Causality in Cognitive Neuroscience: Concepts, Challenges, and Distributional Robustness

Causation in neuroscience: keeping mechanism meaningful

A fundamental goal of research in neuroscience is to uncover the causal structure of the brain. This focus on causation makes sense, because causal information can provide explanations of brain function and identify reliable targets with which to understand cognitive function and prevent or change neurological conditions and psychiatric disorders. In this research, one of the most frequently used causal concepts is 'mechanism' - this is seen in the literature and language of the field, in grant and funding inquiries that specify what research is supported, and in journal guidelines on which contributions are considered for publication. In these contexts, mechanisms are commonly tied to expressions of the main aims of the field and cited as the 'fundamental', 'foundational' and/or 'basic' unit for understanding the brain. Despite its common usage and perceived importance, mechanism is used in different ways that are rarely distinguished. Given that this concept is defined in different ways throughout the field - and that there is often no clarification of which definition is intended - there remains a marked ambiguity about the fundamental goals, orientation and principles of the field. Here we provide an overview of causation and mechanism from the perspectives of neuroscience and philosophy of science, in order to address these challenges.

Causal evidence for a coordinated temporal interplay within the language network

Recent neurobiological models on language suggest that auditory sentence comprehension is supported by a coordinated temporal interplay within a left-dominant brain network, including the posterior inferior frontal gyrus (pIFG), posterior superior temporal gyrus and sulcus (pSTG/STS), and angular gyrus (AG). Here, we probed the timing and causal relevance of the interplay between these regions by means of concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG). Our TMS-EEG experiments reveal region- and time-specific causal evidence for a bidirectional information flow from left pSTG/STS to left pIFG and back during auditory sentence processing. Adapting a condition-and-perturb approach, our findings further suggest that the left pSTG/STS can be supported by the left AG in a state-dependent manner.

Causally informed activity flow models provide mechanistic insight into network-generated cognitive activations

Brain activity flow models estimate the movement of task-evoked activity over brain connections to help explain network-generated task functionality. Activity flow models have been shown to accurately generate task-evoked brain activations across a wide variety of brain regions and task conditions. However, these models have had limited explanatory power, given known issues with causal interpretations of the standard functional connectivity measures used to parameterize activity flow models. We show here that functional/effective connectivity (FC) measures grounded in causal principles facilitate mechanistic interpretation of activity flow models. We progress from simple to complex FC measures, with each adding algorithmic details reflecting causal principles. This reflects many neuroscientists' preference for reduced FC measure complexity (to minimize assumptions, minimize compute time, and fully comprehend and easily communicate methodological details), which potentially trades off with causal validity. We start with Pearson correlation (the current field standard) to remain maximally relevant to the field, estimating causal validity across a range of FC measures using simulations and empirical fMRI data. Finally, we apply causal-FC-based activity flow modeling to a dorsolateral prefrontal cortex region (DLPFC), demonstrating distributed causal network mechanisms contributing to its strong activation during a working memory task. Notably, this fully distributed model is able to account for DLPFC working memory effects traditionally thought to rely primarily on within-region (i.e., not distributed) recurrent processes. Together, these results reveal the promise of parameterizing activity flow models using causal FC methods to identify network mechanisms underlying cognitive computations in the human brain.

Mapping Dysfunctional Circuits in the Frontal Cortex Using Deep Brain Stimulation

Frontal circuits play a critical role in motor, cognitive, and affective processing - and their dysfunction may result in a variety of brain disorders. However, exactly which frontal domains mediate which (dys)function remains largely elusive. Here, we study 534 deep brain stimulation electrodes implanted to treat four different brain disorders. By analyzing which connections were modulated for optimal therapeutic response across these disorders, we segregate the frontal cortex into circuits that became dysfunctional in each of them. Dysfunctional circuits were topographically arranged from occipital to rostral, ranging from interconnections with sensorimotor cortices in dystonia, with the primary motor cortex in Tourette's syndrome, the supplementary motor area in Parkinson's disease, to ventromedial prefrontal and anterior cingulate cortices in obsessive-compulsive disorder. Our findings highlight the integration of deep brain stimulation with brain connectomics as a powerful tool to explore couplings between brain structure and functional impairment in the human brain.

The arrow-of-time in neuroimaging time series identifies causal triggers of brain function

Moving from association to causal analysis of neuroimaging data is crucial to advance our understanding of brain function. The arrow-of-time (AoT), that is, the known asymmetric nature of the passage of time, is the bedrock of causal structures shaping physical phenomena. However, almost all current time series metrics do not exploit this asymmetry, probably due to the difficulty to account for it in modeling frameworks. Here, we introduce an AoT-sensitive metric that captures the intensity of causal effects in multivariate time series, and apply it to high-resolution functional neuroimaging data. We find that causal effects underlying brain function are more distinctively localized in space and time than functional activity or connectivity, thereby allowing us to trace neural pathways recruited in different conditions. Overall, we provide a mapping of the causal brain that challenges the association paradigm of brain function.

