Lidstone Daniel E, Singhala Mohit, Wang Liam J, Brown Jeremy D, Mostofsky Stewart H
School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, United States of America.
Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, United States of America.
PLOS Digit Health. 2025 Jun 18;4(6):e0000879. doi: 10.1371/journal.pdig.0000879. eCollection 2025 Jun.
An overreliance on proprioceptive (intrinsic) sensory input from the body, compared to visual (extrinsic) input from the environment, may underpin core features of autism spectrum disorder (ASD). We developed an engaging videogame ("HaptiKart") as a tool to examine differences in sensory-motor bias (proprioceptive vs. visual) in children and adults with ASD and whether bias correlates with age, core autism features, and intellectual ability. Eighty-one participants (33 ASD, 48 typically-developing, TD) aged 8-31 years played "HaptiKart," a driving videogame with a force-feedback steering wheel that provided "steering assist" during gameplay. In separate trials, proprioceptive and visual feedback were selectively delayed, and differences in driving error between the conditions were used to calculate perceptual bias scores. Effects of autism diagnosis and age on bias scores were examined, controlling for sex, as were associations of perceptual bias with autism symptom severity (ADOS-2, SRS-2), attention-deficit symptom severity (Conners4 ADHD Total Scores) ratings, and IQ (general ability index, GAI). The ASD group exhibited significantly higher proprioceptive bias than did the TD group (p = 0.002). There was a trend for decreasing proprioceptive bias with age, but no significant diagnosis-by-age interaction. Increased proprioceptive bias correlated with higher autism severity and with lower IQ, but not ADHD symptoms. HaptiKart provides a highly scalable approach for measuring sensory-motor bias, revealing that individuals with ASD show elevated proprioceptive bias, correlating with autism severity. HaptiKart's sensory-motor bias measure may thereby serve as a digital biomarker for addressing autism heterogeneity in ways that can improve targeted intervention.
与来自环境的视觉（外在）输入相比，对来自身体的本体感觉（内在）感觉输入的过度依赖可能是自闭症谱系障碍（ASD）核心特征的基础。我们开发了一款引人入胜的电子游戏（“HaptiKart”），作为一种工具来检查患有ASD的儿童和成人在感觉运动偏差（本体感觉与视觉）方面的差异，以及这种偏差是否与年龄、自闭症核心特征和智力能力相关。81名年龄在8至31岁之间的参与者（33名患有ASD，48名发育正常，TD）玩了“HaptiKart”，这是一款带有力反馈方向盘的驾驶电子游戏，在游戏过程中提供“转向辅助”。在单独的试验中，本体感觉和视觉反馈被选择性延迟，并且使用不同条件下驾驶误差的差异来计算感知偏差分数。研究了自闭症诊断和年龄对偏差分数的影响，并对性别进行了控制，同时还研究了感知偏差与自闭症症状严重程度（ADOS-2，SRS-2）、注意力缺陷症状严重程度（Conners4多动症总分）评分以及智商（一般能力指数，GAI）之间的关联。ASD组表现出比TD组显著更高的本体感觉偏差（p = 0.002）。随着年龄增长，本体感觉偏差有下降的趋势，但没有显著的诊断与年龄的交互作用。本体感觉偏差增加与更高的自闭症严重程度和更低的智商相关，但与多动症症状无关。HaptiKart提供了一种高度可扩展的方法来测量感觉运动偏差，揭示了患有ASD的个体表现出更高的本体感觉偏差，这与自闭症严重程度相关。因此，HaptiKart的感觉运动偏差测量可能作为一种数字生物标志物，以能够改善靶向干预的方式解决自闭症的异质性问题。
