A Conversation with Xujun Duan (OHBM 2023 Keynote Interview Pt. 7)
By Lavinia Uscătescu, with editing by Xinhui Li
Capturing the complex activity of the social brain
Dr. Xujun Duan is a professor of Biomedical Engineering at the University of Electronic Science and Technology of China, Chengdu, China. She obtained her PhD in Biomedical Engineering at the University of Electronic Science and Technology of China, with Dr. Vinod Menon as one of her supervisors and mentors. She has extensive research expertise with multimodal and computational neuroimaging methods, which she employs to study the social brain of people diagnosed with autism spectrum disorder (ASD).
In her 2023 OHBM keynote address, she will highlight some of her recent results developing extensive neuroimaging and neurostimulation protocols in a population of autistic children. Using transcranial magnetic stimulation (TMS), she stimulated structures of the social brain (i.e. the parts of the brain responsible for processing information related to social interactions and cues) and followed this up with both neuroimaging and clinical assessments.
In this interview, Dr. Xujun Duan discusses how she overcame the challenges of implementing a research protocol that would adequately capture the complex activity of the social brain, as well as the rewarding moments she enjoyed during this process. Additionally, she offers career advice for early stage researchers who plan on pursuing an academic path.
Lavinia Uscătescu (LU): Regarding the data that you will present at OHBM, it will be along the lines of one of your current projects looking at potential treatments for autistic children. Could you please give me a little bit more insight into that?
Xujun Duan (XD): So briefly, I'm going to introduce our brain imaging study of autism spectrum disorder (ASD) and our major findings, and then the most important thing is that I'm going to report the very exciting results that we have for the personalized MRI-guided transcranial magnetic stimulation (TMS) treatment for autistic kids.
LU: Fascinating. Sounds like a very complex paradigm. So your treatment focuses on applying TMS, is that correct? And how exactly have you come up with this protocol? Is it something you've validated in your previous research?
XD: Yes, it comes from our previous study (reviewed here), as well as the literature showing that stimulating the social brain might potentially modulate and induce neuroplasticity, and thus might have potential impact on the social deficits of ASD. So that's our hypothesis.
LU: And at the end of the protocol, how exactly do you measure, for example, the improvements in social communication?
XD: We measured the Autism Diagnostic Observation Schedule (ADOS) improvements. And we found improvement in social interaction and communication, as well as repetitive behaviors. We used eye tracking to measure their fixation on social stimuli, and it did improve. We also recorded structural and functional brain imaging, because we aim to look at the amygdala, and we found that after the stimulation, the amygdala activation and connectivity of the autistic kids significantly decreased. So it makes us feel confident that the stimulation is reliable, and may really give some effective improvement for them.
LU: Fascinating! And congratulations on your work! And because by now you are an established, accomplished researcher, could you please share some of those challenges that you've had to overcome throughout your career? What advice would you give to young people who aspire to a career in neuroscience?
XD: I do have some advice to the postdocs or young researchers in the field. The first advice that I'm going to give is to choose a research area that you're really interested in, and will be willing to dedicate your life to work for it. And I think this is very important, because the focus and persistence can help you accumulate knowledge and experience and build your academic reputation.
The second advice I'm trying to give is to build good cooperative relationships with others. You know, I'm working in biomedical engineering, and working on autism brain imaging studies. And I need to cooperate with the child health care center, and autism treatment institutes. So without them, I cannot recruit subjects and conduct a clinical trial. And previously, most of my study was based on the ABIDE data set, so I don’t think that doing research on open data versus your own data set is less valuable. But if you want to promote your research and do clinical application, you need to build up your own system.
And I think the third piece of advice that I'm trying to give is that you should build your own team, with team members that have similar goals and values as you, and those can be your students, your postdocs, or your research assistants. But they really need to have similar goals. When I look back on it, I think the most support I get is from my PhD students. And I think the most important quality they have is their passion for autism research.
LU: There was another thing that you mentioned that I became intrigued about: you mentioned that you started actually by studying biomedical engineering. So how did you decide to do autism research after all?
XD: Yes, I majored in biomedical engineering from my bachelor’s degree to PhD, and because this is kind of a multidisciplinary major where we apply engineering principles to solve medical problems. So I am really interested in the neural mechanism and computer aided diagnosis or effective intervention of ASD.
LU: One aspect that relates to psychiatric interventions, which you mentioned before and that I'm sure you can also see with the children that you test, is that autism is such a heterogeneous umbrella diagnosis. Is there a way that you thought about how to approach this? For example, in further dissecting your results, have you noticed perhaps certain sub clusters within the group that you test?
XD: Yes, I always think about that. It's really a critical question and actually I prefer the spectrum approach, because that is how the ASD diagnosis is defined, but actually in practice, we can really observe that there do exist some subtypes, like some of the ASD kids have verbal abilities, some do not. And some of them have an average or even higher IQ level, but others have lower IQ. And some of them have social withdrawal and some are hypersensitive.
LU: So that is truly a challenge that you see firsthand, and it manifests at all levels. I also wanted to touch on the cultural aspects that might be relevant here because we talk about communication patterns, right, that are atypical in autism. So I'm wondering if there are cultural aspects that influenced the way these are perceived or diagnosed in China versus the US, for example. Have you noticed any of that? Can you give me some insight?
XD: Yeah, I think there are cultural differences for ASD research. In the US, I think, you can recruit more so-called “high functioning”* participants, right? But in China, I found it very difficult to recruit such populations. Because in China, there is a difference in parents’ attitudes, or the support from society, so if the child is able to go into the mainstream school [system], the parents are not willing to let others know that they have an autistic kid. So most of our subjects are so-called “low functioning”, who cannot go to the mainstream school and cannot take care of themselves in daily life, but their parents are so eager for them to participate in the research to seek any potential help.
*Note: “high-functioning” is an informal way to refer to autistic individuals who are generally characterized by less prominent intellectual disability. This is not an official clinical category, and its validity, as reflected by its assumed reflection of specific cognitive abilities, has been criticized (see, e.g., Alvares et al., 2020). In the context of this interview, this expression, intentionally placed in quotation marks, is used to refer to study participants who were unable to attend public school and perform most tasks without assistance compared with the level of functioning that would have been expected given their chronological age.
Thanks to Dr. Duan for taking the time to speak with us. Make sure to attend her Keynote Lecture at OHBM 2023!