One of the key challenges in effective development of the integrative Biomedical Informatics concept is to integrate the computational methods and technologies that are used in life-sciences research with the computer sciences and applications supporting health care and clinical research.

This one-day workshop will bring together neuroscientists and clinicians to discuss the synergic integration between the computational methods and technologies used in neuroscience, in order to organise, manage and access the neuroscientific knowledge.

The talks will focus on providing an overview of the state-of-the-art of the different application of biological informatics in neurosciences, such as neuroimaging, neuroingeneering and modeling approaches, and their application in research and clinical settings.

The round table will focus on discussing the better organisation, management and access of the knowledge in the field of neurosciences. Short and long term needs and recommendations will be highlighted.

www.inbiomedvision.eu/workshop-6-july-2012.html

Marielle photographed after her capture and detainment in the Care Bears' secret neuroimaging laboratory.

Marielle is an amnesiac and believed to be from France.

Once upon a time, Marielle went for a walk in a far-off wood. She walked and walked and walked until she wandered quite by accident into the Care-Bear kingdom of Care-a-lot. The poor little bears were terrified at the sight of Marielle, as they had never seen anything like her. As she made her way through the wooded kingdom, they ran off in all directions, looking for the nearest place to hide. Eventually, a small group of the bravest Care Bears captured Marielle in a net. They tied her to a stretcher and carried her to the Care Bears' secret neuroimaging laboratory. They submitted Marielle to all sorts of tests. They even X-rayed her in the belief that it would reveal intimate details about her 'inner' self. However, after examining the X-ray images, they were still none the wiser.

A bright and sunny day! The Canadian Museum of Civilization in Hull is a beautiful architectural marvel incorporated with many curved forms. The modern design's fluid forms and flexibility appears to be in total harmony with the natural world, nearly blending in with the surroundings. Indeed, Oscar Niemeyer described his fondness for curved lines described as seductive and flowing, drawing people in. Scientifically speaking, the love of curves is "innate" and stems from a primal drive. According to recent neuroaesthetics studies, people are more likely to find a room attractive when it is filled with curves than when it is filled with straight lines. Another significant neuroimaging study discovered that the amygdala, sometimes known as the "alarm system of the mind" or the region of the brain that processes fear, is activated when we perceive objects with straight or pointed lines. It appears that while curves elicit a calming sense of comfort, straight lines are seen as menacing symbols of inflexible, geometric rationalism. Maybe it is apt that the museum is on the Latin side of the river while the rigid and upright Parliament Hill building is on the other side!

i think i am the thought police.

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders—which include various affective, behavioural, cognitive and perceptual disorders. The term was first coined by the German physician Johann Christian Reil in 1808.

Psychiatric assessment typically starts with a mental status examination and the compilation of a case history. Psychological tests and physical examinations may be conducted, including on occasion the use of neuroimaging or other neurophysiological techniques. Mental disorders are diagnosed in accordance with criteria listed in diagnostic manuals such as the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, and the International Classification of Diseases (ICD) edited and used by the World Health Organization.

Psychiatric treatment applies a variety of modalities, including medication, psychotherapy and a wide range of other techniques such as transcranial magnetic stimulation. Treatment may be as an inpatient or outpatient, according to severity of function impairment/the disorder in question. Research and treatment within psychiatry as a whole are conducted on an interdisciplinary basis, sourcing an array of sub-specialties and theoretical approaches.

Persistent vegetative state

SpecialtyNeurology

A persistent vegetative state (PVS) is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state (VS), the patient is classified as in a persistent vegetative state. This diagnosis is classified as a permanent vegetative state some months (three in the US and six in the UK) after a non-traumatic brain injury or one year after a traumatic injury. Today, doctors and neuroscientists prefer to call the state of consciousness a syndrome,[1] primarily because of ethical questions about whether a patient can be called "vegetative" or not.[2]

Contents

1Definition

1.1Medical definition

1.2Lack of legal clarity

1.3Vegetative state

1.4Persistent vegetative state

2Signs and symptoms

2.1Recovery

3Causes

4Diagnosis

4.1Diagnostic experiments

4.2Misdiagnoses

5Treatment

5.1Zolpidem

6Epidemiology

7History

8Society and culture

8.1Ethics and policy

8.2Notable cases

9See also

10References

11External links

Definition[edit]

There are several definitions that vary by technical versus layman's usage. There are different legal implications in different countries.

Medical definition[edit]

A wakeful unconscious state that lasts longer than a few weeks is referred to as a persistent (or 'continuing') vegetative state.[3]

Lack of legal clarity[edit]

Unlike brain death, permanent vegetative state (PVS) is recognized by statute law as death in very few legal systems. In the US, courts have required petitions before termination of life support that demonstrate that any recovery of cognitive functions above a vegetative state is assessed as impossible by authoritative medical opinion.[4] In England and Wales the legal precedent for withdrawal of clinically assisted nutrition and hydration in cases of patients in a PVS was set in 1993 in the case of Tony Bland, who sustained catastrophic anoxic brain injury in the 1989 Hillsborough disaster.[3] An application to the Court of Protection is no longer required before nutrition and hydration can be withdrawn or withheld from PVS (or 'minimally conscious' – MCS) patients.[5]

This legal grey area has led to vocal advocates that those in PVS should be allowed to die. Others are equally determined that, if recovery is at all possible, care should continue. The existence of a small number of diagnosed PVS cases that have eventually resulted in improvement makes defining recovery as "impossible" particularly difficult in a legal sense.[6] This legal and ethical issue raises questions about autonomy, quality of life, appropriate use of resources, the wishes of family members, and professional responsibilities.

Vegetative state[edit]

The vegetative state is a chronic or long-term condition. This condition differs from a coma: a coma is a state that lacks both awareness and wakefulness. Patients in a vegetative state may have awoken from a coma, but still have not regained awareness. In the vegetative state patients can open their eyelids occasionally and demonstrate sleep-wake cycles, but completely lack cognitive function. The vegetative state is also called a "coma vigil". The chances of regaining awareness diminish considerably as the time spent in the vegetative state increases.[7]

Persistent vegetative state[edit]

Persistent vegetative state is the standard usage (except in the UK) for a medical diagnosis, made after numerous neurological and other tests, that due to extensive and irreversible brain damage a patient is highly unlikely ever to achieve higher functions above a vegetative state. This diagnosis does not mean that a doctor has diagnosed improvement as impossible, but does open the possibility, in the US, for a judicial request to end life support.[6] Informal guidelines hold that this diagnosis can be made after four weeks in a vegetative state. US caselaw has shown that successful petitions for termination have been made after a diagnosis of a persistent vegetative state, although in some cases, such as that of Terri Schiavo, such rulings have generated widespread controversy.

In the UK, the term is discouraged in favor of two more precisely defined terms that have been strongly recommended by the Royal College of Physicians (RCP). These guidelines recommend using a continuous vegetative state for patients in a vegetative state for more than four weeks. A medical determination of a permanent vegetative state can be made if, after exhaustive testing and a customary 12 months of observation,[8] a medical diagnosis is made that it is impossible by any informed medical expectations that the mental condition will ever improve.[9] Hence, a "continuous vegetative state" in the UK may remain the diagnosis in cases that would be called "persistent" in the US or elsewhere.

While the actual testing criteria for a diagnosis of "permanent" in the UK are quite similar to the criteria for a diagnosis of "persistent" in the US, the semantic difference imparts in the UK a legal presumption that is commonly used in court applications for ending life support.[8] The UK diagnosis is generally only made after 12 months of observing a static vegetative state. A diagnosis of a persistent vegetative state in the US usually still requires a petitioner to prove in court that recovery is impossible by informed medical opinion, while in the UK the "permanent" diagnosis already gives the petitioner this presumption and may make the legal process less time-consuming.[6]

In common usage, the "permanent" and "persistent" definitions are sometimes conflated and used interchangeably. However, the acronym "PVS" is intended[by whom?] to define a "persistent vegetative state", without necessarily the connotations of permanence,[citation needed] and is used as such throughout this article. Bryan Jennett, who originally coined the term "persistent vegetative state", has now recommended using the UK division between continuous and permanent in his book The Vegetative State, arguing that "the 'persistent' component of this term ... may seem to suggest irreversibility".[10]

The Australian National Health and Medical Research Council has suggested "post coma unresponsiveness" as an alternative term for "vegetative state" in general.[11]

Signs and symptoms[edit]

Most PVS patients are unresponsive to external stimuli and their conditions are associated with different levels of consciousness. Some level of consciousness means a person can still respond, in varying degrees, to stimulation. A person in a coma, however, cannot. In addition, PVS patients often open their eyes in response to feeding, which has to be done by others; they are capable of swallowing, whereas patients in a coma subsist with their eyes closed (Emmett, 1989).

Cerebral cortical function (e.g. communication, thinking, purposeful movement, etc) is lost while brainstem functions (e.g. breathing, maintaining circulation and hemodynamic stability, etc) are preserved. Non-cognitive upper brainstem functions such as eye-opening, occasional vocalizations (e.g. crying, laughing), maintaining normal sleep patterns, and spontaneous non-purposeful movements often remain intact.

PVS patients' eyes might be in a relatively fixed position, or track moving objects, or move in a disconjugate (i.e., completely unsynchronized) manner. They may experience sleep-wake cycles, or be in a state of chronic wakefulness. They may exhibit some behaviors that can be construed as arising from partial consciousness, such as grinding their teeth, swallowing, smiling, shedding tears, grunting, moaning, or screaming without any apparent external stimulus.

Individuals in PVS are seldom on any life-sustaining equipment other than a feeding tube because the brainstem, the center of vegetative functions (such as heart rate and rhythm, respiration, and gastrointestinal activity) is relatively intact (Emmett, 1989).

Recovery[edit]

Many people emerge spontaneously from a vegetative state within a few weeks.[10] The chances of recovery depend on the extent of injury to the brain and the patient's age – younger patients having a better chance of recovery than older patients. A 1994 report found that of those who were in a vegetative state a month after a trauma, 54% had regained consciousness by a year after the trauma, whereas 28% had died and 18% were still in the vegetative state. But for non-traumatic injuries such as strokes, only 14% had recovered consciousness at one year, 47% had died, and 39% were still vegetative. Patients who were vegetative six months after the initial event were much less likely to have recovered consciousness a year after the event than in the case of those who were simply reported vegetative at one month.[12] A New Scientist article from 2000 gives a pair of graphs[13] showing changes of patient status during the first 12 months after head injury and after incidents depriving the brain of oxygen.[14] After a year, the chances that a PVS patient will regain consciousness are very low[15] and most patients who do recover consciousness experience significant disability. The longer a patient is in a PVS, the more severe the resulting disabilities are likely to be. Rehabilitation can contribute to recovery, but many patients never progress to the point of being able to take care of themselves.

There are two dimensions of recovery from a persistent vegetative state: recovery of consciousness and recovery of function. Recovery of consciousness can be verified by reliable evidence of awareness of self and the environment, consistent voluntary behavioral responses to visual and auditory stimuli, and interaction with others. Recovery of function is characterized by communication, the ability to learn and to perform adaptive tasks, mobility, self-care, and participation in recreational or vocational activities. Recovery of consciousness may occur without functional recovery, but functional recovery cannot occur without recovery of consciousness (Ashwal, 1994).

Causes[edit]

There are three main causes of PVS (persistent vegetative state):

Acute traumatic brain injury

Non-traumatic: neurodegenerative disorder or metabolic disorder of the brain

Severe congenital abnormality of the central nervous system

Medical books (such as Lippincott, Williams, and Wilkins. (2007). In A Page: Pediatric Signs and Symptoms) describe several potential causes of PVS, which are as follows:

Bacterial, viral, or fungal infection, including meningitis

Increased intracranial pressure, such as a tumor or abscess

Vascular pressure which causes intracranial hemorrhaging or stroke

Hypoxic ischemic injury (hypotension, cardiac arrest, arrhythmia, near-drowning)

Toxins such as uremia, ethanol, atropine, opiates, lead, colloidal silver[16]

Trauma: Concussion, contusion

Seizure, both nonconvulsive status epilepticus and postconvulsive state (postictal state)

Electrolyte imbalance, which involves hyponatremia, hypernatremia, hypomagnesemia, hypoglycemia, hyperglycemia, hypercalcemia, and hypocalcemia

Postinfectious: Acute disseminated encephalomyelitis (ADEM)

Endocrine disorders such as adrenal insufficiency and thyroid disorders

Degenerative and metabolic diseases including urea cycle disorders, Reye syndrome, and mitochondrial disease

Systemic infection and sepsis

Hepatic encephalopathy

In addition, these authors claim that doctors sometimes use the mnemonic device AEIOU-TIPS to recall portions of the differential diagnosis: Alcohol ingestion and acidosis, Epilepsy and encephalopathy, Infection, Opiates, Uremia, Trauma, Insulin overdose or inflammatory disorders, Poisoning and psychogenic causes, and Shock.

