More Than Meets the Eye: Researchers Find Eye Contact Causes Stress and Overactivation in the Brains of Autistic Individuals

They say that eyes are the windows to the soul, but for individuals with autism, a lack of eye contact can reveal much more.

A team of investigators from the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital has shed light on why those with autism often avoid looking others in the eyes.

Here are five things to know about the study published in Nature Scientific Reports this month:

Individuals with autism spectrum disorder (ASD) often find it difficult to look others in the eyes. Many say that maintaining eye contact is uncomfortable or stressful for them – some will even say that “it burns” – which suggests the root of this discomfort is neurological.

Previous work by Nouchine Hadjikhani, MD, PhD, Director of Neurolimbic Research at the Martinos Center and corresponding author of the new study, demonstrated that the subcortical system—the part of the brain that is activated by eye contact and responsible for processing emotions and facial recognition—was oversensitive to direct gaze and emotional expression in autistic individuals.

In her recent study, Hadjikhani presented individuals with ASD and healthy controls with images of faces conveying different emotions and measured their brain activity via functional magnetic resonance imaging (fMRI). When both groups were able to gaze at the images freely, there was no difference in subcortical activation.

When the test was changed to narrow the focus of the images down to the eyes, however, Hadjikhani and team observed that participants with ASD experienced overactivation of the subcortical system.

Images of fearful faces prompted the most significant response, but happy, angry and neutral faces had an effect as well.

The results support the idea that in some individuals with ASD there is an imbalance between the brain’s “excitatory” network, which reacts to stimulation, and the brain’s inhibitory network, which calms it down.

The findings suggest that behavioral therapies that attempt to force individuals with ASD to make eye contact with others could be counterproductive. It may be better to gradually introduce these individuals to making eye contact so that they can learn strategies for managing the sensations that it causes.