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Becker C, Conduit R, Chouinard PA, Laycock R. EEG correlates of static and dynamic face perception: The role of naturalistic motion. Neuropsychologia 2024; 205:108986. [PMID: 39218391 DOI: 10.1016/j.neuropsychologia.2024.108986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 08/09/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024]
Abstract
Much of our understanding of how the brain processes dynamic faces comes from research that compares static photographs to dynamic morphs, which exhibit simplified, computer-generated motion. By comparing static, video recorded, and dynamic morphed expressions, we aim to identify the neural correlates of naturalistic facial dynamism, using time-domain and time-frequency analysis. Dynamic morphs were made from the neutral and peak frames of video recorded transitions of happy and fearful expressions, which retained expression change and removed asynchronous and non-linear features of naturalistic facial motion. We found that dynamic morphs elicited increased N400 amplitudes and lower LPP amplitudes compared to other stimulus types. Video recordings elicited higher LPP amplitudes and greater frontal delta activity compared to other stimuli. Thematic analysis of participant interviews using a large language model revealed that participants found it difficult to assess the genuineness of morphed expressions, and easier to analyse the genuineness of happy compared to fearful expressions. Our findings suggest that animating real faces with artificial motion may violate expectations (N400) and reduce the social salience (LPP) of dynamic morphs. Results also suggest that delta oscillations in the frontal region may be involved with the perception of naturalistic facial motion in happy and fearful expressions. Overall, our findings highlight the sensitivity of neural mechanisms required for face perception to subtle changes in facial motion characteristics, which has important implications for neuroimaging research using faces with simplified motion.
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Affiliation(s)
- Casey Becker
- RMIT University, School of Health & Biomedical Sciences, STEM College, 225-254 Plenty Rd, Bundoora, Victoria, 3083, Australia.
| | - Russell Conduit
- RMIT University, School of Health & Biomedical Sciences, STEM College, 225-254 Plenty Rd, Bundoora, Victoria, 3083, Australia.
| | - Philippe A Chouinard
- La Trobe University, Department of Psychology, Counselling, & Therapy, 75 Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
| | - Robin Laycock
- RMIT University, School of Health & Biomedical Sciences, STEM College, 225-254 Plenty Rd, Bundoora, Victoria, 3083, Australia.
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2
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Bao C, Zhang Q, He C, Zou H, Xia Y, Yan R, Hua L, Wang X, Lu Q, Yao Z. Neural responses to decision-making in suicide attempters with youth major depressive disorder. Neuroimage Clin 2024; 43:103667. [PMID: 39241548 PMCID: PMC11406072 DOI: 10.1016/j.nicl.2024.103667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 09/01/2024] [Accepted: 09/01/2024] [Indexed: 09/09/2024]
Abstract
An improved understanding of the factors associated with suicidal attempts in youth suffering from depression is crucial for the identification and prevention of future suicide risk. However, there is limited understanding of how neural activity is modified during the process of decision-making. Our study aimed to investigate the neural responses in suicide attempters with major depressive disorder (MDD) during decision-making. Electroencephalography (EEG) was recorded from 79 individuals aged 16-25 with MDD, including 39 with past suicide attempts (SA group) and 40 without (NSA group), as well as from 40 age- and sex- matched healthy controls (HCs) during the Iowa Gambling Task (IGT). All participants completed diagnostic interviews, self-report questionnaires. Our study examined feedback processing by measuring the feedback-related negativity (FRN), ΔFN (FRN-loss minus FRN-gain), and the P300 as electrophysiological indicators of feedback evaluation. The SA group showed poorest IGT performance. SA group and NSA group, compared with HC group, exhibited specific deficits in decision-making (i.e., exhibited smaller (i.e., blunted) ΔFN). Post hoc analysis found that the SA group was the least sensitive to gains and the most sensitive to losses. In addition, we also found that the larger the value of ΔFN, the better the decision-making ability and the lower the impulsivity. Our study highlights the link between suicide attempts and impaired decision-making in individuals with major depressive disorder. These findings constitute an important step in gaining a better understanding of the specific reward-related abnormalities that could contribute to the young MDD patients with suicide attempts.
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Affiliation(s)
- Ciqing Bao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Wenzhou Seventh People's Hospital, Wenzhou 325000, China
| | - Qiaoyang Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Psychology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - Chen He
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Haowen Zou
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing 210093, China
| | - Yi Xia
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Rui Yan
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lingling Hua
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, China.
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing 210093, China.
