We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

The Brain and the Meaning of Life Paul Thagard Princeton: Princeton University Press, 2010 274 pages, ISBN: 9780691142722 (hbk): $29.95 This paper criticizes central arguments in Paul Thagard's The Brain and the Meaning of Life, concluding, contrary to Thagard, that there is very little that we can learn from brain research about the meaning of life. The paper offers a critical review of Thagard's argument against nihilism and his argument that it is love, work, and play, rather than other activities, (...) that make life meaningful. Moreover, the paper argues that the rich neurological information Thagard presents throughout the book does not contribute at all to his arguments and, more generally, that neurological research is irrelevant also to almost all other aspects of meaning of life research. (shrink)

This chapter provides a brief overview of the history of behavioral neurology, dividing it roughly into six eras. In the ancient and classical eras, emphasis is placed on two transitions: firstly, from descriptions of head trauma and attempted neurosurgical treatments to the exploratory dissections during the Hellenistic period and the replacement of cardiocentrism; and secondly, to the more systematic investigations of Galenus and the rise of pneumatic ventricular theory. In the medieval through post-Renaissance eras, the scholastic consolidation of knowledge (...) and the role of compendia are emphasized, along with the use of new methods from within a mechanistic framework. With the discovery of electrical conductance and the rise of experimentalism, we frame the modern era as period of intense debate over localization, decomposition, and other mechanistic principles, and marked by rapid discovery about the brain. The chapter ends with a discussion of the contemporary era, focusing on the establishment of behavioral neurology research on aphasia, apraxia, and neuropsychiatric conditions. (shrink)

Neurological syndromes in which consciousness seems to malfunction, such as temporal lobe epilepsy, visual scotomas, Charles Bonnet syndrome, and synesthesia offer valuable clues about the normal functions of consciousness and ‘qualia’. An investigation into these syndromes reveals, we argue, that qualia are different from other brain states in that they possess three functional characteristics, which we state in the form of ‘three laws of qualia’. First, they are irrevocable: I cannot simply decide to start seeing the sunset as green, or (...) feel pain as if it were an itch; second, qualia do not always produce the same behaviour: given a set of qualia, we can choose from a potentially infinite set of possible behaviours to execute; and third, qualia endure in short-term memory, as opposed to non-conscious brain states involved in the on-line guidance of behaviour in real time. We suggest that qualia have evolved these and other attributes because of their role in facilitating non-automatic, decision-based action. We also suggest that the apparent epistemic barrier to knowing what qualia another person is experiencing can be overcome by using a ‘bridge’ of neurons; and we offer a hypothesis about the relation between qualia and one's sense of self. (shrink)

A precise overview of pediatric emergencies would require taxological considerations around the differences between strictly neurological factors, as modulated both via neuroanatomical differentiation in the context of normal vs. abnormal biological development, and underlying neurofunctional mechanisms, and the connection with such processes with the neuromodulated activation of digestive processes. Furthermore, an important distinction between nephrological considerations and urological considerations is necessary, more specifically, by focusing on the treatment of diseases affecting the kidneys and their ability to function in the first (...) case, and on the treatment of diseases affecting the urinary tract in the latter. In this paper, we will present a general overview of the most important aspects of each category, starting with the brief description of neurological emergencies as indicating a general (system-based vs. localized) deterioration of mental capacity, with added possible partial or full loss of cognitive capacities and/or impaired perceptual modalities and consciousness, with or without response to stimuli. (shrink)

Physical activity levels of people with chronic neurological disorders are lower than those of healthy people. Problems in neurological disorders, including gait abnormalities, muscle weakness/loss of strength, spasticity, tremor, fatigue, balance disorder, and incontinence, results in lower physical activity level. After determining the situations that are contraindicated for physical activity, the patients should be evaluated by physiotherapists, and possible risks that may occur should be determined. Many studies have demonstrated that physical activity significantly reduces mortality and morbidity, increases community participation, (...) and improves health-related quality of life. These benefits show that increased physical activity and exercise should be part of the standard management of neurological disorders. In these patients, physical activity programs should be structured individually by providing appropriate environmental conditions and safety, following the assessment of the functional status and severity of the disease. The duration, intensity, and type of planned physical activity should be adjusted individually; Appropriate rest intervals should be given during the activity, and termination criteria should be determined according to individual tolerance. This literature review aims to provide an up-to-date overview of physical activity recommendations for individuals with chronic neurological disorders. (shrink)

The Neurological Disease Ontology (ND) is being developed to provide a comprehensive framework for the representation of neurological diseases (Diehl et al., 2013). ND utilizes the model established by the Ontology for General Medical Science (OGMS) for the representation of entities in medicine and disease (Scheuermann et al., 2009). The goal of ND is to include information for each disease concerning its molecular, genetic, and environmental origins, the processes involved in its etiology and realization, as well as its clinical presentation (...) including signs and symptoms. (shrink)

