Achados de eletroencefalografia, eye-tracking e perfil neuropsicológico de crianças com transtorno do espectro do autismo

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that emerges in early years, characterized by social and behavioral deficits, including stereotypies and specific interests. There are also cognitive weaknesses, such as intellectual and adaptive deficits, along with executive, attentional, and communication dysfunctions. Its pathophysiology remains inconclusive, and diagnosis is based on clinical history and careful observation. The incidence of ASD is high, increasing after revisions of diagnostic criteria and recognition of early intervention. Systematic clinical assessments are crucial for diagnosis, and neuropsychological evaluations help grade impairment and map cognitive profiles, notably in executive functions, attention, language, theory of mind, and intellectual profile. This thesis aimed to assess the association of resources as a supplementary tool for ASD detection. The study included 34 children (17 with ASD and 17 without), aged 4 to 12, matched for age and gender (15 boys and 2 girls in each group). The ASD group was divided into three levels of support: I (7 children), II (6 children), and III (4 children), along with three levels of intellect: below average (8 children), average (6 children), and above average (3 children). Both groups were exposed to facial stimuli with happy, neutral, and angry expressions, with simultaneous recording of electroencephalogram (EEG) and eye-tracking. Data on distribution of brain waves by frequency bands obtained through quantitative EEG (qEEG) and the eye-tracking gaze profile were compared between groups, considering statistically significant differences (p < 0.05). Results revealed discrepancies in more than one parameter of visual tracking of human faces in children with ASD, varying depending on the presented face type. Notable differences were observed in the facial exploration sequence, the number of points traversed, total time, and initial fixation on the eye region, as well as eye movement speed. Among other differences, the ASD group exhibited lower attention, higher speed, and differences in eye movement sequencing when exploring the eye region. qEEG findings also highlighted a distinct pattern in the brain's electrical activity of children with ASD, depending on the presented face type. Slower rhythms were observed in anterior regions during happy faces, while faster rhythms occurred in anterior areas for neutral faces and posterior areas for faces expressing anger. The conclusion was that there are variations in eye-tracking patterns and frequency bands of brain electrical activity in children with ASD when exposed to emotional stimuli. By integrating these findings with the neurocognitive clinical profile, eye-tracking, and qEEG, it is possible to suggest a protocol for tracking and analyzing children with ASD. The use of combined tools to detect warning signs and confirm ASD diagnoses in less time tends to expedite early diagnosis and subsequent intervention implementation.