Differential diagnosis of motor symptoms, for example, akinesia, may be difficult in clinical neuropsychiatry. Symptoms may be either of neurologic origin, for example, Parkinson's disease, or of psychiatric origin, for example, catatonia, leading to a so-called “conflict of paradigms.” Despite their different origins, symptoms may appear more or less clinically similar. Possibility of dissociation between origin and clinical appearance may reflect functional brain organisation in general, and cortical-cortical/subcortical relations in particular. It is therefore hypothesized that similarities and differences between Parkinson's (...) disease and catatonia may be accounted for by distinct kinds of modulation between cortico-cortical and cortico-subcortical relations. Catatonia can be characterized by concurrent motor, emotional, and behavioural symptoms. The different symptoms may be accounted for by dysfunction in orbitofrontal-prefrontal/parietal cortical connectivity reflecting “horizontal modulation” of cortico-cortical relation. Furthermore, alteration in “top-down modulation” reflecting “vertical modulation” of caudate and other basal ganglia by GABA-ergic mediated orbitofrontal cortical deficits may account for motor symptoms in catatonia. Parkinson's disease, in contrast, can be characterized by predominant motor symptoms. Motor symptoms may be accounted for by altered “bottom-up modulation” between dopaminergic mediated deficits in striatum and premotor/motor cortex. Clinical similarities between Parkinson's disease and catatonia with respect to akinesia may be related with involvement of the basal ganglia in both disorders. Clinical differences with respect to emotional and behavioural symptoms may be related with involvement of different cortical areas, that is, orbitofrontal/parietal and premotor/motor cortex implying distinct kinds of modulation – “vertical” and “horizontal” modulation, respectively. Key Words: Bottom-up modulation; catatonia; horizontal modulation; Parkinson's disease; top-down modulation; vertical modulation. (shrink)

The neuropathologies of the self are disorders of the self and identity that occur in association with neuropathology and include perturbations of the bodily, relational, and narrative self. Right, especially medial-frontal and orbitofrontal lesions, are associated with these conditions. The ego disequilibrium theory proposes this brain pathology causes a disturbance of ego boundaries and functions and the emergence of developmentally immature styles of thought, ego functioning, and psychological defenses including denial, projection, splitting, and fantasy that the NPS patient has in (...) common with the child. I hypothesize that during brain development between approximately ages 3 and 7 immature defensive functions and fantasies tend to be replaced by mature defenses and the inhibition of fantasy a process that depends upon maturational processes within the right hemisphere. I propose a four-tiered model of the NPS that emphasizes a multifactorial approach and includes both negative and positive, bottom up and top down, and neuropsychological and psychological factors. (shrink)

Brain mapping studies using dynamic imaging methods demonstrate areas regional cerebral blood flow (rCBF) decreases, as well as areas where increases, during performance of various experimental tasks. Task holds for both sets of cerebral blood flow changes (CBF), providing the opportunity to investigate areas that become and “activated” in the experimental condition relative to control state. Such data yield the intriguing observation that in areas in emotional processing, such as the amygdala, the posteromedial cortex, and the ventral anterior cingulate cortex, (...) although flow as expected during specific emotion-related tasks, flow decreases performance of some attentionally demanding, cognitive tasks. Conversely, in some of the areas that appear to subserve cognitive functions, as the dorsal anterior cingulate and the dorsolateral prefrontal cortices, increases while performing attentionally demanding cognitive tasks, but during some experimentally induced and pathological emotional Although the specific nature of such reciprocal patterns of regional remains unclear, they may reflect an important cross-modal interaction during mental operations. The possibility that neural activity is less in areas required in emotional processing during some higher cognitive processes holds implications for the mechanisms underlying interactions cognition and emotion. Furthermore, the possibility that neural in some cognitive-processing areas is suppressed during intense states suggests mechanisms by which extreme fear or severe may interfere with cognitive performance. (shrink)

Although deductive reasoning is a closed system, one's beliefs about the world can influence validity judgements. To understand the associated functional neuroanatomy of this belief-bias we studied 14 volunteers using event-related fMRI, as they performed reasoning tasks under neutral, facilitatory and inhibitory belief conditions. We found evidence for the engagement of a left temporal lobe system during belief-based reasoning and a bilateral parietal lobe system during belief-neutral reasoning. Activation of right lateral prefrontal cortex was evident when subjects inhibited a prepotent (...) response associated with belief-bias and correctly completed a logical task, a finding consistent with its putative role in cognitive monitoring. By contrast, when logical reasoning was overcome by belief-bias, there was engagement of ventral medial prefrontal cortex, a region implicated in affective processing. This latter involvement suggests that belief-bias effects in reasoning may be mediated through an influence of emotional processes on reasoning. (shrink)

This novel approach plunges the reader into the depths of our own brain.

Logic is widely considered the basis of rationality. Logical choices, however, are often influenced by emotional responses, sometimes to our detriment, sometimes to our advantage. To understand the neural basis of emotionally neutral and emotionally salient reasoning we studied 19 volunteers using event-related fMRI, as they made logical judgments about arguments that varied in emotional saliency. Despite identical logical form and content categories across “hot” and “cold” reasoning conditions, lateral and ventral medial prefrontal cortex showed reciprocal response patterns as a (...) function of emotional saliency of content. “Cold” reasoning trials resulted in enhanced activity in lateral/dorsal lateral prefrontal cortex and suppression of activity in ventral medial prefrontal cortex. By contrast, “hot” reasoning trials resulted in enhanced activation in VMPFC and suppression of activation in L/DLPFC. This reciprocal engagement of L/DLPFC and VMPFC provides evidence for a dynamic neural system for reasoning, the configuration of which is strongly influenced by emotional saliency. (shrink)