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Much of the work on sensory deficits in <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content> has focused on tactile sensations and the perceptual aspects of somatosensation, such as encoding of stimulus intensity and location. Although aberrant pain processing has often been noted in clinical observations of patients with <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content>, it remains largely uninvestigated. Importantly, the neural mechanism underlying higher order cognitive aspects of pain processing such as pain anticipation also remains unknown. Here we examined both pain perception and anticipation in high\u2010functioning adults with <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content> and matched healthy controls (<jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>) using an anticipatory pain paradigm in combination with functional magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content>) and concurrent skin conductance response (<jats:styled-content style=\"fixed-case\">SCR<\/jats:styled-content>) recording. Participants were asked to choose a level of electrical stimulation that would feel moderately painful to them. Compared to <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content> group, <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content> group chose a lower level of stimulation prior to <jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content>. However, <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content> participants showed greater activation in both rostral and dorsal anterior cingulate cortex during the anticipation of stimulation, but not during stimulation delivery. There was no significant group difference in insular activation during either pain anticipation or perception. However, activity in the left anterior insula correlated with <jats:styled-content style=\"fixed-case\">SCR<\/jats:styled-content> during pain anticipation. Taken together, these results suggest that <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content> is marked with aberrantly higher level of sensitivity to upcoming aversive stimuli, which may reflect abnormal attentional orientation to nociceptive signals and a failure in interoceptive inference.<\/jats:p>","DOI":"10.1111\/ejn.13598","type":"journal-article","created":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:13:26Z","timestamp":1493338406000},"page":"592-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Heightened brain response to pain anticipation in high\u2010functioning adults with autism spectrum disorder"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-987X","authenticated-orcid":false,"given":"Xiaosi","family":"Gu","sequence":"first","affiliation":[{"name":"School of Behavioral and Brain Sciences The University of Texas at Dallas Dallas TX 75235 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Psychology Queens College The City University of New York Flushing NY 11367 USA"},{"name":"Department of Biostatistics Boston University School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evdokia","family":"Anagnostou","sequence":"additional","affiliation":[{"name":"Bloorview Research Institute University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latha","family":"Soorya","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Rush University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kolevzon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick R.","family":"Hof","sequence":"additional","affiliation":[{"name":"Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"Fishberg Department of Neuroscience Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"Friedman Brain Institute Icahn School of Medicine at Mount Sinai New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Psychology Queens College The City University of New York Flushing NY 11367 USA"},{"name":"Department of Psychiatry Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"Fishberg Department 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