Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies.

Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.

Predicting individual differences in peak emotional response.

Why does the same experience elicit strong emotional responses in some individuals while leaving others largely indifferent? Is the variance influenced by who people are (personality traits), how they feel (emotional state), where they come from (demographics), or a unique combination of these? In this 2,900+ participants study, we disentangle the factors that underlie individual variations in the universal experience of aesthetic chills, the feeling of cold and shivers down the spine during peak experiences. Here, we unravel the interplay of psychological and sociocultural dynamics influencing self-reported chills reactions. A novel technique harnessing mass data mining of social media platforms curates the first large database of ecologically sourced chills-evoking stimuli. A combination of machine learning techniques (LASSO and SVM) and multilevel modeling analysis elucidates the interacting roles of demographics, traits, and states factors in the experience of aesthetic chills. These findings highlight a tractable set of features predicting the occurrence and intensity of chills-age, sex, pre-exposure arousal, predisposition to Kama Muta (KAMF), and absorption (modified tellegen absorption scale [MODTAS]), with 73.5% accuracy in predicting the occurrence of chills and accounting for 48% of the variance in chills intensity. While traditional methods typically suffer from a lack of control over the stimuli and their effects, this approach allows for the assignment of stimuli tailored to individual biopsychosocial profiles, thereby, increasing experimental control and decreasing unexplained variability. Further, they elucidate how hidden sociocultural factors, psychological traits, and contextual states shape seemingly "subjective" phenomena.

The neurobiology of aesthetic chills: How bodily sensations shape emotional experiences.

The phenomenon of aesthetic chills-shivers and goosebumps associated with either rewarding or threatening stimuli-offers a unique window into the brain basis of conscious reward because of their universal nature and simultaneous subjective and physical counterparts. Elucidating the neural mechanisms underlying aesthetic chills can reveal fundamental insights about emotion, consciousness, and the embodied mind. What is the precise timing and mechanism of bodily feedback in emotional experience? How are conscious feelings and motivations generated from interoceptive predictions? What is the role of uncertainty and precision signaling in shaping emotions? How does the brain distinguish and balance processing of rewards versus threats? We review neuroimaging evidence and highlight key questions for understanding how bodily sensations shape conscious feelings. This research stands to advance models of brain-body interactions shaping affect and may lead to novel nonpharmacological interventions for disorders of motivation and pleasure.

Aesthetic chills mitigate maladaptive cognition in depression.

BACKGROUND: Depression is a major global health challenge, affecting over 300 million people worldwide. Current pharmacological and psychotherapeutic interventions have limited efficacy, underscoring the need for novel approaches. Emerging evidence suggests that peak emotional experiences characterized by awe, transcendence, and meaning hold promise for rapidly shifting maladaptive cognitive patterns in depression. Aesthetic chills, a peak positive emotion characterized by physical sensations such as shivers and goosebumps, may influence reward-related neural pathways and hold promise for modifying core maladaptive beliefs rooted in early adverse experiences. METHODS: We enrolled 96 patients diagnosed with major depressive disorder. A validated database of multimedia known to elicit chills responses (ChillsDB) was used for stimulus presentation. Participants' emotional responses were assessed using the Emotional Breakthrough Inventory (EBI), while shifts in self-schema were measured via the Young Positive Schema Questionnaire (YSPQ). RESULTS: The study found that chill-inducing stimuli have the potential to positively influence the core schema of individuals with depression, impacting areas of self-related beliefs. The associated phenomenology triggered by chills appears to share similarities with the altered states of consciousness induced by psychedelic substances like psilocybin. CONCLUSIONS: These preliminary results suggest that the biological processes involved in aesthetic chills could be harnessed as a non-pharmacological intervention for depression. However, further investigation is necessary to comprehensively understand the neurophysiological responses to chills and to evaluate the practicality, effectiveness, and safety of utilizing aesthetic chills as a preventive measure in mental health care.

Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications.

Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.

