Richard G. Petty, MD

Madness and Genius Revisited

I must have heard a thousand times that there’s a fine line between genius and insanity. I have talked before about the possible link between the two through schizotypal personality disorder. It is quite well known that there are two living Nobel Prize winners who have a diagnosis of schizophrenia and many more who have first-degree relatives with it.

There is some very interesting research in the current issue of the Journal of Clinical Investigation from a team of scientists at the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH).

In the latest installment of a story that has been unfolding over the last three decades, they report on their findings concerning a human gene for a master switch in the brain called DARPP-32. Most people inherit a version of a gene that optimizes their brain's thinking circuitry, yet paradoxically also appears to increase risk for schizophrenia, an illness marked by impaired thinking. The main kinds of thinking involve reasoning, abstraction and creativity.

Over the last two decades, studies in animals, most notably by Nobel Laureate Paul Greengard at Rockefeller University, have established that DARPP-32 in the striatum switches streams of information coming from multiple brain chemical systems so that the cortex can process them. Both the neurotransmitter that DARPP-32 works through – dopamine - and the chromosomal site of the DARPP-32 gene have been implicated in schizophrenia.

The NIMH researchers in this new study have identified a common version of the gene and showed how it impacts the way in which two key brain regions exchange information, so affecting a range of functions from general intelligence to attention.

To understand DARPP-32's role in the human brain, they used genetic, structural and functional magnetic resonance imaging and also post-mortem studies to identify the human gene's variants and their functional consequences.

Seventy five percent of subjects had the most common version of the gene, which boosted the activity of circuits in the prefrontal cortex of the brain. This region is the major filter, controller and processor of cognitive information. When active, it increases structural and functional connections and our performance on tasks that involve thinking. It almost certainly does so by increasing gene expression. In 257 affected families, people with schizophrenia were also more likely to have this common version of the DARPP-32 gene.

DARPP-32 appears to shape and control a circuit running between the striatum and prefrontal cortex. The circuit affects key brain functions implicated in schizophrenia, such as motivation, working memory and reward-related learning.

The senior investigator is Daniel Weinberger, who had this to say,

"Our results raise the question of whether a gene variant favored by evolution, that would normally confer advantage, may translate into a disadvantage if the prefrontal cortex is impaired, as in schizophrenia. Normally, enhanced cortex connectivity with the striatum would provide increased flexibility, working memory capacity and executive control. But if other genes and environmental events conspire to render the cortex incapable of handling such information, it could backfire -- resulting in the neural equivalent of a superhighway to a dead-end."

Although several groups of researchers have looked for the possible clinical relevance of DARPP-32, they have had much success. This study shows a strong connection between the molecule and human cognition and also, perhaps, with schizophrenia.

What is also interesting about this finding is that it helps provide us with a mechanism by which environmental stress could lead to cognitive problems.

Apart from the uninformed tirades of Tom Cruise, I see a lot of opinion pieces on websites and YouTube expressing the opinion that psychiatry is baseless, ostensibly because there is no science behind it. By anyone’s standards, this is high level science utilizing a series of state-of-the-art approaches. And another piece of evidence that psychiatry is becoming more science than art, linking the mind, the brain and the environment into one harmonious whole.

Does the Spinal Cord Think?

In recent years we have become very interested in the ever-increasing evidence there are large complex neural networks outside the brain and autonomic nervous system. The main ones are in the intestine and the heart. These systems are so complex and well organized that some people have talked about us having a “brain” in the heart and another in the intestine. This may be a bit of an over-statement. For instance the cerebellum at the back of the brain is large and highly complex, but is so arranged that it probably cannot generate conscious experience. That particular trick needs a cerebral cortex that self-organizes, recruits new systems when necessary for some particular task and generates vast oscillations that are modulated by genes and the environment.

Now new research has shown that the spinal cord has some of those same properties that we associate with the cerebral cortex. This groundbreaking work has just been published in the journal Science, and the entire paper is available here.

So why the excitement and interest? It often astonishes me how many students who come to my lectures seem not to have a curiosity gene. And there is so much about which we should be curious. Despite the billions spent on research there is still a great deal about the human body that is not understood at all. Not small esoteric things, but huge questions.

For instance how can some people think and communicate even if most of the brain is destroyed by disease? On the other hand some people are incapacitated by the smallest lesion. I’ve taught neurology for years, in particular the art of neurological examination. I was trained by some of the best in the world, so I know how to look for subtle neurological signs. Yet I’ve seen a great many inexplicable things: I saw someone come to autopsy who had no neurological signs, but had a tumor occupying more than half of the dominant hemisphere of the brain.

Here’s another puzzle: we don’t know how humans are able to move. Our muscles are controlled by thousands of nerve cells in the brain, spinal cord and peripheral nervous system. This entire complex system must work as a whole in order to successfully generate a single motion. Yet how quickly do most children learn to stand and walk. The new research has shown that the spinal cord is not a passive signal conductor, but has instead shown that spinal neurons, while engaged in the network activity underlying movements, show irregular firing patterns similar to those seen in the cerebral cortex. Even if we repeat a certain motion with high accuracy, the nerve cells involved never repeat their activity patterns. Just the same as happens in the cerebral cortex.

This is yet more evidence to suggest that “thinking” does not only go on in the brain. It makes sense to think of the major systems - heart, intestine and spine – as key components of the subliminal, pre-conscious mind. Some people like the term subconscious, but that runs into the confusing problem of mixing up the terms subconscious and unconscious.

I talk about some of these differences and how to work these different parts of yourself in the book and CD series Healing, Meaning and Purpose.

Chiropractors have been telling us for years that the spinal cord is a lot more than just a relay system. It looks as if they may have been correct.


If you are interested in following up on my comments about what it takes for a neural network to generate conscious experiences, you may be interested in having a look at my review of the excellent new book Rhythms of the Brain by Gyorgy Buzsáki. and

Daniel J. Benor's WHEE

I have become convinced that the so-called tapping therapies have a great deal to offer many people, as bizarre a they appear the first time that you encounter them!

I have recently come across another form of therapy developed by the holistic psychiatrist and author Daniel J. Benor. I have met Dan many times, and he is one of the most knowledgeable people that I know when it comes to healing, and this new technique seems to be helping a great many people.

He calls it WHEE: Whole Healing - Easily and Effectively, a.k.a. Wholistic Hybrid derived from EMDR and EFT.

Like the other tapping therapies, it seems often to be a quick way to release psychological and physical pains, and it is said to enhance performance in sports. Interestingly, it also seems to help some allergies. There are many helpful resources and a articles at the parent website: Wholistic Healing Research.

If you are looking for more options in your own path toward wellness, or if you have some stubborn problem to deal with, WHEE and the accompanying materials might well be worth your attention.

 

Back Pain, The Brain and Pain Cycles

A German research team using a specialized imaging technique called diffusion tensor imaging (DTI) to look at the differences between back pain sufferers' and healthy volunteers' brains found that individuals suffering from chronic low back pain also had micro-structural changes in their brains. The findings were presented at the annual meeting of the Radiological Society of North America in Chicago by the lead researcher Dr Jurgen Lutz, a radiologist at Ludwig-Maximilians University in Munich, Germany.

DTI tracks the movement of water molecules in the brain's gray and white matter. Individual water molecules are constantly in motion, colliding with each other and other nearby molecules, causing them to spread out, or diffuse. DTI allows us to analyze water diffusion in the tissues of the brain. In normal white matter, water diffuses in only one direction. So if they are moving in the “wrong” direction, we can use this as an indication that there are changes in the fiber pathways.

The investigators studied 20 patients who were experiencing chronic back pain with no precisely identifiable cause and 20 age- and gender-matched healthy volunteers. DTI was performed to measure the diffusion in several areas of each patient's brain. 
 



They discovered the brains of patients with chronic back pain had a more complex and active microstructure compared with the healthy volunteers' brains.

The changes were found in regions of the brain associated with pain-processing, emotion and stress response, including the cingulate gyrus, postcentral gyrus and superior frontal gyrus.

Although it is possible that theses structural disturbances are a cause of chronic pain, it is more likely to be the other way round.

This leads us to a very important concept that is not talked about as much as it should be: it is the idea of pain cycles. Pain cycles can have a physical or psychological origin and are thought to be maintained by some of the centers in the brain that process pain and emotional distress. The two are often mixed together: pain is extremely common in both depression and in bipolar disorder, and pain can, of course, make you feel depressed.

Theses pain cycles will often persist for long periods after the original cause of the pain has gone. So we may continue to feel pain long after a broken bone has healed, or we may continue to suffer emotionally long after a bad relationship should have been dead and buried. Many interventions like acupuncture or injecting steroids or anesthetics into trigger points can interfere with the pain cycle. Similarly there are many therapies, including some of the tapping therapies, that seem to “re-set” some of the systems in the nervous and subtle systems of the body.

In my forthcoming book Sacred Cycles, I talk a lo about these vicious pain cycles and how to interrupt them.

“Pain is part of being alive and we need to learn that. Pain does not last forever, nor is it necessarily unbeatable, and we need to be taught that.”
--Rabbi Harold S. Kushner (American Rabbi Aligned with the Progressive Wing of Conservative Judaism and Writer, 1935-)

“Softness is a dream in every ache to become a better soul.”
--John Kells (Irish-born British Grand Master of T’ai Chi Ch’uan, 1940-)

A Major Breakthrough in Neurogenesis Research

I have written a lot about adult neurogenesis, because it is so incredibly important.

When most of us were in school were taught that the brain is a static structure. That you are born with a certain number of neurons, that constitutes your neural “stash.” And after the age of five you would lose a hundred thousand neurons a day, and if you drank too many martinis it would be two hundred thousand a day. “Facts” and figures repeated from one textbook to another for fifty years. And quite wrong.

Ten years ago it was discovered that there are neural stem cells in the hippocampi of adult rodents. A study published in 1998 provided some evidence that neurogenesis takes place in the adult human hippocampus, but the idea that neurogenesis takes place in adult humans has remained contentious.

Now, an advance online publication on the website of the journal Science provides evidence that neurogenesis may also occur in the olfactory bulb of the human brain.

The whole article, including the pictures is available here. The picture at the top of this article shows new cells appearing in the olfactor bulb.

The investigators examined the rostral migratory stream (RMS) which is the main pathway by which newly born cells from the subventricular zone (SVZ) reach the olfactory bulb in rodents. The researchers discovered that there is a human RMS containing neuroblasts, a.k.a. neural stem cells.

(This is a rat olfactory bulb)

Maurice Curtis and his colleagues examined the brains of cancer patients who had recently died, after having been previously injected with bromodeoxyuridine (BrdU), a chemical that is incorporated into newly synthesized DNA. Cell biologists and oncologists have used the method for years to visualize and monitor the growth of tumors. The researchers found BrdU-positive cells in the olfactory bulbs of the patients’ brains, indicating that they contained newly-generated neurons.

The team then used antibody staining to show that the neuroblasts begin to differentiate into olfactory neurons while migrating through the rostral migratory stream. Upon arriving at the bulb, the cells continued to differentiate, forming mature olfactory neurons.

The patients whose brains were examined were between 38-70 years of age, so the findings show that neurogenesis may occur throughout the duration of the human lifespan. The function of these newly generated cells is unclear, but they may be involved in recognizing and remembering new smells in the later years of life.

The researchers also have preliminary unpublished data that the stem cells not only migrate to the olfactory bulb, but also leave the RMS and migrate into the basal ganglia and cerebral cortex. This is significant, because parts of the basal ganglia degenerate in movement disorders such as Parkinson’s Disease, and specific regions of the cortex degenerate in Alzheimer’s. The possibility that stem cells enter these regions from the RMS could therefore provide a means for developing new treatments for neurodegenerative diseases.

So although at the moment new neurons are only known to be created in a small number of ancient structures in the brain, but that may well change, since the cells are marching over there from regions around the ventricles. After all, why would Nature, the Universe or God have left neural stem cells sitting there unless it was for a good reason? And if adult neurogenesis can be demonstrated in other parts of the brain, then what? An end to the stem cell debates? If the stem cells are already present in the brain, the effort can be directed toward activating and directing them. Could we continue generating new neurons to stave off the dementing illnesses, or is that just science fiction?

The answer is that science fiction is fast becoming science fact. This research will need to be replicated, but I know of several other labs that have already accumulated some similar data to this new paper in Science.

A Possible New Treatment for Attention Deficit Disorder

Although I am always eager to use non-pharmacological treatments whenever possible, sometimes it just isn't possible to us them on their own. I've outlined some of the reasons for treating attention deficit disorder (ADD) in a previous post.

We should soon hear whether the regulatory authorities in the United States and Europe are going to approve a medicine - guanfacine - that we currently use for treating high blood pressure, for the treatment of ADD. In the United States it is currently sold under the trade name Tenex. The medicine works in the brain by modulating a population of receptors known as the central nervous system α-2 adrenergic receptors, which results in reduced sympathetic outflow leading to reduced vascular tone. Its adverse reactions include dry mouth, sedation, and constipation.

The idea of using a medicine like this for treating ADD is not new. Fifteen years ago researchers showed that receptor agonists like clonidine decreased distractibility in aged monkeys. And clonidine itself has occasionally been used for treating ADD for over twenty years.

Guanfacine seems to have some unique properties including decreasing the activity in the caudate nucleus while increasing frontal cortical activity. We would therefore expect it not only to help with ADD symptoms, but it may have some quite specific properties relating to learning new material. A key point is that if approved it will only be the second nonstimulant medicine for ADD, along with atomoxetine (Strattera). Many clinicians have had a lot of trouble with side effects of atomoxetine, particularly if it is used in adult men. So if guanfacine is approved, and if it does not have the same side effects, that would be a big bonus.

New options are always welcome, but it remains important for any new pharmacological treatment to be nested in an Integrated approach, which always includes nutrition, physical and cognitive exercises, psychological and social help, as well as attending to the subtle and spiritual aspects of the problem.

And ADD can be a very big problem, despite the protestations from people who claim that it is a non-disease dreamed up by pharmaceutical companies. Our interest is not just professional, but personal. Every single day we see what can happen if someone forgets their medicine.

If the FDA gives approval for guanfacine I shall immediately report it for you, as well as giving you details of all the safety and tolerability data.