Background: Leprosy is a chronic granulomatous infectious disease having major burden on humans over thousands of years. If untreated, it results in permanent damage to various systems and organs. So we designed this study to evaluate the neurological complications in early stage in adult leprosy patients. Objective: The aim of this study was to find out the pattern of neurological manifestations among adult leprosy patients. Materials and Methods: This cross-sectional hospital-based study on 85 adult tribal leprosy patients was conducted in (...) a district level health care facility from January to December 2014 using simple, direct, standardized questionnaire including history and neurological examinations. Results: The commonest age group affected was 18–30 years (62.4%). Male group was predominant (68.2%). Majority cases (66%) had multibacillary leprosy. At first visit 72.7% cases with neurological findings could not be diagnosed correctly by primary health care personnel. More than six months were required for correct diagnosis in 61.2% cases. Numbness was the commonest (74.5%) neurological symptom. In upper limb, motor findings were predominant with wasting in 50.9% cases. In lower limb, sensory findings were predominant with stock pattern sensory impairment being the commonest (56.4%). Ulnar nerve was the commonest peripheral nerve to enlarge with tenderness. Facial nerve was the commonest cranial nerve involved. All cases with multiple cranial nerves involvement were of multibacillary type. Due to physical disability 92.7% cases lost their jobs. (shrink)

Objectives: The aim of this study is to find out the prevalence and outcome of falciparum malaria with neurological manifestations. Materials and Methods: A prospective cross-sectional hospital-based study of 318 falciparum malaria patients using simple, direct, standardized questionnaire with history, lab investigations and neurological examination from January 2014 to December 2014. Results: July was the most vulnerable month for falciparum malaria causing the highest hospital admission (48.8%) and death (29.3%). The commonest age group affected was 15- 30 years (49.2%). Prevalence (...) of neurological manifestations was 58.8%. Altered sensorium (48.7%) was the most frequent neurological manifestation, followed by abnormal behavior (19.8%) and convulsions (15.5%). Case fatality rate was very high with neurological manifestations, highest with altered sensorium (31.3%). Only 71.1% knows about the neurological manifestations showing very poor perception among tribal. Primary health care providers also failed to diagnose most of the cases (69%) which presented with neurological features. Conclusion: Falciparum malaria with neurological involvement is associated with increased mortality. By documenting different neurological patterns of falciparum malaria and by trained health care personnel, mortality and morbidity rates can be reduced by early diagnosis and management. (shrink)

Psychiatric and neurological disorders have historically provided key insights into the structure-function rela- tionships that subserve human social cognition and behavior, informing the concept of the ‘social brain’. In this review, we take stock of the current status of this concept, retaining a focus on disorders that impact social behavior. We discuss how the social brain, social cognition, and social behavior are interdependent, and emphasize the important role of development and com- pensation. We suggest that the social brain, and its (...) dysfunction and recovery, must be understood not in terms of specific structures, but rather in terms of their interaction in large-scale networks. (shrink)

We have begun work on two separate but related ontologies for the study of neurological diseases. The first, the Neurological Disease Ontology (ND), is intended to provide a set of controlled, logically connected classes to describe the range of neurological diseases and their associated signs and symptoms, assessments, diagnoses, and interventions that are encountered in the course of clinical practice. ND is built as an extension of the Ontology for General Medical Sciences — a high-level candidate OBO Foundry ontology that (...) provides a set of general classes that can be used to describe general aspects of medical science. ND is being built with classes utilizing both textual and axiomatized definitions that describe and formalize the relations between instances of other classes within the ontology itself as well as to external ontologies such as the Gene Ontology, Cell Ontology, Protein Ontology, and Chemical Entities of Biological Interest. In addition, references to similar or associated terms in external ontologies, vocabularies and terminologies are included when possible. Initial work on ND is focused on the areas of Alzheimer’s and other diseases associated with dementia, multiple sclerosis, and stroke and cerebrovascular disease. Extensions to additional groups of neurological diseases are planned. The second ontology, the Neuro-Psychological Testing Ontology (NPT), is intended to provide a set of classes for the annotation of neuropsychological testing data. The intention of this ontology is to allow for the integration of results from a variety of neuropsychological tests that assay similar measures of cognitive functioning. Neuro-psychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases, such as Alzheimer’s disease and multiple sclerosis, and following stroke or traumatic brain injury. NPT is being developed as an extension to the Ontology for Biomedical Investigations. (shrink)

In the light of the results obtained during the last two decades in analysis of signals by time series, it has become evident that the tools of non linear dynamics have their elective role of application in biological, and, in particular, in neuro-physiological and psycho-physiological studies. The basic concept in non linear analysis of experimental time series is that one of recurrence whose conceptual counterpart is represented from variedness and variability that are the foundations of complexity in dynamic processes. Thus, (...) the recurrence plots and the Recurrence Quantification Analysis (RQA) are discussed. It is shown that RQA represents the most general and correct methodology in investigation of experimental time series. By it we arrive to inspect the inner structure of the time series connected to the signals under investigation. Linked to RQA we prospect also the method CZF, recently introduced by us. It is able to account for a true estimation of variability of signals in time as well as in frequency domain. And, consequently, it may be used in conjunction with classical Fourier analysis, accounting however that it is inappropriate in analysis of non linear and non stationary experimental time series. The use of CZF method in fractal analysis is also considered in addition to standard index as Hurst exponent. A large field of possible applications in neurological as well as in psycho-physiological studies is given. Also, there are given examples of other and (possibly linked) applications as example the analysis of beat-to-beat fluctuations of human heartbeat intervals that is sovereign in psycho-physiological studies. We give applications on some different planes to evidence the particular sensitivity of such methods. We reach the objective to show that the previously exposed methods are also able to predict in advance the advent of ventricular tachycardia and/or of ventricular fibrillation. The RQA analysis gives good results. The CZF method gives the most excellent results showing that it is able to give very significant indexes of prediction. We also apply such methods in investigation of state anxiety, and proposing in detail a quantum like model of such phenomenological status of the mind. (shrink)

