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Queen's University

Book Reviews - Psychology and Neuroscience

Anderson W (2008) The Collectors of Lost Souls: Turning Kuru Scientists into Whitemen. The John’s Hopkins University Press: Baltimore NY.

Buckley, KW.
(1989) Mechanical Man: John Broadus Watson and the Beginnings of Behaviorism. The Guilford Press: New York.

Buller, D.J. (2005) Adapting Minds: Evolutionary Psychology and the Persistent Quest for Human Nature. MIT Press: Cambridge, M.A.

Burgess, N., Jeffery, KJ., O'Keefe, J
., eds. (1999) The Hippocampal and Parietal Foundations of Spatial Cognition. Oxford University Press: Oxford. (Published in 2001 in J Psychiatr Neurosci 26:61-62)

Carlson, EA.
(2001) The Unfit: A History of a Bad Idea. Cold Spring Harbour Laboratory Press: Cold Spring Harbour New York.

†  Conn FM, Parker JV (2008) The Animal Research Wars.   Palgrave Macmillan: New York

DeBaggio, T (2002) Losing My Mind. The Free Press: New York.

Gilbert D (2006) Stumbling on Happiness.   Vintage Canada: Toronto

Healy, D.
(2002) The Creation of Psychopharmacology. Harvard University Press: Cambridge MA.

Hutton, JT, Dippel, RL, eds. (1989) Caring for the Parkinson Patient: A Practical Guide. Prometheus Books: Buffalo. (published in 1991 by Beninger, RJ. and Ehmann, TS in Alzheimer Disease Assoc Disorders 5:208-209)

Kushner, HI. (1999) A Cursing Brain? The Histories of Tourette Syndrome. Harvard University Press: Cambridge MA.

† Leibrich J(1999) A Gift of Life: Discovering How to Deal with Mental Illness .  University of Otago Press: Dunedin, New Zealand

Leroi, AM. (2003) Mutants: On Genetic Variety and the Human Body. Viking: New York.

Macmillan, M. (2002) An Odd Kind of Fame: Stories of Phineas Gage. MIT Press: Cambridge MA.

Marcus, G. (2004) The Birth of the Mind. Basic Books: New York.

Milner, PM. (1999) The Autonomous Brain. Lawrence Erlbaum Associates: Mahwah, New Jersey. (Published in 2000 Psycologuy, 11(054)

Porter, R. (2003) Flesh in the Age of Reason: The Modern Foundations of Body and Soul. WW Norton & Co.: New York.

Rapport, R. (2005) Nerve Endings: The Discovery of the Synapse. WW Norton & Co.: New York.

Richardson, RT,
ed. (1991) Activation to Acquisition: Functional Aspects of the Basal Forebrain Choliniergic System. Birkhauser: Basel. (published in 1991 in Behav Pharmacol 2:530-531).

†  Sacks O (1985) The Man Who Mistook His Wife for a Hat and Other Clinical Tales.  Harper & Row: New York

†  Sacks O. (1990) Awakenings. HarperCollins: New York

Striedter, GF (2005) Principles of Brain Evolution. Sinauer Associates Inc.:Sunderland MA, USA

Vanderwolf, CH. (2003) An Odyssey Through the Brain, Behavior and the Mind. Kluver Academic Publishers: Boston MA.

Zimmer, C. (2004) Soul Made Flesh: The Discovery of the Brain and How it Changed the World. Free Press: New York.

† Added in January, 2011.


Anderson W (2008) The Collectors of Lost Souls: Turning Kuru Scientists into Whitemen.  The John’s Hopkins University Press: Baltimore NY

Carleton Gajdusek (1923-2008) won the Nobel Prize in Physiology and Medicine in 1976 and was convicted of child molestation in 1997; after his conviction he left the United States and lived out his life in Europe.  I met him once in the 1980s while traveling to a scientific conference in Europe; he was leaving the conference city where I was arriving.  He gave an immediate impression of intellectual presence and intensity.  Anderson tells the story of Gadjusek’s life within his tale of the search for the causes of kuru, a neurological disease that was rampant among the South Fore people of New Guinea in the middle of the XX century.  Gadjusek first described the disease and then, by winning the trust of the Fore, did autopsies on victims and collected blood and tissue samples that he sent back to the U.S. or to Australia for analyses.  He identified the mode of transmission of kuru by eventually transmitting the disease to primates.  Kuru had a long incubation period and turned out to be similar to scrapie in sheep and goats, familial Creutzfelt-Jakob disease in humans and the recently highly publicized bovine spongiform encephalopathy (known commonly as “mad-cow disease”) in humans.  Kuru was transmitted among the Fore by the practice of funerary cannibalism, in particular by the eating of brains.  The business of getting these primitive Fore people to give a piece of their deceased love one, who they normally eat, to a stranger to send away for analysis, as you can imagine, was complex.

When white people first arrived in the Fore region of New Guinea in the 1950s they were viewed by the locals as returned spirits of the dead.  The locals feared them but were also curious and desirous of the goods made available by the whites – salt, tobacco, soap, newspaper, etc.  The whites own desire to consume food suggested to the Fore that they were actually human.  The “Fore studied their physiognomy and color, touched their genitals, and observed bodily functions and sexual activity” (p. 33).  Anderson paints a picture of a creative, pragmatic people receptive to new ideas and social change.  They learned to distinguish different professional groups – government officials, anthropologists, doctors, missionaries - by the sorts of goods that they brought and their pattern of exchange.  He contrasts the natives with the whites who used rather more blunt tools to identify the Fore, relying on dogmatic assumptions about childishness, ignorance, sorcery and cannibalism.  To the missionaries, they were heathen ready for salvation, to the anthropologists, a savage lot.  Anderson concludes about the first encounters that the Fore were more adept and ready to revise and adjust first impressions; the outsiders by comparison appeared distracted and disinterested.

Gajdusek (and his colleague Vin Zigas) first described kuru as Parkinson-like.  One of their first publications of the phenomenology of kuru appeared in the New England Journal of Medicine in 1957 (Vol. 257, p. 974-978).  They reported that kuru was a chronic neurodegenerative disorder:  once people became symptomatic, there was rapid development of incapacitating tremors, disorders of gait, slurred speech and incoordination; these led to incontinence, choreiform movements, rigidity, inability to swallow, starvation and death.  The early stages were marked by emotionalism, with excessive laughing easily provoked.  Laboratory findings from blood and cerebrospinal fluid to this point were negative.  Gajdusek had been able to extract some brains of kuru victims and get them out of New Guinea to his laboratory at NIH in Bethesda MD.  There his colleague Igor Klatzo first described the characteristic pathological changes in kuru brains – spherical bodies with radiating filaments in the tissue, i.e., amyloid bodies and shrunken nerve cells, some with vacuoles.  The causative agent was still unknown.

For the Fore, donating blood or other specimens represented the formation of a strong link between themselves and the scientists.  They did not see the specimens as being totally separated from themselves but rather that they were entrusting the scientists with part of themselves.  The Fore feared that the specimens might fall into the hands of sorcerers, for example, who could then harm them.  The Fore tradition was to limit the circulation of bodily wastes, especially feces.  They had very deep latrines in their villages.  If they needed to defecate in the bush, they did so secretly, and sometimes wrapped the waste in leaves and brought it back to the village latrine.  Food scraps, nail clippings or pieces of clothing were meticulously cleaned up.  I cannot help wonder if these practices were selected because they increased fitness in these primitive people who knew nothing of the bacteriological causes of disease.  Whatever the origin of these customs, they presented the scientists with formidable barriers to their practices of collecting specimens for laboratory studies.

The Fore already had a system for dividing up the body of a deceased loved one.  The scientists desire to have part of the body was consistent with this tradition but the scientists became enmeshed in the traditions of the Fore.  Female bodies in particular were valued so that when Gajdusek wanted to take a specimen from a female body he came face to face with competing claims for the reproductive capacities of female bodies by young male members of the Fore.
As Gajdusek continued to probe the phenomena and causes of kuru in the remote New Guinea highlands, various famous scientists came through for a visit.  John Eccles, already a Nobel laureate for his studies of the synapse found kuru puzzling.  RA Fisher, the aging British geneticist found Gajdusek untrustworthy and disliked his boisterous American personality; this set Gajdusek aback and fostered some equally negative comments about Fisher.  The population geneticist Theodosius Dobzhansky passed through Indonesia and got wind of the effort by the Australian government to restrict movement of the Fore lest they spread their disease, at that time thought to be possibly genetic.  Dobzhansky penned a letter to Science decrying this policy while not questioning the genetic hypothesis.  Gradually, the genetic hypothesis faded as evidence was lacking and the quarantine was discontinued.

