201
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Corbett BA, Swain DM, Coke C, Simon D, Newsom C, Houchins-Juarez N, Jenson A, Wang L, Song Y. Improvement in social deficits in autism spectrum disorders using a theatre-based, peer-mediated intervention. Autism Res 2013; 7:4-16. [PMID: 24150989 DOI: 10.1002/aur.1341] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 09/04/2013] [Indexed: 01/31/2023]
Abstract
Social Emotional NeuroScience Endocrinology Theatre is a novel intervention program aimed at improving reciprocal social interaction in youth with autism spectrum disorder (ASD) using behavioral strategies and theatrical techniques in a peer-mediated model. Previous research using a 3-month model showed improvement in face perception, social interaction, and reductions in stress. The current study assessed a 2-week summer camp model. Typically developing peers were trained and paired with ASD youth (8-17 years). Social perception and interaction skills were measured before and after treatment using neuropsychological and parental measures. Behavioral coding by reliable, independent raters was conducted within the treatment context (theatre) and outside the setting (playground). Salivary cortisol levels to assess physiological arousal were measured across contexts (home, theatre, and playground). A pretest-posttest design for within-group comparisons was used, and prespecified pairwise comparisons were achieved using a nonparametric Wilcoxon signed-rank test. Significant differences were observed in face processing, social awareness, and social cognition (P < 0.05). Duration of interaction with familiar peers increased significantly over the course of treatment (P < 0.05), while engagement with novel peers outside the treatment setting remained stable. Cortisol levels rose on the first day of camp compared with home values yet declined by the end of treatment and further reduced during posttreatment play with peers. Results corroborate previous findings that the peer-mediated theatre program contributes to improvement in core social deficits in ASD using a short-term, summer camp treatment model. Future studies will explore treatment length and peer familiarity to optimize and generalize gains.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry, Vanderbilt University, Nashville, Tennessee; Vanderbilt Kennedy Center, Nashville, Tennessee
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202
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Yi L, Feng C, Quinn PC, Ding H, Li J, Liu Y, Lee K. Do individuals with and without autism spectrum disorder scan faces differently? A new multi-method look at an existing controversy. Autism Res 2013; 7:72-83. [PMID: 24124133 DOI: 10.1002/aur.1340] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 09/03/2013] [Indexed: 11/07/2022]
Abstract
Individuals with autism spectrum disorder (ASD) are known to process faces atypically. However, there has been considerable controversy regarding whether ASD individuals also scan faces differently from typical adults. Here we compared ASD individuals' face-scanning patterns with those of typically developing (TD) controls and intellectually disabled (ID) but non-ASD individuals with the use of an eye tracker and multiple approaches to analyze eye-tracking data. First, we analyzed the eye movement data with a traditional approach, measuring fixation duration on each area of interest within the face. We found that compared with TD and ID individuals, ASD individuals looked significantly shorter at the right eye. Second, we used a data-driven method that analyzes fixations on each pixel of the face stimulus and found that individuals with ASD looked more at the central nasal area than TD and ID individuals. Third, we used a novel saccade path analysis that measures frequencies of saccades between major face areas. We found that ASD individuals scanned less often between core facial features than TD individuals but did not differ from ID individuals. Findings from the multi-method approaches show that individuals with ASD appear not to have a pervasive ASD-specific atypicality in visual attention toward the face. The ASD-specific atypical face-scanning patterns were shown to be limited to fixations on the eyes and nose.
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Affiliation(s)
- Li Yi
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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203
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Sugarman LI, Garrison BL, Williford KL. Symptoms as solutions: hypnosis and biofeedback for autonomic regulation in autism spectrum disorders. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2013; 56:152-73. [PMID: 24665817 DOI: 10.1080/00029157.2013.768197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Autonomic Dysregulation Theory of autism posits that a phylogenetically early autonomic defect leads to overarousal and impairments in language and social engagement. Cognitive rigidity and repetitive behaviors manifest as mitigating efforts. Focusing on the implications of this premise may provide more productive therapeutic approaches than existing methods. It suggests that self-regulation therapy using hypnosis and biofeedback should be highly effective, especially for young people. Hypnotic strategies can utilize restrictive repetitive behaviors in trance as resources for comfort and control. Biofeedback training can be tailored to focus on autonomic regulation. The authors develop this theory and describe methods of integrating hypnosis and biofeedback that have been therapeutic for people with autism. Directions for future research to validate this approach are discussed.
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204
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García Domínguez L, Stieben J, Pérez Velázquez JL, Shanker S. The imaginary part of coherency in autism: differences in cortical functional connectivity in preschool children. PLoS One 2013; 8:e75941. [PMID: 24098409 PMCID: PMC3788049 DOI: 10.1371/journal.pone.0075941] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 08/23/2013] [Indexed: 11/18/2022] Open
Abstract
Cognition arises from the transient integration and segregation of activity across functionally distinct brain areas. Autism Spectrum Disorders (ASD), which encompass a wide range of developmental disabilities, have been presumed to be associated with a problem in cortical and sub-cortical dynamics of coordinated activity, often involving enhanced local but decreased long range coordination over areas of integration. In this paper we challenge this idea by presenting results from a relatively large population of ASD children and age-matched controls during a face-processing task. Over most of the explored domain, children with ASD exhibited enhanced synchronization, although finer detail reveals specific enhancement/reduction of synchrony depending on time, frequency and brain site. Our results are derived from the use of the imaginary part of coherency, a measure which is not susceptible to volume conduction artifacts and therefore presents a credible picture of coordinated brain activity. We also present evidence that this measure is a good candidate to provide features in building a classifier to be used as a potential biomarker for autism.
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Affiliation(s)
- Luis García Domínguez
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
- Milton and Ethel Harris Research Initiative, York University, Toronto, Ontario, Canada
- * E-mail: (LGD); (JS)
| | - Jim Stieben
- Milton and Ethel Harris Research Initiative, York University, Toronto, Ontario, Canada
- * E-mail: (LGD); (JS)
| | - José Luis Pérez Velázquez
- Neuroscience and Mental Health Programme, Brain and Behaviour Centre, Division of Neurology, Hospital for Sick Children; Department of Paediatrics and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Stuart Shanker
- Milton and Ethel Harris Research Initiative, York University, Toronto, Ontario, Canada
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205
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POP CRISTINAANAMARIA, SIMUT RAMONA, PINTEA SEBASTIAN, SALDIEN JELLE, RUSU ALINA, DAVID DANIEL, VANDERFAEILLIE JOHAN, LEFEBER DIRK, VANDERBORGHT BRAM. CAN THE SOCIAL ROBOT PROBO HELP CHILDREN WITH AUTISM TO IDENTIFY SITUATION-BASED EMOTIONS? A SERIES OF SINGLE CASE EXPERIMENTS. INT J HUM ROBOT 2013. [DOI: 10.1142/s0219843613500254] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Children with autism spectrum disorders have difficulties in identifying situation-based emotions, which is a fundamental ability for mind reading. Social robots received increased attention as assisting tools for improving the social and emotional skills of children with autism. This study investigates whether the social robot Probo can help children with autism spectrum disorders to enhance their performance in identifying situation-based emotions. Three participants (age between 5 and 6) diagnozed with autism spectrum disorders were included in a single case AB experimental design, with intersubjects replications. The results show that children's performance improved with moderate to large effect sizes in identifying both sadness and happiness. Based on these results, we intend to perform more extensive investigations regarding the effectiveness of robot assisted therapy in improving social-emotional abilities for children with autism spectrum disorders.
