A Physiological Marker of Recognition Memory in Adults with Autism Spectrum Disorder? - The Pupil Old/New Effect.

This study investigated the pupil Old/New effect in individuals with Autism Spectrum Disorder (ASD) and typical development (TD). Participants studied verbal and visual meaningful and meaningless materials in black and white on a computer screen. Pupil sizes were measured while participants performed a Remember (episodic memory with context)/Know (semantic memory, no context) recognition memory test. ASD compared to TD individuals showed significantly reduced recognition rates for all materials. Both groups showed better memory for visual compared to verbal (picture superiority effect) and meaningful compared to meaningless materials. A pupil size ratio (pupil size for test item divided by baseline) for old (studied) and new (unstudied) materials indicated larger pupils for old compared to new materials only for the TD but not the ASD group. Pupil size in response to old versus new items was positively related to recognition accuracy, confirming that the pupil Old/New effect reflects a memory phenomenon in the ASD group. In addition, this study suggests an involvement of the noradrenergic neurotransmitter system in the abnormal hippocampal functioning in ASD. Implications of these findings, as well as their underlying neurophysiology, will be discussed in relation to current theories of memory in ASD. Autism Res 2020, 13: 627-640. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Most measures of memory in Autism Spectrum Disorder (ASD) depend on verbal answers. In addition to these verbal answers, this study measured the size of the participants' pupil in response to studied and unfamiliar materials revealing memory difficulties in ASD. Measuring pupil size works nonverbally, outside of conscious awareness and forms the basis of studies on less verbal persons with ASD. Mechanisms and brain regions underlying memory differences in ASD are discussed.