Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications
Abstract
:1. Introduction
1.1. Methodology
- PubMed: PubMed: Specializing in medical sciences, this database was instrumental for acquiring the literature on the diagnostic and neurological aspects of ASD.
- IEEEXplore: Selected for its extensive collection of technology-related publications, particularly those focused on the application of VR, AR, and MR in ASD.
- Wiley Online: Contributed to a well-rounded review with its comprehensive range of subjects, including health, physical sciences, social sciences, and the humanities.
- MDPI: Particularly useful for its focus on extended reality (XR) technologies and as a supplementary source for articles not available in other databases.
- Frontiers: An open-access platform that publishes peer-reviewed articles across multiple disciplines, including science and technology, medicine, and the humanities.
- Elsevier, Springer, Semantic Scholar: These multi-disciplinary databases provided a broad scientific backdrop for our review.
- The research must focus on at least one of the following key terms: ASD, brain structure, brain function, sex differences, or XR technology interventions.
- The studies must present empirical data relating to XR-based ASD interventions or brain activity. For the purpose of this review, “empirical data” refers to quantitative or qualitative information collected through observation or experimentation. This includes, but is not limited to, randomized controlled trials, observational studies, and validated surveys or questionnaires.
- The studies should provide some detailed participant characteristics, including, but not limited to, age, sex, and diagnosis criteria met. This also extends down to their methodology in terms of procedure, type of XR technology used, and equipment.
- The studies should offer significant findings—whether positive or negative—pertaining to the interventions or brain activities under investigation. The studies that had inconclusive findings were excluded.
- Autism Spectrum Disorder (ASD)
- ASD brain activity
- XR and ASD
- Virtual reality and autism
- Augmented reality and autism
- ASD in women
1.2. Paper Organization
2. The Related Literature
2.1. Feasibility of XR-Based Interventions for ASD
- social interaction
- communication and speech
- emotion recognition and control
- daily living skills
- problem behavior reduction
- anxiety symptom reduction
- insomnia control
2.2. Differences in Brain Structures and Function Based on Sex for ASD
2.3. Remarks
- A critical evaluation of the existing research, complete with the identification of gaps and suggestions for future work.
- A comprehensive overview focusing on the specific brain regions most impacted by ASD.
- Novel insights into the sex-specific differences in the neurological manifestations of ASD.
3. Divergent Neurological Correlations in Males and Females with ASD
4. XR Use Cases for ASD
4.1. Social Skills
4.2. Life Skills and Daily Activities
4.3. Concentration
4.4. Neurofeedback
5. Discussion
6. Limitations
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Levels of ASD | Characteristics |
---|---|
Level 1: Requiring Support |
|
Level 2: Requiring Substantial Support |
|
Level 3: Requiring Very Substantial Support |
|
Author(s) | Topic | General Findings | Pros | Cons |
---|---|---|---|---|
Bertram et al. [24] | XR | CAT shows promise, lacks rigorous assessment | Covers multiple areas, provides VR use cases | No consideration for alternatives |
Shoaib et al. [25] | XR | Benefits those with ASD, improves skills | Provides VR use cases | Limited tech coverage, insufficient research |
Mubin et al. [26] | XR | XR improves behavior, attention, reduces stress in ASD | Covers XR use cases and weaknesses | No participant info, limited analysis |
Chen et al. [23] | XR | XR improves ASD outcomes across numerous areas | Categorizes literature by XR tech type | Lack of info on hybrid interventions |
Roberts et al. [27] | XR | Limited evidence on XR’s effectiveness for ASD children | Quality of XR-based studies, mentions of brain anatomy | Unclear effectiveness on older teens |
Maran et al. [28] | XR | XR improves navigation and daily living skills for ID individuals | Wide age range of participants, varying degrees of ID | Small sample sizes, no control group |
Gu et al. [29] | XR | XR platform usage tied to technical features and study traits | Review of XR technologies, high number of studies | No consistent quality check |
Karagiannidis et al. [30] | AR | AR can help people with ASD learn new skills | Coverage of use cases | Very low number of studies |
Wedyan et al. [31] | AR | Limited long-term research on AR’s effectiveness with autistic children | Proposes new AR system, strong evidence for AR usage | Small sample sizes, short study durations |
