Deficits in emotion recognition and processing in children with high callous-unemotional traits: the role of the MAOA gene.

Children with high Callous-Unemotional (CU) traits show deficits in recognizing and processing facial expressions. Alterations in emotion recognition have been linked to a higher synaptic concentration of monoaminergic neurotransmitters. The current study investigated the relationship between the MAOA-Low-activity alleles and the ability to recognize and process facial expressions in 97 male children (8-12 years old) diagnosed with disruptive behavior disorder. Participants completed a computerized emotion-recognition task while an eye-tracking system recorded the number (Fixation Count, FC) and length (Fixation Duration, FD) of fixations to the eye region of the emotional stimuli. Children with high CU traits exhibited lower scores in recognition of sadness and anger, and lower FC and FD for sadness and fear than children with low CU traits. Children carrying the MAOA-Low-activity alleles displayed lower FD for sadness, and FD and FC for fear than those carrying the MAOA-High-activity alleles. These genetic effects appeared even stronger in children with CU traits. Moderation analysis revealed that CU traits were associated with lower FC and FD for fear, and lower FD for sadness, probably due to the MAOA-Low-activity alleles. Our findings, although to be replicated, suggest MAOA-Low-activity alleles as potential genetic biomarkers to identify CU children in need of training focused on emotion processing.

Wearable sensors to measure the influence of sonic seasoning on wine consumers in a live context: a preliminary proof-of-concept study.

BACKGROUND: Any action capable of creating expectations about product quality would be able to modulate experienced pleasantness. In this context, during the 2022 edition of the Internet Festival (Pisa, Italy) a 'social experiment' was promoted to set up an affordable and reliable methodology based on wearable sensors to measure the emotions aroused in a live context on consumers by different kinds of wines. Therefore, five wines (two faulty ones and three high-quality samples) were proposed to 50 non-selected consumers in an arousing context with live jazz music as background. Both explicit (questionnaires) and two different approaches for implicit methods (electrocardiogram (ECG) recorded by wearable sensors vs. smartphones), the latter performed on a subgroup of 16, to measure the emotions aroused by wines and music were utilized synergistically. RESULTS: According to our findings: (i) wine undoubtedly generates a significant emotional response on consumers; (ii) this answer is multifaceted and attributable to the quality level of the wine tasted. In fact, all things being equal, while drinking wine even untrained consumers can perfectly recognize good wines compared to products of lower quality; (iii) high-quality wines are able to induce a spectrum of positive emotions, as observed by the analysis of ECG signals, especially when they are coupled with background music. CONCLUSION: The framework has certainly played to the advantage of good-quality wines, fostering their positive emotional characteristics on the palate even of some less experienced consumers, thanks to a dragging effect towards a positive mood generated by the surrounding conditions (good music in a beautiful location). © 2024 Society of Chemical Industry.

Taste the emotions: pilot for a novel, sensors-based approach to emotional analysis during coffee tasting.

BACKGROUND: Coffee is a natural drink with important properties for the human body and mind, capable of delivering energy and strong emotions, thus being appreciated since ancient times. The qualitative and quantitative assessment of the coffee properties is normally performed by trained panelists, though relying on standardized questionnaires, with possible biases arising. In this study, for the first time in the scientific literature, we applied a technology-based approach, based on the use of wearable sensors, to study the implicit emotional responses of a small cohort of experienced coffee judges, thus taking this chance to assess the feasibility of this approach in such a scenario. The merging of different technologies for capturing biomedical signals, including electrocardiogram, galvanic skin response, and electroencephalogram, was therefore adopted to retrieve results in terms of the relationships between implicit (i.e. psychophysiological) and explicit (i.e. derived from questionnaires) measurements. RESULTS: Significant correlations were obtained between biomedical signals and data from the questionnaires within all the sensory domains (olfaction, vision, taste) investigated, particularly concerning autonomic-related features. CONCLUSIONS: The results obtained confirmed the viability of this new approach in the psychophysical and emotional assessment in coffee tasting judges, paving the way for a new perspective into the universe of coffee quality assessment panels, eventually transferable to broader scale investigations, somewhat dealing with consumer satisfaction and neuromarketing at large. © 2023 Society of Chemical Industry.

Healthy aging: the INTECMAN project.

