Posted by: R. Douglas Fields | August 30, 2014

Sharks Use ESP

shark

As beachgoers flock to the ocean over Labor Day, thoughts of “jaws” will inevitably surface. A shark’s ability to home in on the scent of blood is legendary, but many people are surprised to learn that sharks have a stealthy sixth sense to find prey and explore the world around them. Sharks have the ability to sense an electric aura that surrounds all creatures in seawater–including people.

This sixth sense works where vision fails, in murky water, at night, and when prey animals are buried under sand. This extra sense of perception (ESP) is called “electroreception.” Human beings can only imagine what it must be like to “see” a world of electrical auras the way sharks do.

For four hundred million years sharks and their relatives, the chimaeras and rays, have been using a force of nature that our species learned about only recently–electricity. And, sharks knew something about electricity that scientists never imagined until the 1970s: that all organisms in seawater are surrounded by a weak bioelectric field that pulsates and changes with the animal’s movements and physiological activity. With the surprising discovery of bioelectrical fields, a neuroanatomical mystery extending back to the 1600s was finally solved.

If you look closely at the head of any shark or ray you will see that it is stippled with small pores focused around the mouth. The first person to have examined a shark must have seen them, but what are they?

In 1678, anatomist Stephano Lorenzini guessed that they might be the openings of glands to coat the fish with slime. Squeezampullae raying the pores does expel a crystalline jelly substance. But this doesn’t seem quite right. Sharks are not slimy. In fact, the clear gel inside the pores does not resemble any bodily secretion.

Lorenzini had second thoughts. Writing by candle light centuries before electricity was discovered, and he wrote in his notebook that these mysterious openings must have some hidden function; thus calling on scientists of the future to solve this puzzle of Nature.

If the shark’s skin is peeled away carefully you will see that the pores are openings of long clear tubes, some nearly the diameter of a spaghetti noodle and in some cases nearly as long, but most are much smaller. The tube ends in a swelling somewhat like an eyedropper bulb. A slender nerve trails out of the end of the swollen ending. This structure reminded anatomists of Roman long-necked flasks, called ampulla, so these strange tubes found only under the skin of sharks and their close relatives became known as “ampullae of Lorenzini.”

ampullae
Anatomists tracing the nerves from the ampulla saw that they entered the brain through the top side or dorsal surface. This vital clue meant that ampullae of Lorenzini are sense organs, not glands, because sensory input to the brain–touch, temperature, pain, etc., enters through the dorsal side of the spinal cord, whereas nerves that control muscles exit from the ventral (bottom) side of the brain and spinal cord. But what sense could these strange tubes, unlike any other sense organ in any other animal, possibly detect?

Soon after the electronic amplifier was developed early in the 20th century, physiologists began to use them to detect the weak electrical impulses traveling through nerves. Alexander Sand in 1938 found that when he amplified the signals sent out the nerves of the ampullae of Lorenzini the impulses changed their rate of firing depending on the temperature. The organs were extremely sensitive “thermometers,” detecting changes in temperature as small as 0.2 degrees C. Thus, these organs must allow sharks to detect small temperature differences in seawater.

But when R.W. Murray was repeating Sand’s experiments in the 1960’s, he accidentally switched on an electrical stimulator and the ampullae of Lorenzini responded by firing a burst of electrical impulses down the nerve. Startled by this discovery, he did further tests and found that the organs were remarkably sensitive “voltmeters.” Astonishingly they were more sensitive to weak electric fields than all but the most sensitive electrical instruments available to measure voltage.

Further research by Murray and others showed that gently touching the ampullae also caused nerve impulses to fire, and that the salt concentration and pH of a solution applied to the openings also stimulated nerve impulses in the organs. Now neuroscientists faced a difficult question: How is it possible to know which of these stimuli is the natural stimulus for these sense organs? Touch, taste (salt and pH), and temperature are common senses, but other animals cannot sense such weak electricity. Is it possible that these creatures have a 6th sense that other animals do not have? But if the ampullae of Lorenzini were “voltmeters,” why would a shark have sense organs to detect electricity?

The answer came in the 1970s when neuroscientist Adrianus Kalmijn made a surprising discovery. Using very sensitive electronic instruments he found that all animals in seawater have a very weak electrical field surrounding their body. Further behavioral experiments showed that sharks could locate prey by sensing the fish’s bioelectric field, even when hidden beneath the sand. Moreover, electrodes buried in the sand that emitted weak electric fields just like those surrounding any fish, provoked the shark to attack just as if the electrodes were a hidden prey item. This proved that the sense organs were indeed used by sharks in a normal behavior (feeding) to detect weak electric fields.

This bioelectric aura is not mysterious. It is generated just like electricity is produced in an electric battery. When positive and negatively charged ions in a solution are separated by a barrier, the imbalance in charges in the two compartments creates a voltage, simply because positive and negative charges attract. If there is not an equal balance of charges on both sides of the barrier, a small voltage will be created. In animals the barrier of separation is the animal’s skin and the two different salt solutions are the salty ocean outside the skin and the somewhat different salts in body fluids. This creates and extremely weak voltage, but ampullae of Lorenzini are so sensitive, they could detect whether or not a 1.5 V flashlight battery connected across the distance of the Atlantic Ocean was switched on or off.

In research on electroreception studying blue sharks at sea near the Woods Hole Oceanographic Institution, my colleagues and I observed that sharks would follow the scent of bait (ground-up fish that we pumped through a tube), but in the last moment of attack electroreception would take over and the shark would bite electrodes emitting a weak electric field placed a meter away from the food source. This revealed that surprisingly, electroreception is the most important sense a shark uses to orient its jaws in the final moments of attack, even overriding the scent and smell of blood.

I don’t believe that a shark repellent can be made to stop a shark in a feeding frenzy, but from these experiments I can see how we might use electroreception to avoid being attacked by sharks. By trailing a slender wire behind a swimmer or surfer emitting a weak electric field, the shark would attack the decoy electrode instead of chomping down on its intended meal. Like lizards escaping a predator by dropping its tail as a decoy, the electrical decoy could be life-saving.

Interestingly, in 2003, physicists temporarily and mistakenly revived the long-discarded theory that ampullae of Lorenzini are temperature receptors. This was based on an experiment in which they squeezed out some of the clear gel from the ampullae of Lorenzini onto a microscope slide. The researchers put the two electrodes from their sensitive voltmeter into the gel and heated or cooled one end and discovered that a voltage was generated. What they overlooked was something sharks know well. Metal in contact with a salt solution creates a battery, and the probes of the voltmeter were metal. As everyone knows, the amount of voltage a battery generates depends on temperature.

In reality, the salty gel inside the tubes is just a good electrical conductor. It does not generate electricity. The gel conducts the voltage through the tubes acting like an antenna to collect the bioelectrical signals and send them to voltage sensing cells in the bulb-like ending of the organ. This also explains why so many different kinds of stimuli affect ampullae of Lorenzini. This happens because voltages are affected by very many factors. This also illustrates how rich the sense of electroreception must be. Salt concentration, temperature, pH, and many other factors will affect the bioelectric field surrounding an animals, just as light is reflected differently from many different kinds of surfaces, giving us great insight into properties of different materials that we see. Sharks must be able to learn a great deal about the world from their sense of electroreception.

Experiments using food to study shark behavior can lead to an overly simplistic view of the purpose of ampullae of Lorenzini. Like vision or hearing, electroreception does not exist for only one purpose. Electroreception provides sharks with a unique and very sophisticated means of analyzing the world around them. We humans can only imagine what it must be like to see the world through a strange sixth sense.

More to explore
Fields, R.D. (2007) The shark’s electric sense. Scientific American, August, p. 75-81. http://www.scientificamerican.com/article/the-sharks-electric-sense/

Fields, R.D., Fields, K.D., and Fields, M.C. (2007) Semiconductor gel in shark sense organs? Neuroscience Letters, 426, 166-170. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2211453/

 

Posted by: R. Douglas Fields | August 1, 2014

Lucy Movie Review and Neuro Fact Check

LucyMoviePoster The premise for the movie Lucy is that 90% of human cerebral capacity goes unused, but that’s only the start of the neuroscience bloopers in this new film.

After becoming an unwilling drug mule Lucy is suddenly able to access the full potential of the human brain when a surgically implanted packet of a new street drug ruptures inside her. From “Flowers for Algernon” to “Limitless,” stories about turbocharging brain power are a genre in themselves, but Lucy busts out beyond all reason to throw in nearly every supernatural power ever conceived. Toss every comic book superhero from Popeye to Superman into a blender and the slurry you get is Lucy, a super girl with the power of super intelligence, super strength, ESP, complete control of all the cells in her body, the ability to control other people’s bodies, supersensory reception, mind reading, telekinesis, the talent to tap into mass electronic communications using only her mind in a way that would make the NSA envious and give Edward Snowden a panic attack.

But wait there’s more! Levitation, antigravity, time travel, morphing her body, generating an impenetrable force field, regenerative healing, controlling TV, radio, and cell phone transmission.

But that’s not all! Superhuman speed and agility, X-ray vision, cyber communication, omnilingualism, astral projection, mental projection, telepathy, precognition, electromagnetic manipulation, self-disintegration, … The list goes on and on, but I’m bored trying to list them. There is not space to consider how each of these superpowers may violate the laws of nature or neuroscience. I’ll pick a few issues related to neuroscience that may have some educational value, but first a quick critique of this new film.

The revenge plot that launches the film quickly fizzles out when a side effect of bulking up her brain causes Lucy to lose all emotion and desire. Then the plot shifts to a quest (for knowledge), propelled by a trite Asian mobster chase scenario. The film is sloppy, with illogical and contradictory sequences and amateurishly distracting visual metaphors. To begin with, after all the mayhem and murder to battle her way to the evil gang leader to seek revenge early in the movie, Lucy gives the gangster a flesh wound. Then she leaves, stepping over a massacre of bloody dead corpses so that he can chase her for the rest of the movie. After seeing Lucy toss his bodyguard thugs around like cheap china, the villain never gets a clue that maybe he should have his henchmen take a snort of the powerful stuff. And why is Lucy running at all? Why doesn’t she just turn the mob chief into a pillar of iodized salt using her god-like powers? There is no character development. Lucy appears out of context in the opening scene as if you had channel surfed your way into the middle of a TV sitcom.

