Frontal EEG alpha asymmetry in youth with autism: Sex differences and social-emotional correlates

In youth broadly, EEG frontal alpha asymmetry (FAA) associates with affective style and vulnerability to psychopathology, with relatively stronger right activity predicting risk for internalizing and externalizing behaviors. In autistic youth, FAA has been related to ASD diagnostic features and to internalizing symptoms. Among our large, rigorously characterized, sex-balanced participant group, we attempted to replicate findings suggestive of altered FAA in youth with an ASD diagnosis, examining group differences and impact of sex assigned at birth. Second, we examined relations between FAA and behavioral variables (ASD features, internalizing, and externalizing) within autistic youth, examining effects by sex. Third, we explored whether the relation between FAA, autism features, and mental health was informed by maternal depression history. In our sample, FAA did not differ by diagnosis, age, or sex. However, youth with ASD had lower total frontal alpha power than youth without ASD. For autistic females, FAA and bilateral frontal alpha power correlated with social communication features, but not with internalizing or externalizing symptoms. For autistic males, EEG markers correlated with social communication features, and with externalizing behaviors. Exploratory analyses by sex revealed further associations between youth FAA, behavioral indices, and maternal depression history. In summary, findings suggest that individual differences in FAA may correspond to social-emotional and mental health behaviors, with different patterns of association for females and males with ASD. Longitudinal consideration of individual differences across levels of analysis (e.g., biomarkers, family factors, and environmental influences) will be essential to parsing out models of risk and resilience among autistic youth. Lay SummaryA long history of research links asymmetry in EEG activity across left and right frontal brain regions with risk for mental health concerns, but very little research has explored these relations among youth with ASD. In a group of children and teens, we found that links between asymmetry, social communication, restricted/repetitive behavior, family history, and youth mental health differed for females versus males with an ASD diagnosis. Findings suggest that mental health risk factors may work differently for autistic females versus autistic males.

Automated summary

The study explores the relationship between electroencephalogram (EEG) frontal alpha asymmetry (FAA) and mental health, ASD diagnostic features, and sex in youth. The findings suggest that FAA is associated with social-emotional behaviors, and there are different patterns of association for females and males with an ASD diagnosis.