{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:46:19Z","timestamp":1792586779012,"version":"4.5.0"},"reference-count":59,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While psychophysical studies suggest heightened pain sensitivity in individuals with autism spectrum disorder (ASD), the relationship between subjective pain experience and cortical neurophysiological responses and whether this relationship is sex\u2010dependent, remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional two\u2010group comparison study included 50 adults with Level 1 ASD and 52 age\u2010, sex\u2010 and IQ\u2010matched typically developing controls (TDC). Pain ratings and cortical contact heat\u2010evoked potentials (CHEPs) were recorded in response to 52\u00b0C phasic heat stimuli. ANOVA and regression models assessed the effects of group, sex and pain ratings on CHEP amplitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to TDC, autistic participants reported higher pain scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and had lower N\n                      <jats:sub>2<\/jats:sub>\n                      amplitudes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). A significant Group\u2009\u00d7\u2009Sex interaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) was associated with the lowest N\n                      <jats:sub>2<\/jats:sub>\n                      amplitudes in autistic females (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Regardless of group, in females, higher N\n                      <jats:sub>2<\/jats:sub>\n                      amplitudes were associated with higher pain scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042; model\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032), whereas this association was not significant in males (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Within\u2010group correlation analyses in females showed a significant pain\u2013N\n                      <jats:sub>2<\/jats:sub>\n                      amplitude relationship in TDC (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.734;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) but not in autistic participants (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.371;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.192). Across groups and sexes, higher N\n                      <jats:sub>2<\/jats:sub>\n                      amplitude values were associated with greater attention\u2010to\u2010detail autistic traits (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest a dissociation between subjective pain experience and cortical responses to nociceptive stimulation in autism, particularly among females, consistent with different salience\u2010related or attentional pain processing. These results underscore the importance of considering sex and autism when interpreting pain\u2010evoked cortical responses and challenge the assumption that pain\u2010evoked potentials provide universally objective measures of pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      This study identifies sex\u2010related differences in the relationship between subjective pain ratings and cortical responses to nociceptive stimulation in autistic and typically developing individuals. Autistic females showed particularly attenuated N\n                      <jats:sub>2<\/jats:sub>\n                      amplitudes and a weaker correspondence between pain ratings and cortical responses, suggesting different salience\u2010related or attentional processing of nociceptive stimuli. These findings highlight the importance of considering sex and autistic traits when interpreting pain\u2010evoked cortical responses in autism.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70411","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:30:35Z","timestamp":1791775835000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How the Brain Interprets Pain in Autistic People: Does Sex Matter?"],"prefix":"10.1002","volume":"30","author":[{"given":"Yelena","family":"Granovsky","sequence":"first","affiliation":[{"name":"Department of Neurology Rambam Health Care Campus  Haifa Israel"},{"name":"The Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology  Haifa 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