We present a theory of human artistic experience and the neural mechanisms that mediate it. Any theory of art has to ideally have three components. The logic of art: whether there are universal rules or principles; The evolutionary rationale: why did these rules evolve and why do they have the form that they do; What is the brain circuitry involved? Our paper begins with a quest for artistic universals and proposes a list of ‘Eight laws of artistic experience’ -- a (...) set of heuristics that artists either consciously or unconsciously deploy to optimally titillate the visual areas of the brain. One of these principles is a psychological phenomenon called the peak shift effect: If a rat is rewarded for discriminating a rectangle from a square, it will respond even more vigorously to a rectangle that is longer and skinnier that the prototype. We suggest that this principle explains not only caricatures, but many other aspects of art. Example: An evocative sketch of a female nude may be one which selectively accentuates those feminine form-attributes that allow one to discriminate it from a male figure; a Boucher, a Van Gogh, or a Monet may be a caricature in ‘colour space’ rather than form space. Even abstract art may employ ‘supernormal’ stimuli to excite form areas in the brain more strongly than natural stimuli. Second, we suggest that grouping is a very basic principle. The different extrastriate visual areas may have evolved specifically to extract correlations in different domains , and discovering and linking multiple features into unitary clusters -- objects -- is facilitated and reinforced by direct connections from these areas to limbic structures. In general, when object-like entities are partially discerned at any stage in the visual hierarchy, messages are sent back to earlier stages to alert them to certain locations or features in order to look for additional evidence for the object . Finally, given constraints on allocation of attentional resources, art is most appealing if it produces heightened activity in a single dimension rather than redundant activation of multiple modules. This idea may help explain the effectiveness of outline drawings and sketches, the savant syndrome in autists, and the sudden emergence of artistic talent in fronto-temporal dementia. In addition to these three basic principles we propose five others, constituting a total of ‘eight laws of aesthetic experience’. (shrink)

One of the central problems in cognitive science concerns our ability to understand others in terms of mental state attribution. We, humans, think of each other as having minds, an assumption which indeed forms the basis of our daily communication: by attributing mental state we understand and predict each other’s behavior. But what mechanisms underpin this ability? This is a question that has preoccupied philosophers and cognitive scientists for more than four decades. In this paper, I will examine two dominant (...) solutions, Theory-Theory and Simulation-Theory, to this question. In section one, I distinguish between two different senses of "theory" and cite considerable evidence in favor of the modular version of Theory-Theory. In section two, after introducing Simulation Theory as an alternative to Theory-Theory, I distinguish between three possible senses of "similarity" in simulation, argue that none of them are free from certain difficulties. (shrink)

The aim of this study was to obtain a baseline for clinical application of electroencephalography (EEG) in children and to evaluate the EEG findings in children with various acute and chronic central nervous system disorders and nonepileptic events. EEG records of 250 patients were studied in Neurophysiology Departments of Queen Rania Al-Abdullah Hospital for Children in Jordan. For each patient who had undergone EEG the following data were recorded: age, sex, source of referral (inpatient or outpatient department), reason for EEG, (...) diagnostic impressions, clinical presentation, the result of the EEG examinations and clinical correlation between the seizure type and EEG finding. Males (55%) were slightly outnumbered than females. The majority of cases were between 6-12 years. Total of 63.2% of all referrals for EEG were from outpatient clinics while inpatients accounted for 36.8% of referred cases, with Pediatric Neurology Department referrals being the highest (28.8%). Majority of diagnosis at referral were suspected epilepsy (80%) with epileptiform EEG abnormalities in 32%. Over all 64% the EEG records were normal, including all EEG records of children with syncope and headache. We conclude that there are many unnecessary routine EEG recordings in children. Investigation of epilepsy and acute encephalopathies appear to be the most valuable indications for routine pediatric EEG. EEG can be helpful in classification of seizures. Finding a way to reduce EEG requests is recommended. (shrink)

Critique of Sarcastic Reason is a philosophical dissertation that combines several different fields in order to pave the way for those studying sarcasm at the neurobiological, communicative and socio-political levels of analysis where sarcasm appears, respectively, through associated brain activity, between two or more individuals with higher level metabeliefs, and as a method by which political, religious and other social ideologies are attacked (i.e., one form of "biting sarcasm"). The academic disciplines involved in Critique of Sarcastic Reason include social cognitive (...) and developmental psychology, neuroscience, critical theory, modern and contemporary philosophy of mind, evolutionary biology, logic, metaphysics and epistemology. Sarcasm is argued to only function at the highest levels of metacognition, and sarcasm occurs within social situations during which there are tendencies for two or more people to form desires and disgusts directly related to beliefs about beliefs. Sarcasm is compared to deception and is argued to be best analyzed as either spontaneous or rehearsed. (shrink)

