Cortical Excitation-Inhibition Balance in Autism Varies by Brain Region and Age

Autism spectrum disorder (ASD) is characterized by differences in social communication, interaction, and restricted and repetitive behaviors. The hypothesis that ASD involves altered cortical excitation-inhibition (EI) balance has been extensively investigated, yet evidence remains mixed, partly because EI balance changes substantially during typical maturation. We used resting-state magnetoencephalography (MEG) to examine developmental trajectories of cortical EI alterations with regional specificity in a large cross-sectional cohort (N = 172; 92 typically developing, 80 ASD; ages 6-32). Functional EI (fEI), derived from critical brain dynamics, was estimated across 500 cortical parcellations. Group-averaged fEI maps revealed broadly similar large-scale topographic patterns across groups. Age-stratified analyses revealed increased global fEI in childhood and decreased fEI in adolescence in ASD, with no evidence of a group difference in adulthood. Parcel-wise regressions identified a significant main effect of diagnosis in right dorsolateral prefrontal cortex, where typically developing individuals showed higher fEI across all ages. A significant group-by-age interaction in left inferior parietal cortex indicated diverging developmental trajectories. Finally, fEI in paracentral and precuneus regions was associated with the magnitude of ASD symptoms. These findings indicate that EI imbalance in ASD is neither globally distributed nor static, but expressed through regionally and developmentally specific differences, with relevance for ASD heterogeneity.