Aging is associated not only with the reduction of psychophysical and sensory capacities but also with different types of neurodegenerative disorders up to dementia manifestations. Aging in health and self-sufficiency is strictly dependent on the prevention and correction of factors that may determine reduction of psychophysical capacities (e.g., cardiovascular, locomotor and neurodegenerative ones). To reach this goal, due to the dynamics of social and family changes and to the aging of the population, health professionals can be supported by technologies which provide noninvasive monitoring of physiologic parameters and rely on telemedicine, both instruments of support and care for better aging in the home setting. The authors, starting from the initial idea of a personalized monitoring of different psychophysical variables, defined a pilot study to assess the role of a 12-month individually tailored lifestyle counseling on parameters of mild cognitive impairment in a group of elderly subjects. Data derived from the applied approach appeared promising and may open the road to the possible implementation of individual counseling, based on multiparametric non-obtrusive technologies which take into consideration both psychological and physical aspects, to be followed in the home environment.

Wearable Sensors for Assessing the Role of Olfactory Training on the Autonomic Response to Olfactory Stimulation.

Wearable sensors are nowadays largely employed to assess physiological signals derived from the human body without representing a burden in terms of obtrusiveness. One of the most intriguing fields of application for such systems include the assessment of physiological responses to sensory stimuli. In this specific regard, it is not yet known which are the main psychophysiological drivers of olfactory-related pleasantness, as the current literature has demonstrated the relationship between odor familiarity and odor valence, but has not clarified the consequentiality between the two domains. Here, we enrolled a group of university students to whom olfactory training lasting 3 months was administered. Thanks to the analysis of electrocardiogram (ECG) and galvanic skin response (GSR) signals at the beginning and at the end of the training period, we observed different autonomic responses, with higher parasympathetically-mediated response at the end of the period with respect to the first evaluation. This possibly suggests that an increased familiarity to the proposed stimuli would lead to a higher tendency towards relaxation. Such results could suggest potential applications to other domains, including personalized treatments based on odors and foods in neuropsychiatric and eating disorders.

Rich at risk: socio-economic drivers of COVID-19 pandemic spread.

COVID-19, the novel coronavirus affecting the most part of worldwide countries since early 2020, is fast increasing its prevalence around the world, representing a significant emergency for the population and the health systems at large. While proper treatments are being developed, in-depth studies concerning its way of diffusion are necessary, in order to understand how the virus is actually spreading, through the investigation on some socio-economic indicators for the various countries in the world, retrieved through open-access data publicly available. The correlation analysis displayed significant relationships between COVID-19 incidence with several of such indicators, including the Gross Domestic Product per capita and the number of flights per capita, whereas mortality is mainly related to the main age of the population. All such data displayed an interesting mean to understand the way the virus has diffused worldwide, possibly representing the basis for future preventive measures to effectively challenge a new COVID-19 pandemic wave, but also other, similar pandemics.

Contextual priors do not modulate action prediction in children with autism.

Bayesian accounts of autism suggest that this disorder may be rooted in an impaired ability to estimate the probability of future events, possibly owing to reduced priors. Here, we tested this hypothesis within the action domain in children with and without autism using a behavioural paradigm comprising a familiarization and a testing phase. During familiarization, children observed videos depicting a child model performing actions in diverse contexts. Crucially, within this phase, we implicitly biased action-context associations in terms of their probability of co-occurrence. During testing, children observed the same videos but drastically shortened (i.e. reduced amount of kinematics information) and were asked to infer action unfolding. Since during the testing phase movement kinematics became ambiguous, we expected children's responses to be biased to contextual priors, thus compensating for perceptual uncertainty. While this probabilistic effect was present in controls, no such modulation was observed in autistic children, overall suggesting an impairment in using contextual priors when predicting other peoples' actions in uncertain environments.

Comparative Evaluation of the Autonomic Response to Cognitive and Sensory Stimulations through Wearable Sensors.

Psychological stress is known to activate the autonomic nervous system (ANS), thus representing a useful target to be monitored to understand the physiological, unconscious effect of stress on the human body. However, little is known about how differently the ANS responds to cognitive and sensory stimulations in healthy subjects. To this extent, we enrolled 23 subjects and administered a stress protocol consisting of the administration of sensory (olfactory) and cognitive (mathematical) stressors. Autonomic parameters were unobtrusively monitored through wearable sensors for capturing electrocardiogram and skin conductance signals. The results obtained demonstrated an increase of the heart rate during both stress protocols, with a similar decrease of the heart rate variability. Cognitive stress test appears to affect the autonomic parameters to a greater extent, confirming its effects on the human body. However, olfactory stimulation could be useful to study stress in specific experimental settings when the administration of complex cognitive testing is not feasible.

