title: Intrinsic Visual-Motor Synchrony Correlates With Social Deficits in Autism.
abstract: BACKGROUND
  Imitation, which is impaired in children with autism spectrum disorder (ASD) and critically depends on the integration of visual input with motor output, likely impacts both motor and social skill acquisition in children with ASD; however, it is unclear what brain mechanisms contribute to this impairment. Children with ASD also exhibit what appears to be an ASD-specific bias against using visual feedback during motor learning. Does the temporal congruity of intrinsic activity, or functional connectivity, between motor and visual brain regions contribute to ASD-associated deficits in imitation, motor, and social skills?
  
  
  METHODS
  We acquired resting-state functional magnetic resonance imaging scans from 100 8- to 12-year-old children (50 ASD). Group independent component analysis was used to estimate functional connectivity between visual and motor systems. Brain-behavior relationships were assessed by regressing functional connectivity measures with social deficit severity, imitation, and gesture performance scores.
  
  
  RESULTS
  We observed increased intrinsic asynchrony between visual and motor systems in children with ASD and replicated this finding in an independent sample from the Autism Brain Imaging Data Exchange. Moreover, children with more out-of-sync intrinsic visual-motor activity displayed more severe autistic traits, while children with greater intrinsic visual-motor synchrony were better imitators.
  
  
  CONCLUSIONS
  Our twice replicated findings confirm that visual-motor functional connectivity is disrupted in ASD. Furthermore, the observed temporal incongruity between visual and motor systems, which may reflect diminished integration of visual consequences with motor output, was predictive of the severity of social deficits and may contribute to impaired social-communicative skill development in children with ASD.
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: mb@jhmi.edu.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Nebel
authors.affiliation: Department of Biostatistics, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Ani
authors.initials: A
authors.lastname: Eloyan
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Nettles
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Sweeney
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: Katarina
authors.initials: K
authors.lastname: Ament
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Ward
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Providence, Rhode Island; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Choe
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Anita D
authors.initials: AD
authors.lastname: Barber
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Providence, Rhode Island; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland.
authors.forename: James J
authors.initials: JJ
authors.lastname: Pekar
authors.affiliation: Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Stewart H
authors.initials: SH
authors.lastname: Mostofsky
mesh_terms: D000067877:Autism Spectrum Disorder / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D005260:Female; D005868:Gestures; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009434:Neural Pathways / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012146:Rest; D012720:Severity of Illness Index; D012919:Social Behavior; D014796:Visual Perception / Q000502:physiology*
keywords: Autism; Functional connectivity; Imitation; Independent component analysis; Symptom severity; Visual-motor integration