Converting tests of fundamental social, cognitive, and affective processes into clinically useful bio‐behavioral markers for neurodevelopmental conditions

Abstract

Biomarker discovery has become a central topic in neurodevelopmental research. A validated biomarker could be any objective measure or test that has clinical utility for diagnostic, stratification, or predictive purposes, or that can be used to objectively measure therapeutic efficacy. Here we discuss the potential and challenges of converting tests of fundamental social, cognitive, emotional and motivational processes into clinically useful bio‐behavioral markers for neurodevelopmental conditions. Given the broad clinical and etiological heterogeneity of many neurodevelopmental conditions, we propose moving the focus from identifying group‐defining characteristics to creating cross‐domain bio‐behavioral profiles at the individual level. We outline steps to develop tests that reflect the relevant domains and that are comparable, engaging and sensitive across large age and ability ranges. Analytical validation of these tests requires creating age norms, and optimizing psychometric properties. Individual bio‐behavioral fingerprints of strengths and difficulties across domains can then be combined with multivariate approaches to identify “subgroups.” This may help researchers and clinicians to compare individuals with and without intellectual disability, track developmental stability versus changes, and facilitate family genetic studies. Clinical validation requires including these tests in multidisciplinary, longitudinal and/ or intervention studies to ascertain whether particular subgroups differ in terms of their etiology, clinical symptom profile, prognosis or therapeutic benefit. Potential advantages of bio‐behavioral tests over other biomarker methodologies, such as neuroimaging measures, include the low cost, ease of administration and analysis, low risk, and scalability through on‐line assessments or tablet applications. This article is categorized under: Neuroscience > Development Psychology > Theory and Methods Neuroscience > Clinical Neuroscience Neuroscience > Cognition

Annual Research Review: Looking back to look forward – changes in the concept of autism and implications for future research

“…Consortia have proved vital for genetic research, to collect the hundreds of thousands of samples required. The AIMS‐2‐TRIALS network has collected cognitive data from hundreds of participants across several sites across Europe, alongside potential biomarkers (Loth & Evans, ). Consortia require agreed shared protocols and standardised tasks to pool psychological data.…”

“…The failure, to date, to find qualitatively distinct ‘diagnostic’ biomarkers distinguishing autism from nonautism, has led to a shift to search instead for stratification biomarkers, markers that might predict differences in, for example, prognosis or treatment response, within groups of autistic individuals (Loth & Evans, ). It will be interesting to see whether huge studies such as AIMS‐2‐Trials will reveal distinct biological subtypes.…”

“…With regard to parsing the ‘autisms’, the search for stratification biomarkers to discover autism subgroups for ‘personalised’ interventions is already underway (Loth & Evans, ). There is also considerable research effort focused on understanding the biological path to autism in genetically homogenous subgroups (e.g.…”

Are There Any Biomarkers for Pedophilia and Sexual Child Abuse? A Review

“…However, as biomarkers are defined as "a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacological responses to a therapeutic intervention" (1,2), they may nevertheless be considered as such. Recently, Loth and Evans proposed the term "bio-behavioral" to refer to tests which measure fundamental social, cognitive, emotional, and motivational processes with a neurobiological basis (122). With respect to neurodevelopmental disorders, Loth and Evans discuss a possible conversion of those tests into clinically useful bio-behavioral markers.…”

“…They argue that those tests can be relatively brief, cost-effective, easy to administer and interpret, and have only few risks/side effects. Furthermore, Loth and Evans argue that with respect to autism research more sophisticated biological measures [e.g., structural magnetic resonance imaging (sMRI), fMRI, EEG] do not show better discrimination accuracy between groups than cognitive/behavioral tests (e.g., emotion recognition) (122).…”