 

Hormones, Addictions and Mood

People working with mental illness have been for years now been puzzled by two observations. The first is that mood disorders and schizophrenia follow quite different trajectories in men and women. Women tend to be more vulnerable to mood disorders and if they get schizophrenia it tends to be less severe and to have fewer "negative" symptoms, such as flat, blunted or constricted affect and emotion, poverty of speech and lack of motivation until after menopause. We have looked at some of the reasons for the different rates of mood disorder, in terms of relationships and social pressures, but there must also be a biological component. The second puzzle is that women are more vulnerable to addictive drugs in the days before they ovulate.

New research published in the  Proceedings of the National Academy of Sciences may provide part of the answer to both puzzles.

Colleagues at the National Institute of Mental Health (NIMH), a component of the National Institutes of Health (NIH), have conducted a fascinating imaging study that has shown that fluctuations in levels of sex hormones during women's menstrual cycles affect the responsiveness of the reward systems in the brain.

The reward system circuits include the:

• Prefrontal cortex, which has key roles in thinking, planning and in the control of our emotions and impulses
• Amygdala, which is involved in rapid and intense emotional reactions and the formation of emotional memories
• Hippocampus, which is involved in learning, memory and navigation
• Striatum that relays signals from these areas to the cerebral cortex

It has been known for some time that neurons in the reward circuits are rich in estrogen and progesterone receptors. However, how these hormones influence reward circuit activity in humans has remained unclear.

The researchers used functional magnetic resonance (fMRI) imaging to examine brain activity of 13 women and 13 men while they performed a task that involved simulated slot machines. The women were scanned while they did the task, both before and after ovulation.

When anticipating a reward, in the pre-ovulation phase of their menstrual cycles the women showed more activity in the amygdala and frontal cortex. When women were actually winning prizes, their reward systems were more active if they were in the phase of their menstrual cycle preceding ovulation. This phase of the cycle is dominated by estrogen, compared to postovulatory phase when estrogen and progesterone are both present. When winning, the main systems that became active were in the parts of the brain involved in pleasure and reward.

The researchers also demonstrated that the reward-related brain activity was directly linked to levels of sex hormones. Activity in the amygdala and hippocampus was in directly linked to estrogen levels, regardless of where a woman was in her cycle. When women won prizes during the post-ovulatory phase of the cycle, progesterone modulated the effect of estrogen on the reward circuit.

Men showed a different activation profile from women during both anticipation and delivery of rewards. Men had more activity in the striatum during anticipation compared with women. On the other hand, women had more activity in a frontal cortex when they won prizes.

This research could have a number of important implications. The most obvious is that it confirms what many women know already: they are more likely to take addictive substances or to engage in pleasurable - but perhaps impulsive or risky - behaviors just before they ovulate.

It is not difficult to imagine why this might have developed during evolution.

“Coming to terms with the rhythms of women's lives means coming to terms with life itself, accepting the imperatives of the body rather than the imperatives of an artificial, man-made, perhaps transcendentally beautiful civilization. Emphasis on the male work-rhythm is an emphasis on infinite possibilities; emphasis on the female rhythms is an emphasis on a defined pattern, on limitation.”
--Margaret Mead (American Anthropologist and Writer, 1901-1978)

Chiropractic Treatment in Children with Learning Disorder and Dyslexia

I spend a lot of time scanning, reading and analyzing scientific and medical journals that might have anything in them that are relevant to our themes of Health, Integrated Medicine, Meaning and Purpose.

And as I discussed recently, those that are helpful and accessible may find their way onto the "Journals" resource panel on the left-hand side of this blog. I don't want any of us to get overwhelmed with information, so I check several issues before any of them make the final cut.

Many readers have been kind enough to make suggestion, all of which I have checked on your behalf. So I have just added a journal - Journal of Vertebral Subluxation Research - that I have only discovered in the last month or so, though I've now had a look at all the past issues.

There was a particular article that caught my attention. The paper suggests that chiropractic care may offer significant benefits to children suffering from learning disabilities and dyslexia.

The research was a literature review by the Swiss chiropractor Yannick Pauli, who is President of the Swiss Chiropractic Pediatric Association and who specializes in the care of children suffering from learning and behavioral disorders.

Learning disorders and dyslexia affect anywheere between three and ten percent of school-aged children in the United Sates. The numbers vary depending on the exact criteria that we use. And it is certainly true that individuals with these disorders often suffer from low self-esteem, low levels of motivation, loss of interest in school, academic difficulties and often have problems in social functioning.

Dr. Pauli suggest that any positive effects on learning disabilities and dyslexia may have something to do with improving function in the cerebellum. Most books will tell you that the cerebellum is simply involved in motor corodination, posture and balance. But that has long been known to be a limited view: amongst mammlas, humans have the largest cerebellum relative to the rest of the brain, and it is involved in coordinating not just motor functions, but also sensation, language, emotion and social functions.

According to Pauli, "The only source of constant stimulation to the brain comes from the spine and the postural muscles constantly adjusting to the force of gravity.... If the daily physical stresses of life cause misalignments in the spine -- called vertebral subluxations by chiropractors -- the brain is not adequately stimulated. This can cause problems throughout the body."

This work is preliminary and skeptcs will imediately ask why it was not done by independent scholars? The answer is that they will rarely touch a topic like this unless someone has done some preliminary work to show that it might be worth their attention. This is exactly what happened a number of years ago when several friends of mine - all eminent researchers - decided to examine chiropractic manipulation in low back pain. The research was only done because some British chiropractor had already produced some pilot data. Then the full resources of a major research team swung into action.

I also have some personal observations that lead me to think that the results of this small Swiss study will have traction. Tough not everyone gets better, I have seen several children with neurodevelopmental problems and traumatic brain injuries helped greatly by chiropractic and Ayurvedic forms of manipulation. One of the most striking was a young South Indian girl whose family lived in Germany. She had a form of cerebral palsy, and at the age of 5 was in a bad way. I saw her after a dozen manipulative treatments in London, and the change was stunning.

That is why research is so important. Not just to see if a thing works, but to try and work out in whom it might work. And then to see if we can make the treatment yet better.

Why is Laughter Infectious?

When I was a very young student Monty Python’s Flying Circus was being shown on TV for the first time. The TV room in the halls of residence would normally be home to one or two sleeping stalwarts. But on Monty P. nights we would have seventy or eighty of us crammed into a small room: the sharing of laughter made the whole show ten times funnier.

I think that we’ve all had the experience of infectious laughter. It’s easy enough to see that it can be a social lubricant. But how does it work?

We have known for some time that when we are talking to someone, we often mirror their behavior, copying the words they use and mimicking their gestures. You may know that deliberately copying other people is a technique that we use when we are trying to influence others. It has seemed likely that the same applies to laughter.

Researchers at University College and Imperial College in London have shown that positive sounds such as laughter or a rousing and triumphant "woo hoo!" trigger a response in the listener's brain. This response occurs in the regions of the brain that are activated when we smile, as though preparing our facial muscles to laugh. The research, funded by the Wellcome Trust, Action Medical Research and the Barnwood House Trust, is published in the Journal of Neuroscience.

The research team played a series sounds to volunteers whilst measuring their brain's response using an fMRI scanner. Some of the sounds were positive, such as laughter or the triumphant woo hoo’s, while others were distinctly unpleasant, such as screaming or retching. All of the sounds triggered a response in the volunteer's brain in the region of the premotor cortex. This is part of the brain that prepares the facial muscles to respond to emotion. The response was greater for positive sounds, suggesting that these were more contagious than negative sounds. The researchers believe that this explains why we respond to laughter or cheering with an involuntary smile.

When we are in a group and encounter positive emotions, the brain responds by automatically priming us to smile or laugh. This gives us a way of mirroring the behavior of others, which in turn helps our social interactions. Presumably it plays an important role in building strong bonds between individuals in a group.

There is a global movement which started in India called the laughter clubs, in which people get together to have a really good belly laugh. It has been claimed that these group giggles reduce the chance of developing depression. The data is not good, but there’s one thing for sure: it’s unlikely to cause you much harm.

“Laugh and the world laughs with you; cry and you cry alone.”
--Horace (a.k.a. Quintus Horatius Flaccus, Roman Poet and Satirist, 65-8 B.C.E.)

“What a force is laughter.”
--Alexander Solzhenitsyn (Russian Writer and, in 1970, Winner of the  Nobel Prize in Literature, 1918-)

“The arrival in town of a good clown is of more benefit to the people than the arrival of 20 asses laden with medicine.”

--Thomas Sydenham (English Physician and a Founder of Modern Clinical Medicine and Epidemiology, 1624-1689)

Acupuncture and Parkinson's Disease

Over the last 25 years I have used acupuncture to try and help a great many people with Parkinson's disease. It has certainly helped a lot of the symptoms, but in my experience has not often done much to change the course of the illness. That being said, I have seen a few people who had remarkable improvements that were sustained for months and even years. The best results have usually come when we have used a combination of acupuncture, diet and homeopathy, in addition to regular medications.

So I was very interested to see a study in the journal Brain Research, even though the work used animals, and I've had a longstanding aversion to animal experiments.

There is a chemical called MPTP (1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine) that damages and kills some types of dopaminergic neurons in the brain, so it can produce Parkinsonian symptoms in humans and in some animals.

Mice were injected with MPTP and then some of them received acupuncture every two days in two spots, one behind the knee and one on top of the foot. In humans, these are two of the points that are traditionally considered to be involved in muscle movement. Another group of mice received acupuncture in two spots on the hips that are not believed to be effective for acupuncture. A third group had no acupuncture at all.

By the end of seven days, the MPTP injections had decreased dopamine levels both in the mice that had not received acupuncture, and in the mice that received fake acupuncture, to about half the normal amount. But in the acupuncture-treated group, dopamine levels declined much less steeply, and nearly 80% of the dopamine remained.

The mechanism for such an effect remains unknown. The most likely mechanism is that it is reducing the inflammation in the brain often accompanies and worsens other symptoms of Parkinson's disease. So acupuncture might maintain dopamine levels by preventing this inflammation. The same team of researchers from South Korea has already reported that acupuncture also prevents loss of dopamine neurons in rats.

The clinical studies in humans have been less encouraging, and more closely reflect my clinical experience. The problem is that by the time most people get to see an acupuncturist, they have already lost huge numbers of dopamine neurons and it is difficult to do very much. If acupuncture is to be helpful, we would probably need to be able to identify someone with Parkinson's disease extremely early, perhaps even before clinical signs have appeared, and so far we have no reliable way of doing that.

Altruism and the Brain

There is a fascinating new study which will be out next month in the journal Nature.

Colleagues from Duke University Medical Center in Durham, North Carolina, believe that they have found a region of the brain that is associated with altruism: selfless concern for the well-being of others.

Some scientists have claimed that it is of no value because it has no survival advantage. I've never been able to agree with that extreme position. Another view is that the survival advantage comes from an ability to perceive the intention of others and therefore to anticipate their actions. I'm also not certain that this is genuine altruism, in the sense that altruism should be selfless.

45 volunteers were asked to play a computer game and also to watch the computer play the game. In some instances successful completion of the game resulted in the volunteers winning money for themselves, and in other instances it resulted in money being donated to a charity that each person had chosen at the beginning of the experiment. During these games the researchers took functional magnetic resonance imaging (fMRI) scans of the participants' brains.

According to the old fashioned - and false - theory that pleasure and pain are THE main drivers of behavior, it was assumed that altruistic acts would activate the reward systems in the brain.

They do not.

A region of the brain called the posterior superior temporal cortex (pSTC) is activated by altruism and is very sensitive to the difference between doing something for personal gain and doing it for someone else's gain. The pSTC appears to help us tune into perceiving and giving meaning to the actions of others. It is not focused on reward.

In the next stage of the research the participants were asked questions about the type and frequency of their altruistic or helping behaviors. The researchers then analyzed the responses to generate an estimate of a person's tendency to act altruistically and compared each person's level against their fMRI brain scan. The results showed that pSTC activity rose in proportion to a person's estimated level of altruism. Note that it was their estimated level rather than their actual altruistic acts.

The suggestion by the researchers is that the ability to perceive other people's actions as meaningful is critical for altruism.

I am going to be a Devil's advocate and interpret the data differently. I think it more likely that people who have a good understanding of social relationships are more likely to do things for other people. Helping other just makes sense to you. Both the tests and the imaging could be interpreted in terms of social understanding and empathy. In other words we are looking at an aspect of social cognition.

There may also be another correlation here. Some years ago we showed that in people with chronic schizophrenia there is a shift in the handedness of a particular region of the brain called the planum temporale, which lies on the top of the temporal lobe. This lead to the hypothesis that when people are hearing voices, they really are hearing something being generated in the right hemisphere of the brain. People with schizophrenia sometimes have trouble with reading other people's intentions and may attach meaning to random events. This new research mat help us understand why that can happen.

It also makes clinical sense: the best ways of helping people with mental illness who have these problems is to ensure that they are not on medicines that impair their social cognition, and to use social skills training.

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.”
--Albert Pike (American Lawyer, Masonic Author and Historian, 1809-1891)

“Spiritual energy flows in thankfulness and produces effects on the phenomenal world.”
--William James (American Psychologist and Philosopher, 1842-1910)

Cognitive Brain Health Test

One of the blogs that never fails to provide me with some food for thought is Zack Lynch's Brain Waves.

He has just alerted his readers to a very interesting resource.

The Brain Resource Company launched a free, confidential, 40-minute cognitive brain test in partnership with the Alliance for Aging Research. The company is offering the test at no cost until May 14, 2007.

When you first click on the link for the test, you are taken to a page on Brain Health with a great many links.

I am extremely familiar with the literature on the brain, aging and cognition. So on your behalf, I passed a critical eye over the material. I was really pleased with it. I have one or two very minor quibbles, and one or two of the links are not working yet, but overall the information is excellent and above all reliable.

One thing about doing the test is that it needs for you to be using Windows. So we Macintosh users are left out in the cold. But the test is well worth doing, so if you are a Macintosh user, you might want to see if you can borrow a Windows machine for an hour.

