Mirror neurons: from discovery to autism

Examining the association between variation of ASD and cognitive and affective domains of mentalizing in verbal children with ASD

Cognitive research in autism has often approached mentalizing abilities in global terms, and ultimately judged them to be impaired in Autism Spectrum Disorder (ASD). However, recent studies have demonstrated that these social-cognitive abilities constitute neurocognitive constructs, encompassing both cognitive and affective domains, which are selectively found to be lacking in clinical categories. This study investigates the variation in autistic symptoms in relation to the graduation in gravity of cognitive and affective domains of mentalizing in children with ASD, aged 8 to 12 years. Mentalizing domains are assessed by the false-belief paradigms and by the Reading the Mind in the Eyes tasks in a group of 50 children with ASD. The findings showed that the severity of the children's autistic symptoms is inversely and strongly associated with their performance in first-(r = -0.762, p < .001) and second-order cognitive mentalizing (r = -0.674, p < .001), as well as affective mentalizing (r = -0.653, p < .001). However, the capacity for affective mentalizing was noticeably more impaired compared to those of cognitive mentalizing. The evidence confirms that the lower performance of children with ASD in mentalizing abilities is relatively dependent on the variation in their autistic symptoms and that the cognitive and affective domains of the latter are interrelated constructs.

Is it a Match? Yawn Contagion and Smile Mimicry in Toddlers

Automatic behavioral matching includes Rapid Facial Mimicry (RFM) and Yawn Contagion (YC) that occur when the facial expression of an individual acts as a 'mirror social releaser' and induces the same facial expression in the observer (within 1 s for RFM, and minutes for YC). Motor replication has been linked to coordination and emotional contagion, a basic form of empathy. We investigated the presence and modulating factors of Rapid Smile Mimicry (RSM) and YC in infants/toddlers from 10 to 36 months at the nursery 'Melis' (Turin, Italy). In February-May 2022, we gathered audio and/or video of all occurrences data on affiliative behaviors, smiling during play, and yawning during everyday activities. Both RSM and YC were present, as toddlers were most likely to smile (within 1 s) or yawn (within three-min) after perceiving a smile/yawn from another toddler. Sex, age, and parents' country of origin did not influence RSM and YC occurrence, probably because gonadal maturation was long to come, the age range was skewed towards the early developmental phase, and toddlers had been in the same social group for months. RSM and YC showed social modulation, thus possibly implying more than just motor resonance. Both phenomena were inversely related to affiliation levels (a social bond proxy). Because literature reports that in adults RSM and YC may increase with familiarity, our reversed result suggests that in certain toddler cohorts the same phenomena may help increase socio-emotional coordination and that the function of motoric resonance may be experience- and context-dependent.

Play contagion in African elephants: The closest, the better

Behavioural contagion is an automatic process through which a behaviour performed by an individual (trigger) is reproduced by an observer (responder) without necessarily replicating the exact motor sequence. It has been linked to inter-individual synchronisation and possibly emotional contagion. Play can convey emotions and enhance social bonding, although its contagiousness is understudied. To verify social play contagion presence and modulating factors, we gathered audio-video data on social play, distance and affiliation on a group of savannah African elephants (15 individuals) at Parque de la Naturaleza de Cabarceno (Cantabria, Spain). Social play was contagious as it was more likely started by uninvolved elephants (within 3-min) in Post-Play Condition (PP) - after that other elephants had started playing - than in Matched-control Condition (MC; no previous play). Social play contagion mostly occurred within 30 m - probably due to elephants' limited visual acuity - and it was highest between individuals that affiliated the most, with the distance-affiliation interaction having no effect. The most prominent individuals in the social play network were also the most influential in the play contagion network (Eigenvector-centrality measure). Play contagion was socially modulated, thus suggesting it may extend from motor replication to the replication of the underlying affective state.

Measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in persons on the autism spectrum: A preliminary Rasch analysis

BACKGROUND

Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research.

OBJECTIVE

To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group.

METHODS

Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model.

RESULTS

BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research.

CONCLUSIONS

BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties.

Advances in the Treatment of Autism Spectrum Disorder: Current and Promising Strategies

Autism spectrum disorder (ASD) is an umbrella term for developmental disorders characterized by social and communication impairments, language difficulties, restricted interests, and repetitive behaviors. Current management approaches for ASD aim to resolve its clinical manifestations based on the type and severity of the disability. Although some medications like risperidone show potential in regulating ASD-associated symptoms, a comprehensive treatment strategy for ASD is yet to be discovered. To date, identifying appropriate therapeutic targets and treatment strategies remains challenging due to the complex pathogenesis associated with ASD. Therefore, a comprehensive approach must be tailored to target the numerous pathogenetic pathways of ASD. From currently viable and basic treatment strategies, this review explores the entire field of advancements in ASD management up to cutting-edge modern scientific research. A novel systematic and personalized treatment approach is suggested, combining the available medications and targeting each symptom accordingly. Herein, summarize and categorize the most appropriate ways of modern ASD management into three distinct categories: current, promising, and prospective strategies.

Sensory Phenotypes in Autism: Making a Case for the Inclusion of Sensory Integration Functions

Sensory features are part of the diagnostic criteria for autism and include sensory hypo/hyper reactivity and unusual sensory interest; however, additional sensory differences, namely differences in sensory integration, have not been routinely explored. This study characterized sensory integration differences in a cohort of children (n = 93) with a confirmed diagnosis of autism (5-9 years) using a standardized, norm-referenced battery. Mean z scores, autism diagnostic scores, and IQ are reported. Participants showed substantial deficits in tactile perception, praxis, balance, visual perception, and visual-motor skills. Relationship with autism diagnostic test scores were weak or absent. Findings suggest additional sensory difficulties that are not typically assessed or considered when characterizing sensory features in autism. These data have implications for a greater understanding of the sensory features in the autism phenotype and the development of personalized treatments.

