A systematic review of observational, naturalistic, and neurophysiological outcome measures of nonpharmacological interventions for autism

Objective: Naturalistic and neurophysiological assessments are relevant as outcome measures in autism intervention trials because they provide, respectively, ecologically valid information about functioning and underlying neurocognitive mechanisms. We conducted a systematic review to highlight which specific neurophysiological techniques, experimental tasks, and naturalistic protocols have been used to assess neural and behavioral functioning in autism intervention studies. Methods: Studies were collected from four electronic databases between October 2019 and February 2020: MEDLINE (via PubMed), PsycINFO, LILACS, and Web of Science, and were included if they used structured observational, naturalistic, or neurophysiological measures to assess the efficacy of a nonpharmacological intervention for ASD. Results: Fourteen different measures were used by 64 studies, with the Autism Diagnostic Observation Schedule the most frequently used instrument. Thirty-seven different coding systems of naturalistic measures were used across 51 studies, most of which used different protocols. Twenty-four neurophysiological measures were used in 16 studies, with different experimental paradigms and neurophysiological components used across studies. Conclusions: Cross-study variability in assessing the outcomes of autism interventions may obscure comparisons and conclusions about how different behavioral interventions affect autistic social communication and underlying neurophysiological mechanisms.

Inattention symptoms in early pregnancy predict parenting skills and infant maltreatment during the first year of life

Objective: Maternal attention-deficit/hyperactivity disorder has not been investigated in relation to parenting skills in adolescent mothers. This study investigated whether maternal inattention and hyperactivity/impulsivity symptoms early in pregnancy predict poorer parenting skills and infant maltreatment during the first year of life in adolescent mothers living in adverse environmental conditions. Methods: The participants in this study were 80 adolescent mothers aged 14-19 years and their babies who were taking part in a randomized controlled trial on the effects of a home-visiting program on infant development. Symptoms of maternal attention-deficit/hyperactivity disorder were assessed in the first trimester of pregnancy. Parenting skills (maternal competence, attachment to the baby, home environment) and child maltreatment were assessed when the infants were aged 6 and 12 months. Multilevel linear regression models were constructed to test the extent to which prenatal maternal inattention and hyperactivity/impulsivity symptoms predicted these parenting variables during the first year of the infant's life. Results: Prenatal inattention symptoms significantly predicted lower maternal competence and attachment, a poorer home environment, and greater maltreatment during the first year of life. Hyperactivity did not significantly predict parenting skills or maltreatment. Conclusions: Our findings suggest that inattention symptoms may interfere with parenting abilities in adolescent mothers and should be considered in early intervention programs.

Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research

Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Yet, there are several important limitations to neurocircuit models of OCD. The purpose of the current review is to highlight some of these limitations, including issues related to the complexity of brain and cognitive function, the clinical presentation and course of OCD, etiological factors, and treatment methods proposed by the models. We also provide suggestions for future research to advance neurocircuit models of OCD and facilitate translation to clinical application.

Neuroimaging and electroencephalographic (EEG) methods for investigating neural circuits in mental disorders / Métodos de neuroimagem e eletroencefalografia (EEG) para investigação de circuitos neurais em transtornos mentais

It is increasingly recognised that dysfunction in neural circuits plays a key role in the neurobiological basis of mental disorders. The efficacy of pharmacological and behavioural treatments for mental disorders could therefore be improved by targeting dysfunctions in neurocircuits. However, to achieve this, a better understanding of the specific alterations in neural circuits involved in different mental disorders is required. Such understanding can be acquired by using advanced neuroscience methods to examine the pathways and function of neurocircuits in both typically developing individuals and in those with mental disorders. This article provides an overview of currently available neuroscience methods of investigating neural circuits, including advantages and limitations of different techniques, and highlights the importance of using multi-modal imaging in future research.

É cada vez mais reconhecido que a disfunção nos circuitos neurais desempenha um papel fundamental na base neurobiológica dos transtornos mentais. A eficácia dos tratamentos farmacológicos e comportamentais para os transtornos mentais pode, portanto, ser melhorada por direcionar as disfunções nos neurocircuitos. No entanto, para isso, é necessário um melhor entendimento das alterações específicas nos circuitos neurais envolvidos em diferentes transtornos mentais. Tal entendimento pode ser adquirido usando-se métodos avançados de neurociência para examinar as vias e a função dos neurocircuitos em indivíduos com desenvolvimento típico e naqueles com transtornos mentais. Este artigo fornece uma visão geral dos métodos da neurociência atualmente disponíveis na investigação de circuitos neurais, incluindo vantagens e limitações de diferentes técnicas, e destaca a importância do uso de imagens multimodais em pesquisas futuras.