Children with autism spectrum disorder who are taught to pay more attention to facial expressions and tone of voice show increased activity in the medial prefrontal cortex with functional magnetic resonance imaging, a response that may guide development of future therapies, according to an article in the June issue of Archives of General Psychiatry.

Past neuroimaging studies have shown that individuals with autism spectrum disorders (ASDs), including autism, pervasive developmental disorder and Asperger’s syndrome, show reduced activity in the regions of the brain that respond to such cues (including the medial prefrontal cortex). In the current study, researchers found that treatments aimed at teaching affected children to attend more to facial expression and voice cues was associated with increased activity in the same regions.

“That’s significant. The fact that you can ‘normalize’ activity in this region in the ASD group by directing their attention to these important social cues clearly indicates there’s nothing intrinsically wrong with this region in the autistic brain,” said Mirella Dapretto, associate professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA and a member of the UCLA Ahmanson-Lovelace Brain Mapping Center. Dapretto co-authored the study with her former graduate student Ting Wang, who is now a postdoctoral fellow at Mount Sinai School of Medicine.

“This is a very positive thing,” Dapretto said, “because these findings have implications for future interventions ? they suggest that you could train the autistic brain to make use of the information conveyed by the human face and voice to successfully navigate social interactions.”

The authors had two goals in mind with the study. One was to examine the neural circuitry in the brain that underlies the problems these children face in interpreting communicative intent. The other was to determine whether explicit instructions to pay attention to facial expressions and tone of voice would elicit more normal patterns of brain activity in these children.

While undergoing functional magnetic resonance imaging, 18 boys between the ages of 7 and 17, as well as a control group of 18 typically developing boys, viewed cartoon drawings of children in conversational settings while listening to short vignettes that ended with a potentially ironic remark.

Researchers found that, compared with the typical control group, children on the spectrum had reduced activity in two areas of the brain ? the medial prefrontal cortex and right superior temporal gyrus. But when researchers gave both groups explicit instructions to pay attention to the speaker’s facial expression and tone of voice, only the autism spectrum children showed a significant increase in activity in the medial prefrontal cortex.

“The typically developing kids recognized and interpreted these cues automatically when trying to infer if a speaker’s remark was sincere or sarcastic, so their brains were already responding appropriately,” said Dapretto. “But not so with the ASD kids, who did not show activity in this area when specific instructions weren’t provided. This is the first study to show that you can normalize activity in a key region of the so-called ‘social brain’ in individuals with autism by simply directing their attention to these important social cues.”