The “tell em what your are going to tell them, then tell them, then tell them what you told them, dialog makes the obvious tedious. Hammered in by repeated scenes of Professor Norman, expounding nonsense pseudoscience lecture as if it were true, the lack of scientific fact checking that went into this movie is astonishing. Couldn’t the screen writers have at least typed “GOOGLE” when they were dreaming up this script?

I don’t want to be a kill joy. Why spoil something like “Jack and the Beanstalk,” with the delightful goose laying golden eggs because the premise for the fantasy is inconsistent with science? It is fine to suspend belief for story telling if this illuminates human nature in a compelling way. But in Lucy, the story does not progress beyond the absurd premise. Look a golden egg! Wow, she laid another one! Look another one and it is even bigger…amazing special effects! A story that never advances beyond the premise is infantile. Lucy lays one egg after another exploiting the same contrivance as former disc jockey Casey Kasem with his hyped-up countdown winding up suspense to hear the top-ten pop songs. Viewers grow anxious to see what will happen when Lucy finally reaches 100% of her brain capacity. When we finally get there, the answer–that the meaning of life is to be found in a thumb drive–is an enormous let-down. The Bible story of the Tower of Babel works the same material as Lucy–man’s quest for god-like knowledge and power, but it does a far better job, and it has a cleaver ending. In return for man’s hubris, God puts lowly humans in their place by dividing them by language. The message in Lucy is trivial: that if we could have god-like knowledge we wouldn’t know what to do with it, other than stick someone else with it.

As for the premise; if you lose 10% or your brain power you will know it. The experiment has been done through disease, injury, intoxication, and prefrontal lobotomy. If you lose 90% of your cerebral cortical function, you will not be able to operate on the remaining 10%. You will be brain dead.

Animals do not use less of their brain than humans. Survival of the fittest sees to it that nature is never wasteful. The human brain uses 20% of the body’s total energy but it represents only 2% of the body’s mass. What would happen if an animal built such a costly organ and let 90% of it go idle?

Dolphins do not use twice as much of their brain as humans do and other animals do not use less of their brains than humans. Humans have superior intellect because of the increased cortical network that sustains more complex information processing. Dolphins are not more intelligent than humans. Whales and dolphins have big brains, but their cerebral cortex—the part that gives humans their incomparable intellect, is much simpler in structure than in primate brains or indeed the brains of many other clever terrestrial mammals including your pet dog. Dolphin cerebral cortex is thin. It has poor layering. Humans, primates, and even rodents, have six layers of cerebral cortex. Contrary to the movie, ecolocation in dolphins is not evidence of superior intelligence. After all, bats do it. So do shrews and some birds. None of these critters are considered Einsteins of the animal world.

Life did not begin 1 billion years ago as the movie says; it began 3.5 billion years ago. Not all animals have brains. Worms, insects, slugs, for example, have clusters of neurons stashed throughout their body where they need them instead of having a brain. Not all life has a nervous system; sea sponges for example, not to mention plants. Single-celled animals like the silvery Paramecia swimming in a drop of pond water, move, find food, avoid dangers, even conjugate (in addition to asexual reproduction) just fine with no nervous system at all.

At least the cliché 1950’s premise for super human abilities, radiation exposure, had some biological plausibility from genetic mutations, but the way the drug, CPH4, is supposed to allow Lucy to utilize 100% of her brain is dumb. CPH4 is supposed to be a growth factor stimulating cell division. How a growth factor could give a drug addict an instant high is unclear. Run away cell division is cancer. How cerebral metastasis enables Lucy to obtain supreme knowledge is a bit murky. The entire movie is supposed to have taken place in 24 hours, but this is about how long it takes one mammalian cell to divide in two. Supposedly this growth factor is supplied by the mother’s body and it acts like “an atomic bomb” to energize the formation of fetal bones. Had anyone bothered to fact check this they would have found these developmental facts of life are about as inaccurate as the evolutionary history Professor Norman expounds in his inane lecture. At six weeks gestation the human fetus has no bones. Only the size of a pencil eraser it doesn’t even have limbs yet. It looks like a cashew.

Lucy’s ability to remember suckling on her mother’s breast is impossible. Moreover an increase in brain cells could work to produce amnesia. Recent research indicates that birth of new neurons in the growing brain of young children is one of the reasons we can’t remember events from when our head was still expanding to its adult size. The new neurons disrupted the existing connections between neurons holding memories. Actually, children and infants do learn and remember–the sound of their mother’s voice, how to walk, recognize distinct sounds in their native language. What we lack from our early life experience is declarative memory, which is the memory of facts and events, but this requires understanding. Experience and awareness are necessary to form a “schema,” which is a complete and coherent combination of meaningful events, emotions, in temporal sequence and in relation to what is already stored in the mind to make a declarative memory. Infants are still just trying to make sense of the world. Moreover, human beings are born long before their brain is fully formed. The brain develops after birth so that environmental experience can help guide the process of wiring together our 100 billion neurons properly.

Icarus crashing to earth when his wax wings melt from flying too close to the sun makes an eloquent point with lovely unforgettable imagery, but Lucy is mind-numbing. On a scale of 1 to 5 neurons, a neuroscientist would rate Lucy “one neuron” because the science is abysmal. Filmgoers and literary types will concur because of the juvenile plot and lazy production. Philosophers will rate it two neurons in appreciation of the eastern philosophy patina, especially in the nirvana-like final scene. Those who spend their time staring semi-comatose at reality TV will find the car-chase scenes in Lucy much more exciting than watching fishermen land crabs or realtors flip houses, so they will give Lucy 3 neurons. Taking the mathematical mean, I give Lucy a rating of two neurons– but not cortical pyramidal neurons; just small inhibitory interneurons.

This is an expanded version of my review of this movie first published on the World Science Festival Website:

http://www.worldsciencefestival.com/2014/07/cinema-peer-review-lucy/

Posted by: R. Douglas Fields | June 12, 2014

Why Girls Like Guys Who Kayak

Hazard_Creek_Kayaker She’s checking out your on-line profile.

“I am a scientist who enjoys bird watching and canoeing.”

“Interesting!” she thinks.

Then she scrolls to the next profile; also a scientist:

“I enjoy white water kayaking, and I study alligators in the wild.”

She passes on you with your canoe, and in eager anticipation sends the kayaker an electronic “wink.”

This, according to a study by psychologist John Petraitis, is what most women will do, but why?

John Petraitis limped painfully into his office with his left foot in a black knee-high Velcro cast. His right wrist was wrapped in a matching black cast to stabilize his thumb tendon recently repaired by surgery.

“Skiing deep in the trees makes me come alive.” He says enthusiastically gazing at the gorgeous snow covered mountains surrounding his office in the Department of Psychology at the University of Alaska, at Anchorage.

That explains the snapped Achilles tendon and hand surgery. Many guys are drawn to danger. Whether aggressive skiing, motorcycle racing, or rock-climbing, why are men and boys attracted to risky activities?

Part of the answer, according to John Petraitis’ latest research, together with co-authors Claudia Lampman, Robert Boeckmann, and Evan Falconer, is supported by an experiment analyzing responses to on-line profiles in a mock electronic dating service. A lady’s choice for a first date may be swayed by factors extending back in time to when sharp stones, rather than Sharp computers, were the most advanced technology.

Petraitis was investigating the psychology of adult substance abuse when he was struck by the conspicuous differences in risk-taking behavior between the sexes. The highest rates of cigarette use, heavy alcohol use, binge drinking, and illicit substance use are seen in young people between the age of 15 and 25. Males have higher rates of all these risky activities, and males show up at emergency rooms in much higher numbers with traumatic injuries. They die at higher rates in outdoor accidents such as skiing and car accidents, and they are more often victims of homicide.

Part of the answer could be cultural. Boys are encouraged to display dominance and courage, accept dares and take risks, whereas girls tend to be socialized to be cautious, social, and to show concern for others. Girls play with dolls. Boys play with “action figures.” But the preference for risk-taking behavior in males is seen across all cultures, suggesting something more than socialization may be at work in drawing men and boys to risky pursuits.

The research team suspects that gender-specific behaviors that have been favored over eons of evolution in the battle for survival have left their imprints in our DNA and they are still guiding our mate choices today. As every biologist knows, evolution is about sex. When it comes to sex, females are the ones who make the decision about mates. Males audition.

Consider the garish male peacock with such ridiculously showy tail feathers that actually make it hard to fly and easier for predators to spot them. The male birds strut about displaying their showy tail feathers to impress the peahens in hopes of mating with them. The females, seeing the handsome bird with such a dangerously showy plumage think, “This guy must be amazingly fit to have survived with those dazzling tail feathers.” Genetic fitness, superior ability to survive in the face of dangers and handicaps, that’s what females are seeking in selecting their mates. A mate that can survive great risks must be exceptionally good at avoiding predators and acquiring food.

Many modern women will object to having their mate choices reduced to the pea-brained level of a bird, but have a look at the data. The researchers devised a list of 101 pairs of behaviors in a mock dating service in which each question paired a higher-risk option with a lower-risk choice. For example: Do you prefer a person who enjoys canoeing vs. white water kayaking? The choices included many more subtle risks, such as whether one prefers hot or mild hot sauce. The questionnaire was given to both men and women, and what the results showed is that women greatly preferred guys who engaged in the higher risk behaviors. Guys, in contrast, did not show any preference for women based on their risk-taking profile.

But here’s the really cleaver part. Half of the paired questions dealt with the sort of risks that human beings would have faced thousands of years ago, and the other half dealt with modern risks, such as driving while talking on a cell phone. Neither guys nor gals cared a whit about modern risks in selecting first dates; in fact, these modern risks were likely to be viewed as unattractive and foolish.

Females could care less about a guy who enjoys sticking forks in toasters. There was no electricity in the Stone Age. The risk-taking behaviors women prefer are the ones that deal with overcoming gravity, dealing with wild beasts, crossing water, being indifferent to nasty or dangerous foods, and engaging in human conflict. These are what the research team calls “hunter/gatherer risks,” the kind of risks our cave-man ancestors would have had to deal with. Modern risks, like playing with electricity, fooling with deadly chemicals, taking risks of identity theft, or driving without a seatbelt, did not impress the ladies one bit.

