Neuroscience in the future of psychiatry.
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This paper reviews neuroscientific advances across the therapeutic disciplines and outlines new potential insights into understanding the biology of the psychotherapeutic processes. In a quest to understand the modus operandi of psychotherapy, the author reviews the evolution of the biology of psychotherapy. The mechanisms involved in learning processes, such as memory and priming, attachment, and long-term consequences of early life trauma, demonstrate how brain structures can be affected by environmental changes. Finally, the author proposes that verbal and non-verbal aspects of the psychotherapeutic process mediate their therapeutic effects through biological changes as they work on primitive emotional reflexes and stimulate mentalization processes.
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Brain atlases are equivalent to neuroimage databases provided an appropriate coordinate system to enable multisubject comparisons, along with comprehensive descriptions of the data, are included. Warping tools, visualization, and statistical analyses that accommodate the various neuroimaging modalities can be used to integrate diverse data and form comprehensive maps describing a particular subpopulation's brain structure and function. By linking task performance and genetic information to brain morphology, complex interrelations between genotype, phenotype, and behavior can be established. Several examples of these multimodal, multisubject atlases, including those that are dynamic, are presented.
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Gene delivery to the nervous system represents perhaps the ultimate challenge of gene therapy in view of the complexity of this system, the wide variety of intractable neurological diseases, and the need to deliver the gene to nondividing cells. Although a variety of systems for such gene delivery are under development, herpes simplex virus has unique advantages in terms of its large genome size and its ability to naturally enter a latent state in neuronal cells. Considerable progress has been made in the effective disablement of this virus while retaining its ability to deliver genes and in producing long-term expression of the foreign gene. It is likely that these viruses may ultimately be of use in human gene therapy procedures for otherwise intractable neurological diseases such as Parkinson's disease.
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Magnetoencephalography (MEG) is a noninvasive neuroimaging method for detecting, analyzing, and interpreting the magnetic field generated by the electrical activity in the brain. Modern hardware can capture the MEG signal at hundreds of points around the head in a snapshot lasting only a fraction of a millisecond. The sensitivity of modern hardware is high enough to permit the extraction of a clean signal generated by the brain well above the noise level of the MEG hardware. It is possible to identify signatures of superficial and often deep generators in the raw MEG signal, even in snapshots of data. In a more quantitative way, tomographic images of the electrical current density in the brain can be extracted from each snapshot of MEG signal, providing a direct correlate of coherent collective neuronal activity. A number of recent studies have scrutinized brain function in the new spatiotemporal window that real-time tomographic analysis of MEG signals has opened. The results have allowed the variability in a single area to be seen in the context of activity in other areas and background rhythmic activity. In this view, normal brain function is seen as a cascade of extremely fast events and the unfolding of specialized processes, segregated in space and time and organized into well-defined stages of processing.
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