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Jung C, Kim J, Park K. Cognitive and affective interaction with somatosensory afference in acupuncture-a specific brain response to compound stimulus. Front Hum Neurosci 2023; 17:1105703. [PMID: 37415858 PMCID: PMC10321409 DOI: 10.3389/fnhum.2023.1105703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Acupuncture is a clinical intervention consisting of multiple stimulus components, including somatosensory stimulation and manipulation of therapeutic context. Existing findings in neuroscience consolidated cognitive modulation to somatosensory afferent process, which could differ from placebo mechanism in brain. Here, we aimed to identify intrinsic process of brain interactions induced by compound stimulus of acupuncture treatment. Methods To separately and comprehensively investigate somatosensory afferent and cognitive/affective processes in brain, we implemented a novel experimental protocol of contextual manipulation with somatosensory stimulation (real acupuncture: REAL) and only contextual manipulation (phantom acupuncture: PHNT) for fMRI scan, and conducted independent component (IC)-wise assessment with the concatenated fMRI data. Results By our double (experimentally and analytically) dissociation, two ICs (CA1: executive control, CA2: goal-directed sensory process) for cognitive/affective modulation (associated with both REAL and PHNT) and other two ICs (SA1: interoceptive attention and motor-reaction, SA2: somatosensory representation) for somatosensory afference (associated with only REAL) were identified. Moreover, coupling between SA1 and SA2 was associated with a decreased heart rate during stimulation, whereas CA1 was associated with a delayed heart rate decrease post-stimulation. Furthermore, partial correlation network for these components demonstrated a bi-directional interaction between CA1 and SA1/SA2, suggesting the cognitive modulation to somatosensory process. The expectation for the treatment negatively affected CA1 but positively affected SA1 in REAL, whereas the expectation positively affected CA1 in PHNT. Discussion These specific cognitive-somatosensory interaction in REAL were differed from vicarious sensation mechanism in PHNT; and might be associated with a characteristic of acupuncture, which induces voluntary attention for interoception. Our findings on brain interactions in acupuncture treatment elucidated the underlying brain mechanisms for compound stimulus of somatosensory afferent and therapeutic contextual manipulation, which might be a specific response to acupuncture.
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Affiliation(s)
- Changjin Jung
- Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, Republic of Korea
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jieun Kim
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyungmo Park
- Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea
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2
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Koleske J, Amar JY, Chou CA, Varadhachary AS. Bilateral Painful Hand Seizures: An Atypical Somatotopic Syndrome. Neurohospitalist 2022; 12:706-707. [PMID: 36147758 PMCID: PMC9485685 DOI: 10.1177/19418744221107502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Painful Hand Seizures are a rarely reported form of secondary sensory seizures (SSS) characterized by painful, bilateral sensorimotor hand involvement and preserved consciousness. We report our case to aid neurologists in recognizing SSS as an atypical presentation of seizures.
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Affiliation(s)
- Joshua Koleske
- Washington University School of Medicine, St. Louis, MO, USA
| | - Jordan Y. Amar
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chris A. Chou
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Arun S. Varadhachary
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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Wang W, Yang J, Yu Y, Li H, Liu Y, Yu Y, Yu J, Tang X, Yang J, Takahashi S, Ejima Y, Wu J. Tactile angle discriminability improvement: Contributions of working memory training and continuous attended sensory input. J Neurophysiol 2022; 127:1398-1406. [PMID: 35443143 PMCID: PMC9255707 DOI: 10.1152/jn.00529.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Perceptual learning is commonly assumed to enhance perception through continuous attended sensory input. However, learning is generalizable to performance in untrained stimuli and tasks. Although previous studies have observed a possible generalization effect across tasks as a result of working memory (WM) training, comparisons of the contributions of WM training and continuous attended sensory input to perceptual learning generalization are still rare. Therefore, we compared which factors contributed most to perceptual generalization and investigated which skills acquired during WM training led to tactile generalization across tasks. Here, a Braille-like dot pattern matching n-back WM task was used as the WM training task, with four workload levels (0, 1, 2, and 3-back levels). A tactile angle discrimination (TAD) task was used as a pre- and posttest to assess improvements in tactile perception. Between tests, four subject groups were randomly assigned to four different workload n-back tasks to consecutively complete three sessions of training. The results showed that tactile n-back WM training could enhance TAD performance, with the 3-back training group having the highest TAD threshold improvement rate. Furthermore, the rate of WM capacity improvement on the 3-back level across training sessions was correlated with the rate of TAD threshold improvement. These findings suggest that continuous attended sensory input and enhanced WM capacity can lead to improvements in TAD ability, and that greater improvements in WM capacity can predict greater improvements in TAD performance. NEW & NOTEWORTHY Perceptual learning is not always specific to the trained task and stimuli. We demonstrate that both continuous attended sensory input and improved WM capacity can be used to enhance tactile angle discrimination (TAD) ability. Moreover, WM capacity improvement is important in generalizing the training effect to the TAD ability. These findings contribute to understanding the mechanism of perceptual learning generalization across tasks.
