Walsh Melissa J M, Baxter Leslie C, Smith Christopher J, Braden B Blair
Department of Speech and Hearing Science, Arizona State University, 976 S Forest Mall, Tempe, AZ 85281.
Department of Neuroimaging Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ 85013.
Res Autism Spectr Disord. 2019 Jul;63:63-77. doi: 10.1016/j.rasd.2019.02.008. Epub 2019 Mar 30.
Research suggests adults with autism spectrum disorder (ASD) may use executive functions to compensate for social difficulties. Given hallmark age-related declines in executive functioning and the executive brain network in normal aging, there is concern that older adults with ASD may experience further declines in social functioning as they age. In a male-only sample, we hypothesized: 1) older adults with ASD would demonstrate greater ASD-related social behavior than young adults with ASD, 2) adults with ASD would demonstrate a greater age group reduction in connectivity of the executive brain network than neurotypical (NT) adults, and 3) that behavioral and neural mechanisms of executive functioning would predict ASD-related social difficulties in adults with ASD.
Participants were a cross-sectional sample of non-intellectually disabled young (ages 18-25) and middle-aged (ages 40-70) adult men with ASD and NT development (young adult ASD: =24; middle-age ASD: =25; young adult NT: =15; middle-age NT: =21). We assessed ASD-related social behavior via the self-report Social Responsiveness Scale-2 (SRS-2) Total Score, with exploratory analyses of the Social Cognition Subscale. We assessed neural executive function via connectivity of the resting-state executive network (EN) as measured by independent component analysis. Correlations were investigated between SRS-2 Total Scores (with exploratory analyses of the Social Cognition Subscale), EN functional connectivity of the dorsolateral prefrontal cortex (dlPFC), and a behavioral measure of executive function, Tower of London (ToL) Total Moves.
We did not confirm a significant age group difference for adults with ASD on the SRS-2 Total Score; however, exploratory analysis revealed middle-age men with ASD had higher scores on the SRS-2 Social Cognition Subscale than young adult men with ASD. Exacerbated age group reductions in EN functional connectivity were confirmed (left dlPFC) in men with ASD compared to NT, such that older adults with ASD demonstrated the greatest levels of hypoconnectivity. A significant correlation was confirmed between dlPFC connectivity and the SRS-2 Total Score in middle-age men with ASD, but not young adult men with ASD. Furthermore, exploratory analysis revealed a significant correlation with the SRS-2 Social Cognition Subscale for young and middle-aged ASD groups and ToL Total Moves.
Our findings suggest that ASD-related difficulties in social cognition and EN hypoconnectivity may get worse with age in men with ASD and is related to executive functioning. Further, exacerbated EN hypoconnectivity associated with older age in ASD may be a mechanism of increased ASD-related social cognition difficulties in older adults with ASD. Given the cross-sectional nature of this sample, longitudinal replication is needed.
研究表明,患有自闭症谱系障碍(ASD)的成年人可能会利用执行功能来弥补社交困难。鉴于正常衰老过程中执行功能和执行脑网络存在与年龄相关的标志性衰退,人们担心患有ASD的老年人随着年龄增长社交功能可能会进一步下降。在一个仅包含男性的样本中,我们提出了以下假设:1)患有ASD的老年人比患有ASD的年轻人表现出更多与ASD相关的社交行为;2)患有ASD的成年人与神经典型(NT)成年人相比,执行脑网络的连通性在年龄组间的下降幅度更大;3)执行功能的行为和神经机制可以预测患有ASD的成年人中与ASD相关的社交困难。
参与者是一个横断面样本,包括非智力残疾的年轻(18 - 25岁)和中年(40 - 70岁)患有ASD和NT发育的成年男性(年轻成年ASD组:n = 24;中年ASD组:n = 25;年轻成年NT组:n = 15;中年NT组:n = 21)。我们通过自我报告的社交反应量表 - 2(SRS - 2)总分评估与ASD相关的社交行为,并对社交认知子量表进行探索性分析。我们通过独立成分分析测量的静息态执行网络(EN)的连通性来评估神经执行功能。研究了SRS - 2总分(对社交认知子量表进行探索性分析)、背外侧前额叶皮层(dlPFC)的EN功能连通性以及执行功能的行为测量指标伦敦塔(ToL)总步数之间的相关性。
我们没有证实患有ASD的成年人在SRS - 2总分上存在显著的年龄组差异;然而,探索性分析显示,患有ASD的中年男性在SRS - 2社交认知子量表上的得分高于患有ASD的年轻成年男性。与NT相比,患有ASD的男性在EN功能连通性上年龄组间的下降更为明显(左侧dlPFC)得到了证实,以至于患有ASD的老年人表现出最大程度的低连通性。在患有ASD的中年男性中,dlPFC连通性与SRS - 2总分之间证实存在显著相关性,但在患有ASD的年轻成年男性中未发现。此外,探索性分析显示,年轻和中年ASD组的SRS - 2社交认知子量表与ToL总步数之间存在显著相关性。
我们的研究结果表明,患有ASD的男性中与ASD相关的社交认知困难和EN低连通性可能会随着年龄增长而恶化,并且与执行功能有关。此外,ASD中与年龄较大相关的EN低连通性加剧可能是患有ASD的老年人中与ASD相关的社交认知困难增加的一种机制。鉴于该样本的横断面性质,需要进行纵向重复研究。