ChillsDB 2.0: Individual Differences in Aesthetic Chills Among 2,900+ Southern California Participants.

We significantly enriched ChillsDB, a dataset of audiovisual stimuli validated to elicit aesthetic chills. A total of 2,937 participants from Southern California were exposed to 40 stimuli, consisting of 20 stimuli (10 from ChillsDB and 10 new) presented either in audiovisual or audio-only formats. Questionnaires were administered assessing demographics, personality traits, state affect, and political orientation. Detailed data on chills responses is captured alongside participants' ratings of the stimuli. The dataset combines controlled elicitation of chills using previously validated materials with individual difference measures to enable investigation of predictors and correlates of aesthetic chills phenomena. It aims to support continued research on the mechanisms and therapeutic potential of aesthetic chills responses.

Neural representations of anxiety in adolescents with anorexia nervosa: a multivariate approach.

Anorexia nervosa (AN) is characterized by low body weight, fear of gaining weight, and distorted body image. Anxiety may play a role in the formation and course of the illness, especially related to situations involving food, eating, weight, and body image. To understand distributed patterns and consistency of neural responses related to anxiety, we enrolled 25 female adolescents with AN and 22 non-clinical female adolescents with mild anxiety who underwent two fMRI sessions in which they saw personalized anxiety-provoking word stimuli and neutral words. Consistency in brain response patterns across trials was determined using a multivariate representational similarity analysis (RSA) approach within anxiety circuits and in a whole-brain voxel-wise searchlight analysis. In the AN group there was higher representational similarity for anxiety-provoking compared with neutral stimuli predominantly in prefrontal regions including the frontal pole, medial prefrontal cortex, dorsolateral prefrontal cortex, and medial orbitofrontal cortex, although no significant group differences. Severity of anxiety correlated with consistency of brain responses within anxiety circuits and in cortical and subcortical regions including the frontal pole, middle frontal gyrus, orbitofrontal cortex, thalamus, lateral occipital cortex, middle temporal gyrus, and cerebellum. Higher consistency of activation in those with more severe anxiety symptoms suggests the possibility of a greater degree of conditioned brain responses evoked by personally-relevant emotional stimuli. Anxiety elicited by disorder-related stimuli may activate stereotyped, previously-learned neural responses within- and outside of classical anxiety circuits. Results have implications for understanding consistent and automatic responding to environmental stimuli that may play a role in maintenance of AN.

Preventing antisocial robots: A pathway to artificial empathy.

Given the accelerating powers of artificial intelligence (AI), we must equip artificial agents and robots with empathy to prevent harmful and irreversible decisions. Current approaches to artificial empathy focus on its cognitive or performative processes, overlooking affect, and thus promote sociopathic behaviors. Artificially vulnerable, fully empathic AI is necessary to prevent sociopathic robots and protect human welfare.

VR for Cognition and Memory.

This chapter will provide a review of research into human cognition through the lens of VR-based paradigms for studying memory. Emphasis is placed on why VR increases the ecological validity of memory research and the implications of such enhancements.

Cognitive Science Below the Neck: Toward an Integrative Account of Consciousness in the Body.

Our culture and its scientific endeavor direly need a holistic characterization of mind and body. Many phenomena attest to the profound effects of beliefs on bodily function (e.g., open-label placebo's effects on chronic pain) and interoceptive systems' role in mental processes (e.g., the emerging role of gut microbiomes in the mood). We need a mechanistic, integrative framework to account for these phenomena and generate novel predictions. Major advances have been made in understanding how the nervous system senses and regulates the body and in modeling how the brain implements the computations that subserve such activities. However, the vestiges of Cartesianism have entrained a style of thinking in which systems from the brainstem downward exist as the implementation layer of computational processes supporting sensation and behavior, rather than a complementary locus of information processing. As speakers and microphones, rather than other members of the chorus. We are thus forced to perceive well-documented, belief-driven phenomena like placebo, ritual, and psychosomatic disorders as mysterious obstacles or dubious allies rather than as a wellspring of potential.