“Most people would sooner die than think; in fact they do so.”
--Bertrand Russell (Welsh Mathematician, Philosopher, Pacifist and, in 1950, Winner of the Nobel Prize in Literature, 1872-1970)

“The longer I live, the more beautiful life is.”
--Frank Lloyd Wright (American Architect, 1867-1959)

Memory is a Key to Visualization

Most of us have been told something about the potential benefits of visualizing an outcome, and I know from working with many athletes, chess players, dancers and even surgeons, that most are very good at visualizing exactly what they want and where they are going to be.

I have recently talked about the ways in which encoding of memory for faces and the crucial role of memory in creating images of the future.

There is some important confirmatory research from the Wellcome Trust Centre for Neuroimaging, University College in London. A study led by Dr Eleanor Maguire has just been published in the Proceedings of the National Academy of Sciences. It involved five participants with dense amnesia caused by damage to the hippocampus on both sides of the brain.

The researchers asked the participants – and a control group without amnesia – to imagine several future scenarios, such as visiting a beach, a museum and a castle, and then to describe what the experience would be like. They then analyzed the subjects' comments sentence by sentence, scoring each statement based on whether it involved references to spatial relationships, emotions or specific objects.

All but one of the people with amnesia were worse at imagining future events than people with normal memory. Their visualizations of future events were more likely to be disorganized and lacking in emotion.

Here is a quotation from one of the subjects:"It's not very real. It's just not happening. My imagination isn't…well, I'm not imagining it, let's put it that way."

The hippocampus does not simply relive past experiences, it also supports our ability to imagine any kind of experience including possible future events.

This is yet more evidence against the idea that memory works like a kind of video camera, passively recording your life. It is a far more dynamic process that include your own beliefs, emotions and expectations.

“A rock-pile ceases to be a rock-pile the moment a single man contemplates it, bearing within him the image of a cathedral.”
--Antoine de Saint-Exupéry (French Aviator and Writer, 1900-1944)

“All acts performed in the world begin in the imagination.”
--Barbara Grizzuti Harrison (Italian-America Journalist, Essayist and Author, 1934-2002)

“I visualize things in my mind before I have to do them. It’s like having a mental workshop.”
--Jack Youngblood (American Football Player and Member of the Pro Football Hall of Fame, 1950-)

Leg Length and Cognitive Reserve

I recently mentioned the "Barker Hypothesis" which says that fetal malnutrition is associated with many physical problems later in life.

Well the difficulties may not only be physical.

I would like to tell you about an important concept that we call "Cognitive reserve." This can be thought of as our cognitive resilience. This first came to light almost twenty years ago when a post-mortem study of 137 elderly people was published in the Annals of Neurology, and confirmed something that we had suspected for years: there was a large discrepancy between the degree of Alzheimer’s disease neuropathology and the clinical manifestations of the disease. Some people had extensive pathology but they  clinically had no or very little manifestations of the disease. The investigators also showed that these people had higher brain weights and greater number of neurons compared with age-matched controls. This lead to the idea that they had a greater "reserve." This is why building your brain throughout life is thought to reduce the ce of cognitive impaitrment later on.

Studies have shown that childhood cognition, educational attainment and adult occupation all independently contribute to cognitive reserve, and more recently it has been confirmed that education and the complexity of a person's occupation may both slow the rate of decline in people who already have Alzheimer's disease.

Although height is in part genetically determined, shorter leg length has been found to be associated with an adverse environment in early childhood. In a recent study of older Afro-Caribbean people living in London, shorter leg length was significantly associated with cognitive impairment, leading to the suggestion that shorter leg length may be a marker of early life stressors that then result in reduced cognitive reserve.

It is also worth recalling our discussion about the association between growth hormone and intelligence in children and between intelligence and head size.

And nutrition is one of the determinants of growth hormone synthesis and release.

Naturally this does not mean that less tall people will all get Alzheimer's disease. But these observations have a number of practical consequences. They re-emphasize the importance of good nutrition during pregnancy: something that is simply not available to over a third of the world's population. They also help us to identify some of the people who would most benefit from strategies to increase their cognitive reserve and to avoid some of the things that can strip it away from them.

How We Plan the Future

One of our most remarkable abilities is our capacity for creating a mental picture of events that have not yet happened. It certainly appears that many animals can do something similar, but the human ability to wait and to plan seems to be almost unique. Though with all the recent advances in our understanding about the emotional and cognitive skills of many animal species, I am wary about making too many claims about human specialness.

There is some fascinating research in today’s issue of the Proceedings of the National Academies of Sciences.

Investigators from Washington University in St. Louis, have performed a set of experiments that will not only help us better understand what goes wrong in some diseases, but may ultimately help all of us to become better at visualizing.

They compared the functional MRI scans of 21 healthy volunteers when they were asked either to vividly imagine future events or to recollect past memories.

The images showed clear differences between imagining a birthday already experienced and a birthday yet to come.

In particular, when looking ahead, there were three particular areas of the brain that became activated - the left lateral premotor cortex, the left precuneus and the right posterior cerebellum. These areas of the brain are already known to be involved when we imagine executing body movements, suggesting that when the brain is thinking about the future, it does so in terms of distinct movements and actions that will happen at that point.

The research provides powerful support for the idea that memory and thought about the future are highly interrelated and may help explain why future thought may be impossible without memories.

Other research has shown that when volunteers are asked to think about playing baseball they activate the part of the brain involved in swinging the arm. You will now see the link with the item that I posted yesterday about learning to tango!

These findings are consistent with observations on people who have sustained damage to these regions of the brain: they lose the ability to think ahead. There is a small amout of data to suggest that some of these same regions do not function properly in some people diagnosed with antisocial personality disorder, most of whom have a reckless disregard for the consequences of their actions.

People with depressive disorders often find it very difficult to generate a positive image of the future, in part  because their memory is impaired by the depression.

In classes we have also found that if people maintain complete stillness while visualizing it is quite different from moving and doing the physical actions as you visualize.

Try it for yourself and see what I mean.

“Man can only become what he is able to consciously imagine or to “image forth.”
--Dane Rudhyar (a.k.a. Daniel Chenneviere, French-born American Composer, Theosophist and Astrologer, 1895-1985)

“I am thought. I can see what the eyes cannot see. I can hear what the ears cannot hear. I can feel what the heart does not feel.”
-- Peter Nivio Zarlenga

Learning to Tango

As a youngster I was introduced to most of the social graces: piano lessons – which sadly I hated – shooting, horse riding, fencing and ballroom dancing. And I just loved to tango!

Now I learn that it is, perhaps, something that more people should try.

Colleagues from the University of Turin used functional magnetic resonance imaging to study the hypothesis that simply focusing attention on walking could modify the activity of specific regions of the brain. But instead of using regular walking they taught people to tango. (The whole paper is available online as a free download.)

If you think about it for a moment, regular walking is an automatic process that you learned as a small child. It involves a series of structure in the deep – subcortical - regions of the brain and the spinal cord. The researchers got their experimental subjects to learn the dance by a combination of physical and mental practice. They were asked to perform the basic steps of the tango followed by imagining that – without moving - they were doing the steps.

The experiment showed that the training was associated with an expansion of regions of the brain involved in imagining movement. After the training the visual imagery gradually gave way to motor and kinesthetic ones.

This makes good sense: we normally begin by visualizing and then over time a motor skill like this becomes automatic. I’ve known good dancers who could flip from one dance to another without a moment’s thought.

This new finding suggests that rehabilitation of people who have lost the ability to walk should involve not just the motor act of walking, but also visualization.

But notice that the two processes – visualization and motor learning are separate. This is another nail in the coffin of the popular idea that your brain cannot tell the difference between a real and an imagined activity.

It also provides further evidence that both mental and physical activities can expand and activate regions of the brain.

And what a fun way to do it!


“The truest expression of a people is in its dance and in its music. Bodies never lie.”
--Agnes de Mille (American Choreographer, 1905-1993)

Healing the Broken Brain

I recently reviewed a fascinating book on adult neurogenesis: the creation of new neurons; something that was thought to be impossible until very recently. It is still thought to occur in certain specific regions of the brain, but even that may be changing.
   
The field is moving forward very rapidly and is important to every one of us, which is the reason for writing so much about the topic.

There is an exceptionally interesting article in the current issue of the journal Neuron. Researchers from Lund in Sweden have shown that cells generated from stem cells in an adult, diseased and damaged brain function as normal nerve cells. Not only do the new cells function like proper neurons, they also try to make connections with other neurons, indicating that they are trying to repair, or compensate for diseased or damaged parts of the brain.

This work was done in rats and is in its infancy, but it part of a global effort to learn more about how new neurons are formed, how they function and whether it is possible to help the brain heal itself after a disease or injury.

I am going to go out on a limb and say that it is possible. In Healing, Meaning and Purpose I described an individual with a severe neurological problem that responded to a novel treatment method using the subtle systems of the body. One of the goals of Integrated Medicine is to establish how best to use such methods in combination with conventional medicine not just to treat someone, but to initiate healing.

“A therapist doesn’t heal, he lets healing be.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

Dreaming and Memory

As I am writing this, one of the cats is fast asleep on my desk and clearly involved in a dream that involves running and jumping. It looks as if she's having fun.

I’ve been fascinated by dreams and dreaming ever since I read Sigmund Freud’s The Interpretation of Dreams as a teenager. For over a century, people have speculated about a link between dreams and memory, and another book that influenced me as a youngster was called Dreaming and Memory by Stanley R. Palumbo. These books were firmly rooted in a psychoanalytic framework, and I’ve always been interested in trying to reconcile psychoanalytic and neurological views of our mental life.

So I was intrigued to see an article that just came out in Nature Neuroscience.

Almost six years ago, Matthew A. Wilson at the Massachusetts Institute of Technology (MIT), in Cambridge, Massachusetts demonstrated something very interesting. Rats formed complex memories for sequences of events that they had experienced while they were awake. These memories were replayed while they slept, perhaps reflecting the animal equivalent of dreaming.

These replayed memories were detected in the hippocampus, a region of the brain that is associated with memory. But the researchers were not able to determine whether they were accompanied by the type of sensory experience that we associate with dreams-in particular, the presence of visual imagery.

In the latest research Wilson who is professor of brain and cognitive sciences at MIT's Picower Institute for Learning and Memory, and postdoctoral associate Daoyun Ji looked at what happens in rats' brains when they dream about the mazes they ran while they were awake. They recorded brain activity simultaneously in the hippocampus and the visual cortex, and  demonstrated that replayed memories did, in fact, contain the visual images that were present during the running experience. Neurons that are activated when the animal experiences an event while awake are reactivated during sleep.

There is another piece to this research: the regions of the cerebral cortex that processes input from the senses and the hippocampus communicate with each other during sleep, leading us to speculate that this process reinforces and consolidates memories.

As the authors write, "These results imply simultaneous reactivation of coherent memory traces in the cortex and hippocampus during sleep that may contribute to or reflect the result of the memory consolidation process."

This is of great practical importance: it strongly supports the idea that adequate sleep is necessary to consolidate memory.

When I was a child my parents taught me to read through all my schoolwork just before I went to bed, even if I was tired. Work in psychology has shown that this is often the best way of memorizing factual material, and this new research shows us why.

“Waking is long and a dream short; other than this there is no difference. Just as waking happenings seem real while awake, so do those in a dream while dreaming. In dream the mind takes on another body. In both waking and dream states thoughts, names and forms occur simultaneously.”
--Ramana Maharshi (Indian Hindu Mystic and Spiritual Teacher, 1879-1950)

“The light of consciousness passes through the film of memory and throws pictures on your brain. Because of the deficient and disordered state of your brain, what you perceive is distorted and colored by feelings of like and dislike. Make your thinking orderly and free from emotional overtones, and you will see people and things as they are, with clarity and charity.”
-- Sri Nisargadatta Maharaj (Indian Spiritual Teacher and Exponent of Jnana Yoga and Advaita Doctrine, 1897-1981)

Psilocybin and Mystical Experience

The Psilocybin Molecule

We have discussed mystical experiences a couple of times recently. They are important not only because of what they may teach us about altered states of consciousness, but because they may contain genuine revelations about the nature of reality and they are invariably profoundly meaningful to the person having them.

Earlier this year there was a paper that seemed to come in under some people’s radar, though several heavyweights in the world of psychopharmacology spoke approvingly of the research.

The paper was entitled, “Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.” There are also some superb commentaries on the original paper, all of which are available for free download if you click on the links above.

So what got everyone so excited?

Psilocybin is a psychedelic alkaloid that has been used for religious purposes for centuries. The researchers conducted a double-blind study on the acute and longer-term psychological effects of a high dose of psilocybin. What was particularly important was that the 36 experimental subjects had no previous experience of hallucinogens but who were regularly participating in religious or spiritual activities.

It is also important that the experiments were performed in comfortable, supportive surroundings. The last thing that anyone wanted was for people to have a “Bad trip” and to be left without care and support.

They were given psilocybin and methylphenidate (Ritalin) in separate sessions, the methylphenidate sessions serving as a control and active placebo; the tests were double-blind, with neither the subject nor the administrator knowing which drug was being administered. The degree of mystical experience was measured using a questionnaire on mystical experience developed by Ralph W Hood.

61% of subjects reported a "complete mystical experience" after their psilocybin session, while only 13% reported such an outcome after their experience with methylphenidate. Two months after taking psilocybin, 79% of the participants reported moderately to greatly increased life satisfaction and sense of well-being.

About 36% of participants also had a strong to extreme “experience of fear” or dysphoria (eg, a “bad trip”) at some point during the psilocybin session (which was not reported by any subject during the methylphenidate session), with about one-third of these (13% of the total) reporting that this dysphoria dominated the entire session. These negative effects were reported to be easily managed by the researchers and did not have a lasting negative effect on the subject’s sense of well-being.

The observation that psilocybin reliably elicits a transcendent, mystical state tells us that investigations of these drugs may help us understand molecular alterations in the brain that underlie mystical religious experiences.

But the key point to be made is that finding a biochemical basis for mystical experiences does nothing to belittle them. The biochemical and neurological approaches have nothing to say about the personal meaning and the cultural and social components of the experience. To use Ken Wilber's terminology, this research is only addressing the Upper Right Hand Quadrant.

Important work to be sure, but it would be a mistake to try to reduce mystical experiences to 5HT2A,C receptors alone.