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3
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Reinke P, Deneke L, Ocklenburg S. Asymmetries in event-related potentials part 1: A systematic review of face processing studies. Int J Psychophysiol 2024; 202:112386. [PMID: 38914138 DOI: 10.1016/j.ijpsycho.2024.112386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/06/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024]
Abstract
The human brain shows distinct lateralized activation patterns for a range of cognitive processes. One such function, which is thought to be lateralized to the right hemisphere (RH), is human face processing. Its importance for social communication and interaction has led to a plethora of studies investigating face processing in health and disease. Temporally highly resolved methods, like event-related potentials (ERPs), allow for a detailed characterization of different processing stages and their specific lateralization patterns. This systematic review aimed at disentangling some of the contradictory findings regarding the RH specialization in face processing focusing on ERP research in healthy participants. Two databases were searched for studies that investigated left and right electrodes while participants viewed (mostly neutral) facial stimuli. The included studies used a variety of different tasks, which ranged from passive viewing to memorizing faces. The final data selection highlights, that strongest lateralization to the RH was found for the N170, especially for right-handed young male participants. Left-handed, female, and older participants showed less consistent lateralization patterns. Other ERP components like the P1, P2, N2, P3, and the N400 were overall less clearly lateralized. The current review highlights that many of the assumed lateralization patterns are less clear than previously thought and that the variety of stimuli, tasks, and EEG setups used, might contribute to the ambiguous findings.
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Affiliation(s)
- Petunia Reinke
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany; ICAN Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany.
| | - Lisa Deneke
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Sebastian Ocklenburg
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany; ICAN Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany; Institute of Cognitive Neuroscience, Biopsychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
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4
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Richards JE, Guy MW, Hogan AL, Roberts JE. Neural correlates of face processing among preschoolers with fragile X syndrome, autism spectrum disorder, autism siblings, and typical development. Autism Res 2024; 17:89-108. [PMID: 37916532 DOI: 10.1002/aur.3045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/13/2023] [Indexed: 11/03/2023]
Abstract
The current study examined patterns of event-related potential (ERP) responses during a face processing task in groups of preschoolers uniquely impacted by autism spectrum disorder (ASD), including (1) children with ASD; (2) children with fragile X syndrome (FXS); (3) children with familial risk for ASD, but without a diagnosis (i.e., ASIBs); and (4) a low-risk control (LRC) group. Children with FXS have a high incidence of ASD diagnoses, but there have been no studies of the ERP response to faces in children with FXS and little work focused on children with ASD who have cognitive impairment. The current study examined children's ERP responses to faces and houses in four groups: LRC (N = 28, age = 5.2 years), ASIB (N = 23, age = 5.5 years), FXS (N = 19, age = 5.82 years), and ASD (N = 23, age = 5.5 years). The FXS and ASD groups were characterized by the presence of cognitive impairment. Pictures of upright and inverted faces and houses were presented while recording EEG with a 128-channel system. The N170 occurred at about 200 ms post stimulus onset, was largest on the posterior-lateral electrodes, and was larger for faces than houses. The P1 and N170 ERP components were larger for the FXS group than for the other three groups. The N170 ERP amplitude for the ASD and ASIB groups was smaller than both the LRC and FXS groups, and the LRC and FXS groups had the largest N170 responses on the right side. No difference was found in N170 latency between groups. The similarity of the ASD and ASIB responses suggest a common genetic or environmental origin of the reduced response. Although children with FXS have a high incidence of ASD outcomes, they differed from ASD and ASIB children in this study. Specifically, the children with FXS were hyperresponsive to all stimulus types while the ASD and ASIB groups showed attenuated responses for specific stimuli.
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Affiliation(s)
- John E Richards
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Maggie W Guy
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Abigail L Hogan
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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Marriott Haresign I, Phillips EAM, Whitehorn M, Lamagna F, Eliano M, Goupil L, Jones EJH, Wass SV. Gaze onsets during naturalistic infant-caregiver interaction associate with 'sender' but not 'receiver' neural responses, and do not lead to changes in inter-brain synchrony. Sci Rep 2023; 13:3555. [PMID: 36864074 PMCID: PMC9981599 DOI: 10.1038/s41598-023-28988-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/27/2023] [Indexed: 03/04/2023] Open
Abstract
Temporal coordination during infant-caregiver social interaction is thought to be crucial for supporting early language acquisition and cognitive development. Despite a growing prevalence of theories suggesting that increased inter-brain synchrony associates with many key aspects of social interactions such as mutual gaze, little is known about how this arises during development. Here, we investigated the role of mutual gaze onsets as a potential driver of inter-brain synchrony. We extracted dual EEG activity around naturally occurring gaze onsets during infant-caregiver social interactions in N = 55 dyads (mean age 12 months). We differentiated between two types of gaze onset, depending on each partners' role. 'Sender' gaze onsets were defined at a time when either the adult or the infant made a gaze shift towards their partner at a time when their partner was either already looking at them (mutual) or not looking at them (non-mutual). 'Receiver' gaze onsets were defined at a time when their partner made a gaze shift towards them at a time when either the adult or the infant was already looking at their partner (mutual) or not (non-mutual). Contrary to our hypothesis we found that, during a naturalistic interaction, both mutual and non-mutual gaze onsets were associated with changes in the sender, but not the receiver's brain activity and were not associated with increases in inter-brain synchrony above baseline. Further, we found that mutual, compared to non-mutual gaze onsets were not associated with increased inter brain synchrony. Overall, our results suggest that the effects of mutual gaze are strongest at the intra-brain level, in the 'sender' but not the 'receiver' of the mutual gaze.
