3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 26)

Culture


1. Thanks to Greg Downey I am reading Cecilia Hayes in August 2012 Phil. Trans. R. Soc. B theme issue on evolution of human cognition (including causal reasonining, imitation, language, metacognition, and theory of mind), which is described as a “much more gradual and incremental than previously assumed” with “crucial roles” for “cultural evolution, techno-social co-evolution and gene–culture co-evolution.”

The evolution of human cognition has not merely involved the addition of processes that supervise and control more primitive ways of thinking; it has accelerated an ancient trend towards increasingly powerful and coordinated “embodied” modes of thought [i.e., “thinking that is not fundamentally distinct from acting”].”

2. Also Greg’s latest (6/25/12) in Neuroanthropology: a really beautiful exploration of “Man-Sheep-Dog: Interspecies Social Skills,” which ties in with (1)  by exemplifying humans’ domain-general and (with experience) domain-specific cognitive-develomental mechanisms.

3. Daniel Lende of Neuroanthropology (6/24/12) takes a look at a new paper on the prisoner’s dilemma by William Press and Freeman Dyson in PNAS. For Daniel,

[t]he implications of this paper are fascinating. For biological evolution, it opens up new thinking about reproductive strategies and life history theory, as well as the direct impact on ideas about the evolution of cooperation.
For cultural evolution, it seems to provide some powerful insights into the evolution of inequality in human society. As the agriculture revolution and population growth led to the ability to monopolize social resources and create differential wealth, what happened with social class? Did human cooperation turn from fairness to enforcing the sort of unfair game that Press and Dyson outline?

4. Travis Saunders’s recap (“Is Obesity a Disease?”), exemplifies the problems of medicalization. On the one hand, medicalization can create stigma and diminish personhood; on the other, lack of medicalization can result in a dearth of qualified medical and emotional support for persons living with a health issue. For me the post was a useful reminder that most of the discussion about psychiatry in the media has centered on “bracket creep” of psychiatric diagnosis (over-medicalization) and not on the equally troubling lack of adequate systems of care for persons living with a chronic, severe psychiatric disorder (for UCLA pediatrician and science/policy researcher Neal Halfon [see below], “there is far too little education about the early signs of mental illness and what kinds of interventions can make a difference, and it can be difficult to find appropriate help for a troubled child or adolescent”).

5. This year’s brain series on Charlie Rose featured a segment on depression. Participants included UCLA’s Peter Whybrow, Eric Kandel (Columbia/Howard Hughes), Helen Mayberg (Emory) and Frederick Goodwin (George Washington University). The segment also included Andrew Solomon, who wrote a book about his experiences, The Noonday Demon: An Atlas of Depression ( 2001).

Like Elyn Sacks, Andrew Solomon is unusually eloquent about his illness experience in the segment and in his book and offers a lot of food for thought. Solomon describes his major depression as a gradual onset from within. Eventually, he came to live in a “slowed, paralyzed state” in which making lunch felt like the “stations of the cross.” (Even at the time, he recognized that this predicament was “ridiculous.”) What was particularly interesting was the way in which he described the experience in almost wholly physical terms as a loss of vital energy rather than, for example, a loss of happiness. The anxiety which followed the illness’s onset resembled “that moment when you slip and trip, before you actually hit the ground, that feeling of out-of-control terror” that lasts “day after day.” Overall, he felt that something external was bearing down on him and at the same time “something from inside had been removed.” What followed was a cyclical period of treatment (psychopharmaceuticals and psychotherapy), improvement, and relapse, which he experienced “over and over” until he recognized his illness as “diabetes-like,” organic and permanent, probably to the great relief of the panel. Yet Solomon gives us precisely what Clark Lawlor thinks biomedical psychiatry needs in his new book on the cultural history of depression (Oxford, 2012): “a more richly human and specific vision of this protean but very real illness.”

Neuroscience

1. Joshua Buckholtz (Harvard) and Andreas Meyer-Lindenberg (Heidelberg) have published a major review in the latest issue of Neuron on
Psychopathology and the human connectome: Toward a transdiagnostic model of risk for mental illness. (See also my post on recent reviews on connectomics and psychopathology.)

