Influence of autistic traits and communication role on eye contact behavior during face-to-face interaction.

Eye contact is a central component in face-to-face interactions. It is important in structuring communicative exchanges and offers critical insights into others' interests and intentions. To better understand eye contact in face-to-face interactions, we applied a novel, non-intrusive deep-learning-based dual-camera system and investigated associations between eye contact and autistic traits as well as self-reported eye contact discomfort during a referential communication task, where participants and the experimenter had to guess, in turn, a word known by the other individual. Corroborating previous research, we found that participants' eye gaze and mutual eye contact were inversely related to autistic traits. In addition, our findings revealed different behaviors depending on the role in the dyad: listening and guessing were associated with increased eye contact compared with describing words. In the listening and guessing condition, only a subgroup who reported eye contact discomfort had a lower amount of eye gaze and eye contact. When describing words, higher autistic traits were associated with reduced eye gaze and eye contact. Our data indicate that eye contact is inversely associated with autistic traits when describing words, and that eye gaze is modulated by the communicative role in a conversation.

Differences in Cortical Morphology in People With and Without Migraine: A Registry for Migraine (REFORM) MRI Study.

BACKGROUND AND OBJECTIVES: Structural imaging can offer insights into the cortical morphometry of migraine, which might reflect adaptations to recurring nociceptive messaging. This study compares cortical morphometry between a large sample of people with migraine and healthy controls, as well as across migraine subtypes. METHODS: Adult participants with migraine and age-matched and sex-matched healthy controls attended a single MRI session with magnetization-prepared rapid acquisition gradient echo and fluid-attenuated inversion recovery sequences at 3T. Cortical surface area, thickness, and volume were compared between participants with migraine (including subgroups) and healthy controls across the whole cortex within FreeSurfer and reported according to the Desikan-Killiany atlas. The analysis used cluster-determining thresholds of p < 0.0001 and cluster-wise thresholds of p < 0.05, adjusted for age, sex, and total intracranial volume. RESULTS: A total of 296 participants with migraine (mean age 41.6 years ± 12.4 SD, 261 women) and 155 healthy controls (mean age 41.1 years ± 11.7 SD, 133 women) were included. Among the participants with migraine, 180 (63.5%) had chronic migraine, 103 (34.8%) had migraine with aura, and 88 (29.7%) experienced a migraine headache during the scan. The total cohort of participants with migraine had reduced cortical surface area in the left insula, compared with controls (p < 0.0001). Furthermore, participants with chronic migraine (n = 180) exhibited reduced surface area in the left insula (p < 0.0001) and increased surface area in the right caudal anterior cingulate cortex (p < 0.0001), compared with controls. We found no differences specific to participants with aura or ongoing migraine headache. Post hoc tests revealed a positive correlation between monthly headache days and surface area within the identified anterior cingulate cluster (p = 0.014). DISCUSSION: The identified cortical changes in migraine were limited to specific pain processing regions, including the insula and caudal anterior cingulate gyrus, and were most notable in participants with chronic migraine. These findings suggest persistent cortical changes associated with migraine. TRIAL REGISTRATION INFORMATION: The REFORM study (clinicaltrials.gov identifier: NCT04674020).

Visuomotor tracking strategies in children: associations with neurodevelopmental symptoms.

Children with neurodevelopmental disorders (NDDs) often display motor problems that may impact their daily lives. Studying specific motor characteristics related to spatiotemporal control may inform us about the mechanisms underlying their challenges. Fifty-eight children with varying neurodevelopmental symptoms load (median age: 5.6 years, range: 2.7-12.5 years) performed an interactive tablet-based tracking task. By investigating digit touch errors relative to the target's movement direction, we found that a load of neurodevelopmental symptoms was associated with reduced performance in the tracking of abrupt alternating directions (zigzag) and overshooting the target. In contrast, reduced performance in children without neurodevelopmental symptoms was associated with lagging behind the target. Neurodevelopmental symptom load was also associated with reduced flexibility in correcting for lateral deviations in smooth tracking (spiral). Our findings suggest that neurodevelopmental symptoms are associated with difficulties in motor regulation related to inhibitory control and reduced flexibility, impacting motor control in NDDs.