Autonomic Nervous System Response during Light Physical Activity in Adolescents with Anorexia Nervosa Measured by Wearable Devices.

Anorexia nervosa (AN) is associated with a wide range of disturbances of the autonomic nervous system. The aim of the present study was to monitor the heart rate (HR) and the heart rate variability (HRV) during light physical activity in a group of adolescent girls with AN and in age-matched controls using a wearable, minimally obtrusive device. For the study, we enrolled a sample of 23 adolescents with AN and 17 controls. After performing a 12-lead electrocardiogram and echocardiography, we used a wearable device to record a one-lead electrocardiogram for 5 min at baseline for 5 min during light physical exercise (Task) and for 5 min during recovery. From the recording, we extracted HR and HRV indices. Among subjects with AN, the HR increased at task and decreased at recovery, whereas among controls it did not change between the test phases. HRV features showed a different trend between the two groups, with an increased low-to-high frequency ratio (LF/HF) in the AN group due to increased LF and decreased HF, differently from controls that, otherwise, slightly increased their standard deviation of NN intervals (SDNN) and the root mean square of successive differences (RMSSD). The response in the AN group during the task as compared to that of healthy adolescents suggests a possible sympathetic activation or parasympathetic withdrawal, differently from controls. This result could be related to the low energy availability associated to the excessive loss of fat and lean mass in subjects with AN, that could drive to autonomic imbalance even during light physical activity.

An Innovative, Unobtrusive Approach to Investigate Smartphone Interaction in Nonaddicted Subjects Based on Wearable Sensors: A Pilot Study.

Background and objectives: Smartphones are playing a pivotal role in everyday life, due to the opportunity they grant in terms of simplifying communication, entertainment, education and many other daily activities. Against such positive characteristics, smartphone interaction can result, in particular cases, in dangerous smartphone addiction patterns, possibly leading to several long-term detrimental psychophysiological conditions. Therefore, this pilot aims at assessing the feasibility of using an innovative approach, based on unobtrusive wearable sensors, used for the first time in this specific topic, and psychological questionnaires, to investigate the links between stress and emotions in a group of young, nonaddicted individuals performing smartphone interaction. Materials and methods: 17 volunteers were enrolled for the present study. The study protocol was divided into three phases, with an initial resting state (baseline) of three minutes, a smartphone interaction session (task) of the same length, and a final resting state (recovery), lasting three minutes. In the overall procedure, electrocardiogram (ECG) and galvanic skin response (GSR) measurements, both monitored by wearable sensors, were acquired in order to assess the functioning of the autonomic nervous system (ANS). Results: A significant decrease was seen in pNN50 during the smartphone interaction with respect to the baseline (Z = -2.675, p = 0.007), whereas the Low-to-High Frequency (LF/HF) ratio at task was somewhat correlated with phubbing behaviors (r = 0.655, p = 0.029), assessed through dedicated questionnaires. Conclusions: Taken together with the slight changes in GSR data, such results suggest the feasibility of this approach to characterize the ANS activation during smartphone interaction among young individuals. Further studies should enlarge the study population and involve smartphone-addicted subjects in order to increase the scientific and clinical relevance of such findings.

Excessive physical activity in young girls with restrictive-type anorexia nervosa: its role on cardiac structure and performance.

PURPOSE: The aim of this study was to investigate the influence of hyperactivity on left ventricular mass (LVM) in Anorexia Nervosa restricting-type (AN-R) and the correlation between LVM and auxologic parameters/circulating hormones. METHODS: Echocardiography was performed in 44 AN-R girls, subgrouped in 24 hyperactive (ANH+) and 20 non-hyperactive (ANH-), and in 20 controls (HC). LVM indexed to Body Surface Area (LVMi) and LVM indexed to height (LVMh) were calculated. RESULTS: LVMi and LVMh were significantly lower in the AN-R subjects compared to HC. Moreover, both LVMi and LVMh were higher in the ANH+ than in the ANH-. In the HC, LVMi was higher when compared to the ANH- subjects than to the ANH+. Stepwise analysis revealed that in the ANH+ group, fT4 was the only independent predictor of LVMh, while in the ANH- group, height was the only independent predictors of LVMi. CONCLUSIONS: Despite its negative influence on disease severity and outcome, hyperactivity from the standpoint of cardiac function makes the LVM of AN-R young girls more similar to HC. LEVEL OF EVIDENCE: Level III, case-control study.

