Effect of visual stimuli of pain on empathy brain network in people with and without Autism Spectrum Disorder

Overwhelmed by the man in the moon? Pareidolic objects provoke increased amygdala activation in autism

An interesting feature of the primate face detection system results in the perception of illusory faces in objects, or pareidolia. These illusory faces do not per se contain social information, such as eye-gaze or specific identities, yet they activate the cortical brain face-processing network, possibly via the subcortical route, including the amygdala. In autism spectrum disorder (ASD), aversion to eye-contact is commonly reported, and so are alterations in face processing more generally, yet the underlying reasons are not clear. Here we show that in autistic participants (N=37), but not in non-autistic controls (N=34), pareidolic objects increase amygdala activation bilaterally (right amygdala peak: X = 26, Y = -6, Z = -16; left amygdala peak X = -24, Y = -6, Z = -20). In addition, illusory faces engage the face-processing cortical network significantly more in ASD than in controls. An early imbalance in the excitatory and inhibitory systems in autism, affecting typical brain maturation, may be at the basis of an overresponsive reaction to face configuration and to eye contact. Our data add to the evidence of an oversensitive subcortical face processing system in ASD.

The Current View on the Paradox of Pain in Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which affects 1 in 44 children and may cause severe disabilities. Besides socio-communicational difficulties and repetitive behaviors, ASD also presents as atypical sensorimotor function and pain reactivity. While chronic pain is a frequent co-morbidity in autism, pain management in this population is often insufficient because of difficulties in pain evaluation, worsening their prognosis and perhaps driving higher mortality rates. Previous observations have tended to oversimplify the experience of pain in autism as being insensitive to painful stimuli. Various findings in the past 15 years have challenged and complicated this dogma. However, a relatively small number of studies investigates the physiological correlates of pain reactivity in ASD. We explore the possibility that atypical pain perception in people with ASD is mediated by alterations in pain perception, transmission, expression and modulation, and through interactions between these processes. These complex interactions may account for the great variability and sometimes contradictory findings from the studies. A growing body of evidence is challenging the idea of alterations in pain processing in ASD due to a single factor, and calls for an integrative view. We propose a model of the pain cycle that includes the interplay between the molecular and neurophysiological pathways of pain processing and it conscious appraisal that may interfere with pain reactivity and coping in autism. The role of social factors in pain-induced response is also discussed. Pain assessment in clinical care is mostly based on subjective rather than objective measures. This review clarifies the strong need for a consistent methodology, and describes innovative tools to cope with the heterogeneity of pain expression in ASD, enabling individualized assessment. Multiple measures, including self-reporting, informant reporting, clinician-assessed, and purely physiological metrics may provide more consistent results. An integrative view on the regulation of the pain cycle offers a more robust framework to characterize the experience of pain in autism.

Empathy for pain in individuals with autistic traits during observation of static and dynamic stimuli

Previous studies have reported that individuals with autistic traits, like those with Autism Spectrum Disorder (ASD), may have impaired empathic responses when observing static stimuli of others' pain. However, it remains unclear whether individuals with autistic traits exhibit impaired empathy for pain in response to dynamic stimuli. The present study addressed this question by recruiting 529 individuals whose autistic traits were assessed using the autism-spectrum quotient (AQ) questionnaire. Thirty participants who scored within the top 10% and bottom 10% on the AQ were selected into High-AQ and Low-AQ groups, respectively. This study employed painful whole-body action pictures and videos as static and dynamic stimuli. Both groups were instructed to judge whether the models in the stimuli were experiencing pain, and their reaction times, accuracy and event-related potential (ERP) data were recorded. Results showed that the P2 amplitudes were larger in the High-AQ group than in the Low-AQ group when viewing painful static stimuli, while no difference between the two groups was found when viewing painful dynamic stimuli. These results suggest that autistic traits influenced the emotional processing of others' pain in response to static stimuli.

Self-reported empathy in adults with autism, early psychosis, and social anxiety disorder

The Empathy Quotient (EQ) self-report questionnaire is used to measure empathy in individuals with clinical conditions that have been associated with social impairments. In this study, older teens and adults with autism spectrum disorder (ASD; N = 60), early psychosis (EP; N = 51) and social anxiety disorder (SAD; N = 71) and neurotypical controls (NT; N = 26) were compared on the cognitive empathy, emotional reactivity and social skills sub-scales of the Empathy Quotient (EQ) measure. All three clinical groups reported lower cognitive empathy than NT controls, and the ASD group reported lower cognitive empathy than EP and SAD groups. The ASD group reported lower emotional reactivity than the SAD group. All three clinical groups reported lower social skills that NT controls. The poor self-rated empathy for the ASD and EP groups generally reflects previous research that found individuals with these conditions perform relatively poorly on certain objective measures of empathy. However, the poor self-rated cognitive empathy and social skills for the SAD group conflicts with previous research that has found that SAD groups perform well on objective measures of empathy. This suggests that both EQ and objective measures should be used to fully assess empathy in clinical groups.