Feedback and reward processing in high-functioning autism

Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model predicts an FRN on negative prediction errors, as well as implying a role for the FRN in learning and the adaptation of behavior. However, these predictions have recently been challenged. Notably, studies so far have used tasks in which the outcomes have been contingent on the response. In these paradigms, the need to adapt behavioral responses is present only for negative, not for positive feedback. The goal of the present study was to investigate the effects of positive as well as negative violations of expectancy on FRN amplitudes, without the usual confound of behavioral adjustments. A reversal-learning task was employed in which outcome value and outcome expectancy were orthogonalized; that is, both positive and negative outcomes were equally unexpected. The results revealed a double dissociation, with effects of valence but not expectancy on the FRN and, conversely, effects of expectancy but not valence on the P300. While FRN amplitudes were largest for negative-outcome trials, irrespective of outcome expectancy, P300 amplitudes were largest for unexpected-outcome trials, irrespective of outcome valence. These FRN effects were interpreted to reflect an evaluation along a good-bad dimension, rather than reflecting a negative prediction error or a role in behavioral adaptation. By contrast, the P300 reflects the updating of information relevant for behavior in a changing context.

Dissociable medial frontal negativities from a common monitoring system for self- and externally caused failure of goal achievement

Sensory reactivity is a diagnostic criterion for Autism Spectrum Disorder (ASD), and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. Yet, there is little consensus on best practice approaches to assessing sensory processing dysfunction in adolescents and adults with ASD. Despite growing evidence that sensory symptoms persist into adolescence and adulthood, there is a lack of norms for older age groups, and pediatric assessments may not target appropriate functional outcomes or environments. This review identified approaches used to measure sensory processing in the scientific literature, and to describe and compare these approaches to current best practice guidelines that can be incorporated into evidence-based practice. Method and Analysis: A search of scientific databases and grey literature (professional association and ASD society websites), from January 1987–May 2017, uncovered 4769 articles and 12 clinical guidelines. Study and sample characteristics were extracted, charted, and categorized according to assessment approach. Results: There were 66 articles included after article screening. Five categories of assessment approaches were identified: Self- and Proxy-Report Questionnaires, Psychophysical Assessment, Direct Behavioral Observation, Qualitative Interview Techniques, and Neuroimaging/EEG. Sensory research to date has focused on individuals with high-functioning ASD, most commonly through the use of self-report questionnaires. The Adolescent and Adult Sensory Profile (AASP) is the most widely used assessment measure (n = 22), however, a number of other assessment approaches may demonstrate strengths specific to the ASD population. Multi-method approaches to assessment (e.g., combining psychophysical or observation with questionnaires) may have clinical applicability to interdisciplinary clinical teams serving adolescents and adults with ASD. Contribution: A comprehensive knowledge of approaches is critical in the clinical assessment of a population characterized by symptomatic heterogeneity and wide-ranging cognitive profiles. This review should inform future development of international interdisciplinary clinical guidelines on sensory processing assessment in ASD across the lifespan.

Decision-making is a fundamental aspect of human behavior, especially in uncertain situations where social interactions play a significant role. Social dominance, which involves power dynamics within groups, holds the potential to shape decision-making. Individuals' expectations and certainty about outcomes are crucial for monitoring their performance in social dominance situations. However, the impact of expected and unexpected uncertainty on decision-making in social dominance contexts remains unclear. This study aimed to unravel the neural and behavioral patterns associated with decision-making across varying social dominance levels under conditions of uncertainty. Researchers investigated this by analyzing brain activity in 51 students. Participants were presented with both positive and negative feedback under conditions of both expectation and uncertainty, while their brain activity was recorded using electroencephalography (EEG). Specifically, we investigated the properties of key neural correlates of feedback processing, including feedback-related negativity (FRN), and P3 components of event-related potential (ERP), and reward prediction error (RPE) signals. The results revealed that the low-dominance group exhibited a larger FRN amplitude than the high-dominance group. Also, unexpected-uncertain negative feedback elicits a stronger FRN amplitude than other conditions. P3 amplitude was larger for high-dominance compared to low-dominance individuals. Additionally, P3 amplitude varied by feedback valence and condition, with larger amplitudes for positive feedback and unexpected-uncertain conditions. In FRN wave difference, the high-dominance individuals exhibited more negative amplitude in unexpected-uncertain conditions. This reveals distinct neural responses to uncertainty and feedback between individuals with high and low dominance, suggesting that social hierarchy modulates brain mechanisms underlying decision-making and reward processing.