In 1959 kuru and scrapie were linked by the common appearance of postmortem tissue from human and sheep brains, respectively.  Scientists began to note the common features of the two diseases; sheep with scrapie, like humans with kuru, developed trembling and staggering gaits, for example.  Scrapie had been transmitted in the laboratory from sheep to sheep but the incubation time was long and there was speculation of a slow virus.  Gadjusek’s collaborators in Bethesda undertook to transmit kuru to chimpanzees in the early 1960s.  Finally, a few years later some chimps began to develop symptoms and it was confirmed that kuru was transmitted, the best hypothesis being by a slow virus.  The link to cannibalism became clear around this time and was published in a 1968 Lancet article. Gajdusek went on to receive the Novel Prize in 1976 for the discovery of the mode of transmission of kuru.

But the infectious agent was still not known.  It took another scientist and another Nobel Prize in Physiology and Medicine to complete the story.  In a 1982 Science (Vol. 216, p. 136-144) article, neurologist and biochemist Stanley Prusiner proposed that a protein pathogen termed a prion was responsible for scrapie.  I remember hearing him speak at a meeting of the Society for Neuroscience around this time and that many people ridiculed him for this idea; at the time the evidence was scanty.  However, a number of related events kept his idea prominent.  One was the outbreak in 1985 of mad-cow disease in the UK.  Thousands of cows were destroyed in 1989 and 1990 in an effort to stop the occurrence of this chronic progressive neurological disease.  Pruisner was able to show that mad-cow disease was caused by his elusive prions.  He received the Nobel for discovering an entirely new genre of disease-causing agents.  Prions were shown to be the culprit in Creutzfelt-Jakob disease, kuru, scrapie, bovine spongiform encephalopathy (mad-cow disease), chronic wasting disease in deer, transmissible mink encephalopathy and other related diseases. 

The Collectors of Lost Souls is an excellent book that takes the reader through the emergence of a stone-age people into the XX century within the context of the latest developments in biomolecular science brought to the pursuit of understanding the complex and mysterious disease kuru.  The life of Carleton Gajdusek is at the centre of this interesting story.  Recommended. (Jan. 2010)

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Buckley, KW. (1989) Mechanical Man: John Broadus Watson and the Beginnings of Behaviorism. The Guilford Press: New York.

The author is a scholar of American intellectual history and it really shows in this book. While reviewing Watson’s life from his humble rural beginnings in the south through his rise and fall in academia to his highly influential career in advertising, he portrays the development of thought paralleling the industrialization of America at the beginning of the twentieth century. Americans went from being villagers whose identity was defined by their community to being urban dwellers identified by their employment and income. Buckley charts the role of behaviorist thinking in the transition from Victorian moral values to twentieth century pursuits of individual satisfaction. Watson had tremendous energy and used the media through his work in advertising to make psychology, and in particular behaviorism, a household word. Mechanical Man reflects the concept of a stimulus-driven individual whose emotions and desires are the consequence of his or her environmental history. Watson had the right idea and the means to disseminate it at a time when Stravinsky and the Fauvists were turning traditional thought on its head.

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Buller, D.J. (2005) Adapting Minds: Evolutionary Psychology and the Persistent Quest for Human Nature. MIT Press: Cambridge, M.A.

I have not read many of the primary sources in evolutionary psychology. I have read R Wright’s (1994, Pantheon Books: New York NY) The Moral Animal which I thought was an excellent overview of the field and U Segerstrale’s (2000, Oxford University Press: Oxford) Defenders of the Truth: The Battle for Science in the Sociobiology Debate and Beyond, a book that evaluated the politics of evolutionary psychology. I have continued to learn from colleagues and occasional articles in Science about developments in the field. I read a review of Buller’s book claiming that it provided a balanced discussion of the evidence gathered by evolutionary psychologists and with considerable enthusiasm I decided to read it. I found it a slog with arguments sometimes developed over tens of pages. I felt that Buller really wanted to dismantle the evolutionary psychology enterprise and that made me suspicious about how balanced his presentation really was. I feel like I learned a lot reading this book. I learned more about the primary data upon which many of the elements of evolutionary psychology are based and I encountered again some of the passion that was revealed by Sagerstrale.

Buller, citing Tooby and Cosmides, provided a list of the adaptive problems - e.g., help your relatives, guard your mate - faced by our species in the Pleistocene. He then turned to the idea that modules evolved to deal with these problems and contrasted the idea of domain-specific modules with that of a domain-general processor, the latter a dominant concept especially in the first half of the XX century. All this was part of an extensive background section leading up to a critique of the concept of modules. On pages 93-96, Buller argued that we couldn’t know precisely enough the problems faced by our ancestors to be able to specify the mechanisms for dealing with them. Much of our information comes from extant hunter-gatherers and primates but Buller argues that neither of these is a good choice; the former have been irrevocably changed by periodic contacts with farmers and industrialized people and the common ancestor we share with the latter dates back at least several million years. As an alternative to domain-specific modules, Buller argues for a sort of developmental neuroselectionist model. He uses the development of the frontal cortex as an example pointing out how it develops massive connectivity that is subsequently pruned, active pathways surviving and inactive ones regressing and the neurons dying. I really liked this application of selectionist thinking to brain development and it reminded me of an analogous argument made by Skinner some years ago that organisms emit large amounts of behavior and that responses are selected by their consequences, thereby shaping the behavioral repertoire of the individual. Buller is almost certainly right about the influence of experience on neurodevelopment – there are now many data to support this view – but I suspect too that evolutionary selectionist pressures have acted to favor the development of specialized modules within, for example, the frontal cortex for dealing with specific problems faced by our ancestors.

Buller discussed the idea that women have a module designed to detect and prefer high status men (p 159). He argued that the defining characteristics of high status males vary a lot across cultures so how could a specialized module deal with the variability? He discussed the evidence that older males prefer younger females but that if you look across the age range, older men who prefer younger women still prefer women who are beyond their reproductive years; this could not be adaptive. I remember studying resistance to satiation in rats some years ago. This is a phenomenon whereby rats are trained to press a lever for food while on a food restriction schedule. Then they are allowed to eat ad libitum for some time, say two wk. They are then retested in the lever pressing apparatus and they are observed to lever press and get food that they don’t eat. Gradually they press less and less. A way to understand this phenomenon is to reason that the rats don’t logically work out the fact that they are no longer hungry so pressing the lever will no longer be rewarding. The prior learning drives the behavior of lever pressing in the satiated rats and the feedback from getting food when they are not hungry leads to the gradual decline in lever pressing. In a like manner, there is no reason to think that men will work out that a natural preference for younger women should shift to even younger women when they are older because the women will not longer be fertile. The proclivities that we have as a result of the evolutionary shaping of our current mind are not necessarily conscious any more than the tendency of many birds to fly south in the fall is conscious. The observation that men favor younger women supports the claims of evolutionary psychology even if it is seen in older men.

Buller’s treatment of theory of mind was narrow and not convincing. He never defined the term and I was not convinced that he understood it. He covered the mate-choice literature in some detail. In considering the idea that females have a module for short-term extra-pair copulations, he suggested that it could be a by-product of a preference for symmetrical males, maximum sexual interest at the time of ovulation and general libido. Perhaps. But then doesn’t this mean that there must be a module for preference for symmetrical males? Buller used data from homosexual males arguing that they should have the “male” jealousy mechanism and therefore show the same patterns as males but they don’t. However, there is now ample evidence that the sexually dimorphic nucleus of the hypothalamus is different in heterosexual versus homosexual males and that in homosexual males it resembles that nucleus in females. It is clear that the physiology of homosexual males differs from that of heterosexual males; differences between the two could easily be related to differences in their brains.

