L’importanza degli occhi in SVCF Bronwyn Glaser, Martin Debbané, Amélie Lothe, Mélanie Chabloz, Catherine Pasca, Marie-Christine Ottet, Patrik Vuilleumier and Stephan Eliez

Sommario L’importanza di prestare attenzione agli occhi nello sviluppo cerebrale ed emozionale Esplorazione facciale e durata dello sguardo sugli occhi in SVCF Relazione tra durata dello sguardo sugli occhi e ansietà Risultati di un trattamento: portando l’attenzione agli occhi

Contatto visivo e sviluppo delle regioni cerebrali Eye contact is important to the development of social skills… One model is that early orientation to the eye region develops expertise with faces thus making individuals more attune to emotions and social interactions. We have done several fMRI studies on each of these different steps, which I won’t talk about today, but I would be happy to take questions after… Grace à des connections réciproques, ces régions se dévéloppent ensemble en fonction de l’expérience de l’ndividu. Donc l’efficacité de tout le circuit est dépendant de tous les éléments

Importanza degli occhi nel riconoscimento delle emozioni Looking at the eyes is also important for understanding and recognizing expressions. These strange photos are the product of the Bubbles technique, and illustrate the areas of the face that are especially for key for successful emotion recognition. On the right we see the areas used by normal control to detect emotions, and on the left the areas used by HF autistic individuals Spezio et al, 2007, J Aut Dev Dis

Comparazione facciale: Esperienza di ricerca Modifica dei lineamenti Matura all’età di 10 anni So this launched our investigation of scanpath and the way our patients look at a face. We used a task called the Jane Task to examine Modifica della configurazione Matura all’età di 14 anni Study 5 Mondloch et al, 2002, Perception

Durata dello sguardo sulle regioni di interesse To understand why their face processing treatment is globally affected we drew AOIs around the key features and both heads Sono questi visi uguali o differenti? Study 5

Dove si ferma lo sguardo: Adulto tipico Control adult 24 years old F- I want to show you a picture of that. Here is a typical control subject processing a portion of the task

Dove si ferma lo sguardo: Bambino con difficoltà di apprendimento

Dove si ferma lo sguardo: Bambino con SVCF VCFS 5142 12.5 years old at time of participation M Here is a VCFS individual, though an extreme case- quite a few psychological problems

Durata dello sguardo sulle regioni facciali Tempo sui tratti facciali / Tempo totale sul viso * * * * So now we are looking at their time spent on the features- which are the key areas of interest on these fotographs and on faces in general- these are the percentage of time spent on the features out of total time For your background information indiv with VCFS spent just as much time - no diff but less time on the main features overall. And we see the specific of this here- out of the total time they spent on the heads, we see that they spent sig less time on the eyes (though it was the most interesting areas for both groups, and sig more time on the mouths VCFS average total time on heads (144,415.70 ms), Cont (157,865.10 ms) (tend toward a slightly faster treatment- less complete, detailed scanning? NOT SIGNIFICANT: F(55)=0.0573, p=0.452 However percentage of time on heads, VCFS sig less time on traits (E, N, M): 78.39% VCFS, 86.80% Control F(55)=4.807, p=0.033 Both groups spend the most time on eyes MANOVA significant ANOVA: Eyes F(55)=7.674, p=0.008 (VCFS LESS) Mouth F(55)=6.254, p=0.015 (VCFS MORE) Nose F(55)=1.218, p=0.275 DDs look like controls!!! (Age: 8-15) 22q11DS: N=26 DD: N=17 Control: N=22 Study 5

Regione di interesse per tipo di modifica Tempo sui tratti facciali / Tempo totale sul viso (Age: 8-15) 22q11DS: N=26 DD: N=17 Control: N=22 Study 5

Somma dei punti di fissazione per tipo di modifica Configurazione Lineamenti Uguale (Age: 8-15) 22q11DS: N=26 DD: N=17 Control: N=22 Study 5

Ansietà e durata dello sguardo sugli occhi Self and mother report Mean RCMAS total score: Control: 43.73 DD=51.24 VCFS=52.46 (Age: 8-15) 22q11DS: N=26 DD: N=17 Control: N=22 Study 5

Prima e dopo trattamento: Focus sugli occhi Et finalement nous allons finir avec des résultats de la partie evaluation. Donc c’est tres bien que nos 10 enfants se soient ameliores sur les taches de remediation, mais l’idee c’est que leurs apprentissages se generalisent aux autres jeux ou aux situations dans leurs vies quotidiennes

Riconoscimento dell’emozione: Diverse intensità Donc reprenons la tache classique des emotions So now let’s take this one step farther and look at how individuals with vcfs recognize facial emotion Here is an example of a task that we gave with emotions that were at a 50% degree (low intensity) like this face on the left or 100% high intensity The task is in French of course for our French population, but down below you can see that there is a choice of calm/neutral, happy, angry, fearful, or sad (5 emotions observed across cultures) 50% happy 100% Fearful

