III. Electrophysiological studies of face processing in Williams syndrome

Computerized False Belief Tasks Impact Mentalizing Ability in People with Williams Syndrome

People with Williams syndrome (WS) are characterized by hyper sociability, fluency in languages, and advantageous face-processing skills, leading to the proposal of a social module. Previous studies on the mentalizing abilities of people with WS using two-dimensional pictures, including normal-like, delayed, and deviant behaviors, have yielded mixed results. Thus, this study examined the mentalizing ability of people with WS through structured computerized animations of false belief tasks to investigate whether inferences about other people's minds can be improved in this population. Participants were shown animations containing unexpected location and content changes. After viewing each animation, participants had to answer four types of questions relating to character identification, reality, memory, and false belief. Their responses were recorded and analyzed. A comprehension of false belief was observed in 4-year-old healthy children, whereas children with WS showed enhanced comprehension of false belief (until they attained a chronological age [CA] of 5.9 years), suggesting an improvement in the theory of mind resulting from viewing structured computerized animations. This age is earlier than that reported by previous studies for using theory of mind to pass false belief tests (CA 9 years), even challenging the age at which individuals failed to pass the tests (CA 17.11 years). Structured computerized animations enhanced the mentalizing ability of people with WS to a certain extent. Compared to the typically developing controls, people with WS presented with a lower developmental level in processing false belief tasks. This study has educational implications for the development of computerized social skills interventions for people with WS.

Dissociation of early and late face-related processes in autism spectrum disorder and Williams syndrome

Background

Williams syndrome (WS) and Autism Spectrum Disorders (ASD) are neurodevelopmental conditions associated with atypical but opposite face-to-face interactions patterns: WS patients overly stare at others, ASD individuals escape eye contact. Whether these behaviors result from dissociable visual processes within the occipito-temporal pathways is unknown.

Using high-density electroencephalography, multivariate signal processing algorithms and a protocol designed to identify and extract evoked activities sensitive to facial cues, we investigated how WS (N = 14), ASD (N = 14) and neurotypical subjects (N = 14) decode the information content of a face stimulus.

Results

We found two neural components in neurotypical participants, both strongest when the eye region was projected onto the subject's fovea, simulating a direct eye contact situation, and weakest over more distant regions, reaching a minimum when the focused region was outside the stimulus face. The first component peaks at 170 ms, an early signal known to be implicated in low-level face features. The second is identified later, 260 ms post-stimulus onset and is implicated in decoding salient face social cues.

Remarkably, both components were found distinctly impaired and preserved in WS and ASD. In WS, we could weakly decode the 170 ms signal based on our regressor relative to facial features, probably due to their relatively poor ability to process faces’ morphology, while the late 260 ms component was highly significant. The reverse pattern was observed in ASD participants who showed neurotypical like early 170 ms evoked activity but impaired late evoked 260 ms signal.

Conclusions

Our study reveals a dissociation between WS and ASD patients and points at different neural origins for their social impairments.

An EEG investigation of alpha and beta activity during resting states in adults with Williams syndrome

Background

Williams syndrome (WS) is neurodevelopmental disorder characterised by executive deficits of attention and inhibitory processing. The current study examined the neural mechanisms during resting states in adults with WS in order to investigate how this subserves the attention and inhibitory deficits associated with the syndrome.

Method

Adopting electroencephalography (EEG) methodology, cortical electrical activity was recorded from eleven adults with WS aged 35 + years during Eyes Closed (EC) and Eyes Open (EO) resting states, and compared to that of thirteen typically developing adults matched for chronological age (CA) and ten typically developing children matched for verbal mental ability (MA). Using mixed-design analyses of variance (ANOVA), analyses focused on the full alpha (8–12.5 Hz), low-alpha (8–10 Hz), upper-alpha (10–12.5 Hz), and beta (13–29.5 Hz) bands, as these are thought to have functional significance with attentional and inhibitory processes.

Results

No significant difference in alpha power were found between the WS and CA groups across all analyses, however a trend for numerically lower alpha power was observed in the WS group, consistent with other developmental disorders characterised by attentional/inhibitory deficits such as Attention Deficit Hyperactivity Disorder (ADHD). In contrast, comparable beta power between the WS and CA groups during both EC/EO conditions suggests that their baseline EEG signature is commensurate with successful attentional processing, though this needs to be interpreted with caution due to the small sample size. Analyses also revealed an unusual trend for low variability in the EEG signature of the WS group, which contradicts the heterogeneity typically observed behaviourally.

Conclusions

This novel finding of low variability in the EEG spectra in the WS group has been previously associated with poor behavioural performance in ADHD and is highly informative, highlighting future research needs to also consider how the role of low variability in the EEG profile of WS manifests in relation to their behavioural and cognitive profiles.

Characterizing the neural signature of face processing in Williams syndrome via multivariate pattern analysis and event related potentials

Face recognition ability is often reported to be a relative strength in Williams syndrome (WS). Yet methodological issues associated with the supporting research, and evidence that atypical face processing mechanisms may drive outcomes 'in the typical range', challenge these simplistic characterisations of this important social ability. Detailed investigations of face processing abilities in WS both at a behavioural and neural level provide critical insights. Here, we behaviourally characterised face recognition ability in 18 individuals with WS comparatively to typically developing children and adult control groups. A subset of 11 participants with WS as well as chronologically age matched typical adults further took part in an EEG task where they were asked to attentively view a series of upright and inverted faces and houses. State-of-the-art multivariate pattern analysis (MVPA) was used alongside standard ERP analysis to obtain a detailed characterisation of the neural profile associated with 1) viewing faces as an overall category (by examining neural activity associated with upright faces and houses), and to 2) the canonical upright configuration of a face, critically associated with expertise in typical development and often linked with holistic processing (upright and inverted faces). Our results show that while face recognition ability is not on average at a chronological age-appropriate level in individuals with WS, it nonetheless appears to be a relative strength within their cognitive profile. Furthermore, all participants with WS revealed a differential pattern of neural activity to faces compared to objects, showing a distinct response to faces as a category, as well as a differential neural pattern for upright vs. inverted faces. Nonetheless, an atypical profile of face orientation classification was found in WS, suggesting that this group differs from typical individuals in their face processing mechanisms. Through this innovative application of MVPA, alongside the high temporal resolution of EEG, we provide important new insights into the neural processing of faces in WS.

