孤独症谱系障碍儿童眼睛回避的认知与神经机制

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interactions and communications, and presence of the restricted and repetitive behaviors (APA, 2013). Clinical observations and empirical research have repeatedly found that individuals with ASD exhibited atypical responses to the eyes: they showed diminished eye contacts toward others, compared with the typically developing (TD) counterparts. Two hypotheses have been proposed to explain the mechanisms underlying this eye avoidance in individuals with ASD: the gaze aversion and the gaze indifference hypotheses (Moriuchi, Klin, & Jones, 2017). The gaze aversion hypothesis proposes that individuals with ASD actively avoid looking at others’ eyes, due to their anxiety and uncomfortable responses elicited by the direct eye contacts (e.g., Kliemann, Dziobek, Hatri, Steimke, & Heekeren, 2010; Tanaka and Sung, 2013). In contrast, the gaze indifference hypothesis proposes that individuals with ASD show a passively omitted eye looking due to their insensitivity to the significance of social information conveyed by the eyes (Moriuchi, Klin, & Jones, 2017). Each of these two hypotheses has gained some empirical support from the previous studies. .By combining eye tracking, physiological recording, and functional magnetic resonance imaging (fMRI) techniques, the current project will systematically explore the eye-avoidance in children with ASD in terms of its influential factors, cognitive and neurophysiological mechanisms, and the developmental trajectories. We also aim to develop methods based on the eye avoidance in ASD for the early screening and intervention for children with ASD. Study 1 will use the eye tracking technique and the physiological recording to examine the cognitive mechanism and influential factors of the eye avoidance in children with ASD. Study 2 will use the eye tracking, the physiological recording, and fMRI techniques to explore the neurophysiological mechanisms underlying the eye avoidance in ASD. Using the longitudinal study design, Study 3 will track a group of high-risk infants of ASD for 2.5 years, to explore the developmental trajectory of the eye avoidance in ASD. We also propose to use the eye avoidance as a potential early biomarker for ASD to predict the diagnosis of ASD at 3 year old. Study 4 will use different training protocols for the different types of children with ASD. For the indifference-dominated children with ASD, we plan to use the training protocol based on the reward learning paradigms to increase their social motivation toward people’s faces and gazes; for the aversion-dominated children with ASD, we plan to use the training approach based on the systematic desensitization paradigm, to reduce their hyper-sensitivity toward other people’s direct eye gazes. .Our proposed project, if funded, will contribute theoretically to understand the underlying mechanisms and developmental trajectory of the eye avoidance and their related social interactive deficits in children with ASD. More importantly, our project will provide important insights into the development of early screening tools and individualized intervention protocols for individuals with ASD.

大量研究发现孤独症患者对眼睛的异常加工——相比正常人，他们往往回避看他人的眼睛。前人针对这一现象提出“眼睛漠视”和“眼睛厌恶”两种假说来解释其背后的机制。然而，现有研究并未就眼睛回避的机制进行完整的阐释。本课题针对这两种假说，拟结合眼动、生理及核磁共振脑成像技术，系统地探究孤独症儿童的眼睛回避的认知与神经生理机制，及其发生发展规律。利用纵向研究设计，揭示孤独症眼睛回避机制的发展规律的同时，把眼睛回避作为一个客观指标辅助孤独症的早期鉴别和筛查。我们还认为眼睛回避的机制可能存在个体差异，基于眼动和皮肤电反应可区分出不同孤独症的亚类型，并据此设计有针对性的训练方案：针对漠视型和厌恶型的孤独症儿童分别采取奖赏学习和系统脱敏法进行训练，从而改善眼睛回避。本课题的实施不仅可以从理论上加深对孤独症眼睛回避及相关的社交障碍的的认知神经机制和发展规律的了解，更有助于开发用于早期筛查和辅助治疗的技术和手段。

孤独症谱系障碍（ASD)是一种以社交障碍和刻板行为为主要特征的神经发育障碍。ASD发病率逐年升高，也因其难以治愈，已经成为一个不容忽视的公共卫生难题。与ASD的核心社交障碍有关，大量研究发现ASD患者的对社会信息的加工存在异常，特别是对眼睛的异常加工。相比正常人，他们往往回避看他人的眼睛。然而，这一眼睛回避现象背后的机制仍不明确。.本项目主要采用眼动等神经心理学手段，展开一系列研究，来探讨ASD眼睛回避现象的背后的机制。研究发现：（a)在交互场景下，ASD儿童相比于正常儿童，对他人眼神朝向不敏感，缺乏对延伸的社会性意义的理解；（b)ASD儿童相比于正常儿童，更缺乏自上而下的加工眼镜信息的动机；（c)ASD儿童表现出不一致的面孔注视模式，可能导致其感知到的世界更具有不确定性，从而影响社会交流;(d)课题组还发现ASD儿童面孔注视模式与其视听言语整合之间的关系，并通过调控ASD的面孔注视模式来提高其视听言语整合能力。此外，课题组还运用神经心理学手段，探讨辅助ASD早期筛查和分型的可能性。.本项目不仅有助于解释ASD眼睛回避的机制，从而促进对ASD社交障碍的心理病理机制的理解，也有助于开发和改进ASD的早期筛查和辅助诊断的技术手段。

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