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Affiliation(s)
- CRISTINA ANAMARIA POP
- Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - RAMONA SIMUT
- Vrije Universiteit Brussel, Clinical and Life Span Psychology Department, Brussels, Belgium
| | - SEBASTIAN PINTEA
- Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - JELLE SALDIEN
- Howest University College, Industrial Design Center, Kortrijk, Belgium
| | - ALINA RUSU
- Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - DANIEL DAVID
- Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
- Mount Sinai School of Medicine, USA
| | - JOHAN VANDERFAEILLIE
- Vrije Universiteit Brussel, Clinical and Life Span Psychology Department, Brussels, Belgium
| | - DIRK LEFEBER
- Vrije Universiteit Brussel, Robotics and Multibody Mechanics Research Group, Brussels, Belgium
| | - BRAM VANDERBORGHT
- Vrije Universiteit Brussel, Robotics and Multibody Mechanics Research Group, Brussels, Belgium
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206
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Wang J, Barstein J, Ethridge LE, Mosconi MW, Takarae Y, Sweeney JA. Resting state EEG abnormalities in autism spectrum disorders. J Neurodev Disord 2013; 5:24. [PMID: 24040879 PMCID: PMC3847481 DOI: 10.1186/1866-1955-5-24] [Citation(s) in RCA: 262] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/04/2013] [Indexed: 12/02/2022] Open
Abstract
Autism spectrum disorders (ASD) are a group of complex and heterogeneous developmental disorders involving multiple neural system dysfunctions. In an effort to understand neurophysiological substrates, identify etiopathophysiologically distinct subgroups of patients, and track outcomes of novel treatments with translational biomarkers, EEG (electroencephalography) studies offer a promising research strategy in ASD. Resting-state EEG studies of ASD suggest a U-shaped profile of electrophysiological power alterations, with excessive power in low-frequency and high-frequency bands, abnormal functional connectivity, and enhanced power in the left hemisphere of the brain. In this review, we provide a summary of recent findings, discuss limitations in available research that may contribute to inconsistencies in the literature, and offer suggestions for future research in this area for advancing the understanding of ASD.
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Affiliation(s)
- Jun Wang
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA
| | - Jamie Barstein
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA
| | - Lauren E Ethridge
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA
| | - Matthew W Mosconi
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA.,Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA
| | - Yukari Takarae
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA.,Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA.,Center for Autism Spectrum Disorders, Bond University, Gold Coast, Australia
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207
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Dumas T, Dubal S, Attal Y, Chupin M, Jouvent R, Morel S, George N. MEG evidence for dynamic amygdala modulations by gaze and facial emotions. PLoS One 2013; 8:e74145. [PMID: 24040190 PMCID: PMC3769395 DOI: 10.1371/journal.pone.0074145] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 07/26/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Amygdala is a key brain region for face perception. While the role of amygdala in the perception of facial emotion and gaze has been extensively highlighted with fMRI, the unfolding in time of amydgala responses to emotional versus neutral faces with different gaze directions is scarcely known. METHODOLOGY/PRINCIPAL FINDINGS Here we addressed this question in healthy subjects using MEG combined with an original source imaging method based on individual amygdala volume segmentation and the localization of sources in the amygdala volume. We found an early peak of amygdala activity that was enhanced for fearful relative to neutral faces between 130 and 170 ms. The effect of emotion was again significant in a later time range (310-350 ms). Moreover, the amygdala response was greater for direct relative averted gaze between 190 and 350 ms, and this effect was selective of fearful faces in the right amygdala. CONCLUSION Altogether, our results show that the amygdala is involved in the processing and integration of emotion and gaze cues from faces in different time ranges, thus underlining its role in multiple stages of face perception.
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Affiliation(s)
- Thibaud Dumas
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphanie Dubal
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yohan Attal
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
| | - Marie Chupin
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
| | - Roland Jouvent
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Shasha Morel
- CNRS, UMR 7295, CeRCA, Université François-Rabelais, Tours, France
| | - Nathalie George
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
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208
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Neural correlates of "social gaze" processing in high-functioning autism under systematic variation of gaze duration. NEUROIMAGE-CLINICAL 2013; 3:340-51. [PMID: 24273718 PMCID: PMC3815020 DOI: 10.1016/j.nicl.2013.08.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/15/2013] [Accepted: 08/27/2013] [Indexed: 01/06/2023]
Abstract
Direct gaze is a salient nonverbal signal for social interest and the intention to communicate. In particular, the duration of another's direct gaze can modulate our perception of the social meaning of gaze cues. However, both poor eye contact and deficits in social cognitive processing of gaze are specific diagnostic features of autism. Therefore, investigating neural mechanisms of gaze may provide key insights into the neural mechanisms related to autistic symptoms. Employing functional magnetic resonance imaging (fMRI) and a parametric design, we investigated the neural correlates of the influence of gaze direction and gaze duration on person perception in individuals with high-functioning autism (HFA) and a matched control group. For this purpose, dynamically animated faces of virtual characters, displaying averted or direct gaze of different durations (1 s, 2.5 s and 4 s) were evaluated on a four-point likeability scale. Behavioral results revealed that HFA participants showed no significant difference in likeability ratings depending on gaze duration, while the control group rated the virtual characters as increasingly likeable with increasing gaze duration. On the neural level, direct gaze and increasing direct gaze duration recruit regions of the social neural network (SNN) in control participants, indicating the processing of social salience and a perceived communicative intent. In participants with HFA however, regions of the social neural network were more engaged by averted and decreasing amounts of gaze, while the neural response for processing direct gaze in HFA was not suggestive of any social information processing.
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209
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Yi L, Fan Y, Quinn PC, Feng C, Huang D, Li J, Mao G, Lee K. Abnormality in face scanning by children with autism spectrum disorder is limited to the eye region: evidence from multi-method analyses of eye tracking data. J Vis 2013; 13:13.10.5. [PMID: 23929830 DOI: 10.1167/13.10.5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
There has been considerable controversy regarding whether children with autism spectrum disorder (ASD) and typically developing children (TD) show different eye movement patterns when processing faces. We investigated ASD and age- and IQ-matched TD children's scanning of faces using a novel multi-method approach. We found that ASD children spent less time looking at the whole face generally. After controlling for this difference, ASD children's fixations of the other face parts, except for the eye region, and their scanning paths between face parts were comparable either to the age-matched or IQ-matched TD groups. In contrast, in the eye region, ASD children's scanning differed significantly from that of both TD groups: (a) ASD children fixated significantly less on the right eye (from the observer's view); (b) ASD children's fixations were more biased towards the left eye region; and (c) ASD children fixated below the left eye, whereas TD children fixated on the pupil region of the eye. Thus, ASD children do not have a general abnormality in face scanning. Rather, their abnormality is limited to the eye region, likely due to their strong tendency to avoid eye contact.
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Affiliation(s)
- Li Yi
- Department of Psychology, Sun Yat-sen University, Guangzhou, China.
