Bridging the Internal and External Sensory Worlds in Autism

项目摘要 改变的感觉体验在自闭症中很普遍，不仅与核心神经系统有关， 行为特征受损的社会沟通和重复行为，但在一系列的 相关的合并症，包括睡眠障碍2和焦虑24。最近在感觉领域的工作 强烈表明，可预测性，或缺乏，感官刺激严重影响异常 反应和介导自闭症的感觉灵敏度，焦虑和社会动机之间的关系78 -79。 到目前为止，大多数感觉研究都强调了外感受性感觉--感觉信号起源于大脑皮层。 外部环境-较少的工作对内感受性感觉-感觉信号，来自内脏 和皮肤来向大脑发出关于身体的生理状况的信号6。这些内感受线索通常 情绪体验的前体，因此在以下方面具有重要的跨诊断临床相关性： 精神病学评估外部环境的情感相关性-社会刺激是 嵌入-需要外感受器和内感受器之间持续的信息交换 处理流。换句话说，社交世界的成功导航依赖于多感官 跨越身体边界的整合。对于自闭症来说，至关重要的是，许多内脏内感受信号往往是 非常有节奏（例如，心脏信号），和/或在自主控制下（例如，呼吸信号），因此 远比环境外感受线索更容易预测。平均而言，这种可预测性在以下方面得到增强： 自闭症患者的心率往往比对照组更高，心率变异性更低。在 在本项目期间，我们发现了内脏内感受性的时间整合被严重破坏的证据。 和外感受信号，而没有明确的证据，破坏内感受单独。我们现在建议，在这个 更新，以隔离和测试潜在的神经驱动程序和这种中断的整合的临床后遗症。的 拟议的工作将为感官处理缺陷的后果提供重要的新见解， 自闭症超越了外感受性感觉，包含了一个与自闭症高度相关的感觉环境。 社会情感功能

PROJECT SUMMARY Altered sensory experiences are prevalent in autism and have been implicated in not only the core behavioral characteristics of impaired social communication and repetitive behaviors, but in a range of associated comorbidities including sleep disturbances2 and anxiety24. Recent work in the sensory domain strongly suggests that the predictability, or lack thereof, of sensory stimuli heavily influences aberrant reactions and mediates relations between sensory sensitivity, anxiety, and social motivation in autism78-79. Most sensory research thus far has emphasized exteroceptive sensation—sensory signals that originate in the external environment—with less work on interoceptive sensation—sensory signals that arise from the viscera and skin to signal the brain about the physiological condition of the body6. These interoceptive cues are often the precursors of emotional experience, and thus have significant transdiagnostic clinical relevance in psychiatry. Evaluation of the emotional relevance of the external environment—within which social stimuli are embedded—requires a continuous exchange of information between exteroceptive and interoceptive processing streams. In other words, successful navigation of the social world depends on multisensory integration across the body boundary. Critically for autism, many visceral interoceptive signals tend to be very rhythmic (e.g., cardiac signals), and/or are under voluntary control (e.g., respiratory signals) and are thus far more predictable than environmental exteroceptive cues. This predictability is enhanced on average in individuals with autism, who tend to have higher heart rates and lower heart rate variability than controls. In the current project period, we found evidence for profoundly disrupted temporal integration of visceral interoceptive and exteroceptive signals, without clear evidence of disrupted interoception alone. We now propose, in this renewal, to isolate and test potential neural drivers and clinical sequelae of this disrupted integration. The proposed work will provide important new insights into the consequences of sensory processing deficits in autism that go beyond exteroceptive sensation, incorporating a sensory milieu that has high relevance for social-emotional functioning.