Diagnosis[edit]

Despite converging agreement about the definition of persistent vegetative state, recent reports have raised concerns about the accuracy of diagnosis in some patients, and the extent to which, in a selection of cases, residual cognitive functions may remain undetected and patients are diagnosed as being in a persistent vegetative state. Objective assessment of residual cognitive function can be extremely difficult as motor responses may be minimal, inconsistent, and difficult to document in many patients, or may be undetectable in others because no cognitive output is possible (Owen et al., 2002). In recent years, a number of studies have demonstrated an important role for functional neuroimaging in the identification of residual cognitive function in persistent vegetative state; this technology is providing new insights into cerebral activity in patients with severe brain damage. Such studies, when successful, may be particularly useful where there is concern about the accuracy of the diagnosis and the possibility that residual cognitive function has remained undetected.

Diagnostic experiments[edit]

Researchers have begun to use functional neuroimaging studies to study implicit cognitive processing in patients with a clinical diagnosis of persistent vegetative state. Activations in response to sensory stimuli with positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electrophysiological methods can provide information on the presence, degree, and location of any residual brain function. However, use of these techniques in people with severe brain damage is methodologically, clinically, and theoretically complex and needs careful quantitative analysis and interpretation.

For example, PET studies have shown the identification of residual cognitive function in persistent vegetative state. That is, an external stimulation, such as a painful stimulus, still activates "primary" sensory cortices in these patients but these areas are functionally disconnected from "higher order" associative areas needed for awareness. These results show that parts of the cortex are indeed still functioning in "vegetative" patients (Matsuda et al., 2003).

In addition, other PET studies have revealed preserved and consistent responses in predicted regions of auditory cortex in response to intelligible speech stimuli. Moreover, a preliminary fMRI examination revealed partially intact responses to semantically ambiguous stimuli, which are known to tap higher aspects of speech comprehension (Boly, 2004).

Furthermore, several studies have used PET to assess the central processing of noxious somatosensory stimuli in patients in PVS. Noxious somatosensory stimulation activated midbrain, contralateral thalamus, and primary somatosensory cortex in each and every PVS patient, even in the absence of detectable cortical evoked potentials. In conclusion, somatosensory stimulation of PVS patients, at intensities that elicited pain in controls, resulted in increased neuronal activity in primary somatosensory cortex, even if resting brain metabolism was severely impaired. However, this activation of primary cortex seems to be isolated and dissociated from higher-order associative cortices (Laureys et al., 2002).

Also, there is evidence of partially functional cerebral regions in catastrophically injured brains. To study five patients in PVS with different behavioral features, researchers employed PET, MRI and magnetoencephalographic (MEG) responses to sensory stimulation. In three of the five patients, co-registered PET/MRI correlate areas of relatively preserved brain metabolism with isolated fragments of behavior. Two patients had suffered anoxic injuries and demonstrated marked decreases in overall cerebral metabolism to 30–40% of normal. Two other patients with non-anoxic, multifocal brain injuries demonstrated several isolated brain regions with higher metabolic rates, that ranged up to 50–80% of normal. Nevertheless, their global metabolic rates remained <50% of normal. MEG recordings from three PVS patients provide clear evidence for the absence, abnormality or reduction of evoked responses. Despite major abnormalities, however, these data also provide evidence for localized residual activity at the cortical level. Each patient partially preserved restricted sensory representations, as evidenced by slow evoked magnetic fields and gamma band activity. In two patients, these activations correlate with isolated behavioral patterns and metabolic activity. Remaining active regions identified in the three PVS patients with behavioral fragments appear to consist of segregated corticothalamic networks that retain connectivity and partial functional integrity. A single patient who suffered severe injury to the tegmental mesencephalon and paramedian thalamus showed widely preserved cortical metabolism, and a global average metabolic rate of 65% of normal. The relatively high preservation of cortical metabolism in this patient defines the first functional correlate of clinical–pathological reports associating permanent unconsciousness with structural damage to these regions. The specific patterns of preserved metabolic activity identified in these patients reflect novel evidence of the modular nature of individual functional networks that underlie conscious brain function. The variations in cerebral metabolism in chronic PVS patients indicate that some cerebral regions can retain partial function in catastrophically injured brains (Schiff et al., 2002).

Misdiagnoses[edit]

Statistical PVS misdiagnosis is common. An example study with 40 patients in the United Kingdom reported 43% of their patients classified as PVS were believed so and another 33% had recovered whilst the study was underway.[17] Some PVS cases may actually be a misdiagnosis of patients being in an undiagnosed minimally conscious state.[18] Since the exact diagnostic criteria of the minimally conscious state were only formulated in 2002, there may be chronic patients diagnosed as PVS before the secondary notion of the minimally conscious state became known.

Whether or not there is any conscious awareness with a patient's vegetative state is a prominent issue. Three completely different aspects of this should be distinguished. First, some patients can be conscious simply because they are misdiagnosed (see above). In fact, they are not in vegetative states. Second, sometimes a patient was correctly diagnosed but is then examined during the early stages of recovery. Third, perhaps some day the notion itself of vegetative states will change so to include elements of conscious awareness. Inability to disentangle these three example cases causes confusion. An example of such confusion is the response to a recent experiment using functional magnetic resonance imaging which revealed that a woman diagnosed with PVS was able to activate predictable portions of her brain in response to the tester's requests that she imagine herself playing tennis or moving from room to room in her house. The brain activity in response to these instructions was indistinguishable from those of healthy patients.[19][20][21]

In 2010, Martin Monti and fellow researchers, working at the MRC Cognition and Brain Sciences Unit at the University of Cambridge, reported in an article in the New England Journal of Medicine[22] that some patients in persistent vegetative states responded to verbal instructions by displaying different patterns of brain activity on fMRI scans. Five out of a total of 54 diagnosed patients were apparently able to respond when instructed to think about one of two different physical activities. One of these five was also able to "answer" yes or no questions, again by imagining one of these two activities.[23] It is unclear, however, whether the fact that portions of the patients' brains light up on fMRI could help these patients assume their own medical decision making.[23]

In November 2011, a publication in The Lancet presented bedside EEG apparatus and indicated that its signal could be used to detect awareness in three of 16 patients diagnosed in the vegetative state.[24]

Treatment[edit]

Currently no treatment for vegetative state exists that would satisfy the efficacy criteria of evidence-based medicine. Several methods have been proposed which can roughly be subdivided into four categories: pharmacological methods, surgery, physical therapy, and various stimulation techniques. Pharmacological therapy mainly uses activating substances such as tricyclic antidepressants or methylphenidate. Mixed results have been reported using dopaminergic drugs such as amantadine and bromocriptine and stimulants such as dextroamphetamine.[25] Surgical methods such as deep brain stimulation are used less frequently due to the invasiveness of the procedures. Stimulation techniques include sensory stimulation, sensory regulation, music and musicokinetic therapy, social-tactile interaction, and cortical stimulation.[26]

Zolpidem[edit]

There is limited evidence that the hypnotic drug zolpidem has an effect.[27] The results of the few scientific studies that have been published so far on the effectiveness of zolpidem have been contradictory.[28][29]

Epidemiology[edit]

In the United States, it is estimated that there may be between 15,000 and 40,000 patients who are in a persistent vegetative state, but due to poor nursing home records exact figures are hard to determine.[30]

History[edit]

The syndrome was first described in 1940 by Ernst Kretschmer who called it apallic syndrome.[31] The term persistent vegetative state was coined in 1972 by Scottish spinal surgeon Bryan Jennett and American neurologist Fred Plum to describe a syndrome that seemed to have been made possible by medicine's increased capacities to keep patients' bodies alive.[10][32]

Society and culture[edit]

Ethics and policy[edit]

An ongoing debate exists as to how much care, if any, patients in a persistent vegetative state should receive in health systems plagued by limited resources. In a case before the New Jersey Superior Court, Betancourt v. Trinitas Hospital, a community hospital sought a ruling that dialysis and CPR for such a patient constitutes futile care. An American bioethicist, Jacob M. Appel, argued that any money spent treating PVS patients would be better spent on other patients with a higher likelihood of recovery.[33] The patient died naturally prior to a decision in the case, resulting in the court finding the issue moot.

In 2010, British and Belgian researchers reported in an article in the New England Journal of Medicine that some patients in persistent vegetative states actually had enough consciousness to "answer" yes or no questions on fMRI scans.[34] However, it is unclear whether the fact that portions of the patients' brains light up on fMRI will help these patient assume their own medical decision making.[34] Professor Geraint Rees, Director of the Institute of Cognitive Neuroscience at University College London, responded to the study by observing that, "As a clinician, it would be important to satisfy oneself that the individual that you are communicating with is competent to make those decisions. At the moment it is premature to conclude that the individual able to answer 5 out of 6 yes/no questions is fully conscious like you or I."[34] In contrast, Jacob M. Appel of the Mount Sinai Hospital told the Telegraph that this development could be a welcome step toward clarifying the wishes of such patients. Appel stated: "I see no reason why, if we are truly convinced such patients are communicating, society should not honour their wishes. In fact, as a physician, I think a compelling case can be made that doctors have an ethical obligation to assist such patients by removing treatment. I suspect that, if such individuals are indeed trapped in their bodies, they may be living in great torment and will request to have their care terminated or even active euthanasia."[34]

Notable cases[edit]

Tony Bland – first patient in English legal history to be allowed to die

Paul Brophy – first American to die after court-authorization

Sunny von Bülow – lived almost 28 years in a persistent vegetative state until her death

Gustavo Cerati – Argentine singer-songwriter, composer and producer who died after four years in a coma

Prichard Colón – Puerto Rican former professional boxer and gold medal winner who spent years in a vegetative state after a bout

Nancy Cruzan – American woman involved in a landmark United States Supreme Court case

Gary Dockery – American police officer who entered, emerged and later reentered a persistent vegetative state

Eluana Englaro – Italian woman from Lecco whose life was ended after a legal case after spending 17 years in a vegetative state

Elaine Esposito – American child who was a previous record holder for having spent 37 years in a coma

Lia Lee – Hmong child who spent 26 years in a vegetative state and was the subject of a 1997 book by Anne Fadiman

Haleigh Poutre

Karen Ann Quinlan

Terri Schiavo

Aruna Shanbaug – Indian woman in persistent vegetative state for 42 years until her death. Due to her case, the Supreme Court of India allowed passive euthanasia in the country.

Ariel Sharon

Chayito Valdez

Vice Vukov

Helga Wanglie

Otto Warmbier

See also[edit]

Anencephaly

Brain death

Botulism

Catatonia

Karolina Olsson

Locked-in syndrome

Process Oriented Coma Work, for an approach to working with residual consciousness in patients in comatose and persistent vegetative states

References[edit]

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^ Appel on Betancourt v. Trinitas

^ Jump up to: a b c d Richard Alleyne and Martin Beckford, Patients in 'vegetative' state can think and communicate, Telegraph (United Kingdom), Feb 4, 2010

This article contains text from the NINDS public domain pages on TBI. [1] and [2].

External links[edit]

Sarà, M.; Sacco, S.; Cipolla, F.; Onorati, P.; Scoppetta, C; Albertini, G; Carolei, A (2007). "An unexpected recovery from permanent vegetative state". Brain Injury. 21 (1): 101–103. doi:10.1080/02699050601151761. PMID 17364525.

Canavero S, et al. (2009). "Recovery of consciousness following bifocal extradural cortical stimulation in a permanently vegetative patient". Journal of Neurology. 256 (5): 834–6. doi:10.1007/s00415-009-5019-4. PMID 19252808.

Canavero S (editor) (2009). Textbook of therapeutic cortical stimulation. New York: Nova Science. ISBN 9781606925379.

Canavero S, Massa-Micon B, Cauda F, Montanaro E (May 2009). "Bifocal extradural cortical stimulation-induced recovery of consciousness in the permanent post-traumatic vegetative state". J Neurol. 256 (5): 834–6. doi:10.1007/s00415-009-5019-4. PMID 19252808.