Abnormalities in early visual processes are linked to hypersociability and atypical evaluation of facial trustworthiness: An ERP study with Williams syndrome

Accurate assessment of trustworthiness is fundamental to successful and adaptive social behavior. Initially, people assess trustworthiness from facial appearance alone. These assessments then inform critical approach or avoid decisions. Individuals with Williams syndrome (WS) exhibit a heightened social drive, especially toward strangers. This study investigated the temporal dynamics of facial trustworthiness evaluation in neurotypic adults (TD) and individuals with WS. We examined whether differences in neural activity during trustworthiness evaluation may explain increased approach motivation in WS compared to TD individuals. Event-related potentials were recorded while participants appraised faces previously rated as trustworthy or untrustworthy. TD participants showed increased sensitivity to untrustworthy faces within the first 65-90 ms, indexed by the negative-going rise of the P1 onset (oP1). The amplitude of the oP1 difference to untrustworthy minus trustworthy faces was correlated with lower approachability scores. In contrast, participants with WS showed increased N170 amplitudes to trustworthy faces. The N170 difference to low-high-trust faces was correlated with low approachability in TD and high approachability in WS. The findings suggest that hypersociability associated with WS may arise from abnormalities in the timing and organization of early visual brain activity during trustworthiness evaluation. More generally, the study provides support for the hypothesis that impairments in low-level perceptual processes can have a cascading effect on social cognition.

An event related potential study of ihibitory and attentional control in Williams syndrome adults

The primary aim of the current study was to employ event-related potentials (ERPs) methodology to disentangle the mechanisms related to inhibitory control in older adults with Williams syndrome (WS). Eleven older adults with WS (mean age 42), 16 typically developing adults (mean age 42) and 13 typically developing children (mean age 12) participated in the study. ERPs were recorded during a three-stimulus visual oddball task, during which participants were required to make a response to a rare target stimulus embedded in a train of frequent non-target stimuli. A task-irrelevant infrequent stimulus was also present at randomised intervals during the session. The P3a latency data response related to task-irrelevant stimulus processing was delayed in WS. In addition, the early perceptual N2 amplitude was attenuated. These data are indicative of compromised early monitoring of perceptual input, accompanied by appropriate orientation of responses to task-irrelevant stimuli. However, the P3a delay suggests inefficient evaluation of the task-irrelevant stimuli. These data are discussed in terms of deficits in the disengagement of attentional processes, and the regulation of monitoring processes required for successful inhibition.

Processing of stimulus content but not of emotional valence is altered in persons with Williams syndrome

BACKGROUND

Individuals with Williams syndrome (WS) exhibit hypersociability and may respond atypically to emotional information in social and nonsocial stimuli. It is not yet clear whether these difficulties are specific to emotional content or stimulus type. This study examined the neural processes supporting social and emotional information processing in WS.

METHOD

Visual event-related potentials were recorded in 19 adults with WS and 10 typical peers during a picture-viewing task requiring detection of smiling faces among other social and nonsocial images with positive and negative emotional content.

RESULTS

The participant groups were not significantly different in affective processing of positive and negative stimuli and perceived faces as different from nonsocial images. Participants with WS showed subtle differences in face-specific perceptual processes (e.g. face inversion, N170 lateralisation), suggesting a more feature-based processing. They also demonstrated reduced attention and arousal modulation (P3, late positive potential) in response to faces vs. nonsocial images. These differences were independent of intelligence quotient.

CONCLUSIONS

There was no evidence of greater than typical perceptual, attentional or affective processing of social information in WS. The results support the idea that altered face perception processes and not the increased salience of social stimuli or difficulties with emotion discrimination may contribute to the hypersocial phenotype in WS.

Social Cognition in Williams Syndrome: Face Tuning

Many neurological, neurodevelopmental, neuropsychiatric, and psychosomatic disorders are characterized by impairments in visual social cognition, body language reading, and facial assessment of a social counterpart. Yet a wealth of research indicates that individuals with Williams syndrome exhibit remarkable concern for social stimuli and face fascination. Here individuals with Williams syndrome were presented with a set of Face-n-Food images composed of food ingredients and in different degree resembling a face (slightly bordering on the Giuseppe Arcimboldo style). The primary advantage of these images is that single components do not explicitly trigger face-specific processing, whereas in face images commonly used for investigating face perception (such as photographs or depictions), the mere occurrence of typical cues already implicates face presence. In a spontaneous recognition task, participants were shown a set of images in a predetermined order from the least to most resembling a face. Strikingly, individuals with Williams syndrome exhibited profound deficits in recognition of the Face-n-Food images as a face: they did not report seeing a face on the images, which typically developing controls effortlessly recognized as a face, and gave overall fewer face responses. This suggests atypical face tuning in Williams syndrome. The outcome is discussed in the light of a general pattern of social cognition in Williams syndrome and brain mechanisms underpinning face processing.

Face repetition detection and social interest: An ERP study in adults with and without Williams syndrome

The present study examined possible neural mechanisms underlying increased social interest in persons with Williams syndrome (WS). Visual event-related potentials (ERPs) during passive viewing were used to compare incidental memory traces for repeated vs. single presentations of previously unfamiliar social (faces) and nonsocial (houses) images in 26 adults with WS and 26 typical adults. Results indicated that participants with WS developed familiarity with the repeated faces and houses (frontal N400 response), but only typical adults evidenced the parietal old/new effect (previously associated with stimulus recollection) for the repeated faces. There was also no evidence of exceptional salience of social information in WS, as ERP markers of memory for repeated faces vs. houses were not significantly different. Thus, while persons with WS exhibit behavioral evidence of increased social interest, their processing of social information in the absence of specific instructions may be relatively superficial. The ERP evidence of face repetition detection in WS was independent of IQ and the earlier perceptual differentiation of social vs. nonsocial stimuli. Large individual differences in ERPs of participants with WS may provide valuable information for understanding the WS phenotype and have relevance for educational and treatment purposes.

