Health Begins With The Brain


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This is the presentation on "Health Begins with our Brain" by Professor TANG SW at CUHKSPHPCAA Inauguration Ceremony and 1st Scientific Meeting at School of Public Health, CUHK on 22 Feb 2011.

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Health Begins With The Brain

  1. 1. Health begins with the Brain <br />Professor SW Tang<br />Emeritus Professor of Psychiatry, <br />UC Irvine , USA<br />Director, Institute of Brain Medicine <br />
  2. 2. The Meaning of Life many Million years ago:The primitive Life forms<br />Survival was the meaning of Life <br />To Survive: <br />Food <br />Then to preserve species :<br /> Reproduction<br />
  3. 3. Food & Sex<br />Known for thousands of years:<br />a. “The desire for food and sex is basic to animals, & is human nature” (Mencius) <br />孟子 (告子)“告子曰: 食色性也” <br />b. “Eating and Sex are human wants” (Confucius)<br />孔子: 礼记“饮食男女,人之大欲存焉”<br />
  4. 4. CNS Core was a survival co-ordination center only & still is <br />
  5. 5. The brain of lower animals may not even be essential for short term survival <br />Insects can live for a short term without the brain and to fulfill the purpose of reproduction <br />e.g. praying mantis<br />
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  8. 8. “Thinking” is NOT necessaryfor the continuation of Life <br />
  9. 9. Insects  Mammals <br />Limbic brain added :<br />(hippocampus, amygdala, nucleus accumben and other limbic circuit components) <br />To: Sense danger , eat or run<br />Spatial orientation and memory for food and escape (Hippocampal function, Serotonin (5HT) function)<br />Pleasure (Dopamine (DA)function) : to repeat behavior which are rewarding <br />
  10. 10. Higher Mammals<br />Addition of Cortex to integrate the Limbic and the core brain :<br />Cortex needed for the Analysis of a complex world :<br />To find the best way to carry on with the species:<br />a. strong mate for strong genetics  strong off-springs for best survival<br />b. Analysis of the others<br />c. Build a stable environment for bring up the off-springs (society/civilization) <br />
  11. 11. Major Difference between the Human brain & Brains of lower animals <br />Addition of the <br />1. (Cortex) to<br />2. (Limbic brain) & 3. (Brain core) <br />
  12. 12. Some do not use their cortex (Those who’s life purpose was only “eat and reproduce” ) <br />“The Wisest and the Most Stupid are NOT <br />Changeable ” (Confucius )<br />子曰:“唯上智與下愚不移” (論語 ‧ 陽貨第十七)<br />
  13. 13. Evolution of The Tri- Brain <br />Brain Core : co-ordination center , …. All animals (e.g. insects have only brain core)<br />Limbic Brain : emotion, pleasure, fear, …..All <br />animals (e.g. reptiles have largely limbic brain)<br />The Cortex : <br /> a. Lower animals (small cortex, e.g. rats)<br /> b. Primates (large cortex, e.g. human)<br />
  14. 14. Cortex<br />A<br />Rat <br />Pallium<br />A<br />Cortex<br />subpallium<br />A<br />Avian <br />Primate<br />The Rise of the Cortex : Analysis of <br />Complex environment (dangers abound) <br />
  15. 15. The functions of the Tri-brain are same but forms differ in Human <br />Feeding ( job  earning enough  eat well) [DA, 5HT]<br />Love & Defense (love, attachment, fear, anger, aggression) [5HT, DA, sex hormones]<br />Reproduction ( sensation seeking, attracted to the right mate ) [DA, oxytocin, vasopressin]<br />Continuation of life ( commitment, family function, maternal behavior) [oxytocin, vasopressin]<br />Social Interaction (civilization) [cortisol]<br />
  16. 16. Amygdalaremains an important Structure in evolution and is the basis for psychosomatics <br />Hippocampus <br />Reproductive,Sexual <br />attraction <br />Fear,Anxiety <br />Motor Output<br />Appetitive Reward <br />Thalamus <br />Midbrain<br />Vocalization<br />.e.g. Song <br />OB<br />Sensory Inputs <br />e.g. eye <br />Avian Brain <br />
  17. 17. Role of Amygdala in psychosomatics <br />Inputs<br />Sensory cortex <br />Frontal<br />Pre frontal cortex<br />Hippocampus<br />(contextual input)<br />Olfactory<br />(pheromones)<br />Thalamus<br />Insular Cortex <br />Hormonal <br />Outputs<br />Thalamus<br />Cortex<br />Striatum<br />Hippocampus<br />Hypothalamus<br />Brain Stem<br />Vagal<br />
  18. 18. Vertebrate Cerebrum organization <br />Using More Chemicals<br />+<br />Glu<br />+<br />Cortex<br />+<br />Ach<br />Striatum,<br />Limbic <br />-<br />GABA<br />Peptides<br />Thalamus<br />Hypothalamus<br />Tegmentum<br />Brain Stem<br />DA<br />
  19. 19. Cognitive function<br />Executive <br />function<br />DA reward Pathways<br />Amygdala/<br />Hippocampus <br />Core<br />
  20. 20. Q: To what extent the frontal cortex can modulate amygdala activities ? <br /><ul><li>Aristotle: "The person who is angry at the right things and toward the right people, and also in the right way, at the right time and for the right length of time is morally praiseworthy.”
  21. 21. Menzi : Mother moving thrice to ensure the best environment
  22. 22. Shunzi : Human’s evil nature modifiable by learning </li></li></ul><li>Amygdala & Batman <br />
  23. 23. Amygdala<br />alias of a character in Batman comics<br />a sometime opponent of Batman<br />has reduced cortical capacity, is prone to outbursts of violence due to the removal of his amygdala in an attempt to rid him of his homicidal rage<br />
  24. 24. Autism, Asperger’s and Senseless Cruelty & Violence <br />Amygdala, Insula and Mirror Neuron Implicated <br />
  25. 25. Early Life Resilience Formation <br />Quality and Quantity of early-life maternal care : a predominant signal triggering gene expression in glucocorticoids and corticotropin releasing factor (CRH) <br />development of resilience or vulnerable phenotypes<br />
  26. 26. Cortex<br />Amygdala<br />Weak <br />Cortex<br />Insula<br />Strong <br />Cortex<br />Insula<br />(Aristotle,<br />Shunzi) <br />Amygdala<br />Hypothalamus <br />Pons<br />Insensitive <br />Amygdala<br />Amygdala<br />Highly Buffered <br />Emotion<br />Solution after filtering <br />Un-buffered emotion<br />Solution direct <br />
  27. 27. Human <br />The strength of Cortex over Limbicand <br />Brain Core center:<br />: basis for civilization and social behavior but also the basis for many important human health problems <br />
  28. 28. Health begins with the Brain <br />
  29. 29. Many body functions are under subtle brain control <br />Some commonly known (e.g. cannot use your fingers, walk after stroke), some not so much known (e.g. immunological system)<br />But many related to human social interaction and psychosomatics <br />
  30. 30. Psychosomatic <br />Common Brain based health presentations:<br /> a. Aches & Pains <br /> [Sciatica (special case of psychosomatic:<br /> Floating anxiety sleep disturbances  muscle<br /> tension, back pain <br />b. GI disturbances (very high % of patients in GI clinics) <br />c. Chest discomfort (very high % of patients in cardiac clinics)<br />d. Dermatological (ezcema…) <br />e. Medically unexplained symptoms<br />
  31. 31. Annual Physical check ups:<br />Begins with the Brain<br />Thank You ! <br />