Connolly, Kate. "Car crash victim trapped in a coma for 23 years was conscious", The Guardian, November 23, 2009.

Machado, Calixto, et al. "A Cuban Perspective on Management of Persistent Vegetative State". MEDICC Review 2012;14(1):44–48.

en.wikipedia.org/wiki/Persistent_vegetative_state

Power can significantly change a person's personality. Maybe even transform it. To fight hubris syndrome, we must begin by fighting our tendency to admire power.Power has always inspired writers. Hubris syndrome "- when power drives an individual mad - would also have transfigured a large number of historical personalities.

Hubris (/ˈhjuːbrɪs/, also hybris, from ancient Greek ὕβρις) describes a personality quality of extreme or foolish pride or dangerous overconfidence.[1] In its ancient Greek context, it typically describes behavior that defies the norms of behavior or challenges the gods, and which in turn brings about the downfall, or nemesis, of the perpetrator of hubris.

The adjectival form of the noun hubris is "hubristic". Hubris is usually perceived as a characteristic of an individual rather than a group, although the group the offender belongs to may suffer collateral consequences from the wrongful act. Hubris often indicates a loss of contact with reality and an overestimation of one's own competence, accomplishments or capabilities. Contrary to common expectations,[by whom?] hubris is not necessarily associated with high self-esteem but with highly fluctuating or variable self-esteem, and a gap between inflated self perception and a more modest reality. In ancient Greek, hubris referred to actions that shamed and humiliated the victim for the pleasure or gratification of the abuser. The term had a strong sexual connotation, and the shame reflected upon the perpetrator as well. Violations of the law against hubris included what might today be termed assault and battery; sexual crimes; or the theft of public or sacred property. Two well-known cases are found in the speeches of Demosthenes, a prominent statesman and orator in ancient Greece. These two examples occurred when first Midias punched Demosthenes in the face in the theatre (Against Midias), and second when (in Against Conon) a defendant allegedly assaulted a man and crowed over the victim. Yet another example of hubris appears in Aeschines' Against Timarchus, where the defendant, Timarchus, is accused of breaking the law of hubris by submitting himself to prostitution and anal intercourse. Aeschines brought this suit against Timarchus to bar him from the rights of political office and his case succeeded. In ancient Athens, hubris was defined as the use of violence to shame the victim (this sense of hubris could also characterize rape. Aristotle defined hubris as shaming the victim, not because of anything that happened to the committer or might happen to the committer, but merely for that committer's own gratification: to cause shame to the victim, not in order that anything may happen to you, nor because anything has happened to you, but merely for your own gratification. Hubris is not the requital of past injuries; this is revenge. As for the pleasure in hubris, its cause is this: naive men think that by ill-treating others they make their own superiority the greater. Crucial to this definition are the ancient Greek concepts of honour (τιμή, timē) and shame (αἰδώς, aidōs). The concept of honour included not only the exaltation of the one receiving honour, but also the shaming of the one overcome by the act of hubris. This concept of honour is akin to a zero-sum game. Rush Rehm simplifies this definition of hubris to the contemporary concept of "insolence, contempt, and excessive violence".In Greek mythology, when a figure's hubris offends the pagan gods of ancient Greece, it is usually punished; examples of such hubristic, sinful humans include Icarus, Phaethon, Arachne, Salmoneus, Niobe, Cassiopeia, and Tereus. The concept of hubris is not only derived from Greek philosophy - as it is found in Plato and Aristotle - but also from the theatre, where it allows us to tell the story of great epics, where success goes up to the head of the hero, who claims to rise to the rank of gods; it is then ruthlessly put in its place by Nemesis, the goddess of vengeance. The Greek hybris refers to the excesses and their disastrous consequences.

In its modern usage, hubris denotes overconfident pride combined with arrogance.[10] Hubris is often associated with a lack of humility. Sometimes a person's hubris is also associated with ignorance. The accusation of hubris often implies that suffering or punishment will follow, similar to the occasional pairing of hubris and nemesis in Greek mythology. The proverb "pride goeth (goes) before destruction, a haughty spirit before a fall" (from the biblical Book of Proverbs, 16:18) is thought to sum up the modern use of hubris. Hubris is also referred to as "pride that blinds" because it often causes a committer of hubris to act in foolish ways that belie common sense.[11] In other words, the modern definition may be thought of as, "that pride that goes just before the fall."

Examples of hubris are often found in literature, most famously in John Milton's Paradise Lost, in which Lucifer attempts to compel the other angels to worship him, is cast into hell by God and the innocent angels, and proclaims: "Better to reign in hell than serve in heaven." Victor in Mary Shelley's Frankenstein manifests hubris in his attempt to become a great scientist by creating life through technological means, but comes to regret his project. Marlowe's play Doctor Faustus portrays the eponymous character as a scholar whose arrogance and pride compel him to sign a deal with the Devil, and retain his haughtiness until his death and damnation, despite the fact that he could easily have repented had he chosen to do so.

en.wikipedia.org/wiki/Hubris

Charisma, charm, the ability to inspire, persuasiveness, breadth of vision, willingness to take risks, grandiose aspirations and bold self-confidence—these qualities are often associated with successful leadership. Yet there is another side to this profile, for these very same qualities can be marked by impetuosity, a refusal to listen to or take advice and a particular form of incompetence when impulsivity, recklessness and frequent inattention to detail predominate. This can result in disastrous leadership and cause damage on a large scale. The attendant loss of capacity to make rational decisions is perceived by the general public to be more than ‘just making a mistake’. While they may use discarded medical or colloquial terms, such as ‘madness’ or ‘he's lost it’, to describe such behaviour, they instinctively sense a change of behaviour although their words do not adequately capture its essence. A common thread tying these elements together is hubris, or exaggerated pride, overwhelming self-confidence and contempt for others (Owen, 2006). How may we usefully think about a leader who hubristically abuses power, damaging the lives of others? Some see it as nothing more than the extreme manifestation of normal behaviour along a spectrum of narcissism. Others simply dismiss hubris as an occupational hazard of powerful leaders, politicians or leaders in business, the military and academia; an unattractive but understandable aspect of those who crave power. But the matter can be formulated differently so that it becomes appropriate to think of hubris in medical terms. It then becomes necessary first to rule out conditions such as bipolar (manic-depressive) disorder, in which grandiosity may be a prominent feature. From the medical perspective, a number of questions other than the practicalities of treatment can be raised. For example can physicians and psychiatrists help in identifying features of hubris and contribute to designing legislation, codes of practice and democratic processes to constrain some of its features? Can neuroscientists go further and discover through brain imaging and other techniques more about the presentations of abnormal personality? (Goodman et al., 2007).

We see the relevance of hubris by virtue of it being a trait or a propensity towards certain attitudes and behaviours. A certain level of hubris can indicate a shift in the behavioural pattern of a leader who then becomes no longer fully functional in terms of the powerful office held. First, several characteristics of hubris are easily thought of as adaptive behaviours either in a modified context or when present with slightly less intensity. The most illustrative such example is impulsivity, which can be adaptive in certain contexts. More detailed study of powerful leaders is needed to see whether it is mere impulsivity that leads to haphazard decision making, or whether some become impulsive because they inhabit a more emotional grandiose and isolated culture of decision making.

We believe that extreme hubristic behaviour is a syndrome, constituting a cluster of features (‘symptoms’) evoked by a specific trigger (power), and usually remitting when power fades. ‘Hubris syndrome’ is seen as an acquired condition, and therefore different from most personality disorders which are traditionally seen as persistent throughout adulthood. The key concept is that hubris syndrome is a disorder of the possession of power, particularly power which has been associated with overwhelming success, held for a period of years and with minimal constraint on the leader.

The ability to make swift decisions, sometimes based on little evidence, is of particular importance—arguably necessary—in a leader. Similarly, a thin-skinned person will not be able to stand the process of public scrutiny, attacks by opponents and back-stabbings from within, without some form of self-exultation and grand belief about their own mission and importance. Powerful leaders are a highly selected sample and many criteria of any syndrome based on hubris are those behaviours by which they are probably selected—they make up the pores of the filter through which such individuals must pass to achieve high office.

Hubris is associated in Greek mythology with Nemesis. The syndrome, however, develops irrespective of whether the individual's leadership is judged a success or failure; and it is not dependent on bad outcomes. For the purpose of clarity, given that these are retrospective judgements, we have determined that the syndrome is best confined to those who have no history of a major depressive illness that could conceivably be a manifestation of bipolar disorder.

Hubris is acquired, therefore, over a period. The full blown hubris, associated with holding considerable power in high office, may or may not be transient. There is a moving scale of hubris and no absolute cut-off in definition or the distinction from fully functional leadership. External events can influence the variation both in intensity and time of onset.

Dictators are particularly prone to hubris because there are few, if any, constraints on their behaviour. Here, this complex area is not covered but one of us has considered the matter elsewhere (Owen, 2008). Hitler's biographer, Ian Kershaw (1998, 2000), entitled his first volume 1889–1936 Hubris and the second 1936–1945 Nemesis. Stalin's hubris was not as marked or as progressive as Hitler's. As for Mussolini and Mao both had hubris but probably each also had bipolar disorder. Khrushchev was diagnosed as having hypomania and there is some evidence that Saddam Hussein had bipolar disease (Owen, 2008).

Being elected to high office for a democratic leader is a significant event. Subsequent election victories appear to increase the likelihood of hubristic behaviour becoming hubris syndrome. Facing a crisis situation such as a looming or actual war or facing potential financial disaster may further increase hubris. But only the more developed cases of hubris deserve classification as a syndrome exposed as an occupational hazard in those made vulnerable by circumstance.

Hubris syndrome and its characteristics

Unlike most personality disorders, which appear by early adulthood, we view hubris syndrome as developing only after power has been held for a period of time, and therefore manifesting at any age. In this regard, it follows a tradition which acknowledges the existence of pathological personality change, such as the four types in ICD-10: enduring personality change after trauma, psychiatric illness, chronic pain or unspecified type (ICD-10, 1994)—although ICD-10 implies that these four diagnoses are unlikely to improve.

Initially 14 symptoms constituting the hubristic syndrome were proposed (Owen, 2006). Now, we have shortened and tabulated these descriptions and mapped their broad affinities with the DSM IV criteria for narcissistic personality disorder, antisocial personality disorder and histrionic personality disorder. These three personality disorders also appear in ICD-10, although narcissistic personality disorder is presented in an appendix as a provisional condition, whose clinical or scientific status is regarded as uncertain. ICD-10 considers narcissistic personality disorder to be sufficiently important to warrant more study, but that it is not yet ready for international acceptance. In practice, the correlations are less precise than the table suggests and the syndrome better described by the broader patterns and descriptions that the individual criteria encapsulate.

Establishing the diagnostic features of hubris syndrome

The nosology of psychiatric illness depends on traditional criteria for placing diagnoses in a biomedical framework (Robins and Guze, 1970). There are, however, other underpinnings—psychological or sociological—that can be applied. Validity for a psychiatric illness involves assessing five phases: (i) clinical description; (ii) laboratory studies; (iii) defining boundaries vis-a-vis other disorders; (iv) follow-up study; and (v) family study. While these phases are worth analysing, it has to be recognized that there are severe limitations in rigidly applying such criteria to hubris syndrome given that so few people exercise real power in any society and the frequency amongst those ‘at-risk’ is low. The potential importance of the syndrome derives, however, from the extensive damage that can be done by the small number of people who are affected. As an investigative strategy, it may be that studies such as neuroimaging, family studies, or careful personality assessments in more accessible subjects with hubristic qualities or narcissistic personality disorder from other vulnerable groups might inform the validation process.

Proposed clinical features

Hubris syndrome was formulated as a pattern of behaviour in a person who: (i) sees the world as a place for self-glorification through the use of power; (ii) has a tendency to take action primarily to enhance personal image; (iii) shows disproportionate concern for image and presentation; (iv) exhibits messianic zeal and exaltation in speech; (v) conflates self with nation or organization; (vi) uses the royal ‘we’ in conversation; (vii) shows excessive self-confidence; (viii) manifestly has contempt for others; (ix) shows accountability only to a higher court (history or God); (x) displays unshakeable belief that they will be vindicated in that court; (xi) loses contact with reality; (xii) resorts to restlessness, recklessness and impulsive actions; (xiii) allows moral rectitude to obviate consideration of practicality, cost or outcome; and (xiv) displays incompetence with disregard for nuts and bolts of policy making.

