Dignity neuroscience: universal rights are rooted in human brain science

How does the Brain Matter for the Dignity of Mind and Law?

What does the brain mean in a legal domain, and how does integrating neuroscience and law go beyond the practical difficulties highlighted by social scientists and legal theorists? The debate about the confluence of neuroscience and law is both promising and uncertain. Legal theorists took it as a conceptual error, and neuroscience advocates find it a promising emerging field. The social psychological approach towards law is for critical integration of both. Scholars took an alternative route, considering it a fascinating element of scientific discourse. The present article aims to show that the coming of "brain language" in the everyday legal discourse will not become a reality, as truth is inferred through everyday experiences and the interpretations of scientific knowledge. Scientific knowledge through mapping active brain areas by the available brain visualizing techniques shows the correlation between the brain and behavior, not the causation. So, its use in the legal domain seems less institutionalized, showing the determinism of the brain as less authentic in itself when compared with the intuitive path embedded in culture and history. Implication for sociolegal psychology working for dignity and social justice is discussed.

Dignity in people with dementia: A concept analysis

Background: Dignity, an abstract and complex concept, is an essential part of humanity and an underlying guiding principle in healthcare. Previous literature indicates dignity is compromised in people with dementia (PwD), but those PwD maintain the capacity to live with dignity with appropriate external support. Alzheimer's disease and related dementias (ADRDs) lead to progressive functional decline and increased vulnerability and dependence, leading to heightened risks of PwD receiving inappropriate or insufficient care that diminishes dignity. Considering the increased disease prevalence and the continuously escalating costs of dementia care, establishing a productive value-based guideline may prevent suffering, maximize dignity, and thus promote quality of life (QoL).Aim: The goal of this project is to identify actionable targets for integrating dignity harmoniously and practically into care planning and management for PwD.Research Design: We conducted a concept analysis using Walker and Avant's eight-step process. A comprehensive literature search was conducted (PubMed and CINAHL) with the keywords "dignity," "dementia," "Alzheimer's disease," and "dementia care."Results: A total of 42 out of 4910 publications were included. The concept of dignity in PwD is operationalized as the promotion of worthiness and the accordance of respect that allows the presence and expression of a person's sense of self, regardless of physical, mental, or cognitive health. The concept has two subdimensions: absolute dignity which encompasses the inherent self and relative dignity characterized by its dynamic reflective nature. Worthiness and respect are the two main attributes, while autonomy is an underlying component of dignity. Specific antecedents of dignity in PwD are empowerment, non-maleficence, and adaptive environmental scaffolding. As a consequence of facilitating dignity in PwD, QoL may be enhanced.Conclusion: As a foundational and necessary humanistic value, incorporating dignity into dementia care can lead to efficient and effective care that optimizes QoL in PwD throughout their disease progression.

Artificial intelligence in neurology: opportunities, challenges, and policy implications

Neurological conditions are the leading cause of disability and mortality combined, demanding innovative, scalable, and sustainable solutions. Brain health has become a global priority with adoption of the World Health Organization's Intersectoral Global Action Plan in 2022. Simultaneously, rapid advancements in artificial intelligence (AI) are revolutionizing neurological research and practice. This scoping review of 66 original articles explores the value of AI in neurology and brain health, systematizing the landscape for emergent clinical opportunities and future trends across the care trajectory: prevention, risk stratification, early detection, diagnosis, management, and rehabilitation. AI's potential to advance personalized precision neurology and global brain health directives hinges on resolving core challenges across four pillars-models, data, feasibility/equity, and regulation/innovation-through concerted pursuit of targeted recommendations. Paramount actions include swift, ethical, equity-focused integration of novel technologies into clinical workflows, mitigating data-related issues, counteracting digital inequity gaps, and establishing robust governance frameworks balancing safety and innovation.