The panoply of cognitive, affective, motivational, and social functions that underpin everyday human experience requires precisely choreographed patterns of interaction between networked brain regions. Perhaps not surprisingly, diverse forms of psychopathology are characterized by breakdowns in these interregional relationships. Here, we discuss how functional brain imaging has provided insights into the nature of brain dysconnectivity in mental illness. Synthesizing work to date, we propose that genetic and environmental risk factors impinge upon systems-level circuits for several core dimensions of cognition, producing transdiagnostic symptoms. We argue that risk-associated disruption of these circuits mediates susceptibility to broad domains of psychopathology rather than discrete disorders.

2.  Patric Hagmann [who coined the term “connectomics”], Patricia Grant, and Damien Fair’s recent paper in Frontiers in Systems Neuroscience: “MR Connectomics: a conceptual framework for studying the developing brain.”

3. Update by Ed Yong in The Scientist on Alzheimer’s rogue protein story .

4. From Elizabeth Phelps’s human neuroimaging group at NYU in June 2012 Current Biology: “Nonconscious Fear is Quickly Acquired But Swiftly Forgotten,” suggesting a qualitatively different pathway for nonconscious emotional stimuli.

5. Latest from Drury et al. (Molecular Psychiatry) reports on: “Telomere length and early severe social deprivation: Linking early adversity and cellular aging.”

Psychiatry (with a special focus on implementing nonseparable systems of mental/physical health care)

1. Here is the full link to UCLA’s Neal Halfon’s 6/12/12/ op-ed piece in the LA Times (quoted above): “Mental Illness and Lessons from Kelly Thomas’ Last Cry for Help.”

The latest Journal of the American Academy of Child & Adolescent Psychiatry includes three interesting articles (behind a paywall). The first is co-authored by Stephanie Drury (see the telomere paper above):

2. Recovering From Early Deprivation: Attachment Mediates Effects of Caregiving on Psychopathology
Lucy McGoron, Mary Margaret Gleason, Anna T. Smyke, Stacy S. Drury, Charles A. Nelson, Matthew C. Gregas, Nathan A. Fox, Charles H. Zeanah

3. Maternal Early Life Experiences and Parenting: The Mediating Role of Cortisol and Executive Function
Andrea Gonzalez, Jennifer M. Jenkins, Meir Steiner, Alison S. Fleming

4. Examining Autism Spectrum Disorders by Biomarkers: Example From the Oxytocin and Serotonin Systems
Elizabeth Hammock, Jeremy Veenstra-VanderWeele, Zhongyu Yan, Travis M. Kerr, Marianna Morris, George M. Anderson, C. Sue Carter, Edwin H. Cook,Suma Jacob.

5. Finally, here are links to “Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating developmental Science into Lifelong Health” a policy statement by the American Academy of Pediatrics and “The Lifelong Effects of Early Childhood Adversity and Toxic Stress” by Shonkoff et al. (who propose an “ecobiodevelopmental” framework),  Leeb et al. (CDC) respond :Early childhood adversity and toxic stress: A strategic opportunity for multi-disciplinary partnership between the pediatric and public health communities.

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Connectomics and Psychopathology: A Budding Grove of New Thinking, Research

Neuroscience is moving toward a fairly unified explanation of psychopathology at the level of circuits and systems. The following articles/reviews on connectomics redirect our attention to mental illness as a disorder of connectivity. I’ve also embedded a foundational talk by Olaf Sporns, author of Networks of the Brain (MIT, 2010; reviewed by Terrence Sejnowski for American Scientist Online).

Behrans, T. E. J., & Sporns, O. (2012). Human connectomics. Current Opinion in Neurobiology, 22(1), 144–153. http://dx.doi.org/10.1016/j.conb.2011.08.005

Recent advances in non-invasive neuroimaging have enabled the measurement of connections between distant regions in the living human brain, thus opening up a new field of research: Human connectomics. Different imaging modalities allow the mapping of structural connections (axonal fibre tracts) as well as functional connections (correlations in time series), and individual variations in these connections may be related to individual variations in behaviour and cognition. Connectivity analysis has already led to a number of new insights about brain organization. For example, segregated brain regions may be identified by their unique patterns of connectivity, structural and functional connectivity may be compared to elucidate how dynamic interactions arise from the anatomical substrate, and the architecture of large-scale networks connecting sets of brain regions may be analysed in detail. The combined analysis of structural and functional networks has begun to reveal components or modules with distinct patterns of connections that become engaged in different cognitive tasks. Collectively, advances in human connectomics open up the possibility of studying how brain connections mediate regional brain function and thence behaviour.

