The Unfulfilled Promise of the N170 as a Social Biomarker

An Event-Related Potential Study on Facial Recognition in Children with and without Autism Spectrum Disorders

Purpose

Facial recognition is very primary and important in individuals' development and the event-related potential based on face recognition such as N170 is considered as the most potential objective marker of autism, the hot and difficult point of current research. We will explore the electrophysiological basis of facial recognition with autism and without autism. Given the link between facial recognition and social impairments, the core symptom of autism, it is also necessary to study the correlation between the P1 and N170 components and the severity of social functioning in autism.

Patients and Methods

In this study, autism and age-matched typically developing children were asked to examine photographs of faces, objects and butterflies and event-related potentials were recorded. The parents or caregivers of the participants were asked to fill out the Vineland Adaptive Behavior Scale. Finally, thirteen children with autism (6.60±2.12years) and ten typically developing (6.65±1.64years) children were included in the experiment.

Results

Children with autism showed slower P1 and N170 latencies than typically developing children. The N170 amplitude for faces was larger than that for objects. Considering age as a covariant, the results primarily remained unchanged and the effect size of age was significant for the P1 and N170 latencies. As for the correlation between ERPs and the severity of social impairment, there were some significant correlations between the P1 and N170 latencies and social functioning.

Conclusion

This result not only suggests the electrophysiological basis of facial recognition but also indicates that the P1 and N170 components could assist in the diagnosis and assessment of autism. Moreover, the results suggest that age should be considered in analyses of the P1 and N170 latencies. Due to a limited number of participants, conducting a multi-center and large-sample study in the future is necessary.

Social Functioning in Autistic Children with Below-Average vs. Average IQ: Limited Behavioral and Neural Evidence of Group Differences

Despite the relatively high rates of intellectual disability (ID) in autism, research studies and clinical trials commonly exclude autistic participants with below-average IQ. This study aimed to characterize the effect of intellectual ability on social functioning in autistic adolescents assessed using behavioral and neural measures. Caregiver reports and direct standardized behavioral assessments of social abilities along with event-related potential measures of social and nonsocial information processing were obtained in school-age children with autism and ID (n = 41) matched on age, sex, and autism symptom severity to autistic participants with average IQ (n = 41). Full-scale IQ differences did not affect caregiver reports of social functioning in daily life. Group differences were observed only for the direct behavioral assessments of social perception and cognition (NEPSY Memory for Faces delayed, Theory of Mind) as well as social behavior with an unfamiliar friendly confederate, where higher IQ was associated with better performance. Similarly, the impact of IQ on neural responses was limited to a minimal delay in the processing speed of all visual stimuli and the magnitude of differences between social and nonsocial images, but not on incidental memory for the repeated stimuli. The effects of IQ on behavioral or neural responses did not vary based on biological sex. Below-average full-scale IQ in autistic youth affects results of some but not all behavioral or neural measures probing social functioning. Therefore, enrolling participants with a wider range of intellectual ability could be feasible in future studies.

Characteristics of Cognitive Event-Related Potential Components and N170 Source Analysis in Patients with Acute Cerebellar Infarction

This study aims to evaluate cognitive impairments in patients with acute cerebellar infarction using event-related potentials (ERP) and electrophysiological source imaging (ESI). Thirty patients with acute cerebellar infarction and 32 healthy volunteers were selected. Cognitive potentials were recorded and measured using a visual Oddball paradigm. Source analysis of the N170 component was performed using standardized low-resolution brain electromagnetic tomography (sLORETA) to compare the standardized current density distribution between the two groups under different stimuli. For inverted and upright face stimuli, the amplitudes of N170, VPP, and N300 in the patient group were significantly lower than those in the control group (p < 0.05). For upright house stimuli, the VPP amplitude in the patient group was also lower than that in the control group (p < 0.05). Source analysis revealed that the brain regions with significant differences between the acute cerebellar infarction group and the control group included the temporal and parietal lobes. Specifically, activation in the precuneus was reduced during inverted face stimuli; activation in the middle temporal gyrus was reduced during upright face stimuli; and activation in the middle temporal gyrus and fusiform gyrus was increased during both inverted and upright house stimuli. Patients with acute cerebellar infarction exhibit abnormal P100, N170/VPP, and N300 amplitudes. Source analysis of the N170 component revealed altered activation in the middle and inferior temporal gyri, fusiform gyrus, middle occipital gyrus, and precuneus, which play a role in selective cognitive impairments following cerebellar infarction.