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 2013 containing the following changes from the previous edition: gone are the subcategories ‘Autistic Disorder,’ ‘Asperger Syndrome’ and ‘PDD-NOS,’ replaced by the single diagnosis ‘Autism Spectrum Disorder,’ and there is a new category ‘Social Communication Disorder.’ In this paper I consider what kind of reasons would justify these changes if one were (a) a realist about autism, or (b) one were a constructivist. I explore (...) various analyses of autism in the research literature that portray it as essentially either a psychological, neurological or genetic phenomenon, and discuss these by reference to the diagnostic criteria and by analogy with the way we understand race and sex categories. I conclude that no realist reasons are available to justify the changes in the diagnostic criteria, and further, that the only way the changes could be justified is if one takes the position that the DSM categories are social constructs. I conclude by exploring what implications follow from this. (shrink)

This paper investigates the nature of reality by looking at the philosophical debate between realism and idealism and at scientific investigations in quantum physics and at recent studies of animal senses, neurology and cognitive psychology. The concept of perceptual relativity is examined and this involves looking at sense perception in other animals and various examples of perceptual relativity in science. It will be concluded that the universe is observer dependent and that there is no reality independent of the observer, (...) which is knowable to the observer. The paper concludes by an investigation of what an observer dependent universe would be like and that recognition of an observer dependent world would lead to a more open minded and tolerant world. (shrink)

Direct neurological and especially imaging-driven investigations into the structures essential to naturally occurring cognitive systems in their development and operation have motivated broadening interest in the potential for artificial consciousness modeled on these systems. This first paper in a series of three begins with a brief review of Boltuc’s (2009) “brain-based” thesis on the prospect of artificial consciousness, focusing on his formulation of h-consciousness. We then explore some of the implications of brain research on the structure of consciousness, finding limitations (...) in biological approaches to the study of consciousness. Looking past these limitations, we introduce research in artificial consciousness designed to test for the emergence of consciousness, a phenomenon beyond the purview of the study of existing biological systems. (shrink)

Although neurological disease and mental illness can cause terrible human suffering, strategies for researching their causes and cures are not obvious. Invasive brain research on actual human being...

Largely aided by the neurological discovery of so-called “ mirror neurons,” the attention to motor activity during action observation has exploded over the last two decades. The idea that we internally “ mirror ” the actions of others has led to a new strand of implicit simulation theories of action understanding[1][2]. The basic idea of this sort of simulation theory is that we, via an automatic covert activation of our own action representations, can understand the action and possibly the goal (...) and/or intentions of the observed agent. In this way motor “simulation” is seen as the basis for low-level “mind-reading”; i.e. for the ascription of goals and intentional mental states to others. The thought is that one, through mirroring simulations, can get beyond the observable behaviour to the hidden minds of others. I am questioning the idea of an exclusively “mirroring” role of the motor system in social perception, which is tacitly assumed in this sort of simulation theories. Is motor activity during action observation really primarily a simulation, a detailed “echo” of the others action? My point is not that we never simulate what we observe, but rather to question whether such processes are representative of the overall motor contribution to social cognition. More and more studies on the functional properties of mirror neurons and motor facilitation during perception points to a more complex role of the motor system in action perception. Recently, several proposals have been made attempting to reinterpret and critique the function of motor activity in social situations. I shall here briefly touch on a few of these and sketch parts of my own alternative “social affordance” hypothesis of the sensorimotor contribution to social perception. By way of these analyses I highlight how traditional discussions are marred by problematic theoretical assumptions. It seems to me that we need a thorough reinterpretation not just of mirror neurons and mirroring, but also of what we take motor and social cognition to be. In my view the details of the sensorimotor findings underline the need to move beyond the simplistic idea of the motor system as a unitary output system. In terms of social cognition I question the traditional focus on hidden mental states. I suggest that the motor contribution might have more to do with understanding the process of how others choose their actions, navigate the world and relate to others than with simulating specific actual actions or mental states. I conclude that low-level simulation theories, which see the motor role in social perception as passive “mirroring,” are faced with serious empirical challenges, and that the motor system serve a much more proactive and complex cognitive role in social perception and interaction than previously thought. But my claim is also that many empirical tensions have slipped out of focus due to entrenched theoretical assumptions. Narrow theoretical expectations have marked not only the interpretations but the research itself and I propose that we are in dire need of more studies of actual contextual and interactive social perception. (shrink)