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Affiliation(s)
- Wu Wang
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Jiajia Yang
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, United States
| | - Yinghua Yu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, United States
| | - Huazhi Li
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Yulong Liu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Yiyang Yu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Jiabin Yu
- College of Information Engineering, China Jiliang University, Hangzhou, China
| | - Xiaoyu Tang
- School of Psychology, Liaoning Collaborative Innovation Center of Children and Adolescents Healthy Personality Assessment and Cultivation, Liaoning Normal University, Dalian, China
| | - Jingjing Yang
- School of Computer Science and Technology, Changchun University of Science and Technology, Changchun, China
| | - Satoshi Takahashi
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Yoshimichi Ejima
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Jinglong Wu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Beijing Institute of Technology, Beijing, China
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Pokorny L, Jarczok TA, Bender S. Topography and lateralization of long-latency trigeminal somatosensory evoked potentials. Clin Neurophysiol 2021; 135:37-50. [PMID: 35026539 DOI: 10.1016/j.clinph.2021.11.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/20/2021] [Accepted: 11/08/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Long-latency trigeminal somatosensory evoked potentials (SSEPs) have not been sufficiently studied regarding their topography and lateralization. SSEPs are hypothesized to contribute to the evoked potentials after transcranial magnetic stimulation (TMS). This study focused on trigeminal SSEPs with latencies > 100 ms, potentially overlapping with TMS-evoked N100. METHODS In 14 healthy subjects, the trigeminus was electrically stimulated on the left and right forehead, and time-course, topography, and lateralization of trigeminal SSEPs were examined in 64-channel electroencephalogram (EEG). SSEPs were then compared to TMS-evoked potentials when TMS was applied to the left and right dorsolateral prefrontal cortex. RESULTS Trigeminal stimulation produced a somatosensory N140 with topographic maximum over centroparietal electrodes with larger amplitudes contra- than ipsilaterally to the stimulation. Contralateral potentials after TMS were partly comparable in their topography but differed in latencies. CONCLUSIONS SSEPs generated by electrical stimulation of the trigeminus occurred over somatosensory areas with a contralateral lateralization. Therefore, contralateral potentials after TMS should be interpreted with caution, as they may include somatosensory components. SIGNIFICANCE The topography and lateralization of long-latency trigeminal SSEPs should be considered in future TMS-EEG designs.
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Affiliation(s)
- Lena Pokorny
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
| | - Tomasz Antoni Jarczok
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, KJF Klinik Josefinum, Kapellenstrasse 30, 86154, Augsburg, Germany.
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
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Yang J, Huber L, Yu Y, Bandettini PA. Linking cortical circuit models to human cognition with laminar fMRI. Neurosci Biobehav Rev 2021; 128:467-478. [PMID: 34245758 DOI: 10.1016/j.neubiorev.2021.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Laboratory animal research has provided significant knowledge into the function of cortical circuits at the laminar level, which has yet to be fully leveraged towards insights about human brain function on a similar spatiotemporal scale. The use of functional magnetic resonance imaging (fMRI) in conjunction with neural models provides new opportunities to gain important insights from current knowledge. During the last five years, human studies have demonstrated the value of high-resolution fMRI to study laminar-specific activity in the human brain. This is mostly performed at ultra-high-field strengths (≥ 7 T) and is known as laminar fMRI. Advancements in laminar fMRI are beginning to open new possibilities for studying questions in basic cognitive neuroscience. In this paper, we first review recent methodological advances in laminar fMRI and describe recent human laminar fMRI studies. Then, we discuss how the use of laminar fMRI can help bridge the gap between cortical circuit models and human cognition.