Buckholtz, J. W., & Meyer-Lindenberg, A. (2012). Psychopathology and the human connectome: Toward a transdiagnostic model of risk for mental illness [Review]. Neuron, 74(6), 990–1004. http://dx.doi.org/10.1016/j.neuron.2012.06.002

The panoply of cognitive, affective, motivational, and social functions that underpin everyday human experience requires precisely choreographed patterns of interaction between networked brain regions. Perhaps not surprisingly, diverse forms of psychopathology are characterized by breakdowns in these interregional relationships. Here, we discuss how functional brain imaging has provided insights into the nature of brain dysconnectivity in mental illness. Synthesizing work to date, we propose that genetic and environmental risk factors impinge upon systems-level circuits for several core dimensions of cognition, producing transdiagnostic symptoms. We argue that risk-associated disruption of these circuits mediates susceptibility to broad domains of psychopathology rather than discrete disorders.

Bullmore, E. T., & Sporns, O. (2012). The economy of brain network organization.  Nature Reviews Neuroscience, 13, 336–349. http://dx.doi.org/10.1038/nrn3214

The brain is expensive, incurring high material and metabolic costs for its size — relative to the size of the body — and many aspects of brain network organization can be mostly explained by a parsimonious drive to minimize these costs. However, brain networks or connectomes also have high topological efficiency, robustness, modularity and a ‘rich club’ of connector hubs. Many of these and other advantageous topological properties will probably entail a wiring-cost premium. We propose that brain organization is shaped by an economic trade-off between minimizing costs and allowing the emergence of adaptively valuable topological patterns of anatomical or functional connectivity between multiple neuronal populations. This process of negotiating, and re-negotiating, trade-offs between wiring cost and topological value continues over long (decades) and short (millisecond) timescales as brain networks evolve, grow and adapt to changing cognitive demands. An economical analysis of neuropsychiatric disorders highlights the vulnerability of the more costly elements of brain networks to pathological attack or abnormal development.

Fornito, A., & Bullmore, E. T. (2012). Connectomic intermediate phenotypes for psychiatric disorders. Frontiers in Psychiatry, 3(32). http://dx.doi.org/10.3389/fpsyt.2012.00032

Psychiatric disorders are phenotypically heterogeneous entities with a complex genetic basis. To mitigate this complexity, many investigators study so-called intermediate phenotypes (IPs) that putatively provide a more direct index of the physiological effects of candidate genetic risk variants than overt psychiatric syndromes. Magnetic resonance imaging (MRI) is a particularly popular technique for measuring such phenotypes because it allows interrogation of diverse aspects of brain structure and function in vivo. Much of this work however, has focused on relatively simple measures that quantify variations in the physiology or tissue integrity of specific brain regions in isolation, contradicting an emerging consensus that most major psychiatric disorders do not arise from isolated dysfunction in one or a few brain regions, but rather from disturbed interactions within and between distributed neural circuits; i.e., they are disorders of brain connectivity. The recent proliferation of new MRI techniques for comprehensively mapping the entire connectivity architecture of the brain, termed the human connectome, has provided a rich repertoire of tools for understanding how genetic variants implicated in mental disorder impact distinct neural circuits. In this article, we review research using these connectomic techniques to understand how genetic variation influences the connectivity and topology of human brain networks. We highlight recent evidence from twin and imaging genetics studies suggesting that the penetrance of candidate risk variants for mental illness, such as those in SLC6A4, MAOA,ZNF804A, and APOE, may be higher for IPs characterized at the level of distributed neural systems than at the level of spatially localized brain regions. The findings indicate that imaging connectomics provides a powerful framework for understanding how genetic risk for psychiatric disease is expressed through altered structure and function of the human connectome.

Fornito, A., Zalesky, A., Pantelis, C., & Bullmore, E. T. (2012). Schizophrenia, neuroimaging and connectomics [Review]. NeuroImage. Advance online publication. http://dx.doi.org/10.1016/j.neuroimage.2011.12.090