Migraine is a complex neurological disorder characterized by recurrent moderate to severe headaches, accompanied by additional symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Accurate and timely diagnosis of migraines is crucial for effective management and treatment. However, the diverse range of symptoms and overlapping characteristics with other headache disorders pose challenges in the diagnostic process. In this research, we propose the development of an expert system for migraine diagnosis using artificial intelligence and the CLIPS (C (...) Language Integrated Production System) framework. The expert system utilizes a rule-based inference engine to analyze patient-reported symptoms and provide reliable diagnoses or probability scores indicating the likelihood of migraine. The knowledge base of the expert system is designed based on expert knowledge obtained from medical professionals specializing in migraines. The collected knowledge is translated into a structured format suitable for the CLIPS inference engine, incorporating rules and facts to represent the diagnostic criteria and associated symptoms. The system prompts users to provide relevant information about their symptoms, medical history, and potential triggers. It applies the defined rules and facts to evaluate the likelihood of migraine and generate accurate diagnoses or probability scores. Preliminary evaluation results demonstrate the potential of the expert system as a valuable tool for diagnosing migraines. A dataset of anonymized patient records with confirmed migraine cases was used to test the system. The diagnoses generated by the expert system were compared against the known diagnoses, and a high level of accuracy was observed, with 90% of cases correctly diagnosed as migraines. These results highlight the effectiveness and reliability of the system in assisting medical professionals in the diagnosis of migraines. The proposed expert system offers several advantages for migraine diagnosis. It leverages the collective knowledge and expertise of experienced migraine specialists, providing a standardized and consistent approach to diagnosis. The system can handle large amounts of patient data and effectively analyse complex relationships between symptoms, risk factors, and diagnostic criteria. Furthermore, it offers real-time feedback and recommendations, supporting medical professionals in their clinical decision-making process. Future work involves refining the expert system based on feedback from medical experts, expanding the knowledge base to encompass a wider range of symptoms and risk factors, and conducting further evaluations to enhance its accuracy and applicability in clinical settings. The development of an expert system for migraine diagnosis has the potential to improve the diagnostic process, leading to more effective management and treatment strategies for individuals suffering from migraines. (shrink)

Memory of past episodes provides a sense of personal identity — the sense that I am the same person as someone in the past. We present a neurological case study of a patient who has accurate memories of scenes from his past, but for whom the memories lack the sense of mineness. On the basis of this case study, we propose that the sense of identity derives from two components, one delivering the content of the memory and the other generating (...) the sense of mineness. We argue that this new model of the sense of identity has implications for debates about quasi-memory. In addition, articulating the components of the sense of identity promises to bear on the extent to which this sense of identity provides evidence of personal identity. (shrink)

In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

Optogenetics is an invasive neuromodulation technology involving the use of light to control the activity of individual neurons. Even though optogenetics is a relatively new neuromodulation tool whose various implications have not yet been scrutinized, it has already been approved for its first clinical trials in humans. As optogenetics is being intensively investigated in animal models with the aim of developing novel brain stimulation treatments for various neurological and psychiatric disorders, it appears crucial to consider both the opportunities and dangers (...) such therapies may offer. In this review, we focus on the memory-modifying potential of optogenetics, investigating what it is capable of and how it differs from other memory modification technologies. We then outline the safety challenges that need to be addressed before optogenetics can be used in humans. Finally, we re-examine crucial neuroethical concerns expressed in regard to other MMTs in the light of optogenetics and address those that appear to be unique to the memory-modifying potential of optogenetic technology. (shrink)

Various prominent theories of pain assume that it is pain’s biological function to inform organisms about damage to their bodies. I argue that this is a mistake. First, there is no biological evidence to support the notion that pain was originally selected for its informative capacities, nor that it currently contributes to the fitness of organisms in this specific capacity. Second, neurological evidence indicates that modulating mechanisms in the nociceptive system systematically prevent pain from serving a primarily informative role. These (...) considerations threaten to undermine standard perceptual and representational accounts of pain. (shrink)

So-called 'Frege cases' pose a challenge for anyone who would hope to treat the contents of beliefs (and similar mental states) as Russellian propositions: It is then impossible to explain people's behavior in Frege cases without invoking non-intentional features of their mental states, and doing that seems to undermine the intentionality of psychological explanation. In the present paper, I develop this sort of objection in what seems to me to be its strongest form, but then offer a response to it. (...) I grant that psychological explanation must invoke non-intentional features of mental states, but it is of crucial importance which such features must be referenced. -/- It emerges from a careful reading of Frege's own view that we need only invoke what I call 'formal' relations between mental states. I then claim that referencing such 'formal' relations within psychological explanation does not undermine its intentionality in the way that invoking, say, neurological features would. The central worry about this view is that either (a) 'formal' relations bring narrow content in through back door or (b) 'formal' relations end up doing all the explanatory work. Various forms of each worry are discussed. The crucial point, ultimately, is that the present strategy for responding to Frege cases is not available either to the 'psycho-Fregean', who would identify the content of a belief with its truth-value, nor even to someone who would identify the content of a belief with a set of possible worlds. It requires the sort of rich semantic structure that is distinctive of Russellian propositions. There is therefore no reason to suppose that the invocation of 'formal' relations threatens to deprive content of any work to do. (shrink)

In a series of pre-registered studies, we explored (a) the difference between people’s intuitions about indeterministic scenarios and their intuitions about deterministic scenarios, (b) the difference between people’s intuitions about indeterministic scenarios and their intuitions about neurodeterministic scenarios (that is, scenarios where the determinism is described at the neurological level), (c) the difference between people’s intuitions about neutral scenarios (e.g., walking a dog in the park) and their intuitions about negatively valenced scenarios (e.g., murdering a stranger), and (d) the difference (...) between people’s intuitions about free will and responsibility in response to first-person scenarios and third-person scenarios. We predicted that once we focused participants’ attention on the two different abilities to do otherwise available to agents in indeterministic and deterministic scenarios, their intuitions would support natural incompatibilism—the view that laypersons judge that free will and moral responsibility are incompatible with determinism. This prediction was borne out by our findings. (shrink)