Anti-ableism and scientific accuracy in autism research: a false dichotomy

It was recently argued that autism researchers committed to rejecting ableist frameworks in their research may sacrifice "scientifically accurate" conceptualizations of autism. In this perspective piece, we argue that: (a) anti-ableism vs. scientific accuracy is a false dichotomy, (b) there is no ideology-free science that has claim to scientific accuracy, and (c) autism science has a history of false leads in part because of unexamined ableist ideologies that undergird researcher framings and interpretations of evidence. To illustrate our claims, we discuss several avenues of autism research that were promoted as scientific advances, but were eventually debunked or shown to have much less explanatory value than initially proposed. These research programs have involved claims about autism etiology, the nature of autism and autistic characteristics, and autism intervention. Common to these false leads have been ableist assumptions about autism that inform researcher perspectives. Negative impacts of this work have been mitigated in some areas of autism research, but these perspectives continue to exert influence on the lives of autistic people, including the availability of services, discourses about autism, and sociocultural conceptualizations of autistic people. Examining these false leads may help current researchers better understand how ableism may negatively influence their areas of inquiry. We close with a positive argument that promoting anti-ableism can be done in tandem with increasing scientific accuracy.

Action viewing and language in adolescents with autism spectrum disorder

The mirror neuron system consists of fronto-parietal regions and responds to both goal-directed action execution and observation. The broader action observation network is specifically involved in observation of actions and is thought to play a role in understanding the goals of the motor act, the intention of others, empathy, and language. Many, but not all, studies have found mirror neuron system or action observation network dysfunction in autism spectrum disorder. The objective of this study was to use observation of a goal-directed action fMRI paradigm to examine the action observation network in autism spectrum disorder and to determine whether fronto-parietal activation is associated with language ability. Adolescents with autism spectrum disorder (n = 23) were compared to typically developing adolescents (n = 20), 11-17 years. Overall, there were no group differences in activation, however, the autism spectrum group with impaired expressive language (n = 13) had significantly reduced inferior frontal and inferior parietal activation during action viewing. In controls, right supramarginal gyrus activation was associated with higher expressive language; bilateral supramarginal and left pars opercularis activation was associated with better verbal-gesture integration. Results suggest that action-observation network dysfunction may characterize a subgroup of individuals with autism spectrum disorder with expressive language deficits. Therefore, interventions that target this dysfunctional network may improve expressive language in this autism spectrum subgroup. Future treatment studies should individualize therapeutic approaches based on brain-behavior relationships.

Changes in the geometry and robustness of diffusion tensor imaging networks: Secondary analysis from a randomized controlled trial of young autistic children receiving an umbilical cord blood infusion

Diffusion tensor imaging (DTI) has been used as an outcome measure in clinical trials for several psychiatric disorders but has rarely been explored in autism clinical trials. This is despite a large body of research suggesting altered white matter structure in autistic individuals. The current study is a secondary analysis of changes in white matter connectivity from a double-blind placebo-control trial of a single intravenous cord blood infusion in 2-7-year-old autistic children (1). Both clinical assessments and DTI were collected at baseline and 6 months after infusion. This study used two measures of white matter connectivity: change in node-to-node connectivity as measured through DTI streamlines and a novel measure of feedback network connectivity, Ollivier-Ricci curvature (ORC). ORC is a network measure which considers both local and global connectivity to assess the robustness of any given pathway. Using both the streamline and ORC analyses, we found reorganization of white matter pathways in predominantly frontal and temporal brain networks in autistic children who received umbilical cord blood treatment versus those who received a placebo. By looking at changes in network robustness, this study examined not only the direct, physical changes in connectivity, but changes with respect to the whole brain network. Together, these results suggest the use of DTI and ORC should be further explored as a potential biomarker in future autism clinical trials. These results, however, should not be interpreted as evidence for the efficacy of cord blood for improving clinical outcomes in autism. This paper presents a secondary analysis using data from a clinical trial that was prospectively registered with ClinicalTrials.gov(NCT02847182).

Advances in human intracranial electroencephalography research, guidelines and good practices

Since the second-half of the twentieth century, intracranial electroencephalography (iEEG), including both electrocorticography (ECoG) and stereo-electroencephalography (sEEG), has provided an intimate view into the human brain. At the interface between fundamental research and the clinic, iEEG provides both high temporal resolution and high spatial specificity but comes with constraints, such as the individual's tailored sparsity of electrode sampling. Over the years, researchers in neuroscience developed their practices to make the most of the iEEG approach. Here we offer a critical review of iEEG research practices in a didactic framework for newcomers, as well addressing issues encountered by proficient researchers. The scope is threefold: (i) review common practices in iEEG research, (ii) suggest potential guidelines for working with iEEG data and answer frequently asked questions based on the most widespread practices, and (iii) based on current neurophysiological knowledge and methodologies, pave the way to good practice standards in iEEG research. The organization of this paper follows the steps of iEEG data processing. The first section contextualizes iEEG data collection. The second section focuses on localization of intracranial electrodes. The third section highlights the main pre-processing steps. The fourth section presents iEEG signal analysis methods. The fifth section discusses statistical approaches. The sixth section draws some unique perspectives on iEEG research. Finally, to ensure a consistent nomenclature throughout the manuscript and to align with other guidelines, e.g., Brain Imaging Data Structure (BIDS) and the OHBM Committee on Best Practices in Data Analysis and Sharing (COBIDAS), we provide a glossary to disambiguate terms related to iEEG research.

Eye Gaze in Autism Spectrum Disorder: A Review of Neural Evidence for the Eye Avoidance Hypothesis

Reduced eye contact early in life may play a role in the developmental pathways that culminate in a diagnosis of autism spectrum disorder. However, there are contradictory theories regarding the neural mechanisms involved. According to the amygdala theory of autism, reduced eye contact results from a hypoactive amygdala that fails to flag eyes as salient. However, the eye avoidance hypothesis proposes the opposite-that amygdala hyperactivity causes eye avoidance. This review evaluated studies that measured the relationship between eye gaze and activity in the 'social brain' when viewing facial stimuli. Of the reviewed studies, eight of eleven supported the eye avoidance hypothesis. These results suggest eye avoidance may be used to reduce amygdala-related hyperarousal among people on the autism spectrum.