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Affiliation(s)
- Jiajia Yang
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan; Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA.
| | - Laurentius Huber
- MR-Methods Group, Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, the Netherlands
| | - Yinghua Yu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan; Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA
| | - Peter A Bandettini
- Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA; Functional MRI Core Facility, National Institute of Mental Health, Bethesda, MD, USA
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Yang J, Yu Y, Shigemasu H, Kadota H, Nakahara K, Kochiyama T, Ejima Y, Wu J. Functional heterogeneity in the left lateral posterior parietal cortex during visual and haptic crossmodal dot-surface matching. Brain Behav 2021; 11:e02033. [PMID: 33470046 PMCID: PMC7994684 DOI: 10.1002/brb3.2033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 12/26/2020] [Accepted: 12/31/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Vision and touch are thought to contribute information to object perception in an independent but complementary manner. The left lateral posterior parietal cortex (LPPC) has long been associated with multisensory information processing, and it plays an important role in visual and haptic crossmodal information retrieval. However, it remains unclear how LPPC subregions are involved in visuo-haptic crossmodal retrieval processing. METHODS In the present study, we used an fMRI experiment with a crossmodal delayed match-to-sample paradigm to reveal the functional role of LPPC subregions related to unimodal and crossmodal dot-surface retrieval. RESULTS The visual-to-haptic condition enhanced the activity of the left inferior parietal lobule relative to the haptic unimodal condition, whereas the inverse condition enhanced the activity of the left superior parietal lobule. By contrast, activation of the left intraparietal sulcus did not differ significantly between the crossmodal and unimodal conditions. Seed-based resting connectivity analysis revealed that these three left LPPC subregions engaged distinct networks, confirming their different functions in crossmodal retrieval processing. CONCLUSION Taken together, the findings suggest that functional heterogeneity of the left LPPC during visuo-haptic crossmodal dot-surface retrieval processing reflects that the left LPPC does not simply contribute to retrieval of past information; rather, each subregion has a specific functional role in resolving different task requirements.
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Affiliation(s)
- Jiajia Yang
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA
| | - Yinghua Yu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA.,Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan
| | | | | | | | | | - Yoshimichi Ejima
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Jinglong Wu
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Beijing Institute of Technology, Beijing, China
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Wang L, Li C, Chen D, Lv X, Go R, Wu J, Yan T. Hemodynamic response varies across tactile stimuli with different temporal structures. Hum Brain Mapp 2020; 42:587-597. [PMID: 33169898 PMCID: PMC7814760 DOI: 10.1002/hbm.25243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 11/23/2022] Open
Abstract
Tactile stimuli can be distinguished based on their temporal features (e.g., duration, local frequency, and number of pulses), which are fundamental for vibrotactile frequency perception. Characterizing how the hemodynamic response changes in shape across experimental conditions is important for designing and interpreting fMRI studies on tactile information processing. In this study, we focused on periodic tactile stimuli with different temporal structures and explored the hemodynamic response function (HRF) induced by these stimuli. We found that HRFs were stimulus‐dependent in tactile‐related brain areas. Continuous stimuli induced a greater area of activation and a stronger and narrower hemodynamic response than intermittent stimuli with the same duration. The magnitude of the HRF increased with increasing stimulus duration. By normalizing the characteristics into topographic matrix, nonlinearity was obvious. These results suggested that stimulation patterns and duration within a cycle may be key characters for distinguishing different stimuli. We conclude that different temporal structures of tactile stimuli induced different HRFs, which are essential for vibrotactile perception and should be considered in fMRI experimental designs and analyses.
