Saturday, December 19, 2009

Neurosurgery: does "slice 'n' dice" cut it, when mental disorders are in question?

In "Brain Power: Surgery for Mental Ills Offers Both Hope and Risk" (Benedict Carey, New York Times, November 26, 2006), we learn about attempts to cure mind problems like obsessive-compulsive disorders and phobias through brain surgery. The best face the article can put on it does not disguise the fact that
It is a precise, sophisticated version of an old and controversial approach: psychosurgery, in which doctors operate directly on the brain.
No surprise that the proponents will say it is a great new thing.
In the last decade or so, more than 500 people have undergone brain surgery for problems like depression, anxiety, Tourette’s syndrome, even obesity, most as a part of medical studies. The results have been encouraging, and this year, for the first time since frontal lobotomy fell into disrepute in the 1950s, the Food and Drug Administration approved one of the surgical techniques for some cases of O.C.D.

While no more than a few thousand people are impaired enough to meet the strict criteria for the surgery right now, millions more suffering from an array of severe conditions, from depression to obesity, could seek such operations as the techniques become less experimental.

But with that hope comes risk. For all the progress that has been made, some psychiatrists and medical ethicists say, doctors still do not know much about the circuits they are tampering with, and the results are unpredictable: some people improve, others feel little or nothing, and an unlucky few actually get worse.
I don't even know how much progress has actually been made. The placebo effect guarantees that many people who have put themselves to the trouble of undergoing brain surgery will report feeling better. Maybe they are better. But what if the same effect can be achieved using non-materialist neuroscience techniques, as has been demonstrated.

A friend tells me that at one point, this was the third most e-mailed article at NYT right now. Culturally, it is interesting that so many people wanted to believe that a touch of the knife beats taking control of one's life.

I will not soon forget an interview I once did with a woman who had undergone psychosurgery for mental disorders. She had been a writer but was, at time of interview, a zombie.

She was not incapable of thought. When I suggested she try to get back to writing, she treated it as a new idea that she had never considered. She could have gone back to writing, perhaps, but she no longer had any motivation. She seemed to have given up.

Was the scalpel stronger than she? I don't know, but - apart from removing tumours - I would give a pass on all this scalpel stuff, until we know way more than we do.

Hat tip: Stephanie West Allen at Brains on Purpose

Denyse O'Leary is co-author of The Spiritual Brain.


Neuroscience and popular culture: Neuroscientist examines brains of his family members for killer gene

Here we read,
The idea was to correlate findings from his family's brain scans with a parallel analysis of genes thought to be associated with aggression and violence. Changing activity in certain parts of the brain relates to aggression, emotion and the inhibition of impulsiveness. Dr. Fallon's previous research on murderers had suggested that many killers show distinctive patterns in these brain areas.

"There's gonna be bad news, but I don't know where it will pop up," Dr. Fallon said in September, before he had seen the family data.

- Gautam Naik, "What's on Jim Fallon's Mind? A Family Secret That Has Been Murder to Figure Out: Nature Plays a Prank on a Scientist Looking for Traits of a Killer in His Clan", Wall Street Journal, November 30, 2009
Whatever happened to a fundamental rule of medicine that you do not practice on family members – with or without a license?

Naik decently points out what many miss:
The idea of the "born criminal" has a long history and is deeply controversial. Drawing conclusions about the biology of psychopathic murderers is especially hard because data are scarce. Those in jail rarely agree to a genetic or brain analysis. As a result, scientists rely a good deal on inference. While many people can be aggressive, violent and impulsive, only a tiny fraction become psychopathic killers, capable of committing bone-chilling crimes without empathy, remorse or a sense of right and wrong. Dr. Fallon says his research and other findings suggest that psychopathic killers often have lower intelligence than most people, which can be the result of brain damage.

Dr. Fallon and other scientists increasingly believe that violent offenders emerge when three factors are combined: several "violent" genes; damage to certain brain areas; and exposure to extreme trauma and poor parental bonding in childhood. In other words, nature and nurture.
Notice how personal choice has dropped out of the picture.

I don't know about any of this stuff:

"'violent'" genes? Most people want to live and thrive, however misguided their approach. Whether violent crime results depends on where and how they live, what they expect from life, and how it squares with legal and social codes.

"damage to certain brain areas"? Well, that is unlikely to be inherited, but bad memories of brain damaged adults, passed down as stories, may well be a cultural inheritance.

"exposure to extreme trauma and poor parental bonding in childhood"? Sure, but for every person I have met who shipwrecked on the shoals of life on these accounts, I have met at least six who decided, "I will not live the way I learned."

Anyway, in my experience, the dictum that one should not practise on family members is a sound one.

Denyse O'Leary is co-author of The Spiritual Brain.

Hat tip: Stephanie West Allen at Brains on Purpose

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Neuroscience and popular culture: How much are journalists to blame for pop science culture?

