Preliminary observations on the associations between sensory processing abnormalities and event-related potentials in adults with autism spectrum disorder.

Aim: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is thought to involve a variety of neurophysiological characteristics. Event-related potentials (ERPs) reflect cognitive functions in the brain's cognitive processing. In this study, we investigated differences in P300 and N100 of ERPs between ASD and typically developing groups and focused on the relationship between the components of ERPs and measures of autistic traits and sensory processing characteristics. Methods: ERPs were measured in 96 subjects in the ASD group and 62 subjects in the age- and sex-adjusted typically developing group. Correlations between each component and the scores of the Autism-Spectrum Quotient Japanese version (AQ-J) and the Adolescent and Adult Sensory Profile (AASP) were also evaluated. Results: The ASD group showed a significant decrease in the amplitude of N100 at C3. Furthermore, a negative correlation was found between lower amplitude at C3 of N100 and low registered sensory scores in both groups. Conclusion: Our findings imply that the N100 amplitude at C3 could be a potential indicator for examining the neurophysiological traits of ASD; however, these results should be interpreted with caution due to their preliminary nature. These tentative insights into sensory processing anomalies may be discernible in specific subsets of the ASD population, providing a foundation for future investigative pathways.

Feasibility of a wrist-worn wearable device for estimating mental health status in patients with mental illness.

Object: Real-world data from wearable devices has the potential to understand mental health status in everyday life. We aimed to investigate the feasibility of estimating mental health status using a wrist-worn wearable device (Fitbit Sense) that measures movement using a 3D accelerometer and optical pulse photoplethysmography (PPG). Methods: Participants were 110 patients with mental illnesses from different diagnostic groups. The study was undertaken between 1 October 2020 and 31 March 2021. Participants wore a Fitbit Sense on their wrist and also completed the State-Trait Anxiety Inventory (STAI), Positive and Negative Affect Schedule (PANAS), and EuroQol 5 dimensions 5-level (EQ-5D-5L) during the study period. To determine heart rate (HR) variability (HRV), we calculated the sdnn (standard deviation of the normal-to-normal interval), coefficient of variation of R-R intervals, and mean HR separately for each sleep stage and the daytime. The association between mental health status and HR and HRV was analyzed. Results: The following significant correlations were found in the wake after sleep onset stage within 3 days of mental health status assessment: sdnn, HR and STAI scores, HR and PANAS scores, HR and EQ-5D-5L scores. The association between mental health status and HR and HRV was stronger the closer the temporal distance between mental health status assessment and HR measurement. Conclusion: A wrist-worn wearable device that measures PPG signals was feasible for use with patients with mental illness. Resting state HR and HRV could be used as an objective assessment of mental health status within a few days of measurement.

Automatic evaluation-feedback system for automated social skills training.

Social skills training (SST), which is a rehabilitation program for improving daily interpersonal communication, has been used for more than 40 years. Although such training's demand is increasing, its accessibility is limited due to the lack of experienced trainers. To tackle this issue, automated SST systems have been studied for years. An evaluation-feedback pipeline of social skills is a crucial component of an SST system. Unfortunately, research that considers both the evaluation and feedback parts of automation remains insufficient. In this paper, we collected and analyzed the characteristics of a human-human SST dataset that consisted of 19 healthy controls, 15 schizophreniacs, 16 autism spectrum disorder (ASD) participants, and 276 sessions with score labels of six clinical measures. From our analysis of this dataset, we developed an automated SST evaluation-feedback system under the supervision of professional, experienced SST trainers. We identified their preferred or most acceptable feedback methods by running a user-study on the following conditions: with/without recorded video of the role-plays of users and different amounts of positive and corrective feedback. We confirmed a reasonable performance of our social-skill-score estimation models as our system's evaluation part with a maximum Spearman's correlation coefficient of 0.68. For the feedback part, our user-study concluded that people understood more about what aspects they need to improve by watching recorded videos of their own performance. In terms of the amount of feedback, participants most preferred a 2-positive/1-corrective format. Since the average amount of feedback preferred by the participants nearly equaled that from experienced trainers in human-human SSTs, our result suggests the practical future possibilities of an automated evaluation-feedback system that complements SSTs done by professional trainers.

The Validation of Automated Social Skills Training in Members of the General Population Over 4 Weeks: Comparative Study.