When information on a coma patient’s expected outcome is uncertain, a moral dilemma arises in clinical practice: if life-sustaining treatment is continued, the patient may survive with unacceptably poor neurological prospects, but if withdrawn a patient who could have recovered may die. Continuous electroencephalogram-monitoring is expected to substantially improve neuroprognostication for patients in coma after cardiac arrest. This raises expectations that decisions whether or not to withdraw will become easier. This paper investigates that expectation, exploring cEEG’s impacts when it becomes (...) part of a socio-technical network in an Intensive Care Unit. Based on observations in two ICUs in the Netherlands and one in the USA that had cEEG implemented for research, we interviewed 25 family members, healthcare professionals, and surviving patients. The analysis focuses on the way patient outcomes are constructed, the kind of decision support these outcomes provide, and how cEEG affects communication between professionals and relatives. We argue that cEEG can take away or decrease the intensity of the dilemma in some cases, while increasing uncertainty for others. It also raises new concerns. Since its actual impacts furthermore hinge on how cEEG is designed and implemented, we end with recommendations for ensuring responsible development and implementation. (shrink)

A patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care staff confronted (...) with painful decisions regarding the patient's care, has attracted a considerable amount of discussion within the bioethics community. At present, there is a wealth of literature that discusses the relevant neurology, that elucidates the plethora of ethical challenges in understanding and dealing with the condition, and that analyses the real-world cases which have prominently featured in the mainstream media as a result of emotionally charged, divergent views concerning the provision of care to the patient. However, there is scarcely anything in the published scholarly literature that proposes concrete and practically actionable solutions to the now widely recognized moral conundrums. The present article describes a step in that direction. I start from the very foundations, laying out a sentientist approach which serves as the basis for the consequent moral decision-making, and then proceed to systematically identify and deconstruct the different cases of discord, using the aforementioned foundations as the basis for their resolution. A major intellectual contribution concerns the fluidity of the duty of care which I argue is demanded by the sentientist focus. The said duty is shown initially to have for its object the patient, which depending on the circumstances, can change to the patient's kin, or the health care staff themselves. In conclusion, the proposed framework represents the first comprehensive proposal regarding the decision-making processes involved in the deliberation on the provision of life sustaining treatment to a patient in a PVS. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

This paper addresses a fundamental question in folk metaphysics: how do we ordinarily view human agency? According to the transcendence account, we view human agency as standing outside of the causal order and imbued with exceptional powers. According to a naturalistic account, we view human agency as subject to the same physical laws as other objects and completely open to scientific investigation. According to exceptionalist naturalism, the truth lies somewhere in between: we view human agency as fitting broadly within the (...) causal order while still being exceptional in important respects. In this paper, I report seven experiments designed to decide between these three competing theories. Across a variety of contexts and types of action, participants agreed that human agents can resist outcomes described as inevitable, guaranteed, and causally determined. Participants viewed non-human animal agents similarly, whereas they viewed computers, robots, and simple inanimate objects differently. At the same time, participants judged that human actions are caused by many things, including psychological, neurological, and social events. Overall, in folk metaphysics, human and non-human animals are viewed as exceptional parts of the natural world. (shrink)

Nikola Grahek's influential book Feeling Pain and Being in Pain introduced philosophers to the strange phenomenon of pain asymbolia. Subsequent philosophical debate around asymbolia has been partly taxonomic: the deep question is whether it is best understood as a specific neurological deficit or part of a broader syndrome. This paper looks to the history of asymbolia, positioning the origin of the term within broader historical trends. It shows that strange phenomena about pain and motivation have always presented interpretive challenges, and (...) suggests that the current debate mirrors a historical split between German and French traditions. This does not resolve the debate, but does help place it within broader scientific and philosophical contexts. (shrink)

Two lines of evidence indicate that there exists a reciprocal inhibitory relationship between opposed brain networks. First, most attention-demanding cognitive tasks activate a stereotypical set of brain areas, known as the task-positive network and simultaneously deactivate a different set of brain regions, commonly referred to as the task negative or defaultmode network. Second, functional connectivity analyses show that these same opposed networks are anti-correlated in the resting state. Wehypothesize that these reciprocally inhibitory effects reflect two incompatible cognitive modes, each of (...) which may be directed towards understanding the external world. Thus, engaging onemode activates one set of regions and suppresses activity in the other.Wetest this hypothesis by identifying two types of problem-solving task which, on the basis of prior work, have been consistently associated with the task positive and task negative regions: tasks requiring social cognition, i.e., reasoning about the mental states of other persons, and tasks requiring physical cognition, i.e., reasoning about the causal/mechanical properties of inanimate objects. Social and mechanical reasoning tasks were presented to neurologically normal participants during fMRI. Each task type was presented using both text and video clips. Regardless of presentation modality, we observed clear evidence of reciprocal suppression: social tasks deactivated regions associated with mechanical reasoning and mechanical tasks deactivated regions associated with social reasoning. These findings are not explained by self-referential processes, task engagement, mental simulation,mental time travel or external vs. internal attention, all factors previously hypothesized to explain default mode network activity. Analyses of resting state data revealed a close match between the regions our tasks identified as reciprocally inhibitory and regions of maximal anti-correlation in the resting state. These results indicate the reciprocal inhibition is not attributable to constraints inherent in the tasks, but is neural in origin. Hence, there is a physiological constraint on our ability to simultaneously engage two distinct cognitive modes. Furtherwork is needed tomore precisely characterize these opposing cognitive domains. (shrink)