Effective Connectivity of the Human Mirror Neuron System During Social Cognition

The human mirror neuron system (MNS) can be considered the neural basis of social cognition. Identifying the global network structure of this system can provide significant progress in the field. In this study, we use dynamic causal modeling (DCM) to determine the effective connectivity between central regions of the MNS for the first time during different social cognition tasks. Sixty-seven healthy participants completed fMRI scanning while performing social cognition tasks, including imitation, empathy and theory of mind. Superior temporal sulcus (STS), inferior parietal lobule (IPL) and Brodmann area 44 (BA44) formed the regions of interest for DCM. Varying connectivity patterns, 540 models were built and fitted for each participant. By applying group-level analysis, Bayesian model selection and Bayesian model averaging, the optimal family and model for all experimental tasks were found. For all social-cognitive processes, effective connectivity from STS to IPL and from STS to BA44 was found. For imitation, additional mutual connections occurred between STS and BA44, as well as BA44 and IPL. The results suggest inverse models in which the motor regions BA44 and IPL receive sensory information from the STS. In contrast, for imitation, a sensory loop with an exchange of motor-to-sensory and sensory-to-motor information seems to exist.

The Superior Visual Perception Hypothesis: Neuroaesthetics of Cave Art

Cave Art in the Upper Paleolithic presents a boost of creativity and visual thinking. What can explain these savant-like paintings? The normal brain function in modern man rarely supports the creation of highly detailed paintings, particularly the convincing representation of animal movement, without extensive training and access to modern technology. Differences in neuro-signaling and brain anatomy between modern and archaic Homo sapiens could also cause differences in perception. The brain of archaic Homo sapiens could perceive raw detailed information without using pre-established top-down concepts, as opposed to the common understanding of the normal modern non-savant brain driven by top-down control. Some ancient genes preserved in modern humans may be expressed in rare disorders. Researchers have compared Cave Art with art made by people with autism spectrum disorder. We propose that archaic primary consciousness, as opposed to modern secondary consciousness, included a savant-like perception with a superior richness of details compared to modern man. Modern people with high frequencies of Neanderthal genes, have notable anatomical features such as increased skull width in the occipital and parietal visual areas. We hypothesize that the anatomical differences are functional and may allow a different path to visual perception.

Difficulties in Recognising Dynamic but not Static Emotional Body Movements in Autism Spectrum Disorder

In this study, we investigated whether the difficulties in body motion (BM) perception may led to deficit in emotion recognition in Autism spectrum disorder (ASD). To this aim, individuals with high-functioning ASD were asked to recognise fearful, happy, and neutral BM depicted as static images or dynamic point-light and full-light displays. Results showed slower response times in participants with ASD only in recognising dynamic stimuli, but no group differences in accuracy. This suggests that i) a deficit in action chaining mechanism in ASD may prevent the recognition of dynamic BM automatically and rapidly, ii) individuals with ASD and high cognitive resources can develop alternative—but equally successful—strategies to recognise emotional body expressions. Implications for treatment are discussed

Node Centrality Measures Identify Relevant Structural MRI Features of Subjects with Autism

Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions characterized by impairments in social interaction and communication and restricted patterns of behavior, interests, and activities. Although the etiopathogenesis of idiopathic ASD has not been fully elucidated, compelling evidence suggests an interaction between genetic liability and environmental factors in producing early alterations of structural and functional brain development that are detectable by magnetic resonance imaging (MRI) at the group level. This work shows the results of a network-based approach to characterize not only variations in the values of the extracted features but also in their mutual relationships that might reflect underlying brain structural differences between autistic subjects and healthy controls. We applied a network-based analysis on sMRI data from the Autism Brain Imaging Data Exchange I (ABIDE-I) database, containing 419 features extracted with FreeSurfer software. Two networks were generated: one from subjects with autistic disorder (AUT) (DSM-IV-TR), and one from typically developing controls (TD), adopting a subsampling strategy to overcome class imbalance (235 AUT, 418 TD). We compared the distribution of several node centrality measures and observed significant inter-class differences in averaged centralities. Moreover, a single-node analysis allowed us to identify the most relevant features that distinguished the groups.

Unique deficit in embodied simulation in autism: An fMRI study comparing autism and developmental coordination disorder

A deficit in pre‐cognitively mirroring other people's actions and experiences may be related to the social impairments observed in autism spectrum disorder (ASD). However, it is unclear whether such embodied simulation deficits are unique to ASD or instead are related to motor impairment, which is commonly comorbid with ASD. Here we aim to disentangle how, neurologically, motor impairments contribute to simulation deficits and identify unique neural signatures of ASD. We compare children with ASD (N = 30) to children with Developmental Coordination Disorder (DCD; N = 23) as well as a typically developing group (N = 33) during fMRI tasks in which children observe, imitate, and mentalize about other people's actions. Results indicate a unique neural signature in ASD: during action observation, only the ASD group shows hypoactivity in a region important for simulation (inferior frontal gyrus, pars opercularis, IFGop). However, during a motor production task (imitation), the IFGop is hypoactive for both ASD and DCD groups. For all tasks, we find correlations across groups with motor ability, even after controlling for age, IQ, and social impairment. Conversely, across groups, mentalizing ability is correlated with activity in the dorsomedial prefrontal cortex when controlling for motor ability. These findings help identify the unique neurobiological basis of ASD for aspects of social processing. Furthermore, as no previous fMRI studies correlated brain activity with motor impairment in ASD, these findings help explain prior conflicting reports in these simulation networks.