A comparative analysis of face and object perception in 2D laboratory and virtual reality settings: insights from induced oscillatory responses

In psychophysiological research, the use of Virtual Reality (VR) for stimulus presentation allows for the investigation of how perceptual processing adapts to varying degrees of realism. Previous time-domain studies have shown that perceptual processing involves modality-specific neural mechanisms, as evidenced by distinct stimulus-locked components. Analyzing induced oscillations across different frequency bands can provide further insights into neural processes that are not strictly phase-locked to stimulus onset. This study uses a simple perceptual paradigm presenting images of faces and cars on both a standard 2D monitor and in an immersive VR environment. To investigate potential modality-dependent differences in attention, cognitive load, and task-related post-movement processing, the induced alpha, theta and beta band responses are compared between the two modalities. No evidence was found for differences in stimulus-dependent attention or task-related post-movement processing between the 2D conditions and the realistic virtual conditions in electrode space, as posterior alpha suppression and re-synchronization of centro-parietal beta did not differ between conditions. However, source analysis revealed differences in the attention networks engaged during 2D and 3D perception. Midfrontal theta was significantly stronger in laboratory conditions, indicating higher cognitive load than in the VR environment. Exploratory analysis of posterior theta showed stronger responses in VR, possibly reflecting the processing of depth information provided only by the 3D material. In addition, the theta response seems to be generated by distinct neuronal sources under realistic virtual conditions indicating enhanced involvement of semantic information processing and social cognition.

Electrophysiological correlates of face and object perception: A comparative analysis of 2D laboratory and virtual reality conditions

Human face perception is a specialized visual process with inherent social significance. The neural mechanisms reflecting this intricate cognitive process have evolved in spatially complex and emotionally rich environments. Previous research using VR to transfer an established face perception paradigm to realistic conditions has shown that the functional properties of face-sensitive neural correlates typically observed in the laboratory are attenuated outside the original modality. The present study builds on these results by comparing the perception of persons and objects under conventional laboratory (PC) and realistic conditions in VR. Adhering to established paradigms, the PC- and VR modalities both featured images of persons and cars alongside standard control images. To investigate the individual stages of realistic face processing, response times, the typical face-sensitive N170 component, and relevant subsequent components (L1, L2; pre-, post-response) were analyzed within and between modalities. The between-modality comparison of response times and component latencies revealed generally faster processing under realistic conditions. However, the obtained N170 latency and amplitude differences showed reduced discriminative capacity under realistic conditions during this early stage. These findings suggest that the effects commonly observed in the lab are specific to monitor-based presentations. Analyses of later and response-locked components showed specific neural mechanisms for identification and evaluation are employed when perceiving the stimuli under realistic conditions, reflected in discernible amplitude differences in response to faces and objects beyond the basic perceptual features. Conversely, the results do not provide evidence for comparable stimulus-specific perceptual processing pathways when viewing pictures of the stimuli under conventional laboratory conditions.

Neural correlates of face processing among preschoolers with fragile X syndrome, autism spectrum disorder, autism siblings, and typical development

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.

Real-life relevant face perception is not captured by the N170 but reflected in later potentials: A comparison of 2D and virtual reality stimuli

The perception of faces is one of the most specialized visual processes in the human brain and has been investigated by means of the early event-related potential component N170. However, face perception has mostly been studied in the conventional laboratory, i.e., monitor setups, offering rather distal presentation of faces as planar 2D-images. Increasing spatial proximity through Virtual Reality (VR) allows to present 3D, real-life-sized persons at personal distance to participants, thus creating a feeling of social involvement and adding a self-relevant value to the presented faces. The present study compared the perception of persons under conventional laboratory conditions (PC) with realistic conditions in VR. Paralleling standard designs, pictures of unknown persons and standard control images were presented in a PC- and a VR-modality. To investigate how the mechanisms of face perception differ under realistic conditions from those under conventional laboratory conditions, the typical face-specific N170 and subsequent components were analyzed in both modalities. Consistent with previous laboratory research, the N170 lost discriminatory power when translated to realistic conditions, as it only discriminated faces and controls under laboratory conditions. Most interestingly, analysis of the later component [230–420 ms] revealed more differentiated face-specific processing in VR, as indicated by distinctive, stimulus-specific topographies. Complemented by source analysis, the results on later latencies show that face-specific neural mechanisms are applied only under realistic conditions (A video abstract is available in the Supplementary material and via YouTube: https://youtu.be/TF8wiPUrpSY).