Sexual lust – understood as a feeling of sexual attraction towards another – has traditionally been viewed as a sort of desire or at least as an appetite akin to hunger. I argue here that this view is, at best, significantly incomplete. Further insights can be gained into certain occurrences of lust by noticing how strongly they resemble occurrences of “attitudinal” (“object-directed”) emotion. At least in humans, the analogy between the object-directed appetites and attitudinal emotions goes well beyond their psychological (...) structure to include similar ways in which their occurrence can be introspectively recognized, resulting in similar extensions of their functionality and meaningfulness to the subject. I conclude that although further research is needed, given the strength of the analogy, the ability of lust to satisfy some general requirements for being an emotion, and perhaps certain neurological findings, lust may somewhat uniquely straddle the line between appetite and emotion. (shrink)

The biopsychosocial (BPS) model in psychiatry has come under fire for being too vague to be of any practical use in the clinic. For many, its central flaw consists in lack of scientific validity and philosophical coherence: the model never specified how biological, psychological and social factors causally integrate with one another. Recently, advances in the cognitive sciences have made great strides towards meeting this very ‘integration challenge.’ The paper begins by illustrating how enactivist and predictive processing frameworks propose converging (...) accounts of biopsychosocial integration that are far superior to those of previous theories. It argues, however, that the main problem of implementing the BPS model has less to do with integration than with the lack of a social etiology. Psychiatric practice leans heavily towards ‘bio’ and ‘psycho’ approaches, without an equally developed set of explanatory and therapeutic resources for dealing with the ‘social’ dimension of illness. This leaves psychiatry essentially internalist in orientation. As illustrated most poignantly by conditions such as functional neurological disorders, internalism comes with the risks of stigma and the curtailment of therapeutic possibilities. The paper argues that the answer to the failings of the BPS model lies in combining the integration challenge with the development of an ‘externalist psychiatry,’ which casts both causes and treatment of psychiatric illness onto the social environment. The following two papers explore the conditions that might make this idea a reality. (shrink)

There are a number of important links and similarities between public health and safety. In this extended essay, Gregg D. Caruso defends and expands his public health-quarantine model, which is a non-retributive alternative for addressing criminal behavior that draws on the public health framework and prioritizes prevention and social justice. In developing his account, he explores the relationship between public health and safety, focusing on how social inequalities and systemic injustices affect health outcomes and crime rates, how poverty affects brain (...) development, how offenders often have pre-existing medical conditions (especially mental health issues), how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, how treatment and rehabilitation methods can best be employed to reduce recidivism and reintegrate offenders back into society, and how a public health approach could be successfully applied within the criminal justice system. Caruso's approach draws on research from the health sciences, social sciences, public policy, law, psychiatry, medical ethics, neuroscience, and philosophy, and he delivers a set of ethically defensible and practically workable proposals for implementing the public health-quarantine model. The essay begins by discussing recent empirical findings in psychology, neuroscience, and the social sciences that provide us with an increased understanding of the social and neurological determinants of health and criminal behavior. It then turns to Caruso's public health-quarantine model and argues that the model provides the most justified, humane, and effective approach for addressing criminal behavior. Caruso concludes by proposing a capability approach to social justice grounded in six key features of human well-being. He argues that we cannot successfully address concerns over public health and safety without simultaneously addressing issues of social justice—including the social determinants of health (SDH) and the social determinants of criminal behavior (SDCB)—and he recommends eight general policy proposals consistent with his model. (shrink)

Self-awareness represents the capacity of becoming the object of one’s own attention. In this state one actively identifies, processes, and stores information about the self. This paper surveys the self-awareness literature by emphasizing definition issues, measurement techniques, effects and functions of self-attention, and antecedents of self-awareness. Key self-related concepts (e.g., minimal, reflective consciousness) are distinguished from the central notion of self-awareness. Reviewed measures include questionnaires, implicit tasks, and self-recognition. Main effects and functions of self-attention consist in selfevaluation, escape from the (...) self, amplification of one's subjective experience, increased self-knowledge, self-regulation, and inferences about others' mental states (Theory-of-Mind). A neurocognitive and socioecological model of self-awareness is described in which the role of face-to-face interactions, reflected appraisals, mirrors, media, inner speech, imagery, autobiographical knowledge, and neurological structures is underlined. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, compared to those (...) raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

Much of the work in moral philosophy and the political debate on abortion has focused on when in human development personhood begins. In this article, using a variant of Derek Parfit’s view on personal identity, I instead frame the question as one of victimhood. I argue for what I call the Victim Requirement for the wrongness of killing–killing is wrong only if there is an identifiable victim. An identifiable victim is, temporally speaking, in the midst of a chain of psychological (...) connections in the sense of “Relation R.” I go on to argue for a version of psychological identity which makes consciousness a necessary condition of rational self-interest and numerical identity across time. The implications for the abortion debate, based upon the best neurological evidence, are that abortion cannot be wrong before at least 22 weeks of pregnancy and perhaps significantly later. I then respond to alternatives to my Victim Requirement and argue that they either fail on their own merits or are deeply problematic. Finally, I discuss the role of autonomy and consent in a world where fetal consciousness develops much earlier. (shrink)

