孤独症谱系障碍儿童动态威胁与非威胁情绪面孔的注视特征研究

An eye-tracking study of dynamic threatening and non-threatening emotional faces in children with autism spectrum disorders

目的探究孤独症谱系障碍(autism spectrum disorder, ASD)儿童对动态威胁(恐惧、愤怒)及非威胁情绪(悲伤、快乐)面孔的注视特点, 并探讨其眼动追踪数据与孤独症症状评分的相关性, 为ASD儿童治疗和康复提供依据。方法 2020年11月至2021年6月, 纳入符合入组标准的26名ASD儿童和30名年龄、性别匹配的正常发育儿童(typical developmental, TD), 对ASD儿童采用儿童孤独症评定量表(childhood autism rating scale, CARS)进行症状评估。运用SMI-red便携式眼动追踪记录系统记录两组儿童在自由观看动态威胁及非威胁情绪面孔片段时的眼动注视特征。使用SPSS 21.0软件进行统计学处理, 其中符合正态分布的数据采用独立样本t检验及卡方检验, 对不符合正态分布的数据采用非参数检验。采用Pearson相关分析评定眼动追踪数据与症状评分的相关性。结果 ASD组儿童CARS总分为(32.64±7.42)分。ASD儿童眼动追踪数据表现出注视厌恶特点, ASD儿童注视恐惧[2.41(0.26, 10.65)s]、愤怒[2.17(0.13, 6.13)s]威胁性情绪面孔眼区时的注视时间显著少于TD儿童[8.81(2.54, 12.11)s, 5.21(3.80, 12.49)s], 均差异有统计学意义(恐惧:Z=-2.252, P<0.05;愤怒:Z=-2.793, P<0.01)。ASD儿童对四种情绪面孔嘴区的注视时间[悲伤:3.56(0.44, 7.16)s, 恐惧:2.68(0.42, 4.78)s, 愤怒:2.13(0.35, 4.20)s, 快乐:2.93(0.46, 5.71)s]均显著少于TD儿童[悲伤:11.43(6.97, 14.22)s, 恐惧:6.73(3.65, 10.10)s, 愤怒:6.86(4.55, 12.33)s, 快乐:11.72(7.22, 14.39)s], 均差异有统计学意义(悲伤:Z=-4.502, P<0.01;恐惧:Z=-3.493, P<0.01;愤怒:Z=-4.025, P<0.01;快乐:Z=-4.699, P<0.01)。相关分析发现ASD儿童对情绪面孔注视时间与CARS总分(r=-0.476, P<0.05)呈负相关, 对不同情绪面孔进一步分析发现, ASD儿童对恐惧面孔的注视时间与CARS总分(r=-0.455, P<0.05)呈负相关。结论 ASD儿童眼动追踪显示出与TD儿童相比对威胁性情绪面孔注视时间更少的注视特征, 并且ASD症状越严重, 对恐惧面孔的注视时间越少。

Objective To investigate the gaze characteristics of children with autism spectrum disorder(ASD)on dynamic threatening(fear,anger)and non-threatening emotional(sadness,happiness)faces,and to explore the correlation between their eye-tracking data and autism symptomatology scores to provide a basis for the treatment and rehabilitation of children with ASD.Methods From November 2020 to June 2021,26 children with ASD and 30 age-and sex-matched normally developing children(typical developmental,TD)who met the enrollment criteria were included,and children with ASD were assessed for symptoms by the childhood autism rating scale(CARS).The SMI-red portable eye-tracking recording system was used to record the eye-movement gaze characteristics of children in both groups during free viewing of dynamic threatening and non-threatening emotional face segments.Statistical processing was performed by SPSS 21.0 software.The independent sample t-test and chi square test were used for the data conforming to the normal distribution,and the non parametric test was used for the data not conforming to the normal distribution,and Pearson correlation analysis was used to analyze the correlation between eye-tracking data and symptomatology scores.Results The total CARS score of the ASD group was(32.64±7.42).The eye tracking data for children with ASD showed gaze aversion characteristics.Children with ASD spent significantly less time gazing at the eye area of threatening emotional faces in fear(2.41(0.26,10.65)s)and anger(2.17(0.13,6.13)s)than children with TD(8.81(2.54,12.11)s,5.21(3.80,12.49)s),with statistically significant differences(fear:Z=-2.252,P<0.05.anger:Z=-2.793,P<0.01).Children with ASD spent significantly less time gazing at the mouth area of all four emotional faces(sad:3.56(0.44,7.16)s,fear:2.68(0.42,4.78)s,anger:2.13(0.35,4.20)s,happiness:2.93(0.46,5.71)s)than children with TD(sad:11.43(6.97,14.22)s,fear:6.73(3.65,10.10)s,anger:6.86(4.55,12.33)s,happiness:11.72(7.22,14.39)s),with statistically significant differences(sad:Z=-4.502,P<0.01.fear:Z=-3.493,P<0.01.anger:Z=-4.025,P<0.01.happiness:Z=-4.699,P<0.01).Correlation analysis revealed that the time spent gazing at emotional faces in children with ASD was negatively correlated with the total CARS score(r=-0.476,P<0.05),and further analysis of different emotional faces revealed that the time spent gazing at fearful faces in children with ASD was negatively correlated with the total CARS score(r=-0.455,P<0.05).Conclusions Eye tracking in children with ASD show a gaze profile with less gaze time to threatening emotional faces compared with TD children,and the more severe the symptoms in children with ASD,the less gaze time to fearful faces.