Functional connectivity within an anxiety network and associations with anxiety symptom severity in middle-aged adults with and without autism.
In mid-life autistic adults, weaker insula-based anxiety-circuit wiring tracks with higher anxiety, separate from autism traits.
01Research in Context
What this study did
Lo et al. (2021) scanned middle-aged adults with and without autism. They looked at how tightly an anxiety circuit in the brain was wired.
The team also asked each person how anxious they felt. Then they checked if weaker brain links matched higher anxiety scores.
What they found
Adults with autism said they were more anxious. Their anxiety circuit showed weaker connections, especially in the back part of the insula.
Only the autism group showed a clear link: the weaker the insula link, the higher the anxiety. Autism traits alone did not explain the pattern.
How this fits with other research
Montazeri et al. (2019) saw the opposite pattern in children. In their network map, anxiety sat on the edge and looked the same in autistic and typical kids. The clash fades when you note the age gap: kids may use different brain paths than adults.
Eussen et al. (2016) first showed that amygdala sub-regions were over- or under-connected in autism and tied these patterns to anxiety. Lo et al. (2021) move the lens to the insula and confirm that faulty wiring still matters in mid-life.
Ambrose et al. (2022) found that anxious autistic kids join fewer home and community activities. Ryan’s adult brain data hint that the same wiring problem may limit participation across the lifespan.
Why it matters
If you serve autistic adults, screen for anxiety even when core autism signs look stable. Weak insula-based connectivity gives a neural reason for their worry and may guide future bio-behavioral plans. For now, add anxiety goals to treatment and watch if easing worry also frees up daily living skills.
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02At a glance
03Original abstract
Anxiety is highly prevalent in autism spectrum disorders (ASDs). However, few functional magnetic resonance imaging (fMRI) studies of ASDs have focused on anxiety (and fewer still on anxiety in middle-aged adults). Thus, relationships between atypical connectivity and anxiety in this population are poorly understood. The current study contrasted functional connectivity within anxiety network regions across adults (40-64 years) with and without autism, and tested for group by functional connectivity interactions on anxiety. Twenty-two adults with ASDs (16 males) and 26 typical control (TC) adults (22 males) completed the Beck Anxiety Inventory and a resting-state fMRI scan. An anxiety network consisting of 12 regions of interest was defined, based on a meta-analysis in TC individuals and two studies on anxiety in ASDs. We tested for main effects of group and group by anxiety interactions on connectivity within this anxiety network, controlling for head motion using ANCOVA. Results are reported at an FDR adjusted threshold of q < 0.1 (corrected) and p < 0.05 (uncorrected). Adults with ASDs showed higher anxiety and underconnectivity within the anxiety network, mostly involving bilateral insula. Connectivity within the anxiety network in the ASD group showed distinct relationships with anxiety symptoms that did not relate to ASD symptom severity. Functional connectivity involving the bilateral posterior insula was positively correlated with anxiety in the ASD (but not the TC) group. Increased anxiety in middle-aged adults with ASD is associated with atypical functional connectivity, predominantly involving bilateral insula. Results were not related to ASD symptom severity suggesting independence of anxiety-related effects. LAY SUMMARY: Anxiety is very common in adults with autism but the brain basis of this difference is not well understood. We compared functional connectivity between anxiety-related brain regions in middle-aged adults with and without autism. Adults with autism were more anxious and showed weaker functional connections between these regions. Some relationships between functional connectivity and higher anxiety were specific to the autism group. Results suggest that anxiety functions differently in autism.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1016/j.neubiorev.2018.11.005