National plans and awareness campaigns as priorities for achieving global brain health

Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including representatives of the OneNeurology Partnership (a consortium uniting global neurology organisations), take stock and advocate for urgent acceleration of IGAP implementation. Drawing on lessons from relevant global health contexts, this Health Policy identifies two priority IGAP targets to expedite national delivery of the entire 10-year plan: namely, to update national policies and plans, and to create awareness campaigns and advocacy programmes for neurological conditions and brain health. To ensure rapid attainment of the identified priority targets, six strategic drivers are proposed: universal community awareness, integrated neurology approaches, intersectoral governance, regionally coordinated IGAP domestication, lived experience-informed policy making, and neurological mainstreaming (advocating to embed brain health into broader policy agendas). Contextualised with globally emerging IGAP-directed efforts and key considerations for intersectoral policy design, this novel framework provides actionable recommendations for policy makers and IGAP implementation partners. Timely, synergistic pursuit of the six drivers might aid WHO member states in cultivating public awareness and policy structures required for successful intersectoral roll-out of IGAP by 2031, paving the way towards brain health for all.

Brain Glutamate Dynamics Predict Positive Agency in Healthy Women: Insights from Combined Application of Pharmacological Challenge, Comprehensive Affective Assessment, and Magnetic Resonance Spectroscopy

Contributions of brain glutamate (Glu) to conscious emotion are not well understood. Here, we evaluate the relationship of experimentally induced change in neocortical Glu (ΔGlu) and subjective states in well individuals, using combined application of pharmacological challenge, magnetic resonance spectroscopy (MRS), and comprehensive affective assessment. Drug challenge with d-amphetamine (AMP) (20 mg oral), methamphetamine (MA) (Desoxyn, 20 mg oral), and placebo (PBO) was conducted on three separate test days in a within-subjects double blind design. Proton MRS quantified neurometabolites in the right dorsal anterior cingulate cortex 140-150 min post-drug and PBO. Subjective states were assessed at half hour intervals over 5.5 h on each session, yielding 3792 responses per participant (91,008 responses overall, N = 24 participants), with self-reports reduced by principal components analysis (PCA). PCA produced a primary factor score of AMP- and MA-induced positive agency (ΔPA). MRS indicated drug-induced ΔGlu related positively to ΔPA (ΔGluMA r = +0.44, p < 0.05, N = 21), with large effects in females (ΔGluMA r = +0.52, p < 0.05; ΔGluAMP r = +0.61, p < 0.05, N = 11). Subjective states related to ΔGlu included rise in subjective stimulation, vigor, friendliness, elation, positive mood, positive affect (r's = +0.51 to +0.74, p < 0.05), and alleviation of anxiety in females (r = -0.61, p < 0.05, N = 11). These self-reports correlated with ΔGlu to the extent they loaded on ΔPA (r = 0.95 AMP, p = 5 × 10-10; r = 0.63 MA, p = 0.0015, N = 11), indicating the coherence of ΔGlu effects on emotional states. Timing data indicated Glu shaped positive emotion both concurrently and prospectively, with no relationship with pre-MRS emotion (ΔGluAMP r = +0.59 to +0.65, p's < 0.05; ΔGluMA r = +0.53, p < 0.05, N = 11). Together these findings indicate substantive, mechanistic contributions of neocortical Glu to positive agentic states in healthy individuals, which are most readily observed in women. The findings illustrate the promise of combined application of pharmacological challenge, comprehensive affective assessment, and MRS neuroimaging techniques in basic and clinical studies.

Brain morphological variability between whites and African Americans: the importance of racial identity in brain imaging research

In a segregated society, marked by a historical background of inequalities, there is a consistent under-representation of ethnic and racial minorities in biomedical research, causing disparities in understanding genetic and acquired diseases as well as in the effectiveness of clinical treatments affecting different groups. The repeated inclusion of small and non-representative samples of the population in neuroimaging research has led to generalization bias in the morphological characterization of the human brain. A few brain morphometric studies between Whites and African Americans have reported differences in orbitofrontal volumetry and insula cortical thickness. Nevertheless, these studies are mostly conducted in small samples and populations with cognitive impairment. For this reason, this study aimed to identify brain morphological variability due to racial identity in representative samples. We hypothesized that, in neurotypical young adults, there are differences in brain morphometry between participants with distinct racial identities. We analyzed the Human Connectome Project (HCP) database to test this hypothesis. Brain volumetry, cortical thickness, and cortical surface area measures of participants identified as Whites (n = 338) or African Americans (n = 56) were analyzed. Non-parametrical permutation analysis of covariance between these racial identity groups adjusting for age, sex, education, and economic income was implemented. Results indicated volumetric differences in choroid plexus, supratentorial, white matter, and subcortical brain structures. Moreover, differences in cortical thickness and surface area in frontal, parietal, temporal, and occipital brain regions were identified between groups. In this regard, the inclusion of sub-representative minorities in neuroimaging research, such as African American persons, is fundamental for the comprehension of human brain morphometric diversity and to design personalized clinical brain treatments for this population.

