Psychiatry

Emotions and the brain

Posted on by Iasmina Hornoiu

Once upon a time, I promised I was going to write an article about how emotions affect our decision-making and why it is actually important not to ignore the feelings we have in certain situations…For several, unexplainable reasons I kept postponing this idea, and for that I am very sorry. Having said that, there is no better way of making up for this than to finally keep my promise. So, here we go!

I think I should start off with a small mention: emotions and feelings are distinct things, according to neuroscientist Joseph LeDoux. As he well puts it: “…feelings are what happen when we become consciously aware that our brain is reacting to some significant stimulus,” while it is possible that some brain structures, such as the amygdala “respond to emotional stimuli without the organism being aware of the stimulus.”

In order to achieve a better understanding of what the process of forming emotions involves, scientists talk about emotional experience and emotional expression. The latter refers to body manifestations and behaviours in response to certain stimuli, for example changes in facial expression, heart rate, sweating, skin conductance etc. It has been a subject of debate for several decades whether emotional experience or emotional response is the one responsible for formation of the other, or that they act independently. It is now believed that different emotions depend on specific parts of the brain and are determined by different neural circuits.

But why should we care about emotions in the first place? Some of you might find it strange, but emotions are intensely interconnected with reasoning and decision-making. And no, I don’t mean that they impair the process of making the right decision, it’s actually quite the opposite: most of the times we need emotions in order to be able to do what is best for us in a certain situation.

An interesting case: Phineas Gage 

A man who has gone down in history for surviving a terrible accident at the work place, but maybe mostly because of his importance in understanding the role of emotions in decision-making, is a late 19th century foreman, Phineas Gage. He had been hired as a foreman on a railroad construction site in Vermont and one of his tasks was to sprinkle explosive powder into blasting holes. This sounds like a dangerous thing to do, but Gage was regarded as one of the best people in this field: he was said to be very efficient, energetic, balance-minded, tenacious, a smart and successful business man etc.

One moment of carelessness dramatically changed his life forever, and at the same time had a huge impact on the way scientists began to think of emotions. The powder exploded and a tamping iron entered Gage’s head under his left eye, passing through his left frontal lobe, and exited the skull, leaving a hole which measured more than 9 cm in diameter.

Gage survived, but he “was no longer Gage”, as his friends and acquaintances used to say. Apart from losing vision in his left eye, the man had no motor or sensory deficits, he could hear, touch, sense, walk and talk. It was his personality that was completely changed. He became capricious, irreverent, impatient, and behaved as if he did could not predict, nor care about any professional or personal failure. He was soon fired and found different jobs over time, most of which were related to the accident and the iron rod, which had turned him into some sort of freak.

Some explanations and brain functions

The limbic system is probably the first to come to mind if you refer to brain areas involved in emotions. It consists of structures around the thalamus or in the temporal lobe, such as the amygdala, the hypothalamus, the limbic cortex, the cingulate gyrus, the fornix, the corpus callosum etc. Each one of these structures is involved in specific types of emotion and in triggering certain behaviours or responses through the autonomic nervous system. For example, the amygdala is linked to fear and aggression. Different regions (nuclei) in the amygdala are associated certain functions, so that both emotional expression and experience require the amygdala in order to be formed. Projections from amygdala are sent to the hypothalamus, which determines the autonomic response, the brain stem for behavioural reaction and the cerebral cortex, which is involved in emotional experience. The amygdala is also thought to play a role in enhanced emotional memory.

Regulation of specific emotional behaviours depending on the limbic system is facilitated by one of the major neurotransmitters, serotonine. Neurones containing serotonin originate in the brain stem (in the Raphe nuclei) and send projections to the hypothalamus. Serotonine is associated with a decrease in aggressive behaviour, but at the same time is involved in dominance, as proven by studies in rhesus monkeys.

The Papez Circuit (named after the neurologist James Papez who came up with the idea of an “emotional system”) is composed of interconnected anatomical structures (many of which are part of the limbic system) that link emotional expression and emotional experience together. Papez proposed that the cingulate cortex determines emotional experience, while the major structure involved in emotional expression is the hypothalamus. 

Below I have inserted a diagram showing the Papez Circuit, based on information from Bear et al. Note that the hippocampus is now thought to have less importance in the process of emotion formation.

The Papez Circuit

The discussion above does not fully explain what happened in the case of Phineas Gage. There is much more to emotion than that! Given the fact that the iron rod severely affected Gage’s frontal lobe, we should definitely focus our attention on this structure, too. The frontal lobe and the prefrontal cortices are involved in planning, reasoning, social behaviour, motivation, defining our personalities etc. Damage to these regions, especially to the ventromedial prefrontal cortices, results in decision-making impairment. While the intelligence and the other body functions remain intact, the patient who has suffered the damage is no longer able to exhibit normal social behaviour. The patient becomes emotionless and this lack of emotions and self motivation makes them incapable of making the right decisions.