Face processing in young adults with autism and ADHD: An event related potentials study

Background

Atypicalities in perception and interpretation of faces and emotional facial expressions have been reported in both autism and attention-deficit/hyperactivity disorder (ADHD) during childhood and adulthood. Investigation of face processing during young adulthood (18 to 25 years), a transition period to full-fledged adulthood, could provide important information on the adult outcomes of autism and ADHD.

Methods

In this study, we investigated event-related potentials (ERPs) related to visual face processing in autism, ADHD, and co-occurring autism and ADHD in a large sample of young adults (N = 566). The groups were based on the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2) and the Autism Diagnostic Observation Schedule-2 (ADOS-2). We analyzed ERPs from two passive viewing tasks previously used in childhood investigations: (1) upright and inverted faces with direct or averted gaze; (2) faces expressing different emotions.

Results

Across both tasks, we consistently found lower amplitude and longer latency of N170 in participants with autism compared to those without. Longer P1 latencies and smaller P3 amplitudes in response to emotional expressions and longer P3 latencies for upright faces were also characteristic to the autistic group. Those with ADHD had longer N170 latencies, specific to the face-gaze task. Individuals with both autism and ADHD showed additional alterations in gaze modulation and a lack of the face inversion effect indexed by a delayed N170.

Conclusion

Alterations in N170 for autistic young adults is largely consistent with studies on autistic adults, and some studies in autistic children. These findings suggest that there are identifiable and measurable socio-functional atypicalities in young adults with autism.

Sex differences in automatic emotion regulation in adolescents with autism spectrum disorder

Autism may be underdiagnosed in females because their social difficulties are often less noticeable. This study explored sex differences in automatic facial emotion processing in 45 adolescents with autism spectrum disorder (22 female, 23 male), age 10-16 years, performing active target detection task and Go/NoGo tasks where faces with positive and negative emotional expressions served as irrelevant distractors. The combined sample demonstrated more accurate performance on the target detection (response initiation) than the Go/NoGo task (response inhibition), replicating findings previously reported in typical participants. Females exhibited greater difficulty than males with response initiation in the target detection task, especially in the context of angry faces, while males found withholding a response in the Go/NoGo block with happy faces more challenging. Electrophysiological data revealed no sex differences or emotion discrimination effects during the early perceptual processing of faces indexed by the occipitotemporal N170. Autistic males demonstrated increased frontal N2 and parietal P3 amplitudes compared to females, suggesting greater neural resource allocation to automatic emotion regulation processes. The associations between standardized behavioral measures (autism severity, theory of mind skills) and brain responses also varied by sex: more adaptive social functioning was related to the speed of perceptual processing (N170 latency) in females and the extent of deliberate attention allocation (P3 amplitudes) in males. Together, these findings suggest that males and females with autism may rely on different strategies for social functioning and highlight the importance of considering sex differences in autism. LAY SUMMARY: Females with autism may exhibit less noticeable social difficulties than males. This study demonstrates that autistic females are more successful than males at inhibiting behavioral responses in emotional contexts, while males are more likely to initiate a response. At the neural level, social functioning in females is related to the speed of automatic perceptual processing of facial cues, and in males, to the extent of active attention allocation to the stimuli. These findings highlight the importance of considering sex differences in autism diagnosis and treatment selection.