Schizophrenia is frequently characterized as a disorder of brain connectivity. Neuroimaging has played a central role in supporting this view, with nearly two decades of research providing abundant evidence of structural and functional connectivity abnormalities in the disorder. In recent years, our understanding of how schizophrenia affects brain networks has been greatly advanced by attempts to map the complete set of inter-regional interactions comprising the brain’s intricate web of connectivity; i.e., the human connectome. Imaging connectomics refers to the use of neuroimaging techniques to generate these maps which, combined with the application of graph theoretic methods, has enabled relatively comprehensive mapping of brain network connectivity and topology in unprecedented detail. Here, we review the application of these techniques to the study of schizophrenia, focusing principally on magnetic resonance imaging (MRI) research, while drawing attention to key methodological issues in the field. The published findings suggest that schizophrenia is associated with a widespread and possibly context-independent functional connectivity deficit, upon which are superimposed more circumscribed, context-dependent alterations associated with transient states of hyper- and/or hypo-connectivity. In some cases, these changes in inter-regional functional coupling dynamics can be related to measures of intra-regional dysfunction. Topological disturbances of functional brain networks in schizophrenia point to reduced local network connectivity and modular structure, as well as increased global integration and network robustness. Some, but not all, of these functional abnormalities appear to have an anatomical basis, though the relationship between the two is complex. By comprehensively mapping connectomic disturbances in patients with schizophrenia across the entire brain, this work has provided important insights into the highly distributed character of neural abnormalities in the disorder, and the potential functional consequences that these disturbances entail.

Hagmann, P., Grant, P., & Fair, D. (June, 2012). MR connectomics: A conceptual framework for studying the developing brain [Review]. Frontiers in Systems Neuroscience. http://dx.doi.org/10.3389/fnsys.2012.00043

The combination of advanced neuroimaging techniques and major developments in complex network science, have given birth to a new framework for studying the brain: “connectomics.” This framework provides the ability to describe and study the brain as a dynamic network and to explore how the coordination and integration of information processing may occur. In recent years this framework has been used to investigate the developing brain and has shed light on many dynamic changes occurring from infancy through adulthood. The aim of this article is to review this work and to discuss what we have learned from it. We will also use this body of work to highlight key technical aspects that are necessary in general for successful connectome analysis using today’s advanced neuroimaging techniques. We look to identify current limitations of such approaches, what can be improved, and how these points generalize to other topics in connectome research.

Power, J. D., Cohen, A. L., Nelson, S. M., Wig, G. S., Barnes, K. A., Church, J. A., . . . Petersen, S. E. (2011). Functional network organization of the human brain. Neuron, 72, 665–678. http://dx.doi.org/10.1016/j.neuron.2011.09.006

Real-world complex systems may be mathematically modeled as graphs, revealing properties of the system. Here we study graphs of functional brain organization in healthy adults using resting state functional connectivity MRI. We propose two novel brain-wide graphs, one of 264 putative functional areas, the other a modification of voxelwise networks that eliminates potentially artificial short-distance relationships. These graphs contain many subgraphs in good agreement with known functional brain systems. Other subgraphs lack established functional identities; we suggest possible functional characteristics for these subgraphs. Further, graph measures of the areal network indicate that the default mode subgraph shares network properties with sensory and motor subgraphs: it is internally integrated but isolated from other subgraphs, much like a “processing” system. The modified voxelwise graph also reveals spatial motifs in the patterning of systems across the cortex.

Tost, H., Bilek, E., & Meyer-Lindenberg, A. (2011). Brain connectivity in psychiatric imaging genetics. NeuroImage. Advance online publication. http://dx.doi.org/10.1016/j.neuroimage.2011.11.007

In the past decade, imaging genetics has evolved into a highly successful neuroimaging discipline with a variety of sophisticated research tools. To date, several neural systems mechanisms have been identified that mediate genetic risk for mental disorders linked to common candidate and genome-wide-supported variants. In particular, the examination of intermediate connectivity phenotypes has recently gained increasing popularity. This paper gives an overview of the scientific methods and evidence that link indices of neural network organization to the genetic susceptibility for mental illness with a focus on the effects of candidate genes and genome-wide supported risk variants on brain structure and function.

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 19)

NOTE: I’ve posted four hour-long videos this week. If time doesn’t permit, I’d suggest listening to the Robert Sapolsky videos on depression and schizophrenia, maybe in your car on your way to work or finally taking that drive across the country. You couldn’t have more excellent company on a road trip!

Culture

1. I really enjoyed historian Jesse Ballenger’s first post on his new blog, To Conquer Confusion: A Historian’s Perspective on the Science and Experience of Alzheimer’s Disease and Dementia, entitled: “Blogging and Dementia: Why This Blog.” I think blogging is a good way to throw some light on the curious contents of our “work” minds in process. (Like archeologists, we should “embrace the messiness” and, in Ballenger’s case, ambivalence.) But Ballenger also grapples with an important question, “how can choking the virtual world with one more blog possibly be an act of communicative meaning?”

