Right-lateralized frontal activation underlies successful updating of verbal working memory in adolescents with high-functioning autism spectrum disorder

Adults with autism spectrum disorder (ASD) exhibit altered frontal lobe activation during working memory (WM) processing despite relatively intact WM updating ability. To determine whether this alteration reflects compensation and is also present in adolescents, this study examined prefrontal activation during WM updating in adolescents with ASD using functional near-infrared spectroscopy. Eighteen adolescents with high-functioning ASD and 18 typically developing (TD) adolescents aged 11-18 years successfully underwent a verbal n-back paradigm with a WM (i.e., 2-back) and a control (i.e., 0-back) condition. We found that adolescents with ASD exhibit more right-lateralized prefrontal activation in response to WM load (i.e., 2-back> 0-back) compared to TD adolescents. More importantly, right-lateralized prefrontal activation was associated with better WM updating ability-specifically among adolescents with ASD. Thus, adolescents with ASD might rely on a compensatory mechanism such as the employment of a visuospatial processing style to help them update verbal WM.