Video Modeling and Social Skills Learning in ASD-HF

Autism spectrum disorders represent a heterogeneous group of clinical situations, and are mainly represented by a deficit of social communication. In this study, we compare two strategies to enhance communicative/social skills, namely self-video modeling and peer video modeling. The subjects were divided into two groups treated via the method of self-video modeling (group 1) or peer video modeling (group 2). For both groups of subjects affected by ASD-HF (Autism Spectrum Disorder-high-functioning), three different activities were proposed: (a) interacting with a salesperson while making a purchase, (b) initiating and maintaining a conversation with peers, and (c) starting and maintaining an enjoyable activity with a peer. The ability to rapidly accomplish the task was used as the main criteria to appraise the groups’ responses to the proposed activities. In group 1, the use of self-video modeling procedures demonstrated a faster and correct execution of the three proposed tasks (especially task 3) when compared to group 2. In group 2, the use of peer video modeling has instead led to a slower acquisition of abilities to process and perform the tasks. The use of self-video modeling speeds up the acquisition of skills to perform communicative/social tasks, compared to peer video modeling’s slower performance in subjects with ASD-HF. Results could be related to either the amount of time the subject is exposed to the task or to the capacity of ASD-HF subjects to self-value one’s own actions more than others. In our work, we have tried to reset the differences in exposure time. Therefore, self-video modeling is demonstrated to be more effective, as it produces a response to the signification/mirroring characteristic of ASD-HF.

Emotional contagion in children with autism spectrum disorder varies with stimulus familiarity and task instructions

Although deficits in cognitive empathy are well established in individuals with autism spectrum disorder (ASD), the literature on emotional empathy, or emotional contagion, in individuals with ASD is sparse and contradictory. The authors tested susceptibility to contagious yawning and laughter in children with ASD (n = 60) and typically developing (TD) children (n = 60), ages 5-17 years, under various conditions, to elucidate factors that may affect emotional contagion in these populations. Although TD children showed equal amounts of emotional contagion across conditions, children with ASD were highly influenced by the familiarity of the target stimulus, as well as task instructions that encourage eye gaze to target. More specifically, children with ASD exhibited less contagious yawning and laughter than their TD peers except when their attention was explicitly directed to the eyes or (and even more so) when their parents served as the stimulus targets. The authors explore the implications of these findings for theories about the mechanisms underlying empathic deficits in ASD as well as the clinical implications of having parents involved in treatment.

Contagious itching is heightened in children with autism spectrum disorders

The authors tested susceptibility to contagious itching, laughter, and yawning in 55 children with autism spectrum disorder (ASD), ages 8-14, and 106 typically developing (TD) children, ages 5-14. Children with ASD were less likely to yawn or laugh contagiously compared with TD peers, but showed increased susceptibility to contagious itching, under naturalistic conditions. Contagious yawning and laughter were positively correlated with emotional empathy in the TD group. In contrast, contagious itching showed no relationship to empathy, and was positively correlated with autism symptom severity in the ASD group. The authors explore the implications of these findings in terms of psychological theories about ASD.

Physiotherapists' experiences of the meaning of movement quality in autism: a descriptive phenomenological study

Introduction: Movement quality, represented in unrestricted movements, flow and pleasure, is often lacking in people with autism. One aspect is the non-verbal expression of the present emotional and psychological state of an individual.Purpose: To describe the meaning of movement quality in autism, as experienced by specialized physiotherapists.Method: Ten physiotherapists were interviewed. The data were recorded, transcribed verbatim, and analyzed using Giorgi᾽s descriptive phenomenological method.Findings: The general structure of movement quality in people with autism included eight key constituents: 1) reduced postural control; 2) deviant muscle tone and tension; 3) deviant sensory processing; 4) a lack of conscious awareness; 5) difficulties with body boundaries; 6) coordinating movements (including breathing); 7) lack of anticipatory preparations of movements; and 8) need of cognitive thoughts to control movements.Conclusions: This study provide an understanding of how movement quality in people with autism is expressed. Their lived bodies constantly need to protect themselves from sensory impressions from within or the surroundings, causing emotional distress and obscuring the meaning of their movements. Their bodily expression becomes restrained, fragmented, and hesitant. Understanding movement patterns and emotional reactions following their struggle with movements may facilitate constructive interaction and communication, which give important implications when designing physiotherapy interventions.

"Motion or Emotion? Recognition of Emotional Bodily Expressions in Children With Autism Spectrum Disorder With and Without Intellectual Disability"

The recognition of emotional body movement (BM) is impaired in individuals with Autistic Spectrum Disorder ASD, yet it is not clear whether the difficulty is related to the encoding of body motion, emotions, or both. Besides, BM recognition has been traditionally studied using point-light displays stimuli (PLDs) and is still underexplored in individuals with ASD and intellectual disability (ID). In the present study, we investigated the recognition of happy, fearful, and neutral BM in children with ASD with and without ID. In a non-verbal recognition task, participants were asked to recognize pure-body-motion and visible-body-form stimuli (by means of point-light displays-PLDs and full-light displays-FLDs, respectively). We found that the children with ASD were less accurate than TD children in recognizing both the emotional and neutral BM, either when presented as FLDs or PLDs. These results suggest that the difficulty in understanding the observed BM may rely on atypical processing of BM information rather than emotion. Moreover, we found that the accuracy improved with age and IQ only in children with ASD without ID, suggesting that high level of cognitive resources can mediate the acquisition of compensatory mechanisms which develop with age.

Therapeutic Effects of Bilateral Anodal Transcranial Direct Current Stimulation on Prefrontal and Motor Cortical Areas in Children with Autism Spectrum Disorders: A Pilot Study

Dysfunctional frontal cortical areas associated with clinical features are observed in children with autism spectrum disorder (ASD). This study attempted to identify any potential therapeutic effects of bilateral anodal transcranial direct current stimulation (tDCS) applied over the left and right prefrontal and motor areas on the clinical characteristics of children with ASD. Fifty children with confirmed ASD medical diagnoses were divided equally and randomly into a tDCS treatment group and a control group. The tDCS treatment group underwent 10 sessions (20-min durations, five per week) of bilateral anodal tDCS stimulation applied simultaneously over the left and right prefrontal and motor areas, whereas the control group underwent the same procedures but with the use of sham tDCS stimulation. Total scores and sub-scores of autism treatment evaluation checklist (ATEC) (language and communication; sociability; sensory awareness; and behavioral, health, and physical conditions) were measured before and after the tDCS treatment sessions of both groups. There were significant decreases in total ATEC scores (P = 0.014), sociability sub-scores (P = 0.021), and behavioral, health, and physical condition sub-scores (P = 0.011) in the tDCS treatment group. No significant changes were observed in total ATEC scores and sub-scores in the control group. In conclusion, compared to the control group, bilateral anodal tDCS showed potential therapeutic effects on children with ASD in terms of improvements in sociability, behavior, health, and physical conditions with no reported side effects. Autism Res 2020, 13: 828-836. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Dysfunctional frontal cortical areas are associated with clinical features in children with autism spectrum disorder (ASD). Transcranial direct current stimulation (tDCS) is found to be a safe, noninvasive method to stimulate cortical regions and thus have therapeutic effects on children with ASD. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

