Dick Swaab Geluk

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  • Dick Swaab Geluk

    1. 1. Happiness and the brain Dick Swaab Netherlands Institute for Neuroscience, Amsterdam. .
    2. 2. Reward and Happiness <ul><li>Sensory pleasures are linked to food and sex (evolutionary importance, but also responsible for overpopulation and obesity). </li></ul><ul><li>Social pleasures : social interactions, romantic love, pair bonding, maternal love. </li></ul><ul><li>Higher-order pleasures : artistic, scientific monetary, musical, altru i stic and transcendental pleasures, may lead to happiness . </li></ul><ul><li>Also transcendental pathology (TLE, mania) </li></ul><ul><li>Anhedonia: depression, schizophrenia, autism </li></ul><ul><li>Brain mechanisms : genetic and epigenetic factors </li></ul>
    3. 3. VMAT-2: associated with self-transcendence scale of spirituality (Cloninger)
    4. 4. TLE A patient with ecstatic epileptic attacs saw Jesus. He had an astrocytoma of the temporal lobe. The attacs diappeared after temporal lobectomy.
    5. 5. <ul><li>The air was filled with a big noise, and I thought it had engulfed me. I have really touched God. He came into me myself; yes, God exists, I cried, and I don't remember anything else. You all, healthy people, he said, can't imagine the happiness we epileptics feel during the second before our attack. I don't know if this felicity lasts for seconds, hours, or months, but believe me, for all the joys that life may bring, I would not exchange this one. </li></ul><ul><li>(Dostoevsky, The Idiot). </li></ul>
    6. 6. Carmelite Nuns <ul><li>Re-experience most mystic Christian experience in fMRI. </li></ul><ul><li>(i) activation midtemporal gyrus (~temp. lobe epilepsy; being one with God). </li></ul><ul><li>(ii) activation Caudate Nucleus (happiness and unconditional love). </li></ul><ul><li>(iii) activation brainstem, insula and PFC (emotional, somatoviscerale en autonomic reactions and cortical conciousness) </li></ul><ul><li>(iv) activation pariëtal cortex (out of body experience: disturbed integration of somatic-visual-equilibrium information). </li></ul>
    7. 7. Yoga
    8. 11. <ul><li>Happiness is a physical state of the brain that can deliberately be induced, e.g. by meditation, ecstatic experiences of monks and nuns, meditation,… </li></ul><ul><li>Pathology: TLE, mania . </li></ul>
    9. 13. 2 times more martial problems, 2 times more unfaithful….
    10. 15. OXT/AVP <ul><li>OXT/AVP: - released during orgasm, </li></ul><ul><li>- reinforces social signals </li></ul><ul><li>- attachment and pair bonding (via DA). </li></ul><ul><li>. OXT: - mother-infant interaction </li></ul><ul><li>- maternal behavior via DA </li></ul><ul><li>- high levels related to intense romantic love. </li></ul><ul><li>- increases trust, willingness to invest (via Amygdala) </li></ul>
    11. 16. Coding versus causality <ul><li>Pleasure coding in many brain areas (fMRI. PET): orbitofrontal cortex, anterior cingulate, insula, amygdala, nucleus accumbens, ventral pallidum, VTA,… </li></ul><ul><li>- Cortex deactivated in romantic love and maternal love. </li></ul><ul><li>Some areas are sufficient : stimulation induces a pleasant feeling. </li></ul><ul><li>- Hedonic hotspots : Nucl. Accumbens, ventral pallidum and nucleus brachialis. </li></ul><ul><li>- Selfstimulation hotspots : lateral lateral hypothalamus, septum, nucleus accumbens and medial forebrain bundle </li></ul><ul><li>Few areas are necessary (reward function lost after lesion) : </li></ul><ul><li>- Ventral pallidum, extended amygdala and subst. innominata for sweet. </li></ul><ul><li>- Hypothalamus for sexual behavior, pairbonding, maternal behavior </li></ul>
    12. 17. Kent et al., Psychopharmacol. (2008) 199: 457-480 pleasantness odors water during thirst taste and smell monetary reward Medial OPFC
    13. 18. Kent et al., OFC and pleasantness ratings of food
    14. 22. Coding versus causality <ul><li>Pleasure coding in many brain areas (fMRI. PET): orbitofrontal cortex, anterior cingulate, insula, amygdala, nucleus accumbens, ventral pallidum, VTA,… </li></ul><ul><li>Some areas are sufficient : stimulation e.g. with opiates induces a pleasant feeling. </li></ul><ul><li>- Hedonic hotspots : Nucl. Accumbens, ventral pallidum and nucleus brachialis. </li></ul><ul><li>- Selfstimulation hotspots : lateral lateral hypothalamus, septum, nucleus accumbens and medial forebrain bundle </li></ul><ul><li>Few areas are necessary (reward function lost after lesion) : </li></ul><ul><li>- ventral pallidum, extended amygdala and subst. innominata for sweet, </li></ul><ul><li>- Hypothalamus for sexual behavior, pairbonding, maternal behavior </li></ul>
    15. 25. Hedonic hotspots : Nucl. Accumbens, ventral pallidum and nucleus brachialis. Kent et al., Psychopharmacol.,(2008) 199: 457-480
