Tuesday, April 29, 2014

Stress Rx: Chant two Ommsss, with food, twice daily

How can and should meditation be used to restore physical and mental health in a clinical setting?  That is the question that Emory University neuroscience graduate student Jordan Kohn posed to begin the latest Neuroethics Journal Club.  The discussion thereafter centered on Black et al.’s 2013 Psychoneuroendocrinology paper entitled “Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial.”1 This paper laudably attempts to bridge the mind-body gap and suggests a biological, and perhaps more importantly, a genetic mechanism to explain how yoga can apparently help relieve stress, protect against depression, and restore immune function in caregivers.  The implications of this line of investigation could be widespread as the scientific and medical communities grapple with our fundamental understanding of the mind and body and how to integrate what used to be considered fringe or alternative approaches into the mainstream.

Caregivers for dementia patients have been widely studied because they experience high levels of chronic stress and in turn suffer high rates of depression and other mental and physical health problems.2 Both acute and chronic stress can drastically alter immune system function3 and, not surprisingly, dementia patient caregivers show marked impairments in immunological measures.4 The connection between the immune system and mental health is increasingly studied for its apparent bi-directionality.  Sickness behavior – characterized by fatigue, poor sleep, irritability, and lack of appetite – closely resembles major depression.  In fact, pro-inflammatory cytokines, which are up-regulated during an infection, can induce depression.4

Tuesday, April 22, 2014

Why People’s Beliefs about Free Will Matter: Introducing the Free Will Inventory

*Editor's note: Jason Shepard was one of Emory Neuroethics Program's inaugural graduate Neuroethics Scholars. His co-authored manuscript mentioned below is related to his Scholar's project.

Recently, the question of whether our notions of free will, along with whether our responsibility-holding practices that appear to be based on free will, can survive in light of discoveries from the behavioral and brain sciences was named as one of the Top Ten Philosophical Issues of the 21st Century. The interest in free will and how discoveries in neuroscience and psychology affect our beliefs and attitudes about free will extends well beyond the halls of philosophy departments. The topic has also attracted a lot of interest from neuroscientists, biologists, and psychologists [1]. And, of course, these very debates are of central interest to neuroethicists. The wide range of interests in these debates is a symptom of the fact that these debates matter: The debate over what people believe about free will and how discoveries in the behavioral and brain sciences might impact these beliefs matter for a wide range of theoretical, and perhaps more importantly, practical reasons. Much of the empirical research in this area also points to the need for a valid and reliable tool for measuring people’s beliefs about free will. Below, I touch on some of the reasons why people’s belief in free will matters, and I introduce a new tool for measuring beliefs about free will, the Free Will Inventory, which was published in this month’s issue of Consciousness and Cognition [2].

The free will inventory is available in this month's issue of Consciousness and Cognition.

Whether people believe in free will matters. People’s beliefs in free will impact their behaviors. For example, experimental studies have shown that telling people they don’t have free will increases cheating and stealing, decreases prosocial behaviors and increases aggression, increases conformity, reduces self-control, and impairs the detection of errors. Other studies have shown that belief in free will is positively correlated with job performance of day laborers, and belief in free will is positively related to expectations of future occupational success in college students. These findings suggest that believing in free will may be instrumentally valuable from the standpoints of positive psychology and public morality[3].

Tuesday, April 15, 2014

Ethics, Genetics, and Autism: A Conversation with Dr. Joseph Cubells

Dr. Joseph Cubells
Dr. Joseph Cubells is an Emory psychiatrist who focuses on working with adults with developmental and behavioral disorders, especially Autism Spectrum Disorders (ASD). He is on the cutting edge of using molecular genetics to identify genetic anomalies in his patients with the aim of improving and refining treatment packages. I spoke with Dr. Cubells about his work and the ethical implications of the use of genetic microarray tests with patients. After providing more details about how he uses molecular genetics in his practice, I will focus on our discussion of two primary issues related to his work: (1) the communication of genetic testing procedures and results to families and, (2) the role of health care systems in the widespread use of these tests. 

