Brain Advance Access originally published online on August 19, 2004
Brain 2004 127(12):2703-2716; doi:10.1093/brain/awh289
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Brain Vol. 127 No. 12 © Guarantors of Brain 2004; all rights reserved
The brain response to personally familiar faces in autism: findings of fusiform activity and beyond
1 Department of Neurosciences, 2 Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093 and 3 Center for Autism Research, Children's Hospital, San Diego, CA, USA
Correspondence to Karen Pierce, 8110 La Jolla Shores Drive, La Jolla, CA 92037, USA E-mail: karen{at}brain.ucsd.edu
Past functional MRI (FMRI) studies of autism have reported reduced activation in response to the faces of strangers primarily in the ‘fusiform face area’ (FFA). An alternative and potentially stronger test of FFA function in autism is one that attempts to affect levels of FFA activity using factors believed to modulate function in this brain region, such as face familiarity and the perception of face identity. The current study presented personally meaningful faces, such as mother and co-worker, as well as stranger faces in a rapid event-related FMRI design. Seven autistic and nine normal control adults participated and pressed a button in response to all female faces. A deconvolution analysis revealed significant FFA activity in response to familiar and stranger faces in both autism and normal control groups. Individuals with autism also showed greater fusiform activity in response to familiar faces than stranger faces, as well as the prototypical right hemisphere dominance in response to both types of faces. Normal subjects showed additional activation to familiar faces in the posterior cingulate, amygdala and medial frontal lobes, including the anterior cingulate. Subjects with autism showed a similar, but more limited, network in response to familiar faces. This network included the amygdala and implies that this structure, involved in multiple socio-emotional functions, can be responsive in autism in the presence of stimuli that represent high reward value, such as mother's face. Furthermore, the presence of a distinct network to process familiar faces in autism, one that included limbic structures and was not found in response to the faces of strangers, suggests socio-emotional processing in autism. A potentially noteworthy trend, however, was evidence for a reduction in medial frontal lobe function in the autism group. The main finding of FFA activity in autism stands in contrast to most past FMRI studies of face processing in this disorder. This positive result may reflect the use of personally significant faces that enhanced attention and motivation in the autistic participants. Furthermore, given the proposed role of the FFA in establishing person identity, the use of almost a dozen different personally familiar faces for each participant (totalling 32 non-repeating faces) may have additionally maximized FFA involvement. Therefore, dysfunction in the FFA found in other studies of autism may reflect defects in systems that modulate the FFA, rather than the FFA itself.
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