Adolescence has frequently been characterized as a period of increased risk taking, which may be largely driven by maturational changes in neural areas that process incentives. To investigate age- and gender-related differences in reward processing, we recorded event-related potentials (ERPs) from 80 participants in a gambling game, in which monetary wins and losses were either large or small. We measured two ERP components: the feedback-related negativity (FRN) and the feedback P3 (fP3). The FRN was sensitive to the size of a win in both adult (aged 23-35 years) and adolescent (aged 13-17 years) males, but not in females. Small wins appeared to be less rewarding for males than for females, which may in part explain more approach-driven behavior in males in general. Furthermore, adolescent boys showed both delayed FRNs to high losses and less differentiation in FRN amplitude between wins and losses in comparison to girls. The fP3, which is thought to index the salience of the feedback at a more conscious level than the FRN, was also larger in boys than in girls. Taken together, these results imply that higher levels of risk taking that are commonly reported in adolescent males may be driven both by hypersensitivity to high rewards and insensitivity to punishment or losses.

The current theory implying local, short-range overconnectivity in autism spectrum disorder, contrasting with long-range underconnectivity, is based on heterogeneous results, on limited data involving functional connectivity studies, on heterogeneous paediatric populations and non-specific methodologies. In this work, we studied short-distance structural connectivity in a homogeneous population of males with high-functioning autism spectrum disorder and used a novel methodology specifically suited for assessing U-shaped short-distance tracts, including a recently developed tractography-based atlas of the superficial white matter fibres. We acquired diffusion-weighted MRI for 58 males (27 subjects with high-functioning autism spectrum disorder and 31 control subjects) and extracted the mean generalized fractional anisotropy of 63 short-distance tracts. Neuropsychological evaluation included Wechsler Adult Intelligence Scale IV (WAIS-IV), Communication Checklist-Adult, Empathy Quotient, Social Responsiveness Scale and Behaviour Rating Inventory of Executive Function-Adult (BRIEF-A). In contradiction with the models of short-range over-connectivity in autism spectrum disorder, we found that patients with autism spectrum disorder had a significantly decreased anatomical connectivity in a component comprising 13 short tracts compared to controls. Specific short-tract atypicalities in temporal lobe and insula were significantly associated with clinical manifestations of autism spectrum disorder such as social awareness, language structure, pragmatic skills and empathy, emphasizing their importance in social dysfunction. Short-range decreased anatomical connectivity may thus be an important substrate of social deficits in autism spectrum disorder, in contrast with current models.

Assisted reproductive technology and risk for autism spectrum disorder

BackgroundAutism spectrum disorder (ASD) is heritable and neurodevelopmental with unknown causes. The serotonergic and oxytocinergic systems are of interest in autism for several reasons: (i) Both systems are implicated in social behavior, and abnormal levels of serotonin and oxytocin have been found in people with ASD; (ii) treatment with selective serotonin reuptake inhibitors and oxytocin can yield improvements; and (iii) previous association studies have linked the serotonin transporter (SERT; SLC6A4), serotonin receptor 2A (HTR2A), and oxytocin receptor (OXTR) genes with ASD. We examined their association with high functioning autism (HFA) including siblings and their interaction.MethodsIn this association study with HFA children (IQ > 80), siblings, and controls, participants were genotyped for four single nucleotide polymorphisms (SNPs) in OXTR (rs2301261, rs53576, rs2254298, rs2268494) and one in HTR2A (rs6311) as well as the triallelic HTTLPR (SERT polymorphism).ResultsWe identified a nominal significant association with HFA for the HTTLPR s allele (consisting of S and LG alleles) (p = .040; odds ratio (OR) = 1.697, 95% CI 1.191–2.204)). Four polymorphisms (HTTLPR, HTR2A rs6311, OXTR rs2254298 and rs53576) in combination conferred nominal significant risk for HFA with a genetic score of ≥4 (OR = 2.09, 95% CI 1.05–4.18, p = .037). The resulting area under the receiver operating characteristic curve was 0.595 (p = .033).ConclusionsOur findings, combined with those of previous reports, indicate that ASD, in particular HFA, is polygenetic rather than monogenetic and involves the serotonergic and oxytocin pathways, probably in combination with other factors.Electronic supplementary materialThe online version of this article (doi:10.1186/2049-9256-2-1) contains supplementary material, which is available to authorized users.