Anger, agency, risk and action: a neurobehavioral model with proof-of-concept in healthy young adults

Introduction

Anger can engender action by individuals and groups. It is thus important to understand anger's behavioral phenotypes and their underlying neural substrates. Here, we introduce a construct we term agentic anger, a negatively valenced internal state that motivates action to achieve risky goals. We evaluate our neurobehavioral model via testable hypotheses in two proof-of-concept studies.

Study 1 Methods

Study 1 used the Incentive Balloon Analogue Risk Task in a within-subjects, repeated measures design in 39 healthy volunteers to evaluate: (a) impact of blockade of reward on agentic anger, assessed by self-reports of negative activation (NA), (b) impact of achievement of reward on exuberance, assessed by self-reports of positive activation (PA), (c) the interrelationship of these valenced states, and (d) their relationship with personality.

Study 1 Results

Task-induced NA was positively correlated with task-induced PA, risk-taking on the task and trait Social Potency (SP), a measure of trait agency and reward sensitivity on the Multidimensional Personality Questionnaire Brief-Form.

Study 2 Methods

Study 2 assessed functional MRI response to stakes for risk-taking in healthy volunteers receiving 20 mg d-amphetamine in a double-blinded, placebo-controlled crossover design (N = 10 males), providing preliminary information on ventral striatal response to risky rewards during catecholamine activation.

Study 2 Results

Trait SP and task-induced PA were strongly positively related to catecholamine-facilitated BOLD response in the right nucleus accumbens, a brain region where DA prediction error signal shapes action value and selection. Participants' task-induced NA was strongly positively related with trait SP and task-induced PA, replicating the findings of Study 1.

Discussion

Together these results inform the phenomenology and neurobiology of agentic anger, which recruits incentive motivational circuitry and motivates personal action in response to goals that entail risk (defined as exposure to uncertainty, obstacles, potential harm, loss and/or financial, emotional, bodily, or moral peril). Neural mechanisms of agency, anger, exuberance, and risk-taking are discussed, with implications for personal and group action, decision-making, social justice, and behavior change.

New insights explain that organic agriculture as sustainable agriculture enhances the sustainable development of medicinal plants

As global health care demand continues to increase, medicinal plant productivity must progress without exhausting critical environmental resources. Hence, it is important to explore practices that can improve the quality, safety, and sustainability of medicinal plants, as well as ecological stability. Organic farming has recently gained significance as a sustainable cultivation alternative owing to increased awareness of the adverse effects of conventional cultivation method. Here, this study aimed to investigate the feasibility of organic farming as a solution for sustainable cultivation of medicinal plants from multiple perspectives and long-term benefits to the environment. Organic agricultural practices of medicinal plants were evaluated from a multi-dimensional perspective (environment, economy, and society) using extensive research data and literature and field surveys. Data from medicinal plant cultivation in Inner Mongolia were acquired for 76 sites from four data stations between 2014 and 2021. Data analysis revealed that organic medicinal plants can improve safety by reducing pesticide exposure risks. Simultaneously, organic agriculture of medicinal plants can improve biodiversity by effectively reducing pesticide and fertilizer use, which also provides natural safe products for health care. With the improvement of quality, the retail price will have a certain advantage, which will improve the income of farmers. Moreover, organic agriculture enhanced profitability because of the higher organic premium on medicinal plant products and improved ecosystem stability by increasing plant diversity. The findings of this study suggest that organic cultivation strategies can improve the quality and safety of medicinal plants and further provide a basis for promoting the sustainable development and ecological stability of medicinal plants. However, not all medicinal plant cultivators are guaranteed to adopt organic farming practices, but if all technological elements are correctly applied, the system can be maintained sustainably to expand the area of organically cultivated plants in the future.