BACKGROUND: Social skills training by human trainers is a well-established method of teaching appropriate social and communication skills and strengthening social self-efficacy. Specifically, human social skills training is a fundamental approach to teaching and learning the rules of social interaction. However, it is cost-ineffective and offers low accessibility, since the number of professional trainers is limited. A conversational agent is a system that can communicate with a human being in a natural language. We proposed to overcome the limitations of current social skills training with conversational agents. Our system is capable of speech recognition, response selection, and speech synthesis and can also generate nonverbal behaviors. We developed a system that incorporated automated social skills training that completely adheres to the training model of Bellack et al through a conversational agent. OBJECTIVE: This study aimed to validate the training effect of a conversational agent-based social skills training system in members of the general population during a 4-week training session. We compare 2 groups (with and without training) and hypothesize that the trained group's social skills will improve. Furthermore, this study sought to clarify the effect size for future larger-scale evaluations, including a much larger group of different social pathological phenomena. METHODS: For the experiment, 26 healthy Japanese participants were separated into 2 groups, where we hypothesized that group 1 (system trained) will make greater improvement than group 2 (nontrained). System training was done as a 4-week intervention where the participants visit the examination room every week. Each training session included social skills training with a conversational agent for 3 basic skills. We evaluated the training effect using questionnaires in pre- and posttraining evaluations. In addition to the questionnaires, we conducted a performance test that required the social cognition and expression of participants in new role-play scenarios. Blind ratings by third-party trainers were made by watching recorded role-play videos. A nonparametric Wilcoxson Rank Sum test was performed for each variable. Improvement between pre- and posttraining evaluations was used to compare the 2 groups. Moreover, we compared the statistical significance from the questionnaires and ratings between the 2 groups. RESULTS: Of the 26 recruited participants, 18 completed this experiment: 9 in group 1 and 9 in group 2. Those in group 1 achieved significant improvement in generalized self-efficacy (P=.02; effect size r=0.53). We also found a significant decrease in state anxiety presence (P=.04; r=0.49), measured by the State-Trait Anxiety Inventory (STAI). For ratings by third-party trainers, speech clarity was significantly strengthened in group 1 (P=.03; r=0.30). CONCLUSIONS: Our findings reveal the usefulness of the automated social skills training after a 4-week training period. This study confirms a large effect size between groups on generalized self-efficacy, state anxiety presence, and speech clarity.

Eye-movement analysis on facial expression for identifying children and adults with neurodevelopmental disorders.

Experienced psychiatrists identify people with autism spectrum disorder (ASD) and schizophrenia (Sz) through interviews based on diagnostic criteria, their responses, and various neuropsychological tests. To improve the clinical diagnosis of neurodevelopmental disorders such as ASD and Sz, the discovery of disorder-specific biomarkers and behavioral indicators with sufficient sensitivity is important. In recent years, studies have been conducted using machine learning to make more accurate predictions. Among various indicators, eye movement, which can be easily obtained, has attracted much attention and various studies have been conducted for ASD and Sz. Eye movement specificity during facial expression recognition has been studied extensively in the past, but modeling taking into account differences in specificity among facial expressions has not been conducted. In this paper, we propose a method to detect ASD or Sz from eye movement during the Facial Emotion Identification Test (FEIT) while considering differences in eye movement due to the facial expressions presented. We also confirm that weighting using the differences improves classification accuracy. Our data set sample consisted of 15 adults with ASD and Sz, 16 controls, and 15 children with ASD and 17 controls. Random forest was used to weight each test and classify the participants as control, ASD, or Sz. The most successful approach used heat maps and convolutional neural networks (CNN) for eye retention. This method classified Sz in adults with 64.5% accuracy, ASD in adults with up to 71.0% accuracy, and ASD in children with 66.7% accuracy. Classifying of ASD result was significantly different (p<.05) by the binomial test with chance rate. The results show a 10% and 16.7% improvement in accuracy, respectively, compared to a model that does not take facial expressions into account. In ASD, this indicates that modeling is effective, which weights the output of each image.

Analysis of Feedback Contents and Estimation of Subjective Scores in Social Skills Training.

This paper introduces our analysis results on the feedback contents of Social Skills Training and the consequences of automated score estimation of users' social skills with computational multimodal features. Although previous work showed the possibility of a computerized SST system as a clinical tool, its feedback strategies have not been well-investigated. We focused on the feedback content given by experienced SST trainers in human-human SST sessions to overcome this limitation. We analyzed the points mentioned by experienced SST trainers to determine where they focused during social skills evaluation. We calculated multimodal computational features from video and audio recordings inspired by the results and trained machine learning models for social skills evaluation using these features as input. We trained social skill score prediction models with the highest scores of 0.53 for correlation coefficient and 0.26 for R2. Clinical relevance- We described our automated social skills evaluation method with machine learning models toward a computerized SST system, which can be an additional option to boost the effect of SST by experienced trainers in the future.

Reduced prefrontal hemodynamic response in pediatric autism spectrum disorder measured with near-infrared spectroscopy.