The latter part of the book deals with the work of Daly and Wilson relating child abuse and murders to age of the children and the relatedness of the parent or stepparent. Stepparents are more likely to abuse their children and younger children are more likely to be abused than older children. Buller focused on adoptive parents and the fact that they seldom abuse their children in spite of being unrelated. Daly and Wilson counter that they wanted the kids whereas genetic parents don’t always want theirs. This makes sense but I did feel that Buller had a point. My take on evolutionary psychology is that it is trying to tease out natural tendencies through a heavy overlay of social conditioning and that the effects are often small, accounting for only a fraction of the variance, but, nevertheless, significant. That being the case, it seemed too convenient to argue away the finding that no evidence came through in the case of adoptive parents. Even though the argument of Daly and Wilson seemed too convenient, Buller subsequently used a similar argument in the case of genetic patents. He argued that they were found to abuse their children less because theirs were all wanted children, those being unwanted having been aborted. I think it is very unlikely that all children born to genetic parents are wanted.

This section covered many more issues in excruciating detail. Overall, it seemed that Buller was hell bent on undermining the credibility of all and any evidence adduced by evolutionary psychologists. This determination had the effect of lessening the impact of his arguments. Unlike the reviewer whom I read in choosing this book for inclusion on my “to-read” stack, I did not come away from this read with the impression that this was a balanced account of evolutionary psychology.

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Burgess, N., Jeffery, KJ., O'Keefe, J., eds. (1999) The Hippocampal and Parietal Foundations of Spatial Cognition. Oxford University Press: Oxford. (Published in 2001 in J Psychiatr Neurosci 26:61-62).

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Carlson, EA. (2001) The Unfit: A History of a Bad Idea. Cold Spring Harbour Laboratory Press: Cold Spring Harbour NY.

Western culture has struggled with the question of how to deal with the poor, physically or mentally handicapped and criminals for millennia. In the XIX century, selectionist notions derived from Darwin’s theory of evolution influenced attitudes towards these “degenerate” classes. If society provided for these people they would reproduce and perpetuate a gradual decline in general fitness. An underlying assumption based on an incorrect interpretation of the mechanisms and importance of heredity was that the union of two “degenerates” could never give rise to productive offspring.

The first physiological theory of degeneracy was that it was caused by masturbation, an idea that persisted well into the XX century in spite of the lack of evidence. This notion justified the surgical sexual mutilation of men and women in the XIX century. Along with the misguided dictates of social Darwinism, the use of surgical means to redress the concerns of degeneracy led to the birth of (negative) eugenics. This movement arose in a time of optimism when people believed that it provided a means to improve society. Eugenics received wide “…support among the middle class. It included liberals and conservatives, the hopeful and the pessimistic, idealists and reactionaries, environmentalists and hereditarians; it included physicians, clergy, social workers, professors, journalists, and philanthropists” (p. 388). People believed in human betterment. 

Carlson traces early attempts to identify the underlying reality of heredity. He reviews, for example, the ideas of the influential XIX century biologist Herbert Spencer who proposed the concept of the germ plasm. The author covers the course of thought in Europe and North America not only in medical and scientific circles but in literature and art as well. He discusses people’s reaction to Millet’s painting The Man with the Hoe, an image of a tired peasant in the fields. Some saw it as a symbol of the unfit. Some even argued that he remained as a remnant of a class of people whose elite had been destroyed by generations of war.

Two types of eugenics are described: Positive eugenics, identified with Britain and parts of the Continent and promoted by Galton, involved the intermarriage of gifted individuals, the belief being that their progeny would be superior. This suited the prevalent class structure of turn-of-the-century Europe. Negative eugenics, identified with the United States, involved the sterilization of members of the degenerate layers of society. This suited the more egalitarian classless social structure of the U.S. where people generally believed that anyone with the will and ability to succeed could prosper; those who did not achieve success must have failed in physical ability, motivation, values or mental capacity.

The term “eugenics” has fallen out of favour because of the abuses perpetrated by the sterilization laws in the U.S. and Canada during the latter part of the XIX and early XX century and, of course, because of the abuse of eugenics by Nazi Germany to justify the Holocaust.  Carlson argues that the knee-jerk reaction that people have to the concept of eugenics because of these abuses is misguided. In his closing chapters he argues that there is a need to keep an open mind to interventions such as abortion, to reproductive technologies and molecular medicine. These offer great promise to reduce human suffering. 

The Unfit provides a thoughtful and challenging look at the history of the concept of genetically unfit people.  In the present age of the human genome, when new discoveries about how genes work are reported almost daily, questions about how to use this knowledge ignite old fears about abuses. Carlson provides a perspective that encourages dialogue and open-mindedness.

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Conn FM, Parker JV (2008) The Animal Research Wars.  Palgrave Macmillan: New York

Michael Conn is an associate director and senior scientist at the Oregon National Primate Research Center (ONPRC) and is a professor in the Department of Physiology and Pharmacology and the Department of Cell and Developmental Biology at Oregon Health and Science University in Portland, Oregon.  His research is on molecular mechanisms of hormone actions.  James V Parker was public-information officer of the ONPRC.  He taught theology at Mt. Angel Seminary in Oregon and worked as a science writer.  The two teamed up to write this book.  Conn was on the receiving end of animal rights activists' harassment and Parker is knowledgeable about the animal rights movement and some of its philosophical entanglements.  Together they tell a tale of a fanatical fringe of the animal rights movement that uses sophisticated electronic media to whip up support without much concern for how truthful they are being.  The authors provide some detailed evidence for how the animal rights activists operate.  They provide valuable information about the contributions to human and animal health and welfare that have been made by researchers using animals and they discuss some of the tough questions surrounding this type of research.  During a time when most of the media information about this issue is reports of the activities of the radicals, it is refreshing to read a more balanced and thoughtful discussion of this thorny issue.

To give just one example of the kinds of situations that arise in the animal research war, the authors reported that 46,000 cats are euthanized annually in shelters in the State of Oregon.  An Oregon biomedical research facility came under fire from animal rightists for euthanizing ONE cat annually in research projects.  It would appear that the animal rightists have a specific agenda that targets research rather than one that focuses on saving the lives of animals or preventing animal suffering more broadly.  The authors provide some thoughtful discussion of how this situation has come about.  (Oct. 11, 2010)

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DeBaggio, T. (2002) Losing My Mind. The Free Press: New York.

I have often wondered what it must be like for a person who develops Alzheimer’s disease. Especially as the illness progresses and a person’s ability to communicate recedes into the past, I have wondered what it is like on the inside. DeBaggio provides some insight into this question.He had worked as a journalist for a lot of his life and had written several books. When he was diagnosed with Alzheimer’s he decided to write a book about the progression of the disease. Because he was such an experienced writer, he was able to write quite effectively even after his ability to word-find in conversations was declining. He talks about sitting at his computer and typing without a clear idea of what was going to come out. He details the types of errors in spelling he made and jokes that sometimes even the spell-checker couldn’t figure out what he wanted to say. The book has several narrative lines running simultaneously, not a simple organization for a normal person let alone one who is declining in literary ability. He tells his biography in one line, provides a blow-by-blow description of his fading mental abilities in another, and the third is somewhat poetic reflections on life. The really scary thing is how clearly some of his early signs of Alzheimer’s resonate with my own experiences! Forget I said that.

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Gilbert D (2006) Stumbling on Happiness.  Vintage Canada: Toronto

What makes us different from other animals is our frontal lobe-mediated ability to imagine the future, allowing us to plan and to predict the outcome of our current actions.  That ability, however, is imperfect.  Gilbert provides many examples of how our current state of emotional and physical being biases our predictions of what will happen it the future and of how our selective viewing of circumstances biases our perceptions of what happened.  For example, we pay more attention to favourable information and we accept it uncritically.  These dual faults of presentism and bias make us poor forecasters.

Gilbert writes in a very accessible manner and his wit lightens the mood making the whole experience of Stumbling on Happiness happy indeed.  Following is one example of his playfulness:  “When we have an experience – hearing a particular sonata, making love with a particular person, watching the sun set from a particular window of a particular room – on successive occasions, we quickly begin to adapt to it, and the experience yields less pleasure each time.  Psychologists call this habituation, economists call it declining marginal utility, and the rest of us call it marriage.” (p. 144).  Here is another:  “My friends tell me that I have a tendency to point out problems without offering solutions, but they never tell me what I should do about it” (p. 245). 

