Variations of the Functional Brain Network Efficiency in a Young Clinical Sample within the Autism Spectrum: A fNIRS Investigation

Associations Between Parental Alexithymia and Family Dynamics in Autism Spectrum Disorder

BACKGROUND/OBJECTIVES

Alexithymia is a condition marked by difficulties in identifying and expressing emotions, rooted in both physiological and behavioral mechanisms. The aim of this study was to investigate the relationship between parental alexithymia and family functioning in families of children with Autism Spectrum Disorder (ASD) compared to families of typically developing children (TD).

METHODS

The study sample included parents of children with ASD (n = 120) and a control group of parents of typically developing children (n = 120). A comprehensive set of self-report instruments was used to evaluate alexithymia levels, parental stress, family experience, resilience, cognitive emotion regulation, social support, and family flexibility and cohesion.

RESULTS

The analysis revealed that parental alexithymia in families of children with ASD was directly associated with lower levels of family flexibility and cohesion, independent of increased stress or reduced family resilience. Furthermore, the findings indicate that alexithymia in parents is directly linked to reduced family cohesion in ASD families.

CONCLUSIONS

These results highlight the significant role of parental alexithymia in shaping family dynamics and underscore the necessity for targeted interventions that emphasize emotional skill-building, adaptive coping mechanisms, and resilience to stressful events. This research enhances the understanding of parental alexithymia's effect on family functioning in the context of ASD.

Mapping neural correlates of biological motion perception in autistic children using high-density diffuse optical tomography

BACKGROUND

Autism spectrum disorder (ASD), a neurodevelopmental disorder defined by social communication deficits plus repetitive behaviors and restricted interests, currently affects 1/36 children in the general population. Recent advances in functional brain imaging show promise to provide useful biomarkers of ASD diagnostic likelihood, behavioral trait severity, and even response to therapeutic intervention. However, current gold-standard neuroimaging methods (e.g., functional magnetic resonance imaging, fMRI) are limited in naturalistic studies of brain function underlying ASD-associated behaviors due to the constrained imaging environment. Compared to fMRI, high-density diffuse optical tomography (HD-DOT), a non-invasive and minimally constraining optical neuroimaging modality, can overcome these limitations. Herein, we aimed to establish HD-DOT to evaluate brain function in autistic and non-autistic school-age children as they performed a biological motion perception task previously shown to yield results related to both ASD diagnosis and behavioral traits.

METHODS

We used HD-DOT to image brain function in 46 ASD school-age participants and 49 non-autistic individuals (NAI) as they viewed dynamic point-light displays of coherent biological and scrambled motion. We assessed group-level cortical brain function with statistical parametric mapping. Additionally, we tested for brain-behavior associations with dimensional metrics of autism traits, as measured with the Social Responsiveness Scale-2, with hierarchical regression models.

RESULTS

We found that NAI participants presented stronger brain activity contrast (coherent > scrambled) than ASD children in cortical regions related to visual, motor, and social processing. Additionally, regression models revealed multiple cortical regions in autistic participants where brain function is significantly associated with dimensional measures of ASD traits.

LIMITATIONS

Optical imaging methods are limited in depth sensitivity and so cannot measure brain activity within deep subcortical regions. However, the field of view of this HD-DOT system includes multiple brain regions previously implicated in both task-based and task-free studies on autism.

CONCLUSIONS

This study demonstrates that HD-DOT is sensitive to brain function that both differentiates between NAI and ASD groups and correlates with dimensional measures of ASD traits. These findings establish HD-DOT as an effective tool for investigating brain function in autistic and non-autistic children. Moreover, this study established neural correlates related to biological motion perception and its association with dimensional measures of ASD traits.

Near-Infrared Spectroscopy: A Free-Living Neuroscience Tool to Better Understand Diabetes and Obesity

The human brain is the least accessible of all organs and attempts to study it in vivo rely predominantly on neuroimaging. Functional near-infrared spectroscopy (fNIRS) allows for the study of cortical neural activity in a non-invasive manner that may resemble free-living conditions. Moreover, compared to other neuroimaging tools, fNIRS is less expensive, it does not require the use of ionizing radiation, and can be applied to all study populations (patients suffering from claustrophobia, or neonates). In this narrative review, we provide an overview of the available research performed using fNIRS in patients with diabetes and obesity. The few studies conducted to date have presented controversial results regarding patients with diabetes, some reporting a greater hemodynamic response and others reporting a reduced hemodynamic response compared to the controls, with an unclear distinction between types 1 and 2. Subjects with obesity or a binge eating disorder have reduced prefrontal activation in response to inhibitory food or non-food stimuli; however, following an intervention, such as cognitive treatment, prefrontal activation is restored. Moreover, we discuss the potential of future applications of fNIRS for a better understanding of cortical neural activity in the context of metabolic disorders.

