title: Autistic adolescents show atypical activation of the brain's mentalizing system even without a prior history of mentalizing problems.
abstract: Some autistic children pass classic Theory of Mind (ToM) tasks that others fail, but the significance of this finding is at present unclear. We identified two such groups of primary school age (labelled ToM+ and ToM-) and a matched comparison group of typically developing children (TD). Five years later we tested these participants again on a ToM test battery appropriate for adolescents and conducted an fMRI study with a story based ToM task. We also assessed autistic core symptoms at these two time points. At both times the ToM- group showed more severe social communication impairments than the ToM+ group, and while showing an improvement in mentalizing performance, they continued to show a significant impairment compared to the NT group. Two independent ROI analyses of the BOLD signal showed activation of the mentalizing network including medial prefrontal cortex, posterior cingulate and lateral temporal cortices. Strikingly, both ToM+ and ToM- groups showed very similar patterns of heightened activation in comparison with the NT group. No differences in other brain regions were apparent. Thus, autistic adolescents who do not have a history of mentalizing problems according to our ToM battery showed the same atypical neurophysiological response during mentalizing as children who did have such a history. This finding indicates that heterogeneity at the behavioural level may nevertheless map onto a similar phenotype at the neuro-cognitive level.
authors.affiliation: Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: White
authors.affiliation: Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK.
authors.forename: Uta
authors.initials: U
authors.lastname: Frith
authors.affiliation: Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Rellecke
authors.affiliation: Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Al-Noor
authors.affiliation: Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK. Electronic address: sam.gilbert@ucl.ac.uk.
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D001321:Autistic Disorder / Q000150:complications* / Q000473:pathology*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D002648:Child; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D019416:Head Movements; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D056345:Theory of Mind
chemical_list: D010100:Oxygen
keywords: Autism; Development; Longitudinal; Social impairment; Theory of mind