Gilbert is a psychologist and he drew on many examples from his field to make his point about the inaccuracy of our perceptions or about how we are influenced by things of which we are unaware.  He provides the example of alexithymia, a condition characterized by an inability to describe emotional states even though physiological measures show that such states are experienced.  Another example is blindsight, evidence that apparently blind people do see some things but are not aware of them; this can be assessed using experimental approaches that can tap into that knowledge (p. 68).  There are many additional phenomena that he did not include.  For example, people with amnesia or Alzheimer’s disease learn some things even though they have no awareness of that learning.  All of this makes a good case for his point that things around us about which we have no awareness are constantly influencing us.

Sometimes Gilbert drew on examples from animal studies and from those examples it was possible to see that he was not a biological psychologist.  On page 107, he talked about how easily pigeons can learn to press an illuminated lever to get grain.  Actually, pigeons find it almost impossible to press a lever.  They do, however, peck plastic disks readily and in that case they do so much better when the disc is trans-illuminated.  In his opening chapter, Gilbert talked about completing the sentence, “The human being is the only animal that…” as a lead-in to his arguments about our unique frontal cortical abilities.  He talked about how previous attempts to answer this question by other psychologists had led to ridicule as it was subsequently found that other species also had that ability, e.g., tool use.  I was reminded of this discussion when I read that, “…while rats and pigeons may respond to stimuli as they are presented in the world, people respond to stimuli as they are represented in the mind” (p. 170).  There are a number of observations from the animal literature that contradict this statement.  For example, in devaluation experiments, a stimulus previously associated with food is devalued by presenting it in the absence of food.  If lever press responding that was formerly rewarded by the devalued stimulus was assessed, it was seen to be less than the lever pressing of control animals; lever pressing in these test sessions had no programmed consequences.  Both groups were pressing the same lever in the same context but one group was behaving differently as a result of previous experience with a stimulus that used to be presented for pressing the lever.  The only way that this could have come about was that the value of pressing the lever was represented differently in the brains (minds) of the two groups of rats.  It would appear that Gilbert inadvertently committed the error that he was planning to avoid, at least until his dotage. 

There were many insights in this book that, upon reflection, the reader might have known but perhaps overlooked.  The differential satiety to food versus money is an example (p. 240).  We are all familiar with the feelings of satiety that follow a binge of eating.  We do not, however, feel anything like that after receiving our paycheque at the end of the month or after receiving a windfall bundle of cash.  One obvious difference is that food is a primary reward whereas money is a conditioned reward.  However, even conditioned rewards lose their value when the primary reward with which they have been associated has been devalued.  The thing about money is that its rewarding value is based on its association with many primary rewards, not just one.  This may account for its enduring rewarding qualities and, perhaps, for its ability to delude us into thinking that more of it will make us happier.  (June 27, 2007)

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Healy, D. (2002) The Creation of Psychopharmacology. Harvard University Press: Cambridge MA.

This book provides an historical perspective on psychiatry from the opening of the asylums in the early part of the 19th century to the increasing hegemony of the pharmaceutical industry at the beginning of the 21st. The centerpiece is the discovery of chlorpromazine in 1952. It changed everything. At that time, there were still no known neurotransmitters and the chemical theory of the mind did not exist. Vitalism may have been in its death throes but it was not dead. Chlorpromazine lowered the noise level in the asylums, one of its most immediate and apparent effects. But it did much more than simply provide a strong sedative effect.It greatly improved the lives of many patients. It faced a rough ride through the 60’s when widespread rejection of many traditional institutions, including the medical establishment, led to claims that patients were being kept in chemical straightjackets and drugged against their will. This period corresponded with a strong presence of psychoanalysis in psychiatry. By the 90s, though, psychodynamicists were in decline and biological psychiatry had become the dominant paradigm. With it, or leading it as Healy suggests, the pharmaceutical industry was redefining mental illness. Depression, borderline personality disorders and obsessive-compulsive disorder were on the rise and the companies had the medications to treat them. It makes for fascinating reading to consider who was influencing whom. Healy ends with a chapter in which he looks forward to the future of psychiatry with predictions of an eventual control of schizophrenia and bipolar illness as pharmacotherapeutics and psychogenomics combine to provide effective treatment. Psychiatry will turn its attention to personality disorders and to self-improvement, i.e., cosmetic psychiatry by analogy to cosmetic surgery.

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Hutton, JT., Dippel, RL. (1989) Caring for the Parkinson Patient: A Practical Guide. Prometheus Books: Buffalo. (published in 1991 by Beninger, RJ. and Ehmann, TS. in Alzheimer Disease Assoc Disorders 5:208-209)

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Kushner, HI. (1999) A Cursing Brain? The Histories of Tourette Syndrome. Harvard University Press: Cambridge MA

Tourette’s sufferers have tics and are unable to restrain themselves from grunting, barking or vocalizing obscenities; some have echolalia.Kushner traces the history of this disorder from the early 19th century to the present day. Of particular interest is the dominance of psychoanalytic thinking for almost the entire 20th century. The psychoanalysts were largely transplanted from Europe to America around the time of the Second World War and this orientation dominated psychiatry. It was amazing to read about how the discovery in the 1970s that haloperidol and other antipsychotic medications greatly reduced the symptoms of Tourette’s was interpreted by the psychoanalysts. They continued to argue for a psychogenic cause of symptoms and that the medications simply produced a state that made psychotherapy more applicable. There never was much evidence that psychotherapy worked! The psychoanalysts persisted in attributing tics and other symptoms to repressed sexuality caused by an overbearing mother and passive father.It was very upsetting. Even more upsetting was the revelation that this way of thinking and burdening of parents and patients alike persists to this day especially in France. One thing that I found myself noticing was that patients don’t have difficulty restraining themselves from blurting out non-obscene words.You never hear of a Tourette’s patient going around blurting out “bottles” or “mud puddles”.It is always swear words or racial epithets. This suggests to me that there is active suppression of the circuits for producing these words in the brain. The putative neuronal damage that occurs in Tourette’s leads to a loss of that suppression and the sufferer blurts out inappropriate words. Does that mean that all of us are walking around with a string of expletives on the tips of out tongues, being tentatively held back by fragile inhibitory circuits?

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Leibrich J (1999) A Gift of Life: Discovering How to Deal with Mental Illness.  University of Otago Press: Dunedin, New Zealand

This book contains the brief personal stories of twenty-one people who suffer from or have suffered from mental illness, including that of the author herself in the final chapter.  The devastating impact of mental illness on a person’s life emerges as a central theme, along with the inadequacies of the health care system in dealing with people with mental illness.  Perhaps the strongest message I got from this book was that many people are still functioning emotional beings while they are mentally ill.  I was struck by how people described their emotional experiences, for example, while in a psychotic state and being restrained.  Even though there was no insight into the psychoses, these people were hurt by their failure to communicate effectively with other people.  The concept of multiple, parallel systems in the brain has received much support in recent years and the descriptions by some of the people in this book of their experiences while mentally ill can be understood from this perspective.

There clearly is a continuum of levels of activity of brain dopamine systems.  Excessive activity can lead to psychoses and insufficient activity is associated with Parkinson’s disease.  The level of dopamine activity in most people normally is between these two extremes but even within this “normal” range, there is a continuum from low normal to high normal.  At the high end, people are creative, witty, excited about and interested in things, energetic.  At the low end they are generally less interested in things, less witty, not very energetic.  Often as a person moves towards psychoses, they pass through a period of high energy and creativity.  This is often described as a pleasurable and desirable state characterized by intense energy.  Treatments for psychosis decrease dopaminergic neurotransmission; the patient experiences Parkinson-like side effects if the dose of the drug used to do this is too high.  Even if the dose is not too high, the person is shifted along that normal continuum towards the lower end where they have less creativity, interest and energy.  The comments of a number of the people who tell their stories in A Gift of Life reflect this dynamic.

The effects of elevated dopamine function were reflected in the comments of one woman who suffers from schizophrenia when she wrote that she lives in ecstasy, can tell a good story, lives life to the fullest, could titillate your intellect, and has much to offer.  She commented that it is, “The colourful people against the grey people” (p. 13).  A bipolar poet describes the effects of antipsychotic medication, “The medication I take suppresses my illness and keeps it under control but it also suppresses the creativity and I feel that the two are intertwined together” (p. 43).  He says that when he is on medication he writes very little.  A bipolar patient says his fantasy world can be very pleasurable; experiencing psychosis is like taking cocaine.  Cocaine is a drug that elevates dopaminergic neurotransmission so this was an accurate statement.  Another bipolar patient talking about the highs said, “…the colours were just amazing” (p 131).  These comments reflect the close relationship between level of dopaminergic neurotransmission and experience of the world.

