Department of Physical Medicine & Rehabilitation, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan.
Autism Res. 2021 Nov;14(11):2287-2299. doi: 10.1002/aur.2595. Epub 2021 Aug 23.
Anxiety is exceedingly prevalent among individuals with an autism spectrum condition (ASC). While recent literature postulates anxiety as a mechanism encompassing an underlying amygdala-related elevated baseline level of arousal even to nonthreatening cues, whether this same mechanism contributes to anxiety in those with an ASC and supports the transdiagnostic nature of anxiety remains elusive. In this case-control study of 51 youths (26 ASC), we assessed autism and anxiety via the Autism-Spectrum Quotient and the State-Trait Anxiety Inventory, respectively. Hemodynamic responses, including amygdala reactivity, to explicit and implicit (backwardly masked) perception of threatening faces were acquired using functional Magnetic Resonance Imaging (fMRI). For explicit fear, ASC individuals showed significantly greater negative correlations between the amygdala and the attentional deployment-parietal network. For implicit fear, ASC individuals showed significantly stronger correlations of the amygdala with the prefrontal networks, temporal pole, and hippocampus. Additionally, an fMRI-based neurologic signature for anxiety in ASCs was identified via the LibSVM machine learning model using amygdala-centered functional connectivity during the emotional processing of explicit and implicit stimuli. Hypervigilance to implicit threat in ASCs comorbid with anxiety might exacerbate explicit threat reactivity; hence the use of attentional avoidance patterns to restrict affective hyperarousal for explicitly perceived socioemotional stimuli. Consequently, developing an attention-independent behavioral/neural marker identifying anxiety in ASCs is highly warranted. LAY SUMMARY: This study identifies a dissociation of amygdala reactivity dependent on explicit and implicit threat processing. Implicit anxiety in individuals with an autism spectrum condition (ASC) could outweigh explicitly induced threat. When explicitly perceiving socioemotional stimuli, ASC individuals with anxiety might use attentional avoidance patterns to restrict affective hyperarousal.
焦虑在自闭症谱系障碍（ASC）患者中极为普遍。尽管最近的文献假设焦虑是一种机制，包括杏仁核相关的基础唤醒水平升高，即使面对非威胁性线索也是如此，但这种相同的机制是否会导致 ASC 患者的焦虑，以及是否支持焦虑的跨诊断性质，仍然难以捉摸。在这项对 51 名青少年（26 名 ASC）的病例对照研究中，我们分别通过自闭症-谱系商数和状态-特质焦虑量表评估自闭症和焦虑。使用功能磁共振成像（fMRI）获取对威胁面孔的显式和隐式（向后掩蔽）感知的血液动力学反应，包括杏仁核反应性。对于显式恐惧，ASC 个体表现出杏仁核与注意力分配-顶叶网络之间的显著负相关性。对于隐式恐惧，ASC 个体的杏仁核与前额叶网络、颞极和海马体之间的相关性更强。此外，通过使用基于 LibSVM 的机器学习模型，基于 fMRI 的 ASC 焦虑神经学特征，使用情绪处理中显式和隐式刺激的杏仁核中心功能连接性来识别。ASC 共病焦虑的个体对隐式威胁的过度警惕可能会加剧显式威胁反应；因此，使用注意力回避模式来限制对明确感知的社会情感刺激的情感过度唤醒。因此，开发一种不依赖注意力的行为/神经标志物来识别 ASC 中的焦虑是非常必要的。
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