Why is risky behavior so pronounced in young males? Again, the answer is sex.

“Female fertility is a rare commodity,” Petraitis explains. Males remain fertile into old age, but not so for females. “A 20-year-old male competes with a 60-year-old male” [for attractive women]. The two age groups use different strategies to attract younger women. “Younger males are faster, stronger; they can bounce back from injury or adversity. Older males have more resources to provide for women.” So each group competes for young women in arenas in which they are more likely to win. “Young males are greater risk takers and adventurers to demonstrate their fitness,” he says.

He cites statistics on the biological facts of life to make his case. Males are fertile for 60 years, or 22,000 days. Females are only fertile half as many years, and they are only fertile 26 days/year whereas males are fertile every day. Do the math and in an entire lifetime, women are fertile only 850 days compared to 22,000 days for men. Also, women’s investment in fertility is much greater, considering the 9 months of pregnancy and years devoted to rearing a young child. Women have to be choosy.

Human behavior is complex and one important insight, such as the hunter/gatherer risk appeal identified in this new study, cannot explain everything about male risk taking. Petraitis suspects that males may also engage in risky activities to elevate status among other males. These new findings also do not explain why many women engage in risky activities, but he is devising experiments to investigate these questions.

For guys this research provides revealing insights into our male urge to risk life and limb in tests against gravity, water, fire, wild beasts, and dangerous food, but if you are thinking that taking risks is how to impress women, you are missing an important point. Male fertility is cheap. If a peacock with an outrageous tail gets eaten, well…there are plenty others. Likewise if a guy gets trampled by charging bulls in Pamplona, Spain.

Energetic and fit with a neatly trimmed greying beard, one might easily imagine Petraitis as the kind of guy who would eagerly attempt a 720 with a half-twist off the halfpipe to impress his lady (who happens to be one of the co-authors on the paper). But maybe he shouldn’t.

Reference:
John M. Petraitis, Claudia B. Lampman, Robert J. Boeckmann, and Evan M. Falconer (2014)
Sex Differences in the Attractiveness of Hunter-Gatherer and Modern Risks Journal of Applied Social Psychology 44: 442-453.

Posted by: R. Douglas Fields | May 28, 2014

The Lone Wolf Delusion

wolfAnguish grips the country with news of another horrific mass murder. From local police to the Secret Service, law enforcement worry about the “lone wolf.” These are individuals with no criminal record, feeling alienated and angry, plotting spectacular murder and violence in secret. “Experts” lament that there is no way to track lone wolf killers, but nothing could be farther from the truth. The lone wolf is perhaps the easiest of all potential murderers to identify and stop before they act.

The pop psychology argument says that there is no way to recognize the lone wolf, but that assertion is invalidated by the obvious–the defining feature of the lone wolf, their isolation. The recent mass murders in Santa Barbara were committed by an individual who was angry because no women would accept him. That is because they all knew. Something was off about him and women could sense it. Apparently most people could recognize this as reports state that he had few friends. Even his family knew. And so it is with so many other lone wolves. Such isolation and alienation is something that nearly everyone can plainly see, but too often choose to ignore. It is a common feature of mental illnesses. Isolation is no different from any symptom of a physical illness that appears long before the disease becomes deadly. The clear signs of illness must be acted upon effectively. Lone wolves should be viewed as medical failures. Unless disorders of the mind are addressed as fervently as disorders of the body, the disease will fester like any disease neglected.

Bewilderment about lone wolf murders stems from talking heads babbling on TV, mixing hidden agendas with fear, sensationalism, and ignorance. It is hard to imagine that the best medical experts are loitering outside TV studios waiting for the chair to next to the news anchor to vacate. Mental health experts are not baffled by the lone wolf. They are not baffled by suicide or by the depths of human depravity, cruelty, and suffering that are incomprehensible to most of us. They see these things every day. They understand what has gone wrong in the mind of lone wolves and the steps that must be taken to deal with the underlying disorder.

I will not use their names, but you will know them: Aurora, Sandy Hook, Virginia Tech, the Navy Yard, the Columbia shopping mall near my home, the Federal Building in Oklahoma City, Rep. Gabrielle Giffords, John Lennon’s passing, and now Santa Barbara. The person who took John Lennon from us carried a list of alternative potential targets. All that mattered was their celebrity. Being the agent of a prominent person’s death elevates the assassin’s identity to equal celebrity with their victim by forever interlinking their two names. In a twisted way they exchange their despicable self-identity with the envious identity of the prominent person they slay. Sensational mass murders are no different. Sensationalism is the key word–they seek mass recognition. How else can one explain the manifestoes, YouTube videos, selfie photos and letters mailed to the media? And the media eat it up, incubate and disseminate the pathology. Too often it is not about information and analysis. It is about attracting eyeballs to ogle in astonishment. If Barnum and Bailey were alive today they would invest in cable not canvass. If this were physical illness rather than mental illness the media would be charged with spreading disease.

The names of juvenile criminals are often withheld in the press, as are the names of victims of sexual assault. This is done to prevent further injury. Why, if the lone wolf acts in violent desperation for recognition and infamous glory should the media promote that illness and spread it? This irresponsibility should be condemned just as vigorously as would knowingly spreading tuberculosis or HIV. The names and images of lone wolves and mass murders should not be allowed to reach public notoriety. Report the news, but as in cases of rape, leave out the names.

People fault the police who interviewed the recent murderer at his home before the attack at the request of his mother who was concerned that her son’s deteriorating mental state could lead to self-harm or result in harm to others. This mother’s action should have been effective if systems were in place to respond appropriately. The system failed. It should not have fallen to the police to respond and diagnose this situation in the absence of a crime. They did what they could within the bounds of their authority and knowledge. Would you fault the police if they responded to a man in cardiac arrest and failed to undertake open heart surgery? Would you send a cardiac surgeon into a gun battle with bank robbers?

Consider, instead, the possible outcome if the police had been accompanied by a psychiatrist? Would the psychiatrist have been fooled by the man’s facade?

“How are you feeling?”

“Tell me about your friends.”

“How about your girlfriends?”

“Do you own any guns?”

The answers, body language, questions unanswered, are as revealing to a psychiatrist as a blood test is to a general practitioner. There are civil liberty concerns and potential abuses of authority to protect against, but there are public welfare issues and issues of compassionate treatment of the ill that have to be dealt with as well. All of these same issues are present and have been managed in areas of public health related to communicable illness that threatens individuals and the public at large. Most of those suffering mental illness–and there is no doubt that their illness inflicts intense and prolonged suffering– want to get better. Others will deny that they have any metal illness at all, but psychiatrists are familiar with both types. It is important to appreciate how many similar tragedies unhatched are prevented by mental health professionals at work every day, because their successes do not become news bulletins.

The answer to this horrendous situation must include regarding illnesses of the mind just as directly and vigorously as we do illnesses of the body, and to institute effective ways to recognize and treat those who are ill. No human being is meant to live isolated like a lone wolf. Any time that happens it is a warning sign that must be recognized and acted upon. Psychiatrists cannot cure every one of their patients any more than any doctor can predict who will be cured and who may die from any serious condition, but the difference is that every measure possible is recognized to deal with physical illnesses, while mental illness too often goes ignored. Even all the power and influence of a senator is useless, as the futile efforts of Senator Deeds to obtain mental health assistance for his son hours before he was nearly killed when his son knifed him viciously in the face before committing suicide. The same response by a hospital if applied to an urgent life-risking physical disorder would constitute criminal negligence.

If only the solution were as easy as eliminating access to weapons which is often the direction discussion of these tragedies turns. Weapons cannot be permitted to reach the hands of children or anyone with an unstable mind, but it is obvious that these tragic mass murders happen in states with the strictest gun laws in the country. They occur in countries like China where guns are not available. That debate is a distraction and it overlooks the fact that half of the victims in Santa Barbara were butchered with a knife and he ran down at least one person with his vehicle. Regardless of one’s views on the need for new laws restricting guns, the simple truth is that no one in their right mind could point a gun at another human being, loaded or unloaded, unless their own life or someone else’s life was at stake. Loan wolves will find other ways: knives, cars, nitrate fertilizer, fireworks and pressure cookers. The root problem, the disease itself, must be recognized and treated.

References and Resources

CDC Mental Health Program: http://www.cdc.gov/mentalhealth/about-us.htm

National Institute of Mental Health: http://www.nimh.nih.gov/index.shtml

C. Weber and A. Chang. Experts say violent action by loners is difficult to predict. The Washington Post May 26, 2014 http://www.washingtonpost.com/politics/experts-say-violence-by-loners-is-difficult-to-predict/2014/05/26/fb8e61ea-e522-11e3-afc6-a1dd9407abcf_story.html

Va. senator recalls son’s attack, mental illness. The Washington Times, Jan 27, 2014 http://www.washingtontimes.com/news/2014/jan/27/va-senator-recalls-sons-attack-mental-illness/?page=all

Posted by: R. Douglas Fields | May 26, 2014

Cerebral Storms

LightningI awoke this morning to a ferocious lightning storm. The house shook from thunderous booms. The predawn darkness blanched in blazing white flashes. Lightning is impressive; especially in contrast to the feeble bioelectricity generated by the body’s nerve cells. Or is that just an illusion? Neuroscientist Michael Persinger has done some back-of-the-envelope calculations that may surprise you.

A neural impulse (action potential) is only a tenth of a volt. About the same as a very dead flashlight battery, this voltage is far too feeble to sense. But, that action potential voltage spans across a microscopic distance of a cell membrane (about 10 nm), so scaled up to real world dimensions in which you and I and lightning operate, this neural impulse is equal to 100,000 V/meter! On the microscopic scale inside a cell, that is a lightning bolt. The molecular and cellular components of a cell will experience a neural impulse the way you experience a lightning bolt.

