Download N E U R O A N A L Y S I S : - PROJECT OUTLINE Avi Peled, M.D.

NEUROANALYSIS:
- PROJECT OUTLINE
Avi Peled, M.D.
Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa,
Israel
Scientific Background & Explanation
NeuroAnalysis is an ambitious project to bring together neuroscience and psychiatry
in the every-day clinical practice of the psychiatric clinician (even those how are not
researchers). This will be achieved by reconceptualizing mental disorders as braindisorders using a literature-based "translator" titled "Clinical Brain Profiling" (CBP
Peled 2006; 2009; 2010; 2010). CBP introduces neuroscientific terminology into the
diagnostic process of the clinical psychiatrists thus orienting the field toward a validable neuroscientific diagnostic approach, one that reveals the ethiopathology of
mental disorders offering a novel orientation toward therapies and cures.
It may seem trivial for an outsider that psychiatrists should use brain-related science
in their diagnosis for mental disorders but this is not the case. Today when a
psychiatrist diagnoses patients as having depression anxiety or schizophrenia, these
diagnoses do not have anything to do with neuroscience. Typically the diagnosis will
involve description, i.e., giving a name to the complaints (symptoms) of the patient, if
the patient complains of depressed mood, helplessness, reduced motivation, reduced
appetite and insomnia, he will get the diagnostic title of "depression," this diagnosis
has no added value to the patient or the clinician. It is unlike the regular physician that
diagnosis appendicitis when the patient complains of stomach ache. Upon diagnosing
appendicitis the physician gains added values he knows where (in the body) to go and
what to do (for cure). The psychiatrist that has diagnosed depression or schizophrenia
does not know where to go (in the brain) and what to do for treatment.
Diagnosing mental disorders neuroscientifically is based on the assumption that
mental disorders arias from altered normal optimal brain organization. The normal
brain optimizes connectivity and hierarchical organizations to achieve integrated
information processing and high-level coherent stable conscious experience (Tononi
2010).This is achieved via active synaptic plasticity, offering adaptive dynamic
connectivity needed for brain organization and computation. Small world organization
has been found to be an optimal organization for brain networks (Yan and He 2011).
The healthy brain generates predictions about its environment, creating prophetic
internal models of the world around it (Carhart-Harris and friston 2010) and uses
them as guidance for adaptive efficient behaviors and decision making, these internal
models character how we perceive ourselves and react to others very much shaping
our personality styles. These internal representative predictive models are embedded
in basic network connectivity structures recently found to become known as defaultmode networks (Otti et al 2011).
Over the last decade psychotic symptoms of schizophrenia have been correlated with
many findings pointing toward a disconnection dynamics afflicting the brains of such
patients (Jones 2010). Thus these findings point to the assumption that schizophrenia
symptoms relate to connectivity imbalances in the brain (Peled 1999). When global
brain organizations collapse fragmentation of integrated experience ensues with
resulting psychotic symptoms. The range of schizophrenia symptoms and their
heterogeneity receive explanation from the different degrees and wide range patterns
of connectivity imbalances afflicting the brain of schizophrenia patients (Peled 1999).
Additionally the implication of neuronal plasticity in depression has been
accumulating in recent literature (Baudry et al 2011), this is evident as neuronal death
is correlated with depression, and antidepressant medications act by inducing
neurogenesis and synapto-genesis. Accordingly a synapto-plasticity etiology of
depression can begin to take shape in the form related to plasticity and adaptability.
The idea that personality relates to internal representations upon which we perceive
and react to psychosocial occurrences is centuries old wisdom (McCarthy 1995). The
ability of neuronal network ensembles to incorporate and activate memories is also a
known fact (Rumelhart, and McClelland 1986). Thus neuronal network organization
of the brain can account for internal representations and the recently discovered
Default-Mode-Network can offer a reasonable basic, whole-brain, network
construction for internal representations that determine personality stiles and traits.
These advances in neuroscientific understanding allow for a "default-mode-networkdisturbance" hypothesis underlying the causes of personality disorders.
Equipped with these preliminary insights, a neuroscientific approach to psychiatric
complaints can be generated. Clinical rain profiling (CBP) translates clinical
manifestations of patient to their presumed set of brain alterations or disturbances
(Peled 2006; 2009; 2010; 2010).
What is achieved by introducing CBP? First it achieves introduction of neuroscience
into psychiatric clinical work in a way nonexistent today. Second, it offers novel
perspectives for more effective future therapeutic strategies.
