Aperçu: G.M.
Le
trouble du spectre de l'autisme (TSA) est marqué par des difficultés
socio-communicatives et des anomalies dans le traitement sensoriel.
Les chercheurs ont examiné à la fois la perception de la douleur et l'anticipation chez des
adultes ayant un diagnostic de TSA et chez sujets contrôles sans TSA (HC) en utilisant un
paradigme de la douleur anticipée combiné à l'imagerie par résonance
magnétique fonctionnelle (IRMf) et à l'enregistrement concurrent de la
réponse de la conductance de la peau (SCR).
Les participants ont été invités à choisir un niveau de stimulation électrique qui leur semblerait modérément douloureux.
Par rapport au groupe HC, le groupe TSA a choisi un niveau de stimulation plus bas avant l'IRMf. Cependant,
les participants avec TSA ont montré une plus grande activation dans le
cortex cingulaire antérieur rostral et dorsal lors de l'anticipation de
la stimulation, mais pas pendant la délivrance de la stimulation. Il
n'y avait pas de différence de groupe significative dans l'activation
de l'insula avant l'anticipation ou la perception de la douleur. Cependant, l'activité dans l'insula antérieure gauche était en corrélation avec SCR pendant l'anticipation de la douleur.
Ensemble,
ces résultats suggèrent que le TSA est marqué par un niveau de anormalement plus élevé aux stimuli aversifs à venir, qui peuvent
refléter l'orientation attentionnelle anormale aux signaux nociceptifs
et un échec dans l'inférence interceptive (capacité à évaluer de manière exacte son activité physiologique).
Eur J Neurosci. 2017 Apr 27. doi: 10.1111/ejn.13598.
Heightened Brain Response to Pain Anticipation in High-Functioning Adults with Autism Spectrum Disorder
Gu X1, Zhou TJ2,3, Anagnostou E4, Soorya L5, Kolevzon A6,7, Hof PR7,8,9, Fan J2,6,7,8,9.
Author information
- 1
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235, USA.
- 2
- Department of Psychology, Queens College, The City University of New York, Flushing, NY, 11367, USA.
- 3
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA.
- 4
- Bloorview Research Institute, University of Toronto, Toronto, Canada, M4G 1R8.
- 5
- Department of Psychiatry, Rush University, Chicago, IL, 60612, USA.
- 6
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- 7
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- 8
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- 9
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
Abstract
Autism
spectrum disorder (ASD) is marked by both socio-communicative
difficulties and abnormalities in sensory processing. Much of the work
on sensory deficits in ASD has focused on tactile sensations and the
perceptual aspects of somatosensation, such as encoding of stimulus
intensity and location. Although aberrant pain processing has often been
noted in clinical observations of patients with ASD, it remains largely
uninvestigated. Importantly, the neural mechanism underlying
higher-order cognitive aspects of pain processing such as pain
anticipation also remains unknown. Here we examined both pain perception
and anticipation in high functioning adults with ASD and matched
healthy controls (HC) using an anticipatory pain paradigm in combination
with functional magnetic resonance imaging (fMRI) and concurrent skin
conductance response (SCR) recording. Participants were asked to choose a
level of electrical stimulation that would feel moderately painful to
them. Compared to HC group, ASD group chose a lower level of stimulation
prior to fMRI. However, ASD participants showed greater activation in
both rostral and dorsal anterior cingulate cortex during the
anticipation of stimulation, but not during stimulation delivery. There
was no significant group difference in insular activation during either
pain anticipation or perception. However, activity in the left anterior
insula correlated with SCR during pain anticipation. Taken together,
these results suggest that ASD is marked with aberrantly higher level of
sensitivity to upcoming aversive stimuli, which may reflect abnormal
attentional orientation to nociceptive signals and a failure in
interoceptive inference. This article is protected by copyright. All
rights reserved.
This article is protected by copyright. All rights reserved.
- PMID: 28452081
- DOI: 10.1111/ejn.13598