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PubMed1986

Neuroscience and psychiatry: marriage or coexistence?

Psychiatry, which has experienced the influence of many thrusts in its history, is currently experiencing the impact of neuroscience. Clinicians view the impact with excitement and with apprehension. The author reviews examples of the excitement of scientific developments related to psychiatry. He traces the coexisting evolution of a more differentiated clinical psychiatry and deals with questions of reconciling neuroscience and behavioral approaches. The author's contention is that neuroscience will strengthen psychiatry and that biological and psychological integration will thus be enhanced.

Attitude of Health Personnel↗

PubMedDate not supplied

A neurosciences-in-psychiatry curriculum project for medical students.

OBJECTIVE: Incorporating new neuroscience findings relevant to psychiatry into the medical school curriculum is challenging, especially at the level of clinical learning. In this pilot project, third-year medical student volunteers in their required 8-week clerkship participated in an e-mail-based experience relating contemporary neuroscience to psychiatry. METHODS: A faculty preceptor guided participants using one of the participants' patient work-ups as a platform to explore questions related to the neurosciences. Participants were surveyed for follow up. RESULTS: Eleven of 13 eligible students agreed to participate in the study during one academic year. Data is qualitative, consisting of the responses of the students and the formulations and feedback of the preceptor as the project proceeded. CONCLUSION: Participants were successful in identifying symptom complexes in the sample history and in exploring their questions in the literature and with one another. The protocol is well-suited to distance learning, is relevant to psychiatric education, and is flexible in its application.

Curriculum↗

PubMed1994

Psychotherapy, neuroscience, and philosophy of mind.

Neuroscience is conceptually founded on a philosophy of mind known as identity theory. This theory claims that mental phenomena are reducible to the physical organ of the brain. But identity theory, and consequentially neuroscience, is unable to address essential human features of intentionality, consciousness, and autonomy, i.e., free will. Intentionally is the quality of having content or "aboutness," consciousness is quality of self-awareness, and autonomy is the ability to make undetermined choices. These essential human features make up our common sense and our psychodynamic understanding of ourselves. Without these features we would have to change our entire way of seeing ourselves and our dynamic psychotherapy would be impossible. We need intentionality in psychotherapy because it is only through the content of our patients' thoughts and feelings that we can help them derive meaning; we need consciousness because it is primarily through introspection that we get access to our patients' inner world; and we need autonomy because unless our patients have the option of doing things differently there is no point to the therapeutic endeavor. Consequently, psychiatry cannot rely solely on neuroscience as its basic science without creating a conception of people devoid of essential human features and without eviscerating its psychotherapeutic capacity.

Awareness↗

PubMed2002

Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism.

The strength of psychoanalysis has always been its understanding of affect and motivation. Contemporary developments in cognitive neuroscience offer possibilities of integrating sophisticated, experimentally informed models of thought and memory with an understanding of dynamically and clinically meaningful processes. Aspects of contemporary theory and research in cognitive neuroscience are integrated with psychoanalytic theory and technique, particularly theories of conflict and compromise. After a description of evolving models of the mind in cognitive neuroscience, several issues relevant to psychoanalytic theory and practice are addressed. These include the nature of representations, the interaction of cognition and affect, and the mechanisms by which the mind unconsciously forges compromise solutions that best fit multiple cognitive and affective-motivational constraints.

Affect↗

PubMed2005

Discovery and integrative neuroscience.

Hypothesis driven research has been shown to be an excellent model for pursuing investigations in neuroscience. The Human Genome Project demonstrated the added value of discovery research, especially in areas where large amounts of data are produced. Neuroscience has become a data rich field, and one that would be enhanced by incorporating the discovery approach. Databases, as well as analytical, modeling and simulation tools, will have to be developed, and they will need to be interoperable and federated. This paper presents an overview of the development of the field of neuroscience databases and associate tools: Neuroinformatics. The primary focus is on the impact of NIH funding of this process. The important issues of data sharing, as viewed from the perspective of the scientist and private and public funding organizations, are discussed. Neuroinformatics will provide more than just a sophisticated array of information technologies to help scientists understand and integrate nervous system data. It will make available powerful models of neural functions and facilitate discovery, hypothesis formulation and electronic collaboration.

Animals↗

PubMed2006

A systems approach to behavioral neurobiology: integrating psychodynamics and neuroscience in a psychiatric curriculum.