A comprehensive assessment process for children with autism spectrum disorders

Purpose

The assessment of Autism Spectrum Disorders (ASD) in childhood has two essential aspects: the identification of the risk (under 30 months of age) and the definition of a diagnosis that takes into account its core areas as well as further non-specific aspects. The purpose of this paper is to present an approach that considers the combination of clinical evaluation with the use of tools that analyse the various levels of the child’s functioning as fundamental.

Design/methodology/approach

The comprehensive assessment at the Institute of Ortofonologia in Rome provides the ADOS-2 and the Leiter-R for the evaluation of the symptomatology, the severity level, the non-verbal cognitive functioning and the fluid reasoning; the TCE and the UOI are used to identify, respectively, the child’s emotional skills and the ability to understand the intentions of others, as precursors of the theory of mind. Within this assessment, the Brief-P, the Short Sensory Profile and the RBS are also included for the evaluation of executive functions, sensory pattern and of restricted and repetitive behaviours, as observed by parents.

Findings

How to define a reliable development profile, which allows to plan a specific intervention calibrated on the potential of the child and on his development trajectory, is described. Two clinical cases are also presented.

Originality/value

The entire process is aimed both at a detailed assessment of the child’s functioning and at identifying a specific therapeutic project and predictive factors for achieving an optimal outcome.

Prediction and Mismatch Negativity Responses Reflect Impairments in Action Semantic Processing in Adults With Autism Spectrum Disorders

The neurophysiological mechanisms underlying motor and language difficulties in autism spectrum disorders (ASD) are still largely unclear. The present work investigates biological indicators of sound processing, (action-) semantic understanding and predictive coding and their correlation with clinical symptoms of ASD. Twenty-two adults with high-functioning ASD and 25 typically developed (TD) participants engaged in an auditory, passive listening, Mismatch Negativity (MMN) task while high-density electroencephalography (EEG) was recorded. Action and non-action words were presented in the context of sounds, which were either semantically congruent with regard to the body part they relate to or semantically incongruent or unrelated. The anticipatory activity before sound onset, the Prediction Potential (PP), was significantly reduced in the ASD group specifically for action, but not for non-action sounds. The early-MMN-like responses to words (latency: 120 ms) were differentially modulated across groups: controls showed larger amplitudes for words in action-sound compared to non-action contexts, whereas ASD participants demonstrated enlarged early-MMN-like responses only in a pure tone context, with no other modulation dependent on action sound context. Late-MMN-like responses around 560 ms post-stimulus onset revealed body-part-congruent action-semantic priming for words in control participants, but not in the ASD group. Importantly, neurophysiological indices of semantic priming in ASD participants correlated with the extent of autistic traits as revealed by the Autism Spectrum Quotient (AQ). The data suggest that high-functioning adults with ASD show a specific deficit in semantic processing and predictive coding of sounds and words related to action, which is absent for neutral, non-action, sounds.

Action Semantic Deficits and Impaired Motor Skills in Autistic Adults Without Intellectual Impairment

Several studies indicate the functional importance of the motor cortex for higher cognition, language and semantic processing, and place the neural substrate of these processes in sensorimotor action-perception circuits linking motor, sensory and perisylvian language regions. Interestingly, in individuals with autism spectrum disorder (ASD), semantic processing of action and emotion words seems to be impaired and is associated with hypoactivity of the motor cortex during semantic processing. In this study, the relationship between semantic processing, fine motor skills and clinical symptoms was investigated in 19 individuals with ASD and 22 typically-developing matched controls. Participants completed two semantic decision tasks involving words from different semantic categories, a test of alexithymia (the Toronto Alexithymia Scale), and a test of fine motor skills (the Purdue Pegboard Test). A significant Group × Word Category interaction in accuracy (p < 0.05) demonstrated impaired semantic processing for action words, but not object words in the autistic group. There was no significant group difference when processing abstract emotional words or abstract neutral words. Moreover, our study revealed deficits in fine motor skills as well as evidence for alexithymia in the ASD group, but not in neurotypical controls. However, these motor deficits did not correlate significantly with impairments in action-semantic processing. We interpret the data in terms of an underlying dysfunction of the action-perception system in ASD and its specific impact on semantic language processing.

Mirroring in the Human Brain: Deciphering the Spatial-Temporal Patterns of the Human Mirror Neuron System

Embodied theories of cognition emphasize the central role of sensorimotor transformations in the representation of others' actions. Support for these theories is derived from the discovery of the mirror neuron system (MNS) in primates, from noninvasive techniques in humans, and from a limited number of intracranial studies. To understand the neural dynamics of the human MNS, more studies with precise spatial and temporal resolutions are essential. We used electrocorticography to define activation patterns in sensorimotor, parietal and/or frontal neuronal populations, during a viewing and grasping task. Our results show robust high gamma activation for both conditions in classic MNS sites. Furthermore, we provide novel evidence for 2 different populations of neurons: sites that were only active for viewing and grasping ("pure mirroring") and sites that were also active between viewing and grasping, and perhaps serve a more general attentional role. Lastly, a subgroup of parietal electrodes showed earlier peaks than all other regions. These results highlight the complexity of spatial-temporal patterns within the MNS and provide a critical link between single-unit research in monkeys and noninvasive techniques in human.

