A revisit of the amygdala theory of autism: Twenty years after.

This research review looked at whether problems with a brain area called the amygdala cause social difficulties in autism. After reviewing many studies, researchers found that amygdala problems only explain some autism features, mainly difficulties recognizing faces, but not other social challenges. They suggest that autism involves problems with how different brain areas work together, rather than just one brain region being affected.

This review examines the amygdala theory of autism after twenty years, evaluating evidence linking amygdala dysfunction to social difficulties in autism spectrum disorder. The authors analyzed studies comparing autistic individuals with those having focal amygdala lesions using identical tasks. They found the amygdala accounts for limited autism-related deficits, primarily in face perception but not social attention tasks. The review concludes that a network-based approach is more appropriate than focusing solely on the amygdala.

The authors discuss atypical brain connectivity in autism and propose extending the traditional amygdala theory to include broader brain network considerations using emerging technologies like machine learning and multimodal neuroimaging approaches.

Clinical assessment and intervention should consider broader brain network dysfunction rather than focusing solely on amygdala-related deficits. Face processing difficulties may benefit from specific interventions, while social attention challenges require different approaches targeting distributed brain networks.

This is a narrative review rather than a systematic review or meta-analysis. The specific number of studies reviewed and their methodological quality are not reported. The conclusions are based on selective literature rather than comprehensive systematic evidence synthesis.

The human amygdala has long been implicated to play a key role in autism spectrum disorder (ASD). Yet it remains unclear to what extent the amygdala accounts for the social dysfunctions in ASD. Here, we review studies that investigate the relationship between amygdala function and ASD. We focus on studies that employ the same task and stimuli to directly compare people with ASD and patients with focal amygdala lesions, and we also discuss functional data associated with these studies.

We show that the amygdala can only account for a limited number of deficits in ASD (primarily face perception tasks but not social attention tasks), a network view is, therefore, more appropriate. We next discuss atypical brain connectivity in ASD, factors that can explain such atypical brain connectivity, and novel tools to analyze brain connectivity. Lastly, we discuss new opportunities from multimodal neuroimaging with data fusion and human single-neuron recordings that can enable us to better understand the neural underpinnings of social dysfunctions in ASD. Together, the influential amygdala theory of autism should be extended with emerging data-driven scientific discoveries such as machine learning-based surrogate models to a broader framework that considers brain connectivity at the global scale.