In defining the clinical features of any disorder, more is required than simply listing the symptoms. In the case of hubris syndrome, a context of substantial power is necessary, as well as a certain period of time in power—although the length has not been specified, varying in the cases described from 1 to 9 years. The condition may have predisposing personality characteristics but it is acquired, that is its appearance post-dates the acquisition of power.

Establishment of the clinical features should include the demonstration of criterion reliability, exploration of a preferred threshold for the minimum number of features that must be present, and the measurement of symptoms (e.g. their presence or absence, and a severity scale). This endeavour may also include a decision as to whether the 14 criteria suggested might usefully be revised.

To determine whether hubris syndrome can be characterized biologically will be very difficult. It is the nature of leaders who have the syndrome that they are resistant to the very idea that they can be ill, for this is a sign of weakness. Rather, they tend to cover up illness and so would be most unlikely to submit voluntarily to any testing, e.g. the completion of scales measuring anxiety, neuroticism and impulsivity. Also the numbers of people with the syndrome is likely to be so small preventing the realistic application of statistical analyses. It also needs to be remembered that leaders are prone to using performance-enhancing drugs fashionable at the time. Two heads of government, Eden and Kennedy, were on amphetamines in the 1950s and 1960s. In the 21st century hubristic leaders are likely to be amongst the first to use the new category of so-called cognition enhancers. Many neuroscientists believe that such drugs properly used can be taken without harm. The problem is a leader who takes these without medical supervision and in combination with other substances or in dosages substantially above those that are recommended. In 2008, Nature carried out an informal survey of its mainly scientific readers and found that one in five of 1400 responders were taking stimulants and wake-promoting agents such as methylphenidate and modafinil, or β-blockers for non-medical reasons (Maher, 2008).

In defining the boundaries, one of the more important questions may be to understand whether hubris syndrome is essentially the same as narcissistic personality disorder (NPD), a subtype of NPD or a separate entity. As shown in Table 1, 7 of the 14 possible defining symptoms are also among the criteria for NPD in DSM-IV, and two correspond to those for antisocial personality and histrionic personality disorders (APD and HPD, respectively) (American Psychiatric Association, 2000). The five remaining symptoms are unique, in the sense they have not been classified elsewhere: (v) conflation of self with the nation or organization; (vi) use of the royal ‘we’; (x) an unshakable belief that a higher court (history or God) will provide vindication; (xii) restlessness, recklessness and impulsiveness; and (xiii) moral rectitude that overrides practicalities, cost and outcome.

academic.oup.com/brain/article/132/5/1396/354862/Hubris-s...

La Vie site cites the work of researcher Ian H. Robertson, who studied the effect of hubris on a fish species in Lake Tanganyka in Africa, on which the seizure of power triggers a hormonal reaction that changes their organism. The researcher explains that the situation is similar for humans, whose intelligence is multiplied tenfold by dopamine intake, but "too much dopamine will have harmful consequences. But absolute power floods the brain with dopamine. It also creates an addiction,"says the researcher. That is not all. Excessive self-confidence puts in place a mental mechanism that makes it impossible to assess oneself properly. The more you have a fair appreciation of your own qualities, the more modest you are. And you don't normally feel fit to become head of state,"explains Sebastian Dieguez, a neuroscience researcher at the University of Freiburg.

A collage of axial MRI scans of my own brain showing diffusion tensor information (the diffusion of water molecules in and around membranes). The colours are merely different ways to visualize the section in a program called MRIcro.

Pinhole interpretation of Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, NV, designed by architect Frank Gehry, houses clinical space, a diagnostic center, neuroimaging rooms, physician offices and laboratories devoted to clinical research.

kudaphotography.com

A flashback, or involuntary recurrent memory, is a psychological phenomenon in which an individual has a sudden, usually powerful, re-experiencing of a past experience or elements of a past experience. These experiences can be happy, sad, exciting, or any other emotion one can consider. The term is used particularly when the memory is recalled involuntarily, and/or when it is so intense that the person "relives" the experience, unable to fully recognize it as memory and not something that is happening in "real time" Flashbacks are the "personal experiences that pop into your awareness, without any conscious, premeditated attempt to search and retrieve this memory". These experiences occasionally have little to no relation to the situation at hand. Flashbacks to those suffering posttraumatic stress disorder can seriously disrupt everyday life.What is a flashback? A Viet Nam veteran with Post Traumatic Stress Disorder was driving on the New Jersey Turnpike near Newark Airport when a helicopter flew directly overhead. Suddenly, he slammed on the brakes, pulled his car to the side of the road, jumped out, and threw himself into a ditch. The unexpected sound of the helicopter had taken him back to Viet Nam and a time of being psychologically overwhelmed by incoming enemy fire. The flashback was intense. His experience was not of remembering an event, but of living the event. In an explicit flashback. the person is involuntarily transported back in time. To the person, it does not seem so. What they experience is being experienced as if it were happening in the present. An explicit flashback involves feelings and facts. Flashbacks from early childhood are different. They do not include factual information. Until about five years of age, factual - or explicit - memory is immature. But implicit memory, the memory of an emotional state, may go back to birth. When the memory of a strong emotional state is activated, the person is exposed to an involuntarily replay of what was felt at perhaps age one or two. Since facts are not replayed, the emotions seem to belong to what is going on in the present. Implicit flashbacks from early childhood can be powerful. They can overtake a person, and dominate his or her emotional state. Even so, the person may have no idea that what they are feeling is memory. How could they? If they cannot remember a past event that caused these feelings, the feelings naturally seem to belong to the present. When we have an implicit flashback, we mistakenly believe someone, or something, in the present is causing these feelings. Though something in the present triggered the feelings, the feelings do not fit the present situation. They are far more intense and far more persistent. Those two characteristics - intensity and persistence - are the clues we need to look for, clues that can tell us we are experiencing a flashback. Research at the University at Albany and the University of California Los Angeles has confirmed what therapists have long suspected, that PTSD can be caused by early childhood trauma in which emotions flashback but memory does not. In this research, very young rodents were exposed to one session of traumatic stress. Later, the animals were tested for both memory of the event and for fear response. Because the trauma took place early in their life, the rodents did not remember the environment in which the trauma took place. Yet, the rodents showed clear signs of PTSD: a persistent increase in anxiety when exposed to new situations, and drastic changes in levels of stress hormones. This research indicates that a trauma can cause a stress response even when no memory of the experience is present. It also suggests that therapists need to recognize that stress can be caused by unconscious processes - not just by thoughts. Commenting on the research, Dr. John Krystal, Editor of Biological Psychiatry, said "There may be a mismatch between what people think and how they feel." Where does early trauma come from? Violence and abuse are obvious causes. But seemingly benign practices may also cause trauma. Neurological researcher Allan Schore says the practice of putting a young child in bed, closing the door, and letting them "cry it out" is severely traumatizing. Parents, and so-called experts, have claimed that since the child will not remember this being done, it will have no impact. Schore says research shows that though a child may appear to be peacefully asleep after "crying it out," the child may not be asleep at all, but rather is in a frozen state of "dissociated terror." An article on "crying it out" can be found at this Psychology Today link. Schore writes "the infant's psychobiological response to trauma is comprised of two separate response patterns, hyperarousal and dissociation." Initially, the infant responds with increased heart rate, blood pressure and respiration. The infant's distress is expressed in crying, and then screaming. "A second later-forming, longer-lasting traumatic reaction is seen in dissociation. . . . If early trauma is experienced as 'psychic catastrophe' dissociation represents . . . 'escape where there is no escape'. Certainly no mother wants to intentionally traumatize a child. Helpful information on how to calm a crying baby and get some sleep is ovvered by Sarah Ockwell-Smith

Clients I have worked with to alleviate fear of flying expressed concern about having overwhelming, unbearable feelings on a flight and being unable to escape. They are unable to specify a time when they had such feelings. Yet, such feelings are too much of a threat for them to fly. Taking a flight is an emotional risk. They fear they may have an overwhelming experience, and unable to leave the plane, have no way to escape the experience. Whether they understand it or not, they fear they will have an implicit flashback. Since escape is seen as the answer to emotional overwhelm, escape from the original traumatic experience must have not been impossible.

What can a person do about implicit flashbacks? Three things: 1. Recognize that when an emotion is too intense and too persistent to fit the current situation, you may be experiencing the flashback of an experience from early childhood. 2. Face-to-face with an attuned and empathic therapist, put the emotions into words. Doing so links the therapist's presence to the emotions in the flashback, and neutralizes them; 3. Tell the therapist in detail what triggered the flashback; by linking the therapist's presence to the triggers, the triggers are neutralized. Memory is divided into voluntary (conscious) and involuntary (unconscious) processes that function independently of each other. Theories and research on memory dates back to Hermann Ebbinghaus, who began studying nonsense syllables.[1] Ebbinghaus classified three distinct classes of memory: sensory, short term, and long-term memory. Sensory memory is made up of a brief storage of information within a specific medium (the line you see after waving a sparkler in your field of vision is created by sensory memory). Short term memory is made up of the information currently in use to complete the task at hand. Long term memory is composed of the systems used to store memory over long periods. It enables one to remember what happened two days ago at noon, or who called last night.

Miller (1962–1974) declared that studying such fragile things as involuntary memories should not be done. This appears to have been followed since very little research has been done on flashbacks in the cognitive psychology discipline. Flashbacks have been studied within a clinical discipline however, and they have been identified as symptoms for many disorders, including post traumatic stress disorder.Flashbacks are psychological phenomena during which a person relives a past event or fragments of a past experience. They generally occur involuntarily, abruptly entering an individual’s awareness without the aid of premeditation or conscious attempts to recall the memory, and they may be intense. As flashbacks involve past events, they may have no relevance to what is happening at present.

While people often associate flashbacks solely with visual information, other senses such as smell, taste, touch, and hearing may also be actively involved in the episode. Flashbacks can elicit a wide array of emotions. Some flashbacks are so intense, it may become difficult to distinguish memory from current life events. Conversely, some flashbacks may be devoid of visual and auditory memory and may lead a person to experience feelings of panic, helplessness, numbness, or entrapment. Many individuals report the onset of flashbacks after surviving a near-death experience or another traumatic situation. Those with posttraumatic stress may experience flashbacks as a recurring symptom of the condition. Posttraumatic stress may develop after exposure to military combat, sexual abuse, physical abuse, emotional abuse, or potentially fatal events such as a car crash.

In addition to PTSD, other mental health conditions such as depression, acute stress, and obsessions and compulsions are associated with the development of flashbacks. The use of some drugs—such as lysergic acid diethylamide (LSD)—may also increase the likelihood of a flashback occurring.

Flashbacks may have a profound impact on a person’s mental health. Due to the emotionally charged and uncontrollable nature of flashbacks, affected individuals may find their ability to carry out everyday activities is diminished. Loss of function may lead to a decrease in quality of life, which in turn may be a contributing factor for mood issues such as anxiety and depression. The psychological distress caused by flashbacks may be more immediate. Feelings of helplessness, powerlessness, confusion, and disorientation may often follow a flashback. An individual may become caught up in the flashback and scream, cry, show fear, or exhibit other behaviors that might lead to shame and embarrassment after the episode. These behaviors may damage self-esteem and create tension in interpersonal relationships. While the exact causes of flashbacks have not yet been identified, neuroscience and neuroimaging investigations have revealed information about how they occur. Neural scans of individuals experiencing flashbacks show that specific brain areas, such as the mid-occipital lobe, primary motor cortex, supplementary motor area, and regions of the dorsal stream, are highly activated during the episode. Current research also suggests that factors such as stress, food deprivation, and temporal lobe seizures may play an important role in the onset of flashbacks. Some people may isolate themselves emotionally in order to survive the aftermath of a highly traumatic events. However these survivors may find that the previously isolated thoughts, emotions, and body sensations are still expressed in the present—sometimes many years after the conclusion of the crisis. At times, it may even seem as if intrusive memories and sensations come from nowhere.

By working with a qualified therapist, many people develop an increased ability to cope effectively with flashbacks. In addition to providing further education on flashbacks, a therapist can help a person in treatment gradually unearth and address the source of the trauma—ensuring that previously repressed thoughts, emotions, sensations, and actions are expressed in a safe, healthy environment.