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210
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Domes G, Heinrichs M, Kumbier E, Grossmann A, Hauenstein K, Herpertz SC. Effects of intranasal oxytocin on the neural basis of face processing in autism spectrum disorder. Biol Psychiatry 2013; 74:164-71. [PMID: 23510581 DOI: 10.1016/j.biopsych.2013.02.007] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 02/12/2013] [Accepted: 02/13/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is associated with altered face processing and decreased activity in brain regions involved in face processing. The neuropeptide oxytocin has been shown to promote face processing and modulate brain activity in healthy adults. The present study examined the effects of oxytocin on the neural basis of face processing in adults with Asperger syndrome (AS). METHODS A group of 14 individuals with AS and a group of 14 neurotypical control participants performed a face-matching and a house-matching task during functional magnetic resonance imaging. The effects of a single dose of 24 IU intranasally administered oxytocin were tested in a randomized, placebo-controlled, within-subject, cross-over design. RESULTS Under placebo, the AS group showed decreased activity in the right amygdala, fusiform gyrus, and inferior occipital gyrus compared with the control group during face processing. After oxytocin treatment, right amygdala activity to facial stimuli increased in the AS group. CONCLUSIONS These findings indicate that oxytocin increases the saliency of social stimuli and in ASD and suggest that oxytocin might promote face processing and eye contact in individuals with ASD as prerequisites for neurotypical social interaction.
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Affiliation(s)
- Gregor Domes
- Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Germany.
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211
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Current progress and challenges in the search for autism biomarkers. DISEASE MARKERS 2013; 35:55-65. [PMID: 24167349 PMCID: PMC3774962 DOI: 10.1155/2013/476276] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 04/06/2013] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorders (ASD) encompass a range of neurodevelopmental conditions that are clinically and etiologically very heterogeneous. ASD is currently diagnosed entirely on behavioral criteria, but intensive research efforts are focused on identifying biological markers for disease risk and early diagnosis. Here, we discuss recent progress toward identifying biological markers for ASD and highlight specific challenges as well as ethical aspects of translating ASD biomarker research into the clinic.
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212
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Møller AR, Kern JK, Grannemann B. Are the non-classical auditory pathways involved in autism and PDD? Neurol Res 2013; 27:625-9. [PMID: 16157013 DOI: 10.1179/016164105x25117] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To test the hypothesis that some of the abnormal sensory perceptions that characterize autism may be explained by an abnormal activation of non-classical (extra-lemniscal) sensory pathways. METHODS Twenty-one individuals, 18--45 years of age who were diagnosed with autism participated in the study. Sounds (clicks presented at a rate of 40 per second and 65 dB above the normal threshold) were applied through earphones. Electrical stimulation (100 microS rectangular impulses at a rate of 4 per second) was applied through electrodes placed on the skin over the median nerve at the wrist. The participants were asked to match the loudness of the sound with and without the electrical stimulation applied to the median nerve. RESULTS Electrical stimulation of the median nerve at the wrist in individuals with autism could change the perception of loudness of sounds presented to one ear through an earphone showing a statistically significant abnormal sensory cross-modal interaction. DISCUSSION We interpreted our results to support the hypothesis that some individuals with autism have an abnormal cross-modal interaction between the auditory and the somatosensory systems. Cross-modal interaction between senses such as hearing and the somatosensory system does not occur normally in adults. As only the non-classical (extralemniscal) ascending auditory pathways receive somatosensory input, the presence of cross-modal interaction in autistic individuals is a sign that autism is associated with abnormal involvement of the non-classical auditory pathways, implying that sensory information is processed by different populations of neurons than in non-autistic individuals.
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Affiliation(s)
- Aage R Møller
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA.
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213
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Wagner JB, Hirsch SB, Vogel-Farley VK, Redcay E, Nelson CA. Eye-tracking, autonomic, and electrophysiological correlates of emotional face processing in adolescents with autism spectrum disorder. J Autism Dev Disord 2013; 43:188-99. [PMID: 22684525 DOI: 10.1007/s10803-012-1565-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often have difficulty with social-emotional cues. This study examined the neural, behavioral, and autonomic correlates of emotional face processing in adolescents with ASD and typical development (TD) using eye-tracking and event-related potentials (ERPs) across two different paradigms. Scanning of faces was similar across groups in the first task, but the second task found that face-sensitive ERPs varied with emotional expressions only in TD. Further, ASD showed enhanced neural responding to non-social stimuli. In TD only, attention to eyes during eye-tracking related to faster face-sensitive ERPs in a separate task; in ASD, a significant positive association was found between autonomic activity and attention to mouths. Overall, ASD showed an atypical pattern of emotional face processing, with reduced neural differentiation between emotions and a reduced relationship between gaze behavior and neural processing of faces.
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Affiliation(s)
- Jennifer B Wagner
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Children's Hospital Boston, 1 Autumn Street, Boston, MA 02215, USA.
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214
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Voos AC, Pelphrey KA, Tirrell J, Bolling DZ, Vander Wyk B, Kaiser MD, McPartland JC, Volkmar FR, Ventola P. Neural mechanisms of improvements in social motivation after pivotal response treatment: two case studies. J Autism Dev Disord 2013; 43:1-10. [PMID: 23104615 DOI: 10.1007/s10803-012-1683-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pivotal response treatment (PRT) is an empirically validated behavioral treatment that has widespread positive effects on communication, behavior, and social skills in young children with autism spectrum disorder (ASD). For the first time, functional magnetic resonance imaging was used to identify the neural correlates of successful response to PRT in two young children with ASD. Baseline measures of social communication, adaptive behavior, eye tracking and neural response to social stimuli were taken prior to treatment and after 4 months of PRT. Both children showed striking gains on behavioral measures and also showed increased activation to social stimuli in brain regions utilized by typically developing children. These results suggest that neural systems supporting social perception are malleable through implementation of PRT.
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Affiliation(s)
- Avery C Voos
- Yale Child Study Center, Yale University, New Haven, CT, USA.
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215
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Mathersul D, McDonald S, Rushby JA. Understanding advanced theory of mind and empathy in high-functioning adults with autism spectrum disorder. J Clin Exp Neuropsychol 2013; 35:655-68. [PMID: 23799244 DOI: 10.1080/13803395.2013.809700] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It has been argued that higher functioning individuals with autism spectrum disorders (ASDs) have specific deficits in advanced but not simple theory of mind (ToM), yet the questionable ecological validity of some tasks reduces the strength of this assumption. The present study employed The Awareness of Social Inference Test (TASIT), which uses video vignettes to assess comprehension of subtle conversational inferences (sarcasm, lies/deception). Given the proposed relationships between advanced ToM and cognitive and affective empathy, these associations were also investigated. As expected, the high-functioning adults with ASDs demonstrated specific deficits in comprehending the beliefs, intentions, and meaning of nonliteral expressions. They also had significantly lower cognitive and affective empathy. Cognitive empathy was related to ToM and group membership whereas affective empathy was only related to group membership.
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Affiliation(s)
- Danielle Mathersul
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia.
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216
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Doyle-Thomas KAR, Kushki A, Duerden EG, Taylor MJ, Lerch JP, Soorya LV, Wang AT, Fan J, Anagnostou E. The effect of diagnosis, age, and symptom severity on cortical surface area in the cingulate cortex and insula in autism spectrum disorders. J Child Neurol 2013; 28:732-9. [PMID: 22832774 DOI: 10.1177/0883073812451496] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Functional activity in the anterior cingulate cortex and insula has been reported to be abnormal during social tasks in autism spectrum disorders. However, few studies have examined surface morphometry in these regions and how this may be related to autism spectrum disorder symptomatology. In this study, 27 individuals with autism spectrum disorders and 25 controls between the ages of 7 to 39 years underwent structural magnetic resonance imaging. Our primary analysis examined differences in surface area in the cingulate and insula, between individuals with and without autism spectrum disorders, as well as age-related changes and associations with social impairments. Surface area in the right cingulate was significantly different between groups and decreased more rapidly with age in autism spectrum disorder participants. In addition, greater surface area in the insula and isthmus was associated with poorer social behaviors. Results suggest atypical surface morphometry in brain regions involved in social function, which appeared to be related to poorer social ability scores.