Don't blame journalists, says Jonah Lehrer here on the reporting of science. He makes some excellent points:
Scientists are almost never subjected to critical coverage in the mainstream media. Quick: name the last newspaper or magazine article that dared to criticize or skeptically analyze a piece of published research. If you had trouble thinking of an article, it's because it almost never happens. And this isn't because science is perfect. As a JAMA study reported last year, almost a third of medical studies published in the most prestigious journals are wrong. Flat out false. These are the same studies that get that get faithfully recited in our daily newspapers day after day. This gullible reporting stands in sharp contrast to the way scientists actually perceive things. When I talk to scientists, I'm always impressed by the way they criticize the research of their peers. To take a recent example: a few weeks ago I spent over an hour listening to a neuroeconomist elegantly dissect a very influential fMRI study. (Other scientists subsequently echoed his criticisms.) And yet this same study has been covered extensively in the press, with nary a hint of skepticism. The fact is, science journalists suffer from an excess of politeness. We are intimidated by all the acronyms, and forget to ask difficult questions. But this is our duty. Most researchers, after all, are funded by tax dollars. They have an obligation to explain their research to the public.
He recommends that we stop letting science journals control the flow of news. I agree, except that in areas like "evolutionary psychology," public funding usually means a licence to propound whatever you want, and call it science. Anyway, assuming we all agree that this situation is a disgrace - in the phrase of the old folk tale - who will put the bell on the cat?

Look, I am a science journalist myself, and I say yes, blame science journalists. Too many of us just do not even think to ask enough of the right questions about too many stories.

In fairness, when we do ask, as Lehrer implies, we run into problems. Recently, I offered a piece to a peer reviewed science journal, on why most people do not believe atheistic materialism, as it is represented in popular culture. That's my specific beat.

I warned the editor that I write like a journalist, not like an academic. My offer was accepted, but when I got the peer review, I was dismayed.

It was full of pettifogging demands for definitions of stuff no one needs defining in the context.

Like, for example, when Dean Hamer says that we are a bunch of chemicals running around in a bag or Steve Pinker explains how infanticide "helps" evolution – what’s not to understand? Hundreds of millions of people read this stuff in the popular press - and they understand. It is a series of overlapping circles whose core is materialist atheism.

I withdrew the paper and found another home for it. From that experience, I realized two things:

1. I could never write anything they would want.

2. They would never want anything I could write. (Even though I know stuff they don't.)

Meanwhile, I wrote the lead editor, and said, “If a story rolled through the science press saying that “Sex with dogs helps evolution, study finds”, would anyone really be surprised?”

Would anyone question it? Would anyone ask, is this really science?

That would be nice. But be still, my heart! That train she be a long time comin'.
Hat tip: Stephanie West Allen at Brains on Purpose

Denyse O'Leary is co-author of The Spiritual Brain.

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Psychology: Think positively - or peel potatoes!

A friend tells me that the US Army's new weapon is "thinking positively":
FACED with rising rates of depression, post traumatic stress disorder, drug abuse and suicide among its war-weary soldiers, the Pentagon has turned to the founder of positive psychology, Martin Seligman, to train its troops in how to lead happier lives.

The aim of the four-year program is to make the US Army ''just as psychologically fit as physically fit'', Professor Seligman told the Herald, as a vanguard of more than 150 sergeants learnt about emotional resilience at his University of Pennsylvania research centre.

Despite their ''grizzled'' tough guy images, sergeants are in the best position to pass on psychological coping skills to soldiers in their command in a bid to prevent mental problems developing.

- Deborah Smith, science editor, "US Army's new weapon is thinking positively," Sydney Morning Herald, November 17, 2009
I do not know what "despite" is doing at the head of the last sentence. I would have thought that an experienced NCO or officer would be a useful resource for a troubled recruit.

I hope this’ll do some good (more than I can say for neuroshopping, and similar idle pursuits).

I am glad they US Army is doing this, but it is not new. Good officers have always helped their subordinates understand how to cope with crises and disasters. A person who cannot do so should not be an officer. He should fly a desk somewhere, where he can annoy people who are NOT risking their lives.

Denyse O'Leary is co-author of The Spiritual Brain.


Pop Neuroscience and spirituality: "Dear God, please don't exist, so I can get lucrative assignments, and maybe tenure, teaching easily digested rot .

Here's another gem from the treasure house of New Scientist (Andy Coghlan, "Dear God, please confirm what I already believe", 30 November 2009),
God may have created man in his image, but it seems we return the favour. Believers subconsciously endow God with their own beliefs on controversial issues.

"Intuiting God's beliefs on important issues may not produce an independent guide, but may instead serve as an echo chamber to validate and justify one's own beliefs," writes a team led by Nicholas Epley of the University of Chicago in Proceedings of the National Academy of Sciences.

The researchers started by asking volunteers who said they believe in God to give their own views on controversial topics, such as abortion and the death penalty. They also asked what the volunteers thought were the views of God, average Americans and public figures such as Bill Gates. Volunteers' own beliefs corresponded most strongly with those they attributed to God.
So is the cart pulling the horse, or is the horse pulling the cart? The researchers claim that they have demonstrated that we "map" God's beliefs onto our own. The idea that we might adopt the beliefs that we think God wants us to have is not under consideration.

When the researchers asked different volunteers to prepare speeches in which they took the opposite view from their professed one, we are informed that the volunteer's views of God's beliefs changed.

Of course, that could not be because they had, for the first time, needed to grapple with opposing arguments, could it? Anyway, much neuroscience handwaving in evidence here.

Ryan Sager at TrueSlant goes along for the ride.

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