If instead of the ventromedial prefrontal cortices, another region of the prefrontal cortices is affected, there is a very strong possibility that the patient’s intellectual abilities are compromised, along with their ability to form emotions. This region is called the dorsolateral prefrontal cortices. The person with a damage in this brain area would encounter severe difficulties when it comes to operations on numbers, words, space etc.

Another brain structure involved in the process of emotion forming is located in the right hemisphere. If the somatosensory cortices of this area are injured, the result would be similar to what can be seen in the case of a damaged ventral prefrontal cortex, but there is something more…the processes of basic body singling are also disrupted. This can be observed in patients suffering from anosognosia, a disease in which the patient is unaware and denies their disability.

I have tried to comprise a lot of information and simplify things as much as possible. If you managed to get here with both eyes open, I couldn’t be happier. Hopefully, you can see now why we should also “think with our hearts” when we need to decide about a certain situation…because the “heart” is somewhere in the brain and it knows better than us what we need to do.

For further information:

Antonio Damasio,1995. Decartes’ Error. Vintage Books

Bear et al., 2006. Neuroscience – Exploring the Brain. s.l.:Lippincott Williams & Wilknins pp. 564-581

Article about Phineas Gage

Image by Isuru Priyaranga 

Yourself…and decision-making!

Posted on by Iasmina Hornoiu

I recently came across a very interesting post on Facebook, written in Romanian. This post especially caught my attention first of all because it had been made by a group very dear to me, Yourself; secondly, the topic was exactly the one I was thinking about for my next article. It’s about the role of emotions in decision-making. To be honest, this is something I’ve been studying for a while and I’ve been struggling to synthesise the main ideas for an article. But this post had it all: it is clear, concise, easy to read and definitely not boring.

I now have a very good starting point for my article. So in the meantime, I thought, why not translate it? 🙂

“When we were small it was easy to write letters to Santa, because we knew exactly what we wanted and we made choices with no difficulty. But as we grew older, things got a bit more complicated; the further we navigate the path to maturity and complexity of life, the more it becomes a challenge to make up our minds.

Why is it sometimes so hard to make choices?; Why do we get anxious and agitated whenever we have to face the impossibility of making a decision? Perhaps it comes down to the fact that the process of decision-making involves many options, and taking the variables into consideration involves both reason and emotions.

The logical process of decision-making is based on determining the value of each option. We often try to rule out as many emotional aspects as possible, to detach from them, and to evaluate each alternative in a logical, almost mathematical, way.

On the other hand, decisions we make in particular emotional states, such as when we are angry or extremely happy, are said to be “in the heat of the moment”. So, which one of these two alternatives represents the best way of making a decision?

Antonio Damasio, a Neuroscience specialist, performed studies on people with deficits in the prefrontal cortex (which is responsible for decision-making, among other cognitive functions) and the cortical structures involved in generating emotions. These people would hardly make even the simplest decisions, such as choosing between fish or chicken as a meal, going shopping, taking a walk etc. He also noted that these individuals were able to reasonably evaluate the consequences of their choices and objectively analyse the alternatives, but could not or it was extremely difficult to make any decision, no matter how simple they were.

Going back to the idea of multiple variables in decision-making, emotions are part of these variables and it is important to acknowledge their role in this process. Life is full of choices and decisions, and we have to face them all. Moreover, if our decisions are based on strong moral values, we will find the necessary means to deal with any potential challenge, regardless the final choice (which we could be quite uncertain about).”

I hope you enjoyed it! 🙂

Drawing by James Dowinton

Yourself Facebook page 

Yourself website 

Autism

Posted on by Iasmina Hornoiu

As I was thinking about the way I should structure this article, a question kept running through my head: ”If we were to choose, do we want to be cool idiots or anti-social geniuses?” At first, common sense kicked in: “You cannot really put things like this; when it comes to human beings (and living creatures, in general) there are many shades of grey. Therefore, you can be smart and socially able at the same time. People are complex!” But what is intelligence? What really distinguishes intelligence from geniality? Are geniuses narrow-minded and do they excel in only one or two areas? Doesn’t being smart require broaden interests and different abilities, including social skills? Does intelligence involve creativity? So many questions, so many myths, so much confusion… I decided to write an article about intelligence at some point in the near future, but until then, let us focus on today’s topic – Autism!

