Neural Response to Emotional Faces and Anxiety in Children with Autism Spectrum Disorder

Background: Anxiety is highly prevalent in children with Autism Spectrum Disorder (ASD; White et al., 2009). While it is well established that children with ASD have an atypical brain response to emotional faces (Dawson et al., 2004), there is less research examining anxiety dimensionally and how this comorbidity may affect a child’s neural response to social stimuli. This study investigated electrophysiological (EEG) brain response during a gaze-contingent paradigm that simulated face-to-face interactions.

Objectives: To examine the relationship between anxiety symptoms and face-processing event related brain potential (ERP) components in children with ASD with varying levels of anxiety.

Methods: ERPs were recorded from 24 youth with ASD (18 males, 6 females) and 22 typically developing (TD) controls (13 males, 9 females) using a 128 channel Geodesic Sensor Net). The sample was matched on age (ASD; M: 14.38, SD: 2.36, TD; M: 12.93, SD: 3.00) and IQ (ASD; M: 109.10, SD: 20.35, TD; M: 109.01, SD: 11.55). Participants were presented with 80 distinct photorealistic, animated faces matched for low-level visual features. Utilizing gaze-contingent eye tracking technology, stimuli responded to a participant’s direct fixation to the face by exhibiting happy or fearful emotions. P100 and N170 amplitudes and latencies were extracted from selected electrodes over the occipitotemporal scalp. Difference scores were calculated as Fear minus Happy condition. Anxious symptomology was measured using the following standardized child self-report measures: The Multidimensional Anxiety Scale for Children (MASC-C) and Social Anxiety Scale for Adolescence/Children (SAS-A/SASC-R). Correlations were conducted between the ERP difference scores and standard scores on the anxiety measures. Eye-tracking analyses (data collected using an EyeLink-1000 remote camera system) are ongoing.

Results: In children with ASD, greater left N170 Amplitude to Fear vs. Happy was associated social anxiety (SAS-A/SASC-R Fear of Negative Evaluation [r(24)=.428, p=.04], and MASC-C Humiliation/Rejection [r(23)=.380, p=.07]). Additionally, children with ASD had a shorter P100 Latency to Fear vs. Happy associated with physical symptoms of anxiety (MASC-C Tense/Restlessness [r(23)=-.616, p <.001], MASC-C Somatic/Automatic [r(23)=-.393, p=.06], MASC-C Physical Symptoms Total [r(23)=-.597, p <.001]), as well as overall anxiety (MASC-C Total [r(23)=-.406, p=.06]). Children in the TD group had a smaller right N170 Amplitude to Fear vs. Happy associated with social anxiety (MASC-C Humiliation/Rejection [r(22)=-.469, p=.03], MASC-C Performance Fears [r(22)=-.423, p=.05], MASC-C Social Anxiety Total [r(22)=-.479, p=.03]). Furthermore, the TD group had a smaller right P100 Amplitude to Fear vs. Happy associated with social anxiety (MASC-C Performance Fears [r(22)=-.427, p=.05], MASC-C Social Anxiety Total [r(22)=-.426, p=.05]). No other significant associations were found between the N170 or the P100 Amplitude or latencies and the other subscales of the SAS-A/SASC-R

Conclusions: Results demonstrate that anxiety influences brain response to emotional faces in ASD, providing information potentially useful for stratification in a heterogeneous population. Understanding the role of anxiety in relation to social-communicative biomarkers may lead to targeted, biologically informed treatments.