From brain networks to the patient-environment system in clinical neuroimaging

Like the Hydra of Lerna in Greek mythology, regrowing two heads for each chopped-offone, the advancements in our understanding of the brain produce more questions thananswers. Yet, neuroimaging technologies allowing the visualization of brainarchitecture and activity in vivo have become a central tool in psychiatric research andpresent promising avenues to improve patients' quality of life. Although an impressivedevelopment in data analysis techniques and clinical neuroimaging research programsincluding hundreds, if not thousands of subjects, our understanding of how neuralprocesses contribute to psychiatric disorders remains unclear. The quest to find thecauses of psychiatric illnesses in terms of their neural underpinnings turnedresearchers to assume that it was possible to understand brain alteration in isolationfrom the patient’s body and environment. However, as we will argue through this work,to fully understand the neural characteristics of psychiatric disorders, it would benecessary to consider the body carrying the brain and the environment in which thishappened. That is the patient-environment system. Previous work in philosophy andclinical psychology has emphasized the importance of the patient-environment scale ofanalysis. However, an explicit link between these ideas and clinical neurosciences isstill lacking. In the present work, we build on the radical embodied cognition frameworkto integrate patient-environment data in clinical neuroscience and envisage differentmethodological options that could create hypotheses to challenge the usefulness of theREC framework in psychiatry research.