Pets came up often.  It seemed like pets were very valuable therapeutically to many people with mental illness.  One patient who suffers from depression said she had a dog.  She said, “I just love having him around because you have got to do something…He’s always a good excuse to go for a walk” (p. 54).  Another patient talked about the importance of taking an interest in something outside of yourself.  He said that by caring for something else, you care more for yourself.   Depression is characterized by a loss of interest in things and a failure to experience enjoyment from the things that most people find enjoyable.

Depression is the total opposite of passion” (p. 150).  “Being depressed was like having a whole lot of switches turned off in my brain” (p. 130).  The low end of the dopamine continuum produces some features that are like those of depression and it has been shown that people with Parkinson’s disease are more likely to be depressed than other people with similar long-term disabilities, e.g., multiple sclerosis, suggesting that low dopamine does contribute to depression.  However, depression is not normally treated with pro-dopaminergic drugs but rather with drugs that alter serotonergic and/of adrenergic neurotransmission.  One depressed patient referred to herself as, “neurotransmuted”!  This same woman talked about how her sensitivity was elevated when she was depressed.  She said that she was passionate about things, that she feels more in touch with what others are feeling.  This does not seem to be consistent with low dopaminergic neurotransmission.  She talks about how she can get very tense and very angry.  Again, these are not features associated with low dopamine.

The problem of stigma was raised by a number of the interviewees.  “Society thinks people with mental illness have no will, have nothing to offer any more, have lost their effectiveness in society” (p. 148).  Part of the reason Leibrich wrote this book was to raise awareness about mental illness.  I think she succeeded in this by showing that the people she interviewed were interesting and sensitive human beings who just happened to have a mental disorder to deal with. (Aug. 8, 2010)

Leroi, AM. (2003) Mutants: On Genetic Variety and the Human Body. Viking: New York

By looking at how things go wrong one can learn about how they normally work. Mutations provide valuable information about embryological development. There is an extensive literature about human mutations ranging from dwarfs and other abnormalities depicted in paintings or appearing in written records, for example those of explorers, from the past half millennium. Leroi provides an engaging account of some of these “famous” mutants side-by-side with a discussion of the physiology and molecular biology of the stage during embryological development when they would have occurred. His account includes epidemiological and genetic results and often reviews some of the groundbreaking laboratory work done during the XIX and XX centuries that provided the first clues to the mechanisms of embryological development.

The book’s organization parallels the stages of embryological growth. Thus, a presentation of some cases of conjoined twins segues into a discussion of the earliest period of embryological growth. Consideration of individuals born with missing limbs takes the reader to a discussion of limb buds on the embryo and the role of fibroblast growth factors and other signalling molecules in their elaboration. Skeletal deformities provide a basis for considering bone growth and the wider topic of overall growth. A separate section on mutations of genital development provides a basis for considering the manner in which sex chromosomes influence gender. Mutations of skin colour and hair patterning point to the normal and perturbed function of pituitary hormones. The book is rounded out with a discussion of mutations of aging such as premature aging and theories of why we age.

Along the way, the reader is treated to lots of interesting tidbits. We meet Herman Unthan, The Armless Fiddler who lived from 1848-1928; he wrote his autobiography on a typewriter using his toes. Henri de Toulouse-Lautrec was thought to suffer from osteopetrosis, a bone development abnormality that might have led to his short stature. Leroi relates some tales of the abuse he suffered as a result. Josef Mengele at Auschwitz makes an appearance in the context of the story of the Ovitze family of Transylvanian Jews who suffered from a form of dwarfism.

Leroi does an admirable job of weaving the stories of personal victories over deformities into his overview of embryological development. He provides thoughtful accounts of controversial issues such as cloning.  Especially interesting is his chapter on aging. I found it hard to put this book down.

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Macmillan, M. (2002) An Odd Kind of Fame: Stories of Phineas Gage. MIT Press: Cambridge MA .

I first heard of Phineas Gage in my third-year Physiological Psychology course when he was described as having a major personality change subsequent to an accident that damaged his frontal lobes. The accident took place on Sept. 13, 1848 and involved a tapered tamping iron (3 feet, 7 inches long, maximum diameter of 1.25 inches and weighing 13.25 pounds) being blasted through his skull on the left side, entering in the cheek and exiting the top of the skull. Phineas lived! Macmillan describes his years of detective work to learn the facts of the case; they turned out to be quite limited.There is very little information recorded about Gage’s pre- and post-accident personality. Much of what has been written since is inaccurate and reflects more the overlay of Gage’s case onto developing knowledge about the localization of brain function in general and frontal cortical function in particular.The book provides a good sense of medicine in the nineteenth century and the growth of knowledge about brain function during that period. It also provides an interesting sociological study of the credibility of information contained in textbooks; it is clear that many authors who report the case of Phineas Gage have not read the original papers that provide almost the only direct knowledge of his case. As a bonus, those papers are reproduced in Macmillan’s book.

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Marcus, G. (2004) The Birth of the Mind. Basic Books: New York.

Perhaps one cannot help but be disappointed after reading a book with a title such as this. People seem to thirst for an understanding of the origins of the mind. Some find the mind’s origin in supernatural explanations and others, including many scientists, look for it in nature. Marcus’ materialism is not in doubt from reading this book. However, he does not leave the reader any closer to understanding the question of how mental life rises out of the material stuff of biology.

After reading the book it is clear that he was not attempting to answer that question. This book uses recent knowledge from genetics, the autonomous agent theory, to lead the reader through an understanding of how a small number of genes can produce profound changes in physiology. It begins with some elementary neuroscience and a discussion of the nature-nurture question. Marcus covers many developmental psychology studies that show that much is genetically determined but he stresses the importance of environmental factors in influencing the expression of genes. Nature and nurture work hand in hand during development and learning to mould the brain/mind.

Marcus’ most important contribution with this book is his description of how a tiny number of genes can dramatically increase the complexity of the brain. He presents interesting and heuristic analogies from computer programs that provide a basis for understanding how single commands can have multiple consequences. He touches on some of the functions of genes, for example, creating gradients of trophic factors that influence growth. For a similar and more detailed consideration of this material, I recommend the book by Leroi (2003) entitled Mutants: On Genetic Variety and the Human Body.

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Milner, PM. (1999) The Autonomous Brain. Lawrence Erlbaum Associates: Mahwah, New Jersey. (Published in 2000 Psycologuy, 11(054).

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Porter, R. (2003) Flesh in the Age of Reason: The Modern Foundations of Body and Soul. WW Norton & Co: New York.

This book takes up thought in England from around the beginning of the XVII century concerning the soul and its relationship to the body and traces changing concepts over the next 200 years. It examines how new knowledge from the sciences influenced perceptions of the self and challenged the dominant paradigm, controlled by the Church, of an incorporeal soul inhabiting the flesh. What continues to amaze me is how persevering traditional dualist notions continue to be right into the present century in spite of these early debates. It appears that people continue to cling to the notion of a soul and life after death, never mind God, in spite of the continuing absence of evidence for either.

Porter writes in an engaging and witty manner using contemporary idioms creating an odd anachronistical tension between the period of the ideas he is discussing and the period in which he is writing. Early in the book the reader meets medical scientists like Willis (1622-1675) and Harvey (1578-1657) whose discoveries of the circulation of the blood contributed importantly to the demystification of the workings of the body. Descartes (1596-1650) integrated these notions into his dualism and preserved the dominant paradigm of the time. But Hobbes (1588-1679) pushed the envelope by suggesting that there was no need for the soul in understanding the workings of the body; his materialism challenged the dominant paradigm.

It was ironic to read about how some scientists claimed that scientific research could support dualistic notions of the existence of the soul. Boyle (1627-1691), for example, using his historic observation of a vacuum, claimed that his findings confirmed the presence of spirits in the atmosphere! There were less reverent thinkers of the time; Swift (1667-1745) posited that the soul could be understood as hot air.