Face processing in Williams syndrome is already atypical in infancy

Face processing is a crucial socio-cognitive ability. Is it acquired progressively or does it constitute an innately-specified, face-processing module? The latter would be supported if some individuals with seriously impaired intelligence nonetheless showed intact face-processing abilities. Some theorists claim that Williams syndrome (WS) provides such evidence since, despite IQs in the 50s, adolescents/adults with WS score in the normal range on standardized face-processing tests. Others argue that atypical neural and cognitive processes underlie WS face-processing proficiencies. But what about infants with WS? Do they start with typical face-processing abilities, with atypicality developing later, or are atypicalities already evident in infancy? We used an infant familiarization/novelty design and compared infants with WS to typically developing controls as well as to a group of infants with Down syndrome matched on both mental and chronological age. Participants were familiarized with a schematic face, after which they saw a novel face in which either the features (eye shape) were changed or just the configuration of the original features. Configural changes were processed successfully by controls, but not by infants with WS who were only sensitive to featural changes and who showed syndrome-specific profiles different from infants with the other neurodevelopmental disorder. Our findings indicate that theorists can no longer use the case of WS to support claims that evolution has endowed the human brain with an independent face-processing module.

Atypical development of configural face recognition in children with autism, Down syndrome and Williams syndrome

BACKGROUND

Configural processing in face recognition is a sensitivity to the spacing between facial features. It has been argued both that its presence represents a high level of expertise in face recognition, and also that it is a developmentally vulnerable process.

METHOD

We report a cross-syndrome investigation of the development of configural face recognition in school-aged children with autism, Down syndrome and Williams syndrome compared with a typically developing comparison group. Cross-sectional trajectory analyses were used to compare configural and featural face recognition utilising the 'Jane faces' task. Trajectories were constructed linking featural and configural performance either to chronological age or to different measures of mental age (receptive vocabulary, visuospatial construction), as well as the Benton face recognition task.

RESULTS

An emergent inversion effect across age for detecting configural but not featural changes in faces was established as the marker of typical development. Children from clinical groups displayed atypical profiles that differed across all groups.

CONCLUSION

We discuss the implications for the nature of face processing within the respective developmental disorders, and how the cross-sectional syndrome comparison informs the constraints that shape the typical development of face recognition.

Attentional lapse and inhibition control in adults with Williams Syndrome

Research exploring cognitive processing associated with Williams Syndrome (WS) has suggested that executive functioning deficits exist across the developmental spectrum. Such executive functions include problem solving, planning, dividing attention and inhibiting responses. Within a framework of executive functions, the aim of the current study was to explore attentional lapse and inhibition skills in older adults with WS (n=20; aged 36-61 yr) and consider the implications of deficits within this group. Participants with WS were compared to typical adults of the same chronological age and typical older adults (aged 65+yr) to consider attentional changes seen in the ageing process. The study employed a sustained attention to response task known to assess inhibition and attentional lapse but which had not previously been used with this population. Compared to both groups of typical matches, the results indicated atypicalities of attention and inhibition in adults with WS. Specifically, compared to the typical matches, adults with WS failed to withhold a response (showing inhibition deficits), had problems re-engaging attentional control processes after making an error and showed a generalised deficit of concentration and task engagement. We conclude that further attention should be paid to the cognitive capacity of older individuals with WS in order to consider the everyday challenges faced by this group and to provide adequate intervention and support for daily living.

Contextual integration of causal coherence in people with Williams syndrome

This study investigated causal coherence in people with Williams syndrome (WS). To advance our understanding of this clinical group, we examined their ability to make causal inferences, using their understanding of homonyms (words with the same spelling but distinct meanings) embedded in contexts. A minor goal was to use verbal stimuli to clarify Santos and Deruelle's (2009) findings on the knowledge of causality among people with WS. Participants were presented with two types of scenarios requiring different inference directions: backward inferences (from consequence to cause) and forward inferences (from cause to consequence). Following each scenario, they were asked a comprehension question and given three possible answers that corresponded to a figurative, literal, and unrelated meaning of the homonym embedded in the scenario. The correct answer required the participants to make a successful causal inference. People with WS aged from 13 to 29 (n=17, mental age=6-14) were able to make backward and forward inferences by selecting the context-appropriate meanings of homonyms, thus demonstrating the existence of contextual integration ability in the causal coherence of people with WS. However, as their accuracy in the figurative meaning responses was lower than that of healthy age-matched controls, suggesting the participants with WS, were delayed in the contextual integration of causal coherence. The participants with WS chose a significantly higher percentage of answers with unrelated meanings than the two control groups, indicating a certain degree of weakness in the contextual integration of homonyms in context.

Neural correlates of visual integration in Williams syndrome: gamma oscillation patterns in a model of impaired coherence

Williams syndrome (WS) is a clinical model of dorsal stream vulnerability and impaired visual integration. However, little is still known about the neurophysiological correlates of perceptual integration in this condition. We have used a 3D structure-from-motion (SFM) integrative task to characterize the neuronal underpinnings of 3D perception in WS and to probe whether gamma oscillatory patterns reflect changed holistic perception. Coherent faces were parametrically modulated in 3D depth (three different depth levels) to vary levels of stimulus ambiguity. We have found that the electrophysiological (EEG/ERP) correlates of such holistic percepts were distinct across groups. Independent component analysis demonstrated the presence of a novel component with a late positivity around 200 ms that was absent in controls. Source localization analysis of ERP signals showed a posterior occipital shift in WS and reduced parietal dorsal stream sources. Interestingly, low gamma-band oscillations (20-40 Hz) induced by this 3D perceptual integration task were significantly stronger and sustained during the stimulus presentation in WS whereas high gamma-band oscillations (60-90 Hz) were reduced in this clinical model of impaired visual coherence, as compared to controls. These observations suggest that dorsal stream processing of 3D SFM stimuli has distinct neural correlates in WS and different cognitive strategies are employed by these patients to reach visual coherence. Importantly, we found evidence for the presence of different sub-bands (20-40 Hz/60-90 Hz) within the gamma range which can be dissociated concerning the respective role on the coherent percept formation, both in typical and atypical development.