Due to the elusive nature of involuntary recurrent memories, very little is known about the subjective experience of flashbacks. However, theorists agree that this phenomenon is in part due to the manner in which memories of specific events are initially encoded (or entered) into memory, the way in which the memory is organized, and also the way in which the individual later recalls the event. Overall, theories that attempt to explain the flashback phenomenon can be categorized into one of two viewpoints. The special mechanism view is clinically oriented in that it holds that involuntary memories are due to traumatic events, and the memories for these events can be attributed to a special memory mechanism. On the other hand, the basic mechanism view is more experimentally oriented in that it is based on memory research. This view holds that traumatic memories are bound by the same parameters as all other every-day memories. Both viewpoints agree that involuntary recurrent memories result from rare events that would not normally occur. These rare events elicit strong emotional reactions from the individual since it violates normal expectations. According to the special mechanisms view, the event would lead to fragmented voluntary encoding into memory (meaning that only certain isolated parts of the event would be encoded), thus making the conscious subsequent retrieval of the memory much more difficult. On the other hand, involuntary recurrent memories are likely to become more available, and these are more likely to be triggered by external cues. In contrast to this, the basic mechanism view holds that the traumatic event would lead to enhanced and cohesive encoding of the event in memory, and this would make both voluntary and involuntary memories more available for subsequent recall. What is currently an issue of controversy is the nature of the defining criteria that makes up an involuntary memory. Up until recently, researchers believed that involuntary memories were a result of traumatic incidents that the individual experienced at a specific time and place, but the temporal and spatial features of the event are lost during an involuntary recollection episode. In other words, people who suffer from flashbacks lose all sense of time and place, and they feel as if they are re-experiencing the event instead of just recalling a memory. This is consistent with the special mechanism viewpoint in that the involuntary (unintended) memory is based on a different memory mechanism than its voluntary (intended) counterpart. Furthermore, the initial emotions experienced at the time of encoding are also re-experienced during a flashback episode, and this can be especially distressing when the memory is of a traumatic event. It has also been demonstrated that the nature of the flashbacks experienced by an individual are static in that they retain an identical form upon each intrusion.[9] This occurs even when the individual has learned new information that directly contradicts the information retained in the intrusive memory.

Upon further investigation, it was found that involuntary memories are usually derived from either stimuli (i.e. anything that causes a change in behaviour) that indicated the onset of a traumatic event, or from stimuli that hold intense emotional significance to the individual simply because these stimuli were closely associated with the trauma in terms of timing. These stimuli then become warning signals that if encountered again, serve to trigger a flashback. This has been termed the warning signal hypothesis. For example, a man experiences a flashback upon seeing sun spots on his lawn. This happens because he associates the sun spots with the headlights of the vehicle that he collided with, causing a horrific car accident. According to Ehlers and Clark, traumatic memories are more apt to induce flashbacks simply because of faulty encoding in that the individual fails to take contextual information into account, as well as time and place information that would usually be associated with every-day memories. These individuals become more sensitized to stimuli that they associate with the traumatic event which then serve as triggers for a flashback (even though the context surrounding the stimulus may be unrelated; such as sun spots being unrelated to headlights). These triggers may have elicited an adaptive response during the time of the traumatic experience, but they soon become maladaptive if the person continues to respond in the same way in situations in which no danger may be present.

The special mechanism viewpoint would add to this further by suggesting that these triggers activate the fragmented memory of the trauma, but protective cognitive mechanisms function to inhibit the recall of the original memory of the traumatic event. Dual representation theory enhances this idea by suggesting two separate mechanisms that account for voluntary and involuntary memories; the first of which is called the verbally accessible memory system and the latter is referred to the situationally accessible memory system.

In contrast to this, theories belonging to the basic mechanism viewpoint hold that there are no separate mechanisms that account for voluntary and involuntary memories. The recall of memories for stressful events do not differ under involuntary and voluntary recall. Instead, it is the retrieval mechanism that is different for each type of recall. In involuntary recall, the external trigger creates an uncontrolled spreading of activation in memory, whereas in voluntary recall, this activation is strictly controlled and is goal-oriented.

The hippocampus is highlighted in red.

Several brain regions have been implicated in the neurological basis of flashbacks. The medial temporal lobes, the precuneus, the posterior cingulate gyrus and the prefrontal cortex are the most typically referenced with regards to involuntary memories. The medial temporal lobes are commonly associated with memory. More specifically, the lobes have been linked to episodic/declarative memory and thus damage to these areas of the brain result in disruptions to declarative memory system. The hippocampus, located within the medial temporal regions, has also been highly related to memory processes. There are numerous functions in the hippocampus; these functions also include aspects of memory consolidation.Brain imaging studies have shown flashbacks activate areas associated with memory retrieval. The precuneus, located in the superior parietal lobe and the posterior cingulate gyrus have also been implicated in memory retrieval. In addition, studies have shown activity in areas of the prefrontal cortex to be involved in memory retrieval. Thus, the medial temporal lobe, precuneus, superior parietal lobe and posterior cingulate gyrus have all been implicated in flashbacks in accordance to their roles on memory retrieval. Memory has typically been divided into sensory, short term, and long term processes.According to Rasmuseen & Berntsen, 2009, "long-term memory processes may form the core of spontaneous thought".Thus the memory process most related to flashbacks is long term memory. As well, studies by Rasmuseen & Berntsen, 2009, have shown that long term memory is also susceptible to extraneous factors such as recency effect, arousal and rehearsal as it pertains to accessibility. Compared to voluntary memories, involuntary memories show shorter retrieval times and little cognitive effort. Finally, involuntary memories arise due to automatic processing, which does not rely on higher-order cognitive monitoring, or executive control processing. Voluntary memory is normally associated with contextual information, which is what allows for correspondence between time and place, this is not true of flashbacks. According to Brewin, Lanius et, al, 2009, flashbacks, are disconnected from contextual information, and as a result are disconnected from time and place. To date, the specific causes of flashbacks have not yet been confirmed. Several studies have proposed various potential factors. Gunasekaran et al., 2009, indicate there may be a link between food deprivation and stress on the occurrence of flashbacks. Neurologists suggest temporal lobe seizures may also have some relation. On the reverse side, several ideas have been discounted in terms of their causing flashbacks. Tym et al., 2009, suggest this list includes medication or other substances, Charles Bonnet syndrome, delayed palinopsia, hallucinations, dissociative phenomena, and depersonalization syndrome. A study of the persistence of traumatic memories in World War II prisoners of war investigates through the administration of surveys the extent and severity of flashbacks that occur in prisoners of war. This study concluded that the persistence of severely traumatic autobiographical memories can last upwards of 65 years. Until recently, the study of flashbacks has been limited to participants who already experience flashbacks, such as those suffering from posttraumatic stress disorder, restricting researchers to observational/exploratory rather than experimental studies. Neuroimaging techniques have been applied to the investigation of flashbacks. Using these techniques, researchers attempt to discover the structural and functional differences in the anatomy of the brain in individuals who suffer from flashbacks compared to those who do not. Neuroimaging involves a cluster of techniques, including computerized tomography, positron emission tomography, magnetic resonance imaging (including functional), as well as magnetoencephalography. Neuroimaging studies investigating flashbacks are based on current psychological theories that are used as the foundation for the research, and one such theory that is consistently investigated is the difference between explicit and implicit memory. This distinction dictates the manner in which memories are later recalled, namely either consciously (voluntarily) or unconsciously (involuntarily). These methods have largely relied on subtractive reasoning in which the participant voluntarily recalls a memory and then the memory is again recalled, but this time through involuntary means. Involuntary memories (or flashbacks) are elicited in the participant by reading an emotionally charged script to them that is designed to trigger a flashback in individuals who suffer from post-traumatic stress disorder. The investigators record the regions of the brain that are active during each of these conditions, and then subtract the activity. Whatever is left is assumed to underpin the neurological differences between the conditions. Imaging studies looking at patients with post-traumatic stress disorder as they undergo flashback experiences have identified elevated activation in regions of the dorsal stream including the mid-occipital lobe, primary motor cortex and supplementary motor area. The dorsal stream is involved in sensory processing and therefore these activations might underlie the vivid visual experiences associated with flashbacks. The study also found reduced activation in regions such as the inferior temporal cortex and parahippocampus which are involved in processing allocentric relations. These deactivations might contribute to feelings of dissociation from reality during flashback experiences. Flashbacks are often associated with mental illness as they are a symptom and a feature in diagnostic criteria for posttraumatic stress disorder (PTSD), acute stress disorder, and obsessive-compulsive disorder (OCD). Flashbacks have also been observed in people suffering from manic depression, depression, homesickness, near-death experiences, epileptic seizures, and drug abuse.[19] Some researchers have suggested that the use of some drugs can cause a person to experience flashbacks;users of lysergic acid diethylamide sometimes report "acid flashbacks". While other studies show that the use of drugs, specifically cannabis, can help reduce the occurrence of flashbacks in people with PTSD.

The psychological phenomenon has frequently been portrayed in film and television. Some of the most accurate media portrayals of flashbacks have been those related to wartime, and the association of flashbacks to post-traumatic stress disorder caused by the traumas and stresses of war. One of the earliest screen portrayals of this is in the 1945 film Mildred Pierce. A flashback is an interjected scene that takes the narrative back in time from the current point in the story. Flashbacks are often used to recount events that happened before the story's primary sequence of events to fill in crucial backstory. In the opposite direction, a flashforward (or prolepsis) reveals events that will occur in the future. Both flashback and flashforward are used to cohere a story, develop a character, or add structure to the narrative. In literature, internal analepsis is a flashback to an earlier point in the narrative; external analepsis is a flashback to a time before the narrative started. In movies and television, several camera techniques and special effects have evolved to alert the viewer that the action shown is a flashback or flashforward; for example, the edges of the picture may be deliberately blurred, photography may be jarring or choppy, or unusual coloration or sepia tone, or monochrome when most of the story is in full color, may be used.

en.wikipedia.org/wiki/Flashback_(narrative)

en.wikipedia.org/wiki/Flashback_(psychology)

This High Angular Resolution Diffusion Image (HARDI) of the human brain shows long distance connections, or tracts, grouped on the basis of their anatomical neighborhood. Wiring associated with particular brain structures share the same color. In diffusion imaging, the scanner detects movement of water inside neural fibers to reveal their locations. This image is based on first phase HCP data from the MGH/Harvard/UCLA Connectom scanner. Researchers hope to use the same technique to analyze data from a project related to the HCP’s second phase that will examine connections in teens with mental illness.

This image is not owned by the NIH. It is shared with the public under license. If you have a question about using or reproducing this image, please contact the creator listed in the credits. All rights to the work remain with the original creator.

Credit: Viviana Siless, Ph.D. (www.nmr.mgh.harvard.edu/user/3579434), Anastasia Yendiki, Ph.D.(www.martinos.org/user/6737) MGH/Harvard,

Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA)

More information: www.nih.gov/news-events/news-releases/human-connectome-pr...

NIH funding from: National Institute of Mental Health (NIMH)

My daughter, the doctor! Sure, she's 30 something, and she is a Professor and Scientist in Neuroimaging but still a kid at heart. Just gotta play on that Jungle Gym!

depts.washington.edu/uwautism/research/index.html

Invited guest and dignitaries during the grand opening of the University of Southern California Stevens Hall for Neuroimaging and Informatics Institute at Keck Medicine of USC, November 17, 2016.(USC Photo/Gus Ruelas)

Candid street shot, Teignmouth, Devon, UK.

The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction—or has tried to help someone else to do so—understands why.

Addiction exerts a long and powerful influence on the brain that manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences.

For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain.

In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit.

The scientific consensus has changed since then. Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behavior.

Pleasure principle

The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex (see illustration). Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.

All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.

Addictive drugs provide a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine. The hippocampus lays down memories of this rapid sense of satisfaction, and the amygdala creates a conditioned response to certain stimuli.

www.nhs.uk/smokefree

For all of you who are or will know returning service members after combat or see them in criminal cases or, indeed, anyone with PTSD (including significant others who have been physically, sexually, or emotionally abused by words, acts, and or neglect), I thought you would be very interested in this article from Sunday's San Francisco Chronicle:

PTSD leaves physical footprints on the brain

Justin Berton, San Francisco Chronicle Staff Writer

Sunday, July 27, 2008

Dr. Thomas Neylan (left) and physicist Norbert Schuff are...

At a recent conference for some of the area's leading neurologists, San Francisco physicist Norbert Schuff captured his colleagues' attention when he presented colorful brain images of U.S. soldiers who had returned from Iraq and Afghanistan and were diagnosed with post-traumatic stress disorder.