Scientific rationalism proceeded apace but the dualists (to this very day) refused to yield. Galvani’s (1737-1798) and Volta’s (1743-1827) observations that apparently dead tissue could be induced to move inspired many studies of electricity but also instilled in people an uncertainty about when death really occurred. There followed extensive debate about the definition of death and, for the dualists, about when the soul left the body. These developments inspired Mary Shelley’s (1797-1851) Frankenstein first published in 1818.

With the transition from traditional views of the flesh as an evil burden to be endured on the path to eternal salvation to the flesh as the material of our existence came changing views of personal responsibility for looking after the body. The XVIII century saw a marked rise of fashion and the beginnings of a focus on thinness and health. Youth began to be valued as never before. I was surprised to read that people began to be concerned about obesity. Gibbon (1737-1794), for example, reflected on the problems of his own obesity in his autobiography. During his time, the value of exercise was being discovered. This applied, of course, mostly to the privileged classes who could go through life without having to do much for themselves. I was struck by how relevant many of the points remain today.

An interesting development during the period covered by this book was the birth of the novel. As the traditional mortification of the flesh gave way to the new secularism, people began to write about fictional characters and their feelings and experiences. It became acceptable to dream and imagine things that were previously considered sinful. Porter mentions many of the early novels that appeared at this time, including authors such as Daniel Defoe (1660-1731) and Jean-Jacques Rousseau (1712-1778). It was instructive to view these writings in the context of how thought was changing at the time.

This is a long book with a lot of details about the personalities being discussed and many anecdotes. I found it a slog at times to keep going. On the other hand, emersion in Porter’s perspective was entertaining and provided a novel perspective on the time. Most of all, I am amazed at how resistance to rationalist thought endures today and at the continued influence of the Church. This suggests to me that humans must have a biologically based prediliction to believe in a greater being. Perhaps that belief provides an answer to the mystery of existence. Our brains are designed to solve problems so it makes sense that we would try to figure out where we came from. However, evolutionary biology also provides an answer to this mystery and there is a lot more evidence to support it. Maybe some people resist evolutionary explanations because they do away with life after death. Porter’s book, by examining the foundations of modern thought about the body and soul, helps to bring these questions into perspective.

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Rapport, R. (2005) Nerve Endings: The Discovery of the Synapse. WW Norton & Co: New York.

This little book tells the story of the discovery of the synapse through brief biographies of Santiago Ramon y Cajal (1852-1934) and Camillo Golgi (1843-1926). Both men received the Nobel Prize in 1906 for their pioneering microscopy of the nervous system, Golgi for discovering staining techniques that made it possible to see individual units in the nervous system and Cajal for his brilliant descriptions of neurons. Rapport describes the contrasts between the personalities of the two men and in particular their disagreement about the nature of the nervous system. Golgi was a reticularist, believing that the central nervous system (CNS) formed a continuous network of units connected by what we would today call gap junctions. Cajal, on the other hand, believed that the CNS was formed of discrete units connected with one another across a gap, what is now known as the synapse. It is fascinating to read about Golgi’s acceptance lecture in Stockholm. In spite of the widespread acceptance by then of synapses and neurons, Golgi stuck to his reticularist views to the astonishment (there were gasps!) of the audience.

Cajal was a world-class scientist in Spain during a time when many people thought that scientific discovery was a gift of God. When he started looking at brain tissue through his microscope the neuron was completely unknown. In 1872 Golgi developed his silver staining technique that allowed for the first time the visualization of individual cells in CNS tissue. This technique, termed the “black reaction”, stained only about five percent of the cells. Knowledge of the black reaction spread quickly through anatomy laboratories in Europe and paved the way for the discovery of the neuron. Cajal had developed considerable skill as an artist in his youth and his combination of microscopy and drawing produced superbly accurate and detailed images of neurons that remain one of his most valuable legacies.

Along the way, the reader meets a number of famous anatomists, many known today for the region or cell type of the brain that bears their name: Meynert, Wernicke, Broca, Betz, Forel. Others have techniques named after them, e.g., Weigart. Cajal eventually rubbed shoulders with some of the best known neurophysiologists of the early twentieth century including Sherrington, the inventor in 1897 of the term “synapse”. Even Canada’s own Wilder Penfield shows up as one of Cajal’s students near the time of his death. Cajal said that scientists should be, “…generous souls – poets at times, but always romantics – and they have two essential qualities. They scorn material gain and high academic rank, and their noble minds are captivated by lofty ideals.” (quoted on p. 196). Cajal was a romantic for sure. Writing about observing and recording what he saw, he said: “As with the lover who discovers new perfections every day in the woman he adores, he who studies an object with an endless sense of pleasure finally discerns interesting details and unusual properties…” (quoted on p. 57). I really enjoyed this book.

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Richardson, RT, ed. (1991) Activation to Acquisition: Functional Aspects of the Basal Forebrain Choliniergic System. Birkhauser: Basel. (published in 1991 Behav Pharmacol 2:530-531)

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Sacks O (1985) The Man Who Mistook His Wife for a Hat and Other Clinical Tales.  Harper & Row: New York

This book has been on my shelf for many years awaiting its turn on my to-read pile.  I decided finally to read it because I will be teaching an undergraduate course in brain and behaviour in the coming year and thought it might provide some helpful anecdotes.  It did.

One thing that struck me was the almost total absence of any discussion of mechanism.  Although a number of fascinating cases are presented in a readable and enjoyable manner, there is almost no reference to the brain structures that may be involved and neurotransmitters are almost nowhere to be found.  However, Sacks wrote the first edition of this book in 1970 at a time when much less was known in neurology and neuroscience had not yet emerged as an independent discipline.  Also, Sacks appeared to be targeting a lay readership with limited knowledge of the central nervous system.

Sacks provides many lively descriptions of patients.  The title character, the man who mistook his wife for a hat, had prosopagnosia, a form of visual agnosia characterized by an inability to recognize faces. No mention of the fusiform gyrus, the region likely damaged in this patient.  Of a patient with anterograde amnesia, Sacks explains that it was not that he failed to register memories, but that they were effaced in minutes.  He explains that emotional reactions continue to take place even though memories are lost, anticipating the recognition of declarative and non-declarative memory types that are differentially affected by brain damage to a specific area.

I found the discussion of an aphasic patient interesting as Sacks pointed out how she had an enhanced sense of tone.  The rhythm of speech is termed, ‘prosody’ and may be mediated on the right side of the brain in a regions analogous to the left-side regions for speech reception and production that are damaged in aphasics.  Damage to one side might lead to enhanced function of the other side.  Sacks’ observations are consistent with this dissociation.

Sacks provides a wonderful description of the experience of a patient who is taking the antipsychotic dopamine receptor blocking drug haloperidol (Haldol) to treat Tourette’s.  Under the influence of the drug, “He is slow and deliberate in his movements and judgments, with none of the impatience, the impetuosity, he showed before Haldol, but equally, none of the wild improvisations and inspirations.  Even his dreams are different in quality: ‘straight wishfulfillment,’ he says, ‘with none of the elaborations, the extravaganzas, of Tourette’s’.  He is less sharp, less quick in repartee, no longer bubbling with witty tics or ticcy wit.  He no longer enjoys or excels at ping-pong or other games; he no longer feels ‘that urgent killer instinct, the instinct to win, to beat the other man’; he is less competitive, then, and also less playful; and he has lost the impulse, or the knack, of sudden ‘frivolous’ moves which take everyone by surprise.  He has lost his obscenities, his coarse chutzpah, his spunk.  He has come to feel, increasingly, that something is missing.” (page 100).  Haloperidol blocks dopamine receptors in the brain thereby reducing dopaminergic neurotransmission.  Dopaminergic neurotransmission decreases naturally with age.  I couldn’t help think that this description of the effects of haloperidol paralleled the experiences of aging.  (July 24, 2010)

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Sacks O. (1990) Awakenings. HarperCollins: New York

Until L-DOPA became available for treatment in the late 1960s, people with advanced Parkinson’s disease or post-encephalic parkinsonism were generally doomed to an invalided life in the back wards of hospitals, many times with little or no ability to look after themselves.  The worldwide epidemic of the sleeping sickness, Encephalitis lethargica began near the end of the First World War and by the time it disappeared in 1927 had ravished the lives of over five million people.  Some recovered only to be stricken later in life with post-encephalic parkinsonism.  Some of these post-encephalic patients were hospitalized at ages as young as 25 years and, by the time they eventually were treated by Dr. Sacks with L-DOPA, had been in a relatively non-responsive state for as many as 40 years.  In what has now become a well-known phenomenon as a result of this book, and in part as a result of movies and documentaries that followed original publication of this book in 1973, when given L-DOPA these patients woke up; they began again to move and speak and their long-lost personalities re-emerged.  This was truly a marvel and Awakenings is the story of the lives of these patients, before during and after L-DOPA.  It is a fascinating story well told by Sacks.