Electrophysiological study of face inversion effects in Williams syndrome

OBJECTIVE

In order to evaluate whether face perception is intact or not in Williams syndrome (WS), the face inversion effects (FIE) in the event-related potential (ERP) or magnetoencephalography (MEG) were investigated in three teenaged patients with WS.

METHODS

Responses to the inverted faces and upright faces were compared using MEG for one 13year old girl with WS (subject A) and ERP for boys with WS at 16 and 14years of age (subjects B and C, respectively).

RESULTS

Although age-matched control children showed FIE in both MEG and ERP studies, two subjects (A and B) with WS showed no FIE at all. The neurophysiological data of ERP in subject B was significantly different from those of the age-matched controls. On the other hand, a boy with WS (subject C) showed typical FIE in the same manner as the age-matched controls.

CONCLUSIONS

The difference between those with or without FIE was not explained merely by the chronological age, a simple delay in mental age or in the ability to discriminate among upright faces. The absence of FIE may be related to the severity of a deficit in the dorsal pathway function that is characteristic to the syndrome.

The social phenotype of Williams syndrome

Williams syndrome (WS) offers an exciting model for social neuroscience because its genetic basis is well-defined, and the unique phenotype reflects dimensions of prosocial behaviors. WS is associated with a strong drive to approach strangers, a gregarious personality, heightened social engagement yet difficult peer interactions, high nonsocial anxiety, unusual bias toward positive affect, and diminished sensitivity to fear. New neurobiological evidence points toward alterations in structure, function, and connectivity of the social brain (amygdala, fusiform face area, orbital-frontal regions). Recent genetic studies implicate gene networks in the WS region with the dysregulation of prosocial neuropeptides. The study of WS has implications for understanding human social development, and may provide insight for translating genetic and neuroendocrine evidence into treatments for disorders of social behavior.

Genetic mapping of brain plasticity across development in Williams syndrome: ERP markers of face and language processing

In Williams Syndrome (WS), a known genetic deletion results in atypical brain function with strengths in face and language processing. We examined how genetic influences on brain activity change with development. In three studies, event-related potentials (ERPs) from large samples of children, adolescents, and adults with the full genetic deletion for WS were compared to typically developing controls, and two adults with partial deletions for WS. Studies 1 and 2 identified ERP markers of brain plasticity in WS across development. Study 3 suggested that, in adults with partial deletions for WS, specific genes may be differentially implicated in face and language processing.

Challenging the use of adult neuropsychological models for explaining neurodevelopmental disorders: developed versus developing brains

In this paper, I contrast approaches from adult neuropsychology that seek selective, domain-specific deficits with approaches aimed at understanding the dynamics of developmental trajectories in children with genetic disorders. I stress the crucial difference between developed brains damaged in their mature state, and atypically developing brains. I also challenge the search for single genes to explain selective cognitive-level outcomes. Throughout, the paper argues that it is critical to trace cognitive-level deficits back to their basic-level processes in infancy, where genes are likely to exert their early influences, if we are to understand both the impairments and proficiencies displayed in children with neurodevelopmental disorders.

Sensitivity of the autonomic nervous system to visual and auditory affect across social and non-social domains in williams syndrome

Although individuals with Williams syndrome (WS) typically demonstrate an increased appetitive social drive, their social profile is characterized by dissociations, including socially fearless behavior coupled with anxiousness, and distinct patterns of "peaks and valleys" of ability. The aim of this study was to compare the processing of social and non-social visually and aurally presented affective stimuli, at the levels of behavior and autonomic nervous system (ANS) responsivity, in individuals with WS contrasted with a typically developing (TD) group, with the view of elucidating the highly sociable and emotionally sensitive predisposition noted in WS. Behavioral findings supported previous studies of enhanced competence in processing social over non-social stimuli by individuals with WS; however, the patterns of ANS functioning underlying the behavioral performance revealed a surprising profile previously undocumented in WS. Specifically, increased heart rate (HR) reactivity, and a failure for electrodermal activity to habituate were found in individuals with WS contrasted with the TD group, predominantly in response to visual social affective stimuli. Within the auditory domain, greater arousal linked to variation in heart beat period was observed in relation to music stimuli in individuals with WS. Taken together, the findings suggest that the pattern of ANS response in WS is more complex than previously noted, with increased arousal to face and music stimuli potentially underpinning the heightened behavioral emotionality to such stimuli. The lack of habituation may underlie the increased affiliation and attraction to faces characterizing individuals with WS. Future research directions are suggested.

Attentional disengagement in adults with Williams syndrome

Williams syndrome (WS) is a neurodevelopmental disorder characterized by a distinctive behavioral and cognitive profile, including widespread problems with attention. However, the specific nature of their attentional difficulties, such as inappropriate attentional allocation and/or poor attentional disengagement abilities, has yet to be elucidated. Furthermore, it is unknown if there is an underlying difficulty with the temporal dynamics of attention in WS or if their attentional difficulties are task-dependent, because previous studies have examined attention in established areas of deficit and atypicality (specifically, visuospatial and face processing). In this study, we examined attentional processing in 14 adults with WS (20-59 years) and 17 typically developing controls (19-39 years) using an attentional blink (AB) paradigm. The AB is the decreased ability to detect a second target when it is presented in close proximity to an initial target. Overall, adults with WS had an AB that was prolonged in duration, but no different in magnitude, compared with typically developing control participants. AB performance was not explained by IQ, working memory, or processing speed in either group. Thus, results suggest that the attention problems in WS are primarily due to general attentional disengagement difficulties rather than inappropriate attentional allocation.