“For what is Mysticism? It is not the attempt to draw near to God, not by rites or ceremonies, but by inward disposition? Is it not merely a hard word for 'The Kingdom of Heaven is within’? Heaven is neither a place nor a time.”
Florence Nightingale (English Pioneer of Nursing Known as the “Lady with the Lamp,” 1820-1910)

“The mystical life is the centre of all that I do and all that I think and all that I write. ...I have always considered myself a voice of what I believe to be a greater renaissance - the revolt of the soul against the intellect.”
-- William Butler Yeats (Irish Poet, Dramatist, Writer and, in 1923, Winner of the Nobel Prize in Literature, 1865-1939)

Head Size and Intelligence

In August we discussed some of the new data showing an association between the hormone insulin-like growth factor 1 (IGF-1) and a child’s IQ.

Now new research from the University of Southampton in England has found an association between skull size and intelligence. It seems that the brain volume a child achieves by the age of 1 year helps to determine his or her later intelligence.

The study of 633 newborns born at term has found that those with larger heads scored better on intelligence tests at the age of 4. And those children whose heads were larger than the average at age 8 also had higher IQs. Children who put on a spurt of skull growth after the age of 8 did not show a catch up in their IQ scores, implying that there is a critical period for skull growth, brain and cognitive development.

The researchers also studied the babies’ parents. The babies’ mothers completed surveys about their parenting style, their older children, and other factors such as breastfeeding and postpartum depression.

The babies tended to have higher IQ scores if they had been breastfed for three or more months, if their parents had more education and if they had mothers with high scores on the questionnaire that looked at parenting style.

Even after adjusting for all those factors, babies’ head growth by age 1 remained tied to IQ scores among the 4- and 8-year-olds.

It is also known that older people with a larger head circumference tend to perform better in tests of cognitive function and may have reduced risks of developing Alzheimer’s disease. The protective seeds are sown in the first eight years of life. But there is still much that can be done later in life to protect against the development of Alzheimer’s disease.

Two years ago the same researchers showed that there are critical periods in brain growth and cognitive function in children. Brain growth during infancy and early childhood is more important than growth during fetal life in determining cognitive function. And as we have discussed before in my writings about epigenetics, the food that a child eats, the chemicals that he or she ingests and the attitude of his or her parents and peers can all change the way in which their genes function. Positive influences during the first few formative years can have a massive impact on cognitive function throughout life. But even if a child is exposed to an adverse environment, there are still good chances for repairing the damage throughout life.

Biology is not destiny!

“Intellect annuls fate. So far as a man thinks, he is free.” --Ralph Waldo Emerson (American Poet and Essayist, 1803-1882_

The Seat of the Emotions and the Gateway to Reason

“If passion drives, let reason hold the reins.”
--Benjamin Franklin (American Author, Inventor and Diplomat, 1706-1790)

For many centuries reason and emotion have usually been held to be two poles of a magnet, the North and South of the psyche. Every now and then someone has proposed some other psychological lodestone, but most have finally devolved into this simple binary model.

Yet a moment’s introspection shows us that reason and emotion are inextricably linked. We know from people with alexithymia and a dizzying array of “personality disorders,” that a real-life Mr. Spock would be a hobbled creature. Yet we also know that simple binary models of pleasure and pain as the drivers or behavior are over simplified. It appears that one of the great attainments of many mammalian species - and who knows how many others - is an ability to be moved by more complex considerations of loyalty, propriety and even morality.

There is an important study in this month’s issue of the Journal of Neuroscience. The amygdala is a central processing station in the brain for emotions and is involved in laying down emotional memories. A shock or extreme pleasure may both leave their traces in the amygdala, so it plays a key role in survival.

But this new research shows that the amygdala also plays a role in working memory, a higher cognitive function that is critical for reasoning and problem solving. If you ask someone for a telephone number and you instantly dial the number and then forget it, that is working memory in action. If you choose to remember the number for later, it moves out of working memory into longer term memory stores. In some senses working “memory” is a little bit of a misnomer: it is a function that enables us to manipulate information extremely rapidly.

In two different functional magnetic resonance imaging (fMRI) studies with a total of 74 participants, individual differences in amygdala activity predicted behavioral performance on a working memory task. The experimental subjects were asked to look either at words, such as rooster, elbow, and steel, or faces of attractive men and women. Then they were asked to indicate whether or not the current word or image matched the one they saw three frames earlier. Try it for yourself, and you will see that this is quite challenging. The subjects’ brains were scanned while completing the tasks.

People with stronger amygdala responses during the working memory task also had faster response times.

This is exceptionally important for anyone interested in thinking and learning: it shows that a region of the brain thought to be involved primarily, or perhaps even exclusively, in processing emotions is also involved in higher cognition, even when there is no emotional content.

I think it most likely that the amygdala may be involved in vigilance, perhaps preparing people to better cope with challenging situations and also improving their ability to sort information according to its relevance to the current situation. This is something that people with poor resilience find hard to do, so it may be that the amygdala is involved in developing and maintaining resilience.

This study helps to prove the total inter-relatedness of emotion and cognition and supports learning strategies that are based upon integrating emotion with facts. One of the ways in which health care students are able to remember enormous numbers of facts is by attaching them to patients with whom they have worked. Emotion, interest and empathy can dramatically accelerate learning.

Multiple Sclerosis and Stem Cells

If you have been reading my recent posts about multiple sclerosis (MS), you may be interested in an useful resource from the New York Academy of Sciences.

I have the privilege of being a member of the Academy and I've been impressed by its increasing efforts to educate the general public. There are regular "eBriefings" that are well written and succinct.

This one on stem cells and MS is timely and encouraging. It is also a good jumping off point if you want to follow up on some of the issues.

The existence of stem cells in the central nervous system has already raised some intriguing possibilities for treatments based on activating and directing them in the brain. The second idea, of dismantling the diseases immune system and replacing it with a new clean one, is not science fiction but part of a concerted effort to reprogram the body.

This is precisley the kind of approach that we advocate when we use "Information Medicine," designed to correct faulty information that produces faulty DNA and ultimately faulty proteins and organs.

Direct Brain-to-Brain Communication

The idea that there can be direct communication between people at a distance sounds like the stuff of science fiction.

I will be quite honest: I was always intrigued by the idea of direct contact between brains and I’d had more than my fair share of personal experiences of them. When I was a young student, long before I had started being trained, I suddenly blurted out some very specific information about a classmate that almost lead to a fight: he was enraged, not because of what I said, but because he thought that another friend had betrayed a confidence.

I spent a lot of time poring over experiments done by J.B. Rhine and others, and it all seemed to make sense. But I always had a problem: because I could not understand the mechanism of mind-to-mind communication I remained a bit skeptical. But now the evidence is gradually building up. A few months ago I wrote about some of the intriguing evidence concerning nonlocal interactions of neurons.

If all this is correct and mind-to-mind or brain-to-brain communication is really possible, it instantly changes everything about how we see ourselves and reality. So it is utterly essential to ensure that such extraordinary claims are indeed supported by extraordinary data, and that neither is undermined by shoddy explanatory models.

That is why, as ideas and observations have come forward, I’ve always been at great pains to see whether or not they have been accurate. One of the reasons for going on about the misuse of quantum mechanics has been that the entire topic of parapsychology and of direct brain-to-brain communication is so incredibly important to our worldview.

Unless we have a clear view of who and what we are; what it means to be human; what it means to be an inhabitant of this planet and this Universe and of our place in the grand scheme of things, it is very difficult to devise sensible strategies for healing ourselves and our planet.

I think that I’ve said enough about the misuse of science, but it is just as bad when people misuse the Ageless Wisdom. I’ve just read an article in which the writer talks about the Law of Correspondences, an old Hermetic term that was adopted by the Rosicrucians and Theosophists. The writer said that this Law explains why atoms are just like little solar systems, except that they have electrons whizzing round a nucleus, rather than planets orbiting the sun. This is the kind of silly comment that could only have been made by someone who never got beyond 8th grade physics. For anyone who is interested I can give you chapter and verse as to why the Law of Correspondences does not apply in this situation.

Does this blooper matter? Well yes, because it encourages people to construct an inaccurate view of reality that is based on a very limited visual metaphor, when what is needed is the imagination to stride into a new vision of reality.

So with that, back to brain-to-brain communication. There is a nice article on the topic by Robert Charman in the month’s issue of the Paranormal Review. Sad to say the article is not available online, but the Review itself is available through the Society for Psychical Research in London.

Robert has identified eleven articles that have found evidence of direct brain-to-brain communication using functional MRI and evoked potentials: someone send a signal, there is a blip in the brain of the sender and then a corresponding blip in the brain of the receiver. (Here are some references that I’ve checked out: 1. 2. 3. 4. 5.).

His conclusion is that these high-tech studies have confirmed the possibility of brain-to-brain communication at a distance. I think that he is probably correct, though I know from personal exerience just how hard it can be to analyze data from MRI and EEG measurements of the brain.

Something that I find particularly interesting is that using this technology there seems to be a slight delay in the “communication,” though one study showed that the "receiver" might have an electrical potential in his or her brain before the “sender” had sent the communication. These observations may simply reflect the equipment being used, this observations implies that the mechanism is physical.

However some experiential evidence indicates that there is another type of direct persons to person communications that is instantaneous. For this there is no good scientific evidence, just a lot of experience. The difference between the two forms of communication – delayed and instantaneous – is similar to the difference between instinct (physical, brain and body based) and intuition (nonlocal and transpersonal).

This research and these papers are doing us an enormous service. To quote Robert Charman:
“…The data demonstrating episodes of direct communication between brains exists and will not go away.”

And we know from experience that many if not most people can be trained to improve their ability to communicate at distance both in a time-limited and time-independent modes. The keys? Relaxation, meditation, practice and above all, belief in the possibility that you can do it.

You may remember when Luke Skywalker said to Yoda “I don’t believe it,” to which Yoda responded: “That, is why you fail.”

Chloroquine, Insulin and Inflammation

Your humble reporter was fascinated to read about some new research using the anti-malarial agent chloroquine as a potential treatment for the insulin resistance syndrome.

I have a personal reason for being interested. Hypoglycemia (low blood glucose) is an occasional feature of treatment with chloroquine and in 1980 a study first indicated that chloroquine might slow the break down of insulin by the liver. In the early 1980s there were a flurry of papers indicating that chloroquine did some subtle things to insulin and insulin receptors in many tissues. So we came up with the idea of measuring its effects in humans. There was a memorable occasion on which I was doing an outpatient clinic with an intravenous line in my arm. (English doctors are well known for doing experiments on themselves: I had a professor in medical school who said that you should never do to a patient what you haven’t had done to yourself. I shall leave it to you, gentle reader, to wonder if I've tried everything....).

So there I am doing my clinic when, around 11AM I begin to feel really strange: my glucose level was almost unrecordable and my insulin level was off the chart. Nothing that couldn’t be solved with a large dollop of sugar, but it made me very sympathetic to people who get hypoglycemic from their regular treatments.

Sometimes Nature does our experiments for us: we did a lot of work on diabetes because it is associated with high rates of vascular disease. So understanding the mechanisms by which diabetes does that may help illuminate some of the cellular disturbances underlying arteriosclerosis in general. We are also interested in the few illnesses in which a single disturbed gene may lead to a definable set of signs and symptoms. There is a rare illness known as ataxia telangiectasia in which sufferers have a high risk of developing some cancers particularly lymphomas and leukemia. People with the illness are very sensitive to ionizing radiation, have a specific type of immune deficiency, degeneration of parts of the brain related to muscle function and coordination and they age prematurely. More than ten years ago it was discovered that a single gene - ataxia-telangiectasia mutated (ATM) gene – was responsible for the illness. The gene is responsible for producing a protein that recognizes damage to DNA. It now seems that ATM may also be linked to metabolic and cardiovascular diseases. It does this by inhibiting a protein called JNK, a stress kinase involved in inflammation with related effects in insulin resistance and atherosclerosis. So to everyone’s surprise a gene that can cause a rare disease can also cause insulin resistance.

In the November issue of Cell Metabolism, researchers at Washington University School of Medicine in St. Louis and St. Jude Children's Research Hospital in Memphis, Tennessee report that a small dose of chloroquine eased many symptoms of metabolic syndrome in mice, reducing blood pressure, decreasing hardening and narrowing of the arteries and improving blood sugar tolerance. The results suggest we may only need very low and perhaps infrequent doses of chloroquine to achieve similar effects in humans. Both insulin and chloroquine activate the ATM gene.

This adds to the data that some of the metabolic dysfunctions triggered by obesity may be linked to the inflammatory responses that go wrong in autoimmune disorders like arthritis and systemic lupus erythematosus.

And an older treatment for rheumatoid and lupus just happens to be chloroquine.

Chloroquine itself has some side effects, but this is important information that will help us design more effective and carefully targeted holistic treatments for both metabolic disturbances and inflammatory conditions. All in all, very good news indeed.

Multiple Sclerosis

Multiple sclerosis (MS) can be a horrible illness that does not respect age or class. Neil Cavuto, Captain Beefheart and Montel Williams are just three well-known people who have said that they have the illness. Here is a list of many other sufferers.

MS is a chronic, inflammatory disease that affects the central nervous system (CNS). MS can cause a wide variety of symptoms, including changes in sensation, visual problems, muscle weakness, depression, difficulties with coordination and speech, severe fatigue, and pain. The classic pathology is what is known as demyelination (loss of the myelin that insulates nerve cells). Since myelin is white, the lesions are typically fuond in the white matter of the CNS.

The cause remains unknown, though I shall have more to say about some of the MS theories. Amongst the candidates have been autoimmunity, slow viruses, myelinic enzymes and polio vaccination.

Most people begin to experience symptoms between 20 and 40 years old, and rarely after 50. The onset is usually insidious, though every now and then someone starts with sudden onset of a catastrophic neurological or visual problem. Symptoms are usually vague and the diagnosis is often missed in the early stages. Females are affected slightly more than males. MS seems to be a disease of temperate latitudes in both the Northern or Southern hemispheres and is rarely seen in equatorial regions. This association with latitude has fueled some of the viral theories as well as ideas to do with the impact of decreasing sunlight on vitamin D and cell membrane function.

One of the things that makes the disease such a great masquerader is that it is typically marked by apparently random exacerbations and remissions. As the disease progresses, the remissions become less complete and permanent deficit more apparent.

There is an enormous research literature on MS: over 35,000 papers at last count. But there have been some recent highlights.

