Neural processing of intentional biological motion in unaffected siblings of children with autism spectrum disorder: An fMRI study
Introduction
Research focusing on unaffected siblings of individuals with autism spectrum disorder (ASD) is critical to understanding how the disorder impacts both individuals and families. Recently published studies have examined not only quantitative measures of mental health in siblings, but also their subjective experiences and perceptions (Angell et al., 2012, Petalas et al., 2012, Shivers et al., 2012). Furthermore, study of the “broader phenotype” of autism traits has consistently shown that siblings of children with autism exhibit behavioral deficits in social, communication, and learning domains (see Dawson et al., 2002, for a review). Moreover, Kates et al. (2004) reported shared structural deficits in frontal, temporal, and occipital lobes between discordant twin pairs (one child diagnosed with autism and one unaffected). In this study, all but one of the nine twin pairs contained a unaffected sibling who exhibited the broad autism phenotype, which was defined as showing a language or social delay that was either subclinical (undiagnosed but indicating mild impairment), or clinical (diagnosed as developmental delay or pervasive developmental disorder, but not as autism).
Neuroimaging data from unaffected siblings have also been presented in terms of their similarities to and differences from control children, as well as children with ASD. Dalton, Nacewicz, Alexander, and Davidson (2007) found that unaffected siblings showed decreased fixations onto faces, decreased fusiform gyrus activation, and decreased amygdala volume compared with controls; all of these deficits were also present in the autism group. Belmonte, Gomot, and Baron-Cohen (2010) showed that both unaffected siblings and children with ASD were behaviorally impaired in a non-social visual attention task and also showed atypical brain activations in frontal and cerebellar regions. However, they also noted that a measure of overall functional correlation was decreased in autism but not in siblings. Barnea-Goraly, Lotspeich, and Reiss (2010) reported that deficits shared between children with ASD and siblings extend to the structural modality (measured by significantly reduced white matter fractional-anisotropy values compared to controls) in regions of the brain associated with social cognition. Baron-Cohen’s group reported that neural activations in unaffected siblings are similar to individuals with autism in a face processing task (Spencer et al., 2011). In a visual search task, Spencer et al. (2012) showed not only that unaffected siblings and children with autism show similar reductions in activation, but also that these reductions were correlated with behavioral measures of social interaction. These studies demonstrate that unaffected siblings expressing the broader autism phenotype also have structural and functional neurological deficits, some of which they share with children with ASD.
Taking a different approach, Kaiser et al. (2010) used a social task (point-light displays of biological motion). Crucially, the unaffected siblings were matched with controls on measures of social responsiveness and lacked characteristics of the broader autism phenotype. Thus, any shared neural response patterns could be classified as an endophenotype reflecting ASD vulnerability rather than an epiphenomenon resulting from subclinical behavioral features of the disorder. In that study, children with ASD and unaffected siblings both showed hypoactivations in cortical regions, consistent with prior work. However, they also reported atypical hyperactivations, relative to controls, that were unique to the unaffected siblings. Kaiser et al. hypothesized that these hyperactivations may be neural “compensatory” mechanisms.
Further exploration of similarities and differences in neuroimaging measures between individuals with ASD and their siblings seems pertinent. Given the trajectory of research in ASD, it is natural that many of the previous functional neuroimaging experiments have focused on face processing in unaffected siblings. However, no published studies have extended these findings into the domain of intentional action perception. This extension is required if we are to translate current findings from the low-level social cognition to the experience of actively participating in a social world (a much more complex and higher-level activity).
Prior studies of both children and adults show that brain activations in individuals with ASD differ from controls when viewing actions that are congruent with a prior displayed emotion versus those that are incongruent (Pelphrey et al., 2011, Vander Wyk et al., 2012). The pSTS showed differential activations depending on the congruency of the action, suggested that the region is involved in extracting social meaning (intention) from bodily action. We used functional magnetic resonance imaging (fMRI) to investigate brain activations, as measured by the blood oxygen level-dependent (BOLD) response, to congruent and incongruent intentional actions in unaffected siblings of children with ASD, a matched group of control children, and an unmatched, smaller sample of children with ASD.
The primary hypothesis concerns the comparison of differential activation to incongruent actions in unaffected siblings relative to controls. If the hypothesis concerning compensatory activation is correct, unaffected siblings may show overall greater activation to observed actions, regardless of congruency. However, they may also show increased differential activation to incongruent actions relative to congruent actions. The secondary hypothesis concerns the comparison between the control and ASD groups. Based on prior literature, we expect that they ASD sample will show decreased or no differential activation, and lower activation overall, as a function of congruency.
Section snippets
Subjects
Three groups of participants were recruited. The first group consisted of 22 unaffected siblings (US) of children with ASD with no history of psychiatric disorders (mean age = 12.58, SD = 2.43, range = 9.08–17.25). The second was an age-, gender-, and sample size-matched group of control children (CC) with no presence of ASD in the family and no psychiatric history (mean age = 11.63, SD = 1.85, range = 7.67–15.17). The third group consisted of 14 children diagnosed with ASD (mean age = 10.92, SD = 3.94, range =
pSTS “compensatory region”
The US and CC group-averaged differential (incongruent – congruent) and aggregate (average of both conditions) waveforms for the compensatory-defined pSTS are displayed in Fig. 2B and C. We also show a bar graph representing the peak BOLD response at timepoint 5 relative to onset for the conditions, separated by group (Fig. 2A). We observe control participants showing a high degree of preference to incongruent trials in this region, while unaffected siblings do not; the lack of differentiation
Discussion
Siblings of individuals with an ASD presumably share some genetic risk for ASD. However, few studies have targeted this group, although there appears to be not only a complex pattern of common deficits, but also preserved and perhaps even heightened brain function. The current study directly compared unaffected siblings and control children during action perception, in a paradigm that includes stimuli previously used to examine action understanding and intentional processing in both
Conclusion
Intentional action perception is critical for making sense of social situations, and these cognitive processes, along with the neural bases underlying them, are deeply relevant to our understanding of autism spectrum disorders. Furthermore, exploring the response patterns of unaffected siblings in action perception would be informative from the perspective of discovering neuroendophenotypes, but they are not yet well understood. We report that unaffected siblings of children with autism did not
Funding
This research was funded by NIHM Grant R01MH084080 and the Simons Foundation.
Acknowledgments
The authors would like to sincerely thank the children and families who contributed to this research for their time, patience, and cooperation.
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