2. Kristi Lewton’s review in American Anthropologist, “Complexity in Biological Anthropology in 2011: Species, Reproduction, and Sociality.”

3. The Ethnographer’s guide to big data, part 1 and part 2. Jenna Burrell’s dispatch from the DataEdge conference hosted by UC Berkeley’s School of Information.

4. Via Jason Antrosio’s Anthropology Report, with some skepticism, Zoe Corbyn’s Nature news item, “How Geography Shapes Cultural Diversity.”

5. Norbert Ross, Catherine Timura, and Jonathan Maupin in 6/11/12 Medical Anthropology Quarterly, “The Case of Curers, Noncurers, and Biomedical Experts in Pichátaro, Mexico: Resiliency in Folk-Medical Beliefs.”

Neuroscience

1. I liked neuroscientist Bradley Voytek’s 6/16/12 post “Defending Jonah Lehrer,” which describes some critical issues regarding imaging (and also captures some of the angst surrounding the popularization of research by “non-experts”).

2. Vittorio Gallese (mirror neurons) YouTube video on “The Body in Aesthetic Experience: A Neuroscientific Perspective” from Berkeley’s Science, Technology, Medicine & Society. The talk focuses on his interdisciplinary approach to intersubjectivity and social cognition.

3. Apologies for posting TWO lengthy videos, but I loved Mario Biagioli’s book, Galileo, Courtier, so I had to post HIS Berkeley STMS talk, “Secrecy and Openness Revisited: A Genealogy of Priority in Science.”

4. Interesting 6/12/12 PNAS paper by a group of Finnish researchers, “Emotions Promote Social Interaction by Synchronizing Brain Activity Across Individuals.”

5. Andreas Bartels’ commentary in July 2012  Neuropsychopharmacology, “Oxytocin and the Social Brain: Beware the Complexity,” one of the lessons of which is, “we need to find clever ways to present social stimuli in truly social context.”

Psychiatry

1. The is almost the all-video edition of 3×5, but Robert Sapolsky’s talk on depression is worth hearing. I agree with a commentator who described it as: “Absolute genius. Elegant, simplified without being simplistic, and cohesive.”

2. A second video by Sapolsky on Schizophrenia:

3. I’ve just started reading Andrew Pickering’s The Cybernetic Brain: Sketches of Another Future. Here is link to U of Chicago description and excerpt:

[The Cybernetic Brain] explores the largely forgotten group of British thinkers—Bateson included—that tripped the light fantastic at the frontiers of psychiatry, systems management, politics, epistemology, and Eastern thought as the twentieth century came of age. In the excerpt that follows below, he locates Bateson’s ideas on schizophrenia and enlightenment alongside Western appreciations of Zen, as a form of what Foucault might call “gymnastics of the soul.”

4. Simon Baron-Cohen’s 6/13/12 commentary in The Guardian on “What the McLean Brain Bank Malfunction Means for Autism Research.”

5. From Psychiatric Times, Michael Casher and Joshua Bess on “Determination and Documentation of Insight in Psychiatric Inpatients,” which “reviews the relevant studies involving insight and offers an overview and critique of the various rating scales.”

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 12)

What’s new for week of 2–9 June 2012

Culture

1. Jens Seeberg in 6/11/12 Medical Anthropology Quarterly: “Connecting Pills and People: An Ethnography of the Pharmaceutical Nexus in Odisha, India.”

2. Good review of a good book about the sensitivity of our diagnostic systems to cultural factors, Jonathan Metzl’s The Protest Psychosis: How Schizophrenia Became a Black Disease (Beacon Press, 2009).

3. Research by Yina Ma and Shihui Han (who is coming to our next conference) is featured in “Christians Find It Harder than Atheists to Recognize their Own Faces.”

4. This is a reminder that the Advanced Study Institute in Cultural Psychiatry, which is hosted by McGill’s Division of Social & Transcultural Psychiatry, will take place July 5–7, 2012. The theme is: “Global Mental Health: Bridging the Perspectives of Cultural Psychiatry and Public Health.”

5. Wonderful Emily Martin 3/15/12 lecture at Science, Technology, Medicine & Society (Berkeley), “Steps Toward an Anthropology of the Human Subject in Experimental Psychology,” which begins by describing the rich, entwined history of psych/anthro field expeditions:  “The expedition scientists assumed that the social and cultural environment determined the way the mind perceived the world. (That’s pretty radical. . . . Eighteen-ninety-eight.)  They also assumed that after immersion in the daily life of villagers . . . they could serve as appropriate experimental subjects, comparable to the native inhabitants.”