Autism Spectrum Disorder is a rather peculiar brain disorder with contradictory manifestations. It is one of the reasons for the avalanche of questions above, and it has often left scientists baffled. I am sure most of you are all well aware of the characteristic symptoms an autistic person portrays. If you remember when we talked about empathy and mirror neurones in a previous article, we mentioned autism in the context of a dysregulation in the activity of mirror neurones. As a result, autistic people do not understand and tend to avoid other people, and they might not allow others to touch them. They also develop stereotypical behaviours. Repetition and strict schedules is what people with autism need in order to feel calm and safe. Anything that is out of the ordinary, according to their particular set of rules, can wreak havoc.

Some of you might add that autistic people have severe mental disabilities. I would like to point out a relevant distinction here: patients with Asperger’s syndrome show normal intelligence and often impressive language skills, and are not characterised by the same anti-social behaviours as autistic patients. The latter was first described by Leo Kanner in 1943, whereas Asperger’s syndrome bears the name of its discoverer who, nevertheless, used the same term (autism) in 1944 to describe the disease.

What is amazing about many autistic people is that, despite their so-called “mental retardation” and subaverage IQ (between 30 and 60), they exhibit incredible and unique talents, usually in one or two fields. These fields can rage from art and music to maths and impressive arithmetic skills. Either they are multi-instrumentalists, polyglots, compulsive drawers or writers, or are able to do almost impossible mental calculations, and it comes as no surprise that autistic people were also notorious geniuses (e.g., Michelangelo Buonarroti, Pablo Picasso, Amadeus Mozart, Charles Darwin, John Nash).

On top of this, autistic people can learn a new language or a classical music composition in a matter of days or even instantaneously (as it is the case of multi-instrumentalist Leslie Lemke). And if you are still not impressed, some have an amazing memory, being able to retain every information they read. Kim Peak, the man who inspired the famous film ” Rain Man”, has stored in his memory all the details in the around nine thousand books he has read throughout his life. Nevertheless, he is regarded as retarded and is almost completely dependent on his father.

But what actually happens inside those incredible people’s brains? What makes them work in a way normal people cannot, and yet still, why do they lack what we have? One possible explanation comes down to genes. It appears that a mutation in the fmrp gene causes the loss of the encoded protein, leading to structural brain modifications. The FMRP protein regulates synthesis of proteins in neurones and its absence leads to overly developed brain tissue.

Another theory has to do with brain trauma (such as in the case of epilepsy) at an early age, which can trigger different parts of the brain to be cross-activated. This, in turn, leads to another very interesting phenomenon – synaesthesia. Therefore, autistic individuals associate numbers or different other objects with colours, odours or shapes. This can account for their unbelievable abilities to memorise so much information. Some scientists believe that it is the loss of particular functions in the brain that trigger the genius abilities, more specifically the brain regions that control “higher” cognitive processes are or become inactivated. Ironic as it sounds, the talents of autistic people, which we all aim for, are actually linked to subcortical areas and in a normal individual are usually suppressed by the functions of the cerebral cortex. We can now understand why normal people are “normal” and autistic people are different.

As always, there is much more to tell, but unfortunately limited space requires this article to come to an end. I will come back to this in a future article about the creativity and intelligence. Until then, how about you reflect on the questions at the beginning of this article for a while? Also, I added a link to a very interesting video about an autistic young man who is not only extremely talented but also (surprisingly!) socially able.

For further information:

Antonio Damasio,1995. Decartes’ Error. Vintage Books

Bear et al., 2006. Neuroscience – Exploring the Brain. s.l.:Lippincott Williams & Wilknins pp. 706

Dick Swaab, 2014. We are our brains – From the womb to Alzheimer’s. Penguin Books, pp. 185-194

Video Daniel Tammet (highly recommended) 

Image by Damaris Pop

Mechanisms of schizophrenia

Posted on by Iasmina Hornoiu

It took me a while to figure out whether to divide this article into two parts or to sum up everything in one long, possibly tedious reading. Honestly, I still don’t know, so I’ll just start writing and we shall see what it turns out to be.

I’m sure you’ve all heard of schizophrenia – the disease of thought disorder, or know people who suffer from it. But only a few actually understand what it is about.

No wonder scientists have been struggling to develop efficient treatments for schizophrenia; not only is it largely uncommon (1% of the world’s population is affected), but also its causes are usually unknown. Scientists generally refer to schizophrenia as a psychiatric disease involving a progressive decline in functioning, which begins in early adolescence and persist throughout the patient’s life. Due to its heterogenous symptoms and multiple possible causes, there are many hypotheses that intend to explain what triggers schizophrenia and how it develops.

