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

Leanne M Williams¹, Adam Pines², Andrea N Goldstein-Piekarski³, Lisa G Rosas⁴, Monica Kullar², Matthew D Sacchet², Olivier Gevaert⁵, Jeremy Bailenson⁶, Philip W Lavori⁷, Paul Dagum⁸, Brian Wandell⁹, Carlos Correa¹⁰, Walter Greenleaf⁶, Trisha Suppes¹¹, L Michael Perry⁹, Joshua M Smyth¹², Megan A Lewis¹³, Elizabeth M Venditti¹⁴, Mark Snowden¹⁵, Janine M Simmons¹⁶, Jun Ma¹⁷

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; MIRECC VISN21, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States. Electronic address: leawilliams@stanford.edu.
² Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States.
³ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; MIRECC VISN21, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States.
⁴ Palo Alto Medical Foundation Research Institute and Department of Medicine, 795 El Camino Real, Palo Alto, CA, United States; Department of Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, United States.
⁵ Stanford Center for Biomedical Informatics Research (BMIR), Department of Medicine and Department of Biomedical Data Science, Stanford University, 1265 Welch Road, Stanford, CA, United States.
⁶ Department of Communication, Stanford University, 450 Serra Mall, Stanford, CA, United States.
⁷ Department of Biomedical Data Science, School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, United States.
⁸ Mindstrong Health, Inc., 248 Homer Avenue, Palo Alto, CA, United States.
⁹ Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, United States.
¹⁰ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, United States.
¹¹ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; Biploar and Depression Research Program, Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States.
¹² Departments of Biobehavioral Health and of Medicine, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, United States.
¹³ Center for Communications Science, RTI International, 351 California Street Suite 500, San Francisco, CA, United States.
¹⁴ Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, United States.
¹⁵ Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Avenue, Seattle, WA, United States.
¹⁶ Affect, Social Behavior & Social Cognition Program, National Institute of Mental Health, 6001 Executive Boulevard, Rockville, MD, United States.
¹⁷ Department of Health Policy and Administration, School of Public Health, 1603 West Taylor Street, Chicago, IL, University of Illinois at Chicago, United States.

PMID: 29074231
PMCID: PMC8109191
DOI: 10.1016/j.brat.2017.09.012

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

Leanne M Williams et al. Behav Res Ther. 2018 Feb.

. 2018 Feb:101:58-70.

doi: 10.1016/j.brat.2017.09.012. Epub 2017 Oct 7.

Authors

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; MIRECC VISN21, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States. Electronic address: leawilliams@stanford.edu.
² Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States.
³ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; MIRECC VISN21, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States.
⁴ Palo Alto Medical Foundation Research Institute and Department of Medicine, 795 El Camino Real, Palo Alto, CA, United States; Department of Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, United States.
⁵ Stanford Center for Biomedical Informatics Research (BMIR), Department of Medicine and Department of Biomedical Data Science, Stanford University, 1265 Welch Road, Stanford, CA, United States.
⁶ Department of Communication, Stanford University, 450 Serra Mall, Stanford, CA, United States.
⁷ Department of Biomedical Data Science, School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, United States.
⁸ Mindstrong Health, Inc., 248 Homer Avenue, Palo Alto, CA, United States.
⁹ Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, United States.
¹⁰ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, United States.
¹¹ Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, United States; Biploar and Depression Research Program, Veteran Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA, United States.
¹² Departments of Biobehavioral Health and of Medicine, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, United States.
¹³ Center for Communications Science, RTI International, 351 California Street Suite 500, San Francisco, CA, United States.
¹⁴ Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, United States.
¹⁵ Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Avenue, Seattle, WA, United States.
¹⁶ Affect, Social Behavior & Social Cognition Program, National Institute of Mental Health, 6001 Executive Boulevard, Rockville, MD, United States.
¹⁷ Department of Health Policy and Administration, School of Public Health, 1603 West Taylor Street, Chicago, IL, University of Illinois at Chicago, United States.

PMID: 29074231
PMCID: PMC8109191
DOI: 10.1016/j.brat.2017.09.012

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.

Keywords: Behavior change; Depression; Neuroimaging; Obesity; Self-regulation; Virtual reality.

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Conflict of interest statement

Disclosures

LMW: Received direct (non-salary) research funding from Brain Resource Pty Ltd. as cross-site Academic Principal Investigator lead for the ISPOT-D study (2008–2013).

TS: Consulting fees from A/S H. Lundbeck, Sunovion, Merck & Co, and Astra Zeneca.

AP, ANG-P, LGS, MK, MDS, OG, JM, PWL, PD, BW, CC, WG, LMP, JMSm, MAL, EMV, MS, JMSi, JM: Nothing to disclose.

Figures

**Fig. 1.**
Brain circuits in which the authors theorize plasticity mediates long-term behavior change in regulation of self-focused reflection (Default Mode Network), regulation of cognition (Cognitive Control Network), and regulation of emotion (Negative Affect and Positive Affect Network). aMPFC = anterior medial prefrontal cortex. AG = angular gyrus. PCC = posterior cingulate cortex (includes precuneus). DLPFC = dorsolateral prefrontal cortex (includes anterior prefrontal cortex and inferior frontal cortex). ACC = anterior cingulate cortex. PCG = precentral gyrus. DPC = dorsal parietal cortex. ACC/MPFC = dorsal medial prefrontal cortex (includes dorsal ACC and vMPFC, including ventral—subgenual and pregenual—and rostral ACC). dACC = dorsal anterior cingulate cortex. OFC = orbitofrontal cortex.

See this image and copyright information in PMC

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous