Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
Brain Function Laboratory, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Jul;7(7):669-679. doi: 10.1016/j.bpsc.2022.01.008. Epub 2022 Feb 7.
Conventional paradigms in clinical neuroscience tend to be constrained in terms of ecological validity, raising several challenges to studying the mechanisms mediating treatments and outcomes in clinical settings. Addressing these issues requires real-world neuroimaging techniques that are capable of continuously collecting data during free-flowing interpersonal interactions and that allow for experimental designs that are representative of the clinical situations in which they occur.
In this work, we developed a paradigm that fractionates the major components of human-to-human verbal interactions occurring in clinical situations and used functional near-infrared spectroscopy to assess the brain systems underlying clinician-client discourse (N = 30).
Cross-brain neural coupling between people was significantly greater during clinical interactions compared with everyday life verbal communication, particularly between the prefrontal cortex (e.g., inferior frontal gyrus) and inferior parietal lobule (e.g., supramarginal gyrus). The clinical tasks revealed extensive increases in activity across the prefrontal cortex, especially in the rostral prefrontal cortex (area 10), during periods in which participants were required to silently reason about the dysfunctional cognitions of the other person.
This work demonstrates a novel experimental approach to investigating the neural underpinnings of interpersonal interactions that typically occur in clinical settings, and its findings support the idea that particular prefrontal systems might be critical to cultivating mental health.
临床神经科学中的传统范式在生态有效性方面受到限制，这给研究临床环境中治疗和结果的中介机制带来了几个挑战。解决这些问题需要真正的神经影像学技术，这些技术能够在自由流动的人际互动过程中连续收集数据，并允许设计出与发生它们的临床情况具有代表性的实验设计。
在这项工作中，我们开发了一种范式，将临床环境中发生的主要人际言语互动成分分开，并使用功能近红外光谱来评估临床医生-患者话语的大脑系统（N=30）。
与日常生活中的言语交流相比，人与人之间的跨脑神经耦合在临床互动中显著增加，特别是在前额叶皮层（例如，额下回）和下顶叶皮层（例如，缘上回）之间。临床任务显示，参与者需要默默地思考对方的功能失调认知时，前额叶皮层（尤其是额前皮质 10 区）的活动广泛增加。
这项工作展示了一种研究通常发生在临床环境中的人际互动的神经基础的新实验方法，其发现支持了特定的前额叶系统对于培养心理健康可能至关重要的观点。