The yellow areas, Schuff explained during his presentation at the city's Veterans Affairs Medical Center, showed where the hippocampus, which plays major roles in short-term memory and emotions, had atrophied. The red swatches marked hyperfusion - increased blood flow - in the prefrontal cortex, the region responsible for conflict resolution and decision-making. Compared with a soldier without the affliction, the PTSD brain had lost 5 to 10 percent of its gray matter volume, indicating yet more neuron damage.

Schuff, who was dressed in a Hawaiian shirt just as colorful as the brain images he'd brought, reminded his colleagues that while his findings were preliminary and the trials ongoing, researchers were at least inching closer to finding the biological markers that distinguish a brain affected by PTSD. As the technology of brain imaging improves and the resulting data are refined, doctors believe that one day they will be able to look at a computer screen and see PTSD as clearly as they now see a brain tumor.

"But we're still in the infancy of neuroimaging," Schuff cautioned later in his office. "Do you get PTSD because you have a small hippocampus? Or does a small hippocampus mean you'll develop PTSD? That, we still don't know."

Schuff's research is at the forefront of a bold push by the Department of Defense to address PTSD, the psychological disorder that will haunt an estimated 30 percent of the veterans returning from the current two wars, according to the Pentagon. Forty thousand veterans from Iraq and Afghanistan, Pentagon officials say, have already been diagnosed with PTSD, which is defined as an anxiety disorder triggered by exposure to traumatic events; symptoms can include nightmares, flashbacks and panic attacks.

Left untreated, clinicians say, patients with PTSD are more likely to engage in anti-social behaviors such as alcohol and drug abuse. The disorder, neurologists are now learning, can also lead to long-term maladies, such as Alzheimer's and dementia.

Manhattan Project urgency

The quest is to understand how the disorder begins inside the brain. The Defense Department has invested $78 million in San Francisco's Northern California Institute for Research and Education at the VA center in the past four years, making it the largest VA research institute in the country and the only one that specializes in neuroscience. With 200 researchers on staff, and an estimated 40 ongoing studies that rely on 60 to 80 veterans as research participants, the center has the urgency of a Manhattan Project site, this time searching for a way to end a mental health crisis.

The Department of Defense "has such a compelling need for these answers," said Dr. Thomas Neylan, an associate professor of psychiatry at UCSF and director of the post-traumatic stress disorder program at the VA center. "They want to know these answers now, which is the right approach. We want the answers now; people are still going off to the war, coming back, and a lot of them are suffering for a long time."

The search for PTSD biological markers through brain imagining is the primary concern of five research centers in the country, including teams at Harvard and Emory universities. Researchers believe that once the markers are defined, successful treatments can be developed.

Since 1995, magnetic resonance imaging, or MRI, has been used to explore the brain through mostly black-and-white images with fuzzy resolution. But in the past few years, advances in computer-imaging technology have enabled neurologists to detect the smallest changes in brain activity.

At the San Francisco VA center, thanks to the installment five years ago of a $4 million MRI machine called the 4T - T stands for Tesla, a unit of magnetic field - Schuff and his colleagues are now able to look into the brain at 1 millimeter resolution, in color and in 3-D. By contrast, Schuff said a 1.5T MRI machine could not register atrophy on PTSD brains. But the 7T MRI machine that was installed at the UCSF Mission Bay campus last year can detect microscopic neuron damage that a 4T is incapable of "seeing."

"With each stronger magnet, we get a finer view of what's going on in the brain," Neylan said.

These advances allow neurologists not only to further understand PTSD, but to study its relationship with brain trauma, one of the leading injuries incurred by soldiers in the Iraq and Afghanistan wars.

The effects of IEDs

At the VA conference, titled "The Brain at War: Neurocognitive Consequences of Combat," Col. Karl Friedl, director of the U.S. Army Telemedicine and Advanced Technology Research Center, explained why brain injuries have become more prevalent. The main cause: the improvised explosive device, or IED, a homemade device that has become the enemy's signature weapon.

While some well-armored soldiers were able to survive the IED blasts, incurring no outward signs of damage, they later complained of dizziness and "having their bell rung," symptoms consistent with the lesser-known mild traumatic brain injury (mTBI).

As many as 150,000 troops have been diagnosed with brain injuries, the Congressional Brain Injury Task Force reported last year, but it's unknown how many suffer from mTBI. Mild brain injuries are less often diagnosed because soldiers often believe getting knocked around is part of the job. But over time, with each successive mild brain injury, the effects can become more severe.

The link between mild brain trauma and PTSD is being studied at the VA center in San Francisco by Dr. Gary Abrams, whose preliminary studies show that the overlap between PTSD patients and sufferers of mild brain trauma injury "is tremendous." Abrams has yet to release definitive numbers.

During the next two years, Neylan expects the center will produce a few major findings in terms of possible treatments and advances in neuroimaging. One of the outcomes of the advanced brain imaging could be a prescreen test for soldiers to detect brains already showing PTSD tendencies. Neylan, who specializes in the role sleep plays in a healthy mind, is working on a study of police officers who are resistant to PTSD.

"We're using this opportunity to also see why some people are able to walk away from these situations and live healthy lives," he said, "and why others are not."

Recent attempts to estimate frequency

Iraq and Afghanistan: The number of post-traumatic stress disorder cases is in dispute. The Pentagon estimates 30 percent of veterans from the Afghanistan and Iraq wars will be diagnosed with PTSD. Vietnam War: In 1988, a study by the Centers for Disease Control and Prevention estimated the rate of Vietnam vets with PTSD at 14.7 percent. But the 1990 National Vietnam Readjustment Study calculated the rate at 30.9 percent. Both relied mainly on self-reporting. In 2006, a paper in the journal Science added to the debate by estimating the rate at 18.7 percent. World War II: Though there was no official PTSD diagnosis until 1980, after World War II the term "shell shock" was reported by veterans troubled by combat experiences. Researchers such as Dr. Charles Marmar at the San Francisco VA center's Northern California Institute for Research and Education estimate the number of WWII vets with PTSD is consistent with the 1-in-5 figures found in Vietnam and the Persian Gulf War. - Justin Berton

Experiments probe further into post-traumatic stress disorder

Four PTSD-related research experiments at the San Francisco Veterans Affairs Medical Center:

Nasal spray: Scott Panter is developing a battlefield-ready nasal spray for troops who suffer brain trauma. After the trauma occurs, the brain swells, causing tissue damage. Panter's nasal spray, applied within 20 minutes of a trauma, would aim to stop the swelling process. Troops could carry the spray in their packs and self-apply or administer to others.

D-cycloserine: Dr. Charles Marmar is conducting trials on PTSD patients using D-cycloserine. The drug, which was originally used as an antibiotic for tuberculosis, has also proved to help lab animals "unlearn fear responses." Given in small doses 30 minutes before a therapy session, D-cyclo is meant to help PTSD patients open up about their traumatic experiences and become more willing to engage in therapy. The hypothesis is that the group taking D-cyclo will make more and faster progress in therapy.

Blood/gene test: Dr. Lynn Pulliam is trying to establish a blood profile to diagnose PTSD. Using gene array technology, researchers will be able to take an RNA test, much like a DNA test, to determine whether a patient "tests positive" for PTSD.

Sleep experiment: Dr. Thomas Neylan is conducting a study on improving veterans' sleep habits without drugs. Neylan said PTSD patients often feel anxious about sleeping, in part because they anticipate insomnia but also because they worry about nightmares. Subjects are coached to avoid substances that interfere with their sleep. "If we get them to sleep better at night," Neylan said, "they'll have fewer nightmares and feel better during the day."

- Justin Berton

E-mail Justin Berton at jberton@sfchronicle.com.

sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/07/27/MNH611UU...

This article appeared on page A - 1 of the San Francisco Chronicle

This video was one of the winners of the 2019 “Show us Your Brain!” contest sponsored by the NIH-led Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative.

The video travels through several portions of the brain’s white matter—bundles of fiber that carry nerve signals between the brain and the body, as well as within the brain itself. Fiber colors indicate directionality: left-right fibers (red), front-back fibers (green), and top-bottom fibers (blue).

We start our journey deep within the brain in the limbic system, the area that helps control emotion, learning, and memory. About three seconds in, visual fibers pop into view extending from the eyes to various brain areas into the occipital lobe (one of four major brain lobes) in the back of the brain. About two seconds later, flying over top as the brain starts rotating, we see various fiber bundles spray upward throughout the cerebral cortex, communicating information related to language processing, short-term memory, and other functions.

Dynamic maps like these are created using a 3D imaging technique called diffusion MRI tractography [1]. Postdoctoral researcher Ryan Cabeen and Arthur Toga, director of the University of Southern California Mark and Mary Stevens Neuroimaging and Informatics Institute, Los Angeles, used the method to study how white matter changes in developing and aging brains, and in brains affected by neurodegenerative or neurological disorders. Video created by scientific animator Jim Stanis.

See the full video on the NIH Director’s blog: bit.ly/2Z6r2Nx

Credit: Jim Stanis/Ryan Cabeen/Arthur Toga

NIH support from: National Institute of Neurological Disorders and Stroke & National Institute of Mental Health

fMRI image of preteen brain while child performs a working memory task. The regions in yellow and red are the most active.

Learn more about the ABCD study:

www.drugabuse.gov/news-events/nida-notes/2017/06/research...

Image credit: Richard Watts, PhD, University of Vermont and Fair Neuroimaging Lab, Oregon Health and Science University

NIH support from: National Institute on Drug Abuse (NIDA)

fMRI image of preteen brain while child performs a working memory task, released by ABCD researchers. The regions in yellow and red are most active.Richard Watts, PhD, University of Vermont and Fair Neuroimaging Lab, Oregon Health and Science University

Telepathy

Telepathy (from the Greek τηλε, tele meaning "distant" and πάθη, pathe meaning "affliction, experience"),] is the induction of mental states from one mind to another. The term was coined in 1882 by the classical scholar Fredric W. H. Myers, a founder of the Society for Psychical Research,and has somehow remained more popular than the more-correct expression thought-transference. Many studies seeking to detect, understand, and utilize telepathy have been done within this field. The scientific community does not regard telepathy as a real phenomenon as actual telepathy has never been demonstrated to a greater degree than pure chance under controlled experimental conditions.

Telepathy is a common theme in modern fiction and science fiction, with many superheroes and supervillains having telepathic abilities. In more recent times, neuroimaging has allowed researchers to actually perform early forms of mind reading.

From Wikipedia, the free encyclopedia

Reproduction of famous Libet experiment but with some improvements.

MRI data shows (left) areas of the skull preferentially affected by the amount of Neanderthal-derived DNA and (right) areas of the brain’s visual system in which Neanderthal gene variants influenced cortex folding (red) and gray matter volume (yellow).

More info: www.nih.gov/news-events/news-releases/residual-echo-ancie...

Credit: Michael Gregory, M.D., NIMH Section on Integrative Neuroimaging, NIH

Photo by Steve Cohn

Chemists at Brookhaven National Laboratory have been world leaders in the synthesis of short-lived radioisotopes for nuclear medicine, under sustained support from the U.S. Department of Energy's Office of Science.

In 2012, the American Chemical Society officially recognized the historical significance of the synthesis of 2-deoxy-2-[18F]fluoro-D-glucose (18FDG) in 1976 by chemists in the Brookhaven National Laboratory Chemistry Department in collaboration with the National Institutes of Health and the University of Pennsylvania by designating BNL's chemistry building as a historic research landmark. 18FDG is used to measure glucose metabolism in the living human brain.

18FDG is now the standard radiotracer used for positron emission tomography (PET) neuroimaging and cancer diagnosis, with more than 1.5 million 18FDG PET scans performed annually.

Brookhaven's Joanna Fowler is shown here with an early 18FDG synthesis aparatus in 1979.

Photo by Steve Cohn

Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, NV - the $100 million facility, designed by architect Frank Gehry, houses clinical space, a diagnostic center, neuroimaging rooms, physician offices and laboratories devoted to clinical research.

kudaphotography.com

Body Self Perception

Tilt your head forward and take a look at your body. How do you know that this body belongs to you? How do you actually come to perceive this body as part of yourself? This question has been discussed by philosophers and psychologists for centuries but remained outside the scope of experimental investigation. Henrik Ehrsson and colleagues have been addressing this question from a cognitive neuroscience perspective.