Neuroimmune activation and increased brain aging in chronic pain patients after the COVID-19 pandemic onset.

The COVID-19 pandemic has exerted a global impact on both physical and mental health, and clinical populations have been disproportionally affected. To date, however, the mechanisms underlying the deleterious effects of the pandemic on pre-existing clinical conditions remain unclear. Here we investigated whether the onset of the pandemic was associated with an increase in brain/blood levels of inflammatory markers and MRI-estimated brain age in patients with chronic low back pain (cLBP), irrespective of their infection history. A retrospective cohort study was conducted on 56 adult participants with cLBP (28 'Pre-Pandemic', 28 'Pandemic') using integrated Positron Emission Tomography/ Magnetic Resonance Imaging (PET/MRI) and the radioligand [11C]PBR28, which binds to the neuroinflammatory marker 18 kDa Translocator Protein (TSPO). Image data were collected between November 2017 and January 2020 ('Pre-Pandemic' cLBP) or between August 2020 and May 2022 ('Pandemic' cLBP). Compared to the Pre-Pandemic group, the Pandemic patients demonstrated widespread and statistically significant elevations in brain TSPO levels (P =.05, cluster corrected). PET signal elevations in the Pandemic group were also observed when 1) excluding 3 Pandemic subjects with a known history of COVID infection, or 2) using secondary outcome measures (volume of distribution -VT- and VT ratio - DVR) in a smaller subset of participants. Pandemic subjects also exhibited elevated serum levels of inflammatory markers (IL-16; P <.05) and estimated BA (P <.0001), which were positively correlated with [11C]PBR28 SUVR (r's ≥ 0.35; P's < 0.05). The pain interference scores, which were elevated in the Pandemic group (P <.05), were negatively correlated with [11C]PBR28 SUVR in the amygdala (r = -0.46; P<.05). This work suggests that the pandemic outbreak may have been accompanied by neuroinflammation and increased brain age in cLBP patients, as measured by multimodal imaging and serum testing. This study underscores the broad impact of the pandemic on human health, which extends beyond the morbidity solely mediated by the virus itself.

Machine learning for distinguishing saudi children with and without autism via eye-tracking data.

BACKGROUND: Despite the prevalence of Autism Spectrum Disorder (ASD) globally, there's a knowledge gap pertaining to autism in Arabic nations. Recognizing the need for validated biomarkers for ASD, our study leverages eye-tracking technology to understand gaze patterns associated with ASD, focusing on joint attention (JA) and atypical gaze patterns during face perception. While previous studies typically evaluate a single eye-tracking metric, our research combines multiple metrics to capture the multidimensional nature of autism, focusing on dwell times on eyes, left facial side, and joint attention. METHODS: We recorded data from 104 participants (41 neurotypical, mean age: 8.21 ± 4.12 years; 63 with ASD, mean age 8 ± 3.89 years). The data collection consisted of a series of visual stimuli of cartoon faces of humans and animals, presented to the participants in a controlled environment. During each stimulus, the eye movements of the participants were recorded and analyzed, extracting metrics such as time to first fixation and dwell time. We then used these data to train a number of machine learning classification algorithms, to determine if these biomarkers can be used to diagnose ASD. RESULTS: We found no significant difference in eye-dwell time between autistic and control groups on human or animal eyes. However, autistic individuals focused less on the left side of both human and animal faces, indicating reduced left visual field (LVF) bias. They also showed slower response times and shorter dwell times on congruent objects during joint attention (JA) tasks, indicating diminished reflexive joint attention. No significant difference was found in time spent on incongruent objects during JA tasks. These results suggest potential eye-tracking biomarkers for autism. The best-performing algorithm was the random forest one, which achieved accuracy = 0.76 ± 0.08, precision = 0.78 ± 0.13, recall = 0.84 ± 0.07, and F1 = 0.80 ± 0.09. CONCLUSIONS: Although the autism group displayed notable differences in reflexive joint attention and left visual field bias, the dwell time on eyes was not significantly different. Nevertheless, the machine algorithm model trained on these data proved effective at diagnosing ASD, showing the potential of these biomarkers. Our study shows promising results and opens up potential for further exploration in this under-researched geographical context.