Lian et al. [32] | AR | Mobile AR aids autism intervention to some degree | Discusses mobile applications of AR | Studies involved mostly children, small sample size |
Cavus et al. [33] | AR | AR applicable for multiple fields and disabilities | Calls for more AR-based research | Limited search criteria |
Huamanchahua et al. [34] | AR | AR/VR can enhance education, but usage is limited | Discusses AR and VR platforms used | Participants’ characteristics not discussed |
Shahmoradi et al. [35] | VR | VR technologies had beneficial effects on reducing cognitive problems | Strong assessment of study quality | Very low number of studies, low numbers of women participants |
Zhang et al. [36] | VR | VR improves social functioning, emotion recognition, speech, and language | Overview of popular VR products | Does not discuss applicability for adults with ASD |
Glaser et al. [37] | VR | Inconsistencies in how VR is conceptualized | Need for clear VR definition | Does not address other types of XR technologies |
Bozgeyikli et al. [38] | VR | VR design guidelines for ASD individuals rely on observation and lack generalizability | Covers VR system types, design considerations | Low number of participants |
Mesa-Gresa et al. [39] | VR | VR-based treatment improves at least one common ASD deficit | Reviews clinical and technical databases | Limited insight into variations between males and females. Focus on ‘high performance autism’ |
Author | Technique(s) Used | Pros | Cons |
---|---|---|---|
Supekar et al. [41] | fMRI (functional magnetic resonance imaging) |
|
|
Alaerts et al. [46] |
|
| |
Schumann et al. [47] | MRI |
|
|
Ecker et al. [21,42,48] |
|
| |
Lai et al. [49] |
|
| |
Hull et al. [43] | rs-FMRI |
|
|
Subbaraju et al. [44] |
|
| |
Grossi et al. [50] | EEG |
|
|
Buch et al. [51] | Machine Learning |
|
|
Frazier et al. [52] | Data analysis from the Simons Simplex Collection. t-tests were also used for determining clinical characteristics among women. |
|
|
Paaki et al. [45] | Regional Homogeneity (ReHo) Analysis |
|
|
Brain Region(s) | Related References | Associated Organs |
---|---|---|
Temporal Lobe | [45,47,57,58,59,60,61,62,63,64] | Middle Temporal Gyrus (MTG) |
Amygdala | ||
Fusiform gyrus | ||
Hippocampus * | ||
Insula * | ||
Frontal Lobe | [7,47,58,62,64,65,66,67,68] | Anterior cingulate cortex (ACC) |
Cingulate gyrus | ||
Dorsal anterior cingulate cortex (dACC) * | ||
Dorsolateral prefrontal cortex (DLPFC) | ||
Inferior frontal gyrus (IFG) | ||
Medial prefrontal cortex (MPFC) | ||
Prefrontal cortex | ||
Superior frontal gyrus (SFG) | ||
Subcortical Structures | [69,70] | Basal ganglia |
Cerebellum | [71,72,73,74,75] | Cerebellar vermis |
Occipital Lobe | [64,76] | Visual cortex |
Lateral occipital cortex | ||
Parietal Lobe | [7,62,64,66] | Superior parietal lobule |
Posterior cingulate cortex (PCC) * | ||
Corpus Callosum | [76,77,78,79,80] | N/A |
Areas of Improvement | Sub-Category | Citation | Method | Specific Use Case(s) |
---|---|---|---|---|
Social Skills | Nonverbal Communication | [91] | MR | Nonverbal communication |
Body Language and Facial Expressions | [92,93,94,95] | AR | Body language and facial expressions | |
Social Interaction | [96] | MR | Collaboration | |
[97,98] | VR | Social interaction and social cognition | ||
Emotions | [99,100,101] | - AR MR | Understanding Emotions Empathy Relaxation | |
Life Skills and Daily Activities | Visual Perception 1 | [102,103] | VR | Street crossing |
Physical Well-being 2 | [104,105] | VR AR | Exercise Improving fine motor skills | |
Daily Living 3 | [106,107] | MR VR | Preparing for job interviews Driving | |
Concentration | Task Engagement | [108] | AR | Therapy sessions |
Attention Management 4 | [109] | AR | Attention management in terms of distraction | |
Attention Enhancement 5 | [110] | VR | Attention enhancement | |
Education | Special Education 6 | [111,112] | MR AR | Helping special educators teach children with ASD Improving English Vocabulary |
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Share and Cite
Razzak, R.; Li, J.; He, S.; Sokhadze, E. Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications. Brain Sci. 2023, 13, 1571. https://doi.org/10.3390/brainsci13111571
Razzak R, Li J, He S, Sokhadze E. Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications. Brain Sciences. 2023; 13(11):1571. https://doi.org/10.3390/brainsci13111571
Chicago/Turabian StyleRazzak, Rehma, Joy Li, Selena He, and Estate Sokhadze. 2023. "Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications" Brain Sciences 13, no. 11: 1571. https://doi.org/10.3390/brainsci13111571
APA StyleRazzak, R., Li, J., He, S., & Sokhadze, E. (2023). Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications. Brain Sciences, 13(11), 1571. https://doi.org/10.3390/brainsci13111571