Aberrant Neural Response During Face Processing in Girls With Fragile X Syndrome: Defining Potential Brain Biomarkers for Treatment Studies

BACKGROUND

Children and adolescents with fragile X syndrome (FXS) manifest significant symptoms of anxiety, particularly in response to face-to-face social interaction. In this study, we used functional near-infrared spectroscopy to reveal a specific pattern of brain activation and habituation in response to face stimuli in young girls with FXS, an important but understudied clinical population.

METHODS

Participants were 32 girls with FXS (age: 11.8 ± 2.9 years) and a control group of 28 girls without FXS (age: 10.5 ± 2.3 years) matched for age, general cognitive function, and autism symptoms. Functional near-infrared spectroscopy was used to assess brain activation during a face habituation task including repeated upright/inverted faces and greeble (nonface) objects.

RESULTS

Compared with the control group, girls with FXS showed significant hyperactivation in the frontopolar and dorsal lateral prefrontal cortices in response to all face stimuli (upright + inverted). Lack of neural habituation (and significant sensitization) was also observed in the FXS group in the frontopolar cortex in response to upright face stimuli. Finally, aberrant frontopolar sensitization in response to upright faces in girls with FXS was significantly correlated with notable cognitive-behavioral and social-emotional outcomes relevant to this condition, including executive function, autism symptoms, depression, and anxiety.

CONCLUSIONS

These findings strongly support a hypothesis of neural hyperactivation and accentuated sensitization during face processing in FXS, a phenomenon that could be developed as a biomarker end point for improving treatment trial evaluation in girls with this condition.

Prefrontal Activation During Effortful Processing Differentiates Memory Abilities in Adults with Memory Complaints

Background: Identifying individuals at increased risks for developing Alzheimer’s disease (AD) is crucial for early intervention. Memory complaints are associated with brain abnormalities characteristic of AD in cognitively normal older people. However, the utility of memory complaints for predicting mild cognitive impairment (MCI) or AD onset remains controversial, likely due to the heterogeneous nature of this construct. Objective: We investigated whether prefrontal oxygenation changes measured by functional near-infrared spectroscopy (fNIRS) during an arduous cognitive task, previously shown to be associated with the AD syndrome, could differentiate memory abilities among individuals with memory complaints. Episodic memory performance was adopted as a proxy for MCI/AD risks since it has been shown to predict AD progression across stages. Methods: Thirty-six adults self-reporting memory complaints in the absence of memory impairment completed a verbal list learning test and underwent a digit n-back paradigm with an easy (0-back) and a difficult (2-back) condition. K-means clustering was applied to empirically derive memory complaint subgroups based on fNIRS-based prefrontal oxygenation changes during the effortful 2-back task. Results: Cluster analysis revealed two subgroups characterized by high (n = 12) and low (n = 24) bilateral prefrontal activation during the 2-back but not a 0-back task. The low activation group was significantly less accurate across the n-back task and recalled significantly fewer words on the verbal memory test compared to the high activation group. Conclusion: fNIRS may have the potential to differentiate verbal memory abilities in individuals with self-reported memory complaints.

Looking for “fNIRS Signature” in Autism Spectrum: A Systematic Review Starting From Preschoolers

Accumulating evidence suggests that functional Near-Infrared Spectroscopy (fNIRS) can provide an essential bridge between our current understanding of neural circuit organization and cortical activity in the developing brain. Indeed, fNIRS allows studying brain functions through the measurement of neurovascular coupling that links neural activity to subsequent changes in cerebral blood flow and hemoglobin oxygenation levels. While the literature offers a multitude of fNIRS applications to typical development, only recently this tool has been extended to the study of neurodevelopmental disorders (NDDs). The exponential rise of scientific publications on this topic during the last years reflects the interest to identify a “fNIRS signature” as a biomarker of high translational value to support both early clinical diagnosis and treatment outcome. The purpose of this systematic review is to describe the updating clinical applications of fNIRS in NDDs, with a specific focus on preschool population. Starting from this rationale, a systematic search was conducted for relevant studies in different scientific databases (Pubmed, Scopus, and Web of Science) resulting in 13 published articles. In these studies, fNIRS was applied in individuals with Autism Spectrum Disorder (ASD) or infants at high risk of developing ASD. Both functional connectivity in resting-state conditions and task-evoked brain activation using multiple experimental paradigms were used in the selected investigations, suggesting that fNIRS might be considered a promising method for identifying early quantitative biomarkers in the autism field.