Interpreting and validating complexity and causality in lesion-symptom prognoses

This paper considers the steps needed to generate pragmatic and interpretable lesion-symptom mappings that can be used for clinically reliable prognoses. The novel contributions are 3-fold. We first define and inter-relate five neurobiological and five methodological constraints that need to be accounted for when interpreting lesion-symptom associations and generating synthetic lesion data. The first implication is that, because of these constraints, lesion-symptom mapping needs to focus on probabilistic relationships between Lesion and Symptom, with Lesion as a multivariate spatial pattern, Symptom as a time-dependent behavioural profile and evidence that Lesion raises the probability of Symptom. The second implication is that in order to assess the strength of probabilistic causality, we need to distinguish between causal lesion sites, incidental lesion sites, spared but dysfunctional sites and intact sites, all of which might affect the accuracy of the predictions and prognoses generated. We then formulate lesion-symptom mappings in logical notations, including combinatorial rules, that are then used to evaluate and better understand complex brain-behaviour relationships. The logical and theoretical framework presented applies to any type of neurological disorder but is primarily discussed in relationship to stroke damage. Accommodating the identified constraints, we discuss how the 1965 Bradford Hill criteria for inferring probabilistic causality, post hoc, from observed correlations in epidemiology-can be applied to lesion-symptom mapping in stroke survivors. Finally, we propose that rather than rely on post hoc evaluation of how well the causality criteria have been met, the neurobiological and methodological constraints should be addressed, a priori, by changing the experimental design of lesion-symptom mappings and setting up an open platform to share and validate the discovery of reliable and accurate lesion rules that are clinically useful.

A systematic approach to brain dynamics: cognitive evolution theory of consciousness

The brain integrates volition, cognition, and consciousness seamlessly over three hierarchical (scale-dependent) levels of neural activity for their emergence: a causal or 'hard' level, a computational (unconscious) or 'soft' level, and a phenomenal (conscious) or 'psyche' level respectively. The cognitive evolution theory (CET) is based on three general prerequisites: physicalism, dynamism, and emergentism, which entail five consequences about the nature of consciousness: discreteness, passivity, uniqueness, integrity, and graduation. CET starts from the assumption that brains should have primarily evolved as volitional subsystems of organisms, not as prediction machines. This emphasizes the dynamical nature of consciousness in terms of critical dynamics to account for metastability, avalanches, and self-organized criticality of brain processes, then coupling it with volition and cognition in a framework unified over the levels. Consciousness emerges near critical points, and unfolds as a discrete stream of momentary states, each volitionally driven from oldest subcortical arousal systems. The stream is the brain's way of making a difference via predictive (Bayesian) processing. Its objective observables could be complexity measures reflecting levels of consciousness and its dynamical coherency to reveal how much knowledge (information gain) the brain acquires over the stream. CET also proposes a quantitative classification of both disorders of consciousness and mental disorders within that unified framework.

Identifying causal subsequent memory effects

Over 40 y of accumulated research has detailed associations between neuroimaging signals measured during a memory encoding task and later memory performance, across a variety of brain regions, measurement tools, statistical approaches, and behavioral tasks. But the interpretation of these subsequent memory effects (SMEs) remains unclear: if the identified signals reflect cognitive and neural mechanisms of memory encoding, then the underlying neural activity must be causally related to future memory. However, almost all previous SME analyses do not control for potential confounders of this causal interpretation, such as serial position and item effects. We collect a large fMRI dataset and use an experimental design and analysis approach that allows us to statistically adjust for nearly all known exogenous confounding variables. We find that, using standard approaches without adjustment, we replicate several univariate and multivariate subsequent memory effects and are able to predict memory performance across people. However, we are unable to identify any signal that reliably predicts subsequent memory after adjusting for confounding variables, bringing into doubt the causal status of these effects. We apply the same approach to subjects' judgments of learning collected following an encoding period and show that these behavioral measures of mnemonic status do predict memory after adjustments, suggesting that it is possible to measure signals near the time of encoding that reflect causal mechanisms but that existing neuroimaging measures, at least in our data, may not have the precision and specificity to do so.

