Mundy Peter
University of Miami, Coral Gables, Florida 33146, USA.
J Child Psychol Psychiatry. 2003 Sep;44(6):793-809. doi: 10.1111/1469-7610.00165.
The fundamental social disturbance of autism is characterized, in part, by problems in the acquisition of joint attention skills in the first years of life, followed by impairments in the development of social cognition, as assessed on theory of mind (ToM) measures. Recently, studies have indicated that a system involving the dorsal medial-frontal cortex (DMFC), and the anterior cingulate (AC), may contribute to the development of the tendency to initiate joint attention in infancy. Similarly, research has implicated the DMFC/AC system in ToM performance in typical and atypical individuals. These data suggest it may be useful to consider the functions associated with this system in the developmental psychopathology of autism.
A review of the studies of the connections between the DMFC/AC system, joint attention and ToM task performance.
This review raises the hypothesis that the DMFC/AC may be involved in the basic disturbance in social orienting in autism. The DMFAC/AC may also play a role in the capacity to monitor proprioceptive information concerning self-action and integrate this self-related information with exteroceptive perceptual information about the behavior of other people. A disturbance in these functions of the DMFC/ AC may contribute to the atypical development of intersubjectivity, joint attention and social cognition that may impair the lives of people with autism. Thus, impairment in the development of this system may constitute a neural substrate for socio-cognitive deficits in autism.
自闭症的基本社会障碍部分表现为在生命最初几年获得共同注意技能存在问题,随后在心理理论(ToM)测量中显示出社会认知发展受损。最近的研究表明,一个涉及背内侧前额叶皮质(DMFC)和前扣带回(AC)的系统,可能有助于婴儿期发起共同注意倾向的发展。同样,研究表明DMFC/AC系统在典型和非典型个体的心理理论表现中也有作用。这些数据表明,在自闭症的发展性精神病理学中考虑与该系统相关的功能可能是有用的。
对DMFC/AC系统、共同注意和ToM任务表现之间联系的研究进行综述。
本综述提出了一个假设,即DMFC/AC可能参与了自闭症中社会定向的基本障碍。DMFAC/AC也可能在监测与自我行动有关的本体感觉信息并将这种与自我相关的信息与关于他人行为的外感受知觉信息整合的能力中发挥作用。DMFC/AC这些功能的紊乱可能导致主体间性、共同注意和社会认知的非典型发展,这可能会损害自闭症患者的生活。因此,该系统发育的受损可能构成自闭症社会认知缺陷的神经基础。