fNIRS-derived neurocognitive ratio as a biomarker for neuropsychiatric diseases

Significance: Clinical use of fNIRS-derived features has always suffered low sensitivity and specificity due to signal contamination from background systemic physiological fluctuations. We provide an algorithm to extract cognition-related features by eliminating the effect of background signal contamination, hence improving the classification accuracy. Aim: The aim in this study is to investigate the classification accuracy of an fNIRS-derived biomarker based on global efficiency (GE). To this end, fNIRS data were collected during a computerized Stroop task from healthy controls and patients with migraine, obsessive compulsive disorder, and schizophrenia. Approach: Functional connectivity (FC) maps were computed from [HbO] time series data for neutral (N), congruent (C), and incongruent (I) stimuli using the partial correlation approach. Reconstruction of FC matrices with optimal choice of principal components yielded two independent networks: cognitive mode network (CM) and default mode network (DM). Results: GE values computed for each FC matrix after applying principal component analysis (PCA) yielded strong statistical significance leading to a higher specificity and accuracy. A new index, neurocognitive ratio (NCR), was computed by multiplying the cognitive quotients (CQ) and ratio of GE of CM to GE of DM. When mean values of NCR ( N C R ¯ ) over all stimuli were computed, they showed high sensitivity (100%), specificity (95.5%), and accuracy (96.3%) for all subjects groups. Conclusions: N C R ¯ can reliable be used as a biomarker to improve the classification of healthy to neuropsychiatric patients.

A Narrative Review on Clinical Applications of fNIRS

Functional near-infrared spectroscopy (fNIRS) is a relatively new imaging modality in the functional neuroimaging research arena. The fNIRS modality non-invasively investigates the change of blood oxygenation level in the human brain utilizing the transillumination technique. In the last two decades, the interest in this modality is gradually evolving for its real-time monitoring, relatively low-cost, radiation-less environment, portability, patient-friendliness, etc. Including brain-computer interface and functional neuroimaging research, this technique has some important application of clinical perspectives such as Alzheimer's disease, schizophrenia, dyslexia, Parkinson's disease, childhood disorders, post-neurosurgery dysfunction, attention, functional connectivity, and many more can be diagnosed as well as in some form of assistive modality in clinical approaches. Regarding the issue, this review article presents the current scopes of fNIRS in medical assistance, clinical decision making, and future perspectives. This article also covers a short history of fNIRS, fundamental theories, and significant outcomes reported by a number of scholarly articles. Since this review article is hopefully the first one that comprehensively explores the potential scopes of the fNIRS in a clinical perspective, we hope it will be helpful for the researchers, physicians, practitioners, current students of the functional neuroimaging field, and the related personnel for their further studies and applications.

Applications of Resting-State fNIRS in the Developing Brain: A Review From the Connectome Perspective

Early brain development from infancy through childhood is closely related to the development of cognition and behavior in later life. Human brain connectome is a novel framework for describing topological organization of the developing brain. Resting-state functional near-infrared spectroscopy (fNIRS), with a natural scanning environment, low cost, and high portability, is considered as an emerging imaging technique and has shown valuable potential in exploring brain network architecture and its changes during the development. Here, we review the recent advances involving typical and atypical development of the brain connectome from neonates to children using resting-state fNIRS imaging. This review highlights that the combination of brain connectome and resting-state fNIRS imaging offers a promising framework for understanding human brain development.

Research progress of functional near-infrared spectroscopy in patients with psychiatric disorders

Functional near-infrared spectroscopy (fNIRS) is a technique of detecting cerebral cortical function by using near-infrared light, which is a multifunctional neuroimaging technique and provides a convenient and efficient detection method in neuroscience. In consideration of acceptability, safety, high spatial and temporal resolutions compared with electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI), fNIRS is widely used to study different psychiatric disorders, most prominently affective disorders, schizophrenic illnesses, brain organic mental disorders and neurodevelopmental disorders, etc. The article focuses on the latest research progress and practical application of fNIRS in psychiatric disorders, especially traumatic brain, including studies on the characterization of phenomenology, treatment effects and descriptions of neuroimaging data.

The estimation of the functioning of families with ASD children

BACKGROUND

Autism Spectrum Disorder (ASD) is a disease described as a neurodevelopmental disorder as the impairment of social and communication functions. Life of the people with ASD depends on the early introduction of intensive therapeutic programmes, modifying the undesirable behaviours, and aimed at teaching social and communication skills.