  Dr. Cubells is primarily engaged in clinic work. He has over 200 cases and works exclusively with adults (he does not see patients under the age of 16). Molecular genetics is one technique used in his patient management strategies: “I am very interested in the role of molecular genetic testing in the care of people with neurodevelopmental disabilities. Not so much establishing a diagnosis of autism though because autism is a behavioral diagnosis.” In other words, because there is no genetic or otherwise biologically based test currently available for autism, Dr. Cubells and his team are interested in diagnosing other genetic differences, such as Phelan McDermid Syndrome which occurs when a chromosome is deleted after conception (de novo) and can lead to a variety of physical and developmental disabilities. This condition, and many other genetic anomalies, may contribute or directly lead to the development of autistic characteristics. Most professionals, including myself and Dr. Cubells, now agree that there is not a single ‘autism’ but, rather, many different ‘autisms’ with many different causal pathways, both genetic and environmental.

Tuesday, April 8, 2014

Can free will be modulated through electrical stimulation?

The will to persevere when many of life’s challenges are thrown at us is an ability that comes more naturally for some than for others. Additionally, even the most determined among us have days and times when moving forward through a challenging task just proves too difficult. The subjective nature of this experience can make it difficult to study, but recently researchers from Stanford University published a case study where electrical brain stimulation (EBS) to the anterior midcingulate cortex (aMCC) left two patients with the feeling that a challenge was approaching, but also that they could overcome it [1]. For the most recent journal club of the semester, Neuroscience graduate student and AJOB Neuroscience editorial intern Ryan Purcell led a discussion on the experimental procedure to stimulate what is referred to as the “the will to persevere” and the effect this technology may have if it were to become more mainstream in society.

"The location of the electrodes in P1 and P2 overlaid onto the standard emotional salience network derived from a group of normal human subjects." Parvizi et al.

Tuesday, April 1, 2014

Lamarckian sh*t? Why epigenetics is not eugenics

An argument could be made that communicating scientific advances to the public has never been more important. As the NIH budget stagnated, and then was cut by Sequestration, many of us have realized what a poor job we have been doing convincing the public of the importance of basic science research. Neuroscience itself has been under more scrutiny recently. As Adam Gopnik of The New Yorker wrote in a review of three new books bashing brain research, “Neuroscience can often answer the obvious questions but rarely the interesting ones.” If that is the way that the public sees it, then clearly we are losing something in translation. Recently there has been a push to reverse this trend and reaffirm biomedical research as a source of inspiration and hope for the public. The actor and author Alan Alda, who has long held a passion for science, has made it a personal mission to improve communication about science because “How are scientists going to get money from policy makers, if our leaders and legislators can’t understand what they do?”1

Late last year, Brian Dias, a postdoctoral fellow in Kerry Ressler’s laboratory at Emory, found out just how difficult communicating his work to the public can be. Dias and Ressler had been working on testing whether olfactory fear conditioning would transmit a sensitivity to the conditioned odor across generations. That is, using a mouse model they were exploring whether an experience in your lifetime could affect your children or grandchildren’s response to their environment. They studied the olfactory system because it is extraordinarily well-mapped (thanks in large part to work that Dr. Ressler did in Nobel Laureate Linda Buck’s lab as a graduate student) and shows gross structural changes in mice when they learn to associate an odor with an unpleasant experience1. Recently, there has been a great deal of interest in understanding how an organism’s environment can affect the way in which genes are expressed via a phenomenon call epigenetics.

Epigenetics refers to chemical modifications to the genome that do not affect the DNA sequence itself. Normally, the DNA molecule of each chromosome is tightly packed in a highly complex yet orderly fashion so that it can fit inside the nucleus of the cell. Several types of chemical modifications can be made to DNA that affect how tightly it packs and in turn, the ability of enzymes to transcribe the sequence and initiate the production of the proteins that it codes for. Epigenetic marks do not affect the letters in the code, just how often it is read. Genes can effectively be silenced or activated by these mechanisms, which are still not completely understood.