Self-reported eye contact sensitivity and face processing in chromosome 22q11.2 deletion syndrome.

INTRODUCTION: 22q11.2 deletion syndrome (22qDS) has been associated with varying levels of social impairments, and with atypical visual scanning of faces. The present study explored whether self-reported sensitivity to eye contact might be related to these phenomena. METHOD: Individuals with confirmed 22qDS were interviewed about their experience and possible discomfort with eye contact. In cases where individuals expresesed discomfort, they were subsequently asked about coping mechanisms used to deal with this discomfort. In addition to self-reported eye contact discomfort, gaze to emotional faces was examined using eye tracking. RESULTS: In the subgroup of individuals who reported discomfort during eye contact, eye tracking results revealed a lower amount of gaze in the eyes of neutral faces, as well as the absence of the typical left visual field (LVF) bias, indicative of alterations in hemispheric lateralization. This subgroup also scored lower on a measure of everyday functioning. CONCLUSIONS: Our results show that, by simply asking individuals with this social and communicative disorder about eye gaze discomfort, we may better understand the specific challenges that they experience. Moreover, information gained from such first-person reports together with eye-tracking measures further informs about the integrity of their face processing system, as well as about the nature and degree of impairment in this population.

Sentence memory recall in adolescents: Effects of motor enactment, keyboarding, and handwriting during encoding.

BACKGROUND: Prior research has shown that memory for action sentences is stronger when stimuli are enacted during encoding than simply listened to: the so-called enactment effect. The goal of the present study was to explore how writing during encoding-through handwriting and through keyboarding-fares compared with enacting, in supporting memory recall. METHODS: One hundred Norwegian high school students (64 girls, 36 boys) aged 16-21 years (M = 17.1) participated in the study. Four lists of verb-noun sentences with 12 sentences in each list were presented in four encoding conditions: (i) motor enactment, (ii) verbal listening, (iii) handwriting, and (iv) keyboarding. RESULTS: Results revealed a significant main effect of encoding condition, with the best memory gained in the enactment condition. Regarding writing, results showed that handwriting and keyboarding during encoding produced the lowest recall in comparison with the enactment and verbal listening conditions. CONCLUSION: These results thus provide additional support for the enactment effect. While there has been much discussion on the relative benefits of handwriting versus keyboarding on student performance, both seemed to be equally poor strategies for the particular learning task explored here, potentially through increased cognitive load.

Overwhelmed by the man in the moon? Pareidolic objects provoke increased amygdala activation in autism.

An interesting feature of the primate face detection system results in the perception of illusory faces in objects, or pareidolia. These illusory faces do not per se contain social information, such as eye-gaze or specific identities, yet they activate the cortical brain face-processing network, possibly via the subcortical route, including the amygdala. In autism spectrum disorder (ASD), aversion to eye-contact is commonly reported, and so are alterations in face processing more generally, yet the underlying reasons are not clear. Here we show that in autistic participants (N=37), but not in non-autistic controls (N=34), pareidolic objects increase amygdala activation bilaterally (right amygdala peak: X = 26, Y = -6, Z = -16; left amygdala peak X = -24, Y = -6, Z = -20). In addition, illusory faces engage the face-processing cortical network significantly more in ASD than in controls. An early imbalance in the excitatory and inhibitory systems in autism, affecting typical brain maturation, may be at the basis of an overresponsive reaction to face configuration and to eye contact. Our data add to the evidence of an oversensitive subcortical face processing system in ASD.

A novel end-to-end dual-camera system for eye gaze synchrony assessment in face-to-face interaction.