Arousal Regulation by the External Globus Pallidus: A New Node for the Mesocircuit Hypothesis.

In the decade since its debut, the Mesocircuit Hypothesis (MH) has provided researchers a scaffolding for interpreting their findings by associating subcortical-cortical dysfunction with the loss and recovery of consciousness following severe brain injury. Here, we leverage new findings from human and rodent lesions, as well as chemo/optogenetic, tractography, and stimulation studies to propose the external segment of the globus pallidus (GPe) as an additional node in the MH, in hopes of increasing its explanatory power. Specifically, we discuss the anatomical and molecular mechanisms involving the GPe in sleep-wake control and propose a plausible mechanistic model explaining how the GPe can modulate cortical activity through its direct connections with the prefrontal cortex and thalamic reticular nucleus to initiate and maintain sleep. The inclusion of the GPe in the arousal circuitry has implications for understanding a range of phenomena, such as the effects of the adenosine (A2A) and dopamine (D2) receptors on sleep-wake cycles, the paradoxical effects of zolpidem in disorders of consciousness, and sleep disturbances in conditions such as Parkinson's Disease.

Enhancing learning and retention with distinctive virtual reality environments and mental context reinstatement.

Memory is inherently context-dependent: internal and environmental cues become bound to learnt information, and the later absence of these cues can impair recall. Here, we developed an approach to leverage context-dependence to optimise learning of challenging, interference-prone material. While navigating through desktop virtual reality (VR) contexts, participants learnt 80 foreign words in two phonetically similar languages. Those participants who learnt each language in its own unique context showed reduced interference and improved one-week retention (92%), relative to those who learnt the languages in the same context (76%)-however, this advantage was only apparent if participants subjectively experienced VR-based contexts as "real" environments. A follow-up fMRI experiment confirmed that reinstatement of brain activity patterns associated with the original encoding context during word retrieval was associated with improved recall performance. These findings establish that context-dependence can be harnessed with VR to optimise learning and showcase the important role of mental context reinstatement.

Current State of Potential Mechanisms Supporting Low Intensity Focused Ultrasound for Neuromodulation.

Low intensity focused ultrasound (LIFU) has been gaining traction as a non-invasive neuromodulation technology due to its superior spatial specificity relative to transcranial electrical/magnetic stimulation. Despite a growing literature of LIFU-induced behavioral modifications, the mechanisms of action supporting LIFU's parameter-dependent excitatory and suppressive effects are not fully understood. This review provides a comprehensive introduction to the underlying mechanics of both acoustic energy and neuronal membranes, defining the primary variables for a subsequent review of the field's proposed mechanisms supporting LIFU's neuromodulatory effects. An exhaustive review of the empirical literature was also conducted and studies were grouped based on the sonication parameters used and behavioral effects observed, with the goal of linking empirical findings to the proposed theoretical mechanisms and evaluating which model best fits the existing data. A neuronal intramembrane cavitation excitation model, which accounts for differential effects as a function of cell-type, emerged as a possible explanation for the range of excitatory effects found in the literature. The suppressive and other findings need additional theoretical mechanisms and these theoretical mechanisms need to have established relationships to sonication parameters.

Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity.

Individuals with gender incongruence (GI) experience serious distress due to incongruence between their gender identity and birth-assigned sex. Sociological, cultural, interpersonal, and biological factors are likely contributory, and for some individuals medical treatment such as cross-sex hormone therapy and gender-affirming surgery can be helpful. Cross-sex hormone therapy can be effective for reducing body incongruence, but responses vary, and there is no reliable way to predict therapeutic outcomes. We used clinical and MRI data before cross-sex hormone therapy as features to train a machine learning model to predict individuals' post-therapy body congruence (the degree to which photos of their bodies match their self-identities). Twenty-five trans women and trans men with gender incongruence participated. The model significantly predicted post-therapy body congruence, with the highest predictive features coming from the cingulo-opercular (R2 = 0.41) and fronto-parietal (R2 = 0.30) networks. This study provides evidence that hormone therapy efficacy can be predicted from information collected before therapy, and that patterns of functional brain connectivity may provide insights into body-brain effects of hormones, affecting one's sense of body congruence. Results could help identify the need for personalized therapies in individuals predicted to have low body-self congruence after standard therapy.

