Visual perception of unstructured figures in patients with autism spectrum disorder : a preliminary study

Ambiguous figures, sueh as the reversible figure of the girilold women 5 (Boring, 1930), have mspired an enormous amount ot research into the domain of visual perception. Howevet visual perception of unstructured figures, such as stains on walls, which contain no meanings themselves, has not been a main topic of research in healthy subjects or in subjects with autism spectrum disorder (ASD). The aims of this study were to obtain inkblot re$ponses characteristic of subjects with ASD (n = 36), to compare these response to those of healthy subjects (n = 50), and to assess whether these responses had any relevance to ASD trajts, as evaluated using standard questionnaires, such as the Autism-spectrum Quotient (AQ) and thg Empathy Quotient (EQ). Atl of the responses of each subject were scored Japan Brain Science Society NII-Electronic Library Service apanBrainScienceSociety ! ThistiHe / i,Iili, Sllil}Lesp"cd ,. 'i"1er`e it .l}.:.i.Ml.J...,iofBrainScience, March 30, 2013,Vol.40 using the Exner Comprehensive Scoring System, which is the standard method for evaluating responses to the Rorschach test. The scores of total responses were not different between the subjects with ASD and healthy subjects. Only the scores for the variable designated FM were significantly lower in ASD subjects compared to healthy subjects, indicating that the subjects perceived animals in motion in their visual perceptions of unstructured figures in inkblots. Furthermore, the FM scores demonstrated a significantly inverse correlation with the AQ scores and were $ignificantly coffelated with the EQ scores. Each variable of M indicated a response of humans in motion, with m indicating a response of inanimate in motion, Human indicating total responses conceming humans, and Animal indicating total responses conceming animals; these measurements were not ditferent between the two groups and 6 were not correlated with the scores on the AQ or the EQ. Based on this preliminary study, representations of animals in motion in visual perception may be a subject that could shed light on the biological relevance between unstructured figures and autism traits. Kfflf words ambiguous figure, autjsm phenotype, autism spectrum disordet illusion, inkblots of the Rorschach, unstructured figure, visuat perception lntroduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder that comprises autistic disorder, Aspergeris disorder, and pervasive developmental disorder not othenNise specified as designated in the i!2iegnnoshc end SlatAsifca/ ildlanua/ or nebnta/ avsotvlers Fbutth Eb(h)bn 7etrt y?evofston (DSM-tX--TR) (i]. Behavioral signs of ASD emerge between 6 and t2 months of age in the Japan Brain Science Society NII-Electronic Library Service apanBrainScienceSociety ' Th!stLlte , iiiill:i.iiS ',orsei,-II-l] d rcr,.PSC.J.,.,i.fBrainscie"ce, March 30, 2013,Vol.40 form of a decline in social engagement, such as gazing at faces and social smiles t2]・ [3]. Moreover, the head circumference of subjects with ASD becomes signifioantly larger than that of normal svbjects at 12 to 24 months of. ageE4]: [5]. These results suggest that ASD'should be considered a nearly innate, rather than acquired, disease. The etiology of ASD has not yet been darified. However, genetic components are believed to play important roles in the pathogenesis ot ASD; for exampte, a twin study reported higher rates of concordance in monozygotic twins than in dizygotic twins [6] and a recent transcriptomic anatysls reported different gene expression patterns in the brains of subjects with and without ASD [n. The prevalence of ASD has been proposed to be as high as approximately 1% IS], and no effective treatments for ASD exist, with the exception of those that can aHeviate irritability19] and treat epileptic attacks. 7 Thus,clinical symptoms are most strongly associated with the burdens of caregiver over time [dO]. The clinica1 symptoms of ASD range widely across almost all domains of mentat and cognitive function, aithough social impairments and repetitive pattems of activities represent the core symptoms. For instance, intellectual bility can range from profound impairment to savantism lii]. Epilepsy is a major comoubidity and is recognized in approximateiy 30% of subjects [i2]. The affective and emotional domains can be affected in terms of irritability (e.g., temper tantrums and selFinjurious behavior), which caregivers and school teachers regard as unmanageable behavior and results in the pursuit of drug therapy [i3]. In the memory domain, ASD subjects ean experience suddenly vivid recollections of past personat events, the contents of which are often unpleasant and distressing to them [ri41. Moreover, healthy /i1 Japan Brain Science Society NII-Electronic Library Service apanBrainScienceSocietyTh!stitle .' l' illi ]/k '/-g tll 'III#ew d ."rK..Jour,.t.fBrainscience,March3o,2oi3'voi'4o su bjects, but not su bjects with ASD, show greater memory performance in settLreferential processing as compared to semantic processing [t5], and this result suggests deficits of segeconsciousness in ASD. The perception domain of mental and cognitive function can aiso be affected in subjects with ASD. Peroeption refers to the recognition of all of sensory information for an individual to perceive and understand the environment, whereas sensation refers to sensory information that itself does not include functions of memory, emotjon, and thinking that an indMdual processes after perceiving sensory informatjon. Sensation generally consists of visual, auditory, gustatory, tactile, olfactory, pain, and interoceptive modalities, among