Miglioramenti nel riconoscimento emozionale in SVCF

Prima del trattamento: Adolescente con SVCF Age 16:10

Dopo il trattamento: Adolescente con SVCF

Pre-trattamento

Post-trattamento

Conclusioni Le differenze nella visualizzazione facciale sono relative alle difficoltà nel riconoscimento emozionale e ai cambiamenti cerebrali in SVCF. La mancanza di attenzione agli occhi sembra essere soprattutto legata all’ansietà. Un trattamento preciso mostra importanti cambiamenti sia nel riconoscimento emozionale che sulla esplorazione visiva. Points to under-connectivity (not like dev proso where regions present, but not specialized… this appears to be a lack of comprehensive inputs for faces, probably a result of other structural changes in the brain. Due to what are probably early poverties… we do not see the functional develop that we see and we see increasing structural changes in the fusiform with time

Collaboratori Contatto: bronwyn.glaser@unige.ch Stephan Eliez Bertrand Auckenthaler Catherine Audrin Lucia Bartoloni Sandra Berney Mélanie Chabloz Martin Debbané Sophie Dahoun Michal Epstein Astrid Flahault Manolo Fuentes Sylvie Guller AnnaLaura Lagioia Amélie Lothe Sandra Martinez Léa Matasci Ryan Murray Marie-Christine Ottet Catherine Pasca Marius Peelen Melissa Miguez David Sander Marie Schaer Maude Schneider Lucas Tamarit Patrik Vuilleumier Speciale ringraziamento: Connect22, Génération22, Relais22 Financial Support: SNF CIBM Fondation Eagle Fondation Handicap Mental & Société Contatto: bronwyn.glaser@unige.ch

Emotion recognition: maximal intensity

Emotion recognition: reduced intensity

Face exploration in healthy adults Healthy adults both groups- led to follow a typical or atypical scanpath. Ventral temporal cortex face/non-face specific areas, what saw was that typical scanpath maximizes activity in both types of areas. (White cross hair was where fixation cross jumped, and red fixations where subjects looked.) Morris et al, 2007, SCAN

Visual category localizer task: block design Faces 15sec 15sec Tools 20 images per 15 sec block 300ms per image TIME + 15sec Scenes 15sec Bodies “Press if you see the same picture twice in a row!” Study 4

Behavioral results Visual Category Localizer + Task TIME Study 4 * 23 controls (mean=15.17) 20 22q11DS (mean=14.50) Main effects for diagnosis and category Interaction between diagnosis and category- driven by faces Visual Category Localizer Task TIME + Study 4

Faces > Tools Study 4 23 controls (mean=15.17) Compared voxel localized in normal adults- even in young controls more variance in FFA, but in VCFS is not a story of variance, but rather, or hypoactivation p<0.001 23 controls (mean=15.17) 20 22q11DS (mean=14.50) Study 4

Bodies > Tools Study 4 23 controls (mean=15.17) Tools T statistic calculated by Tools > Bodies, Tools > Faces EBA (extrastriate activity) and diffusivity greater in controls, but when we look at the two groups- the activity in the fusiform area is equal (T Statistic 3.74 for both groups when individually matched) Effect of anxiety/COMT/psychosis: Anxiety (different measures in sample) Used RCMAS Total Anxiety T score (22q11DS 12 patients, Cont 14 patients), find is related to Faces > Tools activation… higher anxiety corresponds to higher contrast estimate, but flat in controls. COMT does not appear to have major affect on parameter estimates from rFG. Val slightly more rFG activity Bodies > Tools, but both low on Faces > Tools. Val greater whole-brain response (and particularly prefrontal response) in general, possibly indicating more connectivity/inputs, but supposition at this point. (11 M, 7 Val, 2 unknown excluded) None of patients are schizophrenic. Absolutely no difference in rFG between yes and no with psychotic symptoms (hallucinations and delusions), but very small groups (12 yes, 8 no). Yes slightly more FG activation, but likely due to age (slightly older: 16 vs. 12 yrs) p<0.001 23 controls (mean=15.17) 20 22q11DS (mean=14.50) Study 4 N=17 per group Mean age= 13.4, (7-21), individually matched

Contatto visivo e sviluppo delle regioni cerebrali This model represents the complexity in terms of the number of areas as well as the interactions between the areas that are involved in face processing. Eye contact is one mechanism that puts into motion many of the areas in the social brain, that ramps up inputs into these different areas thus allowing for experience-driven specialization. Some of the areas that are activated in face processing, from very early on, are subcortical areas, ventral temporal cortex and prefrontal cortex- all of which are changed in 22q11DS Response that we see in the fusiform gyrus appears to be a product of these interactions. We are all experts- that starts early Make simpler- These are changes that likely change the functional development of face processing circuits- circuits that are partially set into motion by early eye contact with babies: Changes include: Structural changes in subcortical circuits (important for processing low-grade info about faces) Axonal organization Developmental changes- volumetric changes in the temporal lobe and thinning in the fusiform gyrus among other regions These changes affect the coming online or the activation of certain regions as well as the specialization (or tuning) of these regions, but they also affect FP indirectly by encouraging a local processing style or by contributing to difficulties with frontal functions like empathy and mentalizing and limbic functions (the degree to which emotions are felt) Figure adapted from Senju, 2008, TICS