Clinical neuroscience and the heart-brain axis (BACN Mid-career Prize Lecture 2021)
Cognitive and emotional processes are shaped by the dynamic integration of brain and body. A major channel of interoceptive information comes from the heart, where phasic signals are conveyed to the brain to indicate how fast and strong the heart is beating. This talk will discuss how interoceptive processes operate across conscious and unconscious levels to influence emotion and memory. The interoceptive channel is disrupted in distinct ways in individuals with autism and anxiety. Selective interoceptive disturbance is related to symptomatology including dissociation and the transdiagnostic expression of anxiety. Interoceptive training can reduce anxiety, with enhanced interoceptive precision associated with greater insula connectivity following targeted interoceptive feedback. The discrete cardiac effects on emotion and cognition have broad relevance to clinical neuroscience, with implications for peripheral treatment targets and behavioural interventions.
The problem of power in single-case neuropsychology
Case-control comparisons are a gold standard method for diagnosing and researching neuropsychological deficits and dissociations at the single-case level. These statistical tests, developed by John Crawford and collaborators, provide quantitative criteria for the classical concepts of deficit, dissociation and double-dissociation. Much attention has been given to the control of Type I (false positive) errors for these tests, but far less to the avoidance of Type II (false negative) errors; that is, to statistical power. I will describe the origins and limits of statistical power for case-control comparisons, showing that there are hard upper limits on power, which have important implications for the design and interpretation of single-case studies. My aim is to stimulate discussion of the inferential status of single-case neuropsychological evidence, particularly with respect to contemporary ideals of open science and study preregistration.