in autism and its possible role in intention understanding

Experiments in monkeys demonstrated that many parietal and premotor neurons coding a specific motor act (e.g., grasping) show a markedly different activation when this act is part of actions that have different goals (e.g., grasping for eating vs. grasping for placing). Many of these "action-constrained" neurons have mirror properties firing selectively to the observation of the initial motor act of the actions to which they belong motorically. By activating a specific action chain from its very outset, this mechanism allows the observers to have an internal copy of the whole action before its execution, thus enabling them to understand directly the agent's intention. Using electromyographic recordings, we show that a similar chained organization exists in typically developing children, whereas it is impaired in children with autism. We propose that, as a consequence of this functional impairment, high-functioning autistic children may understand the intentions of others cognitively but lack the mechanism for understanding them experientially.

Dissociation Between Key Processes of Social Cognition in Autism: Impaired Mentalizing But Intact Sense of Agency

Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus, we compared high-functioning adults with autism to healthy control subjects using an action monitoring and attribution task. Subjects with autism did not show deficits in this task, yet they showed significant mentalizing deficits. Our findings indicate a dissociation between the sense of agency and ascription of mental states in autism. We propose that social-cognitive deficits in autism may arise on a higher level than that of action monitoring and awareness.