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Affiliation(s)
- Krissy A R Doyle-Thomas
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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217
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Abstract
This review presents an overview of functional magnetic resonance imaging findings in autism spectrum disorders (ASDS), although there is considerable heterogeneity with respect to results across studies, common themes have emerged, including: (i) hypoactivation in nodes of the "social brain" during social processing tasks, including regions within the prefrontal cortex, the posterior superior temporal sulcus, the amygdala, and the fusiform gyrus; (ii) aberrant frontostriatal activation during cognitive control tasks relevant to restricted and repetitive behaviors and interests, including regions within the dorsal prefrontal cortex and the basal ganglia; (iii) differential lateralization and activation of language processing and production regions during communication tasks; (iv) anomalous mesolimbic responses to social and nonsocial rewards; (v) task-based long-range functional hypoconnectivity and short-range hyper-connectivity; and (vi) decreased anterior-posterior functional connectivity during resting states. These findings provide mechanistic accounts of ASD pathophysiology and suggest directions for future research aimed at elucidating etiologic models and developing rationally derived and targeted treatments.
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Affiliation(s)
- Gabriel S Dichter
- Departments of Psychiatry and Psychology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
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218
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Silva EB, Filipini R, Monteiro CBDM, Valenti VE, de Carvalho SMF, Wajnsztejn R, de Farias MDCAD, Macedo CC, de Abreu LC. The biopsychosocial processes in autism spectrum disorder. Int Arch Med 2013; 6:22. [PMID: 23656636 PMCID: PMC3671139 DOI: 10.1186/1755-7682-6-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 05/04/2013] [Indexed: 11/17/2022] Open
Abstract
Background Autism is a disorder characterized by pervasive social and communicative impairments, repetitive and stereotyped behaviors and restricted interests. Its causes and effects have been researched from various neurocognitive theoretical perspectives and with the aid of neuroimaging technology. We aimed to describe biopsychosocial processes characteristic of the Autism Spectrum Disorders. Method Literature review using Medline and Scopus databases published between 2001 and 2011, with the keywords "autism", "theory of mind", "executive functions", "central coherence" and “fMRI”. Results The studies found were plotted and organized into tables and an explanatory diagram of the main findings was produced. Conclusions The most popular neurocognitive theories are still unable to fully explain the characteristics of the complications that autistic spectrum disorder causes to the quality of life of individuals living with autism. The association of clinical research and neuroimaging may contribute to a better understanding of the functioning of the brain affected by the disorder.
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Affiliation(s)
- Edgar Bittner Silva
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Av, Príncipe de Gales, 821, 09060-650, Santo André, São Paulo, Brazil.
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219
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Jakab A, Emri M, Spisak T, Szeman-Nagy A, Beres M, Kis SA, Molnar P, Berenyi E. Autistic traits in neurotypical adults: correlates of graph theoretical functional network topology and white matter anisotropy patterns. PLoS One 2013; 8:e60982. [PMID: 23593367 PMCID: PMC3618514 DOI: 10.1371/journal.pone.0060982] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 03/05/2013] [Indexed: 12/27/2022] Open
Abstract
Attempts to explicate the neural abnormalities behind autism spectrum disorders frequently revealed impaired brain connectivity, yet our knowledge is limited about the alterations linked with autistic traits in the non-clinical population. In our study, we aimed at exploring the neural correlates of dimensional autistic traits using a dual approach of diffusion tensor imaging (DTI) and graph theoretical analysis of resting state functional MRI data. Subjects were sampled from a public neuroimaging dataset of healthy volunteers. Inclusion criteria were adult age (age: 18-65), availability of DTI and resting state functional acquisitions and psychological evaluation including the Social Responsiveness Scale (SRS) and Autistic Spectrum Screening Questionnaire (ASSQ). The final subject cohort consisted of 127 neurotypicals. Global brain network structure was described by graph theoretical parameters: global and average local efficiency. Regional topology was characterized by degree and efficiency. We provided measurements for diffusion anisotropy. The association between autistic traits and the neuroimaging findings was studied using a general linear model analysis, controlling for the effects of age, gender and IQ profile. Significant negative correlation was found between the degree and efficiency of the right posterior cingulate cortex and autistic traits, measured by the combination of ASSQ and SRS scores. Autistic phenotype was associated with the decrease of whole-brain local efficiency. Reduction of diffusion anisotropy was found bilaterally in the temporal fusiform and parahippocampal gyri. Numerous models describe the autistic brain connectome to be dominated by reduced long-range connections and excessive short-range fibers. Our finding of decreased efficiency supports this hypothesis although the only prominent effect was seen in the posterior limbic lobe, which is known to act as a connector hub. The neural correlates of the autistic trait in neurotypicals showed only limited similarities to the reported findings in clinical populations with low functioning autism.
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Affiliation(s)
- Andras Jakab
- Department of Biomedical Laboratory and Imaging Science, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
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220
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A quantitative link between face discrimination deficits and neuronal selectivity for faces in autism. NEUROIMAGE-CLINICAL 2013; 2:320-31. [PMID: 24179786 PMCID: PMC3777682 DOI: 10.1016/j.nicl.2013.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/08/2013] [Accepted: 02/13/2013] [Indexed: 11/21/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) appear to show a general face discrimination deficit across a range of tasks including social–emotional judgments as well as identification and discrimination. However, functional magnetic resonance imaging (fMRI) studies probing the neural bases of these behavioral differences have produced conflicting results: while some studies have reported reduced or no activity to faces in ASD in the Fusiform Face Area (FFA), a key region in human face processing, others have suggested more typical activation levels, possibly reflecting limitations of conventional fMRI techniques to characterize neuron-level processing. Here, we test the hypotheses that face discrimination abilities are highly heterogeneous in ASD and are mediated by FFA neurons, with differences in face discrimination abilities being quantitatively linked to variations in the estimated selectivity of face neurons in the FFA. Behavioral results revealed a wide distribution of face discrimination performance in ASD, ranging from typical performance to chance level performance. Despite this heterogeneity in perceptual abilities, individual face discrimination performance was well predicted by neural selectivity to faces in the FFA, estimated via both a novel analysis of local voxel-wise correlations, and the more commonly used fMRI rapid adaptation technique. Thus, face processing in ASD appears to rely on the FFA as in typical individuals, differing quantitatively but not qualitatively. These results for the first time mechanistically link variations in the ASD phenotype to specific differences in the typical face processing circuit, identifying promising targets for interventions.
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221
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Charbonneau G, Bertone A, Lepore F, Nassim M, Lassonde M, Mottron L, Collignon O. Multilevel alterations in the processing of audio-visual emotion expressions in autism spectrum disorders. Neuropsychologia 2013; 51:1002-10. [PMID: 23462241 DOI: 10.1016/j.neuropsychologia.2013.02.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/27/2013] [Accepted: 02/13/2013] [Indexed: 10/27/2022]
Abstract
The abilities to recognize and integrate emotions from another person's facial and vocal expressions are fundamental cognitive skills involved in the effective regulation of social interactions. Deficits in such abilities have been suggested as a possible source for certain atypical social behaviors manifested by persons with autism spectrum disorders (ASD). In the present study, we assessed the recognition and integration of emotional expressions in ASD using a validated set of ecological stimuli comprised of dynamic visual and auditory (non-verbal) vocal clips. Autistic participants and typically developing controls (TD) were asked to discriminate between clips depicting expressions of disgust and fear presented either visually, auditorily or audio-visually. The group of autistic participants was less efficient to discriminate emotional expressions across all conditions (unimodal and bimodal). Moreover, they necessitated a higher signal-to-noise ratio for the discrimination of visual or auditory presentations of disgust versus fear expressions. These results suggest an altered sensitivity to emotion expressions in this population that is not modality-specific. In addition, the group of autistic participants benefited from exposure to bimodal information to a lesser extent than did the TD group, indicative of a decreased multisensory gain in this population. These results are the first to compellingly demonstrate joint alterations for both the perception and the integration of multisensory emotion expressions in ASD.