Neuroscience

1. Rule, Freeman, and Ambady’s June 2012 review, “Culture in Social Neuroscience: A Review” published in Social Neuroscience

2. Latest from PNAS (June 5, 2012): Archie, Altmann, and Alberts in 6/5/12 PNAS: “Social Status Predicts Wound Healing in Wild Baboons.”

3. . . . And Crews et al. using a systems biology approach: “Epigenetic Transgenerational Inheritance of Altered Stress Responses.”i

4. Przyrembel, Smallwood, Pauen, and Singer’s 6/7/12 review “Illuminating the Dark Matter of Social Neurocience: Considering the Problem of Social Interacrtion from Philosophical, Psychological, and Neuroscientific Perspectives” in Frontiers in Human Neuroscience. “This analysis draws attention to the need for paradigms that allow two individuals to interact in a spontaneous and natural manner and to adapt their behaviour and cognitions in a response contingent fashion . . .”

5. See Patrick McGowan commentary and Labonte, Yerko, Gross, Mechawar, Meaney, Szyf, and Turecki study on epigenetics, suicide, and history of child abuse in July issue of Biological Psychiatry.

Psychiatry

1. Howard Markel’s 6/5/12 opinion piece, “The DSM Gets Addiction Right,” in the New York Times.

2. Jeremy Holmes, former chair of the Faculty of Psychotherapy, Royal College of Psychiatrists in BJ Psych on “Psychodynamic Psychiatry’s Green Shoots.”  One example the author discusses is the Scandinavian “needs adapted” approach to schizophrenia, whereby “ the uniqueness of each patient is recognised, medication kept to a minimum, the family dynamics around psychosis charted, and a long-term one-to-one relationship with a key-worker seen as vital to improvement.” See also Alanen et al., Psychotherapeutic Approaches to Schizophrenia Psychosis: Past, Present and Future (Routledge, 2009).

3. Hmm, may have mentioned this one in a previous post, but this is an interesting read if you like history of psychiatry: “Between phenomenological and Community Psychiatry: The Comprehending Anthropology of Jürg Zutt” by Peter Schöonknecht and Tom Dening in June 2012 issue of History of Psychiatry. Speaking in 1957 on the topic of anthropological psychiatry, Zutt said:

It is something relatively new in psychiatry. One may assume that we consider psychosis as psychogenic disorders, and that we do not consider anatomical and physiological causation. This is a misunderstanding … Anatomy and physiology remain two major basics of psychiatry. But we think that the phenomena traditional psychiatry cannot understand in logical terms have to be considered by using other approaches.

4. Last week I reported on the One Mind for Research annual meeting, here’s a link to a background article on the group by Matthew Herper for Forbes: “A Father’s Battle to Change the Future of Brain Research.”

5. Another must-read by Gregory Miller and Steve Cole: “Clustering of Depression and Inflammation in Adolescents Previously Exposed to Childhood Adversity” in July issue of Biological Psychiatry.

Psychiatric Neuroscience, Stigma and the Aging Brain: Dispatch from the Annual Meeting of One Mind for Research

A few weeks ago I attended the first annual meeting of the One Mind for Research Campaign: Curing Brain Disease. (The group’s new CEO is Ret. General Peter Chiarelli, the commanding officer of the 1st Cavalry Division during the Iraq War, and you could practically taste the battle dust in your mouth at the end of the 3-day offensive to eliminate brain disease and its stigma within 10 years.) The meeting, which included NIMH director Thomas Insel, former NIMH director Steven Hyman, and American Psychiatric Association newly elected president John Oldham, featured sessions on the latest psychiatric neuroscience, stigma, and the aging brain. Here are some highlights:

Heterogeneity

One non-surprising take-home message is that psychiatric disorders are not only heterogeneous but many (most?) may eventually be best characterized at the level of circuits/systems. Regarding heterogeneity, the consensus among several speakers was that patients classified as having one illness or another should be further “stratified” as much as possible in order to treat with different neurodeficit-specific compounds  (which is interestingly contrary to some of the proposed changes to DSM-5, such as lumping Asperger’s and Autism, or eliminating subtypes of schizophrenia). UPDATE (8/24/12) This statement requires clarification. The elimination of subtypes in schizophrenia (paranoid, disorganized, catatonic, undifferentiated, etc.) is due to the belief that the disorder’s clinical heterogeneity may be best understood by using a single diagnosis with distinct symptom “dimensions” of psychopathology – hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, negative symptoms (restricted emotional expression or avolition), impaired cognition, depression, mania – each of which, it is proposed, would be measured on a 4-point severity scale. But it’s important to note that these dimensions, or “domains,”  will “cross diagnostic boundaries” introducing a new set of challenges, especially for drug development (Carpenter, 2012).