In spite of the fact that is it a genetic disorder, the environment and external factors (such as viral infections during the intrauterine and infant period) may be crucial to the development of schizophrenia. The symptoms have been divided into two categories. The positive symptoms include thought disorder, hallucinations, delusions, disorganised speech etc., whereas the negative symptoms are characterised by poverty of speech, reduced expression or emotion, memory impairment, anergia, abulia etc. In addition, the brains of schizophrenics show structural macroscopic abnormalities (for instance, the enlarged ventricles and the shrinkage of the surrounding brain tissue), as well as microscopic changes, such as the dysregulation of dysbindin gene in the formation of abnormal dendritic filopodia. There are three types of schizophrenia, according to its symptoms: paranoid schizophrenia – auditory hallucinations, delusions, strong belief of being chased by powerful people; disorganized schizophrenia – reduced emotions and lack of emotional expressions, incoherent speech (mostly negative symptoms); catatonic schizophrenia – impairment of movement, usually immobility and catatonia, bizarre grimacing (this is similar some of the symptoms of hysteria, which has been described as a sexually related and later on, as a psychiatric disorder up until the beginning of the 20th century).

But enough with the boring general details! Let’s get to the fun part: The monoamine hypothesis of schizophrenia! Here we are going to talk about two very important neurotransmitters in the central nervous system: dopamine and glutamate. The second one is the main excitatory neurotransmitter in the brain. There are four main types of glutamate receptors: AMPA, NMDA, kainate and mGluRs. It has been demonstrated that reduced activity of the NMDA receptors can result in some of the negative symptoms of schizophrenia (lack of social behaviour, catatonia).

Dopamine is the metabolic precursor of another neurotransmitter, noradrenaline (norepinephrine). But there is a lot more to dopamine and its roles in the brain than this. There are four main dopaminergic pathways: the mesolimbic pathway – related to the “reward” system and significance; it has its roots in the ventral tegmental area and projects to the nucleus accumbens (in the ventral striatum) and the limbic system; the mesocortical pathway – involved in cognition and motivation; the tuberoinfundibular pathway – roles in lactation; these dopamine neurones originate in the hypothalamus; the nigrostrial pathway – involved in movement planning and connects the substantia nigra (midbrain) to the striatum.

Schizophrenia and another mental illness, a neurodegenerative one, Parkinson’s disease, are also linked to dopamine. When it comes to schizophrenia, it seems that the mesocorticolimbic pathways have more influence on its onset: the ‘positive’ symptoms appear to be triggered by dopaminergic hyperactivity in the mesocorticolimbic system. At the same time, hypoactivity of dopamine is this region is the cause of ‘negative’ symptoms. Nevertheless, it has been discovered that overexpression of the dopamine receptor D2 (DRD2) gene in the striatum also reduces motivational behaviour in mice, therefore mimicking psychotic ‘negative’ symptoms. Similar findings show that increased density of dopamine D2 receptor in the striatum, along with lower thalamic density of this receptor appear to induce divergent thinking, which is associated with schizophrenia.  

All these changes may account for the abnormalities that we see in “mad” people. It seems that we are so fragile, given that often small chemical and physical disruptions can trigger something as big and terrifying as schizophrenia. Imagine hearing, seeing, feeling, smelling things everyone says are not real (schizophrenics often have multiple hallucinations: auditory, visual, gustatory, tactile, olfactory). But to you they are so real and disturbing! Many schizophrenics even hear their own thoughts as if they are coming from the outside and therefore believe that everyone knows what’s in their heads. Imagine having the constant feeling that someone is after you (paranoia) or being certain that you are dead (the Cotard’s Syndrome) or that your husband has an affair (the Othello Syndrome).

I think this topic can never be fully covered and we would spend days talking about schizophrenia, so this article should better come to an end. As I am sure you have lots of questions and comments, don’t be shy and post anything you think it’s relevant to what has been discussed above. Hope you enjoyed this reading.

For further information: 

Bear et al., 2006. Neuroscience – Exploring the Brain. s.l.:Lippincott Williams & Wilknins, pp. 679-684

de Manzano et al., 2010. Thinking Outside a Less Intact Box; Thalamic Dopamine D2 Receptor Densities Are Negatively Related to Psychometric Creativity in Healthy Insividuals. Public Library of Science

Jia et al.,  2014. The Schizophrenia Susceptibility Gene Dysbindin Regulates Dendritic Spine Dynamics. The Journal of Neuroscience, Oct.pp. 34-41

Kandel et al., 2011. Modeling Motivational Deficits in Mouse Models of Schizophrenia: Behavior Analysis as a Guide for Neuroscience. Behavior Processes, pp. 149-156

Kolb et al., 1996. Fundamentals of Human Neuropsychology. 4th Edition ed. s.l.:W.H. Freeman and Company

Image by Damaris Pop