BACKGROUND: Functional neuroimaging studies suggest that prefrontal cortex dysfunction is present in people with autism spectrum disorder (ASD). Near-infrared spectroscopy is a noninvasive optical tool for examining oxygenation and hemodynamic changes in the cerebral cortex by measuring changes in oxygenated hemoglobin. METHODS: Twelve drug-naïve male participants, aged 7-15 years and diagnosed with ASD according to DSM-5 criteria, and 12 age- and intelligence quotient (IQ)-matched healthy control males participated in the present study after giving informed consent. Relative concentrations of oxyhemoglobin were measured with frontal probes every 0.1 s during the Stroop color-word task, using 24-channel near-infrared spectroscopy. RESULTS: Oxyhemoglobin changes during the Stroop color-word task in the ASD group were significantly smaller than those in the control group at channels 12 and 13, located over the dorsolateral prefrontal cortex (FDR-corrected P: 0.0021-0.0063). CONCLUSION: The results suggest that male children with ASD have reduced prefrontal hemodynamic responses, measured with near-infrared spectroscopy.

Intra-individual variability across cognitive task in drug-naïve pediatric patients with obsessive compulsive disorder.

Attention deficit is commonly observed in several psychiatric conditions. In particular, patients with attention deficit hyperactivity disorder exhibit not only attention deficit, but also intra-individual variability in response times (IIV-RT) during the performance of cognitive tasks related to attention span and sustained attention. Although obsessive compulsive disorder (OCD) is commonly observed across childhood, little is known about abnormalities in IIV-RT during the auditory odd-ball task, and how these changes relate to event-related potentials (ERPs) components. In the present study, we compared the ERPs of 15 adolescent and pediatric patients with OCD with 15 healthy age, sex, and IQ-matched controls. We found that tau of IIV-TR was not significantly different between the OCD group and controls, whereas the OCD group exhibited lower mu and sigma compared to controls. Furthermore, we revealed that P300 amplitude was significantly attenuated in the OCD group at Fz, C3, and C4, compared with controls. The present study thereby provided the first evidence that individuals with pediatric or adolescent OCD exhibit lower variability in reaction time in IIV-RT during an auditory odd-ball task than controls. These results suggest that there are no impairments in attention span and sustained attention in pediatric and adolescent patients with OCD.

A longitudinal event-related potential study of selective serotonin reuptake inhibitor therapy in treatment-naïve pediatric obsessive compulsive disorder patients.

Obsessive-compulsive disorder (OCD) is characterized by obsessive thoughts and/or compulsive behaviors, involving specific cognition and/or information processing disorders. Event-related potentials (ERPs) are commonly used as physiological measures of cognitive function. In conscious patients, ERPs are easily and non-invasively measured. Previous ERP studies have revealed differences between OCD patients and control subjects. Whether ERPs reflect the pharmacological effects of OCD treatment, particularly in treatment-naïve pediatric patients, remains unknown. We used the Child's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) to evaluate the symptomatic severity of 12 treatment-naïve pediatric OCD patients. Comparisons were made with 12 age-, sex-, and intelligence-matched controls. The P300 and mismatch negativity (MMN) components were measured during an auditory odd-ball task at baseline in both groups and after the 3-year serotonin reuptake inhibitor (SSRI) treatment in OCD patients. Compared with controls, P300 amplitudes were smaller n the OCD group at Fz, Cz, Pz, C3, and C4. After SSRI treatment, P300 amplitudes increased partly at Fz and C4 in association with symptomatic improvements. We found a significant positive correlation between P300 amplitude in C4 and CY-BOCS scores. Our findings confirm the utility of SSRIs in pediatric OCD, and suggest the utility of ERPs for evaluating pharmacological effects in treatment-naïve pediatric OCD patients.

Event-related potentials reflect the efficacy of pharmaceutical treatments in children and adolescents with attention deficit/hyperactivity disorder.

Few objective biological measures of pharmacological treatment efficacy exist for attention deficit/hyperactivity disorder (ADHD). Although we have previously demonstrated that event-related potentials (ERPs) reflect the effects of osmotic-release methylphenidate in treatment of naïve pediatric patients with ADHD, whether this is true for the therapeutic effects of atomoxetine (ATX) is unknown. Here, we used the Japanese version of the ADHD rating-scale IV to evaluate 14 patients with ADHD, and compared their ERP data with 14 age- and sex-matched controls. We measured P300 and mismatch negativity (MMN) components during an auditory oddball task before treatment (treatment naïve) and after 2 months of ATX treatment. Compared with controls, P300 components at baseline were attenuated and prolonged in the ADHD group at Fz (fronto-central), Cz (centro-parietal), Pz (parietal regions), C3 and C4 electrodes. ATX treatment reduced ADHD symptomology, and after 2 months of treatment, P300 latencies at Fz, Cz, Pz, C3, and C4 electrodes were significantly shorter than those at baseline. Moreover, MMN amplitudes at Cz and C3 electrodes were significantly greater than those at baseline. Thus, ERPs may be useful for evaluating the pharmacological effects of ATX in pediatric and adolescent patients with ADHD.

