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Hypersensitivity to low intensity fearful faces in autism when fixation is constrained to the eyes.

Journal article
Authors Amandine Lassalle
Jakob Åsberg Johnels
Nicole R Zürcher
Loyse Hippolyte
Eva Billstedt
Noreen Ward
Eric Lemonnier
Christopher Gillberg
Nouchine Hadjikhani
Published in Human brain mapping
Volume 38
Issue 2
Pages 5943-57
ISSN 1097-0193
Publication year 2017
Published at Gillberg Neuropsychiatry Centre
Pages 5943-57
Language en
Keywords amygdala; autism; eye contact; fMRI; facial expressions; fear
Subject categories Child and adolescent psychiatry


Previous studies that showed decreased brain activation in people with autism spectrum disorder (ASD) viewing expressive faces did not control that participants looked in the eyes. This is problematic because ASD is characterized by abnormal attention to the eyes. Here, we collected fMRI data from 48 participants (27 ASD) viewing pictures of neutral faces and faces expressing anger, happiness, and fear at low and high intensity, with a fixation cross between the eyes. Group differences in whole brain activity were examined for expressive faces at high and low intensity versus neutral faces. Group differences in neural activity were also investigated in regions of interest within the social brain, including the amygdala and the ventromedial prefrontal cortex (vmPFC). In response to low intensity fearful faces, ASD participants showed increased activation in the social brain regions, and decreased functional coupling between the amygdala and the vmPFC. This oversensitivity to low intensity fear coupled with a lack of emotional regulation capacity could indicate an excitatory/inhibitory imbalance in their socio-affective processing system. This may result in social disengagement and avoidance of eye-contact to handle feelings of strong emotional reaction. Our results also demonstrate the importance of careful control of gaze when investigating emotional processing in ASD. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

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