Does imitation act as an oxytocin nebulizer in autism spectrum disorder?

Sir,There is a growing interest in using oxytocin to improve the social and emotional impairments of individuals with autistic spectrum disorder (ASD). In an elegant paper recently published in Brain , oxytocin was shown to enhance both the score of correct inferences and the low autistic brain activity in the right anterior insula when inferring the emotions and beliefs of others (Aoki et al. , 2014). Using a revisited version of the Sally-Anne Task, Aoki and colleagues suggest that reduced activity of the right anterior insula is a potential neural marker of autistic deficit in social inferences. Oxytocin may target this abnormal insula activity.Children and adults with ASD are described as lacking empathy, affiliative behaviour and social overture. Several studies have suggested that oxytocin has therapeutic effects on autistic deficits in social responses and the understanding of emotion in others (Andari et al. , 2010; Striepens et al. , 2012). More generally, literature on human and non-human primates presents converging evidence of oxytocin’s positive effects on prosocial behaviour (Guastela and MacLeod, 2012; Chang and Platt, 2014). Recently, 7- to 14-day-old macaques where found to increase their facial gesturing at a human caregiver after oxytocin nebulization (Simpson et al. , 2014). Moreover, being imitated predicted oxytocin-associated increases in affiliative behaviours. Even without nebulization, newborn macaques are shown to display more affiliation toward humans who imitate them; they look longer at imitators, spend more time in their proximity and prefer exchanging tokens with them (Paukner et al. , 2009). Such results promote the idea that an empathic connection results from behavioural matching. Indeed, our own research with low-functioning children with ASD similarly assessed the affiliative role of being imitated; children come in close proximity, smile, look at the unacquainted experimenter, touch or kiss the experimenter and decrease self-injuring …