Tkalcec Antonia, Baldassarri Alessandro, Junghans Alex, Somasundaram Vithusan, Menks Willeke M, Fehlbaum Lynn V, Borbàs Réka, Raschle Nora, Seeger-Schneider Gudrun, Jenny Bettina, Walitza Susanne, Cole David M, Sterzer Philipp, Santini Francesco, Herbrecht Evelyn, Cubillo Ana, Stadler Christina
Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Radboud University Medical Centre, Nijmegen, The Netherlands.
J Child Psychol Psychiatry. 2025 May 26. doi: 10.1111/jcpp.14172.
Facial emotion processing deficits and atypical eye gaze are often described in individuals with autism spectrum disorder (ASD) and those with conduct disorder (CD) and high callous unemotional (CU) traits. Yet, the underlying neural mechanisms of these deficits are still unclear. The aim of this study was to investigate if eye gaze can partially account for the differences in brain activation in youth with ASD, with CD, and typically developing youth (TD).
In total, 105 adolescent participants (N = 39, N = 27, N = 39; mean age = 15.59 years) underwent a brain functional imaging session including eye tracking during an implicit emotion processing task while parents/caregivers completed questionnaires. Group differences in gaze behavior (number of fixations to the eye and mouth regions) for different facial expressions (neutral, fearful, angry) presented in the task were investigated using Bayesian analyses. Full-factorial models were used to investigate group differences in brain activation with and without including gaze behavior parameters and focusing on brain regions underlying facial emotion processing (insula, amygdala, and medial prefrontal cortex).
Youth with ASD showed increased fixations on the mouth compared to TD and CD groups. CD participants with high CU traits tended to show fewer fixations to the eye region compared to TD for all emotions. Brain imaging results show higher right anterior insula activation in the ASD compared with the CD group when angry faces were presented. The inclusion of gaze behavior parameters in the model reduced the size of that cluster.
Differences in insula activation may be partially explained by gaze behavior. This implies an important role of gaze behavior in facial emotion processing, which should be considered for future brain imaging studies. In addition, our results suggest that targeting gaze behavior in interventions might be potentially beneficial for disorders showing impairments associated with the processing of emotional faces. The relation between eye gaze, CU traits, and neural function in different diagnoses needs further clarification in larger samples.
自闭症谱系障碍（ASD）患者、品行障碍（CD）患者以及具有高度冷酷无情（CU）特质的个体常被描述存在面部情绪处理缺陷和异常的目光注视。然而，这些缺陷背后的神经机制仍不清楚。本研究的目的是调查目光注视是否能部分解释患有ASD、CD的青少年以及发育正常的青少年（TD）在大脑激活方面的差异。
共有105名青少年参与者（N = 39、N = 27、N = 39；平均年龄 = 15.59岁）在一项内隐情绪处理任务中接受了包括眼动追踪的脑功能成像检查，同时父母/照顾者完成问卷调查。使用贝叶斯分析研究任务中呈现的不同面部表情（中性、恐惧、愤怒）的注视行为（对眼睛和嘴巴区域的注视次数）的组间差异。全因素模型用于研究在纳入和不纳入注视行为参数的情况下，专注于面部情绪处理的脑区（脑岛、杏仁核和内侧前额叶皮层）的大脑激活的组间差异。
与TD组和CD组相比，ASD青少年对嘴巴的注视增加。与TD组相比，具有高CU特质的CD参与者在所有情绪下对眼睛区域的注视往往更少。脑成像结果显示，呈现愤怒面孔时，ASD组右侧前脑岛的激活高于CD组。在模型中纳入注视行为参数减小了该簇的大小。
脑岛激活的差异可能部分由注视行为解释。这意味着注视行为在面部情绪处理中起重要作用，未来的脑成像研究应予以考虑。此外，我们的结果表明，在干预中针对注视行为可能对表现出与情绪面孔处理相关损伤的疾病有潜在益处。不同诊断中目光注视、CU特质和神经功能之间的关系需要在更大样本中进一步阐明。