Quantification of face-to-face interaction can provide highly relevant information in cognitive and psychological science research. Current commercial glint-dependent solutions suffer from several disadvantages and limitations when applied in face-to-face interaction, including data loss, parallax errors, the inconvenience and distracting effect of wearables, and/or the need for several cameras to capture each person. Here we present a novel eye-tracking solution, consisting of a dual-camera system used in conjunction with an individually optimized deep learning approach that aims to overcome some of these limitations. Our data show that this system can accurately classify gaze location within different areas of the face of two interlocutors, and capture subtle differences in interpersonal gaze synchrony between two individuals during a (semi-)naturalistic face-to-face interaction.

A novel tablet-based motor coordination test performs on par with the Beery VMI subtest and offers superior temporal metrics: findings from children with pediatric acute-onset neuropsychiatric syndrome.

Neuropsychiatric and neurodevelopmental disorders are often associated with coordination problems. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) constitutes a specific example of acute and complex symptomatology that includes difficulties with motor control. The present proof-of-concept study aimed at testing a new, bespoke tablet-based motor coordination test named SpaceSwipe, providing fine-grained measures that could be used to follow-up on symptoms evolution in PANS. This test enables computationally precise and objective metrics of motor coordination, taking into account both directional and spatial features continuously. We used SpaceSwipe to assess motor coordination in a group of children with PANS (n = 12, assessed on in total of 40 occasions) and compared it against the motor coordination subtest from the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) 6th edition, traditionally used to follow-up symptomatology. Using a bivariate linear regression, we found that 33 s of the directional offset from tracking a moving target in SpaceSwipe could predict the Beery VMI motor coordination (VMI MC) raw scores (mean absolute error: 1.75 points). Positive correlations between the predicted scores and the VMI MC scores were found for initial testing (radj = 0.87) and for repeated testing (radj = 0.79). With its short administration time and its close prediction to Beery VMI scores, this proof-of-concept study demonstrates the potential for SpaceSwipe as a patient-friendly tool for precise, objective assessment of motor coordination in children with neurodevelopmental or neuropsychiatric disorders.

Discrepancy between high non-verbal intelligence and low accuracy at reading emotional expressions in the eyes reflects the magnitude of social-emotional difficulties in autism.

Many so-called "high functioning" autistic individuals struggle with daily living skills, and have poorer than expected adult outcomes in employment, relationships, and quality of life. Significant discrepancies between non-verbal intelligence and emotional processing can be observed in autism, but the role of the magnitude of this gap in achieving potential psychosocial outcome is not known. Here, we show in a large group of participants (n = 107), that only among those with an autism diagnosis (n = 33), the gap between non-verbal intelligence (as measured by Raven's matrices) and the ability to perform the Reading the Mind in the Eyes test significantly predicts self-perceived emotional/social difficulties as assessed by the Empathy Quotient. Our results suggest that it is specifically the magnitude of the gap between (high) levels of abstract reasoning skills and poor proficiency in reading emotions expressed by the eyes that predicts self-perceived difficulties in emotional and social interactions among adults with autism. A better understanding of the underlying causes of the discrepancy between potential and actual psychosocial outcomes is the first step toward developing the most appropriate support for this vulnerable population, and our study offers some potentially important insights in this regard.

Left visual field bias during face perception aligns with individual differences in reading skills and is absent in dyslexia.

