Samaey Celine, Van der Donck Stephanie, van Winkel Ruud, Boets Bart
Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium.
Department of Neurosciences, Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium.
Front Psychiatry. 2020 Nov 13;11:592937. doi: 10.3389/fpsyt.2020.592937. eCollection 2020.
Autism spectrum disorder (ASD) and primary psychosis are classified as distinct neurodevelopmental disorders, yet they display overlapping epidemiological, environmental, and genetic components as well as endophenotypic similarities. For instance, both disorders are characterized by impairments in facial expression processing, a crucial skill for effective social communication, and both disorders display an increased prevalence of adverse childhood events (ACE). This narrative review provides a brief summary of findings from neuroimaging studies investigating facial expression processing in ASD and primary psychosis with a focus on the commonalities and differences between these disorders. Individuals with ASD and primary psychosis activate the same brain regions as healthy controls during facial expression processing, albeit to a different extent. Overall, both groups display altered activation in the fusiform gyrus and amygdala as well as altered connectivity among the broader face processing network, probably indicating reduced facial expression processing abilities. Furthermore, delayed or reduced N170 responses have been reported in ASD and primary psychosis, but the significance of these findings is questioned, and alternative frequency-tagging electroencephalography (EEG) measures are currently explored to capture facial expression processing impairments more selectively. Face perception is an innate process, but it is also guided by visual learning and social experiences. Extreme environmental factors, such as adverse childhood events, can disrupt normative development and alter facial expression processing. ACE are hypothesized to induce altered neural facial expression processing, in particular a hyperactive amygdala response toward negative expressions. Future studies should account for the comorbidity among ASD, primary psychosis, and ACE when assessing facial expression processing in these clinical groups, as it may explain some of the inconsistencies and confound reported in the field.
自闭症谱系障碍（ASD）和原发性精神病被归类为不同的神经发育障碍，但它们在流行病学、环境和遗传成分以及内表型相似性方面存在重叠。例如，这两种障碍都以面部表情处理受损为特征，而面部表情处理是有效社交沟通的一项关键技能，并且这两种障碍中童年不良事件（ACE）的患病率均有所增加。这篇叙述性综述简要总结了神经影像学研究的结果，这些研究调查了ASD和原发性精神病中的面部表情处理，重点关注这些障碍之间的异同。ASD和原发性精神病患者在面部表情处理过程中激活的脑区与健康对照组相同，尽管程度不同。总体而言，两组在梭状回和杏仁核中的激活均发生改变，并且在更广泛的面部处理网络中的连接也发生改变，这可能表明面部表情处理能力下降。此外，在ASD和原发性精神病中均报告了N170反应延迟或减弱，但这些发现的意义受到质疑，目前正在探索替代的频率标记脑电图（EEG）测量方法，以更有选择性地捕捉面部表情处理障碍。面部感知是一个先天过程，但它也受视觉学习和社会经验的引导。极端环境因素，如童年不良事件，可扰乱正常发育并改变面部表情处理。据推测，ACE会导致神经面部表情处理改变，特别是杏仁核对负面表情的反应过度活跃。未来的研究在评估这些临床群体的面部表情处理时应考虑ASD、原发性精神病和ACE之间的共病情况，因为这可能解释该领域报告的一些不一致和混淆情况。