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Affiliation(s)
- Luyao Wang
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Duanduan Chen
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Xiaoyu Lv
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China
| | - Ritsu Go
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China
| | - Jinglong Wu
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China.,Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Tianyi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China
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Wang W, Yang J, Yu Y, Wu Q, Yu J, Takahashi S, Ejima Y, Wu J. Tactile angle discriminability improvement: roles of training time intervals and different types of training tasks. J Neurophysiol 2019; 122:1918-1927. [PMID: 31461363 PMCID: PMC6879964 DOI: 10.1152/jn.00161.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Perceptual learning, which is not limited to sensory modalities such as vision and touch, emerges within a training session and between training sessions and is accompanied by the remodeling of neural connections in the cortex. However, limited knowledge exists regarding perceptual learning between training sessions. Although tactile studies have paid attention to between-session learning effects, there have been few studies asking fundamental questions regarding whether the time interval between training sessions affects tactile perceptual learning and generalization across tactile tasks. We investigated the effects of different training time intervals on the consecutive performance of a tactile angle discrimination (AD) task and a tactile orientation discrimination (OD) task training on tactile angle discriminability. The results indicated that in the short-interval training group, AD task performance significantly improved in the early stage of learning and nearly plateaued in the later stage, whereas in the long-interval training group, significant improvement was delayed and then also nearly plateaued in the later stage; additionally, improved OD task performance resulted in improved AD task performance. These findings suggest that training time interval affects the early stage of learning but not the later stage and that generalization occurs between different types of tactile tasks. NEW & NOTEWORTHY Perceptual learning, which constitutes important foundations of complicated cognitive processes, is learning better perception skills. We demonstrate that training time interval can affect the early stage of learning but not the later stage. Moreover, a tactile orientation discrimination training task can also improve tactile angle discrimination performance. These findings may expand the characteristics of between-session learning and help understand the mechanism of the generalization across tactile tasks.
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Affiliation(s)
- Wu Wang
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Okayama, Japan
| | - Jiajia Yang
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, Maryland
| | - Yinghua Yu
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, Maryland
| | - Qiong Wu
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Jiabin Yu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Okayama, Japan
| | - Satoshi Takahashi
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Yoshimichi Ejima
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Jinglong Wu
- Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.,Beijing Institute of Technology, Beijing, China
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Cieri F, Esposito R. Psychoanalysis and Neuroscience: The Bridge Between Mind and Brain. Front Psychol 2019; 10:1790. [PMID: 31555159 PMCID: PMC6724748 DOI: 10.3389/fpsyg.2019.01983] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/13/2019] [Indexed: 01/12/2023] Open
Abstract
In 1895 in the Project for a Scientific Psychology, Freud tried to integrate psychology and neurology in order to develop a neuroscientific psychology. Since 1880, Freud made no distinction between psychology and physiology. His papers from the end of the 1880s to 1890 were very clear on this scientific overlap: as with many of his contemporaries, Freud thought about psychology essentially as the physiology of the brain. Years later he had to surrender, realizing a technological delay, not capable of pursuing its ambitious aim, and until that moment psychoanalysis would have to use its more suitable clinical method. Also, he seemed skeptical about phrenology drift, typical of that time, in which any psychological function needed to be located in its neuroanatomical area. He could not see the progresses of neuroscience and its fruitful dialogue with psychoanalysis, which occurred also thanks to the improvements in the field of neuroimaging, which has made possible a remarkable advance in the knowledge of the mind-brain system and a better observation of the psychoanalytical theories. After years of investigations, deriving from research and clinical work of the last century, the discovery of neural networks, together with the free energy principle, we are observing under a new light psychodynamic neuroscience in its exploration of the mind-brain system. In this manuscript, we summarize the important developments of psychodynamic neuroscience, with particular regard to the free energy principle, the resting state networks, especially the Default Mode Network in its link with the Self, emphasizing our view of a bridge between psychoanalysis and neuroscience. Finally, we suggest a discussion by approaching the concept of Alpha Function, proposed by the psychoanalyst Wilfred Ruprecht Bion, continuing the association with neuroscience.
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Affiliation(s)
- Filippo Cieri
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Roberto Esposito
- Department of Radiology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
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