BACKGROUND: When looking at faces, we tend to attend more to the left visual field (corresponding to the right side of the person's face). This phenomenon is called the left visual field bias (LVF) and is presumed to reflect the brain's right-sided dominance for face processing. Whether alterations in hemispheric dominance are present in dyslexia, and are linked with individual differences in word reading development more generally, is still unclear, and no prior research has utilized gaze-based LVF bias to explore these topics. AIMS: The aim of the study was to examine whether the LVF bias differs in dyslexia and to examine the association with word-reading skills assessed dimensionally. SAMPLE: Forty-six 9-13 year-old children with dyslexia and community control children, matched on age and listening comprehension. METHODS: Participants were presented with a recorded face on a screen while their gaze patterns were collected with an eye tracker. Fixations to the left versus the right side of the face stimuli were compared. RESULTS: Results showed a clear LVF bias in community controls, while no such bias was seen in the dyslexic group. Moreover, the strength of the LVF bias was correlated with better word reading in the controls. CONCLUSIONS: Our results suggest a link between weakened hemispheric dominance for face processing in dyslexia and in poor word reading, at least to the extent that the LVF bias actually mirrors underlying physiology. We discuss the implications of these novel findings, highlighting the need for future research to determine the specificity and developmental sources of LVF bias alterations.

Imaging the inflammatory phenotype in migraine.

Several preclinical and clinical lines of evidence suggest a role of neuroinflammation in migraine. Neuroimaging offers the possibility to investigate and localize neuroinflammation in vivo in patients with migraine, and to characterize specific inflammatory constituents, such as vascular permeability, and macrophage or microglia activity. Despite all imaging data accumulated on neuroinflammation across the past three decades, an overview of the imaging evidence of neuroinflammation in migraine is still missing.We conducted a systematic review in the Pubmed and Embase databases to evaluate existing imaging data on inflammation in migraine, and to identify gaps in the literature. We included 20 studies investigating migraine without aura (N = 4), migraine with aura (N = 8), both migraine with and without aura (N = 3), or hemiplegic migraine (N = 5).In migraine without aura, macrophage activation was not evident. In migraine with aura, imaging evidence suggested microglial and parameningeal inflammatory activity. Increased vascular permeability was mostly found in hemiplegic migraine, and was atypical in migraine with and without aura. Based on the weight of existing and emerging data, we show that most studies have concentrated on demonstrating increased vascular permeability as a marker of neuroinflammation, with tools that may not have been optimal. In the future, novel, more sensitive techniques, as well as imaging tracers delineating specific inflammatory pathways may further bridge the gap between preclinical and clinical findings.

The trigeminal pathways.

The role of the trigeminal system in facial and dural sensitivity has been recognized for a long time. More recently, the trigeminal system has also been considered a prominent actor in brain nociceptive innervation. It is the anatomical substrate of several frequent conditions, such as primary or secondary headaches, trigeminal neuralgia, and other orofacial pains. Appreciation of the delicate anatomical arrangement of the trigeminal pathway is one of the keys to understanding these conditions' pathophysiology and to proposing innovative treatments. This review provides a structured presentation of existing knowledge about the trigeminal system, from classical anatomical data to the most recent literature. First, we present the organization of the trigeminal pathway from the trigeminal divisions, nerve, and nuclei to the thalamus and somatosensory cortex. We describe the neurons and fibers' repartition at each level, depending on the location (somatotopic organization) and the type of receptors (modal organization). Such a dual somatotopic-modal arrangement of the trigeminal fibers is especially clear for the juxtapontine segment of the trigeminal nerve and the trigeminal nuclei of the brainstem. It has significant clinical consequences both for diagnosis and treatment. Second, we explore how the trigeminal system is modulated and involved in reflexes, for instance the trigemino-cardiac and the trigemino-autonomic reflexes, which could play an essential role in the autonomic symptoms observed in cluster headache. Finally, we present how to interact with this complex system to relieve pain mediated by the trigeminal system. This section covers both neuromodulatory and lesional approaches.

The pandemic brain: Neuroinflammation in non-infected individuals during the COVID-19 pandemic.