There has recently been a major breakthrough in discovering the mechanism by which myelin forms. The finding from the Keck School of Medicine of the University of Southern California and the Institut de Recherches Cliniques de Montreal in Canada, could have a major impact on the treatment of multiple sclerosis and demyelination as a result of spinal cord injuries.

Jonah Chan and his colleagues showed that a protein, Par-3, is at the base of the myelination process. This protein becomes localized to one side of the myelin-forming cells that are known as Schwann cells, upon contact with the axon that is to be myelinated. Par-3 acts like a kind of molecular scaffold to set-up an "organizing centre" that brings together the key proteins essential for myelination, in particular a receptor for a molecule that is secreted by the neurons.

The researchers found that when they disrupted this organizing centre, cells could not form myelin normally. Importantly, their discovery demonstrates that Schwann cells need to become polarized so that they know which side is in contact with the axon to initiate wrapping and to bring essential molecules to this critical interface.

These studies open up some new possibilities that should help to identify other components that are recruited at the organizing center set-up by Par-3. In multiple sclerosis, or after injury, Schwann cells can re-myelinate axons of the central nervous system to some degree. Therefore, these experiments bring about the possibility that manipulating the Par-3 pathway might allow for more efficient re-myelination of damaged or diseased nerves.

In a separate study researchers from the Virginia Commonwealth University researchers have identified a unique mechanism of action of a new drug that shows great promise for the treatment of MS.

The researchers reported the unique action of FTY720, or Fingolimod, an immunosuppressant drug that was already known to affect the functioning of the immune system by preventing the egress of white blood cells from the lymph nodes into the blood. The article was published in Blood: The Journal of the American Society of Hematology, that appeared online on Sept. 28.

In this study, the research team found that FTY720 also inhibited the activity of a key enzyme called cPLA2, which is necessary for the production of inflammatory mediators, known as eicosanoids. Eicosanoids drive inflammatory disorders such as asthma and multiple sclerosis.

The inhibition of cPLA2 would shut down the entire inflammatory pathway, possibly without the side-effects caused by medications such as Vioxx, that have been withdrawn from the pharmaceutical market.

FTY720, is a drug developed by Novartis, has shown considerable therapeutic effects in a recent small, placebo-controlled clinical trial involving patients with relapsing multiple sclerosis. The study was published in the September 2006 issue of the New England Journal of Medicine by an international research team.

I could easily select a dozen more important papers published in the last year, but I am particularly interested in basic research that teaches us something new, and treatments that could fit into a comprehensive Integrated plan of treatment.

I am going to post more about the causes of this illness as well as less orthodox approaches to help the physical, psychological, social, subtle and spiritual aaspects of these illnesses.

Posttraumatic Stress Disorder and Brain Laterality

I’ve just received an intriguing article from an individual who’s really been through the mill with an array of psychiatric problems going back to childhood.

The last diagnosis that he attracted was posttraumatic stress disorder (PTSD), and he seems to have cured himself by a combination of omega-3 fatty acids and learning to play the banjo left-handed.

This may sound like a bit of an odd claim, but although the writer did not realize it, there is actually some solid science behind his observation.

For years now we have known that if someone is paralyzed down one side after a stroke, binding the good arm or leg leads to rapid reorganization in the cerebral cortex, as a result of which the paralyzed arm or leg may begin to regain function.

One of the most potent ways to improve the functioning of regions of the brain is to try doing things with the opposite hand: if your are right-handed, brushing your teeth or writing with your left hand or using your knife and fork the other way round can all be very illuminating, and can help train your brain. A common tactic in couple’s therapy is to get people to change some habits, like switching the sides of the bed on which a couple sleeps.

The hippocampus of the brain is involved in many functions, but key amongst them is the laying down of short-term memories. People with several stress-related psychiatric disorders, including PTSD, borderline personality disorder with early abuse, depression with early abuse, alcoholism and dissociative identity disorder all have smaller hippocampi, presumably because this part of the brain is exquisitely sensitive to cortisol: high levels can damage and destroy hippocampal cells. Antidepressant medications and some types of cognitive training are thought to lead to the growth of new cells in the hippocampus. It is also possible that having a small hippocampus may predispose someone to the development of PTSD. There is also some evidence that mixed lateral preferences and parental left-handedness may all predispose someone to the development of PTSD.

In PTSD, the left hippocampus and two other brain regions: the left anterior cingulate cortex and both sides of the insula are all smaller than normal. Regions of this small left hippocampus associated with episodic and autobiographical memory is activated by stimuli that wouldn’t have much effect in people without the problem. Some researchers have also found that if the right hippocampus is smaller and more active, it correlates with the severity of PTSD symptoms.

Adults with PTSD have a higher incidence of mixed laterality with respect to handedness than the rest of the population. This has recently also been found in children: there is a positive correlation between PTSD symptom severity and mixed laterality. This strongly suggests that neurological abnormalities may be related to the severity of symptoms in PTSD.

In PTSD, the right amygdala, a region involved in fear and rapid emotional learning and processing, is smaller than the left. In healthy volunteers it’s the same on both sides.

When people with PTSD recall the traumatic event, especially if it involved assault, they over-activate the right hemisphere of the brain. It is not just cerebral blood flow: recent experimental work has shown that PTSD may be associated with a functional asymmetry of the brain, which favors the right hemisphere.

There are actually a number of therapeutic techniques that involve trying to switch the way in which the hemispheres interact. EMDR (which the writer had tried) is one. It is also amongst the techniques developed by Paul Dennison to aid learning.

I also wonder whether the writer has accidentally happened upon a method for treating psychological reversal.

I do wish the writer well, and I also hope that some of my colleagues in research might be interested in exploring some of these training techniques in PTSD.

Mystical Experience

I recently wrote a little bit about mystical experiences and mentioned the most widely used “definition,” the Stace Criteria:

1. Deeply positive mood
2. Experience of Union
3. Ineffable sense
4. Enhanced sense of meaning, authenticity and reality
5. Altered space and time perception/transcendence
6. Acceptance of normally contradictory propositions

There are many ways of inducing the mystical state: -

• Meditation
• Prayer
• Control of breathing: e.g. Pranayama
• Chanting: e.g. Zoroastrian priests
• Dance and movement: for example the whirling Dervishes or Morihei Ueshiba who reportedly achieved a state of mystical union after performing kata
• Light, as happened with the mystic Jacob Boehme
• Biofeedback
• Mantra
• Drugs

Although many people deliberately seek mystical experiences, some come out of a clear blue sky: the French writer, philosopher and Marxist materialist, Simone Weil, reported how reciting a devotional-metaphysical poem by the English religious poet George Herbert (1593-1633) while highly concentrated and emotional, turned her from an agnostic into a mystic. She was not looking for it to happen: it was unsought as it was unexpected. What was interesting was that after that first time, particularly in the last year of her life, she had mystical insights several times a week. Despite – or perhaps because – she was suffering from tuberculosis and was first in a hospital and then in a sanatorium during most of that time.

Some children have had a mystical glimpse before the age of ten, more during adolescence and still more during their thirties or forties. Richard Maurice Bucke in his classic book, Cosmic Consciousness, thought that the peak time was in the early thirties, but it can still happen in people in their seventies.

Many people need a dramatic shock - some form of enforced awakening - that subjugates the ego. Only then do they come alive spiritually. This enforced awakening is effective only if it breaks down old habits, trends, and beliefs. It may come about through working with or reading a teacher like Krishnamurti or Gurdjieff, or through major life events like a life threatening illness or unexpected bereavement. There is also little doubt that people become more interested in spiritual matters and more receptive to them at key points in their lives. Sometimes the experiences may occur as part of the process of individuation described by Carl Jung.

Some years ago I wrote a speculative piece suggesting that some mystical experiences may be triggered by a neurological mechanism involving the reticular activating system of the brain. The popular idea that mysticism is somehow related to the right hemisphere of the brain is probably not accurate. With the passage of time, it begins to look as if those speculations were accurate. Though one of the points that I made at the time, is that although we might be able to find a neurological substrate for mystical experiences that provide the form of the experience, that still left us with the problem of the content of the experience and therefore of its meaning for the individual.

At the beginning, the content of the mystical experience is culture bound and tends to be a product of a person’s belief system, which is why some mystics contradict each other. The Indian spiritual teacher Swami Ramdas (1884-1963) said that joy was both evidence of spiritual fulfillment and an ingredient of spiritual practice, while Simone Weil took an exactly opposite view and substituted unhappiness and suffering for joy: each proposed that a personal experience reflected a broadly universal truth. This is has been a common error for many spiritual teachers and their followers.

Saint Teresa of Ávila, a.k.a. St. Teresa de Jesus, the Spanish nun, mystic and author (1515-1582) was brought up in the Roman Catholic Church, and her mystical revelations fit into classical Catholic dogma. In contrast a modern Christian mystic - Holden Edward Sampson – who was brought up in the Protestant Evangelical Church, thought that his personal experiences proved that Saint Teresa’s writings were false.

These differences of opinion, even amongst the most advanced mystics, are striking but not often discussed. As an example, it amused me to see Ramana Maharshi make gentle fun of Sri Aurobindo's doctrine of spiritual planes. I love and rever the workds of both of these sages. Simone Weil staunchly promoted the spirituality of Greek culture while the French-born writer René Guénon a.k.a. Sheikh 'Abd al-Wahid Yahya thought that there was nothing much to it. As people progress, there is usually more of a confluence: mystics tend to report similar experiences, but they are often still colored by their past lives.

Many people have mystical and spiritual experiences without knowing what is happening to them: they have never studied or been taught anything about them. I have seen quite a number of people who were supposed to be suffering from a psychotic episode, but who were actually having a profound spiritual experience. I have seen many thousands of psychotic people in almost fifty countries, and it is normally not that difficult to differentiate a breakdown from a breakthrough. Though even the most experienced of people sometimes find it difficult to be 100% certain what is going on.

It is essential for health care providers and for anyone who comes into contact with an individual who is having strange experiences, not simple to label them as mentally ill, but to remain alert to the possibility that there may be something yet more profound and meaningful going on in their lives.

Though for some people medicines, psychotherapy and the rest may be very helpful, others need spiritual support and guidance as they grow through a process of spiritual growth.

Brain Growth

Something strange happened to our ancestors. Between about 100,000 to 35,000 years ago, their brains began to grow enormously. 

There have been many theories as to why this happened, from climatic change to a change in diet. Some foods contain chemicals that can stimulate the growth of neurons. And yes, there are also those who claim that some external agency caused the sudden growth of the brain, a la Arthur C. Clarke’s 2001: A Space Odyssey.

But what is exciting is that the growth in the brain may still be going on today.

It is clear that the brain is constantly changing. This growth, change, development and regression does not only occur during development, learning or aging, but also over generations. It is often said that the modern human brain is identical to that of Stone Age man, but that is almost certainly not true. If you were to meet a person from 5,000 years ago, they would probably seem quite unintelligent, because all the things that you have learned have stimulated your cognitive abilities. This stimulation also stimulates the formation of the brain. Recent studies of the genetics underlying brain development have shown that the human brain has changed significantly over the last few thousand years.

A study in the journal Science has taught us something new. The investigators studied the gene Microencephalin (MCPH). When the gene is active it causes a severe reduction in brain size coupled with mental retardation. Remarkably, despite this abnormality, there is an overall retention of normal brain structure and a lack of overt abnormalities outside of nervous system. The function of MCPH in healthy humans is less well known.

What makes this study interesting is the finding that the MCPH has changed during the past ~37.000 years, and that the spread has been fast: there has been a strong positive selection for this gene, indicating that the brain has continued to evolve even in more recent times. This is exceedingly important. I have many times emphasized that human beings are changing extremely rapidly.

There is no reason to assume that the evolution of the brain has stopped, and there is every reason for thinking that this gene is one of the mechanisms of change in response to the environment. It is now key to understand all the modulators of MCPH activity. Is it food, stress or environmental stimuli?

Another recent study in the journal Nature analyzed human chromosome 8, and looked specifically at two regions called the major defensin (DEF) gene cluster and MCPH1. The authors also speculated that these regions have played a significant role in the expanded brain size that can be observed through hominid evolution.

At the end of the article, the authors say something very interesting:

"The majority of the genes in the region of high divergence in distal 8p play important roles in development or signaling in the nervous system. Notably, the extremely large CSMD1 gene, which lies at the peak of divergence and diversity, is widely expressed in brain tissues. High regional mutation rates and positive selection are generally assumed to be distinct, but it is possible that the former may facilitate the latter by increasing the rate of appearance of potentially advantageous single, or interacting, alleles. It is intriguing to speculate whether the accelerated divergence rate of this region has contributed to the rapid expansion and evolution of the primate brain."

For people who are less familiar with this kind of science-speak, let me translate. The study of chromosome 8 should open a whole new field of enquiry about what makes the human brain special. Comparing this region with DNA from other species and from early humans, we will be able to study the relative contribution of these genes to brain size.

Though size isn’t everything (!). The key is to understand the impact of changes in brain size and brain complexity on cognitive processes. In general, there’s a good correlation between intelligence and the volume and complexity of specific regions of the brain.

These new genes and their rapid – and continuing - spread is fascinating. But there are some other things that also differentiate the “naked ape” from other primates. One of the most striking is the large amount of fat that we have in out subcutaneous tissues and in our brains. We also have more of the excitatory amino acid glutamate in our cerebral cortices than chimpanzees or gorillas.

There is much more to be learned, but the consequences for understanding our origins and potential treatments for neurological illnesses are just stunning.

More on Brain Laterality and Attention Deficit Disorder

I recently wrote about the connections between attention deficit disorder and disturbances of the normal lateralization of the brain.

I had a very interesting question from a correspondent:
"Is there any CHANGE in handedness related to the use of stimulant medication?

I have been taking dexadrine (RP: That’s methamphetamine) at 60 mg/day for several months now to address ADD after diagnosis as an adult. I have found that I now use my left hand for some tasks that I would have solely used my right hand previously. For example, I am painting trim with a brush at home currently and have found myself, without forethought, switching hands and cutting in against the walls and other paint colours with my left hand at a skill level that matches my right hand. Is it possible that this is the result of increased "cross-talk" between the hemispheres? My father was not classically ambidextrous but he did play hockey and golf as a "lefty" while writing using his right hand.”

