Preliminary efficacy of social reward value training in toddlers with elevated symptoms of autism

社会奖励价值训练对自闭症症状加重的幼儿的初步效果

• 批准号: 10240563
• 负责人: KATARZYNA CHAWARSKA
• 金额: $ 18.75万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-07 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10240563
• 关键词: Affect; Attention; Basal Ganglia; Birth; Brain; Characteristics; Child; Complex; Data; Development; Enrollment; Environment; Evaluation; Exhibits; Face; Family; Functional Imaging; Functional disorder; Future; Image; Impairment; Individual; Individual Differences; Infant; Intervention Studies; Laboratories; Learning; Longterm Follow-up; Maintenance; Modification; Mothers; Neonatal; Parents; Participant; Pilot Projects; Property; Protocols documentation; Resources; Rest; Rewards; Severities; Siblings; Signal Transduction; Smiling; Social Values; Stimulus; Symptoms; System; Testing; Time; Toddler; Training; Treatment Protocols; Visual attention; acceptability and feasibility; autism spectrum disorder; autistic children; base; cellular imaging; cohort; connectome; follow-up; gaze; hedonic; imaging approach; improved; individuals with autism spectrum disorder; long term memory; molecular imaging; neurodevelopment; novel; personalized medicine; predicting response; response; sample fixation; selective attention; sex; skills; social; social attention; visual tracking

One of the markers of autism spectrum disorders (ASD) in infants and toddlers is impaired selective attention to faces1-6 (Preliminary Study, PS#1). This impairment diminishes their ability to learn from and interact adaptively with others in real-world environments.7 Attentional selection in the social domain relies, in part, on one’s ability to encode reward values of people and store these values in long-term memory as stable values.8- 10 The ‘stable’ values (henceforth, ‘values’) are learned over the course of repeated learning opportunities, and once acquired, they are signaled rapidly, preferentially directing gaze to encoded faces of importance (high- value, HV) based on their hedonic or informative properties in the past.11 Automatic responses based on values stored in long-term memory are essential for survival when decisions have to be made rapidly (e.g., mother versus stranger). Learning about values is subserved by the reward learning system in the brain involving basal ganglia (BG) circuitry.11 This circuitry is implicated in the pathophysiology of ASD12, 13 and extant evidence suggests that individuals with ASD exhibit specific impairments in learning the reward value of social stimuli such as faces.14 (PS#2) Based on this evidence, we propose that limited attention to faces in toddlers with elevated autism symptoms (ASD+) is, in part, driven by impaired value learning in the social domain, affecting their ability to rapidly and preferentially select HV faces and ignore low-value (LV) faces in the complex real-world environment. Consequently, they exhibit diminished spontaneous attention to faces in general, and when they look at faces, they may distribute their limited attentional resources between high- (e.g., mother or therapist) and low-value (stranger) individuals in a trial-and-error fashion. We further hypothesize that reinforcing attention of children with ASD+ toward specific faces through social value training (SVT) will increase their attention to these faces in real-world environments. Here we propose to test a novel SVT in the ASD+ group at 18 months (n=48). In the proposed pilot study, ASD+ toddlers will undergo SVT using a gaze-contingent eye-tracking paradigm. SVT will be administered over a two-day period and the training effects will be assessed by changes in visual attention to HV faces as compared to LV faces between baseline, post-baseline (day 3), and a long-term follow-up (1 month) using two tasks: a laboratory selective attention (LSA) task and real-world selective attention (RWSA) task. We will also evaluate acceptability and feasibility of the value training and contribution of sex, nonverbal developmental level, and severity of autism symptoms to response to the training. Taking advantage of the overlapping cohorts between Projects 1 (neonatal imaging) and Project 5, we will examine if characteristics of resting-state functional connectivity at birth predict response to training in the ASD+ toddlers. To our best knowledge, this is the first study to directly target a marker for ASD by engaging the reward learning system and to evaluate functional integrity of neonatal connectome as a potential predictor of response to training at 18 months.

自闭症谱系障碍（ASD）的标志之一是婴幼儿的选择性注意力受损 至面1 -6（初步研究，PS#1）。这种损害削弱了他们的学习能力和互动能力 在现实世界中，注意力选择在一定程度上依赖于 一个人对人们的奖励价值进行编码并将这些价值作为稳定的价值储存在长期记忆中的能力。 10.“稳定”的价值观（以下简称“价值观”）是在反复学习的过程中学到的， 一旦获得，它们就被迅速地发送信号，优先地将视线引导到重要性（高， 价值，HV）基于其过去的享乐或信息属性。 存储在长期存储器中的值在必须快速做出决定时对于生存是必不可少的（例如， 陌生人（Stranger）大脑中的奖励学习系统有助于学习价值观 涉及基底神经节（BG）回路。11该回路与ASD的病理生理学有关12，13， 现存的证据表明，ASD患者在学习奖励价值方面表现出特定的障碍， 社会刺激，如面孔。14（PS#2）基于这一证据，我们提出，有限的注意面孔， 自闭症症状升高的幼儿（ASD+）部分是由社会中受损的价值学习驱动的。 域，影响他们快速和优先选择HV面孔并忽略低价值（LV）面孔的能力。 复杂的现实环境。因此，他们表现出对面孔的自发注意力减少， 一般来说，当他们看脸时，他们可能会将有限的注意力资源分配给高- (e.g.,母亲或治疗师）和低价值（陌生人）的个人在试错的方式。我们进一步 假设通过社会价值训练加强ASD+儿童对特定面孔注意 (SVT)会增加他们对现实世界中这些面孔的注意力。在这里，我们打算测试一部小说， ASD+组18个月时的SVT（n=48）。在拟议的试点研究中，ASD+幼儿将接受SVT 使用视情况而定的眼动追踪模式。SVT将在两天内进行， 训练效果将通过与LV面部相比，HV面部的视觉注意力变化进行评估， 基线、基线后（第3天）和长期随访（1个月），使用两项任务：实验室选择性 注意（LSA）任务和现实世界选择性注意（RWSA）任务。我们还将评估可接受性， 价值训练的可行性及性别、非言语发展水平和自闭症严重程度的贡献 症状对训练的反应。利用项目1之间的重叠队列 （新生儿成像）和项目5，我们将检查是否在静息状态下的功能连接的特点， 出生预测ASD+幼儿对训练的反应。据我们所知，这是第一次直接研究 通过参与奖励学习系统来瞄准ASD的标记，并评估 新生儿连接体作为18个月时训练反应的潜在预测因子。