Investigating Changes in Reward-Related Neural Correlates After PEERS Intervention in Adolescents With ASD: Preliminary Evidence of a "Precision Medicine" Approach

Background: The Social Motivation Hypothesis proposes that individuals with autism spectrum disorder (ASD) experience social interactions as less rewarding than their neurotypical (TD) peers, which may lead to reduced social initiation. Existing studies of the brain's reward system in individuals with ASD report varied findings for anticipation of and response to social rewards. Given discrepant findings, the anticipation of and response to social rewards should be further evaluated, particularly in the context of intervention outcome. We hypothesized that individual characteristics may help predict neural changes from pre- to post-intervention. Methods: Thirteen adolescents with ASD received the Program for the Education and Enrichment of Relational Skills (PEERS) intervention for 16 weeks; reward-related EEG was collected before and after intervention. Fourteen TD adolescents were tested at two timepoints but did not receive intervention. Event-related potentials were calculated to measure anticipation of (stimulus-preceding negativity; SPN) and response to (reward-related positivity; RewP) social and non-social rewards. Additionally, measures of social responsiveness, social skills, and intervention-engagement were collected. Group differences were analyzed as well as individual differences using prediction models. Result: Parent-reported social responsiveness and social skills improved in adolescents with ASD after participation in PEERS. ASD adolescents displayed marginally decreased anticipation of social rewards at post-intervention compared to pre-intervention. Regression models demonstrated that older adolescents and those with lower parent-reported social motivation prior to participation in PEERS displayed marginally increased social reward anticipation (more robust SPN) from pre- to post-intervention. Participants who displayed more parent-reported social motivation before intervention and were more actively engaged in the PEERS intervention evidenced increased social reward processing (more robust RewP) from pre- to post-intervention. Conclusion: Findings suggest that there may be differences in saliency between wanting/anticipating social rewards vs. liking/responding to social rewards in individuals with ASD. Our findings support the hypothesis that identification of individual differences may predict which adolescents are poised to benefit the most from particular interventions. As such, reported findings set the stage for the advancement of "precision medicine." This investigation is a critical step forward in our ability to understand and predict individual response to interventions in individuals with ASD.

Refining biomarker evaluation in ASD

This commentary reflects on reasonable biomarker expectations in ASD by addressing three key questions: What is a biomarker? What is required for a biomarker in ASD? How can biomarkers be useful in ASD? In addressing these queries, a path forward emerges based on clear definition of the objective for any given ASD biomarker and evaluation of each biomarker relative to current best practices.

Brief Report: Preliminary Evidence of the N170 as a Biomarker of Response to Treatment in Autism Spectrum Disorder

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by primary difficulties in social function. Individuals with ASD display slowed neural processing of faces, as indexed by the latency of the N170, a face-sensitive event-related potential. Currently, there are no objective biomarkers of ASD useful in clinical care or research. Efficacy of behavioral treatment is currently evaluated through subjective clinical impressions. To explore whether the N170 might have utility as an objective index of treatment response, we examined N170 before and after receipt of an empirically validated behavioral treatment in children with ASD. Method: Electroencephalography (EEG) data were obtained on a preliminary cohort of preschool-aged children with ASD before and after a 16-week course of PRT and in a subset of participants in waitlist control (16-weeks before the start of PRT) and follow-up (16-weeks after the end of PRT). EEG was recorded while participants viewed computer-generated faces with neutral and fearful affect. Results: Significant reductions in N170 latency to faces were observed following 16 weeks of PRT intervention. Change in N170 latency was not observed in the waitlist-control condition. Conclusions: This exploratory study offers suggestive evidence that N170 latency may index response to behavioral treatment. Future, more rigorous, studies in larger samples are indicated to evaluate whether the N170 may be useful as a biomarker of treatment response.

Facial Expression Processing Across the Autism-Psychosis Spectra: A Review of Neural Findings and Associations With Adverse Childhood Events