In the practice of medicine, an understanding of the biological functioning of organs and organ systems is the basis for theories of pathology and clinical practice. If psychoanalysis is to be accepted by the medical and psychiatric community, it must be based on a sophisticated understanding of the organ from which mental and emotional experiences emanate and use scientifically acceptable language. Each approach to psychotherapy has its own vocabulary for describing neuropsychological processes. Neurobiological vocabulary provides the various factions "neutral ground" upon which to carry on a multidisciplinary integrative dialogue. An understanding of behavioral neuroscience allows the therapist to look beyond the labels that spawn division and identify unifying biological principles that are described in a variety of ways in a multitude of theories. We contend that the neural network/representational approach to neurobiology views human mental experience as the result of multiple complex integrated systems, and is therefore holistic and antireductionistic in its perspective. Such a biologically informed psychotherapy facilitates integration of skill sets and flexibility in technique. With these principles in mind, the therapist can base his or her approach to the patient based on these principles rather than on devotion to one particular "school" or another. Because behavioral neuroscience supports many of the basic tenets of psychoanalytic theory, such an integrative psychotherapy would be psychodynamically informed. In this paper, we outline some of the ideas we present in our neuroscience course and how we relate biological concepts with some core principles of psychodynamics and psychotherapy.

Behavior Therapy↗

PubMedDate not supplied

[Neuroscience in Al Andalus and its influence on medieval scholastic medicine].

INTRODUCTION: Since the application of technical medicine by the Greeks, modern neurology has been based on a body of knowledge and cultural heritage from ancient times. In this paper we review the contribution made by Al Andalus to neuroscience during the Middle Ages and its repercussions on modern neurology. DEVELOPMENT: Following the death of Mohammed in the vii century AD, Islam enjoyed one of the most spectacular periods of expansion in the history of mankind. Occupation of the cities of Alexandria and Gundishapur put the Arabs into contact with original Greco Latin manuscripts, which were assimilated and divulged by Islamic scientists in the middle eastern caliphates of Damascus and Bagdad as well as the western caliphates of Al Andalus (Spain) and Kairwan (Tunis). This classical hippocratico galenico medicine was refashioned into the so called arabized galenism, which markedly influenced the Scholastics and the cultured world of the lower Middle Ages and became the basis of European medicine until well into the Renaissance period. There was a first Spanish cultural Renaissance in Al Andalus during the ix xii centuries, which led to a flowering unheard of in the Middle Ages before then. Andalusian doctors made major contributions to the body of knowledge about neuroscience and developed major philosophical concepts of human understanding. Thus, Abulcasis (936 1013), the father of modern surgery, developed material and technical designs which are still used in neurosurgery. Averroes suggested the existence of Parkinson s syndrome and attributed photoreceptor properties to the retina. Avenzoar described meningitis, intracranial thrombophlebitis, mediastinal tumours and made contributions to modern neuropharmacology. Maimonides wrote about neuropsychiatric disorders and described rabies and belladonna intoxication. CONCLUSION: Aside from the political, religious and cultural differences between Al Andalus and the Christian kingdoms of the Iberian peninsula, the historical Andalusian period (711 1492) forms one of the most brilliant periods of Spanish neuroscience.

History, Medieval↗

PubMedDate not supplied

[The occupational risk in IRCCS of Neurosciences].

The results of meta-analysis carried out on all documents for the valuation of the risk, recorded by IRCCS of Neuroscience, has led to identify a risk matrix for the medical personnel of the Scientific Institute of Neuroscience. Such analysis allowed to tackle the day to day risk faced by hospital staff. As a general rule the IRCCS of Neurosciences distinguishes themselves as structures of mainly neurologic typology and as structures of more typical psychiatric interest. In the first case the analogy with the traditional Hospital structures are more noticeable, in the second case instead the kind of patients and the particular relations between the health worker and the patient himself may represent an important differentiation factor. This is, above all, evident on the biological risk; for it's determinism has an important rule the interpersonal relationship between the health worker and the patient. Concerning other risk factors such as the chemical and the allergic one, it is noticeable a closed analogy with the actual Hospital reality. On work organization level, manual handling of patients is often necessary and also the relatives risks. In this kind of structures the stress factor is of the greatest importance, it should therefore have a strong consideration on the valuation of risk by the IRCCS.

Academies and Institutes↗

PubMed2004

Neurodevelopmental treatment stroke rehabilitation: a critique and extension for neuroscience nursing practice.