This is a fascinating question. There is evidence of shifts of functional lateralization in a number of situations, including severe changes in mood.

There is also some experimental data to support what the writer’s observations, though most of it comes from research in children.

1. A study from the Netherlands showed that in children treated with methylphenidate, their manual dexterity and handwriting improved and became more accurate.
2. Research from Germany using high density magnetoencephalography (MEG), showed that treatment improved activity in the frontal lobes of the brain.
3. Investigators in New Mexico found that unmedicated children with ADHD had slower reaction time in their legs, which got better, particularly in the right leg, when they were given treatment.
4. Another study, this time from Israel, also showed that children with ADHD had a lateralized attentional deficit that got better when they were treated.
5. Children off treatment seem to have lower activity in the right hemisphere of the brain, which normalizes with treatment.
6. Stimulant medications do not themselves seem to have an impact on inter-hemispheric transfer. But what it may do is to improve the imbalance between the hemispheres.

So I would suspect that the writer’s brain is becoming generally more efficient.

And his letter has also suggested a small research project.

I sense a grant proposal in our near future.

Tourette’s Syndrome

No surprise here, but I was just sitting on a plane.

Again.

When I heard people sniggering.

Why? A young man in his thirties was walking along trying to find his seat. As he did so he was constantly grunting, saying partially intelligible words and jerking. As a clinician it was immediately obvious that he almost certainly had Tourette’s syndrome, a developmental disorder of the brain in which people have involuntary, stereotyped, repetitive motor and phonic tics. Some people with the disorder exclaim obscene words or socially inappropriate and derogatory remarks, which together are known as coprolalia.

The illness was originally named for Georges Albert Édouard Brutus Gilles de la Tourette, (1859–1904), a French physician and neurologist, who published an account of nine patients with the now classic clinical features in 1885.

You may not often see someone with this problem, but it is good to know what it is, and that it is an illness that can cause great distress.

We have recently made some interesting discoveries about Tourette’s syndrome.

1. It is an illness involving the dopamine systems in the basal ganglia of the brain together with some regions of the midbrain and some very specific linked regions of the cerebral cortex, cerebellum and limbic system.
2. In adults with Tourette’s syndrome, the prefrontal cortex is a little smaller than normal, and the corpus callosum linking the hemispheres is larger than expected. These findings correlate with problems in the way in which people transfer information between the hemispheres and modulate attention.
3. Very recent evidence has shown us that there are small hyper-intense lesions in the deep regions of the brain in people with Tourette’s, obsessive-compulsive disorder and attention deficit disorder. These three problems seem to have a number of biological links and two or more may co-exist in the same person. In children and adolescents with Tourette’s, the tics tend to get better over time but obsessive-compulsive disorder symptoms become more severe and persistent as they get older.
4. There is important evidence that in some people, Tourette’s is linked to a post-infectious autoimmune disorder, and many have antibodies directed against neurons in the brain.
5. There is also a link between Tourette’s and having low iron stores. Low iron stores are common in people with many chronic inflammatory illnesses. Iron is crucially important in the development of key regions of the brain. We do not have any viable evidence that giving people iron supplements will reduce the severity of Tourette’s, but it is something that needs to be examined in a formal study.

People have typically been treated with antipsychotic medicines such as risperidone that block dopamine receptors in the brain, and they can certainly help. A more recent approach is to use medicines like aripiprazole that modulate dopamine activity in the brain. A recent study done by some colleagues in the United Kingdom have confirmed that aripiprazole seems to be very helpful in about half of patients with Tourette’s, though neurological side effects do sometimes occur.

There has recently been a lot of interest in Habit Reversal Therapy: a behavioral treatment for tics. The therapy takes a lot of time and effort, but it is very interesting that behavior therapy can help with a neurological illness.

There is no published data on the use of Integrated Medicine in the treatment of people with Tourette’s, but many experts have reported that some patients have been helped with homeopathy and acupuncture.

That guy in the next seat who is cursing may not just be mean and uncouth. He may be suffering.

But maybe not for much longer.

We are getting very close. Not just to discovering the physical basis of the illness, but perhaps its meaning and purpose as well.

New discoveries are coming thick and fast, and I shall keep posting about those that will help individuals and illuminate the principles of Integrated Medicine.

Pramipexole

Pramipexole is a remarkably interesting medicine about which you are likely to hear a lot in the near future. It is an agonist, which means that it has a positive effect, on D2 dopamine receptors and also on a little-known group of dopamine receptors, known as the D3 group. If you want to get really clever the dopamine receptor D3 group is abbreviated to DRD3. Pramipexole has been in use for almost a decade in the treatment of Parkinson's disease, and approximately 9.1 million prescriptions for pramipexole have been written in the U.S. since its launch in 1997. It is not without its problems. In Parkinson’s disease it may cause dizziness, involuntary movement, hallucinations, headache, difficulty falling asleep, sleepiness, and nausea. Some people have also had behavioral dyscontrol while taking it.

At a meeting in Athens in February of 2006, we saw confirmation of something that had been shown in previous research: pramipexole seems to be a very effective treatment for restless legs syndrome (RLS). A study published in the journal Neurology has given us a more detailed understanding of the risks and benefits of pramipexole.

The investigators report a 12-week, multicenter, double-blind, randomized, placebo-controlled study of fixed daily doses of pramipexole (0.25 mg, 0.50 mg, and 0.75 mg) involving 344 patients with moderate to severe RLS. Data from 339 patients were analyzed to evaluate the effect of pramipexole treatment on efficacy and safety. The mean age of patients was 51.4 years and the mean duration of RLS symptoms was 5.1 years. The results were very promising, even though half of the patients on placebo also showed an improvement. The most commonly reported side effect included nausea (19.0%), headache (17.8%), insomnia (10.5%) and somnolence (10.1%).

In Europe pramipexole it has been approved for use in this indication. It is marketed as Sifrol® / Mirapexin® In the United States we currently only have one approved medical treatment for RLS, and that is the GlaxoSmithKline medicine ropinirole (Requip), that works at the same D3 receptors in the brain and spinal cord. Ropinirole is effective in a proportion of people with RLS, but it has also been linked to sleepiness, drops in blood pressure and fainting, so those are included in its label.

RLS may be associated with some other illnesses so I was very interested to see two reports of the use of pramipexole in bipolar depression as well as a report of its possible use in REM Behavior Sleep Disorder.

One of the most exciting potential uses for pramipexole may be in some people with fibromyalgia. I’ve mentioned that fibromyalgia, bipolar disorder and some other psychiatric illnesses may be connected. The idea that we might be able to use just one medicine to support our Integrated Medicine approach is very attractive, and also helps point us toward a deeper understanding of what exactly goes wrong at the physical level in RLS, depression and fibromyalgia.

I’ll keep you posted.

Erasing Your Neurological Hard Drive

Did you ever see the movie Total Recall, and wondered if it might really be possible to erase someone's memory and implant a new one? Well, that might just be a little closer than most people realize.

One of the mechanisms of the storage of memories in the brain is thought ot involve a process known as long-term potentiation (LTP), that strengthens synaptic connections between neurons. The mechanism of LTP has been a mystery, but recently it was discovered that there is a biochemical pathway that utliizes something called an atypical protein kinase C isoform,  protein kinase Mzeta (PKMz), that seems to be a key player in LTP.

New research from a team at  SUNY Downstate Medical Center, in Brooklyn, New York, using a PKMz inhibitor reverses LTP and produces persistent loss of 1-day-old spatial information, proving that PKMz is crucial to laying down memories in the brain.

There are many ways of losing memory. Apart from being belabored about the head and shoulders with a stout cudgel, alcohol and benzodiazepines are all fairly reliable ways of causing transient memory loss. But they also may fail, and each may have other unpleasant consequences.

But this is different: undestanding the basic mechanism of memory formation may enable us to obliterate unpleasant or wanwanted memories in conditions like chronic pain and posttraumatic stress disorder. It may also help us understand something more about the mysteries of illnesses like Alzheimer's and Dementia of Lewy Body type, in which memory can be lost.

But it is also important to keep an eye on this research. I would not like either a government or a corporation to have a way reliably to erase our memories.

Though I've often thought that I'd quite like to have one of those little Neutralizers that they had in Men in Black.....

Attention Deficit Disorder and Brain Laterality

Here two topics that are very close to my heart: the puzzle of laterality and asymmetry and attention deficit disorder.

We live in an asymmetric Universe. Fundamental particles tend to rotate and wobble to the left rather than the right; most molecules show a lateral shift; and all the biologically active amino acids - the building blocks of proteins - are in the L-form. Meaning that in solution they bend light to the left. The R-forms, that bend light to the right, for the most part don’t work in biological systems. Some of the most extraordinary asymmetry is seen in the human brain. There’s a myth that about the hemispheres of the brain that I’ve talked about before, but bears repeating.

The idea that the left hemisphere of the brain is specialized for logic, analysis and language, while the right hemisphere is holistic, artistic and mystical has been circulating for over thirty years. It has even been suggested that the right hemisphere of the brain is the seat of intuition, which cannot be correct. It may be involved in instinct, but it is impossible to reduce a non-local psycho-spiritual experience to groups of brain cells. There may be correspondence – the right hemisphere becoming activated during intuition, but not causality: right hemisphere activation as the cause of intuition.

This notion of discrete functioning of the hemisphere has become so pervasive that it is commonplace to hear people describing themselves as being "right brained,” or accusing someone else of being "left brained."

A simple concept that is also profoundly wrong. This is fine as a metaphor, but not as a fact. It is true that language is more highly represented in the left hemisphere of the brain in right-handed men. But language is bilaterally represented in women. Most men tend to use a small strip of the left hemisphere for language, women tend to use both hemispheres at once. There’s still a left-sided predominance, but it’s quite a different pattern from most men’s brain.

Boy’s brains mature more slowly than girls’ brains, and by adolescence are more lateralized than are the brains of girls and women. The truth is that we cannot neatly divide up the functions of our brains, and we need both sides of our brain if we are to function at our best.

Until very recently most experts said that handedness was a purely human attribute. Yet anyone who has every lived with a cat, dog or horse knows that that is wrong, and now there’s literature to prove it.

I tried to put that mistake to bed in a review article that included a detailed discussion about brain asymmetries in animals. I also reviewed the excellent evidence that certain regions of the brain have been becoming more lateralized over the last 100,000 years.

I’d like to show you why this talk of brain lateralization is not a sterile academic debate.

We do not know if left-handedness or mixed handedness is more common in ADD/ADHD. But the evidence is getting stronger and stronger that there is something different in people with ADD/ADHD in how they use the two sides of their brains.

Three conditions: autism, dyslexia and ADD/ADHD share one characteristic: they are all marked by what we call atypical cerebral asymmetry in that they don’t have the normal left hemisphere dominance for language. This is more of a problem for boy, since they normally make more use of their left hemispheres. But it’s not all bad: atypical cerebral asymmetry may also be associated with certain aspects of creativity.

Researchers in New Zealand have just reported something strange, but which is consistent with previous research. When healthy right-handed children are asked to bisect a line drawn on a page, when they use their right hand they tend to bisect the line toward the right, and with the left hand toward the left. But children with ADD/ADHD don’t do this. The researchers have now gone further and suggested that there are at least two types of ADD/ADHD, in one of which – ADHD-I – the primary problem is in the right hemisphere of the brain.

Using an entirely different methodology, researchers in Baltimore, Maryland, have found that children with ADHD use their brains differently when engaged in patterned motor activity.

In an earlier post I talked about the dorsolateral prefrontal cortex, and there is an important connection to it is called the cingulate cortex. A new study has shown that adults with ADD had significantly smaller overall amounts of cortical gray matter, and reduced volumes of their prefrontal and anterior cingulate regions. Both are highly lateralized in the human brain.

Compared with controls, unmedicated children with ADHD have a small right cingulate cortex, but it is normal in children who have been treated, indicating that the treatment is doing more than treating symptoms: it may actually be re-wiring the brain.

Research from the UCLA Neuropsychiatric Institute and David Geffen School of Medicine showed that in adults with ADHD, showed reduced left hemisphere specialization, were better at processing emotions, and worse at processing words compared to controls. They tend to use their right hemispheres more and their left hemispheres less.

Unaffected individuals constantly shift their attention toward the important or salient things in their environment. Children with ADHD have a problem with directed attention: the ability to allocate and direct attention toward a salient stimulus. New research has discovered that this is due to problems in a region of the brain called the parietal lobe that is known to play a significant role in shifting attention and detecting specific or salient targets in the environment. As a result the child’s brain does not know what is important.

These findings do not tell us whether the primary problem is a way in which specific parts of the brain talk to each other, or whether the scientists are actually measuring the way in which the brain reacts to deficits in one region. Perhaps other regions take over the functions of parts that are not working as they should.

The most important take home message is that we already have methods for stimulating and integrating the hemispheres of the brain. Few have so far been much used in ADD, but this information gives us a whole new way forward.

Women, Asthma and the Brain

There’s been a longstanding puzzle in medicine. Well actually there are lots of them, but here’s one that may be a puzzle no more.

For many years now, it’s been known that asthma is more common in women, and also that psychological stress can cause flare ups of asthma.

Many women experience “menstrual flaring:” a worsening of asthma around the time of their menstrual period. There is also a strange paradox: some women with asthma wheeze less if they take an oral contraceptive, while some non-asthmatic women begin to wheeze when they take it. In some women pregnancy makes asthma worse, and in others it affords months of relief of symptoms. Women who are obese are more likely to get asthma, presumably because their intra-abdominal fat stores are churning out inflammatory mediators.

Researchers from the University of Wisconsin have shed  some important light on this link between asthma and the brain. In research published in the Proceedings of the National Academy of Sciences. In the study, six patients with mild asthma were exposed to ragweed or dust-mite extracts. The subjects were shown three different categories of words: asthma-related (e.g., "wheeze"), non-asthma negative ("loneliness") or neutral ("curtains").

Using functional magnetic resonance imaging, they showed that activity in two regions, known as the anterior cingulate cortex and the insula showed increased activity when the asthma-related words were heard compared with the other types. What is more, this enhanced activity was specifically linked to physiologic signals from the ragweed and dust-mite extracts. So being exposed to asthma-relevant emotional stimuli is associated with markers of inflammation and airway obstruction in asthmatic people exposed to an asthma-producing antigen.