Event-Related Potentials Correlate with the Severity of Child and Adolescent Patients with Attention Deficit/Hyperactivity Disorder.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) symptoms can continue through adolescence and adulthood, including difficulty in staying focused, paying attention, and controlling behavior, as well as hyperactivity. While children and adolescents with ADHD have functional impairments at multiple dimensions, there are no objective biological indicators to assess the severity of ADHD. Event-related potentials (ERPs) are widely used as a noninvasive method for evaluating sensory and cognitive processes involved in attention tasks. Previous studies have shown that P300 amplitude or latency, a main component in ERPs, is altered in patients with ADHD. However, little is known about the relationship between P300 and the severity of ADHD symptoms. METHOD: We sought to measure both P300 amplitude and latency in ERPs during auditory oddball tasks in 44 patients with ADHD (mean age ± SD 10.28 ± 3.43 years) and 15 age- and gender-matched normally developing children (11.40 ± 3.02 years). In ADHD patients, we also assessed symptom severity using the ADHD rating scale-IV-Japanese version. RESULT: In ADHD groups, P300 amplitude and latency were attenuated and prolonged compared to controls at the frontocentral, centroparietal, and parietal positions. Furthermore, levels of P300 latency at these positions are positively correlated with the inattention subscale scores measured by the ADHD rating scale-IV-Japanese version. CONCLUSIONS: The present study revealed that the degree of P300 latency might reflect the severity of ADHD symptoms with children and adolescents, suggesting that ERPs are a useful technique to evaluate the severity of ADHD symptoms.

Prefrontal dysfunction in pediatric Tourette's disorder as measured by near-infrared spectroscopy.

BACKGROUND: Tourette's disorder (TD) is a chronic childhood-onset disorder characterized by the presence of multiple motor and vocal tics. Despite strong evidence that the pathophysiology of TD involves structural and functional disturbances of the basal ganglia and cortical frontal areas, in vivo imaging studies have produced conflicting results. Recent developments in near-infrared spectroscopy (NIRS) technology have enabled noninvasive assessment of brain function in people with psychiatric disorders. METHODS: We asked 10 individuals with pediatric TD and 10 healthy controls who were age- and sex- matched to perform the Stroop color-word task during NIRS. We used prefrontal probes and a 24-channel NIRS machine to measure the relative concentrations of oxyhemoglobin (oxy-Hb) every 0.1 s during the task. RESULTS: We found that oxy-Hb changes in the prefrontal cortex were significantly smaller in the TD group compared with the control group, especially in the left dorsolateral prefrontal cortex. CONCLUSIONS: Our data suggest that individuals with pediatric TD have a reduced prefrontal hemodynamic response as measured by NIRS.

Increased prefrontal hemodynamic change after atomoxetine administration in pediatric attention-deficit/hyperactivity disorder as measured by near-infrared spectroscopy.

AIM: Atomoxetine, approved in Japan for the treatment of pediatric attention-deficit/hyperactivity disorder (ADHD) in April 2009, is a nonstimulant that is thought to act presynaptically via the inhibition of norepinephrine reuptake. Near-infrared spectroscopy is a non-invasive optical tool that can be used to study oxygenation and hemodynamic changes in the cerebral cortex. The present study examined the effects of a clinical dose of atomoxetine on changes in prefrontal hemodynamic activity in children with ADHD, as measured by near-infrared spectroscopy using the Stroop Color-Word Task. METHODS: Ten children with ADHD participated in the present study. We used 24-channel near-infrared spectroscopy to measure the relative concentrations of oxyhemoglobin in the frontal lobes of participants in the drug-naïve condition and those who had received atomoxetine for 8 weeks. Measurements were conducted every 0.1 s during the Stroop Color-Word Task. We used the ADHD Rating Scale-IV-Japanese version (Home Version) to evaluate ADHD symptoms. RESULTS: We found a significant decrease in ADHD Rating Scale-IV-Japanese version scores, from 30.7 to 22.6 (P=0.003). During the Stroop Color-Word Task, we found significantly higher levels of oxyhemoglobin changes in the prefrontal cortex of participants in the atomoxetine condition compared with those in the drug-naïve condition. CONCLUSIONS: This increase in oxyhemoglobin changes might indicate an intensified prefrontal hemodynamic response induced by atomoxetine. Near-infrared spectroscopy is a sensitive tool for measuring the pharmacological effects of atomoxetine in children with ADHD.