While COVID-19 research has seen an explosion in the literature, the impact of pandemic-related societal and lifestyle disruptions on brain health among the uninfected remains underexplored. However, a global increase in the prevalence of fatigue, brain fog, depression and other "sickness behavior"-like symptoms implicates a possible dysregulation in neuroimmune mechanisms even among those never infected by the virus. We compared fifty-seven 'Pre-Pandemic' and fifteen 'Pandemic' datasets from individuals originally enrolled as control subjects for various completed, or ongoing, research studies available in our records, with a confirmed negative test for SARS-CoV-2 antibodies. We used a combination of multimodal molecular brain imaging (simultaneous positron emission tomography / magnetic resonance spectroscopy), behavioral measurements, imaging transcriptomics and serum testing to uncover links between pandemic-related stressors and neuroinflammation. Healthy individuals examined after the enforcement of 2020 lockdown/stay-at-home measures demonstrated elevated brain levels of two independent neuroinflammatory markers (the 18 kDa translocator protein, TSPO, and myoinositol) compared to pre-lockdown subjects. The serum levels of two inflammatory markers (interleukin-16 and monocyte chemoattractant protein-1) were also elevated, although these effects did not reach statistical significance after correcting for multiple comparisons. Subjects endorsing higher symptom burden showed higher TSPO signal in the hippocampus (mood alteration, mental fatigue), intraparietal sulcus and precuneus (physical fatigue), compared to those reporting little/no symptoms. Post-lockdown TSPO signal changes were spatially aligned with the constitutive expression of several genes involved in immune/neuroimmune functions. This work implicates neuroimmune activation as a possible mechanism underlying the non-virally-mediated symptoms experienced by many during the COVID-19 pandemic. Future studies will be needed to corroborate and further interpret these preliminary findings.

Choroid Plexus Volume in Multiple Sclerosis vs Neuromyelitis Optica Spectrum Disorder: A Retrospective, Cross-sectional Analysis.

BACKGROUND AND OBJECTIVES: The choroid plexus has been shown to play a crucial role in CNS inflammation. Previous studies found larger choroid plexus in multiple sclerosis (MS) compared with healthy controls. However, it is not clear whether the choroid plexus is similarly involved in MS and in neuromyelitis optica spectrum disorder (NMOSD). Thus, the aim of this study was to compare the choroid plexus volume in MS and NMOSD. METHODS: In this retrospective, cross-sectional study, patients were included by convenience sampling from 4 international MS centers. The choroid plexus of the lateral ventricles was segmented fully automatically on T1-weighted MRI sequences using a deep learning algorithm (Multi-Dimensional Gated Recurrent Units). Uni- and multivariable linear models were applied to investigate associations between the choroid plexus volume, clinically meaningful disease characteristics, and MRI parameters. RESULTS: We studied 180 patients with MS and 98 patients with NMOSD. In total, 94 healthy individuals and 47 patients with migraine served as controls. The choroid plexus volume was larger in MS (median 1,690 µL, interquartile range [IQR] 648 µL) than in NMOSD (median 1,403 µL, IQR 510 µL), healthy individuals (median 1,533 µL, IQR 570 µL), and patients with migraine (median 1,404 µL, IQR 524 µL; all p < 0.001), whereas there was no difference between NMOSD, migraine, and healthy controls. This was also true when adjusted for age, sex, and the intracranial volume. In contrast to NMOSD, the choroid plexus volume in MS was associated with the number of T2-weighted lesions in a linear model adjusted for age, sex, total intracranial volume, disease duration, relapses in the year before MRI, disease course, Expanded Disability Status Scale score, disease-modifying treatment, and treatment duration (beta 4.4; 95% CI 0.78-8.1; p = 0.018). DISCUSSION: This study supports an involvement of the choroid plexus in MS in contrast to NMOSD and provides clues to better understand the respective pathogenesis.

Face Processing in School Children with Dyslexia: Neuropsychological and Eye-tracking Findings.

Dyslexia is a neurodevelopmental difficulty affecting reading, but recent data in adults suggest that difficulties also extend to face processing. Here, we tested face processing in school children with and without dyslexia, using eye-tracking and neuropsychological tests. Children with dyslexia didn't differ significantly from controls in face gaze patterns, face memory, or face identification accuracy. However, they were slower and more heterogeneous, with larger within-group variance than controls. Increased gaze patterns toward the eyes were associated with better face memory in controls. We discuss the possible role of experiential factors in prior research linking dyslexia and face processing differences.