AIMS

The goal of the present work is to estimation the functioning of families with an ASD child and compare it to the functioning of families with children not diagnosed with ASD.

METHODS

The study was performed using Flexibility and Cohesion Evaluation Scales. The study included 70 parents of ASD children, and 70 parents with children without diagnosed ASD, as the control group.

RESULTS

The parents of children with autism achieve lower results in the Balanced Cohesion sub-scale than the control group. Also, the parents of ASD children obtained higher scores in the Disengaged sub-scale than the control group.

CONCLUSIONS

The results of this papers can suggesting the risk of the appearance of a disturbed family system, functioning in families with children with ASD, which should be a trigger for providing these families with early family functioning diagnosis and consequent support and therapy.

Prediction in Autism by Deep Learning Short-Time Spontaneous Hemodynamic Fluctuations

This study aims to explore the possibility of using a multilayer artificial neural network for the classification between children with autism spectrum disorder (ASD) and typically developing (TD) children based on short-time spontaneous hemodynamic fluctuations. Spontaneous hemodynamic fluctuations were collected by a functional near-infrared spectroscopy setup from bilateral inferior frontal gyrus and temporal cortex in 25 children with ASD and 22 TD children. To perform feature extraction and classification, a multilayer neural network called CGRNN was used which combined a convolution neural network (CNN) and a gate recurrent unit (GRU), since CGRNN has a strong ability in finding characteristic features and acquiring intrinsic relationship in time series. For the training and predicting, short-time (7 s) time-series raw functional near-infrared spectroscopy (fNIRS) signals were used as the input of the network. To avoid the over-fitting problem and effectively extract useful differentiation features from a sample with a very limited size (e.g., 25 ASDs and 22 TDs), a sliding window approach was utilized in which the initially recorded long-time (e.g., 480 s) time-series was divided into many partially overlapped short-time (7 s) sequences. By using this combined deep-learning network, a high accurate classification between ASD and TD could be achieved even with a single optical channel, e.g., 92.2% accuracy, 85.0% sensitivity, and 99.4% specificity. This result implies that the multilayer neural network CGRNN can identify characteristic features associated with ASD even in a short-time spontaneous hemodynamic fluctuation from a single optical channel, and second, the CGRNN can provide highly accurate prediction in ASD.

Reliability evaluation on weighted graph metrics of fNIRS brain networks

Background

Resting-state fNIRS (R-fNIRS) imaging data has proven to be a valuable technique to quantitatively characterize functional architectures of human brain network. However, whether the brain network metrics derived using weighted brain network model is test-retest (TRT) reliable remains largely unknown.

Methods

Here, we firstly constructed weighted brain networks on a group of 18 participants, and then applied graph-theory approach to quantify topological parameters of each weighted network. The intraclass correlation coefficient (ICC) was further applied to quantify the TRT reliability of network metrics.

Results

We found that the reliability of the weighted network metrics is threshold-sensitive, and most of these network metrics showed fair to excellent reliability. Specifically, the global network metrics, e.g., clustering coefficient, path length, local efficiency and global efficiency were of excellent level reliability (ICC >0.75) on both HbO and HbR signals. The nodal network metrics, e.g., degree and efficiency, generally also showed excellent level reliability on both HbO and HbR signals, and the reliability of these two metrics was better than that of nodal betweenness.

Conclusions

Overall, these findings demonstrated that most weighted network metrics derived from fNIRS are TRT reliable and can be used for brain network research.

Novel analysis of fNIRS acquired dynamic hemoglobin concentrations: application in young children with autism spectrum disorder

A novel analysis of the spatial complexity of functional connectivity (SCFC) was proposed to investigate the spatial complexity of multiple dynamic functional connectivity series in an fNIRS study, using an approach combining principal component analysis and normalized entropy. The analysis was designed to describe the complex spatial features of phase synchrony based dynamic functional connectivity (dFC), which are unexplained in traditional approaches. The feasibility and validity of this method were verified in a sample of young patients with autism spectrum disorders (ASD). Our results showed that there were information exchange deficits in the right prefrontal cortex (PFC) of children with ASD, with markedly higher interregion SCFCs between the right PFC and other brain regions than those of normal controls. Furthermore, the global SCFC was significantly higher in young patients with ASD, along with considerably higher intraregion SCFCs in the prefrontal and temporal lobes which represents more diverse information exchange in these areas. The study suggests a novel method to analyze the fNIRS required dynamic hemoglobin concentrations by using concepts of SCFC. Moreover, the clinical results extend our understanding of ASD pathology, suggesting the crucial role of the right PFC during the information exchange process.