Predicting Empathy From Resting State Brain Connectivity: A Multivariate Approach.

Recent task fMRI studies suggest that individual differences in trait empathy and empathic concern are mediated by patterns of connectivity between self-other resonance and top-down control networks that are stable across task demands. An untested implication of this hypothesis is that these stable patterns of connectivity should be visible even in the absence of empathy tasks. Using machine learning, we demonstrate that patterns of resting state fMRI connectivity (i.e. the degree of synchronous BOLD activity across multiple cortical areas in the absence of explicit task demands) of resonance and control networks predict trait empathic concern (n = 58). Empathic concern was also predicted by connectivity patterns within the somatomotor network. These findings further support the role of resonance-control network interactions and of somatomotor function in our vicariously driven concern for others. Furthermore, a practical implication of these results is that it is possible to assess empathic predispositions in individuals without needing to perform conventional empathy assessments.

White matter integrity in brain structures supporting semantic processing is associated with value-directed remembering in older adults.

White matter microstructure changes substantially in aging. To better understand how the integrity of white matter structures supports the selective learning of rewarding material, 23 healthy older adults were tested on a value-directed remembering task. This task involved successive free recall word lists where items differed in importance, as denoted by value cues preceding each word. White matter structure was measured using diffusion tensor imaging (DTI). We found that greater structural integrity (as measured by lower mean diffusivity) in left inferior fronto-occipital fasciculus was associated with greater recall for high-value items, but not low-value items. Older adults with greater structural integrity in a tract involved in semantic processing are thus able to more successfully encode high-value items for subsequent recall. However, unlike prior findings in younger adults, older adults' memory for high value-items was not significantly correlated with the structural integrity of the uncinate fasciculus, nor with the strength of anatomical connectedness between the bilateral nucleus accumbens to ventral tegmental area reward pathway. These structural imaging findings add support to recent functional neuroimaging demonstrations that value-related modulation of memory in older adults depends heavily on brain circuits implicated in controlled processing of semantic knowledge.

Enhancing the Ecological Validity of fMRI Memory Research Using Virtual Reality.

Functional magnetic resonance imaging (fMRI) is a powerful research tool to understand the neural underpinnings of human memory. However, as memory is known to be context-dependent, differences in contexts between naturalistic settings and the MRI scanner environment may potentially confound neuroimaging findings. Virtual reality (VR) provides a unique opportunity to mitigate this issue by allowing memories to be formed and/or retrieved within immersive, navigable, visuospatial contexts. This can enhance the ecological validity of task paradigms, while still ensuring that researchers maintain experimental control over critical aspects of the learning and testing experience. This mini-review surveys the growing body of fMRI studies that have incorporated VR to address critical questions about human memory. These studies have adopted a variety of approaches, including presenting research participants with VR experiences in the scanner, asking participants to retrieve information that they had previously acquired in a VR environment, or identifying neural correlates of behavioral metrics obtained through VR-based tasks performed outside the scanner. Although most such studies to date have focused on spatial or navigational memory, we also discuss the promise of VR in aiding other areas of memory research and facilitating research into clinical disorders.

Memory Recall for High Reward Value Items Correlates With Individual Differences in White Matter Pathways Associated With Reward Processing and Fronto-Temporal Communication.

