Cerebrum's Web edition has yielded its fruits and a soon to be annual anthology of the best of what Cerebrum has to offer. The idea is that prominent neuroscientists debate newly discovered insights in brain science, and their impact on our future world. 

With the exception of Stroke, on which there are two articles, the sixteen, single article chapters cover:

• Stroke
• Pain research
• Neural underpinnings of ethical behaviour
• Obsessive-Compulsive disorder
• Sleepwalking
• Minimizing harm in science
• Supernatural belief
• Autism
• Traumatic memory
• Aesthetic sense in animals
• Drug development and brain imaging
• Happiness
• Comatose patients
• Three book reviews, making up chapters 14-16.

Nicolas Bazan and Louis Caplan talk about stroke and the need for better interventions. Their point of departure is naturally prevention, with an analysis of 700 000 cases to determine what loading each avoidable human pursuit or facet contributes, with blood pressure providing in excess of half those cases.  Cholesterol is next up, with cigarettes; heart arrhythmias and alcohol abuse are the other protagonists. The expected analysis follows with regard to aspects of early warning and treatments, as well as recovery.  Bazan follows with his contribution, which is the search for a new strategy to protect the brain.  This focuses, in contrast to Caplan with views on Neuroprotectin D1 and ways to enhance its actions, or even introduce more to the brain.

Kathleen Foley and Maia Szalavitz argue for a National Institute on Pain Research: pain research is of course a very fertile ground for development. They argue that similar amounts be spent on pain, as are on addictions for instance.

Donald Pfaff produces, in part, a response to Gazzaniga's recent and well publicized work on ethics in neuroscience.  He takes up the concept of fair behaviour, which Pfaff feels is a Christian and universal golden rule, and of course it actually is Talmudic more than Christian, but that of course just makes his point.  Most of us would however comment to our patients that the world isn’t fair, and that the Just World hypothesis is probably bunkum: good things happen to bad people, and vice versa.  Working on the basis that unlearned fear results in a central amygdala nucleus response of freezing, and that learned fear is more lateral nucleus and related to a memory trace, namely acquired fear, he examines the signals to the amygdala.  There are two routes for fearful information, one via the cortex, one direct from the thalamus (antechamber, in Greek).  These signals are not identical, even if triggered from the same source input.  Interesting to any debate here, is the role of BDNF, or brain derived neurotrophic factor, known to participate in stress and fear, and of course now is a target for depression research given its role in neuroprotection. He is looking to show how shared fears contribute to the concept of fair play, with elements of social recognition coming into play as well.

Judith L Rapoport and Gale Inoff-Germain state they have a success story to tell about brain science in unshackling the slaves of obsessive-compulsion. They give a summary of the state of the art in the neurobiology of OCD with some distinctly Susan Swedo type of inferences.  Don't look for these references though, the book has only a few endnotes related to only some of the chapters, and this isn’t one of them. Neither is the success story clear, as Rapoport produces no stories here, not as she did in her boy-couldn't-stop-washing-hands book. PANDAS treatments and other interventions are discussed.

Interesting stuff emerges from Shelly and Stewart Gunn, both Texans, she a scientist, he a writer.  Sleepwalking emerges from the dark, they begin, literally and figuratively of course.  They describe people walking off scaffolding, to the top of a crane, such incidents not always ending well, and often attracting a label of suicide, wrongly it seems.  With few treatments, crafting a safe sleep environment seems to be the bottom line.

Henry Greely is the second, ethics-related chapter's author.  He speaks of the dark side of science, understandably the nuclear arm’s race was one of the biggies.  Eugenics played a part in the deprivation of civil rights in both USA and Nazi Germany, prefrontal lobotomies and leucotomies, no matter how feted by the Nobel Committee, proved unkind in the extreme.  In more contemporary terms, he talks of herbal remedies such as Gingko, of use of prescription drugs to enhance arousal and learning, the use of lie detection MRI, the forcing of medication on those too ill to meet their destiny on Death Row, so they can be executed while sane, and other coercions which may be possible, such as a putative treatment to make teenagers more compliant with parental demands (I would buy it!!).  Primum Non Nocere. The advances in neuroscience are breathtaking, but first, we must ensure we do no harm.

Bruce Hood is interested in the Supernatural. 93% of Americans do too, which I think is more than those who believe in a god.  There is no science behind such things, and the opposite it true, but science never got in the way of a good phobia.  For Hood, the answer lies in intuitive reason and the way the brain bridges poor understanding by filling the gaps with belief, rather than reason. It’s easy to demonstrate, if one is familiar with Escher and the gyri.  Here, hood uses the four PakMan arranged around a pseudo square to illustrate his concepts on perceptual confabulation.  I won’t go through the intriguing arguments he makes from the viewpoint of a cognitive scientist, and leave the voyage of discovery to those who buy or borrow the book.

Diane Chugani and Kayt Sukel (again, the second author is just that, an author) look at the brains of children with Autism, and the need to actually treat, rather than manage autism.  The authors look at imaging as a major resource, and also the role of serotonin in autism.  They base this on their research that shows a constant pattern of serotonin synthesis in sufferers, rather than the peak and trough that there should be in normal development at those ages when autism rages. They are thus arguing for a paradigm shift to intervention, and do so for the rest of the chapter.

Half way through the book and Jacek Debiec and Margaret Altemus address the issue of treatment in traumatic memory.  If one is to intervene, then the formation and reconsolidation of memory is a focus, and they do, moving from animal to human models. 

Lesley Rogers and Gisela Kaplan have clearly found elephants that paint and birds that make music, the latter phenomenon clearly more possible: they are looking at whether or not animals have a sense of the aesthetic, rather than the pragmatic senses.  However, birdsong is apparently subject to constant review until it resembles templated stereotypes, and thus is more craft than art. So the Brown Thresher with its 2000 song repertoire, slightly more than the Rolling Stones, is likely to have a few cover versions in there with an impact on its mating futures market.  Animals are however put forward by these authors as more creative aesthetes than we think.

Paul Mathews is a bigwig at GSK, the drug company, and is keen to impart information on the science of drug trials and how neuroimaging is likely to impact on that, an idea close to my company’s heart, as one of our core businesses is just that: pharma trials and brain imaging.  His focus is on fMRI, with little attention to other areas that are more controversial perhaps, such as temporal imaging.

Silvia Cardoso draws on Damasio, Darwin and even Maslow for a discussion on happiness, but Will Smith did it better in a movie with a 'y'.  Nicholas Schiff and Joseph Fins look at comatose patients in inverted commas: this means for them that this is a treatable state, or they hope so.  They discuss brain injury epidemiology and vegetative states in detail, and of course mention Terry Schiavo and other famous cases in their discussion of deep brain stimulation and other interventions.

The rest of the book is made up of book reviews, which is a bit of a gyp, as I think Dennis the Menace used to say.

The book otherwise is readable, and interesting, but hardly equivalent to say Best of the Brain from Scientific American which draws on a much more advanced provider and this is represented in the content. However, as a source of enjoyment, if not advanced edification, this book is enough for most who would buy it, and a good idea overall.

© 2007 Roy Sugarman

Roy Sugarman, Ph.D., Director of Clinical and Neuropsychological Services, Brain Resource Company, Ultimo, Australia

Categories: Psychology