Brain Complexity in Children with Mild and Severe Autism Spectrum Disorders: Analysis of Multiscale Entropy in EEG

Multiscale entropy (MSE) model quantifies the complexity of brain functions by measuring the entropy across multiple time-scales. Although MSE model has been applied in children with Autism spectrum disorders (ASD) in previous studies, they were limited to distinguish children with ASD from those normally developed without corresponding severity level of their autistic features. Therefore, we aims  to explore and to identify the MSE features and patterns in children with mild and severe ASD by using a high dense 64-channel array EEG system. This study is a cross-sectional study, where 36 children with ASD were recruited and classified into two groups: mild and severe ASD (18 children in each). Three calculated outcomes identified brain complexity of mild and severe ASD groups: averaged MSE values, MSE topographical cortical representation, and MSE curve plotting. Averaged MSE values of children with mild ASD were higher than averaged MSE value in children with severe ASD in right frontal (0.37 vs. 0.22, respectively, p = 0.022), right parietal (0.31 vs. 0.13, respectively, p = 0.017), left parietal (0.37 vs. 0.17, respectively, p = 0.018), and central cortical area (0.36 vs. 0.21, respectively, p = 0.026). In addition, children with mild ASD showed a clear and more increase in sample entropy values over increasing values of scale factors than children with severe ASD. Obtained data showed different brain complexity (MSE) features, values and topographical representations in children with mild ASD compared with those with severe ASD. As a result of this, MSE could serve as a sensitive method for identifying the severity level of ASD.

Does fMRI repetition suppression reveal mirror neuron activity in the human brain? Insights from univariate and multivariate analysis

Mirror neurons (MN) have been proposed as the neural substrate for a wide range of clinical, social and cognitive phenomena. Over the last decade, a commonly used tool for investigating MN activity in the human brain has been functional magnetic resonance (fMRI) repetition suppression (RS) paradigms. However, the available evidence is mixed, largely owing to inconsistent application of the methodological criteria necessary to infer MN properties. This raises concerns about the degree to which one can infer the presence (or absence) of MN activity from earlier accounts that adopted RS paradigms. We aimed to clarify this issue using a well-validated fMRI RS paradigm and tested for mirror properties by rigorously applying the widely accepted criteria necessary to demonstrate MN activity using traditional univariate techniques and Multivariate Pattern Analysis (MVPA). While univariate whole brain analysis in healthy adults showed uni-modal RS effects within the supplementary motor area, no evidence for cross-modal RS effects consistent with mirror neuron activity was found. MVPA on the other hand revealed a region along the anterior intraparietal sulcus that met the criteria for MN activity. Taken together, these results clarify disparate evidence from earlier RS studies, highlighting that traditional univariate analysis of RS data may not be sensitive for detecting MN activity when rigorously applying the requisite criteria. In light of these findings, we recommend that short of increasing sample sizes substantially, future studies using RS paradigms to investigate MNs across the human brain consider the use of MVPA.

The Impact of Autistic Traits on Self-Recognition of Body Movements

Despite the sparse visual information and paucity of self-identifying cues provided by point-light stimuli, as well as a dearth of experience in seeing our own-body movements, people can identify themselves solely based on the kinematics of body movements. The present study found converging evidence of this remarkable ability using a broad range of actions with whole-body movements. In addition, we found that individuals with a high degree of autistic traits showed worse performance in identifying own-body movements, particularly for simple actions. A Bayesian analysis showed that action complexity modulates the relationship between autistic traits and self-recognition performance. These findings reveal the impact of autistic traits on the ability to represent and recognize own-body movements.

High-Frequency Repetitive Transcranial Magnetic Stimulation Applied to the Parietal Cortex for Low-Functioning Children With Autism Spectrum Disorder: A Case Series

Background: Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique to stimulate specific areas of cortical dysfunction in several neuropsychiatric diseases; however, it is not known whether high-frequency rTMS (HF-rTMS) over the left inferior parietal lobule, in low functioning children with autism spectrum disorder (ASD), improves core symptoms. Method: Eleven low-functioning children with ASD completed two separate HF-rTMS treatment courses, 6 weeks apart. Each treatment course involved five 5-s trains at 20 Hz, with 10-min inter-train intervals, on left inferior parietal lobule each consecutive weekday for a 3-week period (15 treatments per course). Subjects were assessed at five time points: immediately before and after the first HF-rTMS course, immediately before and after the second HF-rTMS course, and 6 weeks after the second rTMS treatment course. Treatment effectiveness was evaluated using the Verbal Behavior Assessment Scale (VerBAS) and Autism Treatment Evaluation Checklist (ATEC). The latter test consists of four subtest scales: Language, Sociability, Sensory, and Behavior. In addition, daily treatment logbooks completed by parents were considered as one of the outcome measures. Results: Participants showed a significant reduction in language- and social-related symptoms measured by ATEC from pretreatment to the 6-week follow-up after the second treatment course. Moreover, some possible improvements in imitation and cognition were reported by caregivers. Conclusions: Our findings suggest that HF-rTMS over the left parietal cortex might improve core deficits in low-functioning children with ASD.

Mu rhythm desynchronization is specific to action execution and observation: Evidence from time-frequency and connectivity analysis

Mu desynchronization is the attenuation of EEG power in the alpha frequency range recorded over central scalp locations thought to reflect motor cortex activation. Mu desynchronization during observation of an action is believed to reflect mirroring system activation in humans. However, this notion has recently been questioned because, among other reasons, the potential contamination of mu rhythm and occipital alpha activity induced by attention processes following presentation of visual stimuli in observation conditions. This study examined the validity of mu desynchronization as a measure of mirroring system activation in infants and further investigated the pattern of functional connectivity between the central and occipital regions during execution and observation of movement. EEG was recorded while 46 9-month-old infants executed grasping actions and observed an experimenter grasping. Current source density (CSD) was applied to EEG data and, time-frequency and connectivity analyses were performed in CSD transformed data. Mu desynchronization was evident over central regions during both execution and observation of movements. Independent alpha desynchronization over occipital region was also present in both conditions. The connectivity analyses revealed that central-occipital areas were functionally more connected compared to other areas of the brain during observation of movements. Collectively, the results demonstrate the validity of mu desynchronization as an index of infant mirroring system activity and support the proposal of a functional connection between distinct mirroring and attention processes during observation of action.

