Specific Brain Activity During Theory of Mind Tasks in Autistic Individuals: A Meta-Analysis of fMRI Studies

Autistic individuals exhibit differences in Theory of Mind (ToM) compared to neurotypical (NT) individuals. The aim of this study was to meta-analyse the neural correlates that contributed to the manifestation of the expression differences in ToM between autistic individuals and the NT population. A total of 328 autistic participants and 314 NT participants from 18 studies were included. We adopted Activation Network Mapping, which is a novel neuroimaging meta-analysis method based on activation seeds and functional connectivity to identify brain networks, to investigate how the ToM network of the autistic group differed from that of the NT group. The thalamus and precuneus robustly participated in the ToM network of the autistic group. Moreover, the temporoparietal junction and the right hemisphere of the limbic system, especially the thalamus, caudate, and cingulum, were less involved in the autistic group's ToM network, compared to the NT group. Our findings provide the first quantitative evidence supportive of the distinct patterns in the ToM brain network in the autistic population. The current findings indicate that the primary difference in ToM task performance in autistic individuals may stem from altered information processing mechanisms rather than deficits in core ToM abilities.