Neural processing of race by individuals with Williams syndrome: do they show the other-race effect? (And why it matters)

Williams syndrome (WS) is a genetic condition with a distinctive social phenotype characterized by excessive sociability accompanied by a relative proficiency in face recognition, despite severe deficits in the visuospatial domain of cognition. This consistent phenotypic characteristic and the relative homogeneity of the WS genotype make WS a compelling human model for examining genotype-phenotype relations, especially with respect to social behavior. Following up on a recent report suggesting that individuals with WS do not show race bias and racial stereotyping, this study was designed to investigate the neural correlates of the perception of faces from different races, in individuals with WS as compared to typically developing (TD) controls. Caucasian WS and TD participants performed a gender identification task with own-race (White) and other-race (Black) faces while event-related potentials (ERPs) were recorded. In line with previous studies with TD participants, other-race faces elicited larger amplitude ERPs within the first 200 ms following the face onset, in WS and TD participants alike. These results suggest that, just like their TD counterparts, individuals with WS differentially processed faces of own-race versus other-race, at relatively early stages of processing, starting as early as 115 ms after the face onset. Overall, these results indicate that neural processing of faces in individuals with WS is moderated by race at early perceptual stages, calling for a reconsideration of the previous claim that they are uniquely insensitive to race.

Severity of hyperacusis predicts individual differences in speech perception in Williams Syndrome

BACKGROUND

Williams Syndrome (WS) is a neurodevelopmental disorder of genetic origin, characterised by relative proficiency in language in the face of serious impairment in several other domains. Individuals with WS display an unusual sensitivity to noise, known as hyperacusis.

METHODS

In this study, we examined the extent to which hyperacusis interferes with the perception of speech in children and adults with WS. Participants were required to discriminate words which differed in one consonant of a cluster when these contrasts were embedded in a background of noise.

RESULTS

Although the introduction of noise interfered with performance on a consonant cluster discrimination task equally in the WS and control groups, the severity of hyperacusis significantly predicted individual variability in speech perception within the WS group.

CONCLUSIONS

These results suggest that alterations in sensitivity to input mediate atypical pathways for language development in WS, where hyperacusis exerts an important influence together with other non-auditory factors.

Contextual effect in people with Williams syndrome

This study was aimed at investigating the semantic integration ability of people with WS in building up a coherent and gist theme from the context of presented sentences. Previous studies have indicated rich lexical semantic knowledge and typical semantic priming in this clinical group, but atypical brainwave patterns have been reported in studies of semantic comprehension. An integration difficulty hypothesis of merging meanings into sentences was proposed to explain the discrepancy (Tyler et al., 1997). In this study, this hypothesis was examined by means of proposition integration. Participants were presented sentences embedded with different numbers of propositions under various scenarios. Successful integration of semantically related propositions under same scenario was demonstrated by high false alarm recognition to sentences with more propositions (a maximum of four in this study). The results revealed that healthy adults showed integration ability when the number of propositions in a sentence were more than three, with increased false alarm rates and confidence ratings, whereas people with WS showed no differences in sentences with increased proposition numbers. Typically developing children controls confined recognition phenomenon to sentences carrying more than two propositions. Hence, it was concluded that contextual effects in terms of proposition integration was a gradual development from childhood into adulthood and a deviant development in people with WS.

Behavioural features of Italian infants and young adults with Williams-Beuren syndrome

BACKGROUND

The increased interest in social interaction in Williams-Beuren syndrome (WBS) is evident from infancy onwards, together not only with increased empathy, positive interpersonal bias, but also with social disinhibition. Previous studies have described behavioural and emotional problems as being widely represented in WBS. There is limited scope for comparisons between literature data because of the variety of instruments used to assess behaviour.

METHOD

Forty-one children and young adults with WBS were enrolled and underwent general cognitive assessment. In order to compare our data with the literature, we used standardised questionnaires used in previous studies (Developmental Behaviour Checklist: DBC-P). General cognitive abilities, gender and age were included in the analysis.

RESULTS

Behavioural problems were more relevant than expected according to intellectual impairment. Some features were present at any age: inattention, anxiety, disruptive behaviours. Antisocial conduct was almost absent; perseverative conduct, a poor sense of danger and, more generally, self-absorbed behaviours tended to diminish along with age and to be linked to more pronounced cognitive impairment.

CONCLUSION

As previously described for other countries, behaviour disturbances occur frequently in the Italian WBS population. Our data could support the existence of some 'intrinsic' behavioural characteristics in WBS such as inattention and anxiety, which are detectable and important at any age; both learning and social exposure to a structured context such as school could help diminish self-absorbed behaviour.

From genes to brain development to phenotypic behavior: "dorsal-stream vulnerability" in relation to spatial cognition, attention, and planning of actions in Williams syndrome (WS) and other developmental disorders

Visual information is believed to be processed through two distinct, yet interacting cortical streams. The ventral stream performs the computations needed for recognition of objects and faces ("what" and "who"?) and the dorsal stream the computations for registering spatial relationships and for controlling visually guided actions ("where" and "how"?). We initially proposed a model of spatial deficits in Williams syndrome (WS) in which visual abilities subserved by the ventral stream, such as face recognition, are relatively well developed (although not necessarily in exactly the same way as in typical development), whereas dorsal-stream functions, such as visuospatial actions, are markedly impaired. Since these initial findings in WS, deficits of motion coherence sensitivity, a dorsal-stream function has been found in other genetic disorders such as Fragile X and autism, and as a consequence of perinatal events (in hemiplegia, perinatal brain anomalies following very premature birth), leading to the proposal of a general "dorsal-stream vulnerability" in many different conditions of abnormal human development. In addition, dorsal-stream systems provide information used in tasks of visuospatial memory and locomotor planning, and these systems are closely coupled to networks for attentional control. We and several other research groups have previously shown deficits of frontal and parietal lobe function in WS individuals for specific attention tasks [e.g., Atkinson, J., Braddick, O., Anker, S., Curran, W., & Andrew, R. (2003). Neurobiological models of visuospatial cognition in children with Williams Syndrome: Measures of dorsal-stream and frontal function. Developmental Neuropsychology, 23(1/2), 141-174.]. We have used the Test of Everyday Attention for Children (TEA-Ch) which aims to attempt to separate components of attention with distinct brain networks (selective attention, sustained attention, and attention control-executive function) testing a group of older children with WS, but this test battery is too demanding for many children and adults with WS. Consequently, we have devised a new set of tests of attention, the Early Childhood Attention Battery (ECAB). This uses similar principles to the TEA-Ch, but adapted for mental ages younger than 6 years. The ECAB shows a distinctive attention profile for WS individuals relative to their overall cognitive development, with relative strength in tasks of sustained attention and poorer performance on tasks of selective attention and executive control. These profiles, and the characteristic developmental courses, also show differences between children with Down's syndrome and WS. This chapter briefly reviews new research findings on WS in these areas, relating the development of brain systems in WS to evidence from neuroimaging in typically developing infants, children born very preterm, and normal adults. The hypothesis of "dorsal-stream(s) vulnerability" which will be discussed includes a number of interlinked brain networks, subserving not only global visual processing and formulation of visuomotor actions but interlinked networks of attention.