In people with asthma and other stress-related conditions, these brain regions may be hyper-responsive to disease-specific emotional and physiologic signals. Taken together, these could contribute to problems that worsen the asthma, such as inflammation.

And one of the ways of making these regions of the brain hyper-responsive? Bathe them in estrogen.

That still does not explain why pregnancy and the oral contraceptive makes some women’s asthma better, and does the opposite in others. But it may just have to do with the “set point” of the cells in these regions of the brain. In the same way that we might set the thermostat in out house. An already hyper-responsive brain might be normalized and an under-active one stimulated to be over-active.

We need to do some more experiments, but these are a great start.

If you ever wheeze, have a look to see if there are stressors or hormonal events that trigger you. Whether you are being treated with homeopathy, herbals or conventional therapy, knowing when to expect trouble gives you the power to adapt you treatment when you are entering a risky time in your life.

Music and the Mind

The next book in the Healing, Meaning and Purpose cycle will be entitled Sacred Cycles. One chapter is entitled Music and the Mind. I am in no doubt that music can produce incredibly powerful healing.

I was interested to read about a small study published in the journal Brain.

Canadian scientists from McMaster University compared 6 children aged four to six who took music lessons for a year with 6 children who did had no music lessons outside school. The six who had lessons attended a Suzuki music school, using a Japanese approach that encourages children to listen to and imitate music before they attempt to read it.

They found the musical group performed better on a memory test also designed to assess general intelligence skills such as literacy and mathematical ability.

The investigators also measured changes in the children's brain electrical responses to sounds during the year. They measured brain activity using a technique called magnetoencephelography while the children listened to two types of sounds: a violin tone or a burst of white noise.

All the children recorded larger responses when listening to the violin tones compared with the white noise - indicating that more of the brain’s activity was being deployed to process meaningful sounds.
All the children responded more quickly to the sounds over the course of the year of the study - suggesting greater efficiency of the maturing brain.

However, when the researchers focused on a specific measurement related to attention and sound discrimination, they found a greater change over the year among the Suzuki children.

In the group having music lessons, there were measurable changes in as little as four months. Previous studies have shown that older children given music lessons recorded greater improvements in IQ scores than children given drama lessons, but this is the first time that such young children have been tested.

Though this is only a small study, it strongly suggests that music is good for children's cognitive development. I ifnd this particularly interesting after researchers appeard to have dismantled the "Mozart Effect." Perhaps they were premature in doing so.

I also take my hat off the researchers. As someone who’s done a lot of scanning and measurement, I know only too well, that to get young children to stay still enough to get meaningful readings must have been a Labor of Hercules!

I’d also like to mention a conference in November that sadly I shall not be able to attend, but promises to be a splendid event. It’s the International Sound Healing Conference, taking place on November 10-14 in Santa Fe, New Mexico. They have a stellar group of presenters, including Jill Purce, Don Campbell, Fabien Maman, James D’Angelo, Master Charles Cannon, John Diamond and a host of other experts in the fields of sound and healing. It should be quite an event!

“Words are the pen of the heart, but music is the pen of the soul.” --Shneur Zalman of Liadi (Rabbi and Founder of Chabad Lubavitch, 1745-1812)

“Music is the wine that fills the cup of silence.” --Robert Fripp (Musician, Guitarist and Spiritual Seeker, 1946-)

Neurotheology

Over the last three decades researchers at a number of universities have studied meditators and people in prayer, or experiencing mystical experiences, and tried to pinpoint the region of the brain responsible for these experiences. Some researchers went as far as to suggest that there’s a specific region of the brain that’s responsible for direct communication with God, while others have been far more skeptical. One of my early teachers was convinced that mystical experiences were simply forms of temporal lobe epilepsy. I was just as convinced that he was wrong. But back then I was the student, and he the master. So I was put firmly in my place. Neuropsychologist Michael Persinger and his group at Laurentian University in Canada has reported that he can very precise magnetic fields to artificially stimulate regions within the temporal lobes to induce a state of “sensed presence.”

A new study conducted by Mario Beauregard and Vincent Paquette from Montreal has just been published in the journal Neuroscience Letters.

The investigators used functional MRI (fMRI) scanning in 15 Carmelite nuns to try to examine the brain processes underlying the Unio Mystica: the Christian notion of mystical union with God. This is the latest episode in a field that is becoming known as neurotheology.

The nuns were asked to relive a mystical experience rather than actually trying to achieve one. Rather than reveal a spiritual center in the brain – a “God spot,” as the popular press called it - the researchers found a dozen different regions of the brain were activated during the recall of the mystical experience. The experience was mediated by brain systems and regions that are normally implicated in emotion, self-awareness and body representation.

It is important to note that despite the title of the study – “Neural correlates of a mystical experience in Carmelite nuns” - this was actually an experiment on memory, and there were some technical objections to the study. There is a fine critique here.

There is also a point that I have brought up before: can we really try to reduce complex psychological and spiritual experiences to a groups or systems of neurons? My own view is that we are seeing necessary neurological correlates of an experience, but that these measurements tell us nothing at all about the key aspects of what the nuns remember: the sense of meaning, value and purpose that flow from the mystical experience.

Our Unique Brains

One of the fundamental tenets of the old self-help movement is that we all have the same brains and so we all have the potential to become a Leonardo da Vinci, Albert Einstein or Michelangelo.

But is this really true?

I’ve talked a lot about the way in which genes in the brain do not so much determine your behavior, but instead predispose you to respond to the environment in certain ways. If asked the question, “Why has she got depression? Was it because of the abuse as a child, or because her grandmother had depression?” The answer is “Yes.” All of the above.

I’ve examined many hundreds of brain scans, and one of the most striking features of them is their variability. It’s a strange paradox: when we look at the nerves running to your fingers or your toes, they are pretty much in the same place in everyone. The veins and arteries are often in different places, but those peripheral nerves tend to stay put.

Yet when we get to the brain, things are very different. I’ve never seen two brain that look the same. This has been a big problem in research: how do you compare the brain of someone with depression with a healthy volunteer? We usually end up doing all sorts of sophisticated computer modeling to be able to compare two very different brains. This is also why we are a bit skeptical about people who claim to be able to diagnose illnesses based on brain scans. There is just so much variability.

This came up last week, when Grigory Perelman turned down a prestigious honor for his extraordinary work in mathematics. Here we have someone who’s brain works quite differently from other people. He has a very remarkable gift, but I doubt that anyone else could simulate what he has achieved.

I knew a woman who was employed as an air traffic controller by the Royal Air Force. Like all air traffic controllers, she had to have an amazing ability: to be able to tell – without instruments - where every plane was in the sky. With planes flying in different directions at 300-500 knots, the variables are staggering. Yet Veronica and her co-controllers could do it easily.

One of the reasons that I landed in the United States was that I was given a problem to solve. It had to do with measuring an inaccessible region of the brain that is mind-bogglingly important. World class investigators had been trying to solve the problem for four years. After years of playing chess, I have a reasonable ability to visualize things in three dimensions. That was all that it took to solve the problem. Within three weeks we started cranking out data that changed the way in which we think about major mental illness.

Could anyone model Grigory Perelman, or Veronica the air traffic controller or my modest efforts in brain imaging? Is that something that everyone can do?

The answer is almost certainly not.

Although we are forever being told that we can each be whatever we want to, that is not what the evidence says.

I am in no doubt that most people have the potential to perform far above their accustomed level.

But I’m just as sure that not everyone can do everything.

There is often a subtle subtext here: if you have not achieved everything that you want, it is because you have failed. And that’s wrong. Human potential is magnificent, but there are almost certainly some neurological constraints on what each of us can achieve. The key to much of our work is to see how we can expand beyond those neurological limitations.

There’s a terrific discussion of some of these issues by Steven Pinker from Harvard.

Memory and Anticipation

“Nothing is so wretched or foolish as to anticipate misfortunes. What madness is it to be expecting evil before it comes.”
--Lucius Annaeus Seneca (a.k.a. Seneca the Younger, Spanish-born Roman Philosopher and Statesman, c.4 B.C.E.-A.D. 65)

We are all aware that memories of powerful and in particular disturbing emotional events - such as an act of violence or the unexpected death of a loved one - are more vivid and deeply imprinted in the brain than mundane recollections of everyday matters. When I was sixteen years old I was in a head-on car crash: I can still recall the number of the license plates of the car that was driving down the wrong side of the road as it barreled into us. But particularly positive emotions are also remembered in far more vivid detail, and those memories are less likely to be lost. This all makes good sense from an evolutionary perspective: we need to be able to remember things that carry a strong emotional charge.

Colleagues at the University of Wisconsin in Madison have found that the mere anticipation of a fearful situation can activate two memory-forming regions of the brain: even before the event has occurred.

The investigators used functional MRI scans with 40 healthy participants who viewed aversive or neutral pictures preceded by predictive warning cues. Previous research reported sex differences in the way in which memory and emotion interact: in women, memory associations were found with a region called the left amygdala. But the association was with the right amygdala in men. This new study refines these findings: they were confined to the ventral amygdala during picture viewing and delayed memory.

Both men and women who had previously been given an indication that gruesome pictures were going to be shown were more likely to remember them.

What this means is that the act of anticipation may play an important role in whether the memory of a tough experience remains fresh and vivid. This makes sense based on our own experiences of events: do you remember the fear associated with a visit to the dentist that built and built before you got there? That anticipation can itself modify the memories of an event.

The findings are published in this week’s issue of the Proceedings of the National Academy of Sciences. They have important implications for the treatment of some psychological conditions such as post-traumatic stress disorder (PTSD) and social anxiety that are often characterized by flashbacks and intrusive memories of upsetting events

We have long known that our memories are not like some video recording forever preserved within our neurons. Some memories are false, many change over time and others lose their emotional charge. It is possible to implant false memories in people, and by re-writing our own life stories we can change the narrative of our lives and how we react to life events.

Samuel Johnson once said that, “The true art of memory is the art of attention.”

I’m quite sure that he is correct, and this research proves it. I’ve always been blessed – or cursed – with a prodigious memory, to the extent of being able to remember the lab values on every patient that I ever saw during my clinical years, and when I was younger being able to read pages of a textbook from memory. I’m quite convinced that my memory is no better than anyone else’s: I’m just a little better at using it.

The trick to using my memory was discovering at an early age that I could remember virtually anything if I really focused my attention on it. So I would focus on the book to the exclusion of everything else for a minute or two. Rest for a minute and then do it again. To this day, that is the best technique that I know for laying down long-term memory. My father also had this faculty, and when I was a youngster he would tell me not to write down things like shopping lists or to construct “To do” lists. He told me that, “if you really have to remember things you will. And if you’re not interested in something you don’t need a “to do” list.”

I only use lists if I have to do something tedious. This is a good test for you. If something that you are doing really engages your attention it is likely one of your core desires, and there is no need to be writing down a list of things to do. If it does not, and you have to write everything down, it’s probably not a core desire. You may still need to write down an action plan, but that’s to get your creative juices flowing, not to stimulate your memory.

I have developed quite a number of techniques for improving memory and concentration. Some are home grown, others modified from methods and techniques that others have taught me. I’ve been collecting and testing them for years. I’m doing a lot of flying this week, so I shall have the time to be put some of them together into a free report. I shall let you know when it’s ready and if you ask, I shall send you a copy.

There is one important reason for writing down thoughts once you have done something, and that is to help them be part of your legacy. That’s a topic to which we are going to return many times in the next few weeks.


“What we anticipate seldom occurs, what we least expected generally happens.”
--Benjamin Disraeli, 1st Earl of Beaconsfield (English Statesman, Novelist and, in 1868 and from 1874-1880, British Prime Minister, 1804-1881)

Monkey See, Monkey Do

This is the title of a short article on mirror neurons in New Scientist.

Pier Ferrari at the University of Parma, Italy, and colleagues tested 21 newborn Macaques by holding each in front of a researcher who made various facial expressions.

The article has links to two movie clips showing the young Macaques beginning to imitate the researcher.

The study indicates that the capacity for imitation occurred earlier in the primate evolutionary tree than previously thought, and before the rhesus monkey ancestor split from the human lineage, about 25 million years ago.

Yet another apparently characteristic that was thought to be uniquely human, that was then found to be shared by young apes, and is now shown to be an even more general attribute of sentient creatures.

We have recently been doing some informal expriements with a kitten and an older cat that seem to have remarkable powers of mimicry. Not at the same level as the Macaques, but still mimicking head position and mouth opening. I cannot find any published research on mimickery in cats, but I shall ask around and report back.

When Being First Is Not the Only Thing

Regular readers and anyone who's looked at my blogroll, knows that I like Zach Lynch's consistently insightful blog.

He has been working on a project for four years, and now it appears that someone is coming out with some of the same ideas in a book that is due to arrive in late September.

This does not look to me like plagiarism. Once a new idea is out there, it quickly spreads, and people will run with it.

You might be interested to see some of the comments that I made on Zach's site.

The other book may be superb. But the important point is that although being first is the only thing in competitive games, in the world of ideas that will help us, being first is not the only thing.

Being correct is the only thing.

Dementia

I have written about Alzheimer's disease in the past, but it is important for everyone to know that not all dementia, and certainly not all memory loss, is Alzheimer's disease.

There is a brief article on the Psychiatric Resource Forum website that will point you toward some extra resources.

Our biggest interest is always in ensuring that someone who seems to be developing a dementing illness doesn't actually have one of the large number of remediable causes of cognitive decline, such as depression, an underactive thyroid, vitamin B12 or folate deficiency, or an unusual condition called normal pressure hydrocephalus.

Parkinson’s Disease, Allergies and Inflammation

The symptoms of Parkinson’s disease have been reported throughout history, but it was first described in the modern era by the great Scottish neurologist James Parkinson in 1817. Even after all these years, we still do not know all that much about what causes it. There’s an interesting study in the August issue of the journal Neurology, which is the official publication of the American Academy of Neurology.

Investigators from the Mayo Clinic used what is known as a case-control design (196 cases and 196 matched controls). What they found was that people who suffered from hay fever or allergic rhinitis, are 2.9 times more likely to develop Parkinson’s disease over a 20-year period.

The researchers did not find any association with autoimmune illnesses such as lupus, rheumatoid arthritis, pernicious anemia or vitiligo. They also did not find any association with asthma.

