new avenues for Neurosciences research and therapy Overview - PowerPoint PPT Presentation

Virtual reality: Monash Institute of Cognitive and Clinical new avenues for Neurosciences research and therapy

Overview  Objective (greater impact)  Current model (bi-directional limitations)  New model (VR = promising)  Success  Examples  Risks  Payoffs

OBJECTIVE - impact Basic Classification Diagnosis Treatment Outcomes 17 Years !!

OBJECTIVE – take advantage Clinical Neuroscience self-control Clinical Neuropsychiatry Clinical Neuropsychology

OBJECTIVE – self-control

OBJECTIVE – self-control Self-Control is more important than intelligence and social class !!

OBJECTIVE – self-control Self-control - dynamic - individual - context  compelled to act (video 1)  in the zone / excitement (video 2)  intense cravings / pre-occupations  withdrawal /negative affect  cue-reactivity

CURRENT MODEL – clinical (NPsych) Self-control 1929 !! - dynamic - individual - context Synder et al., 2015, Frontiers in Psychology external internal validity validity

CURRENT MODEL – neuroscience Self-control - dynamic - individual - context Value-Based Choice how people use different types of information (probability, reward, punishment) to guide decision-making ( no learning component ). Blakemore et al., 2012, Nature Neuroscience

CURRENT MODEL – neuroscience Reinforcement Learning Self-control typically involve learning which abstract stimuli predict winning or - dynamic losing points or money . - individual Reward Trial Avoidance Trial Neutral Trial - context Display stimuli 2000ms Display choice 3500ms Display outcome 1500ms O O O R R R Incentive Motivation how much effort an individual is prepared to exert to gain reward . Kim et al (2006)

CURRENT MODEL – neuroscience Self-control - dynamic - individual - context X – gambling X – practical (scanner / time) X – reliable X – improvised

CURRENT MODEL Clinical Neuroscience Clinical Neuropsychology Clinical Treatment Self-control - dynamic - individual - context external internal validity validity

CURRENT MODEL - tension

NEW MODEL

NEW MODEL

SUCCESS – emotions/motivations/physiology

SUCCESS – huge investment BALANCE – optimism/profit mongering ! Do not over-inflate claims Rigorous neuroscience (controlled CTs)

SUCCESS – early prototypes Personality Assessment in Ecological Settings by Means of Virtual Reality Pietro Cipresso Istituto Auxologico Italiano, Milan, Italy Giuseppe Riva Istituto Auxologico Italiano, and Università Cattolica del Sacro Cuore, Milan, Italy

SUCCESS – MCI  Dementia

SUCCESS Substances Behaviour OCD

SUCCESS – more palatable

SUCCESS – feasible

SUCCESS ? – efficacious

SUCCESS ? – efficacious

SUCCESS – urge to gamble

VR EXPOSURE – OCD & GAMBLING

VR CASINO

Near Miss Gambling outcomes

Near Miss  value-based choice  incentive motivation  reinforcement learning  physiological reactions  attentional bias Gambling outcomes

Near Miss R1 full win R2 ? Signal near miss (near miss > full win) R3 full miss start finish ? Signal (near miss > full miss)

VR-Enhanced Exposure

VR-Enhanced – Awareness/Policy

VR-Enhanced – Awareness/Policy

VR-Enhanced – Regulation

VR: new avenues for research and therapy Problem (gambling disorder) Dow-Schull (2012)

RISKS $$ programming tools / coding nausea hands just don’t like it ! (client OR clinician) norms psychometrics targeted neuro-cognitive endpoints computational modelling

RISKS Clinical Neuroscience Clinical Neuropsychiatry Clinical Neuropsychology

PAYOFFS – truly interdisciplinary Clinical Neuroscience Fundamentals & Modelling Clinical Neuropsychiatry Clinical Neuropsychology Phenomenology & Drug Treatment Psychometric & Psychosocial Treatment OUTCOMES !! Assessment, Classification, Diagnosis, Prediction, Treatments

Comprehensive Phenotyping Motivations

Treatment Approaches & Mechanisms lifestyle & technology – physical & mental Lifestyle Virtual Reality Brain Stimulation Cognitive Training

Biological Physical Immersion & Exposure to Gambling Cues Technological Regulation of Cravings & Urges Mental Cognitive

Biological Biological Prime plasticity via neuro- trophins/-genesis Physical Immersion & Exposure to Gambling Cues Technological Regulation of Cravings & Urges Mental Mental Cognitive Cognitive Den Ouden et al., In Submission

Enhancement of Plasticity Craving / Control Biological Physical Physical Immersion & Exposure to Gambling Cues Technological Regulation of Cravings & Urges Mental Mental Cognitive Cognitive

Treatment: lifestyle & technology – physical & mental

Monash Institute of Cognitive and Clinical Neurosciences