Repetitive Transcranial Magnetic Stimulation-Associated Changes in Neocortical Metabolites in Major Depression: A Systematic Review

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We reviewed 12 studies that measured metabolites pre and post rTMS in MDD.

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Frontal lobe Glu, Gln, NAA, and GABA increased after rTMS.

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Increases in metabolites were often associated with MDD symptom improvement.

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We propose novel intracellular mechanisms by which metabolites are altered by rTMS.

Introduction

Repetitive Transcranial magnetic stimulation (rTMS) is an FDA approved treatment for major depressive disorder (MDD). However, neural mechanisms contributing to rTMS effects on depressive symptoms, cognition, and behavior are unclear. Proton magnetic resonance spectroscopy (MRS), a noninvasive neuroimaging technique measuring concentrations of biochemical compounds within the brain in vivo, may provide mechanistic insights.

Methods

This systematic review summarized published MRS findings from rTMS treatment trials to address potential neurometabolic mechanisms of its antidepressant action. Using PubMed, Google Scholar, Web of Science, and JSTOR, we identified twelve empirical studies that evaluated changes in MRS metabolites in a within-subjects, pre- vs. post-rTMS treatment design in patients with MDD.

Results

rTMS protocols ranged from four days to eight weeks duration, were applied at high frequency to the left dorsolateral prefrontal cortex (DLPFC) in most studies, and were conducted in patients aged 13-to-70. Most studies utilized MRS point resolved spectroscopy acquisitions at 3 Tesla in the bilateral anterior cingulate cortex and DLPFC. Symptom improvements were correlated with rTMS-related increases in the concentration of glutamatergic compounds (glutamate, Glu, and glutamine, Gln), GABA, and N-acetylated compounds (NAA), with some results trend-level.

Conclusions

This is the first in-depth systematic review of metabolic effects of rTMS in individuals with MDD. The extant literature suggests rTMS stimulation does not produce changes in neurometabolites independent of clinical response; increases in frontal lobe glutamatergic compounds, N-acetylated compounds and GABA following high frequency left DLPFC rTMS therapy were generally associated with clinical improvement. Glu, Gln, GABA, and NAA may mediate rTMS treatment effects on MDD symptomatology through intracellular mechanisms.

Leadership in Education, Medical Education and Health

We observe the impact of quality of leadership in our daily lives [...].

Long-Latency Event-Related Potentials (300-1000 ms) of the Visual Insight

The line of insight research methods that have high temporal and surface resolution is not large—these are EEGs, EPs, and fMRI, as well as their combinations and various options for assessing temporal events of random understanding. The objective of this research was to study the classification of insight for visual illusory images consisting of several objects simultaneously according to the analysis of early, middle, late, and ultra-late components (up to 1000 ms) of event-related potentials (ERPs). ERP research on 42 healthy subjects (men) aged 20–28 years was performed. The stimuli were a line of visual images with an incomplete set of signs, as well as images-illusions, which, with different perceptions, represent different images. The results showed the similarity of the tests to correct recognition of fragments of unrecognition and double images. At the intermediate stage of perception (100–200 ms), in both cases, the activity of the central and frontal cortex decreased, mainly in the left hemisphere. At the later stages of information processing (300–500 ms), the temporal-parietal and occipital brain parts on the right were activated, with the difference that when double objects were perceived, this process expanded to 700–800 ms with the activation of the central and occipital fields of the right hemisphere. Outcomes allowed discussing two possible options for actualizing the mechanisms of long-term memory that ensure the formation of insight—the simultaneous perception of images as part of an illusion. The first of them is associated with the inhibition of the frontal cortex at the stage of synthesis of information flows, with the subsequent activation of the occipital brain parts. The second variant is traditional and manifests itself in the activation of the frontal brain areas, with the subsequent excitation of all brain fields by the mechanisms of exhaustive search.