Now consider the minuscule charge carried by a single action potential of only 1.6 X 10^ -19 Coulombs. In terms of energy, this is a vanishingly small 1.9 X 10^ -20 Joules. But now consider that there are 10^10 neurons in your cerebral cortex and that they are happily firing away at an average frequency of about 1 Hz. Do the math and you’ll find that the total energy per second in your gray matter is 10 ^-10 J/s. Now proportion this to the 1330 cc volume of your brain (assuming it is average…maybe a bit bigger than average if you are reading this), and the result is an energy density of 10 ^-7 J/s.m^3.

A typical lightning strike drives a flow of about 10 Coulombs of electrons across a potential difference of 10^8 V, resulting in 10^9 Joules of energy. Impressive. Now if you figure that there are about 70-100 lightning strikes per second world-wide, this results in lightning generating about 10^11 J/s of energy. That is 100 gigawatts of power! But you already knew this:

Dr. Emmett Brown (frantically): 1.21 gigawatts! 1.21 gigawatts! Great Scott!

Marty McFly: What the hell is a gigawatt?

…flash:
Emmett Brown: Marty, I’m sorry, but the only power source capable of generating 1.21 gigawatts of electricity is a bolt of lightning!

…Off to the clock tower and back to the future…

cerebral storm
Now lightning discharges within a narrow shell of atmosphere about 2 km thick, multiply that times the 6,378 km radius of the earth, and this is a volume of 1 X 10^18 m^3. You guessed it. The energy density of all the world’s lightning is 10^-7 J/s>m^3, and that is the same energy density as inside your head.

Ahh, but the current is enormous in a lightning bolt. It can vaporize a tree instantly. That is true. A lightning bolt carries a whopping 100 Amps. But, that electric current is carried through a pretty narrow channel as we can plainly see when the bolt of lightning scores a direct hit the hands of the clock tower. The current in a lightning bolt flows inside a channel of about 1 cm in diameter. Dividing the current in a lightning bolt by the diameter of this channel gives remarkably the same current density as dividing the current generated by an action potential flowing through an axon. So even though the current is much larger in a lightning strike because of its absolute size factor of 10 ^10 larger, the “minuscule” current density driven by an action potential is comparable to a lightning bolt through the cross sectional area of an axon.

Bedazzled by lightning in the predawn hours a cerebral storm of corresponding electrical power blazes away in the world inside your head. When scaled up in proportion from the extreme miniaturization of cellular components in your brain, the neural electrical storm inside your skull is equal in power to all the lightning in the world. The dazzling display of electricity in the howling storm is matched by an even more amazing electrical storm in your brain as your imagination wanders, trying to cook up reasons to stay in bed just a bit longer.

References
Persinger, M.A. (2012) Brain electromagnetic activity and lightning: potentially congruent scale-invariant quantitative properties. Front. Integrative Neuroscience, vol 6 article 19, p. 1-7.

Posted by: R. Douglas Fields | January 2, 2014

Ladies out of Luck: FDA Blocks “Female Viagra”

womanGuys who need it have Viagra; Ladies with the similar needs have nothing now that the FDA has denied approval of a new drug, flibanserin, which would treat sexual dysfunction in women. What’s interesting from a neuroscience perspective is how the drug works. What’s interesting from a social perspective is how difficult it is to address this medical concern in women pharmacologically.

The FDA denied the new drug application by Sprout Pharmaceuticals in October, 2013 asking for more proof that flibanserin treatment works. It’s pretty simple to prove that Viagra works. That drug acts on the vascular system to boost vapid hydraulics in the penis. But it is not so simple to prove a libido lifting drug works for females. Human sexuality is difficult to model in animal experiments. Even in clinical studies it can be difficult to design human experiments that lead to clear conclusions because human sexual behavior is complex, especially so in woman most would agree. In contrast to Viagra, what exactly would a drug target in women whose biological sexual response is a bit more complicated than boosting blood flow? Flibanserin is not a hormone. It does not target the body at all. It targets the brain.

Women with hypoactive sexual desire disorder (HSDD) simply experience no desire for sexual activity, which can undermine wellbeing and interpersonal relationships just as impotence does for men. Flibanserin acts on neurotransmitters that are involved in sexual desire and pleasure, stimulating actions of the neurotransmitters dopamine and norepinephrine and reducing serotonin activity. If you follow the logic behind this pharmaceutical, it is suddenly quite obvious that a person with deficiencies in these neurotransmitter systems could have problems with sexual function. Indeed, sexual desire in people is complex and it can be quite fragile to stresses of many types. Sexual dysfunction is also associated with many mental illnesses and mood disorders. Moods are, after all, the product of specific neurotransmitters acting on circuits in the brain that control emotion. So what’s the recent published experimental evidence say about flibanserin in promoting increased libido in females?

Simon et al, at George Washington University School of Medicine, reported in November, 2013 in the journal Menopause, on flibanserin acting as a serotonin receptor 2A antagonist and serotonin 1A agonist to treat HSDD. The study included 468 premenopausal women receiving the drug and an equal number receiving a placebo for 24 weeks. The results show a statistically significant improvement in number of satisfying sexual events in women treated with the drug; the size of the effect, however, was quite small. There were also adverse side effects reported, including dizziness, sleepiness, nausea, and headache.

A study published this month in the journal Psychopharmacology by Galez et al, from the University of Versailles Saint-Quentin-e Yvelines, France, tracked the action of the drug in the brains of female rats. A gene called c-fos is a well-known marker of neural activity. Simply staining brain tissue in the appropriate way to see if c-fos is turned on in cells allows researchers to determine if a particular neuron is firing actively. The study shows that the drug increased activity in several brain regions, including the nucleus accumbens, arcuate hypothalamic nucleus, locus coeruleus, and other areas known to be active in females during sexual arousal. These brain regions belong to the mesolimbic dopaminergic pathway and hypothalamic structures that integrate sexual cues and influence sexual motivation. The problem is that this result simply shows that the drug acts on the neurotransmitter receptors that it is known to interact with chemically. The behavioral consequences were not studied.

In a review article published in 2012, Fooladi and Davis, at the Monash University, Melbourne, Australia, examined the literature on a wide range of potential drug treatments for female sexual dysfunction, including data on flibanserin available at the time. They found no non-hormonal drugs, including flibanserin, that are clearly beneficial.

They did conclude that systemic testosterone, however “has been demonstrated to be effective for the treatment of HSDD and have a good safety profile.” This is encouraging because there are already testosterone pharmaceuticals approved for treating males. In fact, two million prescriptions for testosterone treatment have been written for women in 2006 and 2007, according to the article, representing approximately 21% of all testosterone prescriptions (that are intended for males). The FDA has not approved testosterone use in women for treating HSSD. “This provokes the question as to who the regulators are most concerned about protecting?” the authors ask. The experts see a contradiction when the compound is approved for men but it raises serious safety issues when used for women, even though women represent 21% of the people who are taking the drug today without adverse health issues. (Testosterone is a naturally occurring hormone in females too.)

According to the CBS news article by Castillo, two large studies failed to show a benefit of testosterone patch or gels for women and the European Medicines Agency withdrew marketing authorization for it in 2012, leaving women with no approved medication that is effective in treating this medical condition.

References
Castillo, M. CBS News December 11, 2013, 2:06 PM http://www.cbsnews.com/news/manufacturers-of-female-viagra-flibanserin-appeal-fda-denial/

Fooladi, E., and Davis, S.R. (2012) An update on the pharmacological management of female sexual dysfunction. Expert Opin Pharmacother. 13:2131-42.

Gelez, H., (2013) Brain neuronal activation induced by filbanserin treatment in female rates. Psychopharmacology, 230:639-52.

Simon, J.A., et al., Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial. Menopause, Nov 25 e-pub ahead of print.

See also Sprout Pharmaceuticals Appeals FDA Decision On New Drug Application For Flibanserin To Treat Hypoactive Sexual Desire Disorder In Premenopausal Women

http://www.prnewswire.com/news-releases/sprout-pharmaceuticals-appeals-fda-decision-on-new-drug-application-for-flibanserin-to-treat-hypoactive-sexual-desire-disorder-in-premenopausal-women-235380991.html

First published on BrainFacts.org

http://blog.brainfacts.org/2013/12/ladies-out-of-luck-fda-blocks-female-viagra/#.UsV8k_RDun8

Posted by: R. Douglas Fields | December 17, 2013

23andGUVMT– Health and Safety or What? An Antiestablishment Perspective

Is the recent FDA action blocking access to the personal gene analysis services of the company 23andMe really about health and safety? This controversy may instead be more about fear of the future and protecting special interests. What we could be seeing is the usual Luddite paranoia arising at every historic advance in technology, but this time it seems, fear is being exploited by the powerful establishment who may see their dominion at risk. For many, this is fundamentally an issue of civil rights.

The argument being made by the FDA is that people who receive the results are not equipped to interpret the medical implications of the data. By law, analysis of health data is something that only a medical doctor can do, and the FDA enforces that system. Secondly, anyone dispensing medical advice without a doctor’s license must be stopped. On that point, there is no disagreement, but is this what 23andMe is doing?

23andMe provides customers not only their personal gene analysis; they also distill and organize the data according to the known functions of the relevant gene variants published in the scientific literature. What does the scientific literature say about a particular cholesterol gene, for example, and how do combinations of genes having similar biological effects alter the mathematical odds of acquiring a certain biological result? These biological results range broadly from tracing a person’s ancestry back 5 generations, to predicting your ability to taste certain flavors, to indicating how efficiently certain drugs–caffeine or Plavix–for example, will be broken down in your body, to isolating how much of your genome retains traces of DNA inherited from Neanderthals. This is fascinating stuff and very useful. If you are not interested in any of these things, you will not want to use the services of 23andMe, but if you are interested, why should the government prevent you from having it?

Analysis of genetic data is an enormous undertaking, and this is very well done at 23andMe from what I have seen–even providing hotlinks directly to the scientific papers on the gene in question. The company distills the data so that the individual can take the results and any concerns they may have to their personal physicians to use in managing their health. Simply giving a person a list of hundreds or thousands of genes would be useless for most people. The data analysis that 23andMe provides their customers is vital. If that’s practicing medicine, arrest my librarian. (Note to FDA: Don’t mess with librarians. They are smart, organized, and know where things are.)

