Autism: Mirroring, Neurofeedback, and Empathy. Jaime A. Pineda, Ph.D. University of California, San Diego U.S.A.

Transcription

1 Autism: Mirroring, Neurofeedback, and Empathy Jaime A. Pineda, Ph.D. University of California, San Diego U.S.A.

2 Outline of Talk 1. Autism and the mirror neuron theory 2. Mu rhythms and mirror neuron activity 3. Empathy and mu rhythms 4. Mu rhythm neurofeedback as neurological rehabilitation in autism

3 Au#sm Spectrum Disorders (ASD) Problems in: Social ability Language development Behavior

4 Common Characteris#cs of Social Dysfunc#ons Impairment in social play and imagina#on Difficulty interpre#ng ac#ons and inten#ons of others Inability to par#cipate in a reciprocal conversa#on Language delays Impaired joint/sustained aeen#on Trouble imita#ng others Absence of empathy

5 Mirror Neurons A class of neurons that discharge when the monkey performs an ac#on and when it observes a similar ac#on done by another agent Found in: area F5 (homolog of Broca s area) inferior parietal cortex (PF/PFG/7b) Ac+vated by: Goal directed ac#ons (reaching, grasping, holding) Observa#on of similar ac#ons performed by biological agents Di Pellegrino et al., Exp. Brain Res., 1992, 91,

6 Mirror Neuron Ac#vity Rizzolatti et al., Cogn. Brain Res., 1996, 3:

7 Perception-to-Action Mapping Selectivity Congruent (effector dependent; Kinematics of movement) Perception Action Logically-Related (effector independent; 2X; Goal of movement)

8 The Mirror Neuron Theory of Au#sm Au#sm as deficits in imita#on learning (Rogers and Pennington, 1991) MNS as the neural basis for imita#on learning (Iacoboni et al., 1999) Dysfunc#ons in MNS may help explain social dysfunc#ons in au#sm (Williams et al., 2001) If mirror neurons support the ability to imitate others and to understand the goal behind their ac7ons, the disrup7on of this system might also impair the later development of the ability to understand the state of mind of other individuals. (Iacoboni and Dapretto, 2006; Meltzoff and Decety, 2003; Oberman and Ramachandran, 2007; Rizzolatti et al., 2009)

9 Ac#va#on for Imita#on of Facial Emo#ons Dapretto et al., Nat Neurosci., 2006

10 Mu Rhythms and Mirror Neuron Ac#vity Mu rhythms reflect ac#vity in sensorimotor cortex that is modulated by MNS (Altschuler et al., 2000) Sensorimotor simula#on of observed ac#ons are reflected in mu rhythm ac#vity (Pineda, 2005)

11 Characteris#cs of the Human Mu Rhythm Maximal over sensorimotor areas AEenuated or blocked by movement Not affected by opening/closing the eyes Not affected by auditory/visual s#mula#on in the absence of movement Kuhlman, W.N., Electroenceph. Clin. Neurophys., 1978, 44: 83-93

12 The Mirror Neuron System mu rhythm (8-12 Hz) Normal Oscilla#ons at rest MNS Ac#vity - - > Suppression Iacoboni and Dapretto, Nature Reviews, 2006,7:

13 Are Mu Rhythms Affected by Ac#ons and the Observa#on of Ac#ons? Baseline Move Observe Imagine Pineda et al., IEEE Trans. Rehab. Engr., 2000, 8(2):

14 Do ASD Children Have A Dysfunc#onal MNS? RATIONALE If mu rhythms reflect MNS ac#vity then ASD individuals should show differences in mu rhythms compared to typically- developing controls Oberman et al., Brain Res Cogn Brain Res. 2005, 24(2):190-8.

15 Experimental Paradigm Measured mu power (2 min of EEG) in children (7-17 yrs): Typically developing (n=12) High func#oning ASD (n=10) Condi#ons Self- movement of hand Watching video of someone moving their hand Watching a video of balls moving up and down

16 ASD Children Exhibit an Absence of Mu Suppression to Observa#on of Ac#ons

17 Is the Mirror Broken and Unfixable? Oberman et al., Neuropsychologia, 2008

18 Do MNS Areas Modulate Mu Rhythms? Inferior frontal gyrus Sensorimotor cortex Superior temporal sulcus Inferior parietal lobule RATIONALE If mirror neurons in IFG are involved in the direct modula#on of sensorimotor mu rhythms, then temporary inhibi#on of these neurons should prevent suppression of mu rhythms and cause au#s#c- like behaviors. Keuken et al., Brain Research, 2011

19 Method: Transcranial Magne#c S#mula#on Measured EEG in typically developing adults (n=8) before and aher IFG s#mula#on Observa#on of movement (4 videos) Simple (hand movements) and complex (social interac#ons) Baron- Cohen s Eyes Task Emo#on and gender discrimina#on 1 Hz rtms (5 min at ~ 40-50% absolute threshold) targeted at leh IFG

20 IFG Inhibi#on Results in an Absence of Mu Suppression During Observa#on of Ac#ons

21 IFG Inhibi#on Reduces Behavioral Performance in an Emo#on Recogni#on Task Reaction Time Accuracy

22 Empathy and Mu Rhythms Simula#on theories argue that during the processing of emo#onal faces observers ac#vate sensorimotor representa#ons involved in crea#ng their own emo#onal facial expressions in order to recognize the emo#ons and infer the feelings and inten#ons of others (Adolphs, 2003; Goldman and Sripada, 2005).

