Widespread Hyper-Coupling and Frequency-Specific Dysregulation of Phase-Amplitude Coupling in Young Children with Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is characterized by widespread aberrations in brain scalp-level synchronization. Phase-amplitude coupling (PAC), which reflects cross-frequency neuronal oscillatory interactions, serves as a crucial metric for assessing functional brain integration. However, the specific patterns of PAC at both intra-region and inter-region scalp levels in young children with ASD, as well as their precise associations with clinical symptoms, remain unclear. Methods: This study enrolled 237 children with ASD aged 3–9 years and 201 age-matched typically developing (TD) children. Resting-state electroencephalography (EEG) data were acquired from all participants. The analysis systematically examined low-frequency oscillation phase (δ, θ, α) modulation of high-frequency oscillation amplitude (β and low γ) from both intra-region and inter-region dimensions. The PAC strength was quantified using the modulation index (MI). Multiple comparisons were corrected using the Bonferroni method. Finally, correlations between PAC metrics and Autism Behavior Checklist (ABC) scores were analyzed. Results: Compared to the control group, children with ASD exhibited significant frequency-specific PAC abnormalities: (1) Multi-regional γ hyper-coupling: There was a significant enhancement in the modulation of γ amplitude by δ/θ/α phase across the measured scalp regions, suggesting abnormal high-frequency synchronization. (2) Dissociated β modulation patterns: The ASD group showed increased δ–β coupling (predominantly in frontal, temporal, and occipital lobes) alongside significantly reduced α–β coupling (localized to frontal and central regions). This reflects both an abnormal locking of slow-wave activity to the β band and a diminished regulatory role of α oscillations. (3) Clinical correlation: Notably, abnormally elevated PAC strength (particularly in the δ/θ/α–γ bands) showed a negative correlation with clinical symptom severity—that is, stronger coupling was associated with lower scores on the ABC. Conclusions: Leveraging a large-sample dataset, this study characterizes the landscape of aberrant cross-frequency interactions in young children with ASD. Our findings indicate that the neuroelectrical activity in ASD goes beyond mere connectivity anomalies by demonstrating altered PAC strength at both the intra-region and inter-region levels. Notably, the strength of this aberrant intra-region PAC is correlated with clinical symptoms.