Zusammenfassung
Im Gegensatz zu anderen medizinischen Disziplinen zeichnet sich die Psychiatrie durch die spezielle Berücksichtigung des subjektiven Erlebens der Patienten auf. Da das subjektive Erleben an die Erste-Person-Perspektive gebunden ist und das Gehirn lediglich in der Dritte-Person-Perspektive beobachtet werden kann, stellt sich die Frage nach der Verknüpfung beider Perspektiven in der psychiatrischen Forschung. Es wird hier daher ein neuer methodischer Ansatz, eine so genannte Erste-Person-Neurowissenschaft, vorgestellt, wo das subjektive Erleben direkt mit neuronalen Prozessen in Verbindung gebracht werden kann. Da die Komplexität der Strukturen und Inhalte des subjektiven Erlebens eine Lokalisation desselbigen in bestimmten und spezifischen Hirnregionen unmöglich erscheinen lässt, stehen hier das Zusammenspiel und Koordination der neuronalen Aktivität über verschiedene Hirnregionen hinweg, die so genannte neuronale Integration, im Vordergrund. Dieses wird anhand von zwei Prinzipien der neuronalen Integration, der reziproken Modulation und der Top-Down-Modulation, bei Katatonie und Depression exemplarisch erläutert. Es wird geschlussfolgert, dass eine Erste-Person-Neurowissenschaft in diesem Sinne einen Beitrag zur Pathophysiologie psychiatrischer Erkrankungen und ultimativ zur Entwicklung von diagnostischen und therapeutischen Markern leisten kann.
Abstract
Unlike other medical disciplines psychiatry can be characterized by the special importance of subjective experience. Since subjective experience is tied to First-Person-Perspective and investigation of the brain is possible only in Third-Person-Perspective, the question how subjective experience can be linked to neuronal processes is raised in psychiatry. We suggest a novel methodological approach, First-Person-Neuroscience where subjective experience can be linked directly and systematically to neuronal processes. Due to complexity of the structures and contents of subjective experience, localization in specific brain regions seems inappropriate. Instead, the interplay and coordination of neuronal activity across several brain regions, so-called neuronal integration, should be considered in First-Person-Neuroscience. This is illustrated by two principles of neuronal integration, top-down modulation and reciprocal modulation, whose abnormal function can be related to subjective experience of patients with catatonia and depression. It is concluded that First-Person-Neuroscience can contribute to reveal abnormal brain function in psychiatric disorders and ultimately to development of diagnostic and therapeutic markers.
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Prof. Dr. med. habil. Dr. phil. habil. Georg Northoff
Klinik für Psychiatrie, Psychotherapie und Psychosomatische Medizin · Universitätsklinikum Magdeburg
Leipziger Straße 44
39120 Magdeburg ·
eMail: georg.northoff@medizin.uni-magdeburg.de
