In the 12 days leading up to our holiday hiatus, we are looking back on the past year and sharing some highlights in Massachusetts General Hospital research news from each month of 2017.

June 2017:

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 based at 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:

1. Individuals with autism 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.
2. Previous work by Nouchine Hadjikhani, MD, PhD, Director of Neurolimbic Research in the Martinos Center and corresponding author of the new study, demonstrated that the subcortical system, the part of the brain activated by eye contact and responsible for processing emotions and facial recognition, was oversensitive to direct gaze and emotional expression in autistic individuals.
3. In her most recent study, Hadjikhani presented images of faces conveying different emotions to study subjects with and without autism 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.
4. When the test was changed to narrow the focus to the eyes, Hadjikhani observed overactivation of the subcortical system in participants with autism. Images of fearful faces prompted the most significant response, but happy, angry and neutral faces had an effect as well. Their results support the idea that there is an imbalance between the brain’s “excitatory” network, which reacts to stimulation, and inhibitory network, which calms it down.
5. The findings suggest that behavioral therapies that try to force individuals with autism to make eye contact could be counterproductive. A better approach may be to slowly introduce these individuals to eye contact so they can learn strategies for managing the accompanying sensations.