Implementing Cognitive Training Into a Surgical Skill Course: A Pilot Study on Laparoscopic Suturing and Knot Tying

Mini-invasive surgery-for example, laparoscopy-has challenged surgeons' skills by extending their usual haptic space and displaying indirect visual feedback through a screen. This may require new mental abilities, including spatial orientation and mental representation. This study aimed to test the effect of cognitive training based on motor imagery (MI) and action observation (AO) on surgical skills. A total of 28 postgraduate residents in surgery took part in our study and were randomly distributed into 1 of the 3 following groups: (1) the basic surgical skill, which is a short 2-day laparoscopic course + MI + AO group; (2) the basic surgical skill group; and (3) the control group. The MI + AO group underwent additional cognitive training, whereas the basic surgical skill group performed neutral activity during the same time. The laparoscopic suturing and knot tying performance as well as spatial ability and mental workload were assessed before and after the training period. We did not observe an effect of cognitive training on the laparoscopic performance. However, the basic surgical skill group significantly improved spatial orientation performance and rated lower mental workload, whereas the 2 others exhibited lower performance in a mental rotation test. Thus, actual and cognitive training pooled together during a short training period elicited too high a strain, thus limiting potential improvements. Because MI and AO already showed positive outcomes on surgical skills, this issue may, thus, be mitigated according to our specific learning conditions. Distributed learning may possibly better divide and share the strain associated with new surgical skills learning.

Performance monitoring in the medial frontal cortex and related neural networks: From monitoring self actions to understanding others' actions

Action is a key channel for interacting with the outer world. As such, the ability to monitor actions and their consequences - regardless as to whether they are self-generated or other-generated - is of crucial importance for adaptive behavior. The medial frontal cortex (MFC) has long been studied as a critical node for performance monitoring in nonsocial contexts. Accumulating evidence suggests that the MFC is involved in a wide range of functions necessary for one's own performance monitoring, including error detection, and monitoring and resolving response conflicts. Recent studies, however, have also pointed to the importance of the MFC in performance monitoring under social conditions, ranging from monitoring and understanding others' actions to reading others' mental states, such as their beliefs and intentions (i.e., mentalizing). Here we review the functional roles of the MFC and related neural networks in performance monitoring in both nonsocial and social contexts, with an emphasis on the emerging field of a social systems neuroscience approach using macaque monkeys as a model system. Future work should determine the way in which the MFC exerts its monitoring function via interactions with other brain regions, such as the superior temporal sulcus in the mentalizing system and the ventral premotor cortex in the mirror system.

Mirror Neurons Modeled Through Spike-Timing-Dependent Plasticity are Affected by Channelopathies Associated with Autism Spectrum Disorder

Mirror neurons fire action potentials both when the agent performs a certain behavior and watches someone performing a similar action. Here, we present an original mirror neuron model based on the spike-timing-dependent plasticity (STDP) between two morpho-electrical models of neocortical pyramidal neurons. Both neurons fired spontaneously with basal firing rate that follows a Poisson distribution, and the STDP between them was modeled by the triplet algorithm. Our simulation results demonstrated that STDP is sufficient for the rise of mirror neuron function between the pairs of neocortical neurons. This is a proof of concept that pairs of neocortical neurons associating sensory inputs to motor outputs could operate like mirror neurons. In addition, we used the mirror neuron model to investigate whether channelopathies associated with autism spectrum disorder could impair the modeled mirror function. Our simulation results showed that impaired hyperpolarization-activated cationic currents (Ih) affected the mirror function between the pairs of neocortical neurons coupled by STDP.

Trouble du spectre de l’autisme : une agentivité morale objective, rigoriste et émotionnelle

Le trouble du spectre de l’autisme (TSA) désigne un ensemble de troubles neurodéveloppementaux caractérisé par des difficultés de communication et d’interactions sociales, ainsi que des comportements, intérêts et activités restreints et répétitifs (1). Concernant les interactions sociales, les personnes autistes auraient notamment des difficultés d’empathie, souvent considérées comme altérant leurs capacités morales. Ainsi, plusieurs études en psychologie et en neuroscience tentent de détecter des processus empathiques défaillants à l’origine d’altérations de leur compréhension de la moralité (2-4). Les problèmes sociaux des personnes autistes se manifestent aussi par des difficultés dans leur vie affective qui concernent leurs propres états émotionnels (5-9). Je suggère que les particularités morales des personnes autistes sont issues de leurs particularités d’accès émotionnel, soit la façon dont elles se rapportent à leurs propres émotions, et non pas de déficits d’empathie. Je montrerai que ces particularités ne les empêchent en aucun cas de faire partie de la communauté morale. Les personnes autistes peuvent être de rigoureux agents moraux, c’est-à-dire qu’elles présentent une certaine intransigeance et inflexibilité morale. Ces particularités seront expliquées. À la lumière des théories sur les processus duaux, je montrerai comment leurs particularités socio-émotionnelles et morales sont toutes deux sous-tendues par une surutilisation de processus de type 2, soit une surutilisation de raisonnements cognitifs délibérés et basés sur des règles, plutôt que des processus automatiques, de type 1. L’objectif principal de cette étude sera donc de mettre en évidence les particularités qui permettent aux personnes autistes d’être des agents moraux certes inflexibles, mais néanmoins émotionnellement investis dans les situations à caractère moral.

Emotional cues and social anxiety resolve ambiguous perception of biological motion

Perceptions of ambiguous biological motion are modulated by different individual cognitive abilities (such as inhibition and empathy) and emotional states (such as anxiety). This study explored facing-the-viewer bias (FTV) in perceiving ambiguous directions of biological motion, and investigated whether task-irrelevant simultaneous face emotional cues in the background and the individual social anxiety traits could affect FTV. We found that facial motion cues as background affect sociobiologically relevant scenarios, including biological motion, but not non-biological situations (conveyed through random dot motion). Individuals with high anxiety traits demonstrated a more dominant FTV bias than individuals with low anxiety traits. Ensemble coding-like processing of task-irrelevant multiple emotional cues could magnify the facing-the-viewer bias than did in the single emotional cue. Overall, those findings suggest a correlation between high-level emotional processing and high-level motion perception (subjective to attentional control) contributes to facing-the-viewer bias.