The soft computing-based approach to investigate allergic diseases: a systematic review.

BACKGROUND: Early recognition of inflammatory markers and their relation to asthma, adverse drug reactions, allergic rhinitis, atopic dermatitis and other allergic diseases is an important goal in allergy. The vast majority of studies in the literature are based on classic statistical methods; however, developments in computational techniques such as soft computing-based approaches hold new promise in this field. OBJECTIVE: The aim of this manuscript is to systematically review the main soft computing-based techniques such as artificial neural networks, support vector machines, bayesian networks and fuzzy logic to investigate their performances in the field of allergic diseases. METHODS: The review was conducted following PRISMA guidelines and the protocol was registered within PROSPERO database (CRD42016038894). The research was performed on PubMed and ScienceDirect, covering the period starting from September 1, 1990 through April 19, 2016. RESULTS: The review included 27 studies related to allergic diseases and soft computing performances. We observed promising results with an overall accuracy of 86.5%, mainly focused on asthmatic disease. The review reveals that soft computing-based approaches are suitable for big data analysis and can be very powerful, especially when dealing with uncertainty and poorly characterized parameters. Furthermore, they can provide valuable support in case of lack of data and entangled cause-effect relationships, which make it difficult to assess the evolution of disease. CONCLUSIONS: Although most works deal with asthma, we believe the soft computing approach could be a real breakthrough and foster new insights into other allergic diseases as well.

A Combined Independent Source Separation and Quality Index Optimization Method for Fetal ECG Extraction from Abdominal Maternal Leads.

The non-invasive fetal electrocardiogram (fECG) technique has recently received considerable interest in monitoring fetal health. The aim of our paper is to propose a novel fECG algorithm based on the combination of the criteria of independent source separation and of a quality index optimization (ICAQIO-based). The algorithm was compared with two methods applying the two different criteria independently-the ICA-based and the QIO-based methods-which were previously developed by our group. All three methods were tested on the recently implemented Fetal ECG Synthetic Database (FECGSYNDB). Moreover, the performance of the algorithm was tested on real data from the PhysioNet fetal ECG Challenge 2013 Database. The proposed combined method outperformed the other two algorithms on the FECGSYNDB (ICAQIO-based: 98.78%, QIO-based: 97.77%, ICA-based: 97.61%). Significant differences were obtained in particular in the conditions when uterine contractions and maternal and fetal ectopic beats occurred. On the real data, all three methods obtained very high performances, with the QIO-based method proving slightly better than the other two (ICAQIO-based: 99.38%, QIO-based: 99.76%, ICA-based: 99.37%). The findings from this study suggest that the proposed method could potentially be applied as a novel algorithm for accurate extraction of fECG, especially in critical recording conditions.

A systematic review of the association between allergic asthma and autism.

INTRODUCTION: Autism Spectrum Disorder represents a burdensome condition in early childhood, with a number of risk factors proposed to explain its pathogenesis, most of which without a reliable scientific basis. Allergic asthma is likely to be one of the possible comorbilities of autism. EVIDENCE ACQUISITION: In this paper, the relationship between autism and allergic asthma was analyzed through a systematic literature review, conducted according to the PRISMA Guidelines. The review was performed on PubMed and Science Direct database and covered the period January 1, 2004-July 9, 2016. The search was limited to articles published in peer-reviewed journals. The obtained results were sorted by relevance and the most significant case-control, epidemiological and nationwide-based works associating autism and allergic asthma in humans were selected. EVIDENCE SYNTHESIS: A slight correlation between these conditions has been found in more than a half studies selected, suggesting a possible association between the two diseases. Small sample sizes of some works and some methodological limitations rise uncertainty about this link. CONCLUSIONS: Autism Spectrum Disorder and asthma could be associated conditions, as evidenced by the higher prevalence of asthma in autistic children with respect to typically developed controls, with also a verisimilar biological basis. Despite that, future studies are required to provide more reliable data, also by employing animal models, to better clarify this, still unsure, relationship. Methods for study selection and inclusion criteria were specified in advance and documented in PROSPERO protocol #CRD42014012851.