Introduction Autism spectrum disorders (ASD) are a group of neurodevelopmental conditions characterized by impairments in social interaction, communication (both verbal and non-verbal), and repetitive behaviors. The global prevalence of ASD has increased significantly, with an estimated 28.3 million cases worldwide. Although many individuals with ASD have normal cognitive and language skills, difficulties with social interactions and understanding nonverbal cues can interfere with their ability to form romantic and sexual relationships, potentially leading to inappropriate behaviors and a distorted experience of sexuality. Objectives This paper aims to review the literature on sexuality in individuals with ASD, focusing on typical sexual behaviors, sexual preferences, as well as hypersexuality and paraphilic fantasies and behaviors within this population. Methods A non-systematic literature review was conducted, with article selection from PubMed using the keywords: “autism spectrum disorders”, “sexuality”, “hypersexuality” and “paraphilia”. Results Studies have shown that adolescents with ASD experience higher rates of inappropriate sexual behaviors and gender dysphoria compared to neurotypical peers. Variants in sexual orientation, including homosexuality, asexuality, and bisexuality, are more prevalent in this population. Recent research indicates that sexual experiences, both alone and with others, are common among individuals with high-functioning ASD, with one study revealing that 47% expressed interest in having a romantic partner. Despite this, adults with ASD, especially men, are generally less likely to be in romantic relationships. They also exhibit more hypersexual and paraphilic fantasies and behaviors than neurotypical individuals. Hypersexual behaviors are predominantly observed among male ASD individuals, while paraphilias, such as voyeurism and fetishism, are frequently reported among both ASD men and women. Sadistic and masochistic fantasies and behaviors are also common in this group. Conclusions The results indicate that individuals with ASD have a higher prevalence of sexual orientation variants and inappropriate behaviors compared to their peers. Although they have sexual interests and desires for relationships, their ability to express sexuality in a healthy way is hindered by communication deficits, social interaction challenges, and an unsupportive environment, exacerbated by inadequate sexual education. These challenges prevent many from fully embracing their sexuality. Specialized, evidence-based sexual education addressing the unique needs of individuals with ASD is essential for promoting healthier sexual behaviors and improving psychosocial well-being. Disclosure of Interest None Declared

Fronto-occipital Structural Disconnectivity as an Endophenotype of ASD

Intelligence plays a significant role in determining the severity of Autism Spectrum Disorder (ASD), thus understanding intelligence among children with ASD is important to guide planning of appropriate interventions. Scores on IQ tests as well as intelligence sub-components between ASD and typically developed (TD) children, reflect distinct underlying cognitive processes. Therefore, a comprehensive investigation of the neuropsychological aspects of children ASD may better refine our understanding of the cognitive abilities among children with ASD. The current cross-sectional study investigated differences in intelligence profiles and executive function among children with TD children and children with High-Functioning Autism Spectrum Disorder (HFASD). A total of 34 participants met criteria for inclusion with 24 participants in the TD group, and 10 in the HFASD. Some of the measures which were used included the SB-LM, Executive Function Indonesia (EFI), and Autism Spectrum Quotient: Children's Version (AQ-Child). Data were analysed using Spearman correlation and Mann-Whitney test. Results showed no differences in the intelligence profile in both groups, yet significant differences were found in the composite EF, Inhibitory Control, and Cognitive Flexibility. Additionally, there was a difference in the correlation of intelligence and EF variables between the two groups. Thus, it can be concluded that both groups show qualitatively different cognitive processes. A recommendation derived from these results is that comprehensive EF assessment and treatment should be conducted as part of the global evaluation of ASD patients, primarily to design an intervention to enhance their academic domain.

This study examined the effects of facial color on emotion recognition in individuals with high-functioning autism spectrum disorder compared to typically developing individuals. A total of 34 participants with high-functioning autism spectrum disorder and 39 typically developing individuals underwent two cognitive facial expression tasks using images altered to have a reddish color representing anger. Task 1 required participants to categorize images as either fear or anger as the emotion corresponding to the image, while Task 2 required ranking the images along a continuum from anger to fear. Results showed that individuals with high-functioning autism spectrum disorder exhibited a facial color effect similar to typically developing participants but had lower accuracy in recognizing facial emotions. Interestingly, the color effect was less pronounced in Japanese individuals with autism spectrum disorder when viewing faces of the same race, but more pronounced for unfamiliar European faces. This suggests that individuals with high-functioning autism spectrum disorder may develop compensatory strategies for recognizing facial expressions, and that cultural and racial factors influence emotion perception in individuals with autism spectrum disorder.

