Different aberrant mentalizing networks in males and females with autism spectrum disorders: Evidence from resting-state functional magnetic resonance imaging.
Autistic males over-connect their mentalizing brain areas, while autistic females under-connect—so sex must guide how we assess and treat.
01Research in Context
What this study did
Yang et al. (2018) scanned adults with and without autism while they rested. The team looked at how tightly the brain’s "mentalizing" areas talk to each other. They split the groups by sex to see if wiring patterns differ in autistic men versus autistic women.
No tasks were given; the pictures show natural brain chatter. The researchers asked: do males and females with autism show opposite connection styles?
What they found
Autistic men had extra-strong links between mentalizing regions compared with typical men. Autistic women showed weaker links than typical women. Same diagnosis, opposite wiring: over-connected in males, under-connected in females.
How this fits with other research
Pielech et al. (2016) saw the same split using a social task: only autistic men showed reduced brain activity, while autistic women looked like typical women. The two studies line up—males diverge more on both activation and connectivity.
Harrop et al. (2018) tracked eye gaze and found autistic girls kept typical face-looking, but autistic boys did not. Again, girls looked "more typical," supporting the idea that female autism can mask itself.
Lacroix et al. (2024) added EEG data showing autistic women spread their brain activity wider when viewing fearful faces. Together, the papers show sex differences repeat across imaging types and tasks.
Costa et al. (2017) seems to clash: high-functioning autistic women showed reduced face looking. The difference is age and ability—adult women in that study had subtle but real social attention gaps. The takeaway: autistic females may look "typical" on some measures yet still show deficits on closer inspection.
Why it matters
If you assess autism with male-based norms, you can miss autistic females. Look for smaller social slips, not obvious gaps. When you read brain-imaging reports, ask if data were split by sex. Tailor goals: males may need help pruning over-active networks, females may need help boosting weaker ones.
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02At a glance
03Original abstract
Previous studies have found that individuals with autism spectrum disorders show impairments in mentalizing processes and aberrant brain activity compared with typically developing participants. However, the findings are mainly from male participants and the aberrant effects in autism spectrum disorder females and sex differences are still unclear. To address these issues, this study analyzed intrinsic functional connectivity of mentalizing regions using resting-state functional magnetic resonance imaging data of 48 autism spectrum disorder males and females and 48 typically developing participants in autism brain imaging data exchange. Whole-brain analyses showed that autism spectrum disorder males had hyperconnectivity in functional connectivity of the bilateral temporal-parietal junction, whereas autism spectrum disorder females showed hypoconnectivity in functional connectivity of the medial prefrontal cortex, precuneus, and right temporal-parietal junction. Interaction between sex and autism was found in both short- and long-distance functional connectivity effects, confirming that autism spectrum disorder males showed overconnectivity, while autism spectrum disorder females showed underconnectivity. Furthermore, a regression analysis revealed that in autism spectrum disorder, males and females demonstrated different relations between the functional connectivity effects of the mentalizing regions and the core autism spectrum disorder deficits. These results suggest sex differences in the mentalizing network in autism spectrum disorder individuals. Future work is needed to examine how sex interacts with other factors such as age and the sex differences during mentalizing task performance.
Autism : the international journal of research and practice, 2018 · doi:10.1177/1362361316667056