Gut to brain interaction in Autism Spectrum Disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters.

BACKGROUND: A high prevalence of a variety of gastrointestinal (GI) symptoms is frequently reported in patients with Autism Spectrum Disorders (ASD). The GI disturbances in ASD might be linked to gut dysbiosis representing the observable phenotype of a "gut-brain axis" disruption. The exploitation of strategies which can restore normal gut microbiota and reduce the gut production and absorption of toxins, such as probiotics addition/supplementation in a diet, may represent a non-pharmacological option in the treatment of GI disturbances in ASD. The aim of this randomized controlled trial is to determine the effects of supplementation with a probiotic mixture (Vivomixx®) in ASD children not only on specific GI symptoms, but also on the core deficits of the disorder, on cognitive and language development, and on brain function and connectivity. An ancillary aim is to evaluate possible effects of probiotic supplementation on urinary concentrations of phthalates (chemical pollutants) which have been previously linked to ASD. METHODS: A group of 100 preschoolers with ASD will be classified as belonging to a GI group or to a Non-GI (NGI) group on the basis of a symptom severity index specific to GI disorders. In order to obtain four arms, subjects belonging to the two groups (GI and NGI) will be blind randomized 1:1 to regular diet with probiotics or with placebo for 6 months. All participants will be assessed at baseline, after three months and after six months from baseline in order to evaluate the possible changes in: (1) GI symptoms; (2) autism symptoms severity; (3) affective and behavioral comorbid symptoms; (4) plasmatic, urinary and fecal biomarkers related to abnormal intestinal function; (5) neurophysiological patterns. DISCUSSION: The effects of treatments with probiotics on children with ASD need to be evaluated through rigorous controlled trials. Examining the impact of probiotics not only on clinical but also on neurophysiological patterns, the current trial sets out to provide new insights into the gut-brain connection in ASD patients. Moreover, results could add information to the relationship between phthalates levels, clinical features and neurophysiological patterns in ASD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02708901 . Retrospectively registered: March 4, 2016.

A Novel Application for Cognitive Evaluation in Mountain Ultramarathons: Olfactory Assessment.

OBJECTIVE: Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea). METHODS: An Odor Identification Test was administered before (T0; n = 53), at 148.7 kms (T1; n = 32) and after the race (T2; n = 28). The effect of dehydration and sleep deprivation on olfactory function was assessed. Olfactory function was also assessed in non-MUM athletes and sedentary controls (C) at rest. RESULTS: A majority of the athletes completed the olfactory test at all time intervals. Olfactory function decreased throughout the race (T0: 13.8 ± 1.9, T1: 13.7 ± 1.6, T2: 13.1 ± 1.8; T0 vs T2 P = .01). There was no relationship with race time or sleep deprivation on the sense of smell throughout the competition. However, there was a combined effect with decreased olfaction during the second half of the race, while a poor relationship was seen between olfaction and total body water at midterm (T1: rs = -0.427; P = .019), but not at baseline or after the race. MUM athletes had similar olfactory scores to C (13.8 ± 1.9 vs 13.7 ± 1.4) and non-MUM (13.8 ± 1.9 vs 13.9 ± 1.6) athletes. CONCLUSIONS: This pilot study showed the feasibility of olfactory evaluation as a minimally invasive cognitive impairment assessment. The test can be used in logistically difficult environments, adding scientific value to this promising method. Although olfaction decreased after prolonged physical activity, further studies are warranted to make the relationship between cognition and external factors (eg, sleep deprivation, dehydration) more clear.

The role of wearable sensors and wireless technologies for the assessment of heart rate variability in anorexia nervosa.

