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نمایش مقاله

Title:

Naturalistic fMRI in Autism (Movie-Watching and Social Scenes): Clinically Interpretable Markers and Reproducibility—A Scoping Review

Subject:

Autism and Brain Mapping

Presenter Author:
Name:	Zeinab Sinaeifar

Author:
Name 1:	Zeinab Sinaeifar - Corresponding - Presenter
Affiliation 1:	maternal-fetal and neonatal research center, family health institute, imam khmeini hospital, tehran university of medical sciences, tehran, iran

Name 2:	Mohammad Azizi
Affiliation 2:	maternal-fetal and neonatal research center, family health institute, imam khmeini hospital, tehran university of medical sciences, tehran, iran

Name 3:	Sara Mehri
Affiliation 3:	maternal-fetal and neonatal research center, family health institute, imam khmeini hospital, tehran university of medical sciences, tehran, iran

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Abstract

Original Research

introduction :

Naturalistic functional MRI (fMRI) paradigms (e.g., movie watching) probe social–sensory processing under ecologically valid conditions and may yield clinically interpretable biomarkers for autism spectrum disorder (ASD). We scoped (1) which naturalistic fMRI markers most consistently differentiate ASD from typically developing (TD) participants, (2) whether markers relate to clinical phenotype, and (3) what evidence exists for reproducibility.

Methods:

We conducted a scoping review of PubMed and Google Scholar from database inception to 16 February 2025. Eligible studies were peer-reviewed, included ASD participants, acquired fMRI during naturalistic audiovisual stimulation (commercial film, documentary, sitcom, or comparable continuous social scenes), and reported group differences in stimulus-locked neural responses and/or associations with standardized clinical measures. We extracted sample characteristics, stimulus type, primary analytic approach (inter-subject correlation and inter-subject functional correlation), and reproducibility signals (repeat viewing/test–retest and external validation).

Results:

Across included studies, the dominant and convergent finding was reduced stimulus-locked synchrony across individuals with ASD (lower inter-subject alignment), typically with relative preservation in primary sensory cortices and larger reductions in higher-order association and social–semantic systems. In the four studies with fully extractable sample sizes, there were at least 54 ASD and 57 TD participants (minimum N=111). Two complementary patterns were repeatedly reported: (1) greater between-subject variability (“idiosyncrasy”) in ASD despite measurable within-individual stimulus tracking in select repeat-viewing designs, and (2) heterogeneous, time-localized network responses during specific movie segments when using dynamic inter-subject connectivity approaches. Clinical interpretability was supported by studies linking response idiosyncrasy or variability to social comprehension and/or symptom dimensions.

Conclusion:

Naturalistic fMRI in ASD consistently indicates reduced inter-individual neural synchrony and increased idiosyncratic processing during ecologically valid stimulation, with clinically relevant phenotype associations in a subset of studies. However, evidence of reproducibility is limited beyond select repeat-viewing designs, and analytic heterogeneity remains a major barrier to clinical deployment. Near-term translation priorities include standardized stimulus annotation, transparent motion/QC thresholds, harmonized preprocessing/denoising, preregistered primary endpoints, and multicenter replication to establish normative reference ranges.

Keywords:

autism spectrum disorder; naturalistic fMRI; movie watching; inter-subject correlation; dynamic functional connectivity; biomarkers; reproducibility.