Working memory deficits in high-functioning adolescents with autism spectrum disorders: neuropsychological and neuroimaging correlates

Barendse, Evelien M.; Hendriks, Marc P. H.; Jansen, Jacobus F.A.; Backes, Walter H.; Hofman, Paul A.M.; Thoonen, Geert; Kessels, R.P.C.; Aldenkamp, Albert P. · 2013 · OpenAlex-citations

DOI: 10.1186/1866-1955-5-14

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Summary

This review paper investigates working memory (WM) deficits in high-functioning adolescents with autism spectrum disorders (ASD), aiming to clarify the neuropsychological and neuroimaging correlates of these impairments. The authors are motivated by the observation that while executive dysfunction is common in ASD, existing theories (such as theory of mind deficits or weak central coherence) fail to fully explain the broad spectrum of symptoms. Since WM is central to complex cognitive processing and social cognition, the paper posits that WM deficits may underlie the social and behavioral challenges characteristic of ASD. The review focuses specifically on adolescents, a period of significant neural development, to bridge the gap between cognitive theories and observed behavioral difficulties. The authors conducted a comprehensive review of existing neuropsychological and functional magnetic resonance imaging (fMRI) studies involving high-functioning adolescents and young adults with ASD. They analyzed data from various studies that utilized standardized WM tasks, such as the CANTAB spatial working memory task, the WRAML finger windows task, and oculomotor delayed response tasks. The review also examined neuroimaging studies that employed tasks like mental rotation, n-back tasks for faces, and the preparing-to-overcome prepotency (POP) task to assess brain activation and connectivity patterns during WM processing. The analysis compared performance and neural activity in ASD groups against typically developing controls, often matching for age, gender, and IQ. The neuropsychological findings reveal inconsistent results, largely dependent on task complexity. While some studies found no significant WM differences, others demonstrated specific impairments in spatial working memory, particularly when tasks imposed higher cognitive loads or required processing complex social information. For instance, adolescents with ASD made more errors on tasks with higher memory loads (e.g., eight items) compared to lower loads (e.g., four items). These deficits were linked to difficulties in context-relevant updating and rapid biasing of task-relevant cognitions. Neuroimaging studies indicated that rather than a focused deficit in the prefrontal cortex, individuals with ASD exhibit a more global processing or connectivity deficiency. Specifically, fMRI results showed reduced activation in the anterior cingulate, dorsolateral prefrontal cortex, and caudate nucleus, as well as reduced functional connectivity between frontal and parietal regions during WM tasks. Some studies also noted shifted activation patterns in areas associated with social information processing, such as the posterior temporal lobes. The significance of these findings lies in the suggestion that WM deficits, particularly in the spatial domain and under high cognitive load, contribute to the social impairments seen in ASD. The authors conclude that the "overwhelmed feeling" often reported by individuals with ASD during complex social interactions may stem from the high WM demands required to process rapidly changing social cues. The observed global connectivity deficiencies in the fronto-parietal WM network provide a neural basis for these cognitive struggles. The paper calls for further research to explicitly link these WM and neuroimaging findings to the specific behavioral difficulties in ASD, suggesting that understanding WM mechanisms could offer new insights into the etiology and treatment of social deficits in autism.

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• working memory