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Affiliation(s)
| | - E A M Phillips
- Department of Psychology, University of East London, London, E15 4LZ, UK
| | - M Whitehorn
- Department of Psychology, University of East London, London, E15 4LZ, UK
| | - F Lamagna
- Department of Psychology, University of East London, London, E15 4LZ, UK
| | - M Eliano
- Department of Psychology, University of East London, London, E15 4LZ, UK
| | - L Goupil
- LPNC/CNRS, Grenoble Alpes University, Grenoble, France
| | - E J H Jones
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK
| | - S V Wass
- Department of Psychology, University of East London, London, E15 4LZ, UK
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Aran Ö, Garcia SE, Hankin BL, Hyde DC, Davis EP. Signatures of emotional face processing measured by event-related potentials in 7-month-old infants. Dev Psychobiol 2023; 65:e22361. [PMID: 36811377 PMCID: PMC9978929 DOI: 10.1002/dev.22361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 12/29/2022]
Abstract
The ability to distinguish facial emotions emerges in infancy. Although this ability has been shown to emerge between 5 and 7 months of age, the literature is less clear regarding the extent to which neural correlates of perception and attention play a role in processing of specific emotions. This study's main goal was to examine this question among infants. To this end, we presented angry, fearful, and happy faces to 7-month-old infants (N = 107, 51% female) while recording event-related brain potentials. The perceptual N290 component showed a heightened response for fearful and happy relative to angry faces. Attentional processing, indexed by the P400, showed some evidence of a heightened response for fearful relative to happy and angry faces. We did not observe robust differences by emotion in the negative central (Nc) component, although trends were consistent with previous work suggesting a heightened response to negatively valenced expressions. Results suggest that perceptual (N290) and attentional (P400) processing is sensitive to emotions in faces, but these processes do not provide evidence for a fear-specific bias across components.
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Affiliation(s)
- Özlü Aran
- University of Denver, Department of Psychology
| | - Sarah E. Garcia
- Department of Psychiatry, Columbia University Irving Medical Center
| | | | - Daniel C. Hyde
- University of Illinois at Urbana-Champaign, Department of Psychology
| | - Elysia Poggi Davis
- University of Denver, Department of Psychology
- University of California, Irvine, Department of Pediatrics
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7
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Syrov N, Yakovlev L, Miroshnikov A, Kaplan A. Beyond passive observation: feedback anticipation and observation activate the mirror system in virtual finger movement control via P300-BCI. Front Hum Neurosci 2023; 17:1180056. [PMID: 37213933 PMCID: PMC10192585 DOI: 10.3389/fnhum.2023.1180056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/13/2023] [Indexed: 05/23/2023] Open
Abstract
Action observation (AO) is widely used as a post-stroke therapy to activate sensorimotor circuits through the mirror neuron system. However, passive observation is often considered to be less effective and less interactive than goal-directed movement observation, leading to the suggestion that observation of goal-directed actions may have stronger therapeutic potential, as goal-directed AO has been shown to activate mechanisms for monitoring action errors. Some studies have also suggested the use of AO as a form of Brain-computer interface (BCI) feedback. In this study, we investigated the potential for observation of virtual hand movements within a P300-based BCI as a feedback system to activate the mirror neuron system. We also explored the role of feedback anticipation and estimation mechanisms during movement observation. Twenty healthy subjects participated in the study. We analyzed event-related desynchronization and synchronization (ERD/S) of sensorimotor EEG rhythms and Error-related potentials (ErrPs) during observation of virtual hand finger flexion presented as feedback in the P300-BCI loop and compared the dynamics of ERD/S and ErrPs during observation of correct feedback and errors. We also analyzed these EEG markers during passive AO under two conditions: when subjects anticipated the action demonstration and when the action was unexpected. A pre-action mu-ERD was found both before passive AO and during action anticipation within the BCI loop. Furthermore, a significant increase in beta-ERS was found during AO within incorrect BCI feedback trials. We suggest that the BCI feedback may exaggerate the passive-AO effect, as it engages feedback anticipation and estimation mechanisms as well as movement error monitoring simultaneously. The results of this study provide insights into the potential of P300-BCI with AO-feedback as a tool for neurorehabilitation.