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Affiliation(s)
- Geneviève Charbonneau
- Centre de Recherche en Neuropsychologie et Cognition-CERNEC, Département de psychologie, Université de Montréal, CP 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
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222
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A proton magnetic resonance spectroscopic study in autism spectrum disorders: amygdala and orbito-frontal cortex. Brain Dev 2013; 35:139-45. [PMID: 23114054 DOI: 10.1016/j.braindev.2012.09.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 09/24/2012] [Accepted: 09/29/2012] [Indexed: 11/21/2022]
Abstract
We previously reported neural dysfunction in the anterior cingulate cortex and dorsolateral prefrontal cortex in autistic patients using proton magnetic resonance spectroscopy ((1)H-MRS). In this investigation, we measured chemical metabolites in the left amygdala and the bilateral orbito-frontal cortex (OFC), which are the main components of the social brain. We also examined the association between these metabolic findings and social abilities in subjects with autism. The study group included 77 autistic patients (3-6years old; mean age 4.1; 57 boys and 20 girls). The control subjects were 31 children (3-6years old; mean age 4.0; 23 boys and 8 girls). Conventional proton MR spectra were obtained using the STEAM sequence with parameters of TR=5 sec and TE=15 msec by a 1.5-tesla clinical MRI system. We analyzed the concentrations of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr), and choline-containing compounds (Cho) using LCModel (Ver. 6.1). The concentrations of NAA in the left amygdala and the bilateral OFC in autistic patients were significantly decreased compared to those in the control group. In the autistic patients, the NAA concentrations in these regions correlated with their social quotient. These findings suggest the presence of neuronal dysfunction in the amygdala and OFC in autism. Dysfunction in the amygdala and OFC may contribute to the pathogenesis of autism.
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223
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Tye C, Mercure E, Ashwood KL, Azadi B, Asherson P, Johnson MH, Bolton P, McLoughlin G. Neurophysiological responses to faces and gaze direction differentiate children with ASD, ADHD and ASD+ADHD. Dev Cogn Neurosci 2013; 5:71-85. [PMID: 23466656 DOI: 10.1016/j.dcn.2013.01.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 12/17/2012] [Accepted: 01/02/2013] [Indexed: 01/25/2023] Open
Abstract
Children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) demonstrate face processing abnormalities that may underlie social impairment. Despite substantial overlap between ASD and ADHD, ERP markers of face and gaze processing have not been directly compared across pure and comorbid cases. Children with ASD (n=19), ADHD (n=18), comorbid ASD+ADHD (n=29) and typically developing (TD) controls (n=26) were presented with upright/inverted faces with direct/averted gaze, with concurrent recording of the P1 and N170 components. While the N170 was predominant in the right hemisphere in TD and ADHD, children with ASD (ASD/ASD+ADHD) showed a bilateral distribution. In addition, children with ASD demonstrated altered response to gaze direction on P1 latency and no sensitivity to gaze direction on midline-N170 amplitude compared to TD and ADHD. In contrast, children with ADHD (ADHD/ASD+ADHD) exhibited a reduced face inversion effect on P1 latency compared to TD and ASD. These findings suggest children with ASD have specific abnormalities in gaze processing and altered neural specialisation, whereas children with ADHD show abnormalities at early visual attention stages. Children with ASD+ADHD are an additive co-occurrence with deficits of both disorders. Elucidating the neural basis of the overlap between ASD and ADHD is likely to inform aetiological investigation and clinical assessment.
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Affiliation(s)
- Charlotte Tye
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK.
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224
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Mathersul D, McDonald S, Rushby JA. Automatic facial responses to affective stimuli in high-functioning adults with autism spectrum disorder. Physiol Behav 2013; 109:14-22. [DOI: 10.1016/j.physbeh.2012.10.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 09/05/2012] [Accepted: 10/05/2012] [Indexed: 01/21/2023]
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225
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Zilbovicius M, Saitovitch A, Popa T, Rechtman E, Diamandis L, Chabane N, Brunelle F, Samson Y, Boddaert N. Autism, social cognition and superior temporal sulcus. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojpsych.2013.32a008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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226
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Bridging the gap between neuroscientific and psychodynamic models in child and adolescent psychiatry. Child Adolesc Psychiatr Clin N Am 2013; 22:1-31. [PMID: 23164125 DOI: 10.1016/j.chc.2012.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This article provides a selective review of the neuroscience and child-psychoanalytic literature, focusing on areas of significant overlap and emphasizing comprehensive theories in developmental neuroscience and child psychoanalysis with testable mechanisms of action. Topics include molecular biology and genetics findings relevant to psychotherapy research, neuroimaging findings relevant to psychotherapy, brain regions of interest for psychotherapy, neurobiologic changes caused by psychotherapy, use of neuroimaging to predict treatment outcome, and schemas as a bridging concept between psychodynamic and cognitive neuroscience models. The combined efforts of neuroscientists and psychodynamic clinicians and theorists are needed to unravel the mechanisms of human mental functioning.
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227
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The face-sensitive N170 component in developmental prosopagnosia. Neuropsychologia 2012; 50:3588-99. [DOI: 10.1016/j.neuropsychologia.2012.10.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 09/17/2012] [Accepted: 10/14/2012] [Indexed: 11/18/2022]
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228
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Olexová L, Talarovičová A, Lewis-Evans B, Borbélyová V, Kršková L. Animal models of autism with a particular focus on the neural basis of changes in social behaviour: An update article. Neurosci Res 2012; 74:184-94. [DOI: 10.1016/j.neures.2012.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 09/25/2012] [Accepted: 10/25/2012] [Indexed: 10/27/2022]
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229
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Spencer MD, Holt RJ, Chura LR, Calder AJ, Suckling J, Bullmore ET, Baron-Cohen S. Atypical activation during the Embedded Figures Task as a functional magnetic resonance imaging endophenotype of autism. Brain 2012; 135:3469-80. [PMID: 23065480 PMCID: PMC3501969 DOI: 10.1093/brain/aws229] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 06/02/2012] [Accepted: 06/26/2012] [Indexed: 01/08/2023] Open
Abstract
Atypical activation during the Embedded Figures Task has been demonstrated in autism, but has not been investigated in siblings or related to measures of clinical severity. We identified atypical activation during the Embedded Figures Task in participants with autism and unaffected siblings compared with control subjects in a number of temporal and frontal brain regions. Autism and sibling groups, however, did not differ in terms of activation during this task. This suggests that the pattern of atypical activation identified may represent a functional endophenotype of autism, related to familial risk for the condition shared between individuals with autism and their siblings. We also found that reduced activation in autism relative to control subjects in regions including associative visual and face processing areas was strongly correlated with the clinical severity of impairments in reciprocal social interaction. Behavioural performance was intact in autism and sibling groups. Results are discussed in terms of atypical information processing styles or of increased activation in temporal and frontal regions in autism and the broader phenotype. By separating the aspects of atypical activation as markers of familial risk for the condition from those that are autism-specific, our findings offer new insight into the factors that might cause the expression of autism in families, affecting some children but not others.