Development of social systems neuroscience using macaques

This paper reviews the literature on social neuroscience studies using macaques in the hope of encouraging as many researchers as possible to participate in this field of research and thereby accelerate the system-level understanding of social cognition and behavior. We describe how different parts of the primate brain are engaged in different aspects of social information processing, with particular emphasis on the use of experimental paradigms involving more than one monkey in laboratory settings. The description begins with how individual neurons are used for evaluating socially relevant information, such as the identity, face, and focus of attention of others in various social contexts. A description of the neural bases of social reward processing and social action monitoring follows. Finally, we provide several perspectives on novel experimental strategies to help clarify the nature of interacting brains under more socially and ecologically plausible conditions.

Training of Cerebrovascular Specialists: The Surgeon's View

The key to becoming an expert in a surgical field is mainly practice and perseverance. The old-fashioned system of teaching from one older person to a younger one, by simple demonstration, imitation, and practice, cannot be replaced in the surgical field by more modern didactic tools. Structured and explicit concepts, however, can accelerate the learning process. Structured concepts consist of a system of specifics-for example, types of aneurysms in the field of vascular pathology-and standard operating procedures. It is important to realize that the teaching requirements of the surgical disciplines differ substantially from those of the conservative disciplines. The number of procedures performed is probably the most critical factor for competence. At our center we have used the target number of 100 microsurgical aneurysm cases treated under supervision before sufficient competence is considered to have been achieved for independent surgery. Following initial training a certain amount of practice is required to remain current or competent. The proficiency requirements accepted in aviation could be seen as a guide for proficiency requirements in neurosurgery. In aviation, a minimum of 12 per year is specified for most critical procedures.

Response Hand Differentially Affects Action Word Processing

Recent approaches in the tradition of theories of semantic and conceptual “grounding” emphasize the role of perceptual and motor knowledge in language as well as action understanding. However, the role of the two cerebral hemispheres in integrating action-motor and language processes is not clear yet. The present study looked at the influence of a simultaneous motor tapping task on word processing. In a lexical decision task, uni-manual and bi-manual hand-related, and foot-related action verbs were presented in the left and right visual half-field. A group of healthy participants performed tapping with the left hand and lexical decisions with their right hand. In a second group of participants, the reversed hand response pattern was applied. The results showed that response hand had an influence on functional lateralization of word processing when responses were executed with the non-dominant hand. Projecting words to the ipsilateral hemisphere relative to the hemisphere performing lexical decisions led to significantly decreased performance. The results showed that left hand responses led to an increased accuracy for hand-related in contrast to foot-related action verbs. The findings suggest an influence of response hand on action word processing.

Evaluating the importance of social motor synchronization and motor skill for understanding autism

Impairments in social interaction and communicating with others are core features of autism spectrum disorder (ASD), but the specific processes underlying such social competence impairments are not well understood. An important key for increasing our understanding of ASD-specific social deficits may lie with the social motor synchronization that takes place when we implicitly coordinate our bodies with others. Here, we tested whether dynamical measures of synchronization differentiate children with ASD from controls and further explored the relationships between synchronization ability and motor control problems. We found (a) that children with ASD exhibited different and less stable patterns of social synchronization ability than controls; (b) children with ASD performed motor movements that were slower and more variable in both spacing and timing; and (c) some social synchronization that involved motor timing was related to motor ability but less rhythmic synchronization was not. These findings raise the possibility that objective dynamical measures of synchronization ability and motor skill could provide new insights into understanding the social deficits in ASD that could ultimately aid clinical diagnosis and prognosis. Autism Res 2017, 10: 1687-1699. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Predicting symptom severity in autism spectrum disorder based on cortical thickness measures in agglomerative data

Machine learning approaches have been widely used for the identification of neuropathology from neuroimaging data. However, these approaches require large samples and suffer from the challenges associated with multi-site, multi-protocol data. We propose a novel approach to address these challenges, and demonstrate its usefulness with the Autism Brain Imaging Data Exchange (ABIDE) database. We predict symptom severity based on cortical thickness measurements from 156 individuals with autism spectrum disorder (ASD) from four different sites. The proposed approach consists of two main stages: a domain adaptation stage using partial least squares regression to maximize the consistency of imaging data across sites; and a learning stage combining support vector regression for regional prediction of severity with elastic-net penalized linear regression for integrating regional predictions into a whole-brain severity prediction. The proposed method performed markedly better than simpler alternatives, better with multi-site than single-site data, and resulted in a considerably higher cross-validated correlation score than has previously been reported in the literature for multi-site data. This demonstration of the utility of the proposed approach for detecting structural brain abnormalities in ASD from the multi-site, multi-protocol ABIDE dataset indicates the potential of designing machine learning methods to meet the challenges of agglomerative data.

Single-neuron and genetic correlates of autistic behavior in macaque

Atypical neurodevelopment in autism spectrum disorder is a mystery, defying explanation despite increasing attention. We report on a Japanese macaque that spontaneously exhibited autistic traits, namely, impaired social ability as well as restricted and repetitive behaviors, along with our single-neuron and genomic analyses. Its social ability was measured in a turn-taking task, where two monkeys monitor each other's actions for adaptive behavioral planning. In its brain, the medial frontal neurons responding to others' actions, abundant in the controls, were almost nonexistent. In its genes, whole-exome sequencing and copy number variation analyses identified rare coding variants linked to human neuropsychiatric disorders in 5-hydroxytryptamine (serotonin) receptor 2C (HTR2C) and adenosine triphosphate (ATP)-binding cassette subfamily A13 (ABCA13). This combination of systems neuroscience and cognitive genomics in macaques suggests a new, phenotype-to-genotype approach to studying mental disorders.