Neuroimaging Evidence of Facial Emotion Processing in Autism Spectrum Disorder: A Meta-Analysis of Functional Neuroimaging Studies

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PURPOSE: The neural mechanisms underlying facial emotion processing (FEP) difficulties in autistic people remain unclear. This Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) meta-analysis examined brain activity during FEP in autistic people. METHOD: We systematically searched three databases (PubMed, Web of Science, PsycINFO) for fMRI studies (published up to September 2, 2025) comparing DSM-diagnosed autistic people with non-autistic people (NAP) during FEP, and eligible studies reported whole-brain coordinates. A convergence analysis of the contrasts between the ASD and NAP groups was performed. Subgroup analyses and meta-regressions were conducted to explore potential sources of heterogeneity. RESULTS: A total of 25 fMRI studies, comprising 632 autistic people and 568 non-autistic people, were included in this meta-analysis. The results revealed a widespread convergence of decreased activation in the inferior frontal gyrus (IFG), middle temporal gyrus (MTG), fusiform gyrus (FG), cerebellum (Cb), and insula during FEP in autistic people at an uncorrected threshold level with P < 0.005. Among these, only the IFG passed FWE correction with P < 0.05. Subgroup exploratory analyses based on task type suggested that both explicit and implicit tasks may elicit a convergence of decreased activation along the ventral stream (IFG, FG, MTG), while explicit tasks may additionally involve convergence of increased activation in visual processing regions (lingual gyrus and inferior longitudinal fasciculus) at an uncorrected threshold level with P < 0.005. In addition, subgroup exploratory analysis of age showed autistic minors may recruit more visual resources compared to adults at an uncorrected threshold level with P < 0.005, and the exploratory regression analysis showed that higher IQ may be associated with decreased neural activity in the superior occipital gyrus (SOG) at an uncorrected threshold level with P < 0.005. CONCLUSION: Dysfunctional brain activity during facial emotion processing in autistic people was most robustly reflected in the convergence of decreased activation in the IFG, particularly the left IFG-op. Exploratory analyses further suggested that other aberrant brain activations may be focused on the ventral stream. In addition, exploratory subgroup analyses indicated that explicit tasks and minors might recruit multiple visual systems, potentially as a compensatory strategy.

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