The dead donor rule justifies current practice in organ procurement for transplantation and states that organ donors must be dead prior to donation. The majority of organ donors are diagnosed as having suffered brain death and hence are declared dead by neurological criteria. However, a significant amount of unrest in both the philosophical and the medical literature has surfaced since this practice began forty years ago. I argue that, first, declaring death by neurological criteria is both unreliable and unjustified but (...) further, the ethical principles which themselves justify the dead donor rule are better served by abandoning that rule and instead allowing individuals who have suffered severe and irreversible brain damage to become organ donors, even though they are not yet dead and even though the removal of their organs would be the proximal cause of death. (shrink)

One of the most important recent developments in the study of concepts has been the resurgence of interest in nativist accounts of the human conceptual system. However, many theorists suppose that a key feature of neural organization—the brain’s plasticity—undermines the nativist approach to concept acquisition. We argue that, on the contrary, not only does the brain’s plasticity fail to undermine concept nativism, but a detailed examination of the neurological evidence actually provides powerful support for concept nativism.

There are currently two legally established criteria for death: the irreversible cessation of circulation and respiration and the irreversible cessation of neurologic function. Recently, there have been technological developments that could undermine the irreversibility requirement. In this paper, I focus both on whether death should be identified as an irreversible state and on the proper scope of irreversibility in the biological definition of death. In this paper, I tackle the distinction between the commonsense definition of death and the biological definition (...) of death to show that even the commonsense concept of death is specified by biological facts. Resting on this argument, I argue that any definition of death is a posteriori. Thus, irreversibility is part of any definition of death because the actual phenomenon of death is irreversible. In addition, I show that the proper domain of irreversibility in a definition of death is circumscribed by physical possibilities and that irreversibility in the definition of death refers to current possibilities for the reversal of relevant biological processes. I conclude that, despite recent technological advancements, death is still irreversible. (shrink)

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

I consider Glimcher's claim to have given an account of mental functioning that is at once neurological and decision-theoretical. I am skeptical, but remark on some good ideas of Glimcher's.

To biologise racism is to treat racism as a neurological phenomenon susceptible to biochemical intervention. In 'Race on the Brain: What Implicit Bias Gets Wrong About the Struggle for Racial Injustice', Kahn (2018) critiques cognitive psychologists and neuroscientists for framing racism in a way that tends to biologise racism, which he argues draws attention and resources away from non-individualistic solutions to racial inequality. In this paper I argue the psychological sciences can accommodate several of Kahn’s criticisms by adopting a situated (...) approach to cognition, where we take environmental features as integral to the cognitive processes that manifest racial bias. (shrink)

This paper clarifies Merleau-Ponty’s original account of “higher-order” cognition as fundamentally embodied and enacted. Merleau-Ponty’s philosophy inspired theories that deemphasize overlaps between conceptual knowledge and motor intentionality or, on the contrary, focus exclusively on abstract thought. In contrast, this paper explores the link between Merleau-Ponty’s account of motor intentionality and his interpretations of our capacity to understand and interact productively with cultural symbolic systems. I develop my interpretation based on Merleau-Ponty’s analysis of two neuropathological modifications of motor intentionality, the case (...) of the brain-injured war veteran Schneider, and a neurological disorder known as Gerstmann’s syndrome. Building on my analysis of Schneider’s sensorimotor compensatory performances in relation to his limitations in the domains of algebra, geometry, and language usage, I demonstrate a strong continuity between the sense of embodiment and enaction at all these levels. Based on Merleau-Ponty’s interpretations, I argue that “higher-order” cognition is impaired in Schneider insofar as his injury limits his sensorimotor capacity to dynamically produce comparatively more complex differentiations of any given phenomenal structure. I then show how Merleau-Ponty develops and specifies his interpretation of Schneider’s intellectual difficulties in relation to the ambiguous role of the body, and in particular the hand, in Gerstmann’s syndrome. I explain how Merleau-Ponty defends the idea that sensorimotor and quasi-representational cognition are mutually irreducible, while maintaining that symbol-based cognition is a fundamentally enactive and embodied process. (shrink)

In his 1953 lectures at the College de France, Merleau-Ponty dedicated much effort to further developing his idea of embodied subject and interpreted fresh sources that he did not use in Phenomenology of Perception. Notably, he studied more in depth the neurological notion of "body schema". According to Merleau-Ponty, the body schema is a practical diagram of our relationships to the world, an action-based norm with reference to which things make sense. Merleau-Ponty more precisely tried to describe the fundamentally dynamic (...) unity of the body, i.e. the fact there are various possibilities how the practical "diagram" of body schema could be de-differentiated (in pathology) or further refined (via cognitive and cultural superstructures, symbolic systems). This chapter summarises Merleau-Ponty's interpretation of the notion, while contrasting it to the more traditional understanding of the body in phenomenology and recent philosophical texts dealing with body schema. (shrink)