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Affiliation(s)
- Michael D Spencer
- Department of Psychiatry, University of Cambridge, Autism Research Centre, Douglas House, 18 b Trumpington Road, Cambridge CB2 8AH, UK.
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230
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Autism spectrum disorder: does neuroimaging support the DSM-5 proposal for a symptom dyad? A systematic review of functional magnetic resonance imaging and diffusion tensor imaging studies. J Autism Dev Disord 2012; 42:1326-41. [PMID: 21932156 DOI: 10.1007/s10803-011-1360-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with 'autism spectrum disorder' (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported abnormal function and structure of fronto-temporal and limbic networks with social and pragmatic language deficits, of temporo-parieto-occipital networks with syntactic-semantic language deficits, and of fronto-striato-cerebellar networks with repetitive behaviors and restricted interests in ASD patients. Therefore, this review partially supports the DSM-5 proposal for the ASD dyad.
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231
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Abstract
Both high-functioning autism (HFA) and social phobia (SP) involve profound social interaction deficits. Although these disorders share some similar symptoms, they are conceptualized as distinct. Because both HFA and SP are defined behaviorally, the degree of overlap between the two disorders may result in misinterpretation of symptoms. However, the deficits in each disorder differ, particularly in areas of social interaction, emotion recognition and expression, and communication. This paper reviews the literature that informs our current understanding of the behavioral overlaps and differences in HFA and SP. The review also addresses the implications of our current knowledge of these two disorders for differential diagnosis, treatment, and future research. Interdisciplinary, developmentally-oriented research may help extend current approaches to HFA and SP.
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232
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Towler J, Eimer M. Electrophysiological studies of face processing in developmental prosopagnosia: neuropsychological and neurodevelopmental perspectives. Cogn Neuropsychol 2012; 29:503-29. [PMID: 23066851 DOI: 10.1080/02643294.2012.716757] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
People with developmental prosopagnosia (DP) show severe face-recognition deficits that typically emerge during childhood without history of neurological damage. We review findings from recent event-related brain potential (ERP) studies of face perception and face recognition in DP. The generic face-sensitivity of the N170 component is present in most DPs, suggesting rapid category-selective streaming of facial information. In contrast, DPs show atypical N170 face inversion effects, indicative of impaired structural encoding, specifically for upright faces. In line with neurodevelopmental accounts of DP, these effects are similar to those observed for other developmental disorders, as well as for younger children and older adults. Identity-sensitive ERP components (N250, P600f) triggered during successful face recognition are similar for DPs and control participants, indicating that the same mechanisms are active in both groups. The presence of covert face-recognition effects for the N250 component suggests that visual face memory and semantic memory can become disconnected in some individuals with DP. The implications of these results for neuropsychological and neurodevelopmental perspectives on DP are discussed.
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Affiliation(s)
- John Towler
- Department of Psychological Sciences, Birkbeck College, University of London, UK
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233
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Dundas EM, Best CA, Minshew NJ, Strauss MS. A lack of left visual field bias when individuals with autism process faces. J Autism Dev Disord 2012; 42:1104-11. [PMID: 21986874 DOI: 10.1007/s10803-011-1354-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It has been established that typically developing individuals have a bias to attend to facial information in the left visual field (LVF) more than in the right visual field. This bias is thought to arise from the right hemisphere's advantage for processing facial information, with evidence suggesting it to be driven by the configural demands of face processing. Considering research showing that individuals with autism have impaired face processing abilities, with marked deficits in configural processing, it was hypothesized that they would not demonstrate a LVF bias for faces. Eye-tracking technology was used to show that individuals with autism were not spontaneously biased to facial information in the LVF, in contrast to a control group, while discriminating facial gender.
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234
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Konishi Y, Okubo K, Kato I, Ijichi S, Nishida T, Kusaka T, Isobe K, Itoh S, Kato M, Konishi Y. A developmental change of the visual behavior of the face recognition in the early infancy. Brain Dev 2012; 34:719-22. [PMID: 22310452 DOI: 10.1016/j.braindev.2012.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 01/09/2012] [Accepted: 01/11/2012] [Indexed: 10/14/2022]
Abstract
The purpose of this study was to examine developmental changes in visuocognitive function, particularly face recognition, in early infancy. In this study, we measured eye movement in healthy infants with a preference gaze problem, particularly eye movement between two face stimulations. We used the eye tracker system (Tobii1750, Tobii Technologies, Sweden) to measure eye movement in infants. Subjects were 17 3-month-old infants and 16 4-month-old infants. The subjects looked two types of face stimulation (upright face/scrambled face) at the same time and we measured their visual behavior (preference/looking/eye movement). Our results showed that 4-month-old infants looked at an upright face longer than 3-month infants, and exploratory behavior while comparing two face stimulations significantly increased. In this study, 4-month-old infants showed a preference towards an upright face. The numbers of eye movements between two face stimuli significantly increased in 4-month-old infants. These results suggest that eye movements may be an important index in face cognitive function during early infancy.
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Affiliation(s)
- Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan.
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235
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Weisberg J, Milleville SC, Kenworthy L, Wallace GL, Gotts SJ, Beauchamp MS, Martin A. Social perception in autism spectrum disorders: impaired category selectivity for dynamic but not static images in ventral temporal cortex. Cereb Cortex 2012; 24:37-48. [PMID: 23019245 DOI: 10.1093/cercor/bhs276] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Studies of autism spectrum disorders (ASDs) reveal dysfunction in the neural systems mediating object processing (particularly faces) and social cognition, but few investigations have systematically assessed the specificity of the dysfunction. We compared cortical responses in typically developing adolescents and those with ASD to stimuli from distinct conceptual domains known to elicit category-related activity in separate neural systems. In Experiment 1, subjects made category decisions to photographs, videos, and point-light displays of people and tools. In Experiment 2, subjects interpreted displays of simple, geometric shapes in motion depicting social or mechanical interactions. In both experiments, we found a selective deficit in the ASD subjects for dynamic social stimuli (videos and point-light displays of people, moving geometric shapes), but not static images, in the functionally localized lateral region of the right fusiform gyrus, including the fusiform face area. In contrast, no group differences were found in response to either static images or dynamic stimuli in other brain regions associated with face and social processing (e.g. posterior superior temporal sulcus, amygdala), suggesting disordered connectivity between these regions and the fusiform gyrus in ASD. This possibility was confirmed by functional connectivity analysis.
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Affiliation(s)
- Jill Weisberg
- NIMH, Laboratory of Brain and Cognition, Bethesda, MD 20850
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236
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Impaired gamma-band activity during perceptual organization in adults with autism spectrum disorders: evidence for dysfunctional network activity in frontal-posterior cortices. J Neurosci 2012; 32:9563-73. [PMID: 22787042 DOI: 10.1523/jneurosci.1073-12.2012] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Current theories of the pathophysiology of autism spectrum disorders (ASD) have focused on abnormal temporal coordination of neural activity in cortical circuits as a core impairment of the disorder. In the current study, we examined the possibility that gamma-band activity may be crucially involved in aberrant brain functioning in ASD. Magneto-encephalographic (MEG) data were recorded from 13 adult human participants with ASD and 16 controls during the presentation of Mooney faces. MEG data were analyzed in the 25-150 Hz frequency range and a beamforming approach was used to identify the sources of spectral power. Participants with ASD showed elevated reaction times and reduced detection rates during the perception of upright Mooney faces, while responses to inverted stimuli were in the normal range. Impaired perceptual organization in the ASD group was accompanied by a reduction in both the amplitude and phase locking of gamma-band activity. A beamforming approach identified distinct networks during perceptual organization in controls and participants with ASD. In controls, perceptual organization of Mooney faces involved increased 60-120 Hz activity in a frontoparietal network, while in the ASD group stronger activation was found in visual regions. These findings highlight the contribution of impaired gamma-band activity toward complex visual processing in ASD, suggesting atypical modulation of high-frequency power in frontoposterior networks.