An unusual attraction to the eyes in Williams-Beuren syndrome: a manipulation of facial affect while measuring face scanpaths

INTRODUCTION

This study aimed to investigate face scanpaths and emotion recognition in Williams-Beuren syndrome (WBS) and whether: (1) the eyes capture the attention of WBS individuals faster than typically developing mental age-matched controls; (2) WBS patients spend abnormally prolonged periods of time viewing the eye region; and (3) emotion recognition skills or eye gaze patterns change depending on the emotional valance of the face.

METHODS

Visual scanpaths were recorded while 16 WBS patients and 16 controls passively viewed happy, angry, fearful, and neutral faces. Emotion recognition was subsequently measured.

RESULTS

The eyes did not capture the attention of WBS patients faster than controls, but once WBS patients attended to the eyes, they spent significantly more time looking at this region. Unexpectedly, WBS patients showed an impaired ability to recognise angry faces, but face scanpaths were similar across the different facial expressions.

CONCLUSIONS

Findings suggest that face processing is atypical in WBS and that emotion recognition and eye gaze abnormalities in WBS are likely to be more complex than previously thought. Findings highlight the need to develop remediation programmes to teach WBS patients how to explore all facial features, enhancing their emotion recognition skills and "normalising" their social interactions.

The missing developmental dimension in the network perspective

We welcome network theory as a tool for modelling the multi-directional interactions that characterise disease. However, we feel that Cramer et al. have neglected one important aspect: how diseases change over developmental time. We discuss principles such as fan in, fan out, bottlenecks, and common pathways, and argue that modelling these developmental aspects can be vital, particularly in deriving properly targeted treatments.

Contrasting patterns of language-associated brain activity in autism and Williams syndrome

Two neurodevelopmental disorders, Williams syndrome (WS) and autism, are both commonly described as having opposite social profiles: social avoidance in autism vs hypersociability in individuals with WS. The goal of this study was to contrast the brain activity associated with language processing in these two populations, in order to understand the very likely interplay between the use of language and the sociability dimension, on which these disorders diverge. Towards this aim, the N400 component of the event-related potentials was used to quantify the processing of semantic integration in these two populations. Results revealed that individuals with WS showed a significantly larger N400 effect, as compared to both typical controls and individuals with autism, while the latter group demonstrated the smallest N400 effect. The findings demonstrate quite opposite profiles of neural correlates of language processing in WS and autism, mirroring their contrasting social phenotypes.

The fusiform face area is enlarged in Williams syndrome

Williams syndrome (WS) is a genetic condition characterized by atypical brain structure, cognitive deficits, and a life-long fascination with faces. Face recognition is relatively spared in WS, despite abnormalities in aspects of face processing and structural alterations in the fusiform gyrus, part of the ventral visual stream. Thus, face recognition in WS may be subserved by abnormal neural substrates in the ventral stream. To test this hypothesis, we used functional magnetic resonance imaging and examined the fusiform face area (FFA), which is implicated in face recognition in typically developed (TD) individuals, but its role in WS is not well understood. We found that the FFA was approximately two times larger among WS than TD participants (both absolutely and relative to the fusiform gyrus), despite apparently normal levels of face recognition performance on a Benton face recognition test. Thus, a larger FFA may play a role in face recognition proficiency among WS.

Discovering structure in auditory input: evidence from Williams syndrome

We examined auditory perception in Williams syndrome by investigating strategies used in organizing sound patterns into coherent units. In Experiment 1, we investigated the streaming of sound sequences into perceptual units, on the basis of pitch cues, in a group of children and adults with Williams syndrome compared to typical controls. We showed that individuals with Williams syndrome were sensitive to the same pitch cues as typical children and adults when streaming these patterns. In Experiment 2, we evaluated differences in reliance on pitch and contour cues in unfamiliar melody perception in a group of adults with Williams syndrome relative to typical control children and adults. Unlike controls who demonstrated greater proficiency when contour cues were available, adults with Williams syndrome showed no such advantage.

Just another face in the crowd: evidence for decreased detection of angry faces in children with Williams syndrome

The detection of social threat is crucial for adaptive behaviour. Previous studies have shown that angry faces capture attention and are processed more efficiently than happy faces. While this anger superiority effect has been found in typical and atypical development, it is unknown whether it exists in individuals with Williams syndrome (WS), who show reduced social fear and atypical sociability. In this study, children with WS searched for angry or happy target faces surrounded by 2, 5 or 8 distracters (happy or angry faces, respectively). Performance was compared to that of mental age-matched controls. Results revealed no group differences for happy faces, however for angry faces, the WS, but not the control group, showed a significant performance decrease for the 8-distracters condition, indicating the absence of an anger superiority effect, in good agreement with evidence for abnormal structure and function in brain areas for social threat processing in WS.

Cross-modal influences of affect across social and non-social domains in individuals with Williams syndrome

The Williams syndrome (WS) cognitive profile is characterized by relative strengths in face processing, an attentional bias towards social stimuli, and an increased affinity and emotional reactivity to music. An audio-visual integration study examined the effects of auditory emotion on visual (social/non-social) affect identification in individuals with WS and typically developing (TD) and developmentally delayed (DD) controls. The social bias in WS was hypothesized to manifest as an increased ability to process social than non-social affect, and a reduced auditory influence in social contexts. The control groups were hypothesized to perform similarly across conditions. The results showed that while participants with WS exhibited indistinguishable performance to TD controls in identifying facial affect, DD controls performed significantly more poorly. The TD group outperformed the WS and DD groups in identifying non-social affect. The results suggest that emotionally evocative music facilitated the ability of participants with WS to process emotional facial expressions. These surprisingly strong facial-processing skills in individuals with WS may have been due to the effects of combining social and music stimuli and to a reduction in anxiety due to the music in particular. Several directions for future research are suggested.