Autism spectrum disorder (ASD) and primary psychosis are classified as distinct neurodevelopmental disorders, yet they display overlapping epidemiological, environmental, and genetic components as well as endophenotypic similarities. For instance, both disorders are characterized by impairments in facial expression processing, a crucial skill for effective social communication, and both disorders display an increased prevalence of adverse childhood events (ACE). This narrative review provides a brief summary of findings from neuroimaging studies investigating facial expression processing in ASD and primary psychosis with a focus on the commonalities and differences between these disorders. Individuals with ASD and primary psychosis activate the same brain regions as healthy controls during facial expression processing, albeit to a different extent. Overall, both groups display altered activation in the fusiform gyrus and amygdala as well as altered connectivity among the broader face processing network, probably indicating reduced facial expression processing abilities. Furthermore, delayed or reduced N170 responses have been reported in ASD and primary psychosis, but the significance of these findings is questioned, and alternative frequency-tagging electroencephalography (EEG) measures are currently explored to capture facial expression processing impairments more selectively. Face perception is an innate process, but it is also guided by visual learning and social experiences. Extreme environmental factors, such as adverse childhood events, can disrupt normative development and alter facial expression processing. ACE are hypothesized to induce altered neural facial expression processing, in particular a hyperactive amygdala response toward negative expressions. Future studies should account for the comorbidity among ASD, primary psychosis, and ACE when assessing facial expression processing in these clinical groups, as it may explain some of the inconsistencies and confound reported in the field.

EEG-IP: an international infant EEG data integration platform for the study of risk and resilience in autism and related conditions

BACKGROUND

Establishing reliable predictive and diganostic biomarkers of autism would enhance early identification and facilitate targeted intervention during periods of greatest plasticity in early brain development. High impact research on biomarkers is currently limited by relatively small sample sizes and the complexity of the autism phenotype.

METHODS

EEG-IP is an International Infant EEG Data Integration Platform developed to advance biomarker discovery by enhancing the large scale integration of multi-site data. Currently, this is the largest multi-site standardized dataset of infant EEG data.

RESULTS

First, multi-site data from longitudinal cohort studies of infants at risk for autism was pooled in a common repository with 1382 EEG longitudinal recordings, linked behavioral data, from 432 infants between 3- to 36-months of age. Second, to address challenges of limited comparability across independent recordings, EEG-IP applied the Brain Imaging Data Structure (BIDS)-EEG standard, resulting in a harmonized, extendable, and integrated data state. Finally, the pooled and harmonized raw data was preprocessed using a common signal processing pipeline that maximizes signal isolation and minimizes data reduction. With EEG-IP, we produced a fully standardized data set, of the pooled, harmonized, and pre-processed EEG data from multiple sites.

CONCLUSIONS

Implementing these integrated solutions for the first time with infant data has demonstrated success and challenges in generating a standardized multi-site data state. The challenges relate to annotation of signal sources, time, and ICA analysis during pre-processing. A number of future opportunities also emerge, including validation of analytic pipelines that can replicate existing findings and/or test novel hypotheses.

Frequency-Tagging Electroencephalography of Superimposed Social and Non-Social Visual Stimulation Streams Reveals Reduced Saliency of Faces in Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) have difficulties with social communication and interaction. The social motivation hypothesis states that a reduced interest in social stimuli may partly underlie these difficulties. Thus far, however, it has been challenging to quantify individual differences in social orientation and interest, and to pinpoint the neural underpinnings of it. In this study, we tested the neural sensitivity for social versus non-social information in 21 boys with ASD (8-12 years old) and 21 typically developing (TD) control boys, matched for age and IQ, while children were engaged in an orthogonal task. We recorded electroencephalography (EEG) during fast periodic visual stimulation (FPVS) of social versus non-social stimuli to obtain an objective implicit neural measure of relative social bias. Streams of variable images of faces and houses were superimposed, and each stream of stimuli was tagged with a particular presentation rate (i.e., 6 and 7.5 Hz or vice versa). This frequency-tagging method allows disentangling the respective neural responses evoked by the different streams of stimuli. Moreover, by using superimposed stimuli, we controlled for possible effects of preferential looking, spatial attention, and disengagement. Based on four trials of 60 s, we observed a significant three-way interaction. In the control group, the frequency-tagged neural responses to faces were larger than those to houses, especially in lateral occipito-temporal channels, while the responses to houses were larger over medial occipital channels. In the ASD group, however, faces and houses did not elicit significantly different neural responses in any of the regions. Given the short recording time of the frequency-tagging paradigm with multiple simultaneous inputs and the robustness of the individual responses, the method could be used as a sensitive marker of social preference in a wide range of populations, including younger and challenging populations.