Parkinsonism is caused by a loss of the brain’s dopaminergic neurons, cells that are located in the ventral midbrain and that project forward to a region termed the striatum because of its stripy appearance in dissected brain tissue.  Dopaminergic neurons are so-named because they produce and release the chemical neurotransmitter dopamine.  Dopamine acts as a sort of clutch in the brain, engaging cortical circuits that process information about the world with output circuits that function to produce motor acts like walking, reaching, grasping and smiling.  As a result of the action of dopamine, we are able to convert our will into action.  The decision to walk to the store is all anyone needs to then walk to the store assuming that their body is not disabled by damage to muscles or bones, for example.  For the Parkinson’s patient, suffering from the loss of brain dopamine, the will to act does not necessarily lead to the action.  It is important to understand that Parkinson’s patients are not unable to act per se.  Intense and/or frightening stimuli, for example a fire alarm, can cause Parkinson’s patients to get up and run out of a building, only then to collapse again into their unresponsiveness.  It is really that without dopamine, the will to act and the action itself are no longer linked.

One of the questions that I have often wondered about was what mental experience would be like without dopamine.  Would the unmedicated parkinsonian individual have a rich mental life filled with the recollections, plans, dreams and fears normally experienced but be unable to convert any intention into action?  I looked for the answer to this question in Awakenings.  (This edition of Awakenings included all the copious footnotes that were omitted from previous editions and I found some of the material I was looking for in the footnotes.)  When discussing the meaning of “akinesia”, Sacks speaks of a, “…retardation or resistance which impedes movement, speech and even thought, and may arrest it completely.  Patients so affected may find that as soon as they ‘will’ or intend or attempt a movement, a ‘counter-will’ or ‘resistance’ rises up to meet them” (p. 7, Sacks’ italics).  On the one hand, the definition makes it sound like even thought may be arrested.  On the other, it sounds like movements might be willed but then arrested by a counter-will.  So is there will?

Parkinsonism is gravity, L-DOPA is levity” (p. 8, footnote 11).  “(T)here is…in many akinetic patients, a corresponding ‘stickiness’ of mind and bradyphrenia, the thought stream as slow and sluggish as the motor stream.  The thought stream, the stream of consciousness, speeds up in these patients with L-DOPA…” (pp. 8-9, footnote 12).  These comments strongly suggest that the motor slowing experienced in parkinsonism has associated with it a mental slowing.  This suggests that parkinsonian individuals do not have the rich mental life that is experienced by people with intact dopaminergic neurotransmission.

It appears that as decreases in dopamine levels progress with the disease, motor slowing and mental slowing proceed apace.  The will is not lost immediately but gradually weakens as thoughts slow.  Thus, Sacks describes Charcot’s observations of patients who would sit for hours not only motionless but with no impulse to move, apparently lacking will to engage in any activity.  Before L-DOPA, patients apparently registered what was happening around them but with a lack of attention and a profound indifference.  All aspects of being and behaviour, including thoughts, appetites, and feelings, no less than movements, were brought to a standstill.  One patient, after receiving L-DOPA reported, “It is so long since I had any feelings” (p. 101-102).  This suggests that unmedicated parkinsonian patients do not think or feel or, perhaps, that the thought that does occur takes place very slowly.  Apparently, without dopamine there is not only a loss of movement, but a loss of attention, thought and feeling.

Although an unmedicated parkinsonian patient apparently does not attend, think, feel or move, the individual does perceive.  One patient, after receiving L-DOPA, described her experience while in a parkinsonian state:  “I ceased to have any moods… I ceased to care about anything.  Nothing moved me – not even the death of my parents.  I forgot what it felt like to be happy or unhappy.  Was it good or bad?  It was neither.  It was nothing” (p. 71).  Another patient who was unresponsive for 43 years, upon awakening with L-DOPA reported, “I can give you the date of Pearl Harbor… I can give you the date of Kennedy’s assassination.  I’ve registered it all – but none of it seems real… I’ve been a spectator for the past forty-three years” (p. 83, footnote 58).  Yet another patient described her experience as being aware of what was happening around her and of what the date was but that she herself had, “no feeling of happening” (p. 167, Sacks’ italics), only the feeling that time had stopped.  These comments suggest that there was awareness and a sense of self but, as already described, no feeling.  The Parkinson’s patient does perceive events but she does not have any feeling about them.  It would appear that dopamine is not necessary for self-awareness, the sense of “I”.

Most patients who responded to L-DOPA eventually became sensitized to it so that they frequently entered states of enhanced dopaminergic neurotransmission.  This was often associated with hyperkinesia, the opposite of the bradykinesia seen before L-DOPA was introduced.  There are often comments about mental experiences while in this state that are opposite and complementary to those described above for decreased dopamine.  For example, one patient in a state of enhanced dopaminergic neurotransmission reported being forced to think things, the opposite of the absence of thought before L-DOPA.  Sack’s described the art, a drawing of a tree, of one patient before L-DOPA, “… a small, meager thing, stunted, impoverished, a bare winter tree with no foliage at all”, on L-DOPA, “…the tree acquires vigor, life, imagination – and foliage” and during L-DOPA-induced dopaminergic hyperfunctioning, “…the tree may acquire a fantastic ornateness and exuberance, exploding with a florescence of new branches and foliage with little arabesques, curlicues, and whatnots, until finally its original form is completely lost beneath this enormous, this baroque, elaboration” (p. 155, footnote 80).  One patient described her experience on L-DOPA as, “So tingly, like my blood is champagne.  I am bubbling and bubbling and bubbling inside” (p. 156).  Increased dopaminergic neurotransmission led to a flood of thoughts and actions and strong feelings.

It seems that even when dopaminergic neurotransmission is low and producing a parkinsonian state, signals in cortical circuits can “break through” to produce motor acts.  For example, Sacks described the apparent lifting of Parkinson’s disease by interesting or activating situations; I mentioned the fire alarm example above.  Immobile patients can walk if another person accompanies them.  One patient described it this way:  “When you walk with me, I feel in myself your power of walking.  I partake of the power and freedom you have.  I share your walking powers, your perceptions, your feelings, your existence” (p. 282).  Parkinson’s people can similarly be activated by music.  These observations suggest that some stimuli may be able to activate a hypofunctioning dopamine system to the level needed for motor control to be engaged.  In recent years it has been found that social cooperation can activate regions of the brain that contain dopaminergic cell bodies or that receive dopaminergic input.  These findings from functional magnetic resonance imaging (fMRI) studies provide independent support for the observation that some stimuli can produce motor activation in parkinsonian patients.

Two final observations caught my attention.  One was that a patient who received L-DOPA declared, “I feel like a man in love” (p. 209).  Recent fMRI studies have shown that being in the early stages of romantic love leads to evidence of increased dopaminergic activity.  Perhaps it follows that L-DOPA-enhanced dopaminergic activity leads to feeling like being in love.  The other was the idea of latent Parkinson’s disease.  The idea was that there may be people with low dopamine levels but not levels low enough to cause symptoms.  However, when these people experience life events that may lead to lowering of dopaminergic neurotransmission, e.g., depression, the symptoms of Parkinson’s disease may suddenly emerge (see p. 238, footnote 115).

The stories of post-encephalic patients with parkinsonism who were treated with L-DOPA provide a unique opportunity to learn about the experiences of people who live in a state of low dopamine.  Now that L-DOPA and related drugs are available it is rare to find people in this state.  Thus, Awakenings is a valuable resource for students of dopamine and behaviour in particular and neurotransmitters and behaviour in general.  Dr. Sacks has provided a treasure trove of clinical observations.  (Sept. 7, 2010).

Striedter, GF (2005) Principles of Brain Evolution. Sinauer Associates Inc.:Sunderland MA, USA.