About the author: Henrik Ehrsson is a group leader in the Department of Neuroscience at the Karolinska Institute, Stockholm, Sweden. He was an HFSP Long-Term Fellow from 2004-2007 in the laboratory of Richard Passingham at the Wellcome Trust Centre for Neuroimaging at University College London. In 2007 he moved to Stockholm with an HFSP Career Development Award. He has been successful in obtaining competitive grants such as the Starting Grant from the European Research Council.

The first indication that the self-perception of the body is something that is actually produced by brain comes from the clinical literature. Patients who have suffered from stroke affecting frontal and parietal regions can develop conditions with disturbed perception of their own body. Some of these patients develop a deficit that can take the form of denying or disowning parts of the body. Although these cases indicate that the frontal and parietal association cortices are related to body self-perception they do not pinpoint the specific brain mechanisms involved because typically the lesions are large and affect multiple areas including the underlying white matter tissue.

We have used a classical approach in psychology to investigate body self perception: we studied illusions to learn more about the basic processes that underlie normal perception and combined this with state-of-the-art brain imaging techniques to identify the underlying brain mechanisms in healthy individuals. One particularly informative illusion is the ‘rubber hand illusion’ where people experience that a prosthetic hand is in fact their own hand. When synchronous touches are applied to a rubber hand, in full view, and the real hand, which is hidden behind a screen, most individuals will sense the touches on the rubber hand and experience that the artificial limb is their own. Even more dramatic is the ‘out-of-body’ illusion. In this setup the participants wear a set of head mounted displays in front of their eyes which are connected to two CCTV cameras placed one and a half meters behind them. The two cameras provide a stereoscopic image and the participants, who can thus see themselves from the point of view of the cameras, i.e. from the back. The experimenter then jabs a rod towards a location just below the cameras while simultaneously touching the participant’s chest, which is out-of-view. The visual impressions of a hand approaching a point below the cameras and the felt touches on the chest lead the participants to experience the illusion of being located one and a half meters behind their real body, with loss of self-identification with that body. Subsequent experiments demonstrated that people can perceive an entire artificial body, or another person’s body, as their own. In these experiments the two cameras were attached to a helmet worn by a life-size mannequin (or another individual) and positioned so that they were looking down on the mannequin’s body when it was touched synchronously with the real body (see Figure below).

By clarifying the precise combination of factors that are necessary and sufficient to elicit these changes in body self-perception we can develop models of body self-perception. It turns out that the critical factors are that the information from the eyes, skin and muscles matches both in time and space, that there is an ego-centric visual perspective of the body, and that the object to be owned has a sufficient human-like appearance. We then use these principles to develop testable hypotheses about the neuronal mechanisms of body self-perception.

To this end we used functional magnetic resonance imaging to show that neuronal substrates of body self perception involve areas in the frontal and parietal lobes that receive convergent visual, tactile, and proprioceptive afferent input, so called multisensory areas. Of particular interest were neuronal populations in the ventral premotor cortex and areas in the intraparietal that integrate visual, tactile and muscle sense information in body-part-centered reference frames in the space near the body. These neurons most probably mediate the perception of a limb as one’s own because our fMRI experiments have found significantly increased activation in these areas when people experience the rubber hand illusion and full-body illusion (see Figure above), and that the activity in this area closely matches the perceptual principles determining these illusions so that the stronger the activity the stronger the illusory self perception.

Taken together these studies represent a major advance in our understanding of the brain mechanisms mediating body self-perception. By applying these principles we can develop new clinical and industrial technologies where the self-perception of the body is deliberately manipulated. For example, one can use the rubber hand illusion to enhance the feeling of ownership of artificial limbs used by amputees, and the projection of ownership onto simulated bodies represents a new direction in virtual reality research which could enhance user control, realism, and the feeling of ‘presence’ in industrial, educational and entertainment applications.

By clarifying the precise combination of factors that are necessary and sufficient to elicit these changes in body self-perception we can develop models of body self-perception. It turns out that the critical factors are that the information from the eyes, skin and muscles matches both in time and space, that there is an ego-centric visual perspective of the body, and that the object to be owned has a sufficient human-like appearance. We then use these principles to develop testable hypotheses about the neuronal mechanisms of body self-perception.

To this end we used functional magnetic resonance imaging to show that neuronal substrates of body self perception involve areas in the frontal and parietal lobes that receive convergent visual, tactile, and proprioceptive afferent input, so called multisensory areas. Of particular interest were neuronal populations in the ventral premotor cortex and areas in the intraparietal that integrate visual, tactile and muscle sense information in body-part-centered reference frames in the space near the body. These neurons most probably mediate the perception of a limb as one’s own because our fMRI experiments have found significantly increased activation in these areas when people experience the rubber hand illusion and full-body illusion (see Figure above), and that the activity in this area closely matches the perceptual principles determining these illusions so that the stronger the activity the stronger the illusory self perception.

Taken together these studies represent a major advance in our understanding of the brain mechanisms mediating body self-perception. By applying these principles we can develop new clinical and industrial technologies where the self-perception of the body is deliberately manipulated. For example, one can use the rubber hand illusion to enhance the feeling of ownership of artificial limbs used by amputees, and the projection of ownership onto simulated bodies represents a new direction in virtual reality research which could enhance user control, realism, and the feeling of ‘presence’ in industrial, educational and entertainment applications.

By clarifying the precise combination of factors that are necessary and sufficient to elicit these changes in body self-perception we can develop models of body self-perception. It turns out that the critical factors are that the information from the eyes, skin and muscles matches both in time and space, that there is an ego-centric visual perspective of the body, and that the object to be owned has a sufficient human-like appearance. We then use these principles to develop testable hypotheses about the neuronal mechanisms of body self-perception.

To this end we used functional magnetic resonance imaging to show that neuronal substrates of body self perception involve areas in the frontal and parietal lobes that receive convergent visual, tactile, and proprioceptive afferent input, so called multisensory areas. Of particular interest were neuronal populations in the ventral premotor cortex and areas in the intraparietal that integrate visual, tactile and muscle sense information in body-part-centered reference frames in the space near the body. These neurons most probably mediate the perception of a limb as one’s own because our fMRI experiments have found significantly increased activation in these areas when people experience the rubber hand illusion and full-body illusion (see Figure above), and that the activity in this area closely matches the perceptual principles determining these illusions so that the stronger the activity the stronger the illusory self perception.

Taken together these studies represent a major advance in our understanding of the brain mechanisms mediating body self-perception. By applying these principles we can develop new clinical and industrial technologies where the self-perception of the body is deliberately manipulated. For example, one can use the rubber hand illusion to enhance the feeling of ownership of artificial limbs used by amputees, and the projection of ownership onto simulated bodies represents a new direction in virtual reality research which could enhance user control, realism, and the feeling of ‘presence’ in industrial, educational and entertainment applications.

Key references

Ehrsson HH, Spence C and Passingham RE. 'That's my hand!' Activity in the premotor cortex reflects feeling of ownership of a limb. Science, (2004) 305:875-877.

Ehrsson HH. The experimental induction of out-of-body experiences. Science (2007), 317:1048

Ehrsson HH, Weich K, Weiskopf N, Dolan RJ and Passingham RE. Threatening a rubber hand that you feel is yours elicits a cortical anxiety response. Proc. Natl. Acad. Sci. USA (2007), 104:9828-9833.

Ehrsson HH, Rosén B, Stockselius A, Ragnö C, Köhler P, Lundborg G. Upper limb amputees can be induced to experience a rubber hand as their own. Brain (2008) 131, 3443-3452.

Petkova VI & Ehrsson HH. If I were you: perceptual illusion of body swapping. PLoS One (2008), 3(12):e3832,

Slater M, Perez-Marcos D, Ehrsson HH and Sanchez-Vives MV. Inducing illusory ownership of a virutal body. Frontiers in Neuroscience (2009), 3:214-220

Berlin Center for Advanced Neuroimaging, Berlin 2012

Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, NV - the $100 million facility, designed by architect Frank Gehry, houses clinical space, a diagnostic center, neuroimaging rooms, physician offices and laboratories devoted to clinical research.

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ACRM 99th Annual Conference: Progress in Rehabilitation Research — Translation to Clinical Practice

CORE: 8-11 NOV // PRE-CON: 6-8 NOV

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(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

(left to right) Rohit Varma, MD, MPH. Dean of the Keck School of Medicine of USC, son Sean Stevens, Mark and Mary Stevens, USC Trustees and benefactors, USC President C. L. Max Nikias and Arthur Toga, PhD, Ghada Irani Chair cut the ribbon during the grand opening of the University of Southern California Stevens Hall for Neuroimaging and Informatics Institute at Keck Medicine of USC, November 17, 2016.(USC Photo/Gus Ruelas)

U.S. Senator Martin Heinrich touring UNM's Biomedical Research and Integrative NeuroImaging Center with Assistant Professor Jonathan Brigman, Assistant Professor Jason Weick, and Neurosciences Professor Dr. Bill Shuttleworth.

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

Web-savvy 55-76 year-olds show as much as twice the brain activation in areas associated with decision making and reasoning as technologically-challenged individuals when searching online.

Neural activation is higher when performing online activities than reading a book, leading the authors of the study to conclude that Googling may help exercise and improve brain function

Center on Aging, University of California, Los Angeles

www.guardian.co.uk/technology/2008/oct/15/google-ageing-r...

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

USC President C. L. Max Nikias, Mrs. Niki C. Nikias, Mary Stevens, and USC Trustee Mark Stevens.

Photo by Steve Cohn

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

Au Groupe d'imagerie Cérébrale, des techniques de neuroimagerie fonctionnelle et structurale servent à élucider la pathophysiologie de plusieurs maladies psychiatriques, y compris la schizophrénie, la dépression, etc.

At the Brain Imaging Group, functional and structural neuroimaging techniques are used to better understand the pathophysiology of several psychiatric diseases including schizophrenia, depression, etc…

(left to right) Rohit Varma, MD, MPH. Dean of the Keck School of Medicine of USC, USC President's wife Niki Nikias, philanthropist Ghada Irani, USC President C. L. Max Nikias, Mark and Mary Stevens, USC Trustees and benefactors, Arthur Toga, PhD, Ghada Irani Chair and son Sean Stevens during the grand opening of the University of Southern California Stevens Hall for Neuroimaging and Informatics Institute at Keck Medicine of USC, November 17, 2016.(USC Photo/Gus Ruelas)

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

(1)

Connectome

connectomes.org/

In their words:

"A connectome is a synapse-resolution mapping of connections between

all neurons in a model organism's brain. In other words, a

synapse-resolution circuit diagram of the brain. Current approaches to

mapping the connectomes of model organisms employ serial block face

scanning electron microscopy (SBF-SEM) and transmission electron

microscopy (TEM). The only connectome that has been mapped out to date

has been from the flatworm, C. elegans, which has only around 300

neurons."

(2)

ConnectomeViewer

www.connectomeviewer.org/

In their words:

"The field of Connectomics research benefits from recent advances in

structural neuroimaging technologies on all spatial scales. The need

for software tools to visualize and analyse the emerging data is

urgent. ... The Connectome Viewer application was developed to meet

the needs of basic and clinical neuroscientists, as well as complex

network scientists, providing an integrative, extensible platform to

visualize and analyze Connectomics data.With the Connectome File

Format, interlinking different datatypes such as networks, surface

data, and volumetric data is easy and might provide new ways of

analyzing and interacting with data."

In addition to the viewer, this site also provides quite a variety of

datasets

that can be used to test different features and functions.

(3)

Human Connectome Project

humanconnectome.org/

In their words:

"The HCP will map the human connectome as accurately as possible in a

large number of normal adults and will make this data freely available

to the scientific community using a powerful, user-friendly

informatics platform."

"Successful charting of the human connectome in normal adults will be

enormously informative. Even more importantly, it will pave the way

for studies that reveal how brain circuitry changes during development

and aging and how it differs in numerous neurological and psychiatric

disorders. In short, it will transform our understanding of the human

brain in health and disease."

(4)

BrainMaps

brainmaps.org/

In their words:

"Brain atlases have traditionally been one resolution and

non-interactive. The next-generation brain atlas is multiresolution,

highly interactive, and fully integrated with the latest research

literature. This is BrainMaps.org, a complete online brain atlas

founded on the principle that a brain atlas is a dynamic, interactive,

multiresolution research and didactic tool that facilitates brain

exploration and knowledge discovery."

As if that isn't enough, BrainMaps also has an API for

developers and and open source /

OpenGL-based 3D

viewer!