Brain barriers and their potential role in migraine pathophysiology.

Migraine is a ubiquitous neurologic disease that afflicts people of all ages. Its molecular pathogenesis involves peptides that promote intracranial vasodilation and modulate nociceptive transmission upon release from sensory afferents of cells in the trigeminal ganglion and parasympathetic efferents of cells in the sphenopalatine ganglion. Experimental data have confirmed that intravenous infusion of these vasoactive peptides induce migraine attacks in people with migraine, but it remains a point of scientific contention whether their site of action lies outside or within the central nervous system. In this context, it has been hypothesized that transient dysfunction of brain barriers before or during migraine attacks might facilitate the passage of migraine-inducing peptides into the central nervous system. Here, we review evidence suggestive of brain barrier dysfunction in migraine pathogenesis and conclude with lessons learned in order to provide directions for future research efforts.

Data-driven analysis of gaze patterns in face perception: Methodological and clinical contributions.

Gaze patterns during face perception have been shown to relate to psychiatric symptoms. Standard analysis of gaze behavior includes calculating fixations within arbitrarily predetermined areas of interest. In contrast to this approach, we present an objective, data-driven method for the analysis of gaze patterns and their relation to diagnostic test scores. This method was applied to data acquired in an adult sample (N = 111) of psychiatry outpatients while they freely looked at images of human faces. Dimensional symptom scores of autism, attention deficit, and depression were collected. A linear regression model based on Principal Component Analysis coefficients computed for each participant was used to model symptom scores. We found that specific components of gaze patterns predicted autistic traits as well as depression symptoms. Gaze patterns shifted away from the eyes with increasing autism traits, a well-known effect. Additionally, the model revealed a lateralization component, with a reduction of the left visual field bias increasing with both autistic traits and depression symptoms independently. Taken together, our model provides a data-driven alternative for gaze data analysis, which can be applied to dimensionally-, rather than categorically-defined clinical subgroups within a variety of contexts. Methodological and clinical contribution of this approach are discussed.

Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4-7-year-old children: A Japanese birth cohort study.

Background: An overrepresentation of neurodevelopmental problems (NDPs) has been observed in individuals with avoidant/restrictive food intake disorder (ARFID). Previous studies on the association between ARFID and NDPs have been limited by cross-sectional data from clinical samples of small size. This study aimed to extend previous research by using prospectively collected data in a non-clinical child cohort. We examined the occurrence of early NDPs in 4-7-year-old children with suspected ARFID and how predictive early NDPs are of ARFID. Methods: Data were collected via parent-report a sub-sample of the Japan Environment and Children's Study (JECS) including 3728 children born 2011-2014 in Kochi prefecture. NDPs were assessed biannually between 0.5 and 3 years of age with the Ages and Stages Questionnaire-3, at age 2.5 years with the ESSENCE-Q, and at age 1 and 3 years via parent-reported clinical diagnoses. ARFID was identified cross-sectionally (at age 4-7 years) using a newly developed screening tool. Logistic regressions were used to test association of (1) a composite early NDP risk score, (2) specific early NDPs, and (3) neurodevelopmental trajectories over time with ARFID. Results: Children in the highest risk percentiles of the NDP risk score had roughly three times higher odds of having suspected ARFID; the absolute risk of later ARFID for children above the 90th percentile was 3.1%. Early NDPs (excluding early feeding problems) were more predictive of later ARFID than were early feeding problems. Specific NDPs predictive of ARFID were problems with general development, communication/language, attention/concentration, social interaction, and sleep. Neurodevelopmental trajectories of children with and without suspected ARFID started to divert after age 1 year. Conclusions: The results mirror the previously observed overrepresentation of NDPs in ARFID populations. In this non-clinical child cohort, early feeding problems were common and rarely developed into ARFID; however, our findings imply that they should be monitored closely in children with high NDP risk to prevent ARFID.