The Neural Mechanisms of Gaze-Based Social Interaction in Adults with High-Functioning Autism: Investigating the Effects of Predictability

Background: Autism is characterized by impairments in communication and social interaction. Recent findings indicate that this might be due to disturbances in the automatic integration of social cues for decision-making. In addition, it has been proposed that low levels of predictability of the outcome of an interaction might be particularly problematic for individuals with autism.

Objectives: Hence, the main focus of this study is to examine whether the predictability of the outcome of an interaction has an influence on the neural basis of social encounters in adults with autism.

Methods: In a combined fMRI and eyetracking study individuals with high-functioning autism (HFA) and matched healthy controls were, therefore, asked to interact with a virtual character via gaze, who they believed was controlled by a real person outside the scanner. In contrast to this cover story, the agent’s gaze behavior was systematically varied on a trial-by-trial basis to either follow or not follow the participant’s gaze. Additionally, trials were either initiated with a cue predicting the outcome of the interaction or not. Accordingly, we analyzed how differences in the prior knowledge about the person’s behavior would influence the neural activation patterns during gaze-based social interaction in individuals with HFA compared to the control participants.

Results: Results replicate previous findings that demonstrate the involvement of reward-related neurocircuitry during gaze-following in control subjects. By contrast, in HFA participants, differential effects were observed in primary sensory areas, while effects in reward-related regions were more strongly modulated by the predictability of the outcome of the interaction.

Conclusions: In sum, this study offers valuable insights into the neural mechanisms of gaze-based social interactions in individuals with HFA by demonstrating modulatory effects of predictability on the neural processing of social interactions.