Thérapie cognitivo-comportementale

Les thérapies comportementales et cognitives ou TCC (en anglais, cognitive behavioral therapy ou CBT) regroupent un ensemble de traitements des troubles psychiatriques (notamment addictions, psychoses, dépressions et troubles anxieux) qui partagent une approche selon laquelle la technique thérapeutique doit être fondée sur les connaissances issues de la psychologie scientifique. Elles doivent obéir à des protocoles relativement standardisés. Elles évaluent souvent l'évolution du patient au cours de la thérapie. Elles acceptent la démarche de médecine fondée sur les faits. Les TCC ont pour particularité de s'attaquer aux difficultés du patient dans « l'ici et maintenant » par des exercices pratiques centrés sur les symptômes observables au travers du comportement et par l'accompagnement par le thérapeute qui vise à intervenir sur les processus mentaux dits aussi processus cognitifs, conscients ou non, considérés comme à l'origine des émotions et de leurs dés

Real-Time fMRI Neurofeedback: Methods and Application to Chronic Tinnitus

Nicolas Gninenko

In the last twenty years, advances in real-time functional magnetic resonance imaging (rt-fMRI) have offered exciting new tools to study the human brain. One of them, termed rt-fMRI neurofeedback (NF), has turned the MRI scanner environment into an interactive brain-computer interface (BCI), allowing to position brain activity as the independent variable in the relationship ranging from brain function to observed behavior. This paradigm immediately gained considerable interest in the fMRI research community, as the idea of grasping volitional control over a precisely targeted brain area suddenly became feasible. Since then, a multitude of studies have used this technique in drastic efforts to normalize pathological brain activity (or connectivity) in a wide range of neurological disorders, ultimately seeking clinical and behavioral improvement.Among these, chronic tinnitus, commonly referred to as "ringing in the ears", has been considered a promising condition for NF interventions. Tinnitus has been linked to wide disruptions in brain functions involving attention, cognition, emotional distress, and auditory and sensory processing, among others. It has also been associated with hyperactivity in the primary auditory cortex after acoustic trauma. Currently, no cure exists for a complete relief of symptoms. A previous proof-of-concept study suggested that learned down-regulation of the auditory cortex slightly improved short-term subjective reports of tinnitus severity in a small group of participants. Here, we present the longest NF clinical trial to date in chronic tinnitus (NeuroTin), in which 60 patients are enrolled across 3 different interventions: electroencephalography NF (EEG NF), fMRI NF, and cognitive behavioral therapy (CBT), nowadays considered as standard care for tinnitus. The aim is to assess whether any of the two NF approaches can outperform standard CBT training for alleviation of tinnitus distress. In this dissertation, we present clinical outcomes and neuroimaging findings for the fMRI NF group.Twenty-one participants learned to down-regulate the activity of their primary auditory cortex over 15 weeks of fMRI NF training. While only a few participants managed to learn down-regulation, we found a significant clinical relief in tinnitus distress lasting up to one year in the fMRI NF group, as opposed to the CBT group. We demonstrate the superiority of fMRI NF training over standard care CBT and show, for the first time, resulting long-term benefits in quality of life. Furthermore, we bring additional evidence regarding the implication of a highly modulated small brain region in tinnitus, bilaterally located in the parietal operculum (OP3). We describe its effective connectivity with regions pertaining to the auditory pathway and discuss its implication in a possibly altered multisensory integration mechanism in tinnitus. Then, using a co-activation patterns analysis, we unveil 4 functional brain networks co-occurring with the deactivation of OP3. We identify them as (1) an auditory-visual network comprising an important node of the auditory pathway (the medial geniculate body), (2) a part of the NF control network, (3) the default mode network, and (4) a somatosensory network likely linked to other sensory integration modalities. Lastly, we characterize the average dynamics of these 4 functional networks and discuss new avenues for fMRI NF interventions and treatments in chronic tinnitus.

EPFL2022

Computational Approaches for Studying Dietary Behaviors with Digital Traces

Kristina Gligoric

Human nutrition and dietary habits shape our health, daily life, societies, the environment, and life on earth in general. However, it remains challenging to understand and attempt to change dietary behaviors using traditional methods due to measurement and causal identification challenges.In this thesis, we contribute computational and causal approaches leveraging large-scale passively sensed digital traces to shed new light on our dietary behaviors and derive novel scientific insights. We study dietary behaviors in two types of contexts: campus-wide and worldwide. Based on digital traces capturing behaviors of tens of thousands of people on campus and millions of internet users, we develop observational study designs that enable the isolation of causal effects of implicit behavioral interventions, including forming social ties, being exposed to the food choice of others, and stay-at-home interventions. The thesis is organized into three parts.The first part presents studies based on situated on-campus food purchase logs. In the first study, we show how, when a person acquires a new eating partner on campus, the healthiness of their food choice shifts significantly in the direction of their new eating partner's dietary patterns. In the second study, we identify purchasing mimicry, i.e., copying the food choices of others in the purchasing queue, as a specific behavioral mechanism for how similarities in dietary behaviors between individuals occur on campus. The second part of the thesis leverages online information-seeking traces (Google search query logs). Studying worldwide dietary behaviors, we identify and describe global shifts in dietary interests during the first wave of the COVID-19 pandemic, larger and longer-lasting than the typical changes during the end-of-year holidays in Western countries.In the third part, we critically investigate the limits to how much computational approaches can reveal about dietary behaviors in the general population. We contribute a framework for reasoning about biases of digital traces and present a case study of food consumption in Switzerland. The bias estimates derived in the case study imply that researchers should aim to establish evidence of validity before relying on social media and tracking apps---two frequently used digital traces---as proxies for true food consumption in the general population.The novel scientific findings and methodological advances presented here contribute to the existing knowledge about human dietary behaviors and inform the design of future food systems, policies, and behavioral interventions.

EPFL2022

Interactions between Personality, Depression, Anxiety and Cognition to Understand Early Stage of Alzheimer's Disease

Valérie Rita Madeleine Zufferey

The multifaceted nature of Alzheimer's disease (AD) and Mild cognitive impairment (MCI) can lead to wide inter-individual differences in disease manifestation in terms of brain pathology and cognition. The lack of understanding of phenotypic diversity in AD arises from a difficulty in understanding the integration of different levels of network organization (i.e. genes, neurons, synapses, anatomical regions, functions) and in inclusion of other information such as neuropsychiatric characteristics, personal history, information regarding general health or subjective cognitive complaints in a coherent model. Non-cognitive factors, such as personality traits and behavioral and psychiatric symptoms, can be informative markers of early disease stage. It is known that personality can affect cognition and behavioral symptoms. The aim of the paper is to review the different types of interactions existing between personality, depression/anxiety, and cognition and cognitive disorders at behavioral and brain/genetic levels.

BENTHAM SCIENCE PUBL LTD2020

Real-Time fMRI Neurofeedback: Methods and Application to Chronic Tinnitus

Nicolas Gninenko

EPFL2022

Computational Approaches for Studying Dietary Behaviors with Digital Traces

Kristina Gligoric

EPFL2022