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Functional imbalance of visual pathways indicates alternative face processing strategies in autism

From the Department of Psychiatric Neurophysiology (Drs. Hubl, Federspiel, Strik, and Dierks), University Hospital of Clinical Psychiatry, Bern, Switzerland; and Department of Child and Adolescent Psychiatry (Drs. Bölte and Pousstka, S. Feineis–Matthews) and Institute of Neuroradiology (Dr. Lanfermann), Department of Radiology, University of Frankfurt, Germany.

Address correspondence and reprint requests to Dr. D. Hubl, Department of Psychiatric Neurophysiology, University Hospital of Clinical Psychiatry, Bolligenstrasse 111, CH-3000, Bern, Switzerland 60; e-mail: hubl{at}puk.unibe.ch

Objective: To investigate whether autistic subjects show a different pattern of neural activity than healthy individuals during processing of faces and complex patterns.

Methods: Blood oxygen level–dependent (BOLD) signal changes accompanying visual processing of faces and complex patterns were analyzed in an autistic group (n = 7; 25.3 [6.9] years) and a control group (n = 7; 27.7 [7.8] years).

Results: Compared with unaffected subjects, autistic subjects demonstrated lower BOLD signals in the fusiform gyrus, most prominently during face processing, and higher signals in the more object-related medial occipital gyrus. Further signal increases in autistic subjects vs controls were found in regions highly important for visual search: the superior parietal lobule and the medial frontal gyrus, where the frontal eye fields are located.

Conclusions: The cortical activation pattern during face processing indicates deficits in the face-specific regions, with higher activations in regions involved in visual search. These findings reflect different strategies for visual processing, supporting models that propose a predisposition to local rather than global modes of information processing in autism.

Received February 14, 2002. Accepted in final form July 22, 2003.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table ofContents for the November 11 issue to find the title link for this article.

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