Effective connectivity in autism

The aim was to go beyond functional connectivity, by measuring in the first large‐scale study differences in effective, that is directed, connectivity between brain areas in autism compared to controls. Resting‐state functional magnetic resonance imaging was analyzed from the Autism Brain Imaging Data Exchange (ABIDE) data set in 394 people with autism spectrum disorder and 473 controls, and effective connectivity (EC) was measured between 94 brain areas. First, in autism, the middle temporal gyrus and other temporal areas had lower effective connectivities to the precuneus and cuneus, and these were correlated with the Autism Diagnostic Observational Schedule total, communication, and social scores. This lower EC from areas implicated in face expression analysis and theory of mind to the precuneus and cuneus implicated in the sense of self may relate to the poor understanding of the implications of face expression inputs for oneself in autism, and to the reduced theory of mind. Second, the hippocampus and amygdala had higher EC to the middle temporal gyrus in autism, and these are thought to be back projections based on anatomical evidence and are weaker than in the other direction. This may be related to increased retrieval of recent and emotional memories in autism. Third, some prefrontal cortex areas had higher EC with each other and with the precuneus and cuneus. Fourth, there was decreased EC from the temporal pole to the ventromedial prefrontal cortex, and there was evidence for lower activity in the ventromedial prefrontal cortex, a brain area implicated in emotion‐related decision‐making. Autism Res 2020, 13: 32–44 . © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary To understand autism spectrum disorders better, it may be helpful to understand whether brain systems cause effects on each other differently in people with autism. In this first large‐scale neuroimaging investigation of effective connectivity in people with autism, it is shown that parts of the temporal lobe involved in facial expression identification and theory of mind have weaker effects on the precuneus and cuneus implicated in the sense of self. This may relate to the poor understanding of the implications of face expression inputs for oneself in autism, and to the reduced theory of mind.