Oxytocin increases eye contact during a real-time, naturalistic social interaction in males with and without autism

TLDR

Autism spectrum conditions affect about 1 % of the population and are marked by deficits in social communication, while oxytocin has been reported to influence social‑communicative function and its neural underpinnings. The study used a randomized double‑blind, placebo‑controlled, within‑subject design, administering 24 IU intranasal oxytocin to 32 autistic and 34 control males during a real‑time interaction with a researcher, with eye movements recorded via eye tracking. Intranasal oxytocin selectively increased eye‑contact duration in both autistic and control males, with the largest effect in autistic participants who had low baseline eye contact, demonstrating a therapeutic benefit in real‑time social interaction.

Abstract

Autism spectrum conditions (autism) affect ~1% of the population and are characterized by deficits in social communication. Oxytocin has been widely reported to affect social-communicative function and its neural underpinnings. Here we report the first evidence that intranasal oxytocin administration improves a core problem that individuals with autism have in using eye contact appropriately in real-world social settings. A randomized double-blind, placebo-controlled, within-subjects design is used to examine how intranasal administration of 24 IU of oxytocin affects gaze behavior for 32 adult males with autism and 34 controls in a real-time interaction with a researcher. This interactive paradigm bypasses many of the limitations encountered with conventional static or computer-based stimuli. Eye movements are recorded using eye tracking, providing an objective measurement of looking patterns. The measure is shown to be sensitive to the reduced eye contact commonly reported in autism, with the autism group spending less time looking to the eye region of the face than controls. Oxytocin administration selectively enhanced gaze to the eyes in both the autism and control groups (transformed mean eye-fixation difference per second=0.082; 95% CI:0.025-0.14, P=0.006). Within the autism group, oxytocin has the most effect on fixation duration in individuals with impaired levels of eye contact at baseline (Cohen's d=0.86). These findings demonstrate that the potential benefits of oxytocin in autism extend to a real-time interaction, providing evidence of a therapeutic effect in a key aspect of social communication.