In addition, people who developed Parkinson’s disease used anti-inflammatory agents less frequently than controls, although this result was not statistically significant. The results may support the hypothesis that there is an inflammatory component in the causation of Parkinson’s disease.

You may ask, “Why on earth would anyone even look at a link like this?” The answer is that there have been previous reports of an association between the use of non-steroidal anti-inflammatories and lower rates of Parkinson’s disease in men but not in women and Alzheimer’s diseases.

This study does not suggest that hay fever causes Parkinson’s disease: it provides evidence for an association between the two. Parkinson’s is probably a group of illnesses with different causes. However, if chronic inflammation around the upper airways could produce inflammation in the brain, we might have a whole new way of preventing a degenerative brain disease.

In a future posting I’ll talk about some natural methods for reducing the burden of inflammation in your body.

Science, Quantum Mechanics and Mystical Experience

I've had a very long standing interest in altered states of consciousness.

For me this has never been an academic exercise. Though I grew up at a time when meditation and mysticism was all the rage, I was actually trying to make sense of some of my own experiences. Since early childhood I'd had all manner of odd experiences that in later life I learned were the norm. It's just that most people ignore or forget their experiences or are "trained" not to talk about them. In the mid-1980s I lectured on the subject of mystical experiences at the Society for Psychical Research and the College of Psychic Studies in London. (I recently discovered that there are still tapes of those talks available after all these years!)

As part of another project, I recently analyzed most of the world literature on altered state of consciousness in all the languages that I can read, and found over 2,800 valuable papers. There is a huge amount of research going on.

I've also come across a number of short but very interesting interviews with a number of original thinkers in the field of consciousness, including Huston Smith, Daniel Dennett, Freeman Dyson and a number of other thinkers. If you have any interest in consciousness you will probably find something to interest you here.

Enjoy!

Blueberries

One of the principles of integrated medicine is that anything that’s good for you should have more than one benefit. So omega-3 fatty acids may help with cardiovascular health, mood, memory, attention deficit disorder, as well as the health of skin and bones.

Another one is the blueberry. I’ve been sufficiently impressed by the data on the health benefits of blueberries to have been a regular grower and consumer for years. They contain a number of potentially healthful compounds including polyphenols and anthocyanins, which can help modulate and balance the free radical systems of the body. Remember what I said recently about the value of keeping some free radicals in the body? The last thing that we want to do is to be rid of all of them!

There is reasonably good evidence that regularly eating blueberries can support cardiovascular health and there have been suggestions that they may reduce the risk and aggression of cancers of the prostate and colon.

There is also some evidence in animals that some of the components of blueberries may reduce inflammation and the effects of strokes – interruptions to the blood flow in the brain.

As a consumer, I’ve been carefully watching the growing evidence indicating that blueberries – or some of their constituents may have effects on animal cognition, brain aging and the normal neuroprotective mechanisms in the hippocampal region of the brain.

We do not yet have proof that these same effects occur in humans, and there are always three questions when we look at nutritional data:

1. Can we extrapolate from the animal to humans? Mice are not men
2. Are the amounts of blueberries or blueberry extracts even close to what humans could consume without spending all day eating, or getting a terribly upset intestine? There have been countless reports of the benefits of supplements that had to be taken in the most enormous doses to do any good. I’ve mentioned before the problem of L-arginine, which is sold as a “Natural Viagra.” Except that you need to take around nine grams for it to do much good, and most supplements contain less than a tenth of that. Regular readers will also remember my report concerning an article on coffee and sex. It was said that coffee would raise a woman’s libido. And indeed it does, if she drinks at least ten large cups of coffee at once. And coffee is a marvelous diuretic.
3. When extracts are used, are we sure that we are getting the correct ingredient of the fruit? Many beneficial fruits contain just the right combination of nutrients to help us, so each can be taken in a small dosage or concentration. As with so much in integrated medicine, combinations are key. Take out one extract of a fruit, and you may lose the clinical effect that you wanted.

All that being said, the evidence is becoming progressively more interesting, and there is enough suggestive evidence for me to keep packing away the blueberries.

And just to show that I leave no stone unturned when checking the literature on your behalf, I rejoiced to learn that supplementing the diet of Arctic char with various supplements - including blueberries – improved the quality of his, ahem, semen. I do not know how this information will help any of us yet. Neither do I really know why a fish would want to eat blueberries or any of the other supplements that they were tried on. Though I'm sure that people have often asked similar off the wall questions about some of my research....

Yet Another Piece of Research on the Dangers of Multitasking

Time has published another article on one of my “favorite” topics: the dangers of multitasking. I’ve written several items about this pernicious problem.

The new study from UCLA, is in the current issue of the Proceedings of the National Academy of Sciences. The investigators recruited a group of volunteers, all of whom were in their 20s. They had them work on a simple categorization task, in which they were asked to sort a stack of cards into different piles depending on the shapes printed on them. The volunteers then repeated the experiment with a second set of cards, this time while also listening to a set of high- and low-pitched beeps through a headphone and counting up all the high-pitched ones. As they worked, the subjects also underwent functional magnetic resonance imaging that enables us to follow brain blood flow.

In both versions of the test, the subjects did equally well on the categorization task, making about the same amount of errors. But when the investigators later asked the volunteers more-analytical questions, asking them details about the patterns of the cards and ways in which they could be categorized, the subjects showed a far more flexible understanding of those cards they had sorted without the distraction of the beeps.

When not distracted, the hippocampus of the brain, which is involved in creating short term memories and in constructing a map of external space, was actively engaged. When distracted by beeps, a less sophisticated part of the brain - the striatum – took over the task. This is one of the brain regions normally dedicated to mastering repetitive motor task or simple habits.

The practical consequence of this is that if you need to learn new information that requires analysis, you should not be doing anything else at the same time.

It may be that some people with attention deficit disorder will behave differently: there is some data that a proportion of them learn better if there are external distractors.

Technorati tags: Multitasking Attention Proceedings of the National Academy of Sciences Attention deficit disorder

Mel's Madness

In the midst of all the furor about Mel Gibson and his self-admittedly foul behavior while under the influence of alcohol, an important point has been missed: when someone is drunk or brain damaged, is their behavior just disinhibition? Are they behaving this way because they’ve lost the cerebral censor that normally maintains our social demeanor? The Romans certainly thought so: in banqueting halls they would have roses carved into columns and the ceiling. The rose - the symbol of secrets - was a reminder to be discrete when alcohol might begin to lossen the tongue.

When the frontal lobes are on strike, does our “true” personality emerge? Or can alcohol, drugs and brain injury produce brand new behaviors that are not just totally out of character, but predictable by the drug or type of injury?

The answer is a mixture of the two. I know a man who is in the running for the Nobel Prize in medicine. But a couple of years ago it was all over the press when he shattered the arm of an innocent man in the middle of an alcohol-fueled frenzy. Was it the alcohol? Yes, I’m sure that it was. But the scientist has had a very long history of anger problems and of bullying younger colleagues. The alcohol was the catalyst to behavior that he normally keeps in check, but which was just waiting to come out of its cage. I’ve treated hundreds of alcohol abusing people, and the amiable ones far outnumber the violent ones. And the majority of the violent ones had also been violent when not drinking.

Some drugs and chronic alcohol abuse can produce stereotyped hallucinations and behaviors. Some alcoholic people really do see bugs and pink elephants, and there are many other examples of predictable perceptual and behavioral disturbances with drugs and with brain injuries.

Students of the healing arts learn that damage to certain regions of the brain is associated with specific behavioral and emotional consequences. This teaching goes back more than a century, and generations of students have been told that, “Damage here causes depression, and damage here causes mania, and over there a lesions will damage one type of language.” Yet for three decades we have known that much of this teaching is fictitious. I was taught brain localization by some of the finest neurologists in the world, and yet each would admit the inaccuracy of their methods. A new study from Brisbane, Australia supports that nihilism. The investigators examined 61 consecutive people admitted to a stroke unit. “Strokes” are either vascular blockage or bleeds affecting the brain.

They could find no significant relationship between the side or location of a lesion and the development of post-stroke depression. But the kinds of people that they were before the stroke had a big impact:  pre-morbid neuroticism and a past history of mental disorder were important predictors of depression following stroke.

So why all the fuss about Mel? Because people are asking if deep down inside he really has been harboring some of the dark, mean spirited thoughts that he expressed to the police, and that the alcohol was the catalyst and not the creator of his diatribe.

“The intoxication of anger, like that of the grape, shows us to others, but hides us from ourselves. We injure our own cause in the opinion of the world when we too passionately defend it.”
-- Charles Caleb Colton (English Clergyman and Author, c.1780-1832)

Technorati tags: Mel Gibson Alcohol abuse Pre-morbid personality Brain

Posttraumatic Stress Disorder, Resilience and the Brain

There has always been a puzzle about posttraumatic stress disorder (PTSD): why do some people get it and others don't? It has always seemed that if the stress was bad enough, and particularly if it was unexpected, then pretty much anyone could get PTSD. But in between the mild stressor that makes one person fall apart and suffer terribly, while others scarcely notice, and the severe trauma that catches almost everyone, is a great unexplained mass of suffering people.

Six years ago research by Tamara Gurvits and her colleagues from the VA in Manchester, New Hampshire first suggested that people with PTSD may have some subtle neurological problems that couldn’t be explained away by alcohol abuse or injury. Now the same group has published a new study that adds significantly to our knowledge about this issue. A study of twins lead the investigators to conclude that the neurological abnormalities predated the PTSD and most likely predisposes patients to it.

The researchers studied 49 pairs of identical male twins in whom one twin had been exposed to combat during the Vietnam War and the other had not.

In 25 pairs the combat-exposed twin had a current diagnosis of PTSD, while the remaining 24 twins did not have the problem.

All the subjects were tested for what we call neurological “soft signs.” This is not a good term, and refers to subtle neurological disturbances, usually involving some complex systems of the brain. They include things like an impaired sense of direction, being able to do rapid, complex motor actions, copying pictures and movements. The combat veterans with PTSD scored higher on the soft signs tests than did the veterans without PTSD. But now it gets interesting: the identical twins of people with PTSD also had high soft sign scores. In other words there appears to a familial vulnerability to developing PTSD. This is consistent with a fascinating new paper on the neurological circuitry involved in fear. We can now map out some of the neurological vulnerabilities involved in PTSD as well as some of the neurological consequences of severe PTSD. Nobody knows if we can reverse them with psychological or other approaches, but we now think it is very possible.

There is a lot more work to be done. But as a first suggestion: someone who has this kind of evidence of vulnerability to PTSD should be the first to get advanced training in developing resilience. We already know that even the most limited efforts to bolster and develop resilience can have marked effects.

The key is to start building your resilience starting today.

“Always plan. It wasn't raining when Noah built the ark.”
--Richard C. Cushing (American Roman Catholic Cardinal, 1895-1970)

Technorati tags: Posttraumatic stress disorders Brain Vietnam veterans Resilience

Neural Stem Cells

Stem cell research presents us with one of the most difficult moral and ethical dilemmas. Most of us have our opinions about the whole matter. But there is now a very real possibility that the scientific piece may be resolved in a different way altogether.

A recent study in the Proceedings of the National Academy of Sciences has confirmed that in adult mammals, the regions of the brain below the ventricles – the fluid-filled spaces – of the brain, harbor neural stem cells. The evidence for their existence has been building over the last five years. But this latest report is of great interest. The scientists were able to show that a soluble carbohydrate-binding protein named galectin-1 promotes the proliferation of these neural stem cells in the adult brain. These neural stem cells are highly active in the forebrains of mice.

We have yet to discover their role in adult human brains. But it would seem a safe bet that they will if anything be more active in humans, since we are endowed with incredible neural plasticity that is way beyond anything seen in most other species. And we would therefore expect to see more potential for neurogenesis in the human brain. It is valuable to place this new finding in the context of experimental work indicating that some medicines may stimulate adult neurogenesis.

“I've found that the chief difficulty for most people was to realize that they had really heard new things: that is things that they had never heard before. They kept translating what they heard into their habitual language. They had ceased to hope and believe there might be anything new.”
--Peter Demianovich Ouspensky (Russian Philosopher, 1878-1947)

Technorati tags: Stem cells Neurogenesis Adult brain

Growing Your Brain

Several years ago we learned that London taxi drivers grew a small part of their hippocampus while learning “The Knowledge,” a detailed map of the streets of the city. Unlike most American cities, London is like a rabbit warren that has been growing organically for two thousand years. Despite the Great Fire of 1666, and the best efforts of Hitler’s Luftwaffe, the basic illogical structure has just become more complex over the centuries. The hippocampus is intimately involved in memory, navigation and in constructing a map of your surroundings. It has also been established that professional musicians and people who use Braille, all have increases in the size and complexity of a specific region of the brain.

We now learn from researchers in Germany that medical students show an increase in the amount of grey matter in the posterior part of the hippocampus and also in regions of the parietal lobes while studying for their exams. It is calculated that a medical student learns around 6,000 new words during his or her training, so it is no surprise that the brain changes to accommodate all this new information.

This new finding just adds to our knowledge about the plasticity of the brain. Even if you do not have to learn 6,000 new words and innumerable new concepts and practical techniques, it is worth knowing that learning any new knowledge or skills will likely grow specific regions of your brain.

So make a resolution to learn at least one new thing each day, and to work on developing a new skill. It doesn’t matter whether it is learning to knit or how to play chess. Each will likely help you.

Later this year we will be bringing out a book that teaches brain stretching skills based on the latest advances in brain science.

Watch this space!

Technorati tags: Hippocampus Parietal lobe Learning Medical students Neurogenesis

Psychotropic Medicines and Neurogenesis

One of the genuine breakthroughs of the last few years has been the understanding that the brain is not a static structure, but is instead an organ that grows, refashions and repairs itself to a remarkable degree.

You may be interested in a brief review article looking at the effects of some of the medicines that appear able to stimulate neurogenesis in the adult brain.

It is no longer far-fetched science fiction to say that we are likely soon to be able to regenerate parts of the brain and spinal cord that have been damaged by disease or trauma. And in the meantime, we have an array of stratgeies that you can adopt to keep your brain active throughout life, while dramatically reducing your risk of developing dementia.

Technorati tags: Neurogenesis Antipsychotics Antidepressants Brain repair