The aim of this article is to review neurodevelopmental treatment (NDT) literature and existing stroke NDT nursing research, as well as explore issues related to professional collaboration in stroke rehabilitation and implications for neuroscience nursing practice. NDT or the Bobath approach is used to encourage stroke patients to use the affected side of their body in order to promote and relearn normal movement and to reduce muscle spasticity. Neuroscience nurses have an important role in facilitating stroke patients to practise transferring out of bed and performing activities of daily living outside of physiotherapy and occupational therapy sessions. Neuroscience nurses also care for stroke patients over a 24-hour perio. Therefore, it is important that nurses understand physiotherapy and occupational therapy strategies in stroke rehabilitation.

Activities of Daily Living↗

PubMed1994

[Neuroscience and medical instruction].

The historical origins and developments of neuroscience are shortly revised. The recent advances at the molecular level and its relevance for clinical practice are emphasized. The general content of the programs and methods of neuroscience teaching in medicine are briefly discussed. It is concluded that neuroscience education in medicine must be expanded and reorganized in this country both at undergraduate and postgraduate level.

Curriculum↗

PubMed1993

[Neuropathology in the neurosciences. A system in transition].

Neuropathology (Np) is a full member of the neurosciences. As a basic neuroscience it is directed to the behaviour of nervous tissues under pathogenic conditions. The theoretical and methodical core of Np concerns the morphological features of pathological disorders and processes of the nervous system. The goal of Np data presentation is an objective description of the structural changes; their time course as processes, and if possible their causal constellations. Complementary to this analytical task is that of reconstructing the pathological process and at a higher level the conception of pathomorphological entities, e.g. as syndromes. Clinical Np is an alliance of Np with neurology, psychiatry and neurosurgery for representing the structural basis of diseases and the role of morphology in diagnosis and clinical management. Prerequisite for the proper functioning of Np is an integration with these other specialist fields. The clinical neuropathologist therefore has to be in certain respects also a neurologist. The same is true of the alliances of Np with other neurosciences, which is already reflected in recent neuropathological methodology. Detailed training programs are necessary for clinical Np, covering all aspects of its medical and social implications. Enough options should be offered for horizontal flexibility of curricula, futherance of secondary special training and support of good unconventional approaches by junior scientists.

Brain↗

PubMed1996

[Bibliometric evaluation of the Spanish scientific output in neurosciences. Analysis of the publication with international readership between 1984 and 1993].

A bibliometric study was made of the Spanish scientific output in the Neurosciences between 1984 and 1993. The material studied was selected in accordance with the Science Citation Index (SCI) for the year 1993 (Neurosciences section) and from the journals considered to be a "priority' by the data base Excepta Medica CD: Neurosciences. The usual bibliometric rules were used: price's law of scientific literature growth, Bradford's law of scientific literature dispersal and Lotka's law of author productivity. The national participation indices (IPa) in the leading publications with an international readership, the % SUP index (% of documents included in 10% of the world top quality production), the authors/articles index, institutional contributions and the geographical origin of these were all analyzed also. Our results showed an exponential growth in the Spanish neuroscientific literature (correlation coefficient: 0.981) and increasing IPa (period 1984-1988; 0.88; period 1989-1993: 1.59). A total of 1,488 original documents were analyzed. There was an impact factor (FI) of over 3 in 20.8% of the articles, with an average FI of 2.701. The % SUP was 6.07. The journal with the largest numbers of original papers in Brain Research (Bradford's first zone) with 186 articles and the largest IPa was in the Journal of Pineal Research (8.403). The total number of authors was 2,470, total signatures of authors were 5,958 (3.04% of the authors had a productivity index (IP) > or = 1 and 57% an IP = 0. The average number of authors/article was 4.02. The origin of the articles was: University (56.77%), Hospital (26.73%) and CSIC (14.95%). Scientific production was concentrated in the CCAA of Madrid and Cataluña 55.93%, followed by Andalucia, Castilla-León and Valencia (22.57%).

Bibliometrics↗

PubMed1996

The changing pattern of neuroscience PhDs in the UK.

The establishment by the Wellcome Trust of two four-year PhD programmes in neuroscience, in which PhD students will study neuroscience in greater depth and breadth and be able to make a more informed choice of PhD project and supervisor, marks a commitment to improving the quality of graduate training in neuroscience in the UK.

Education, Graduate↗

PubMed1992

Understanding implicit memory. A cognitive neuroscience approach.

Dissociations between implicit and explicit memory have attracted considerable attention in recent memory research. A central issue concerns whether such dissociations require the postulation of separate memory systems or are best understood in terms of different processes operating within a single system. This article presents a cognitive neuroscience approach to implicit memory in general and the systems-processes debate in particular, which draws on evidence from research with brain-damaged patients, neuroimaging techniques, and nonhuman primates. The article illustrates how a cognitive neuroscience orientation can help to supply a basis for postulating memory systems, can provide useful constraints for processing views, and can encourage the use of research strategies that the author refers to as cross-domain hypothesis testing and cross-domain hypothesis generation, respectively. The cognitive neuroscience orientation suggests a complementary role for multiple systems and processing approaches.