Regarding introduction of neuroscience into psychiatric, for example the psychiatrist
on the night shift, representing a patient to his colleague, replacing him on the ward
for the morning shift, will describe patient phenomenology in neuroscientific terms.
You will find him saying "this patient complains of depression and has a long history
of non-adaptive personality traits; it seems he is suffering from de-optimization
dynamics related to immature biased default-mode-network organizations." Another
patient suffering from disintegrated conscious experience (psychosis), will be
presented as having "connectivity imbalance" of a "disconnection type." As a first
step such language immediately engages the clinician with the relevant neuroscience
of his patient bringing psychiatry back to neuroscience. As a second step it opens up
directions for therapeutic interventions.
Regarding novel perspectives for more effective future therapeutic strategies, these
neuroscientific conceptualizations immediately entails what needs to be achieved to
cure the patients. For example the first patient requires induction of plasticity
dynamics that will, both optimize brain dynamics (antidepressant effect), and lay the
ground for improving upon the default-mode-network organization. This can be done
with applying relevant experience-dependent corrective protocols (more targeted
psychotherapy-like strategies). The second patient that with psychotic manifestations,
may be scheduled for connectivity rebalancing protocols using brain stimulation,
magnetically/electrically driven, or optogentically engineered.
In summary it seems we are fast approaching the time when psychiatrists will
diagnose their patients' neuroscientifically using CBP-like formulations. Such
achievement is a critical step toward effective cures for mental disorders.
Resources & scientific tools
Web-based CBP program including tutorials, video tutorials and usage manuals at:
http://neuroanalysis.org.il/
Plan
In this proposal two phases are proposed, 1) an educational phase creating active
clinical-research professional international teams using CBP as their scientific
framework, 2) these newly professional research-clinicians will come together
(meetings and collaborations) to develop new brain-technologies for curing mental
disorders.
Funding
The necessary funding for organizing managing workshops, meetings and setting up a
university based degree program
For workshop see: http://neuroanalysis.org.il/wp-content/uploads/2011/09/NA_Workshop_Call-for-registration.pdf
For
degree
program
see:
http://neuroanalysis.org.il/wpcontent/uploads/2010/11/Neuroanalyist_training_program.pdf
References
Peled A. Brain profiling and clinical neuroscience. Medical hypothesis 67,
941-946 2006.
Peled A. Neuroscientific psychiatric diagnoses. Medical hypothesis 73, 220229 2009.
Peled A. The paradigm shift for psychiatry is already here!. AAP&P vol 2;
3.17. P51, 2010
Peled A. The neurophysics of psychiatric diagnosis: Clinical brain profiling. Med
Hypotheses. 2010 Sep 7.
Tononi G Information integration: its relevance to brain function and consciousness.
Arch Ital Biol. 2010 Sep;148(3):299-322.
Yan C, He Y. Driving and driven architectures of directed small-world human brain
functional networks. PLoS One. 2011;6(8):e23460. Epub 2011 Aug 12
Carhart-Harris RL, Friston KJ. The default-mode, ego-functions and free-energy: a
neurobiological account of Freudian ideas. Brain. 2010 Apr;133(Pt 4):1265-83. Epub
2010 Feb 28.
Otti A, Gündel H, Wohlschläger A, Zimmer C, Sorg C, Noll-Hussong M.
[Default mode network of the brain : Neurobiology and clinical significance.]
[Article in German] Nervenarzt. 2011 May 18. [Epub ahead of print]
Jones MW Errant ensembles: dysfunctional neuronal network dynamics in
schizophrenia. Biochem Soc Trans. 2010 Apr;38(2):516-21.
Peled A. Multiple constraint organization in the brain: a theory for schizophrenia.
Brain Res Bull. 1999 Jul 1;49(4):245-50.
Baudry A, Mouillet-Richard S, Launay JM, Kellermann O. New views on
antidepressant action. Curr Opin Neurobiol. 2011 Apr 27
Peled A. The neurophysics of psychiatric diagnosis: clinical brain profiling. Med
Hypotheses. 2011 Jan;76(1):34-49.
McCarthy JB. Adolescent character formation and psychoanalytic theory. Am J
Psychoanal. 1995 Sep;55(3):245-67
Rumelhart, D.E., McClelland J.L., Parallel Distributed Processing: Exploration in the
Microstructure of Cognition, PDP Research group ed., Vol. 1 and 2. (MIT Press,
Cambridge, 1986).