Are aging outcomes worse for women with autism? Sex differences in the neurocircuitry of symptom camouflaging and its vulnerability to aging

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7. Project Summary/Abstract Women with autism spectrum disorder (ASD) show more compensation for ASD traits than men (termed camouflaging); to do so, they may capitalize more on cognitive control and underlying fronto-subcortical connectivity. In our data, older women with ASD show lower cognitive control abilities and a stronger coupling between cognitive control and camouflaging than men; thus, older age may have a more dramatic impact on symptom presentation in women with ASD than men. The long-term goal of this research is to elucidate the ecological and neurobiological mechanisms underlying lifespan changes in symptom presentation in ASD. The specific aims of this proposal are to 1) characterize the neural connectivity correlates of camouflaging in a large sample of adult men and women with ASD and 2) determine sex differences in the vulnerability of camouflaging and underlying brain circuits to aging in older adults with ASD. Significance: This study will identify the sex- specific brain networks underlying camouflaging in ASD and their vulnerability to aging. Findings will inform biologically-based interventions in the less characterized and vulnerable older adult cohort with ASD. Methods: Aim 1 leverages open-access data and data from our lab; Aim 2 will examine our lab’s ongoing longitudinal data (2 and 4 year follow-ups). Camouflaging will be defined as the discrepancy between self-report/observed ASD traits. Brain connectivity will be measured via resting-state functional MRI (fMRI) and diffusion tensor imaging. Mrs. Walsh aspires to become an academic professor investigating the ecological and neurobiological mechanisms of compensation in ASD. Her long-term goal is to lead an interdisciplinary clinical laboratory dedicated to basic and translational science to improve adult outcomes in ASD. As a speech language pathologist, she has experience in pediatric phenotyping of ASD and clinical assessment of social behavior. In her PhD program, she has gained expertise in aging and ASD neuroscience; fMRI analysis; and neuropsychological evaluation. The training plan will fulfill the following goals to complement her current expertise: 1) advanced neuroimaging analysis (structural connectivity, longitudinal brain changes, and multi-site data); 2) phenotyping in adults with ASD; and 3) social psychological theory and methods for characterizing social behavior in ASD. Training in neuroimaging and social psychology methods will occur primarily at Arizona State University (ASU). ASU is a well-regarded, R1 institution with collaborations at Barrow Neurological Institute’s state-of-the-art neuroimaging facilities. Training in phenotyping of ASD will occur at the Southwest Autism Research and Resource Center, a community center dedicated to ASD research and clinical care across the lifespan. These institutions provide optimal supportive environments for Mrs. Walsh to meet her training goals. They are at the forefront of aging research in ASD, collaboratively, launching one of the first longitudinal studies of cognitive and brain aging in adults with ASD. In addition to the proposed goals, training will focus on professional development as a research scientist and dissemination of findings to the broader community.