Amygdala response to faces parallels social behavior in Williams syndrome

Individuals with Williams syndrome (WS), a genetically determined disorder, show relatively strong face-processing abilities despite poor visuospatial skills and depressed intellectual function. Interestingly, beginning early in childhood they also show an unusually high level of interest in face-to-face social interaction. We employed functional magnetic resonance imaging (fMRI) to investigate physiological responses in face-sensitive brain regions, including ventral occipito-temporal cortex and the amygdala, in this unique genetic disorder. Participants included 17 individuals with WS, 17 age- and gender-matched healthy adults (chronological age-matched controls, CA) and 17 typically developing 8- to 9-year-old children (developmental age controls, DA). While engaged in a face discrimination task, WS participants failed to recruit the amygdala, unlike both CA and DA controls. WS fMRI responses in ventral occipito-temporal cortex, however, were comparable to those of DA controls. Given the integral role of the amygdala in social behavior, the failure of WS participants to recruit this region during face processing may be a neural correlate of the abnormally high sociability that characterizes this disorder.

Approachability and the amygdala: insights from Williams syndrome

Williams syndrome (WS) is a genetic neurodevelopmental disorder in which hypersociability is a characteristic feature. Given that the amygdala has been identified as an integral component of the neural system underlying sociability, researchers have suggested that the abnormal amygdala volumes found in individuals with WS may play a role in their hypersociability. The aim of this study was to examine the relationship between amygdala volume and hypersociability, as measured by approachability ratings, in 22 individuals with WS and 22 normal controls matched on chronological age, sex, and handedness. We confirmed previous findings of increased amygdala volumes and higher approachability ratings of both 'positive' and 'negative' faces in individuals with WS. A positive relationship between right amygdala volume and approachability ratings was found in individuals with WS, particularly ratings of 'negative' faces. The results unexpectedly revealed that individuals with WS report using features other than the eyes and mouth to determine approachability, particularly when they are younger. These findings support the theory that amygdala dysfunction in WS is related to their hypersociability. Furthermore, we propose that individuals with WS use atypical cognitive strategies compared to controls to determine approachability.

William's syndrome: gene expression is related to parental origin and regional coordinate control

William's syndrome (WS) features a spectrum of neurocognitive and behavioral abnormalities due to a rare 1.5 MB deletion that includes about 24-28 genes on chromosome band 7q11.23. Study of the expression of these genes from the single normal copy provides an opportunity to elucidate the genetic and epigenetic controls on these genes as well as their roles in both WS and normal brain development and function. We used quantitative RT-PCR to determine the transcriptional level of 14 WS gene markers in a cohort of 77 persons with WS and 48 normal controls. Results reported here: (1) show that the expression of the genes deleted in WS is decreased in some but not all cases, (2) demonstrate that the parental origin of the deletion contributes to the level of expression of GTF2I independently of age and gender and (3) indicate that the correlation of expression between GTF2I and some other genes in the WS region differs in WS subjects and normal controls, which in turn points toward a regulatory role for this gene. Interspecies comparisons suggest GTF2I may play a key role in normal brain development.

Defining the social phenotype in Williams syndrome: a model for linking gene, the brain, and behavior

Research into phenotype-genotype correlations in neurodevelopmental disorders has greatly elucidated the contribution of genetic and neurobiological factors to variations in typical and atypical development. Etiologically relatively homogeneous disorders, such as Williams syndrome (WS), provide unique opportunities for elucidating gene-brain-behavior relationships. WS is a neurogenetic disorder caused by a hemizygous deletion of approximately 25 genes on chromosome 7q11.23. This results in a cascade of physical, cognitive-behavioral, affective, and neurobiological aberrations. WS is associated with a markedly uneven neurocognitive profile, and the mature state cognitive profile of WS is relatively well developed. Although anecdotally, individuals with WS have been frequently described as unusually friendly and sociable, personality remains a considerably less well studied area. This paper investigates genetic influences, cognitive-behavioral characteristics, aberrations in brain structure and function, and environmental and biological variables that influence the social outcomes of individuals with WS. We bring together a series of findings across multiple levels of scientific enquiry to examine the social phenotype in WS, reflecting the journey from gene to the brain to behavior. Understanding the complex multilevel scientific perspective in WS has implications for understanding typical social development by identifying important developmental events and markers, as well as helping to define the boundaries of psychopathology.

Research Review: Williams syndrome: a critical review of the cognitive, behavioral, and neuroanatomical phenotype

This review critically examines the research findings which characterize the cognitive, behavioral, and neuroanatomical features of Williams syndrome (WS). This article analyzes 178 published studies in the WS literature covering the following areas: 1) General intelligence, 2) Language skills, 3) Visuospatial and face processing skills, 4) Behavior patterns and hypersociability, 5) Musical abilities, and 6) Brain structure and function. We identify methodological issues relating to small sample size, use and type of control groups, and multiple measures of task performance. Previously described 'peaks' within the cognitive profile are closely examined to assess their veracity. This review highlights the need for methodologically sound studies that utilize multiple comparison groups, developmental trajectories, and longitudinal analyses to examine the WS phenotype, as well as those that link brain structure and function to the cognitive and behavioral phenotype of WS individuals.

Atypical unfamiliar face processing in Williams syndrome: what can it tell us about typical familiarity effects?

INTRODUCTION

Familiar and unfamiliar face perception is typically dissociated by the relative use of internal and external face features. The Williams syndrome (WS) social phenotype emphasises hypersociability, with an interest in interacting with people irrespective of familiarity. The aim is to explore whether unfamiliar face processing is characterised by the typical dissociation between internal and external features in WS, or whether the social stimulus drive towards strangers is linked to atypicalities of unfamiliar face processing.