The second argument the FDA makes is that ordinary citizens do not have the ability to interpret the results and a person might act inappropriately on the basis of the information. Someone might panic if informed that they carry a gene variation with a propensity for a deadly disease, for example.

But this is nothing new. The same argument could be made with respect to a high cholesterol reading or an HIV test. Having a genetic risk does not mean that you will get the disease, just as having high cholesterol does not diagnose that you will have a heart attack or stroke. People understand this and they manage to cope with having access to their cholesterol readings or HIV test result by acting in any way they see fit to do.

The technology being used is well established and reliable–I use it in my own laboratory research and have done so for over a decade. Of course there will be errors–false positives and false negatives in any genetic screen. Name a test (medical or otherwise) that does not have these. Most of us can handle the befuddlement of the engine warning light flashing on in our car. Often it is a false signal, but that’s fine. It is important for the driver to have the information to decide what to do. An essential distinction between genomic analysis and the engine light on your dashboard is that if the warning light stresses you, there is little you can do to avoid it, but 23andMe customers requested the information. They understand that with thousands of genes being assayed, the result of any genomic analysis is not a diagnosis; it is a screen.

In effect, the argument the FDA makes is that people are too ignorant or irresponsible to have access to information about their own body. This is the heart of the issue, and it is a troubling argument. The underlying question that people should be asking is why should the FDA be taking this patronizing view?

As citizens of a free society all of us must be concerned anytime the government acts to withhold information from its citizens. When government censorship concerns information about one’s own body, the abridgment of freedom is even more alarming, because the information is personal and vital to an individual’s right to pursue life and happiness:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. –That to secure these rights, Governments are instituted among Men, delivering their just powers from the consent of the governed.–That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it.

Those are revolutionary remarks of a bunch of radicals. Today we are much more enlightened. We understand that the government knows what is best for us. The role of government is to protect us from our own bad judgments.

“No, you may not have a large soda.”

The revolutionary genetic pioneers paying 23andMe for genetic screening refuse to acquiesce to this well-intentioned government censorship. They cannot seem to understand that government’s role is to know what is best for us, and to regulate what personal information about ourselves we should have. In their distorted zeal to embrace the future, these people see the FDA action as fundamentally at odds with the founding principles of our society. As these wackos would have it, the role of a free government is to serve the people and secure personal liberty. These fanatics eschew the rightful relationship of dominion and subservience citizens should have to government and the power establishment. In their radical view, the FDA action is government censorship of information that concerns personal information that an individual desires to have, is willing to pay their money to obtain, and to use it for their own personal benefit. We simply can’t have that–right?

People are naturally wary of anything new and so they more likely to swallow any argument maintaining the status quo. 23andMe breaks the corporate/government establishment in health care by giving individuals direct access to information about their own body. The issues about security of the genetic data, misuse of it, and whether or not a person can utilize it appropriately in their own health, are not new. The same arguments apply to any of the current types of medical laboratory analyses and records. By that logic, a person should not get an HIV test because, my God! What if that information were to become public?

Scientific progress has already undermined the strangle hold on direct access to personal health data, and the FDA and medical industry are having a difficult time keeping pace with the advances. The FDA’s action in approving home pregnancy tests or glucose monitors, for example, invalidates their argument about people being able to understand and utilize personal genome analysis responsibly.

Those arguing against 23andMe are using fear mongering tactics. They suggest hidden and subversive motives, and damn the company by association with the likes of Google. “They are mining my personal data!” Google is scary. Try searching the internet for “baldness” or “PMS” and see what pop-ups sprout at the edge of your screen. You understand how this works–right? Data mining is what fuels the internet, which has propelled a revolution that has changed in the world, and it has only gotten started. Are you worried about the Safeway grocer analyzing your shopping list to get the low-down-and-dirty on you? Some folks are, but they are not going to be the ones using 23andMe anyway. Change and the unknown–whether radiation, genetic engineering, or almost anything new–is what gives some people goose bumps.

That mad man, Henry Ford, proposes to replace the normal means of transportation with a “horseless carriage.” What few people realize is that the hazardous contraption carries up to 20 gallons of a highly explosive mixture of hexane and octane on board! Even breathing the smoke out of the engine’s smokestack will kill you. That’s a fact. Do you want something like that in your corral! This thing is dangerous, and who needs it anyway? Is there any place you cannot go on your horse?

Yes, looking back we can see the quaint phobias of those who came before us. We are smarter today, though.

I hear tell one of them ‘lectric vehicles ran over a hunk of metal and burnt up! I hope they put them Tesla guys out of bidness!

But this time, it appears to many, that the fear mongering is being exploited by the powerful establishment. The 23andMe debate has exposed the extent to which personal access to one’s data about their own health is blocked by government regulation. If you wanted to know your cholesterol level, for example, you cannot obtain it directly. You would have to call and make an appointment with a doctor. Wait until he could see you. Tell him in person you want the test and pay the doctor to write you a prescription authorizing you to go to a laboratory to have the analysis done. You need to make an appointment at the laboratory and go there to have the test performed. The lab sends the results–not back to you–they send it to your doctor. In a few weeks you can go back for your follow-up appointment and the doctor will read you the cholesterol concentration from the lab report. That’s how the health industry works in this country today. The very expensive and inefficient process fuels an enormous industry of insurance, real estate, doctor office staff, and the pharmaceutical industry. The results of tests go to the doctor, not to you, and that’s the way “they” like it. Even though you may simply want to know the HDL and LDL cholesterol readings in your own blood, you cannot have the information without paying a doctor as the middleman. This is the issue.

Hey! It’s my cholesterol. I made it. I only what to know how much I made. My genes are no different. Who has the right to tell me I can’t look at my genes? There’s no problem with a fortune teller measuring your lifeline. Walk into any drugstore and there are tons of health supplements and vitamins to treat everything from dementia to impotence–almost none of it backed by clinical studies showing that they work. But we cannot have access to the latest in scientific technology for our own personal use. Smoking, gun control, immunization, however you feel about it, do have consequences for society at large. There is a necessary balance between personal choice and public good, but looking at your own genes is personal. What justifies the government extending its reach into a persons genes?

At one time anyone in this country could purchase cocaine and opiates legally. But then at one time it was illegal to purchase alcohol. The pendulum swings, and it is pretty clear which way it is swooshing these days.

Bill Gates, who is devoting his philanthropic activities to improving health in the developing world, has a broader view of health care from his global perspective. “By far, most people on the planet are born, live their entire lives and die without ever seeing a doctor,” he said last week in a speech at the NIH. This perspective shows how extreme healthcare has become as a business in the United States. If you want to see your own body, you need the government’s permission. Then if access is granted, you will be permitted to see it only through the eyes of a doctor who will describe it to you. The great irony is that people in the underdeveloped world lack access to the most modern medical science because of poverty, whereas people in the developed world lack access to it because of politics.

Imagine! What if a person could know what genes they have that could affect their health. It’s not science fiction. It is political fiction.

This has been modified from an earlier publication on Huffington Post:

http://www.huffingtonpost.com/dr-douglas-fields/genetic-testing_b_4421313.html

Posted by: R. Douglas Fields | December 4, 2013

Transforming Terrorizing Memories

fear outlet-2
I’ll never forget it. They strapped electrodes to my wrist, cranked up a black dial on a frightening electronic device encrusted with switches and knobs, and shocked me repeatedly with jolts of electricity. No, this was not torture and the memory is not a traumatic one. I was inside the laboratory of Dr. Daniela Schiller, a psychologist at Mt. Sinai Medical School in New York City, experiencing the same treatment that she and her coworkers used to discover a new way to alter traumatic memories. The latest research from her team provides a method to blot out traumatic memories that are stored in a part of the brain called the amygdala, not just suppress them as current treatments for PTSD do, but to alter the memory itself.

Just as the participants in this study did, I watched a computer screen while my right wrist was wired up to an electrical stimulator to deliver a painful shock. A second set of sensing electrodes, two black Velcro strips with wires attached, were strapped like rings around the pads of two fingertips on my left hand. These sensed the amount of nervous perspiration I produced. Sweaty palms are an involuntary reaction to threat; part of the body’s fight-or-flight response that braces the mind and body to defend against an attacker or flee to safety. The heart pounds, stomach churns, muscles twitch with adrenalin-fueled energy, sweat beads up on our forehead and mental focus sharpens to rev up all systems in the body to survive a potentially deadly danger.

These are the bodily sensations of fear, and they are the same reactions in people suffering panic attacks and other anxiety disorders. Fear is a life-saving rapid response, but in some people with anxiety disorders or PTSD, the overwhelming fear becomes debilitating. The problem inside the brain is that panic is triggered inappropriately by stimuli that are unrelated to real threats. Terror can grip them without warning, sometimes crippling their lives. Sleep is may become impossible. Others may fear venturing outside or cannot fly in a plane. A military veteran may panic suddenly upon hearing a sound connected in their memory to a past trauma.

New research published this week in the Proceedings of the National Academy of Sciences reports a new discovery of how the brain records and regulates threatening memories. To understand this new finding, it is helpful to know more about threat memories and how PTSD, panic attacks, and other anxiety disorders are treated currently.

Treating anxiety disorders
Current behavioral therapy for treating anxiety disorders utilizes exposure therapy. This is based on animal research in which a painful stimulus becomes associated with another stimulus that is not in itself dangerous. For example, if a rat hears the sound of a bell and then receives a mild electrical shock, it will quickly learn that the bell heralds a nasty jolt of pain to follow. Sound the bell again and the rat freezes in fear even if you do not shock it. This conditioned fear response is how many of us learned as children not to stick hairpins into an electric outlet or play with matches.

Eventually we lost our fear of match boxes and electric outlets after many subsequent experiences with them that were harmless. This is how exposure therapy works. A soldier who survived a harrowing road-side bombing in Afghanistan might develop extreme anxiety about driving a car. Therapists may treat this disabling fear by having the person drive in a safe environment repeatedly until the terror of the bombing connected in his memory with driving gradually subsides. This can be helpful, but frequently exposure therapy is not effective.