Animals↗

PubMed1996

Brain imaging and cognitive neuroscience. Toward strong inference in attributing function to structure.

Cognitive neuroscience has emerged from the neurosciences and cognitive psychology as a scientific discipline that aims at the determination of "how brain function gives rise to mental activity" (S. M. Kosslyn & L. M. Shin, 1992, p. 146). While research in cognitive neuroscience combines many levels of neuroscientific and psychological analyses, modern imaging techniques that monitor brain activity during behavioral or cognitive operations have significantly contributed to the emergence of this discipline. The conclusions deduced from these studies are inherently localizationistic in nature; in other words, they describe cognitive functions as being localized in focal brain regions (brain activity in a defined brain region, phi, is involved in specific cognitive function, psi). A broad discussion about the virtues and limitations of such conclusions may help avoid the emergence of a mentalistic localizationism (i.e., the attribution of mentalistic concepts such as happiness, morality, or consciousness to brain structure) and illustrates the importance of a convergence with information generated by different research strategies (such as, for example, evidence generated by studies in which the effects of experimental manipulations of local neuronal processes on cognitive functions are assessed). Progress in capitalizing on brain-imaging studies to investigate questions of the form "brain structure or event phi is associated with cognitive function psi" may be impeded because of the way in which inferences are typically formulated in the brain imaging literature. A conceptual framework to advance the interpretation of data describing the relationships between cognitive phenomena and brain structure activity is provided.

Animals↗

PubMed2000

Cognitive neuroscience: origins and promise.

Both Freud and Wundt had hoped to base psychology on an understanding of the neural basis of mental events. Their efforts were unsuccessful because the structure and function of the human brain was not available for empirical study at the physiological level. Over the last part of this century, there has been amazing growth and vitality in the field of human brain function. In this paper, we trace critical developments in the fields of cognitive psychology, neuropsychology, and brain imaging related to the development of cognitive neuroscience. Cognitive Neuroscience has established that the decomposition of mental events can be united with an understanding of the mental and emotional computations carried out by the human brain. Cognitive neuroscience has the capability of influencing psychology in diverse areas from how children develop to how adults age; from how humans learn to how we imagine; from volitional control to psychopathologies.

Adult↗

PubMed2000

Transcranial magnetic stimulation and cognitive neuroscience.

Transcranial magnetic stimulation has been used to investigate almost all areas of cognitive neuroscience. This article discusses the most important (and least understood) considerations regarding the use of transcranial magnetic stimulation for cognitive neuroscience and outlines advances in the use of this technique for the replication and extension of findings from neuropsychology. We also take a more speculative look forward to the emerging development of strategies for combining transcranial magnetic stimulation with other brain imaging technologies and methods in the cognitive neurosciences.

Animals↗

PubMed2001

Impact of a neuroscience intensive care unit on neurosurgical patient outcomes and cost of care: evidence-based support for an intensivist-directed specialty ICU model of care.

Analysis of patient data from a new neuroscience intensive care unit (NSICU) permitted evaluation of whether such a specialty ICU favorably altered clinical outcomes in critically ill neuroscience patients, and whether such a care model produced an efficient use of resources. A retrospective review was performed to compare (1) the clinical outcomes, as defined by percent mortality and disposition at discharge, between patients with a primary diagnosis of intracerebral hemorrhage treated in 1995 in medical or surgical ICUs and those treated in the same medical facility in an NSICU in 1997; and (2) the efficiency of care, as defined by length of ICU stay, total cost of care, and specific resource use, between patients treated in the NSICU and national benchmark standards for general ICUs during the 1997 fiscal year (FY). In the latter, extracted patient population data on neurosurgery patients requiring ICU treatment during FY 1997 were used with the following adjacent-disease related group (A-DRG)-coded diseases: craniotomy with and without coma or intracerebral hemorrhage, and skull fracture with and without coma lasting longer than 1 hour. Outcome measures of percent mortality and disposition at discharge in patients with intracerebral hemorrhage were significantly improved (P < .05), compared with those in a similar cohort treated 2 years earlier in a general ICU setting. Also, patients treated in the NSICU had shorter hospital stays (P < .01 ) and lower total costs of care (P < .01) than a national benchmark. The data suggest that a neuroscience specialty ICU arena staffed by specialty-trained intensivists and nurses is beneficial.

Aged↗