Using a revolutionary technique called "hyperscanning" that allows for simultaneous fMRIs of multiple patients in the same setting, researchers at Baylor College have noted a major neurological abnormality affecting the way patients with Asperger's syndrome perceive themselves and their working relationships with others. Adolescents with Asperger's, a less disabling or "high functioning" variation on the autism spectrum, displayed less activity in a key region of the brain while playing a "trust game" with other subjects, leading researchers to assert that their sense of self-awareness and their ability to grasp the minutiae of the ongoing interaction were compromised by their condition. This study marks the first time the brains of autistic patients have been scanned while in the midst of social interaction, and it will certainly serve to further define the social cognition deficits created by autism.
The game, a standard clinical test used to assess a subject's sense of trust and reciprocity in social interactions, involves two individuals designated "trustee" and "investor." The latter decides how much of a given sum to lend to the trustee; the amount of money triples in the process and the trustee must then decide how much to compensate the investor. The game's most common results are predictable: both generosity and selfishness beget the same responses in turn. Participating Asperger's patients understood the game just as well as control subjects in other studies, and they did not play the game in a dramatically different manner, but their brains told another story, revealing a very unusual sense of perception regarding themselves and their playing partners.
The scans revealed, in a deeper sense, that individuals with Asperger's do not consider the responses of others in the same way that control patients do. Where unaffected subjects displayed a conscious desire to know that the other party favored and trusted them, Asperger's patients did not seem to experience the same need. Researchers called this discrepancy evidence of "an inability to perceive themselves as social creatures," noting that the patterns displayed by these patients more closely resembled those of control subjects playing similar games against a computer opponent. At the point in the game in which players decide how much to invest or return, their brains simply did not display the same level of activity in the cingulate cortex, an information-processing area of the brain most responsible for cooperative shared-reward impulses (particularly active during financial transactions). Confirming the connection: the degree of activity, or lack thereof, in this region corresponded with the severity of each patient's condition. While control subjects' brains shifted between conceptions of "self" and "other" during relevant phases of the game, the autistic patients seemed to make no such distinction.
These observations may further explain some of the social obstacles that autistic patients face every day: most have trouble speaking for their own interests or representing themselves. And the study highlights the fact that Asperger's, while considered a very mild form of the disorder, still affects brain functions on a dramatic scale. Some theorize that the autistic brain may, in some respects, be more or less constantly unengaged in the same way that those of control patients "switch themselves off" and bypass sensations of self-awareness when engaged in complex technical tasks that require intense concentration on varied stimuli. The same principle may explains the "face blindness" common to so many autistic children; they simply don't respond to others as independent entities because they fail to see themselves as such.
Drawing specific conclusions from this study and applying them to the treatment of autistic individuals may prove difficult, but brain scans focusing on the neurological process in question could, at the very least, help to determine the severity of a patient's condition. And the study's findings certainly lend a bit more credence to the perception of autistic individuals as socially aloof, and somewhat unaware of the way in which others see them, rather than self-centered or uncaring. This in itself is a crucial distinction.
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