“Some of the bravest people I know are people with PTSD,” Schiller told me as I sat wired up to her experimental apparatus, because unlike individuals who may indeed be fearless, people with PTSD courageously cope with ceaseless terror and persevere in their daily lives.

Rather than suppress the fear, it would be better to break the connection in memory between the bombing incident and the normal experience of riding in a car.

“That memory can change is a natural process that is occurring every day of our lives. We pretty much create a false memory on a daily basis,” Schiller says. So rather than suppress the fear, the scientists set out to change the conditioned fear response recorded inside the brain.

Memory track overdub
Scientists have learned a great deal about how memories are recorded and how emotional memories are suppressed. A paired structure deep inside the brain called the amygdala is an important focus of activity for threat detection, learning, and controlling the body’s emotional and physiological response to danger. The prefrontal cortex, just behind the forehead, can inhibit neural activity in the amygdala and suppress its reaction to a threatening experience. This circuitry from the prefrontal cortex is how exposure therapy suppresses anxiety and fear.

Neuroscientists have also recently learned that when a specific memory is recalled, it becomes vulnerable for a certain window of time to being altered or even eliminated. Recalling a memory is something like pulling a book off the library shelf for review. The book is now subject to alteration or destruction, and it must be placed back in the proper place on the shelf. Disrupt a person’s attention in the middle of browsing, and the book can be easily misfiled. The process of reshelving a memory immediately after it is recalled is called reconsolidation, and research has uncovered the details of how this works down to the specific molecules in synapses that encode information.

Reconsolidation may sound odd, but it does make sense when one considers what memories are for in the first place. Fundamentally, memories allow us to use past experience to direct our behavior appropriately in the future. This means that memories need to be updated, because things change. Your memory of Obama has certainly changed since the first time you heard the name, for example. The memory has become richer, linked with many other experiences, and separated from others that are no longer relevant and forgotten.

“In principle, reconsolidation suggests that in order to change memories one must first retrieve them,” Schiller explains. She deduced that rather than trying to suppress the person’s fearful response to driving, for example, by repeated experiences driving in a safe environment, one might break the terrorizing connection between the traumatic memory of the roadside bombing and the normal experience of being inside an automobile. If the traumatic memory is recalled, it should become especially sensitive to being extinguished. The electrodes on my wrist were how Schiller and her team set out to test the idea.

A blue square flashed on the computer screen. Shortly thereafter a purple square appeared followed by a painful jolt of electricity that made my fingers clench automatically. Ouch! Meanwhile signals from the electrodes testing the perspiration on my fingers traced out a graph on a computer monitor that the scientists were watching. The trace being graphed out in real time shot up the instant I was shocked. Pain triggered my body’s flight-or-flight response.

The next time the purple box appeared on the screen the trace showing my perspiration level spiked again–even before I was shocked. My amygdala had already learned to associate the purple square with the shock. Seeing the purple square tripped my body’s fight-or-flight response just like driving would do for the veteran with PTSD. In contrast, the blue square appearing repeatedly on the screen caused no rise in my perspiration or anxiety. That blue square was safe. Subjects in these experiments will show the same automatic anxiety reaction to the purple square when tested days later.

Now if the scientists began to flash the purple square over and over again without giving the shock, the stress response to the purple square will diminish with time. This is because the prefrontal cortex has learned that bad things don’t always happen every time one sees the purple square, and it sends inhibitory signals to the amygdala to suppress its threat response. Schiller and colleagues, including among others psychologist Elizabeth Phelps and neurobiologist Joseph LeDoux of New York University, were able to see this happening by having the subjects participate in these experiments while inside an fMRI brain scanner. They saw that the prefrontal cortex was becoming active in addition to the amygdala during extinction, and the functional connections between it and the amygdala were growing stronger. However, when these subjects were tested a day later, the fingertip stress monitor showed that seeing the purple square often triggered the treat and fear reaction again. Exposure therapy helped, but the feared connection between the purple square and an electric shock was still recorded in memory inside the amygdala.

A new approach–recall and revise
Next the team tested wither the mechanism of reconsolidation could be exploited to break the connection between the purple square and the electrical shock. To do this, they simply reminded the person of this connection by flashing the purple square on the screen and delivering the shock. Then they follow up immediately with exposure therapy (flashing the square repeatedly without an electric shock). Doing this proved to be far more effective in reducing the stress response to the purple square, than if they had used extinction therapy without first reminding the participants of the threat. By monitoring changes in the brain’s activity using an fMRI they could see how this was working inside neural circuits.

Two things could explain why extinction therapy during the reconsolidation period is more effective. It could be that the prefrontal cortex was strongly inhibiting the memory of threat connected to the purple square, or alternatively, the connection between the purple square and the painful shock stored in the amygdala could be diminished. The fMRI showed that the prefrontal lobes did not become activated when the purple square was flashed in people given extinction therapy during the period of memory reconsolidation. In essence the brain (amygdala) had forgotten the connection between the electric shock and the purple square, because the prefrontal cortex was not being activated to inhibit the threat memory. (To be precise, the experiments used various necessary controls that involved three colored squares, one that was used for extinction therapy and one that was used for extinction during the memory reconsolidation period, so that they could compare the efficacy of each approach in each individual.)

To put this new laboratory finding into a real-life scenario, imagine that you are bullied at the school bus stop by neighborhood thugs John and his delinquent brother Greg. Their sister Betty never bothers you, but every time you see John or Greg you become anxious and fearful. If days go by without either brother bothering you, your body’s threat response will gradually subside, but you haven’t forgotten that they are potential threats. An fMRI of your brain would show that your prefrontal cortex was suppressing the threat response in your amygdala from John or Greg attacking you in the past. This is how extinction operates at the level of neural networks.

One morning, John bullies you again when you arrive at the bus stop, but immediately after he reverses his behavior and behaves friendly toward you. Then days go by without any harassment from either brother. The next time you see John and Greg, what happens? Your body does not react in fear to the sight of John, but when Greg approaches your heart races.

An fMRI would show that there is less neural activity between your prefrontal cortex and amygdala when you see John than when you see Greg. In fact, your body’s defensive response when seeing John is no different from that provoked by seeing Betty. The explanation is that the recent bullying by John forced you to recall the memory of him as a bully, and doing that made the memory subject to being changed. When John began to behave in a friendly manner toward you while the recent bullying incident was being reshelved in your memory, the original conditioned reflex that connected him with a threat was modified by the new experience.

In contrast, your memory of Greg as an aggressor had not been recalled so the conditioned response to him recorded in your amygdala remained intact. Your fear response to seeing Greg in several subsequent friendly encounters was suppressed by the increased activity in your prefrontal cortex inhibiting the fear memory in your amygdala, but your prefrontal cortex did not intervene to suppress the fearful response to seeing John. The research shows that the process of extinction works far better if the traumatic memory is first recalled rather than extinction therapy given at any other time.

This fictional scenario conveys the gist of the new findings; how this might actually play out in real life goes well beyond the controlled findings in the laboratory experiments and several other factors would enter the mix and likely affect the outcome. The important concept is that extinction therapy works better if applied right after recalling the traumatic memory rather than if it is applied at other times, and that there is a critical window of opportunity to modify a memory during the brief period when it is being reconsolidated.

“We hope that the reconsolidation window would prove useful for treating PTSD,” Schiller says. “This would require some modifications in current therapy to specifically target this phase of memory.”

Professor of Neurobiology at the Weizmann Institute in Israel, Yadin Dudai, who was not involved in the study, agrees with Schiller that these new findings are a promising beginning for developing new treatments in the future, but more research is needed.

“In real life, PTSD is very persistent, it involves a very dense web of associations and lingers or even becomes intensified over years and decades,” Dudai explains. “Incidentally, I had a conversation last week with a colleague who experienced trauma in combat 40 years ago. This still haunts him at nights.”

People wishing for better therapies for anxiety disorders should welcome this new research but it is important not to overstate the new scientific understanding in terms of immediate new therapies. “We learn a lot from these studies on how elementary building blocks of memories are retained and updated, but we have to be careful in invoking excessive hope prematurely that results from models, as important as they are, will quickly translate into treatment,” Dudai says.

Nevertheless, new information about how connections from the prefrontal cortex to the amygdala operate in overcoming fears that are conditioned by experience, provides some interesting insights into why some people may be more likely to develop anxiety disorders or PTSD than others. These brain connections may be stronger in some people than in others.

Commenting on this new research, psychologist BJ Casey, Director of the Sackler Institute at Weill Cornell Medical College, (who was not involved in the study), says “These findings are very exciting and have important implications for novel evidence-based treatments of not only PTSD, but other forms of anxiety and stress related disorders such as phobias.” Drawing parallels to her own research on adolescents, she sees some interesting implications, because the prefrontal cortex is not fully developed in adolescents. Thus adolescents may not be able to suppress threat responses in the amygdala as effectively as in adults.

“We have previously shown diminished extinction learning in adolescents due to the maturational changes in the prefrontal cortex,” Casy says. The new findings using extinction therapy during the reconsolidation period could be especially effective in treating adolescent anxiety because it bypasses the need for regulation of emotional responses from the prefrontal cortex.

Despite the important value of this memory research in treating anxiety disorders, some may find the fact that scientists can change memories disconcerting. Dudai agrees, but observes that “Any development of a potential therapeutic tool is accompanied by justified concerns. Even swallowing Tylenol may be harmful.”

Schiller understands the concern too, but agrees with Dudai. “Like any finding in science, this finding can be misused, but it is our social responsibility to find treatments for PTSD, especially when putting soldiers and Special Forces at risk.”

As I watched my brain and body respond automatically to the threatening squares, I was astonished by how robotic it all seemed. There was nothing I could do to control it. I felt some sense of what it must be like for people living with anxiety disorders that overwhelm them suddenly in ways that are entirely beyond their ability to control. As researchers uncover how our brain encodes memory, updates it, and they trace the neurocircuitry that connects emotional fear and threat reactions to specific triggers, we are coming closer to developing better therapies that are based on neuroscience to overcome phobias, anxieties, and to break the cycle of reliving horrific post-traumatic terrors.

Reference:
Schiller, D., et al., Extinction during reconsolidation of threat memory diminishes prefrontal cortex involvement. Proc. Natl. Acad. Science, USA, on-line in advance of print, doi/10.1073/pnas.1320322110.