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237
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Saitovitch A, Bargiacchi A, Chabane N, Brunelle F, Samson Y, Boddaert N, Zilbovicius M. Social cognition and the superior temporal sulcus: implications in autism. Rev Neurol (Paris) 2012; 168:762-70. [PMID: 22981269 DOI: 10.1016/j.neurol.2012.07.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 07/23/2012] [Indexed: 10/27/2022]
Abstract
The most common clinical sign of autism spectrum disorders (ASD) is social interaction impairment, which is associated with communication deficits and stereotyped behaviors. Based on brain-imaging results, our hypothesis is that abnormalities in the superior temporal sulcus (STS) are highly implicated in ASD. These abnormalities are characterized by decreased grey matter concentration, rest hypoperfusion and abnormal activation during social tasks. STS anatomofunctional anomalies occurring early across brain development could constitute the first step in the cascade of neural dysfunctions underlying autism. It is known that STS is highly implicated on social perception processing, from perception of biological movements, such as body movements or eye gaze, to more complex social cognition processes. Among the impairments that can be described in social perception processing, eye gaze perception is particularly relevant in autism. Gaze abnormalities can now be objectively measured using eye-tracking methodology. In the present work, we will review recent data on STS contributions to normal social cognition and its implication in autism, with particular focus on eye gaze perception.
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Affiliation(s)
- A Saitovitch
- Unité Inserm 1000, service de radiologie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, université Paris V René-Descartes, 149, rue de Sèvres, 75015 Paris cedex 15, France.
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238
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239
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Sato W, Toichi M, Uono S, Kochiyama T. Impaired social brain network for processing dynamic facial expressions in autism spectrum disorders. BMC Neurosci 2012; 13:99. [PMID: 22889284 PMCID: PMC3459703 DOI: 10.1186/1471-2202-13-99] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 07/24/2012] [Indexed: 11/10/2022] Open
Abstract
Background Impairment of social interaction via facial expressions represents a core clinical feature of autism spectrum disorders (ASD). However, the neural correlates of this dysfunction remain unidentified. Because this dysfunction is manifested in real-life situations, we hypothesized that the observation of dynamic, compared with static, facial expressions would reveal abnormal brain functioning in individuals with ASD. We presented dynamic and static facial expressions of fear and happiness to individuals with high-functioning ASD and to age- and sex-matched typically developing controls and recorded their brain activities using functional magnetic resonance imaging (fMRI). Result Regional analysis revealed reduced activation of several brain regions in the ASD group compared with controls in response to dynamic versus static facial expressions, including the middle temporal gyrus (MTG), fusiform gyrus, amygdala, medial prefrontal cortex, and inferior frontal gyrus (IFG). Dynamic causal modeling analyses revealed that bi-directional effective connectivity involving the primary visual cortex–MTG–IFG circuit was enhanced in response to dynamic as compared with static facial expressions in the control group. Group comparisons revealed that all these modulatory effects were weaker in the ASD group than in the control group. Conclusions These results suggest that weak activity and connectivity of the social brain network underlie the impairment in social interaction involving dynamic facial expressions in individuals with ASD.
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Affiliation(s)
- Wataru Sato
- The Hakubi Project, Primate Research Institute, Kyoto University, Inuyama, Aichi 484-8506, Japan.
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240
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Wright B, Alderson-Day B, Prendergast G, Bennett S, Jordan J, Whitton C, Gouws A, Jones N, Attur R, Tomlinson H, Green G. Gamma activation in young people with autism spectrum disorders and typically-developing controls when viewing emotions on faces. PLoS One 2012; 7:e41326. [PMID: 22859975 PMCID: PMC3409185 DOI: 10.1371/journal.pone.0041326] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 06/20/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Behavioural studies have highlighted irregularities in recognition of facial affect in children and young people with autism spectrum disorders (ASDs). Recent findings from studies utilising electroencephalography (EEG) and magnetoencephalography (MEG) have identified abnormal activation and irregular maintenance of gamma (>30 Hz) range oscillations when ASD individuals attempt basic visual and auditory tasks. METHODOLOGY/PRINCIPAL FINDINGS The pilot study reported here is the first study to use spatial filtering techniques in MEG to explore face processing in children with ASD. We set out to examine theoretical suggestions that gamma activation underlying face processing may be different in a group of children and young people with ASD (n = 13) compared to typically developing (TD) age, gender and IQ matched controls. Beamforming and virtual electrode techniques were used to assess spatially localised induced and evoked activity. While lower-band (3-30 Hz) responses to faces were similar between groups, the ASD gamma response in occipital areas was observed to be largely absent when viewing emotions on faces. Virtual electrode analysis indicated the presence of intact evoked responses but abnormal induced activity in ASD participants. CONCLUSIONS/SIGNIFICANCE These findings lend weight to previous suggestions that specific components of the early visual response to emotional faces is abnormal in ASD. Elucidation of the nature and specificity of these findings is worthy of further research.
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Affiliation(s)
- Barry Wright
- Lime Trees Child, Family and Adolescent Unit, North Yorkshire and York Primary Care Trust, York, United Kingdom.
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241
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Are the Autism and Positive Schizotypy Spectra Diametrically Opposed in Empathizing and Systemizing? J Autism Dev Disord 2012; 43:695-706. [DOI: 10.1007/s10803-012-1614-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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242
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Greimel E, Nehrkorn B, Schulte-Rüther M, Fink GR, Nickl-Jockschat T, Herpertz-Dahlmann B, Konrad K, Eickhoff SB. Changes in grey matter development in autism spectrum disorder. Brain Struct Funct 2012; 218:929-42. [PMID: 22777602 PMCID: PMC3695319 DOI: 10.1007/s00429-012-0439-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
Abstract
Results on grey matter (GM) structural alterations in autism spectrum disorder (ASD) are inconclusive. Moreover, little is known about age effects on brain-structure abnormalities in ASD beyond childhood. Here, we aimed to examine regional GM volumes in a large sample of children, adolescents, and adults with ASD. Magnetic resonance imaging scans were obtained in 47 male ASD subjects and 51 matched healthy controls aged 8-50 years. We used whole-brain voxel-based morphometry to first assess group differences in regional GM volume across age. Moreover, taking a cross-sectional approach, group differences in age effects on regional GM volume were investigated. Compared to controls, ASD subjects showed reduced GM volumes in the anterior cingulate cortex, posterior superior temporal sulcus, and middle temporal gyrus. Investigation of group differences in age effects on regional GM volume revealed complex, region-specific alterations in ASD. While GM volumes in the amygdala, temporoparietal junction, septal nucleus and middle cingulate cortex increased in a negative quadratic fashion in both groups, data indicated that GM volume curves in ASD subjects were shifted to the left along the age axis. Moreover, while GM volume in the right precentral gyrus decreased linearly with age in ASD individuals, GM volume development in controls followed a U-shaped pattern. Based on a large sample, our voxel-based morphometry results on group differences in regional GM volumes help to resolve inconclusive findings from previous studies in ASD. Results on age-related changes of regional GM volumes suggest that ASD is characterized by complex alterations in lifetime trajectories of several brain regions that underpin social-cognitive and motor functions.
