From Computation to Clinic

Proposal for a Mechanistic Disease Conceptualization in Clinical Neurosciences: The Neural Network Components (NNC) Model

ABSTRACT

Clinical neurosciences, and psychiatry specifically, have been challenged by the lack of a comprehensive and practical framework that explains the core mechanistic processes of variable psychiatric presentations. Current conceptualization and classification of psychiatric presentations are primarily centered on a non-biologically based clinical descriptive approach. Despite various attempts, advances in neuroscience research have not led to an improved conceptualization or mechanistic classification of psychiatric disorders. This perspective article proposes a new-work-in-progress-framework for conceptualizing psychiatric presentations based on neural network components (NNC). This framework could guide the development of mechanistic disease classification, improve understanding of underpinning pathology, and provide specific intervention targets. This model also has the potential to dissolve artificial barriers between the fields of psychiatry and neurology.

Neuromarkers in addiction: definitions, development strategies, and recent advances

Substance use disorders (SUDs) are the most costly and prevalent psychiatric conditions. Recent calls emphasize a need for biomarkers-measurable, stable indicators of normal and abnormal processes and response to treatment or environmental agents-and, in particular, brain-based neuromarkers that will advance understanding of the neurobiological basis of SUDs and clinical practice. To develop neuromarkers, researchers must be grounded in evidence that a putative marker (i) is sensitive and specific to the psychological phenomenon of interest, (ii) constitutes a predictive model, and (iii) generalizes to novel observations (e.g., through internal cross-validation and external application to novel data). These neuromarkers may be used to index risk of developing SUDs (susceptibility), classify individuals with SUDs (diagnostic), assess risk for progression to more severe pathology (prognostic) or index current severity of pathology (monitoring), detect response to treatment (response), and predict individualized treatment outcomes (predictive). Here, we outline guidelines for developing and assessing neuromarkers, we then review recent advances toward neuromarkers in addiction neuroscience centering our discussion around neuromarkers of craving-a core feature of SUDs. In doing so, we specifically focus on the Neurobiological Craving Signature (NCS), which show great promise for meeting the demand of neuromarkers.

Motivational context determines the impact of aversive outcomes on mental effort allocation

It is well known that people will exert effort on a task if sufficiently motivated, but how they distribute these efforts across different strategies (e.g., efficiency vs. caution) remains uncertain. Past work has shown that people invest effort differently for potential positive outcomes (rewards) versus potential negative outcomes (penalties). However, this research failed to account for differences in the context in which negative outcomes motivate someone - either as punishment or reinforcement. It is therefore unclear whether effort profiles differ as a function of outcome valence, motivational context, or both. Using computational modeling and our novel Multi-Incentive Control Task, we show that the influence of aversive outcomes on one's effort profile is entirely determined by their motivational context. Participants (N:91) favored increased caution in response to larger penalties for incorrect responses, and favored increased efficiency in response to larger reinforcement for correct responses, whether positively or negatively incentivized.

Listening to the Data: Computational Approaches to Addiction and Learning

Computational approaches hold great promise for identifying novel treatment targets and creating translational therapeutics for substance use disorders. From circuitries underlying decision-making to computationally derived neural markers of drug-cue reactivity, this review is a summary of the approaches to data presented at our 2023 Society for Neuroscience Mini-Symposium. Here, we highlight data- and hypothesis-driven computational approaches that recently afforded advancements in addiction and learning neuroscience. First, we discuss the value of hypothesis-driven algorithmic modeling approaches, which integrate behavioral, neural, and cognitive outputs to refine hypothesis testing. Then, we review the advantages of data-driven dimensionality reduction and machine learning methods for uncovering novel predictor variables and elucidating relationships in high-dimensional data. Overall, this review highlights recent breakthroughs in cognitive mapping, model-based analysis of behavior/risky decision-making, patterns of drug taking, relapse, and neuromarker discovery, and showcases the benefits of novel modeling techniques, across both preclinical and clinical data.

Individual differences in computational psychiatry: a review of current challenges

Bringing precision to the understanding and treatment of mental disorders requires instruments for studying clinically relevant individual differences. One promising approach is the development of computational assays: integrating computational models with cognitive tasks to infer latent patient-specific disease processes in brain computations. While recent years have seen many methodological advancements in computational modelling and many cross-sectional patient studies, much less attention has been paid to basic psychometric properties (reliability and construct validity) of the computational measures provided by the assays. In this review, we assess the extent of this issue by examining emerging empirical evidence. We find that many computational measures suffer from poor psychometric properties, which poses a risk of invalidating previous findings and undermining ongoing research efforts using computational assays to study individual (and even group) differences. We provide recommendations for how to address these problems and, crucially, embed them within a broader perspective on key developments that are needed for translating computational assays to clinical practice.

Self-judgment dissected: A computational modeling analysis of self-referential processing and its relationship to trait mindfulness facets and depression symptoms

Cognitive theories of depression, and mindfulness theories of well-being, converge on the notion that self-judgment plays a critical role in mental health. However, these theories have rarely been tested via tasks and computational modeling analyses that can disentangle the information processes operative in self-judgments. We applied a drift-diffusion computational model to the self-referential encoding task (SRET) collected before and after an 8-week mindfulness intervention (n = 96). A drift-rate regression parameter representing positive-relative to negative-self-referential judgment strength positively related to mindful awareness and inversely related to depression, both at baseline and over time; however, this parameter did not significantly relate to the interaction between mindful awareness and nonjudgmentalness. At the level of individual depression symptoms, at baseline, a spectrum of symptoms (inversely) correlated with the drift-rate regression parameter, suggesting that many distinct depression symptoms relate to valenced self-judgment between subjects. By contrast, over the intervention, changes in only a smaller subset of anhedonia-related depression symptoms showed substantial relationships with this parameter. Both behavioral and model-derived measures showed modest split-half and test-retest correlations. Results support cognitive theories that implicate self-judgment in depression and mindfulness theories, which imply that mindful awareness should lead to more positive self-views.

Computational models of subjective feelings in psychiatry

Research in computational psychiatry is dominated by models of behavior. Subjective experience during behavioral tasks is not well understood, even though it should be relevant to understanding the symptoms of psychiatric disorders. Here, we bridge this gap and review recent progress in computational models for subjective feelings. For example, happiness reflects not how well people are doing, but whether they are doing better than expected. This dependence on recent reward prediction errors is intact in major depression, although depressive symptoms lower happiness during tasks. Uncertainty predicts subjective feelings of stress in volatile environments. Social prediction errors influence feelings of self-worth more in individuals with low self-esteem despite a reduced willingness to change beliefs due to social feedback. Measuring affective state during behavioral tasks provides a tool for understanding psychiatric symptoms that can be dissociable from behavior. When smartphone tasks are collected longitudinally, subjective feelings provide a potential means to bridge the gap between lab-based behavioral tasks and real-life behavior, emotion, and psychiatric symptoms.