Dyslexia: Causes and Concomitant Impairments

In recent decades, theories have been presented to explain the nature of dyslexia, but the causes of dyslexia remained unclear. Although the investigation of the causes of dyslexia presupposes a clear understanding of the concept of cause, such an understanding is missing. The present paper proposes the absence of at least one necessary condition or the absence of all sufficient conditions as causes for impaired reading. The causes of impaired reading include: an incorrect fixation location, too short a fixation time, the attempt to recognize too many letters simultaneously, too large saccade amplitudes, and too short verbal reaction times. It is assumed that a longer required fixation time in dyslexic readers results from a functional impairment of areas V1, V2, and V3 that require more time to complete temporal summation. These areas and areas that receive input from them, such as the fusiform gyrus, are assumed to be impaired in their ability to simultaneously process a string of letters. When these impairments are compensated by a new reading strategy, reading ability improves immediately.

From the origins to the stream of consciousness and its neural correlates

There are now dozens of very different theories of consciousness, each somehow contributing to our understanding of its nature. The science of consciousness needs therefore not new theories but a general framework integrating insights from those, yet not making it a still-born "Frankenstein" theory. First, the framework must operate explicitly on the stream of consciousness, not on its static description. Second, this dynamical account must also be put on the evolutionary timeline to explain the origins of consciousness. The Cognitive Evolution Theory (CET), outlined here, proposes such a framework. This starts with the assumption that brains have primarily evolved as volitional subsystems of organisms, inherited from primitive (fast and random) reflexes of simplest neural networks, only then resembling error-minimizing prediction machines. CET adopts the tools of critical dynamics to account for metastability, scale-free avalanches, and self-organization which are all intrinsic to brain dynamics. This formalizes the stream of consciousness as a discrete (transitive, irreflexive) chain of momentary states derived from critical brain dynamics at points of phase transitions and mapped then onto a state space as neural correlates of a particular conscious state. The continuous/discrete dichotomy appears naturally between the brain dynamics at the causal level and conscious states at the phenomenal level, each volitionally triggered from arousal centers of the brainstem and cognitively modulated by thalamocortical systems. Their objective observables can be entropy-based complexity measures, reflecting the transient level or quantity of consciousness at that moment.

Can neurofeedback provide evidence of direct brain-behavior causality?

Neurofeedback is a procedure that measures brain activity in real-time and presents it as feedback to an individual, thus allowing them to self-regulate brain activity with effects on cognitive processes inferred from behavior. One common argument is that neurofeedback studies can reveal how the measured brain activity causes a particular cognitive process. The causal claim is often made regarding the measured brain activity being manipulated as an independent variable, similar to brain stimulation studies. However, this causal inference is vulnerable to the argument that other upstream brain activities change concurrently and cause changes in the brain activity from which feedback is derived. In this paper, we outline the inference that neurofeedback may causally affect cognition by indirect means. We further argue that researchers should remain open to the idea that the trained brain activity could be part of a "causal network" that collectively affects cognition rather than being necessarily causally primary. This particular inference may provide a better translation of evidence from neurofeedback studies to the rest of neuroscience. We argue that the recent advent of multivariate pattern analysis, when combined with implicit neurofeedback, currently comprises the strongest case for causality. Our perspective is that although the burden of inferring direct causality is difficult, it may be triangulated using a collection of various methods in neuroscience. Finally, we argue that the neurofeedback methodology provides unique advantages compared to other methods for revealing changes in the brain and cognitive processes but that researchers should remain mindful of indirect causal effects.

Causal mapping of human brain function

Mapping human brain function is a long-standing goal of neuroscience that promises to inform the development of new treatments for brain disorders. Early maps of human brain function were based on locations of brain damage or brain stimulation that caused a functional change. Over time, this approach was largely replaced by technologies such as functional neuroimaging, which identify brain regions in which activity is correlated with behaviours or symptoms. Despite their advantages, these technologies reveal correlations, not causation. This creates challenges for interpreting the data generated from these tools and using them to develop treatments for brain disorders. A return to causal mapping of human brain function based on brain lesions and brain stimulation is underway. New approaches can combine these causal sources of information with modern neuroimaging and electrophysiology techniques to gain new insights into the functions of specific brain areas. In this Review, we provide a definition of causality for translational research, propose a continuum along which to assess the relative strength of causal information from human brain mapping studies and discuss recent advances in causal brain mapping and their relevance for developing treatments.

Hyperscanning Alone Cannot Prove Causality. Multibrain Stimulation Can

Brains that work together, couple together through interbrain synchrony. Does interbrain synchrony causally facilitate social interaction? This question cannot be answered by simply recording from multiple brains (hyperscanning). It instead requires causal protocols entailing their simultaneous stimulation (multibrain stimulation). We highlight promising findings and future horizons of this nascent field.