Introduction Autism spectrum disorder (ASD) is a lifelong disorder affecting children quite early in life, manifested as delays in communication and stereotypic behaviors. To date, it is diagnosed clinically using the Diagnostic and Statistical Manual-5 (DSM-V) criteria due to the lack of biomarkers that can specifically denote the disorder. The role of synucleins in this context has been considered due to the increasing evidence of neurodegeneration in many autistic children. Synucleins are a group of soluble neuronal proteins primarily expressed in the central nervous system. They are of three types: α-, β-, and ɣ-synuclein. α-synuclein is involved in vesicle trafficking and release of neurotransmitters. There is no uniformity in the scientific community regarding their levels of autism, with few studies showing increasing levels and others to the contrary. Hence, the present study was conceived to analyze the levels of α-synuclein and β-synuclein in autistic children and to correlate with the disease severity. Objectives The main objectiveof the study was to assess the levels of α- and β-synuclein in autistic children of 2-8 years of age and to identify the correlation between the severity of core symptoms of autism and α- and β-synuclein levels. It is intended to assessthe possibility of using α- and β-synuclein/their ratioas a biomarker of the severity of autism. Materials and methods Plasma levels of α-synuclein and β-synuclein were measured in 160ASD childrenand 40 healthy age and sex-matched children by ELISA. Their symptom severity was assessed with CARS-2 ST and the Indian Scale of Autism Assessment (ISAA). Values of α- and β-synuclein were analyzed for correlation with the severity rating of ASD. Cut-off values ofα-synuclein and β-synuclein that discriminate the presence of autism and its severity were assessed using Jamovi 2.4.14 software. Results The results show that α-synuclein levels were significantly reduced (5.02 ± 0.586; range: 3.13-6.0 ng/ml) when compared with healthy controls (29.47 ± 18.62 ng/ml; range: 22.39- 36.56) with p < 0.001, and β-synuclein levels were elevated (1424 ng/ml ± 122; range: 1229-1616 ng/ml) when compared to control, though not significantly. Plasma levels of α-synuclein significantly correlate with disease severity with good diagnostic accuracy (86%), but β-synuclein levels did not correlate with severity. The fold changes of synucleins, especially the fold decrease in levels of α-synuclein, were discriminative for the diagnosis and severity with good sensitivity (93.6%), specificity (74.3%), positive predictive (92.6%), and negative predictive values (76.5%). The fold increase in β-synuclein did not have any significance in predicting the severity of autism. Conclusion The present study showed thatα-synuclein and β-synuclein were associated with ASD and can be used to assess its severity. A fold decrease inα-synuclein was found to have good discriminating value in differentiating the severity of autism. It may be of use especially in mild and high-functioning autism, when clinically distinguishing them may be difficult.

BackgroundThere are few studies documenting the persistence of self-injury in individuals with autism spectrum disorder (ASD) and consequently limited data on behavioural and demographic characteristics associated with persistence. In this longitudinal study, we investigated self-injury in a cohort of individuals with ASD over 3 years to identify behavioural and demographic characteristics associated with persistence.MethodsCarers of 67 individuals with ASD (Median age of individuals with ASD in years = 13.5, Interquartile Range = 10.00–17.00), completed questionnaires relating to the presence and topography of self-injury at T1 and three years later at T2. Analyses were conducted to evaluate the persistence of self-injury and to evaluate the behavioural and demographic characteristics associated with persistence of self-injury.ResultsAt T2 self-injurious behaviour had persisted in 77.8 % of individuals. Behavioural correlates of being non-verbal, having lower ability and higher levels of overactivity, impulsivity and repetitive behaviour, were associated with self-injury at both time points. Risk markers of impulsivity (p = 0.021) and deficits in social interaction (p = 0.026) at T1 were associated with the persistence of self-injury over 3 years.ConclusionsImpulsivity and deficits in social interaction are associated with persistent self-injury in ASD and thus may act as behavioural risk markers. The identification of these risk markers evidences a role for behaviour dysregulation in the development and maintenance of self-injury. The findings have clinical implications for proactive intervention; these behavioural characteristics may be utilised to identify ‘at risk’ individuals for whom self-injury is likely to be persistent and therefore those individuals for whom early intervention may be most warranted.

Individuals with autism spectrum disorder (ASD) perform poorly in working memory (WM) tasks, with some literature suggesting that their impaired performance is modulated by WM load. While some neuroimaging and neurophysiological studies have reported altered functional connectivity during WM processing in individuals with autism, it remains largely unclear whether such alterations are moderated by WM load. The present study aimed to examine the effect of WM load on functional connectivity within the prefrontal cortex (PFC) in ASD using functional near-infrared spectroscopy (fNIRS). Twenty-two children with high-functioning ASD aged 8–12 years and 24 age-, intelligent quotient (IQ)-, sex- and handedness-matched typically developing (TD) children performed a number n-back task with three WM loads (0-back, 1-back, and 2-back). Hemodynamic changes in the bilateral lateral and medial PFC during task performance were monitored using a multichannel NIRS device. Children with ASD demonstrated slower reaction times, specifically during the “low load” condition, than TD children. In addition, the ASD and TD groups exhibited differential load-dependent functional connectivity changes in the lateral and medial PFC of the right but not the left hemisphere. These findings indicate that WM impairment in high-functioning ASD is paralleled by load-dependent alterations in right, but not left, intrahemispheric connectivity during WM processing in children with ASD. A disruption of functional neural connections that support different cognitive processes may underlie poor performance in WM tasks in ASD.