This article was first published on Scientific American: http://blogs.scientificamerican.com/mind-guest-blog/2013/11/25/how-to-erase-bad-memories

Posted by: R. Douglas Fields | November 27, 2013

Creativity Madness and Drugs

Sgt Pepper Cover

Writers are crazy and rock musicians want to be–neuroscientists meet and explain why

San Diego--Would we have Poe’s Raven today if the tormented author had taken lithium to suppress his bipolar illness? Not likely, considering the high frequency of psychiatric illnesses among writers and artists concludes psychiatrist Kay Jamison of Johns Hopkins Medical School speaking this week at the Society for Neuroscience annual meeting in San Diego. Madness electrifies the creative process Jamison concludes, but this difficult drug-use dilemma raises an even more provocative question: Would we have Lucy in the Sky with Diamonds had the Beatles not taken LSD?

Lord Tennyson, Virginia Woolf, and Vincent Van Gogh, are familiar examples of artists and writers who suffered serious mental illnesses, but Jamison explained that psychiatric illness was the cruel engine of their creativity. Tracing their family pedigrees she showed that many of these artists’ siblings, parents, and descendants were institutionalize in mental hospitals, committed suicide, or endured life-long struggles with mania, despair, schizophrenia, or other mental disorders. The genetic backbone to mental illness is strong. Ernest Hemingway and his supermodel granddaughter Margaux Hemingway both killed themselves. Separated from one another in environment and experience by a generation, their fates were inevitably tethered by their DNA. In all, seven members of the Hemingway family died at their own hand. This raises the question of why the genes of such devastating brain dysfunctions should persist in the human gene pool. ErnestHemingway

Statistics show that among all categories of creative artists, writers suffer by far the highest incidence of bipolar disorder, outstripping all other artistic professions. Why? Jamison concludes that the manic phase of bipolar disorder infuses the writer with furious energy and limitless stamina. The author foregoes sleep, is driven to take daring risks, expands their imagination and embraces grandiose thinking.

The crash of depression ending the manic phase immerses the writer in the depths of human suffering. This infuses poets and writers with the most monumental and profound dimensions of human experiences, moving them to contemplate the meaning of life, confront the certainty of death, and struggle against the agony of despair to survive adversity.

Once upon a midnight dreary, while I pondered weak and weary, [from The Raven]poe mug

Secondly, this introspective soul-searching phase raises self-criticism and sharpens editing of the copious material penned in the heat of mania.

Cured of their mental illness, such artists and writers would be gutted of their creativity and stripped of the means to realize it. Society would be deprived the beauty and insight the creative works of Van Gogh and Poe inspire had their tormented minds been healed with drugs. Thus, the seeds of madness survive like weeds in the human gene pool because, while not pretty, they are needed. Despite the cruel agony of such life-threatening disorders as bipolar disease and schizophrenia, the fruits of such creative minds benefit society.

Evidence of the link between madness and creativity goes well beyond statistics–it is now possible to see this connection in the disturbed wiring of the human brain. Rex Jung and colleagues of the University of New Mexico found that the same structure that is underdeveloped in the brains of people with schizophrenia (connections to the prefrontal cortex) are less well organized in people who score highly on psychological tests of creativity.

Choosing Madness
The potent mix of creativity and madness is imposed on writers and creative artists by the randomness of a genetic dice roll, but many artists with healthy minds choose to accept the Faustian bargain and induce madness with drugs to reach new summits in their art.

“Acid really opened me up,” Graham Nash of Crosby Stills and Nash discloses in his new autobiography Wild Tales, speaking of the transformative role LSD had on him as a songwriter. “I’d never heard anything like these songs,” he said after hearing David Crosby’s Déjá vu and Steven Stills’ Suite Judy Blue Eyes, which broke the mold of the 2.5 min format and saccharine lyrics of 1950s and 60s rock and roll.

“I was use to writing in the standard pop form–an intro, first, second verse, go to the chorus… Déjá vu was a completely different beast. I was completely blown away.” Nash describes creating the song Cathedral under the influence of LSD, just as the Beatles and other rock songwriters admit. From Cathedral:

And my head didn’t know just who I was
And I went spinning back in time
And I am high…upon the altar
High… upon the altar, high

Crosby_Stills_Nash_and_Young_1970 “Weed unlocked my mind and my emotions, which had to be awakened for me to start writing meaningfully,” Nash explains. “I love Jennifer Eccles/ I know that she loves me…la-la-la-la… It sounded like bubblegum,” Nash says contrasting his past formulaic superficial songwriting as a member of the rock and roll band the Hollies.

“We were maniacs,” Nash writes. “We smoked a joint and snorted a line before every session–a CSN ritual. It put us in a rapturous mood.”

Cocaine revved up their nervous systems to such a manic frenzy the musicians often had to re-record sessions because the tempo of their guitar work and singing was ridiculously fast. “We would go into the studio at two in the afternoon and not come out until around four the next morning.” Heroin, at least for David Crosby, was the counterweight to the manic phase.

Mania, depression and other mental disorders are devastating. Not only disabling for the individuals afflicted with them, mental illness shatters personal relationships, fractures families, and cost society at large. Many courageous people struggle to hold their lives together under the burden of such a random and all-consuming disorder that mental illness uncontrolled by effective therapy can inflict. Other people who choose to induce these conditions pharmacologically will suffer the same burdens and life-risking consequences. But those who exploit drugs to manipulate their mind suffer even greater risks from two additional threats: toxicity and addiction.

Jimi Hendrix, Janis Joplin, Hillel Slovak (Red Hot Chili Peppers), Jonathan Melvoin (Smashing Pumpkins), Alan Wilson (Canned Heat), Jim Morrison (The Doors), Nick Drake, Elvis Presley, Keith Moon and John Entwistle (both from The Who), Sid Vicious (Sex Pistols), Brent Mydland (Grateful Dead), Steve Clark (Def Leppard), David Ruffin (The Temptations), Howie Epstein (Tem Petty and the Heartbreakers), Allen Woody (The Allman Brothers Band), Dee Dee Ramone (Ramones), Momma Cass, and Ike Turner, are only a sampling of songwriters and musicians who died of a drug overdose. Apart from the personal tragedy drug addiction inflicted on these artists, a looming question unravels the motivation that impelled them to do it for the sake of their creative art: Was the music they produced using a pharmacological crutch worth the silence of music unborn, which will never be heard because of their premature death?

As George Koob, newly appointed director of the NIH, National Institute on Alcohol Abuse and Alcoholism, explained at the SfN meeting in his lecture on The Neurocircuitry of Addiction, allowing addicted lab rats to have unrestrained access to drugs or alcohol during withdrawal results in the animal consuming ever increasing amounts of the drugs–eventually self-administering levels of alcohol or opiates that would kill an animal that was not addicted. Rock stars and others with the wealth to afford limitless access to drugs fall into the same trap as the rat pressing a bar in its cage to deliver limitless drugs.

“There is a Polaroid picture I have of a rock of cocaine that was bigger than the eight ball sitting next to it in the shot–and Tim Drummond and I finished it in three days,” Nash writes.

These drugs of addiction activate the brain’s reward system (amygdala, ventral striatum, and frontal cortex) which uses the neurotransmitter dopamine, but the system becomes less sensitive to the drug with repeated exposure to it, thus ratcheting up the dose needed to achieve the same effect (a process called drug tolerance). Eventually the brain’s reward system is shot. The addict now takes the drug not to achieve pleasure, but rather to avoid activating the brain’s pain and stress circuitry that are stimulated when the drug is withheld. “Reward in excess can activate the brain and body stress systems,” Koob said in his presentation at the SfN meeting.

Koob’s research shows that in this stage of addiction, the body’s stress system becomes chronically activated. The same surge of hormones that ignite the fight-or-flight response in the hypothalamus and amygdala of the brain, setting the heart pounding, muscles twitching, and skin sweating, become activated during withdrawal and the drug is now taken to quell panic, not to obtain a reward.

“He’d been more and more drug dependent, slipping into a state he called ‘cocaine psychosis,’ the paranoia that comes with being too high most of the time,” Nash explains of Crosby’s addiction. “He was so heavily into cocaine that most of Croz’s waking moments were spent figuring out how to score, where and when to get it, how much he had left, and how much to share with his friends.”

“It actually got so bad, we had to build a room adjacent to the stage so Croz could wander off and freebase between songs. Often, David walked offstage, threw up from the drugs, and was literally dragged back to sing.”

Addiction to cocaine, methamphetamine, and opiates is prevalent among well-known writers, including Stephen King, Robert Louis Stevenson, Philip K. Dick, Hunter Thompson, Ken Kesey, William Burroughs, Jack Kerouac, and Charles Dickens. LSD was used and advocated by Ginsberg, Thompson, and Kesey. Generally lacking in rock star wealth, alcohol is often the drug of abuse for writers, including many of those mentioned above as well as John Cheever, Tennessee Williams, Dylan Thomas, Truman Capote, William Faulkner, F. Scott Fitzgerald, and most famously, Ernest Hemingway.

Toxic Mix
The third blow in the Faustian bargain of exploiting drugs to promote creative artwork is toxicity. The toxic effects of alcohol on the brain are quite well recognized. A Cambridge University study published in the journal Molecular Psychiatry in 2012 highlights the toxic effects of cocaine on the brain. MRI imaging shows that the brain atrophies at twice the normal rate with age in cocaine-dependent individuals, losing about 3cc of gray matter per year. A person beginning to use cocaine at age 15 having a normal gray matter volume of 800 cc is down to 700 cc by the time he reaches 50 years of age. The loss of 100 ccs of gray matter (the volume of three shot glasses) seriously undermines cognitive function. Moreover, like a prefrontal lobotomy the loss of brain tissue is targeted. Most severely atrophied are the prefrontal and temporal lobes, areas critical for executive function and memory. According to neuroscientist Antonio Demasio of the University of Southern California speaking about creativity in the symposium at the SfN meeting that he chaired on this subject, these are the most critical brain regions for creativity, which requires imagination, abstraction, analysis, and memory.

