Influence of Attention and Arousal on Sensory Abnormalities in ASD

描述（由申请人提供）：对感官刺激的异常反应是自闭症谱系障碍（ASD）的常见临床特征。在许多标准化的评估中，感觉症状被包括在ASD的特征中，基于这些自我或观察报告的研究发现，在所有感觉模式中，感觉寻求或感觉回避的比例都有所增加，尽管这些异常的性质和受影响的感觉模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一个重要临床症状，但对其潜在机制的了解很少或根本没有。此外，由于关于这些症状的绝大多数证据仅基于行为描述，因此尚不清楚这些症状本质上是真正的感官症状，还是反映了一般唤醒水平、注意力或感知的异常。基于我们自己的工作和现有的证据，我们提出了一个模型，在这个模型中，ASD的基本感觉功能是完整的，而感觉行为的异常是由不良调节的唤醒和注意对感觉反应的影响造成的。我们建议使用脑电图（EEG）和年轻成人和儿童ASD唤醒的生理测量（皮肤电导和心率）来解决这个重要问题。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。各种各样的治疗干预针对感觉功能，但缺乏证据表明这些治疗的有效性。了解感觉异常的本质和感觉行为受到干扰的处理水平将指导更有效的治疗干预和/或特定的药物治疗的发展。因为异常的感觉行为是最麻烦的ASD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. PUBLIC HEALTH RELEVANCE: Over- or under-sensitivity to sights and sounds are among the most common clinical symptoms in ASD, but little is known about whether these problems are sensory in nature or secondary to problems with physiological alertness/arousal or attention. There are a variety of treatments for sensory symptoms, but there is little scientific base for these treatments or evidence that they are effective. This project will examine the nature of sensory abnormality in ASD in order to provide scientific guidance for drug or behavioral treatments of sensory symptoms.