Perspectives before incremental trans-disciplinary cross-validation of clinical self-evaluation tools and functional MRI in psychiatry: 10 years later

Abstract

Translational validity (or trans-disciplinary validity) is defined as one possible approach to achieving incremental validity by combining simultaneous clinical state-dependent measures and functional MRI data acquisition. It is designed under the assumption that the simultaneous administration of the two methods may produce a dataset with enhanced synchronization and concordance. Translational validation aims at “bridging” the explanatory gap by implementing validated psychometric tools clinically in the experimental settings of fMRI and then translating them back to clinical utility. Our studies may have identified common diagnostic task-specific denominators in terms of activations and network modulation. However, those common denominators need further investigation to determine whether they signify disease or syndrome-specific features (signatures), which, at the end of the day, raises one more question about the poverty of current conventional psychiatric classification criteria. We propose herewith a novel algorithm for translational validation based on our explorative findings. The algorithm itself includes pre-selection of a test based on its psychometric characteristics, adaptation to the functional MRI paradigm, exploration of the underpinning whole brain neural correlates in healthy controls as compared to a patient population with certain diagnoses, and finally, investigation of the differences between two or more diagnostic classes.

Kinesthesia and Temporal Experience: On the ‘Knitting and Unknitting’ Process of Bodily Subjectivity in Schizophrenia

“…This network is involved in executive functions [ 87 ]). A disturbance in the interaction between three large-scale brain networks; DMN, CEN, and salience network (SAL) was found in psychotic patients [ 88 ]. Most recently, real-time correlation between item responses on the paranoid self-evaluation scale and activations in the DMN (precuneus and angular gyrus) in schizophrenia was described and contrasted with the activations during depression items processing and response [ 89 ] (SAL consists of the anterior insula (AI) and the dorsal anterior cingulum (dACC).…”

“…It has been proposed [ 95 ] that a pathological interaction pattern of the triple network accounts for different psychopathological manifestations. Bolton and colleagues [ 88 ] evaluated the interaction of right anterior insula-driven networks for subjects in different at-risk-for psychosis conditions and showed that across intrinsic states the insular seed activates the whole resting-state scan along with other well-known networks. Nomi and colleagues [ 96 ] showed that CAP3 and CAP6 included visual and basal ganglia networks, and CAP6 may support dopaminergic paths implicated in insular activity [ 97 ].…”

“…It is important to highlight the contrast Bolton and colleagues ([ 88 ], p. 7) showed between ultra-high-risk and healthy controls or subjects with basic symptoms regarding the balance interaction within the triple network. UHR subjects did not instantiate a competitive activity between CAP1 and CAP2, which could be associated with psychotic dissociation between the individual and social realms [ 107 ].…”

“…UHR subjects did not instantiate a competitive activity between CAP1 and CAP2, which could be associated with psychotic dissociation between the individual and social realms [ 107 ]. Bolton and colleagues [ 88 ] speculatively proposed that the loss of CAP1 regulatory activity might be associated with the weakening of CEN regulatory top-down activity and might give way to further disintegration of the triple network associated with the unfolding of self-disturbances in psychotic patients [ 108 ].…”

“…The anterior insula regulates the activity between DMN and CEN, which is disrupted before the onset of psychosis. Bolton and colleagues ([ 88 ], p. 7) evidenced that the UHR subjects had greater periods of synchrony between the right anterior insula and the DMN and lost the competitive dynamics between the synchronic activity of the SAL and DMN, and the CEN and insular activity (along with DMN deactivation). A similar dynamic pattern is evidenced in children, who have greater individual activity from each of the triple networks than synchronic activity between them [ 109 ].…”