Altered pre-ejection period response to social evaluative threat in adolescents with autism spectrum disorder

Abstract

Introduction The autonomic nervous system (ANS) is involved in regulating social behavior; Autism Spectrum Disorder (ASD) is characterized by alterations in social behavior and reduced physiological response to threat. We hypothesized that adolescents with ASD would show reduced ANS response to social threat. Methods Eighteen males with ASD and thirteen males with typical development (TD), ages 12 to 17, completed a social threat paradigm while wearing an impedance cardiography apparatus. We calculated pre-ejection period (PEP) and tested for between-group differences in PEP response to social threat. We also conducted correlation analyses between PEP change scores and clinical symptom scales. Results There was an effect of diagnosis on change in PEP from baseline to the onset of social threat (F=7.60, p=0.01), with greater changes in PEP in TD compared to ASD. PEP change score and the Social Communication Questionnaire (r=0.634, p=0.005) and the ADHD Problems Subscale of the Child Behavior Checklist (r=0.568, p=0.014) were correlated. Conclusions These findings suggest reduced arousal in response to social threat in ASD, with preliminary evidence that reduced sympathetic activation is associated with increased social behavior symptoms.

The pre-ejection period is a highly stress dependent parameter of paramount importance for pulse-wave-velocity based applications

“…Quite to the contrary, we were able to show that PEP is a parameter of high interindividual variability which is prone to large changes under the influence of mental and physical load. These results confirm and extend the findings of psychobiologists, who demonstrated individual differences in PEP response to situations of perceived stress ( 20 – 22 ).…”

“…On the contrary, works from the field of psychobiology have shown that PEP does change under stress ( 18 – 20 ). Moreover, the degree of PEP variation under stress seems to be highly variable between different individuals ( 21 , 22 ).…”

Stress System Activation in Children and Adolescents With Autism Spectrum Disorder

“…Besides, higher baseline RSA was related to higher levels of social skills, such as faster emotion recognition, in ASD children ( Van Hecke et al, 2009 ; Bal et al, 2010 ). Furthermore, adolescent males diagnosed with ASD (ages 12–17 years) had reduced SNS activation relative to TD controls, as indicated by the lower change in the pre-ejection period (PEP) (i.e., the interval from stimulation of the left heart ventricle to the opening of the aortic valve) at the onset of a modified version of the TSST ( Edmiston et al, 2017b ). The authors suggested that the reduced arousal in response to social cues may lead to reduced attention to social stimuli and subsequently to the altered social behaviors characterizing ASD ( Edmiston et al, 2017b ).…”

“…Furthermore, adolescent males diagnosed with ASD (ages 12–17 years) had reduced SNS activation relative to TD controls, as indicated by the lower change in the pre-ejection period (PEP) (i.e., the interval from stimulation of the left heart ventricle to the opening of the aortic valve) at the onset of a modified version of the TSST ( Edmiston et al, 2017b ). The authors suggested that the reduced arousal in response to social cues may lead to reduced attention to social stimuli and subsequently to the altered social behaviors characterizing ASD ( Edmiston et al, 2017b ). Nevertheless, to date, findings regarding the associations between ANS regulation and social skills in children and adolescents with ASD converge on the fact that better skills and fewer difficulties are associated with sympathetic withdrawal and parasympathetic increase during social interaction ( Neuhaus et al, 2016 ; Patriquin et al, 2019 ).…”

A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology

“…Although much research has investigated a role for HPA signaling in the relationship between autism and psychopathology, this has yielded inconsistent results. There is a large body of evidence suggesting global disruptions to cortisol signaling in autism (95,(185)(186)(187)(188)(189)(190)(191)(192)(193) and independent studies have reported HPA hyperactivation (185,188,194,195) and increased stress reactivity (186,196) in ASC. A relationship between elevated evening cortisol and psychopathology in ASC has been proposed (194); altered cortisol responses were associated with GAD and social anxiety in boys with ASC (197,198), while the cortisol awakening response was reported to correlate with depression and suicidal ideation in autistic girls (199).…”