When given a long list of items to remember, people typically prioritize the memorization of the most valuable items. Prior neuroimaging studies have found that cues denoting the presence of high value items can lead to increased activation of the mesolimbic dopaminergic reward circuit, including the nucleus accumbens (NAcc) and ventral tegmental area (VTA), which in turn results in up-regulation of medial temporal lobe encoding processes and better memory for the high value items. Value cues may also trigger the use of elaborative semantic encoding strategies which depend on interactions between frontal and temporal lobe structures. We used diffusion tensor imaging (DTI) to examine whether individual differences in anatomical connectivity within these circuits are associated with value-induced modulation of memory. DTI data were collected from 19 adults who also participated in an functional magnetic resonanceimaging (fMRI) study involving a value-directed memory task. In this task, subjects encoded words with arbitrarily assigned point values and completed free recall tests after each list, showing improved recall performance for high value items. Motivated by our prior fMRI finding of increased recruitment of left-lateralized semantic network regions during the encoding of high value words (Cohen et al., 2014), we predicted that the robustness of the white matter pathways connecting the ventrolateral prefrontal cortex (VLPFC) with the temporal lobe might be a determinant of recall performance for high value items. We found that the mean fractional anisotropy (FA) of each subject's left uncinate fasciculus (UF), a fronto-temporal fiber bundle thought to play a critical role in semantic processing, correlated with the mean number of high value, but not low value, words that subjects recalled. Given prior findings on reward-induced modulation of memory, we also used probabilistic tractography to examine the white matter pathway that links the NAcc to the VTA. We found that the number of fibers projecting from left NAcc to VTA was reliably correlated with subjects' selectivity index, a behavioral measure reflecting the degree to which recall performance was impacted by item value. Together, these findings help to elucidate the neuroanatomical pathways that support verbal memory encoding and its modulation by value.

Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive-compulsive disorder.

Cognitive behavioral therapy (CBT) is an effective treatment for many with obsessive-compulsive disorder (OCD). However, response varies considerably among individuals. Attaining a means to predict an individual's potential response would permit clinicians to more prudently allocate resources for this often stressful and time-consuming treatment. We collected resting-state functional magnetic resonance imaging from adults with OCD before and after 4 weeks of intensive daily CBT. We leveraged machine learning with cross-validation to assess the power of functional connectivity (FC) patterns to predict individual posttreatment OCD symptom severity. Pretreatment FC patterns within the default mode network and visual network significantly predicted posttreatment OCD severity, explaining up to 67% of the variance. These networks were stronger predictors than pretreatment clinical scores. Results have clinical implications for developing personalized medicine approaches to identifying individual OCD patients who will maximally benefit from intensive CBT.

Medical Decision-Making Processes and Online Behaviors Among Cannabis Dispensary Staff.

BACKGROUND: Most cannabis patients engage with dispensary staff, like budtenders, for medical advice on cannabis. Yet, little is known about these interactions and how the characteristics of budtenders affect these interactions. This study investigated demographics, workplace characteristics, medical decision-making, and online behaviors among a sample of budtenders. METHODS: Between June and September 2016, a cross-sectional Internet survey was administered to budtenders in the San Francisco Bay Area and Greater Los Angeles. A total of 158 budtenders fully responded to the survey. A series of comparisons were conducted to determine differences between trained and untrained budtenders. RESULTS: Among the 158 budtenders, 56% had received formal training to become a budtender. Several demographic differences were found between trained and untrained budtenders. For workplace characteristics, trained budtenders were more likely to report budtender as their primary job (74% vs 53%), practice more than 5 years (34% vs 11%), and receive sales commission (57% vs 16%). Trained budtenders were significantly less likely to perceive medical decision-making as very important (47% vs 68%) and have a patient-centered philosophy (77% vs 89%). Although trained budtenders had significantly lower Internet usage, they were significantly more likely to exchange information with patients through e-mail (58% vs 39%), text message (46% vs 30%), mobile app (33% vs 11%), video call (26% vs 3%), and social media (51% vs 23%). CONCLUSIONS: Budtenders who are formally trained exhibit significantly different patterns of interaction with medical cannabis patients. Future studies will use multivariate methods to better determine which factors independently influence interactions and how budtenders operate after the introduction of regulations under the newly passed Proposition 64 that permits recreational cannabis use in California.