(5)

BrainMeta

brainmeta.com/

In their words:

"BrainMeta was established for the purpose of accelerating the

development of neuroscience through web-based initiatives, which

include the development, implementation and support of a wide range of

neuroinformatics tools, services, and databases."

(6)

Allen Institute for Brain Science: Brain Atlas

www.brain-map.org/

In their words:

"A growing collection of online public resources integrating extensive

gene expression and neuroanatomical data, complete with a novel suite

of search and viewing tools."

(7)

Brain Museum: Comparative Mammalian Brain Collections

www.brainmuseum.org/index.html

In their words:

"This web site provides browsers with images and information from one

of the world's largest collection of well-preserved, sectioned and

stained brains of mammals. Viewers can see and download photographs of

brains of over 100 different species of mammals (including humans)

representing over 20 Mammalian Orders."

(8)

MSU: Brain Biodiversity Bank

www.msu.edu/~brains/index.html

In their words:

"The Brain Biodiversity Bank refers to the repository of images of and

information about brain specimens contained in the collections

associated with the National Museum of Health and Medicine at the

Armed Forces Institute of Pathology in Washington, DC. These

collections include, besides the Michigan State University Collection,

the Welker Collection from the University of Wisconsin, the

Yakovlev-Haleem Collection from Harvard University, the Meyer

Collection from the Johns Hopkins University, and the Huber-Crosby and

Crosby-Lauer Collections from the University of Michigan.

Our purpose here is to provide some examples of ways in which images

and information from the Collections, in digital format, can be used

in educational, research and commercial enterprises. Millions of

beautifully stained sections from hundreds of different brains,

assembled in many locations over the past century can be made

available for a broad variety of purposes."

Want more pics?

Wikipedia: List of neuroscience databases

en.wikipedia.org/wiki/List_of_neuroscience_databases

Want more neuro imaging software?

UCLA: Laboratory of Neuro-Imaging

www.loni.ucla.edu/

Entry in category 3. Locations and instruments; Copyright CC-BY-NC-ND: Robert Terziev

Before the invention of radiology, the body was a black box and diagnosis was purely symptomatic or intuitive. Radiology allows doctors to see through the patient, making pathologies visible and bringing light into the black box. In the medical community, the brain is seen as the last organ that has not been fully understood in its function. The advanced imaging techniques of neuroradiology thereby represent the final step in western medicine’s ability to decipher the human body.

The photograph depicts a typical hospital scene, complete with cold aestheitcs and sterile atmosphere, barely what one would naturally associate with an environment conducive to healing, yet perfectly in line with the approach of contemporary western medicine.

Citation: Godani M, Canavese F, Del Sette M, Walter U. Update on transcranial sonography applications in movement disorders. Journal of Diagnostic Imaging in Therapy. 2014; 1(1): 110-128.

dx.doi.org/10.17229/jdit.2014-1113-008

Abstract

Over the past 20 years transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. The most widely recognised finding for movement disorders has been an increase in echogenicity of the substantia nigra, an area of the midbrain that is affected in idiopathic Parkinson’s disease (IPD). This finding has enabled a reliable diagnosis of IPD with high predictive values. Other sonographic features - such as hypoechogenicity of the brainstem raphe and hyperechogenicity of the lentiform nucleus - might help to increase the differential diagnosis of IPD and other movement disorders. In comparison with other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), TCS can currently be performed with portable machines and has the advantages of non-invasiveness with high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized - or can only be visualized with significant effort - with other imaging methods. This present update summarizes the current methodological standards and defines the assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles for differential diagnosis of IPD and other movement disorders. Finally, we provide detailed information about the advantages and limitations of this novel neuroimaging method.

Keywords: transcranial sonography; Parkinson’s disease; atypical parkinsonian syndromes; secondary parkinsonian syndromes

Rick Friedman for The New York Times

Dr. Michael Gazzaniga is a veteran neuroscientist and a fledgling bioethicist as a member of President Bush's Council on Bioethics

May 10, 2005

A Career Spent Learning How the Mind Emerges From the Brain

By CARL ZIMMER

HANOVER, N.H. - If you walk into the office of a scientist, chances are you'll see a white board hanging on the wall covered in scrawls. A molecular biologist's white board might be covered by hideous tangles of protein chains. A geophysicist might doodle India crashing into southern Asia.

The scribbles of Dr. Michael Gazzaniga, the director of the Center for Cognitive Neuroscience at Dartmouth, are more metaphysical. Arrows travel from a pair of eyes into a cartoon brain, finally ending at the word "Apple." Another picture bluntly sums up the modern debate over free will, with a stick figure's head labeled "Brain," and two bubbles point toward it - one labeled "Judge" and the other "Neu" - short for neuroscience. Floating uncertainly off to one side is a third bubble that asks, "Mind?"

Big questions are Dr. Gazzaniga's stock in trade. In the 1980's he helped found cognitive neuroscience, a discipline designed to find out how the mind emerges from the brain. Today, at age 65, he continues to oversee a busy lab where brain scans offer clues to how we unconsciously create theories to explain the outer world and our inner lives.

Dr. Gazzaniga (pronounced guh-ZAHN-eh-guh) deals with another set of big questions as a member of President Bush's Council on Bioethics, where he and his fellow members grapple with the moral dimensions of cutting-edge scientific research ranging from life-extending medicine to gene therapy. While he is congenial and diplomatic, Dr. Gazzaniga has also proved to be a powerful voice of dissent on the council.

These two experiences, as veteran neuroscientist and fledgling bioethicist, have come together in a new book by Dr. Gazzaniga called "The Ethical Brain." In it, Dr. Gazzaniga argues that understanding the latest developments in neuroscience is essential for the public to make sound decisions about the promise and dangers of advances in medicine. Neuroscience is even shedding light on how moral beliefs take shape in our brain.

"If people learn more about what the underlying brain story is, I think it will help them think more clearly about the situation," Dr. Gazzaniga said in an interview at his Dartmouth office.

Other neuroscientists have high praise for Dr. Gazzaniga's book, which is one of the first examination of neuroethics, the intersection of ethics and neuroscience.

"It's a new lens for looking at these issue, and he's the first person to focus it and get a sharp picture," said Dr. Judy Illes, director of the program in neuroethics at the Stanford Center for Biomedical Ethics.

Dr. Gazzaniga's career began in the lab of Dr. Roger W. Sperry, a California Institute of Technology neuroscientist who won the 1981 Nobel Prize in Medicine for his studies on the connection between the brain's hemispheres. The right side of the brain is linked to the left side of the body, and vice versa. The two hemispheres communicate through a bundle of fibers called the corpus callosum. Dr. Sperry showed in animal experiments that if the corpus callosum was cut, each hemisphere became unaware of what was experienced in the other.

Dr. Gazzaniga studied this effect in humans. Surgeons sometimes cut the corpus callosum of people with severe epilepsy to reduce their seizures. In 1960, Dr. Gazzaniga examined one such patient, known as W. J. He found that human hemispheres became isolated as well. W. J. could put together a simple jigsaw puzzle with either his left or right hand, for example, but not both.

The hemispheres also displayed different strengths and weaknesses. W. J. could read complicated writing with his right eye, but with his left eye he gave only a blank response.

"Boom - the whole thing unfolds in front of your eyes," Dr. Gazzaniga said. "It was a great moment. I'm not sure I've had such a great moment of a scientific nature since."

Studies on split-brain patients have dominated Dr. Gazzaniga's work ever since. In the 1970's, he and his colleagues reported that the left hemisphere acts as an interpreter, creating theories to makes sense of a person's experiences.

Their first clue came from an experiment Dr. Gazzaniga carried out with Dr. Joseph LeDoux, now at New York University. A patient called P. S. was shown a picture, and was then asked to choose a related image from a set of other pictures. What P. S. didn't know was that he was being shown a different image in each eye.

Dr. Gazzaniga and Dr. LeDoux showed P. S. a picture of a chicken claw in his right eye and a snow-covered house in the left eye. P. S. pointed to a chicken with his right hand and a snow shovel with his left.

"I'll never forget the day we got around to asking P. S., 'Why did you do that?' " said Dr. Gazzaniga. "He said, 'The chicken claw goes with the chicken.' That's all the left hemisphere saw. And then he looks at the shovel and said, 'The reason you need a shovel is to clean out the chicken shed.' "

Dr. Gazzaniga hypothesized that P. S.'s left hemisphere made up a story to explain his actions, based on the limited information it received. Dr. Gazzaniga and his colleagues have carried out the same experiment hundreds of times since, and the left hemisphere has consistently acted this way.

"The interpreter tells the story line of a person," Dr. Gazzaniga said. "It's collecting all the information that is in all these separate systems that are distributed through the brain." While the story feels like an unfiltered picture of reality, it's just a quickly-thrown-together narrative.

In the late 1970's, Dr. Gazzaniga rallied his colleagues to turn this sort of research into a full-fledged field, which they called cognitive neuroscience. He helped organize a scientific society and started a journal, and every five years he edits a gigantic tome summarizing what scientists know about how the mind emerges from the brain.

"More than anyone else, Mike Gazzaniga created the field of cognitive neuroscience," said Dr. George Miller, a cognitive psychologist at Princeton.

In December 2001, Dr. Gazzaniga was invited to join the bioethics council by Dr. Leon Kass, its current chairman. "I said, 'I don't know anything about bioethics,' " Dr. Gazzaniga recalled. Dr. Kass assured him that the council wasn't supposed to be a group of bioethicists, and Dr. Gazzaniga agreed to join.

The council immediately took up the debate on stem cell research. Dr. Gazzaniga supports the cloning of cells to produce embryos that can be used to extract stem cells. Others on the council felt very differently. They argued that a fertilized human egg represented a potential unique individual and that creating such eggs solely for research was wrong.

Dr. Gazzaniga is quick to point out that his differences with other council members were strictly intellectual. "There's no one I don't respect on the committee. They're all smart people," he said. "I heatedly disagree with some of them, but they're not lunatics."

Nevertheless, he did not shy from argument. At one meeting in 2002, Dr. Kass described his sense of awe at watching cells divide. "I countered him with, 'You ever see a tumor cell divide?' " Dr. Gazzaniga said. "It's also pretty miraculous event, but all it does is fill you up with rage. You can look at it in two different ways."

Dr. Gazzaniga argues that it is meaningless to call a fertilized egg a potential human being. "There's potential for 30 homes in a Home Depot, but if the Home Depot burns down, the headline isn't '30 Homes Burn Down.' It's 'Home Depot Burns Down,' " Dr. Gazzaniga said.

He argues that stem cell policy makers should take brain death as their model. After brain death, surgeons routinely remove organs for transplants. Stem cell research should, therefore, be acceptable on embryos in which the structures that will develop into the brain have not yet emerged - before 14 days postfertilization.

The actual biology of embryos doesn't conform to notions of unique human potential in early embryos, Dr. Gazzaniga argued. A single fertilized egg can split into twins - turning one supposedly unique human being into two. What's more, twins can then sometimes fuse back together into a single embryo, known as a chimera. "So we had one person, and then we had two people, and then we have one person again," he said. "So what's that all about?"

In "The Ethical Brain," Dr. Gazzaniga discusses his views on stem cell research, along with a range of other important issues. He describes his worry that the techniques of neuroscience may be misused.

For example, he thinks it is wrong to use neuroimaging as a lie detector or as a tool to determine whether criminals are responsible for their crimes. "It shouldn't be dragged into the courtroom," he said. "I think it's totally misused if you're trying to find the errant pixel in the brain that's responsible for why someone killed someone."

Neuroscience's biggest contribution to ethics, Dr. Gazzaniga predicted, is only just emerging: a biological explanation of morality. "In the next 20 years, we're probably going to define why our species seems to have a certain sort of moral compass," he said.

Current research suggests that this moral compass appears to be the product of the human brain's intricate circuitry for understanding other people's thoughts and feelings. Just looking at pictures of people stubbing their toes in doors, for example, activates the same regions of the brain that switch on when people stub their own toes. "When I have an empathetic moment, I literally feel your pain," Dr. Gazzaniga said.

Dr. Gazzaniga argues that when we experience these feelings, the brain's interpreter produces rational explanations for them. The particular explanation it produces depends on a person's particular upbringing. "Each culture may build up a theory, and that may be passed down as traditions and religious moral systems."

But, he said, "the basic reason you don't kill is because your brain tells you it's not a good idea to kill."

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