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Affiliation(s)
- Nikolay Syrov
- V. Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- *Correspondence: Nikolay Syrov,
| | - Lev Yakovlev
- V. Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Andrei Miroshnikov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Alexander Kaplan
- V. Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Department of Human and Animal Physiology, Faculty of Biology, Lomonosov Moscow State University, Moscow, Russia
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8
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Guy MW, Richards JE, Roberts JE. Cortical Source Analysis of the Face Sensitive N290 ERP Component in Infants at High Risk for Autism. Brain Sci 2022; 12:1129. [PMID: 36138866 PMCID: PMC9497227 DOI: 10.3390/brainsci12091129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Appropriate head models for cortical source analysis were investigated and applied to source analyses examining the neural bases of the face-sensitive N290 event-related potential (ERP) component in infants at high risk for autism spectrum disorder (ASD). This included infant siblings of children with ASD (ASIBs) and infants with fragile X syndrome (FXS). First, alternative head models for use with ASIBs and FXS were investigated. Head models created from the infant's own MRI were examined in relation to five head models based on average MRI templates. The results of the head model comparison identified group-specific (i.e., ASIB or FXS) head models created from a large collection of structural MRIs as the best substitution for the head model created from the participant's own structural MRI. Second, the cortical source analysis was completed on N290 data collected from a previous study to investigate brain areas associated with face sensitive ERP responses. Participants' own MRIs were used for head models when available, and the group-specific head model was used when the participants' own MRIs were not available. The results provide evidence for unique patterns of neural activation during face processing across infants at high and low risk for ASD and across etiologically distinct high-risk groups. All infants demonstrated greater activation to faces than toys in brain areas most associated with specialized face processing. Infants with FXS displayed higher levels of activation to faces across all areas analyzed, while ASIBs show more muted levels of activation. Overall, the results of the current study demonstrate the importance of group-specific head models for accurate cortical source analysis in infants at high risk for ASD. This also allows for further research on early distinctions in brain function based on risk status.
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Affiliation(s)
- Maggie W. Guy
- Department of Psychology, Loyola University Chicago, Chicago, IL 60660, USA
| | - John E. Richards
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Jane E. Roberts
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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Kujawa A, Brooker RJ. Methods and metrics for EEG/ERP assessment of emotion and cognition in young children. Dev Psychobiol 2022; 64:e22284. [DOI: 10.1002/dev.22284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Autumn Kujawa
- Department of Psychological Sciences Vanderbilt University Nashville Tennessee USA
| | - Rebecca J. Brooker
- Department of Psychological and Brain Sciences Texas A&M University College Station Texas USA
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Guy MW, Richards JE, Hogan AL, Roberts JE. Neural Correlates of Infant Face Processing and Later Emerging Autism Symptoms in Fragile X Syndrome. Front Psychiatry 2021; 12:716642. [PMID: 34899412 PMCID: PMC8651978 DOI: 10.3389/fpsyt.2021.716642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/20/2021] [Indexed: 12/02/2022] Open
Abstract
Fragile X syndrome (FXS) is the leading known genetic cause of autism spectrum disorder (ASD) with 60-74% of males with FXS meeting diagnostic criteria for ASD. Infants with FXS have demonstrated atypical neural responses during face processing that are unique from both typically developing, low-risk infants and infants at high familial risk for ASD (i.e., infants siblings of children with ASD). In the current study, event-related potential (ERP) responses during face processing measured at 12 months of age were examined in relation to ASD symptoms measured at ~48 months of age in participants with FXS, as well as siblings of children with ASD and low-risk control participants. Results revealed that greater amplitude N290 responses in infancy were associated with more severe ASD symptoms in childhood in FXS and in siblings of children with ASD. This pattern of results was not observed for low-risk control participants. Reduced Nc amplitude was associated with more severe ASD symptoms in participants with FXS but was not observed in the other groups. This is the first study to examine ASD symptoms in childhood in relation to infant ERP responses in FXS. Results indicate that infant ERP responses may be predictive of later symptoms of ASD in FXS and the presence of both common and unique pathways to ASD in etiologically-distinct high-risk groups is supported (i.e., syndromic risk vs. familial risk).
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Affiliation(s)
- Maggie W. Guy
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - John E. Richards
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Abigail L. Hogan
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Jane E. Roberts
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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