23 Do mu rhythms reflect sensorimotor simula#on of facial expressions during empathy? N=22 undergraduate students at UCSD (11 males/females) 4 blocks of faces (happy and disgusted) in two condi#ons (empathy/non- empathy) and 2 blocks of buildings 40 unique photos for each emo#on (both genders; 3 ethnici#es) presented pseudorandomly Empathy: try to share the emo#ons felt and expressed by the photographed people Posi#ve and Nega#ve Affect Scale- Expanded (PANAS- X) filled out aher each empathy condi#on Non- empathy: rate how aerac#ve the photographed face is

24 Experimental Paradigm: Timing of Individual Trials

25 Methods 32 channels of EEG (linked mastoid) Bandpass: Hz; 500 Hz sampling rate Data were FIR filtered (4-30 Hz) A three- stage second- order blind iden#fica#on (SOBI) algorithm applied Remove EOG components Remove EMG components in brain ac#vity Iden#fy mu rhythm components

26 Leh Hemisphere Mu Component Clusters

27 Right Hemisphere Mu Component Clusters

28 Spectral Analysis Event- related spectral perturba#ons computed using wavelet decomposi#on with Morlet tapers A 2 (empathy/non- empathy) x 2 (happy/disgusted) repeated measures ANOVA

29 ERD present at 500 ms post s#mulus to both emo#ons regardless of empathy

30 ERSP Results

31 Neurofeedback as Neurological Rehabilita#on Based on operant condi#oning (learning) Noninvasive Posi#ve treatment outcomes obtained rapidly Few known adverse side effects Outcomes maintained long aher treatment ends Principled reason or theore#cal underpinning to why it would work

32 Applica#on of EEG Neurofeedback ADHD Substance abuse Anxiety Depression Epilepsy OCD Learning disabili#es Migraines Pain Cogni#ve impairments Sleep dysregula#on

33 Neurofeedback and Au#sm SM Cortex Frontal - parietal areas may be underconnected If we change the dynamics of the sensorimotor mu oscilla#ons, And these oscilla#ons are func#onally linked to the MNS network (IFG, IPL, STS), Then we may affect func#onal connec#vity via neuroplas#c changes and recover MNS engagement This can lead to posi#ve changes. IPL IFG STS

34 BCI System Mul#channel Feature Extrac#on Interface Technology Data Acquisi#on PaEern Recogni#on Mapping to Keyboard Commands User Applica#on

35 Mu Rhythm- based Neurological Rehabilita#on Amplitude Training at C4 30 min x 3/week x 10/20 weeks HF ASD: 7-17 yr olds, n=27 Experimental/Control groups Mu ac#vity above threshold (E) EMG ac#vity below threshold (E/C) Pineda et al., Research in ASD, 2008

36 Pre/Post Assessments Verifica#on of diagnosis (IQ, ADI, ADOS) Quan#ta#ve EEG Test of Variable AEen#on (TOVA) Imita#on ability (Apraxia imita#on) Mu suppression index (MSI) Au#sm Treatment Evalua#on Checklist Neuroimaging (fmri, fcmri, DTI, MRS)

37 TD and ASD Groups Learn to Control Mu Rhythms ASD TD

38 Global Changes in Amplitude and Coherence

39 ASD Group Shows Recovery of Mu Suppression following Training

40 ASD Group Shows Posi#ve Changes in Sustained AEen#on

41 ASD Groups Shows Posi#ve Changes in Parental Assessment Autism Treatment Evaluation Checklist

42 Conclusions 1. Findings support the mirror neuron theory of autism 2. EEG mu rhythms reflect mirror neuron activity 3. Aspects of empathy can be measured by changes in mu rhythms 4. Neurofeedback centered on mu rhythms has positive effects on symptoms of autism

43 Collaborators Vilayanur Ramachandran Lindsay Oberman Eric Altschuler Andrey Vankov Bill Skinner Chulie Ulloa Brendan Allison Ed Hubbard Joe McCleery Erin Hecht David Brang ScoE Carey MaE Schalles Robin Johnson Julia Stephen Adrienne Moore Rajiv Rao Chris Robinson Hanie Elfenbein Alex Bressler Steven Thurman Jena Davis Dong Suk Christa Futagaki Judith Kaye Lee Edwards Ralph- Axel Mueller Brandon Keehn Alan Lincoln Dick Gevirtz Oriana Clark Jia- Min Bai Derrick Asher Dane Chambers MaE Earhardt Heather Pelton Alicia Trigerio Albert Ayala Stephen Johnson Steve Gilmore Nick Pojman Kelly Head Michael Linden Tom Sullivan