The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model

Abstract

Precision medicine models for personalizing achieving sustained behavior change are largely outside of current clinical practice. Yet, changing self-regulatory behaviors is fundamental to the self-management of complex lifestyle-related chronic conditions such as depression and obesity - two top contributors to the global burden of disease and disability. To optimize treatments and address these burdens, behavior change and self-regulation must be better understood in relation to their neurobiological underpinnings. Here, we present the conceptual framework and protocol for a novel study, "Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomes (ENGAGE)". The ENGAGE study integrates neuroscience with behavioral science to better understand the self-regulation related mechanisms of behavior change for improving mood and weight outcomes among adults with comorbid depression and obesity. We collect assays of three self-regulation targets (emotion, cognition, and self-reflection) in multiple settings: neuroimaging and behavioral lab-based measures, virtual reality, and passive smartphone sampling. By connecting human neuroscience and behavioral science in this manner within the ENGAGE study, we develop a prototype for elucidating the underlying self-regulation mechanisms of behavior change outcomes and their application in optimizing intervention strategies for multiple chronic diseases.

Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review

“…Another study included people with no clinical diagnosis of mental disorder but with psychological distress. e studies by Williams et al [44], Ma et al [45], and their colleagues included patients with clinically significant depression, the studies by Naslund and colleagues [46,47] included patients with diagnoses of severe mental health illness (i.e., schizophrenia, bipolar disorder, major depressive disorder), and the study by Levinson and colleagues [48] included exclusively patients with eating disorders. Actual sample sizes ranged from 10 (pilot study with patients with severe mental illness recruited from one community mental health centre) to 219 (randomized control trial including people with psychological distress recruited by advertisements in local newspapers from three Finnish cities).…”

“…e two studies by Naslund and colleagues [46,47] and the one by Levinson and colleagues [48] were neither randomized nor blinded. Although the other four studies [44,45,49,50] were randomized controlled trials, only the study by Ma and colleagues [45] was blind. Although the target populations of the studies were diverse (e.g., pregnant women and people with an eating disorder or a severe mental illness), according to their reports, a common bias is the recruitment by convenience sampling, which limits the generalization of their results.…”

Problem Solving Therapy-induced Amygdala Engagement Mediates Weight Loss and Lifestyle Behavior Change in Patients With Obesity and Depression: A Randomized Controlled Trial

“…All participants provided written informed consent. Protocols of the RAINBOW and ENGAGE trials were previously published (23,24).…”

“…The current analysis leveraged neuroimaging data from the ENGAGE study, which was conducted in a RAINBOW subsample to investigate potential neural mechanisms underlying the integrated intervention for obesity and depression (23). To speci cally investigate whether neural targets related to emotion regulation following treatment of depression mediates weight management, this analysis used functional magnetic resonance imaging (fMRI) data at baseline and 2 months, as well as diet, physical activity, and weight outcome data at baseline, 6, and 12 months.…”

Image Systems Simulation for 360° Camera Rigs

“…Head mounted visual displays can provide a compelling and immersive experience of a three-dimensional scene. Because the experience can be very impactful, there is a great deal of interest in developing applications ranging from clinical medicine, behavioral change, entertainment, education and experience-sharing [1] [2].…”