Influence of Attention and Arousal on Sensory Abnormalities in ASD

描述(由申请人提供)：对感觉刺激的异常反应是自闭症谱系障碍(ASD)的常见临床特征。感觉症状被包括在一些标准化评估的ASD档案中，基于这些自我或观察报告的研究发现，在所有感觉形式中寻求感觉或感觉回避的比率增加，尽管这些异常的性质和受影响的感觉形式在个体之间差异很大。尽管普遍认为感觉异常是自闭症的重要临床症状，但对其潜在机制的了解很少或根本不了解。此外，由于绝大多数关于这些症状的证据仅基于行为描述，尚不清楚这些症状是否真的是感官性质的，或者它们是否反映了一般唤醒水平、注意力或知觉的异常。基于我们自己的工作和现有的证据，我们提出了一个模型，在该模型中，ASD的基本感觉功能是完整的，感觉行为的异常是由于调节不良的唤醒和注意对感觉反应的影响而导致的。我们建议在患有自闭症的年轻人和儿童中使用脑电(EEG)和生理唤醒测量(皮肤电导和心率)来解决这一重要问题。我们将评估听觉和视觉感觉功能，包括感觉反应、习惯化和神经反应恢复的水平，并将检查唤醒和注意对感觉反应的影响。针对感觉功能的治疗干预措施种类繁多，但几乎没有证据表明这些治疗的有效性。了解感觉异常的性质和感觉行为受到干扰的加工水平将指导开发更有效的治疗干预措施和/或特定的药物治疗。由于感觉行为异常是ASD最麻烦的症状之一，为这些症状的治疗提供科学依据将对该领域产生重大影响。

DESCRIPTION (provided by applicant): Abnormal responses to sensory stimulation are a commonly reported clinical feature of autism spectrum disorder (ASD). Sensory symptoms are included in the ASD profile on a number of standardized assessments, and studies based on these self- or observational reports find increased rates of sensation seeking or sensation avoidance in all sensory modalities, although the nature and affected sensory modality of these abnormalities varies greatly between individuals. Despite the general consensus that sensory abnormalities are an important clinical symptom in autism, there is little or no understanding of the underlying mechanisms. Further, because the vast majority of evidence regarding these symptoms is based solely on behavioral descriptions, it is not clear if these symptoms are truly sensory in nature or if they reflect abnormalities of general arousal levels, attention or perception. Based upon our own work and existing evidence, we suggest a model in which basic sensory function is intact in ASD and abnormalities in sensory behavior result instead from the influence of poorly modulated arousal and attention on sensory responsiveness. We propose to address this important issue using electroencephalography (EEG) and physiological measures of arousal (skin conductance and heart rate) in young adults and children with ASD. We will assess auditory and visual sensory functions including levels of sensory response, habituation and neural response recovery, and will examine the influence of arousal and attention on sensory responsiveness. A wide variety of therapeutic interventions target sensory function, but there is scant evidence for the efficacy of these treatments. Understanding the nature of sensory abnormalities and the processing level at which sensory behavior is perturbed will guide the development of more effective therapeutic interventions and/or specific pharmacological treatments. Because abnormal sensory behavior is among the most troublesome of ASD symptoms, providing a scientific basis for treatment of these symptoms would have a significant impact on the field.