Here’s an example of why categories can be confounding. Rene Hen gave a fascinating talk on a hippocampus-related process – pattern separation, the way in which our brains are able to reduce “the average overlap between two representations, thus making similar representations more distinct or orthogonalized in order to afford rapid learning without inducing interference and retrieval errors,” which is balanced by pattern completion. Pattern separation is impaired in PTSD as well as schizophrenia.

Connectivity

But I noticed that interest in the intermediate phenotype concept prevalent in psychiatric neuroscience literature during the last decade is now accompanied by an interest in big science, e.g., fresh efforts (reminiscent of Galen’s rete mirabile) to understand structural and functional connections within and across regions of the brain that are, also, exquisitely sensitive to environmental interactions. And this has significant treatment implications. As Emory fear scientist Kerry Ressler remarked, “we have to change how we think about therapy, the brain is not a bag of molecules that can be treated by a drug.”

MIT computational neuroscientist and TED pundit Sebastian Seung (“I am my connectome”) has received a lot of attention in the popular press recently for his work on the connectivity of individual neurons. (According to Seung, the dynamic or functional connectivity of neurons and the white-matter structural “connectome” interact in much the same way water rushing down a mountainside and the terrain over which it flows do.) But one of the most exciting sessions at the conference featured the work of Olaf Sporns and colleagues, who are focusing on structural and functional connectivity at the macro-scale, based on the concept of brain networks. These investigations rely on diffusion imaging (for structural connectivity) and resting state fMRI (for functional connectivity). In his talk, Sporns likened these anatomical connections to complex social or other kinds of networks that exist in the world. (“A common language is emerging,” said Sporns, one that is able to link network interactions within and across multiple levels of organization, which he referred to as “network science.”) Focusing on these interactions seems a little more doable than trying to link objective biomarkers to subjective experience (which Vaughan Bell of Mind Hacks likened to counting commas in a poem).

In the same session, William Seeley gave a fascinating talk on the connectional architecture of neurodegeneration in brain disorders, including Alzheimer’s, each of which has a distinct pattern. His group found, for example, that resting-state connectivity patterns of healthy brains related to episodic memory using fMRI mirrored the atrophy patterns in Alzheimer’s as the disease progressed from the medial temporal lobe to the neocortex. (The more radical idea (that may be reappearing in the science), another speaker said, is that these disorders are connectopathic and initially triggered by rogue proteins.) Here’s a link to the relevant Neuron 2012 paper.

 Stigma

In the session on stigma, Elyn Saks (USC), author of The Center Cannot Hold, discussed the “positive, negative, and cognitive” dimensions of schizophrenia, in regard to the latter dimensions specifically referring to short-term memory, visuo-spatial abilities, etc. She discussed how she was able to balance borderline impairment in some areas of cognition, e.g., short-term memory, by leveraging her strengths and “passed” for many years in academia as “normal.” During the talk I was struck by Dr. Saks’s certainty that psychotherapy is the reason for her lack of negative symptoms, which made me wonder, just how correlated are these symptoms with a person’s level of social disconnection? (The social neuroscience in this area by Naomi Eisenberger – who just published a review in Nature – and others relating social disconnection to some of the same pathways as physical pain is really interesting in this regard.)

Unfortunately, stigma is “alive and well,” according to sociologist Bernice Pescosolido, who spoke eloquently around the depressing fact that despite huge leaps in scientists’ neurobiological understanding of mental illness, despite the disappearance by the rest of us into what Mary-Jo DelVecchio Good calls the “biotechnical embrace” re matters of the mind, there has been virtually no change in Americans’ level of prejudice regarding persons whom NYU anthropologist Emily  Martin refers to as living under the description of a mental disorder. We just don’t believe it’s a disease like any other, and if you or your family have the rotten luck to be on the receiving end, this adds astronomically to the confusion, anxiety, and fear about which neuroanthropologist Greg Downey has so eloquently written ( “Slipping into Psychosis”).