PURPOSE: Bradycardia and abnormal cardiac autonomic function are related to increased mortality in anorexia nervosa (AN). The aim of this study was to assess heart rate (HR) and HR variability of young adolescents with AN as compared to controls by means of wearable sensors and wireless technologies. METHOD: The ECG signal was recorded in 27 AN girls and 15 healthy girls at rest using a wearable chest strap. The tachogram, the mean intervals between R peaks (meanRR), the root mean square of successive differences (RMSSD), the power of low-frequency (LF) and high-frequency (HF) bands and the LF/HF ratio were assessed. RESULTS: All AN girls showed a reduced HR and an increased meanRR and RMSSD. An HF increase, a LF decrease, and a LF/HF reduction indicated a prevalence of the parasympathetic on sympathetic activity. CONCLUSIONS: The instruments used in this pilot study were feasible, unobtrusive and extremely suitable in AN subjects who are burdened by high incidence of cardiovascular mortality; their application could open to new approaches of vital signs monitoring in hospitals as well as in home settings.

[Telemedicine and wireless devices in heart failure]. / Telemedicina e sistemi wireless nello scompenso cardiaco.

Telemedicine has the potential to constitute the central element of the future primary care and become an effective means of prevention and early warning of acute exacerbation of chronic diseases. Up to now, the application of telemedicine has found a variety of difficulties, regarding the types and methods of acquisition and transmission of biological signals, the acceptance and cooperation of the patient, etc. The latest technological developments involve the combined use of wireless technologies and smartphones, for the collection and the transmission of data, and specific softwares for their automatic analysis. This paper examines some of the critical aspects in the application of new technologies for heart failure remote management.

Autistic traits and perspective taking in youths with anorexia nervosa: an exploratory clinical and eye tracking study.

BACKGROUND: Despite their apparent dissimilarity, Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD) share many features, especially in terms of social and emotional difficulties. In recent years, empathic abilities in AN have been frequently assessed using self-report measures. Otherwise, the director task (DT) has been used to investigate the ability to take the visual perspective of another individual in a communicative context, using eye-tracking technology. The aim of the current study was to test the presence of autism-relevant features in AN, through: (i) comparing self-reported autistic traits and empathic abilities in a group of young inpatients with AN and age/gender matched healthy controls (HC); (ii) comparing performance on the director paradigm. METHODS: The participants were females in the age-range between 11 and 18 years: 24 with AN and 23 HC. Autistic traits, empathic abilities, and severity of the eating disorder were respectively measured using: the Autism Quotient (AQ), the Interpersonal Reactivity Index (IRI), and the Eating Disorder Inventory-3 (EDI-3). Both groups performed a computerized task in which a director instructed them to move objects placed on a set of shelves using a mouse, while their eye gaze was tracked. A total of 36 shelf configurations, divided into three categories (with dimensional distractor - with spatial distractor - control), were created. RESULTS: Subjects with AN showed higher autistic traits than HC. Eye-tracking data revealed that subjects with AN took longer to decide which object to select and where to move it, both in distractor-trials and in control-trials. In the AN group, we found a significant negative correlation between the total score of the AQ and the number of fixations to the irrelevant object in the dimensional control condition -in which the subjects were asked to focus on dimensional aspects of the object (large-small)-. CONCLUSIONS: Autistic traits were over-represented in a group of young inpatients with AN. Through the use of eye-tracking technology, this exploratory study documented some differences between AN inpatients and HC in their online processes during the perspective taking tasks, which could be considered a target of tailored intervention. A larger sample of patients is needed to confirm these preliminary findings.

Pupillary responses for social versus non-social stimuli in autism: A systematic review and meta-analysis.

Pupillometry has gained attention as a valuable tool for assessing autonomic nervous system activity and studying phasic changes in pupil size to comprehend underlying neurocognitive mechanisms. However, knowledge regarding pupillary responses to social processing in autism is limited. We conducted a systematic review and meta-analysis, examining research studies on pupil size changes that compare social and non-social stimuli in autism. Electronic searches were performed for articles up to September 2023 and relevant studies were evaluated following PRISMA guidelines. Out of 284 articles screened, 14 studies were eligible for systematic review. The results indicated that non-autistic individuals showed larger pupil size for social compared to non-social stimuli (g = 0.54; 95 % CI [0.25, 0.82]), whereas autistic individuals seemed to exhibit no differences between the two conditions. However, high heterogeneity was observed between studies in autistic populations, compromising interpretability. Despite such limitations, pupillary responses may constitute an objective physiological marker of social processing in autism. This review emphasizes the need for further investigations into pupillary responses in autism across different life stages.