    16. 26. Coding versus causality <ul><li>Pleasure coding in many brain areas (fMRI. PET): orbitofrontal cortex, anterior cingulate, insula, amygdala, nucleus accumbens, ventral pallidum, VTA,… </li></ul><ul><li>Some areas are sufficient : stimulation induces a pleasant feeling. </li></ul><ul><li>- Hedonic hotspots : Nucl. Accumbens, ventral pallidum and nucleus brachialis. </li></ul><ul><li>- Selfstimulation hotspots : lateral lateral hypothalamus, septum, nucleus accumbens and medial forebrain bundle </li></ul><ul><li>Few areas are necessary (reward function lost after lesion) : </li></ul><ul><li>- ventral pallidum, extended amygdala and subst. innominata for sweet, </li></ul><ul><li>- Hypothalamus for sexual behavior, pair bonding, maternal behavior </li></ul>
    17. 29. OCD
    18. 30. Does DBS produce pure “wanting” rather than “liking”?
    19. 31. Coding versus causality <ul><li>Pleasure coding in many brain areas (fMRI. PET): orbitofrontal cortex, anterior cingulate, insula, amygdala, nucleus accumbens, ventral pallidum, VTA,… </li></ul><ul><li>Some areas are sufficient : stimulation induces a pleasant feeling. </li></ul><ul><li>- Hedonic hotspots* : Nucl. Accumbens, ventral pallidum and nucleus brachialis. </li></ul><ul><li>- Selfstimulation hotspots : lateral lateral hypothalamus, septum, nucleus accumbens and medial forebrain bundle </li></ul><ul><li>Few areas are necessary (reward function lost after lesion) : </li></ul><ul><li>- ventral pallidum, extended amygdala and subst. innominata for sweet, </li></ul><ul><li>- Hypothalamus for sexual behavior, pair bonding, maternal behavior </li></ul>
    20. 32. * *
    21. 33. 2003: no tuber cinereum, no infundibulum, no pituitary stalk, no corp. mamill., no bottom of 3 rd ventricle (concirmed by endoscopy) TEMP, CLOCK and MEMORY DIET AGRRESION Not: sex, attention, sleep Craniopharyngioma, operation, 1990 (than 18 years old
    22. 34. Neurotransmitters and reward systems <ul><li>VTA-NA: DA inhibited by cortisol </li></ul><ul><li>Opiates (Stimulation hotspots) </li></ul><ul><li>OXT, vasopressin: (social brain, pair bonding, romantic love, deficient in autism). </li></ul><ul><li>OXT inhibits amygdala (via GABA) and reduces fear. AVP has reverse effects. </li></ul><ul><li>5HT: appetite and mood, decreased in beginning of romantic love and (other) compulsive disorders. </li></ul>
    23. 41. Anhedonia <ul><li>Depression* (cortisol inhibits DA release in VTA) </li></ul><ul><li>Schizophrenia </li></ul><ul><li>Addiction </li></ul>
    24. 44. A.Kalsbeek
    25. 46. Anhedonia <ul><li>Depression </li></ul><ul><li>Schizophrenia </li></ul><ul><li>Addiction* </li></ul>
    26. 48. Makris et al.,
    27. 50. RR >2 for depression, schizophrenia and obesity, 1.6 for addiction.
    28. 53. Conclusions <ul><li>Reward/happiness: genetic & epigenetic factors (e.g. dysmaturity) </li></ul><ul><li>Pleasure coding: PFC etc etc </li></ul><ul><li>Sufficient for reward: hedonic and selfstimulation hotspots </li></ul><ul><li>Necessary for reward (Ventr. Pall for sweet, Hypothalamus for sex and pair bonding) </li></ul><ul><li>Neurotransmitters- VTA-NA: DA, inhibited by cortisol </li></ul><ul><li>- Opiates Stimulation hotspots) </li></ul><ul><li>- Oxytocin, vasopressin (social brain, deficient in autism </li></ul><ul><li>Risk: polymorphisms and environmental factors </li></ul><ul><li>New therapy: DBS </li></ul>
    29. 56. Biol.Psych. 2008, 64, 192-2002.
    30. 57. Glucocorticoid hypothesis (Atypical depression) <ul><li>hypercortisolemia in MD (Gold and Chrousos, 2002) </li></ul><ul><li>Glucocrticoid treatment: 33% (Mitchell and O’Keane) (O) </li></ul><ul><li>Cushing syndrome (Gold et al., 1995) (O) </li></ul><ul><li>*SNPs GR gene NR3C1 (West et al., 2006) </li></ul><ul><li>*SNP MR gene (Kuningeas et al., 2007) </li></ul><ul><li>*Inhibitors of cortisol production as anti-depressants (O) (metyrapone, aminoglutethamide, ketoconazole) Reus et al. 1997; Murphy, 1997) </li></ul><ul><li>*GR-antagonist (mifepristone (RU486)) for psychotic (I) depression (Gold 2002, Belanoff et al 2002) </li></ul><ul><li>GR/MR receptor imbalance (Wang et al., 2008) (I) </li></ul><ul><li>Corticosteroids affect DA-system (anhedonia) (Dunlop and Nemeroff, 2007) (O) </li></ul>
    31. 59. Happiness and the brain Dick Swaab Netherlands Institute for Neuroscience, Amsterdam.
    32. 60. Makris et al.,
    33. 61. Neurotransmitters and reward systems <ul><li>VTA-NA: DA, inhibited by cortisol </li></ul><ul><li>Opiates Stimulation hotspots) </li></ul><ul><li>Oxytocin, vasopressin (social brain, deficient in autism </li></ul>
    34. 75. The neurobiology of depression Dick Swaab Netherlands Institute for Neuroscience, Amsterdam. Depression as a multi-causal networksyndrome
    35. 76. L-Dopa

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