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Affiliation(s)
- Ellen Greimel
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of the RWTH Aachen, Aachen, Germany.
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243
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Skelly LR, Decety J. Passive and motivated perception of emotional faces: qualitative and quantitative changes in the face processing network. PLoS One 2012; 7:e40371. [PMID: 22768287 PMCID: PMC3386961 DOI: 10.1371/journal.pone.0040371] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 06/06/2012] [Indexed: 11/17/2022] Open
Abstract
Emotionally expressive faces are processed by a distributed network of interacting sub-cortical and cortical brain regions. The components of this network have been identified and described in large part by the stimulus properties to which they are sensitive, but as face processing research matures interest has broadened to also probe dynamic interactions between these regions and top-down influences such as task demand and context. While some research has tested the robustness of affective face processing by restricting available attentional resources, it is not known whether face network processing can be augmented by increased motivation to attend to affective face stimuli. Short videos of people expressing emotions were presented to healthy participants during functional magnetic resonance imaging. Motivation to attend to the videos was manipulated by providing an incentive for improved recall performance. During the motivated condition, there was greater coherence among nodes of the face processing network, more widespread correlation between signal intensity and performance, and selective signal increases in a task-relevant subset of face processing regions, including the posterior superior temporal sulcus and right amygdala. In addition, an unexpected task-related laterality effect was seen in the amygdala. These findings provide strong evidence that motivation augments co-activity among nodes of the face processing network and the impact of neural activity on performance. These within-subject effects highlight the necessity to consider motivation when interpreting neural function in special populations, and to further explore the effect of task demands on face processing in healthy brains.
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Affiliation(s)
- Laurie R Skelly
- Department of Psychology, The University of Chicago, Chicago, Illinois, United States of America.
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244
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Cook J, Barbalat G, Blakemore SJ. Top-down modulation of the perception of other people in schizophrenia and autism. Front Hum Neurosci 2012; 6:175. [PMID: 22715325 PMCID: PMC3375615 DOI: 10.3389/fnhum.2012.00175] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/29/2012] [Indexed: 11/30/2022] Open
Abstract
Accurately and efficiently perceiving social cues such as body movements and facial expressions is important in social interaction. Accurate social perception of this kind does not solely rely on “bottom-up” visual processing but is also subject to modulation by “top-down” signals. For example, if instructed to look for signs of happiness rather than fear, participants are more likely to categorize facial expressions as happy—this prior expectation biases subsequent perception. Top-down modulation is also important in our reactions to others. For example, top-down control over imitation plays an important role in the development of smooth and harmonious social interactions. This paper highlights the importance of top-down modulation in our perception of, and reactions to, others. We discuss evidence that top-down modulation of social perception and imitation is atypical in Autism Spectrum Conditions and in schizophrenia, and we consider the effect this may have on the development of social interactions for individuals with these developmental disorders.
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Affiliation(s)
- Jennifer Cook
- Department of Psychiatry, University of Cambridge London, UK
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245
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Isaac L. Facing the future: face-emotion processing deficits as a potential biomarker for various psychiatric and neurological disorders. Front Psychol 2012; 3:171. [PMID: 22701441 PMCID: PMC3373164 DOI: 10.3389/fpsyg.2012.00171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 05/11/2012] [Indexed: 11/13/2022] Open
Affiliation(s)
- Linda Isaac
- Clinical Psychology, Behavioural Science Institute, Radboud University Nijmegen, Netherlands
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Abstract
Social disability represents a unifying feature in the diverse group of individuals with autism spectrum disorder (ASD). Social neuroscience is the study of brain mechanisms supporting interpersonal interaction. In this paper, we review brain imaging studies of the social brain and highlight practical applications of these scientific insights. Understanding of social brain mechanisms holds promise as a tool for defining meaningful subgroups of children with ASD to facilitate genetic analyses and to inform treatment selection. Because social brain systems emerge in infancy, social neuroscience may help to detect atypical development before symptoms manifest. This conceptualization of ASD is a hopeful one, as social brain systems remain malleable well into development and are thus amenable to targeted intervention.
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Affiliation(s)
- James C McPartland
- Yale Child Study Center, 230 South Frontage Road, New Haven, CT 06520, USA.
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247
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White SJ. The Triple I Hypothesis: Taking Another(’s) Perspective on Executive Dysfunction in Autism. J Autism Dev Disord 2012; 43:114-21. [DOI: 10.1007/s10803-012-1550-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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248
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Altered balance of proteolytic isoforms of pro-brain-derived neurotrophic factor in autism. J Neuropathol Exp Neurol 2012; 71:289-97. [PMID: 22437340 DOI: 10.1097/nen.0b013e31824b27e4] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Defects in synaptic development and plasticity may lead to autism. Brain-derived neurotrophic factor (BDNF) plays a critical role in synaptogenesis and synaptic plasticity. BDNF is synthesized as a precursor, pro-BDNF, which can be processed into either a truncated form or into mature BDNF. Previous studies reported increased BDNF-immunoreactive protein in autism, but the mechanism of this increase has not been investigated. We examined BDNF mRNA by real-time reverse transcription-polymerase chain reaction and BDNF protein by Western blotting and enzyme-linked immunosorbent assay in postmortem fusiform gyrus tissue from 11 patients with autism and 14 controls. BDNF mRNA levels were not different in the autism versus control samples, but total BDNF-like immunoreactive protein, measured by enzyme-linked immunosorbent assay, was greater in autism than in controls. Western blotting revealed greater pro-BDNF and less truncated BDNF in autism compared with controls. These data demonstrate that increased levels of BDNF-immunoreactive protein in autism are not transcriptionally driven. Increased pro-BDNF and reduced truncated BDNF are consistent with defective processing of pro-BDNF to its truncated form. Distortion of the balance among the 3 BDNF isoforms, each of which may exhibit different biological activities, could lead to changes in connectivity and synaptic plasticity and, hence, behavior. Thus, imbalance in proteolytic isoforms is a possible new mechanism for altered synaptic plasticity leading to autism.
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249
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Krippl M, Karim AA. ["Theory of mind" and its neuronal correlates in forensically relevant disorders]. DER NERVENARZT 2012; 82:843-52. [PMID: 20848075 DOI: 10.1007/s00115-010-3073-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Theory of mind (ToM), the ability to recognize mental states of others, and empathy are crucial cognitive-emotional processes for appropriate social interactions. Deficits in these processes can lead to maladjusted social behavior or even to aggressive or criminal behavior. ToM and empathy deficits have been found in different forensically relevant disorders, such as schizophrenia, pedophilia but especially in autism and psychopathy according to Hare. Most notably, autistic and psychopathic patients differ in their type of deficits and in their neuronal correlates. While autistic individuals lack the ability to take the perspective of others, psychopaths lack empathy. The aim of this article is to provide a better understanding of the pathophysiology of ToM and empathy deficits in forensically relevant disorders by reviewing and discussing the findings of neuroimaging and lesion studies and to highlight crucial implications for neuropsychotherapy according to Grawe.
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Affiliation(s)
- M Krippl
- Forensische Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, Göttingen, Deutschland.
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250
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Lauvin MA, Martineau J, Destrieux C, Andersson F, Bonnet-Brilhault F, Gomot M, El-Hage W, Cottier JP. Functional morphological imaging of autism spectrum disorders: Current position and theories proposed. Diagn Interv Imaging 2012; 93:139-47. [DOI: 10.1016/j.diii.2012.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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