METHOD

The procedure replicates that previously used with typically developing children. Participants with WS (aged 10-18 years) and typically developing comparison participants determine whether two face parts are from the same person or different people, using the whole face, internal, and external features.

RESULTS

Only participants with WS, and not typically developing participants, show greater accuracy matching unfamiliar faces from internal than external features.

CONCLUSIONS

Evidence of atypical unfamiliar face processing in WS may inform models of typical face perception, revealing the origins of the relative advantage for internal features typically associated with familiar but not unfamiliar faces. The results also have implications for understanding more clearly the social phenotype associated with WS.

Orientation and affective expression effects on face recognition in Williams syndrome and autism

We sought to clarify the nature of the face processing strength commonly observed in individuals with Williams syndrome (WS) by comparing the face recognition ability of persons with WS to that of persons with autism and to healthy controls under three conditions: Upright faces with neutral expressions, upright faces with varying affective expressions, and inverted faces with neutral expressions. No differences were observed under the upright/neutral expression condition. However, the WS group was more accurate than the autism group when discriminating upright faces with varying affective expressions, whereas the opposite pattern emerged when discriminating inverted faces. We interpret these differences as a reflection of the contrasting social features of the two syndromes.

Reduced parietal and visual cortical activation during global processing in Williams syndrome

Several lines of investigation suggest that individuals with Williams syndrome (WS), a neurodevelopmental disorder of well-characterized genetic etiology, have selective impairments in integrating local image elements into global configurations. We compared global processing abilities in 10 clinically and genetically diagnosed participants with WS (eight females, two males; mean age 31y 10mo [SD 9y 7mo], range 15y 5mo-48y 4mo) with a typically developed (TD) age- and sex-matched comparison group (seven females, one male; mean age 35y 2mo [SD 10y 10mo], range 24y-54y 7mo) using functional magnetic resonance imaging (fMRI). Behavioral data showed participants with WS to be significantly less accurate (p<0.042) together with a non-significant trend to be slower than the TD comparison group while performing the global processing task. fMRI data showed participants with WS to possess reduced activation in the visual and parietal cortices. Participants with WS also showed relatively normal activation in the ventral occipitotemporal cortex, but elevated activation in several posterior thalamic nuclei. These preliminary results largely confirm previous research findings and neural models implicating neurodevelopmental abnormalities in extended subcortical and cortical visual systems in WS, most notably dorsal-stream pathways.

Increased local gyrification mapped in Williams syndrome

Applying a recently developed method to analyze gyrification with excellent spatial resolution across thousands of points across the lateral and medial cortical surface, we mapped differences in cortical surface anatomy between subjects with Williams syndrome (WS; n=42) and an age-matched sample of healthy subjects (n=40). WS subjects showed increased gyrification bilaterally in occipital regions and over the cuneus. Differences were more pronounced in the left hemisphere than in the right, with additional regions of increased gyrification in WS in the left precuneus, posterior and anterior cingulate, paracentral and mesial frontal lobe. No cortical area was significantly more convoluted in healthy subjects relative to the WS subjects. On the lateral surfaces, the direction and pattern of gyrification asymmetries were similar in WS subjects and controls; posterior brain regions had greater gyrification in the left hemisphere, while anterior brain regions showed greater gyrification in the right hemisphere. On the medial surfaces, control subjects and WS individuals differed considerably with respect to the degree but also direction of gyrification asymmetry. Our findings confirm and extend previous studies measuring cortical complexity at the global whole-brain or hemispheric levels. The observed gyrification abnormalities in individuals with WS might be related to dysfunctions in neuronal circuits and consequently contribute to the distinct cognitive and behavioral profile accompanying the disorder.

Development of structure and function in the infant brain: implications for cognition, language and social behaviour

Recent advances in cognitive neuroscience have allowed us to begin investigating the development of both structure and function in the infant brain. However, despite the rapid evolution of technology, surprisingly few studies have examined the intersection between brain and behaviour over the first years of life. Even fewer have done so in the context of a particular research question. This paper aims to provide an overview of four domains that have been studied using techniques amenable to elucidating the brain/behaviour interface: language, face processing, object permanence, and joint attention, with particular emphasis on studies focusing on early development. The importance of the unique role of development and the interplay between structure and function is stressed throughout. It is hoped that this review will serve as a catalyst for further thinking about the substantial gaps in our understanding of the relationship between brain and behaviour across development. Further, our aim is to provide ideas about candidate brain areas that are likely to be implicated in particular behaviours or cognitive domains.

Symmetry of cortical folding abnormalities in Williams syndrome revealed by surface-based analyses

We analyzed folding abnormalities in the cerebral cortex of subjects with Williams syndrome (WS), a genetically based developmental disorder, using surface-based analyses applied to structural magnetic resonance imaging data. Surfaces generated from each individual hemisphere were registered to a common atlas target (the PALS-B12 atlas). Maps of sulcal depth (distance from the cerebral hull) were combined across individuals to generate maps of average sulcal depth for WS and control subjects, along with depth-difference maps and t-statistic maps that accounted for within-group variability. Significant structural abnormalities were identified in 33 locations, arranged as 16 bilaterally symmetric pairs plus a lateral temporal region in the right hemisphere. Discrete WS folding abnormalities extended across a broad swath from dorsoposterior to ventroanterior regions of each hemisphere, in cortical areas associated with multiple sensory modalities as well as regions implicated in cognitive and emotional behavior. Hemispheric asymmetry in the temporal cortex is reduced in WS compared with control subjects. These findings provide insights regarding possible developmental mechanisms that give rise to folding abnormalities and to the spectrum of behavioral characteristics associated with WS.

The magnetoencephalographic response to upright and inverted face stimuli in a patient with Williams syndrome

The processing of faces in a patient with Williams syndrome was investigated using magnetoencephalography by evaluating responses to upright and inverted face stimuli. His processing of upright faces was not different from that of healthy adults. However, the processing of inverted faces was faster than those of healthy adults and faster than his processing of upright faces. The result indicated the absence of face inversion effect usually observed in healthy adults.