Striedter suggested that early evolutionists like TH Huxley (1825-1895) who knew poverty and struggled to advance his social position may have seen evolution as advancing in a somewhat similar linear manner.  C Darwin (1809-1882), by contrast, was wealthy from birth and was more inclined to see evolution as branched; he viewed speciation by natural selection as producing family trees.  In spite of this distinction, the linear notions of Huxley and others and the scala naturae that they suggest influenced thinking about species well into the XX century and comparative anatomists are quick to point out this error in thinking.

We have come a long way from these early notions.  Neurocladistics has clarified the homology concept (shared derived characters) by presenting a clear methodology for reconstructing the phylogenic history of individual characters.  Once cladists find enough homologues they can build robust classifications thus advancing comparative neurobiology.  It is never easy, though, and even highly conserved systems like those that utilize the neurotransmitters norepinephrine, serotonin or dopamine show variations among vertebrate groups, e.g., teleosts and mammals, that are still difficult to interpret.

Relative brain size (brain:body ratio expressed in log-log plots) is a useful metric for comparing groups.  It turns out that the mammals and birds have the largest brain sizes compared to total body size.  Ratios are lower for reptiles and amphibians with, perhaps surprisingly, cartilaginous fishes in between.  Some researchers and theorists have wondered about the pressures that would lead to larger relative brain size.  One possibility is that larger brains are needed for living in social groups but the correlation between social group size and relative brain size in 24 primate species is poor.  A significant correlation was found, however, between grooming clique size and relative brain size. 

Striedter talks about the “guts-for-brains” hypothesis recently discussed by A Gibbons (2007, Science 316, 1560); as we moved to a calorically richer meat diet, we needed to invest less energy in gastrointestinal function and could use that energy to fuel a larger brain.  Predigesting meat by cooking it may have helped.  Striedter suggests the chicken-and-egg alternative that as brain size increased, the dietary shift to meat became possible.  As is so often the case, it is probably some of both.

How our neocortex got to be so large is an interesting question.  It appears that here there is evidence for the emergence of new areas, possibly resulting from an older area developing during ontogenesis into two areas instead of one.  The evidence suggests that brain complexity increased independently in different lineages.  Mammals and teleosts share complex diencephalons but in mammals the dorsal thalamus segregated into many nuclei while in teleosts the posterior tuberculum became more complex.  “…complex brains evolved repeatedly among the vertebrates but the details of the complexity tend to vary between clades” (p. 214).

The evolution of neuronal connectivity provides many insights into the workings of genetics and the targets of evolutionary change.  Developing neurons compete for a trophic factor from muscle, a case of epigenetic population matching.  This eliminates the need for genes to specify the specific wiring of muscles.  Epigenetic cascades take place, for example, in the visual system where increased retinogeniculate projections lead to increased geniculocortical projections.

I particularly enjoyed the discussion of the corticospinal tract.  I have known for many years that it is most developed in primates and much less developed or almost nonexistent in other mammals.  Only placentals with a well-developed motor cortex have a well-developed corticospinal tract.  “…with increasing neocortex size, corticospinal axons penetrate deeper into the ventral horn... and further down the spinal cord” (p. 238).  Most people who think about the basal ganglia think in terms of cortico-striato-thalamo-cortical loops that ultimately influence motor cortical output represented by the corticobulbar and corticospinal projection systems.  However, these same loops can be found in species that lack extensive corticospinal tracts; in these cases, cortical output to the striatum must be able to reach brainstem and spinal motor nuclei via another route.  That route would be via caudally coursing basal gangliar output that does not loop back through the thalamus.  The anatomy of these caudally projecting noncortical (extrapyramidal) motor influences remains to be fully worked out.

The comparison of mammalian and avian brains has always been a challenge for comparative neuroanatomists because it has proven difficult to identify apparent homologous structures.  In recent years the realization that the dorsal ventricular ridge of birds has undergone extensive elaboration has helped to sort this out.  This region is even layered like mammalian cortex.  The Wulst is the bird’s most likely homologue to the mammalian neocortex. 

Lots to learn in this book. (March 27, 2008)

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Vanderwolf, CH. (2003) An Odyssey Through the Brain, Behavior and the Mind. Kluver Academic Publishers: Boston MA.

Vanderwolf spent the last 40 years studying the behavior and electrophysiological brain activity of rats and related species. He is a brilliant behavioral scientist who eschews outmoded and ineffective mentalistic concepts in psychology, advocating a brain-and-behavior approach. This book is autobiographical and throughout one meets various figures from Canadian and international psychology who are well known in the field. There is periodic reflection about his own ideas and the direction that his research took, musings about his own ridiculous ideas and the blind alleys that they took him down. There is too a large contribution to the field. Vanderwolf identified a systematic relationship between hippocampal and cortical electroencephalographic (EEG) activity and various types of behavior. He meticulously sought and found the neurotransmitter systems that mediate this EEG and in so doing debunked earlier twentieth century ideas about the reticular activating system. He tells a story about this discovery and his communication of it at a scientific meeting that was not very warmly accepted. It was that old familiar feeling that any scientist knows when he or she comes up with an idea that goes against the current trends.

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Zimmer, C. (2004) Soul Made Flesh: The Discovery of the Brain and How it Changed the World. Free Press: New York.

After touching on Galen’s (c. 130-c. 200) contributions to understanding the workings of the blood and brain and Aquinas’ (1225-1274) embrace of Aristotle, Zimmer moves quickly to the XVI and XVII century. By briefly introducing the work of Copernicus (1473-1543), Galileo (1564-1642) and Descartes (1596-1650), he sets the stage for the growth of science and modern medicine. The influential work of the alchemist Paracelsus (c.1493-1541) contributed to the eventual rejection of Galen’s humoral theories in favour of specific remedies for specific diseases; Paracelsus is credited with the invention of laudanum, for example, a mixture of alcohol and opium that was used as an analgesic for over 400 years.

A central player in the transition to modern thinking about the workings of the body was Harvey (1578-1657). Credited with the discovery of the circulation of the blood, “…Harvey was to medicine what Galileo was to physics” (p. 65). Harvey reached into the heart of Galen’s account of how the body worked and showed that it was flawed. However, the XVI and XVII centuries were risky times to challenge established thought as the persecution of Galileo and posthumous publication of Copernicus attest. Zimmer weaves the reactions of Harvey’s contemporaries to his work into the political fabric of the time in Britain. The reader meets Charles I (1600-1649), Cromwell (1599-1658) and Charles II (1630-1685), learns how the Civil War affected the fortunes of many intellectuals and how the attitude of the dominant groups influenced the reception of their ideas.

The Oxford Experimental Philosophy Club was formed around 1650. It included Thomas Willis (1621-1675), a physician who took the lead in discovering the workings of the brain. He knew Harvey and his work. Working with a number of his colleagues who were skilled in dissection (e.g., Pettty, 1623-1687) and drawing (e.g., Wren, 1632-1723, of architectural fame), he pushed the study of the central and peripheral nervous system to new levels and published a book of his findings that was widely influential for centuries. What makes for fascinating reading is the tension between Willis and other members of the Oxford Circle, on the one hand, and materialists like Hobbes (1588-1679), on the other. Willis and many of his colleagues, e.g., Boyle (1627-1691) the father of modern chemistry and one of the people credited with establishing experimental methodology, were theists and worked hard to emphasize how their discoveries uncovered the marvels of God’s workings.

Sometime between 1661 and 1663, Willis dissected a human brain, having learned of methods to preserve the brain and to harden it so that it could be removed intact. He removed the external covering of the brain, the cerebral cortex, and noted the grey structures with patterns of stripes buried beneath. He named this region the corpus striatum, meaning striped body. This was the first time ever that this part of the brain had been identified, named and published. In the XX and XXI centuries, hundreds of neuroscientists, myself included, have dedicated their careers to the study of the functions of the corpus striatum. Around the same time, Wren used a hollow porcupine quill attached to a bladder to make intravenous injections into dogs. He assessed the effects of injecting a number of substances including alcohol. Psychopharmacology was born.

Willis dissected the brains of many animals including humans. He noted the similarity in structure among species as varied as fish and apes, he noted that even invertebrates have nervous systems with central ganglia and fibres running throughout their bodies. He noted that the blood seemed to circulate to all regions of the nervous system. Zimmer argues that Willis is the true founder of modern neuroscience and that his work marks the beginning of the neurocentric age. A great book.

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