Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
Center for Brain and Cognitive Development, Birkbeck College, University of London, London, UK.
J Child Psychol Psychiatry. 2021 Feb;62(2):149-159. doi: 10.1111/jcpp.13267. Epub 2020 May 25.
Visual exploration in autism spectrum disorder (ASD) is characterized by attenuated social attention. The underlying oculomotor function during visual exploration is understudied, whereas oculomotor function during restricted viewing suggested saccade dysmetria in ASD by altered pontocerebellar motor modulation.
Oculomotor function was recorded using remote eye tracking in 142 ASD participants and 142 matched neurotypical controls during free viewing of naturalistic videos with and without human content. The sample was heterogenous concerning age (6-30 years), cognitive ability (60-140 IQ), and male/female ratio (3:1). Oculomotor function was defined as saccade, fixation, and pupil-dilation features that were compared between groups in linear mixed models. Oculomotor function was investigated as ASD classifier and features were correlated with clinical measures.
We observed decreased saccade duration (∆M = -0.50, CI [-0.21, -0.78]) and amplitude (∆M = -0.42, CI [-0.12, -0.72]), which was independent of human video content. We observed null findings concerning fixation and pupil-dilation features (POWER = .81). Oculomotor function is a valid ASD classifier comparable to social attention concerning discriminative power. Within ASD, saccade features correlated with measures of restricted and repetitive behavior.
We conclude saccade dysmetria as ASD oculomotor phenotype relevant to visual exploration. Decreased saccade amplitude and duration indicate spatially clustered fixations that attenuate visual exploration and emphasize endogenous over exogenous attention. We propose altered pontocerebellar motor modulation as underlying mechanism that contributes to atypical (oculo-)motor coordination and attention function in ASD.
自闭症谱系障碍(ASD)患者的视觉探索表现为社交注意力减弱。在视觉探索过程中,眼球运动功能的基础研究还很欠缺,而在限制观看条件下,眼球运动功能研究提示 ASD 存在眼球运动失调,其表现为桥脑小脑运动调节改变导致扫视距离异常。
本研究使用远程眼动追踪技术,在 142 名 ASD 患者和 142 名匹配的神经典型对照组中,记录他们在观看包含和不包含人类内容的自然主义视频时的眼球运动功能。该样本在年龄(6-30 岁)、认知能力(60-140 智商)和男女比例(3:1)方面存在异质性。线性混合模型用于比较组间的眼球运动功能,包括扫视、注视和瞳孔扩张特征。我们将眼球运动功能作为 ASD 分类器,并将特征与临床指标进行相关性分析。
我们观察到,与观看人类内容的视频相比,ASD 患者的扫视持续时间(∆M = -0.50,CI [-0.21, -0.78])和扫视幅度(∆M = -0.42,CI [-0.12, -0.72])均显著降低,这一结果独立于视频内容。我们未观察到注视和瞳孔扩张特征的组间差异(POWER =.81)。眼球运动功能是一种有效的 ASD 分类器,与社交注意力相比具有相似的判别力。在 ASD 患者中,扫视特征与受限和重复行为的测量结果相关。
我们认为扫视失调是 ASD 的一种眼球运动表型,与视觉探索有关。扫视幅度和持续时间的降低表明 ASD 患者的注视较为局限,这可能会减弱视觉探索,并强调内源性注意力对外源性注意力的影响。我们提出,桥脑小脑运动调节改变可能是导致 ASD 患者眼球运动和注意力功能异常的潜在机制。