A new study reports an unexpected and persistent new mechanism for cocaine toxicity. Kevin Schneider and Anthony DeCaprio, chemists at Florida International University, report in a new paper published electronically in advance of print in the journal Chemical Research Toxicology, that enzymes in the liver (P450) react with cocaine to create a highly reactive chemical intermediate (cocaine-thiol), that binds to proteins and damages them by oxidation. The chemical reaction is so strong, this newly discovered reaction product can be used forensically to detect cocaine use in a person months after taking the drug.cocaine rxn

His body devastated by drugs and near death, David Crosby’s life was only saved by a liver transplant.

Marijuana may have opened Graham Nash’s mind but it may also have damaged it. A large body of evidence indicates that cannabis use is damaging to the brain, especially when used in adolescence when cannabis use increases the risk of developing schizophrenia and other neuropsychiatric problems later in life. A 2012 report in the Proceedings of the National Academy of Sciences by Madeline Meier and colleagues at Duke University following a cohort of 1,037 people from their birth in 1972 and 1973 to age 38 shows that cannabis users suffer a major decline in cognition. Neuropsychological testing was conducted at age 13 before cannabis use, and again at age 38. Those who used cannabis had a marked reduction in cognitive ability and the impairment was most severe when cannabis was used during adolescence when the brain is undergoing intense development. The neurotoxic effects on the adolescent brain have life-long consequences. Their study found that the mean IQ plummeted to below 90 in frequent cannabis users who began using cannabis as adolescents. IQ also drops in cannabis users who begin using marijuana as adults, but the damage is not as great.

Wild Tales Cover Graham Nash describes the creative breakthroughs drugs allowed him, Crosby, Stills, and Young to achieve, but he also portrays honestly and in harrowing detail the tragic effects of drug use on himself and other band members, and especially the ghastly spiral of addiction and illness that nearly took David Crosby’s life. His honest and revealing account is clearly a work of love for his friends and family. In addition to the intriguing historical and autobiographical accounts it provides, this book also gives insight into how creativity works, how it can be facilitated using illicit drugs, and how drug addiction consumes lives. For a neuroscientist, the description of Crosby’s descent into drug use, near death, and recovery is a graphic case study in the neuroscience of addiction.

People abuse drugs for many reasons, most related to personal stresses. Many people who suffer mental illness, including writers and artists, turn to drugs to self-medicate, but some artists take them intentionally to boost their creativity and the performance of their art. Madness and creativity are linked, and some artists are willing to endure the self-destruction of devastating mood disorders and psychosis of mental illness to fuel creative works of art by deliberately inducing these mental states with drugs to unbalance an otherwise healthy brain.

But there is a critical distinction separating artists who endure mental illness and create art from those who take drugs to create. The creative work of an artist who overcomes their mental illness–often by turning to art and literature to help them cope–is an inspirational personal triumph. But the creative work of a person who induces mental imbalance pharmacologically is the product of a drug.

There are many questions arising from this mix of creativity, madness, and drugs.

1. Should artists and writers with bipolar disorder, for example, be treated with drugs even though this will diminish their creative drive and possible success as an artist?

2. Can the creative product–a song, painting, poem, or book– justify the sacrifice and harm that will accompany conducting the creative pursuit under the influence of drugs?

3. Would we have had rock music without drugs?

4. If we accept the use of marijuana, cocaine, methamphetamine, LSD, and alcohol by rock musicians to achieve creative breakthroughs and delight us with their performance, what does that say about us in being willing to accept the destruction of another human being for our entertainment?

References
Chadwick, B., Miller, M.L. and Hurd, Y.L., (2013) Cannabis use during adolescent development: susceptibility to psychiatric illness. Frontiers in Psychiatry 4:129. doi: 10.3389/fpsyt.2013.00129
Graham Nash Wild Tales 2013, Crown Publishing Group, NY
Jung, R.E. (2010) White matter integrity, creativity, and psychopathology: Disentangling constructs with diffusion tensor imaging. PLOS One 5(3): e9818. doi:10.1371/journal.pone.0009818
Meier, M.H. et al., (2013) Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc. Natl. Acad. Sci. USA http://www.pnas.org/cgi/doi/10.1073/pnas.1206820109
Schneider, K.J. and DeCaprio, A.P. (2013) Covalent thiol adduncts arising from reactive intermediates of cocaine biotransformation. Chem. Research in Toxicology, published on-line in advance of print: dx.doi.org/10.1021/tx4003116

This article was first published on Scientific American:

http://blogs.scientificamerican.com/mind-guest-blog/2013/11/22/creativity-madness-and-drugs/

Posted by: R. Douglas Fields | October 31, 2013

When Crying Triggers Murder

Squeezing her hand over the toddler’s nose and mouth she smothered him to death because he would not stop crying. Last Monday 22-year-old Jessica Fraraccio pleaded guilty in court to felony murder of 23-month-old Elijah Nealey in the summer of 2012. No one in their right mind could conceive of committing such a horrible act, but babies are tragically killed or left severely brain damaged by shaken baby syndrome inflicted by a parent, family member, or caretaker frustrated by a child’s incessant crying. Dismissing those with depraved minds, how can we comprehend such sad stories as this one in the Washington Post?

Jessica Fraraccio was well known to the Nealeys when they hired the young woman as a babysitter for their son Elijah and his two sisters. The Nealeys knew her parents well. Jessica is a devout Catholic who was studying child development in the hope of owning her own day care business someday.

Friends and family testified in court that Fraraccio is a kind and giving person. According to the newspaper article “She is incapable of wishing evil; in high school she wouldn’t even gossip about the girls everyone ‘hated’, one friend wrote in a letter to the court.”

Everyone is bewildered by the tragic crime. “We never would have dreamt of this,” Mike Nealey said of the young women they thought they knew. “I don’t know how to process it,” he said after hearing the shocking and remorseful admission [1].

Now the young woman faces the prospect of 50 years in prison and the Nealeys are living with horrendous grief from the murder of their son who would have had his birthday in September. Nothing can excuse such a horrible crime, but to reduce the chances of another child suffering a similar fate, it is necessary to seek an understanding of what went wrong.

Babies and toddlers are especially vulnerable to brain damage caused by fierce shaking because of their comparatively large heads and weak supporting neck muscles. The violent whiplash caused by shaking a baby smashes the infant’s brain against the internal walls of their skull inflicting severe trauma. According to a recent study, 18-25% of babies who are hospitalized after being shaken in frustration will die (Barr 2012). 80% of children who survive are left with significant lifelong brain injuries.

The trigger is crying. It seems paradoxical that crying could trigger murdering a child on impulse.

An infant’s first act in life is to cry. This stimulates concern and provokes an urgent caregiving response in people hearing it. Neuroimaging shows that infant crying stimulates brain activity in areas involved in parenting behavior, empathy, attention, and stress. Mothers are more sensitive to the cries of their own infants than to the crying of unfamiliar infants, and neuroimaging illuminates this behavioral preference in the level of activity invoked in the mother’s brain.

The impulsive murders of crying infants are often as bewildering to the perpetrators, who are frequently otherwise devoted parents, and it is baffling to others who struggle to comprehend the horror. The perpetrators of shaken baby syndrome are most likely to be males related to the child. This is followed in frequency by boyfriends or stepfathers; then mothers, and to a lesser extent by temporary caregivers. The helpless victims are much more likely to be male than female. These statistics must provide clues to understanding how the unthinkable can happen.

The leading hypothesis for the greater number of victims who are boys is cultural. Males should not cry but females do. Thus incessant crying in a female child is more tolerated.

Adult men are more aggressive and stronger than women, so their violent actions are more powerful and deadly. Crying does evoke different responses in the male and female brain, though. Neuroimaging shows that infant hunger cries strongly interrupt “mind wandering circuits,” (the dorsal medial prefrontal and posterior cingulate) in women, whereas men tend to carry on with less interruption in thought (De Pisapia et al., 2013). Women in general show greater response to crying and laughter in brain regions processing empathy than do men (Chun et al., 2012). Cognitive control by the left auditory cerebral cortex actively inhibits activity in the right amygdala in response to laughing or crying and this reduces stress and anxiety (Tschacher et al, 2010).

Rather than dismissing this violent response to a baby’s cries as psychotic behavior, Ronald Barr (2012) concludes that shaken baby syndrome is a tragic failure of otherwise normal, common interaction between infants and caregivers. According to this analysis, crying is an ambiguous signal. It can provoke positive, supportive, survival-promoting caregiving responses, as well as negative, destructive, survival-endangering caregiver responses.

The onset of crying provokes a caregiving response, but if the caregiver is capable and provides “good care” the baby should cease crying. If instead the crying cannot be stopped, the caregiver may unconsciously interpret the crying as indicating that they are not capable caregivers. Thus rather than triggering a biological response to satisfy the need of an infant– hunger or the need to change a diaper, for example–crying now signals personal criticism. These opposite responses to crying are not deliberate conscious thoughts generated in the cerebral cortex; they arise in the unconscious emotional brain.

This explanation is only a hypothesis, but the statistics indicating that family members close to the child have a greater probability of violently shaking their baby than do caregivers seem consistent with this interpretation. If this suggested explanation is true, such tragedies are cruel ironies. This analysis might account for the paradox of how someone who is apparently devoted and caring could respond tragically to incessant cries of an infant with rage instead of love.

References
Barr, R.G. (2012) Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers. Proc. Natl. Acad. Sci. U.S.A. 109, 17294-301.

Chun, J.W. (2012) Common and differential brain responses in men and women to nonverbal emotional vocalization s by the same and opposite sex. Nerosci. Lett. 515: 157-61.

De Pisapia, N., et al (2013) Sex differences in directional brain response to infant hunger cries. Neuroreport 24: 142-6.

Musser, E.D., et la. (2012) The neural correlates of maternal sensitivity: an fMRI study. Dev. Cogn. Neurosci 2; 428-36.

Tschacher, W., (2010) Brain connectivity in listening to affective stimuli: a functional magnetic resonance imaging (fMRI) study and implications for psychotherapy. Psychother. Res. 20:576-88.

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1. Jeremy Borden, (2013) Baby sitter guilty in Virginia toddler’s death, The Washington Post, October 21, 2013

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