Alzheimer’s and the Fountain of Youth

But I don’t want to end this post on such a depressing note. Stanford researcherTony WyssCoray discussed the importance of not seeing the brain as an isolated organ. His group is studying the effects of stress, inflammation, and other environmental insults on brain function. In one experiment, the investigators infused the blood of young mice into old mice, and there were many positive effects in terms of neurogenesis, increased synaptic activity, increased spine density, reduced neuroinflammation, and improved spatial memory. (This announcement initiated a small wave of mouse jokes.) A brilliant neuroscientist sittling behind me said in a vaguely accented English (seriously) that it would be a difficult and expensive process to determine which substances within the blood to focus on; in the meantime, why not just transfuse old people with young people’s plasma? This is precisely what John Huston, playing a Joseph Kennedy-esque character, does in the movie Winter Kills (“I get it from the kids up at Amherst”). As the general concluded, “What I’ve learned among other things is that, THIS IS A GOOD TIME TO BE A MOUSE.”

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 5)

Culture

1. “What Makes Something Ethnographic?” Carole McGranahan’s 5/31/12 post on Savage Minds summarizes her experience teaching a new undergraduate course. (The group eventually came up with their own 9-item list.)

2. And that list reminded me of the conclusion in “Ways of Looking at Ethnographic Film,” an edited excerpt – from “Seeing Anthropology” by Karl Heider et al. – available on TV Multiversity.

3. Clark Lawlor of h-madness reviews Junko Kitanaka’s “Depression in Japan: Psychiatric Cultures for a Society in Distress” (Princeton, 2011).

4. Rafael Núñez et al.’s “Contours of Time: Topographic Construals of Past, Present, and Future in the Yupno Valley of Papua New Guinea,” in July 2012 Cognition.

5. Rebecca Sear’s 2/21/12 presentation at UCLA’s Center for Behavior, Evolution, and Culture is available on video, “How Much Does Family Matter?A Comparative Study of Kin Influences on Fertility.”

Neuroscience

1. Lauren O’Connell and Hans Hofmann of UT (Austin), who looked at 88 species of vertebrates from five class –  fish, amphibians, reptiles, birds, and mammals,  report in the 6/1/12 issue of Science on “Evolution of a Vertebrate Social Decision-Making Network.”

2.  Karl Deisseroth’s “Optogenetics and Psychiatry: Applications, Challenges, and Opportunities,” introducing the 6/15/12  special issue of Biological Psychiatry. “Why is optogenetics so important to psychiatry,” you may ask? Because “one of [its] unique and most versatile features . . . is well aligned with what may be a core feature of psychiatric disease (altered function along pathways of neural communication).”

3.  Proust wasn’t a neuroscientist, and neither is Jonah Leher (who as of today is a staff writer at The New Yorker, here’s link to the new home of Frontal Cortex). An old, but very rich post + commentary, which may make you want to revisit the post by Kate Clancy and commentary/discussion between Kate Clancy and Daniel Lende on interdisciplinary graduate education. Would an anthropologist who spends a year in an imaging lab qualify?

4. One of Bradley Voytek’s favorite TED talks (by Oliver Sacks), “What hallucination reveals about our minds.” (Speaking of which, the makers of Prometheus nailed the genre, including the annoying cadence.)

5. Scicurious masterfully unpacks a paper by Volkow et al. on sleep deprivation in 6/4/12 Sciam.

Psychiatry

1. “Our New Era of Anxiety,” an excerpt from Allan Horwitz and Jerome Wakefield’s new book, “All We Have to Fear,” in 6/2/12 Salon.

2. “An Unnplanned Post-Mortem,” Mind Hacks on suicide.

3. “The Best of Times, the Worst of Times for Psychiatric Disease,” Nature Neuroscience on psychiatric genetics.

4. The h-madness post on the War, Memory, Trauma (link to Centre for the History of Medicine exhibit).

5. A must read: Didier Fassin and Richard Rechtman’s “The Empire of Trauma: An Inquiry into the Condition of Victimhood” (Princeton, 2009/trans). Link to intro.

BONUS: This year I participated in the consistently wonderful meetings hosted by UCLA’s Mind, Medicine, and Culture interdisciplinary discussion group, which is led by Carole Browner, Linda Garro, Doug Hollan, and Jason Throop.  It’s definitely worth it to join the list-serve when MMAC resumes next Fall.