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.
Literatur
-
1
Klosterkötter J.
Neurophilosophie, Neurowissenschaft und Psychopathologie.
Fortschr Neurol Psychiat.
2005;
73
127-128
-
2
Fuchs T.
[In Process Citation].
Nervenarzt.
2005;
76 (1)
1-10
-
3
Schäfer M L.
Die gegenwärtigen Geist-Gehirn-Theorien in der Analytischen Philosophie des Geistes und ihre epistemische Bedeutung für die Psychiatrie.
Fortschr Neurol Psychiat.
2005;
73
129-142
-
4
Northoff G, Witzel J, Bogerts B.
Neuroethik - eine Disziplin der Zukunft?.
Nervenarzt.
2005;
im Druck
-
5 Northoff G. Philosophy of the brain. The brain problem. Amsterdam: John Benjamins Publishing 2004
-
6
Synofzik M, Huber L, Wiesing U.
[Philosophizing about the mysteries of the brain. Overview of neurophilosophy].
Nervenarzt.
2004;
75 (12)
1147-1152
-
7 Bollas L. Der Schatten des Objekts: Das ungedachte Bekannte. Zur Psychoanalyse der frühen Entwicklung. Stuttgart: Klett-Cotta 1997
-
8 Northoff G. et al .Major differences in subjective experience of akinetic states in catatonic and parkinsonian patients. 1998: 161-178
-
9 Northoff G. Katatonie. Einführung in die Phänomenologie, Klinik und Pathophysiologie eines Psychomotorischen Syndroms. Stuttgard: Enke 1997
-
10
Jack A I, Roepstorff A.
Introspection and cognitive brain mapping: from stimulus-response to script-report.
Trends Cogn Sci.
2002;
6 (8)
333-339
-
11
Northoff G.
“Brain-Paradox” and “Embeddment” - Do we need a “philosophy of the brain”?.
Brain and Mind.
2001;
2
37-41
-
12
Varela F J, Shear J.
First-Person-Methologies: What, Why, How?.
J of Consciousness Studies.
1999;
6 (2 - 3)
1-14
-
13
Varela F J, Shear J.
The views from within.
J of Consciousness Studies.
1999;
6 (2 - 3)
1-9
-
14
Lutz A. et al .
Guiding the study of brain dynamics by using first-person-data: synchrony patterns correlate with ongoing conscious states during a simple visual task.
Proc Natl Acad Sci U S A.
2002;
99 (3)
1586-1591
-
15 Heinzel A. et al .How do we modulate our emotions? Parametric fMRI reveals cortical midline structures as regions specifically involved in the processing of emotional valences. Cognitive Brain Research 2005 in Druck
-
16 Grimm S. et al .Segregated neural representation of distinct emotion dimensions in the prefrontal cortex - An fMRI study. Neuroimage 2005 in Druck
-
17
Varela F J.
Neurophenomenologie: A methodological remedy for the hard problem.
J of Consciousness Studies.
1996;
3 (4)
330-349
-
18 Panksepp J. Affective Neuroscience: the foundations of human and animal emotions. New York: Oxford University Press 1998
-
19
Panksepp J.
The periconscious substrates of consciousness: affective states and the evolutionary origins of the self.
Journal of Consciousness Studies.
1998;
5 (5 - 6)
566-582
-
20
Friston K.
Learning and inference in the brain.
Neural Netw.
2003;
16 (9)
1325-1352
-
21
Price C J, Friston K J.
Functional imaging studies of neuropsychological patients: applications and limitations.
Neurocase.
2002;
8 (5)
345-354
-
22
Price C J, Friston K J.
Degeneracy and cognitive anatomy.
Trends Cogn Sci.
2002;
6 (10)
416-421
-
23
Friston K J, Price C J.
Generative models, brain function and neuroimaging.
Scand J Psychol.
2001;
42 (3)
167-177
-
24
Friston K J, Price C J.
Dynamic representations and generative models of brain function.
Brain Res Bull.
2001;
54 (3)
275-285
-
25
Northoff G, Bermpohl F.
Cortical midline structures and the self.
Trends Cogn Sci.
2004;
8 (3)
102-107
-
26
Northoff G. et al .
Reciprocal modulation and attenuation in the prefrontal cortex: an fMRI study on emotional-cognitive interaction.
Hum Brain Mapp.
2004;
21 (3)
202-212
-
27
Northoff G.
What catatonia can tell us about “top-down modulation”: a neuropsychiatric hypothesis.
Behav Brain Sci.
2002;
25 (5)
555-577; discussion 578 - 604
-
28
Northoff G. et al .
GABA-ergic modulation of prefrontal spatio-temporal activation pattern during emotional processing: a combined fMRI/MEG study with placebo and lorazepam.
J Cogn Neurosci.
2002;
14 (3)
348-370
-
29
Masterman D L, Cummings J L.
Frontal-subcortical circuits: the anatomic basis of executive, social and motivated behaviors.
J Psychopharmacol.
1997;
11 (2)
107-114
-
30
Lamme V A.
Separate neural definitions of visual consciousness and visual attention; a case for phenomenal awareness.
Neural Netw.
2004;
17 (5 - 6)
861-872
-
31
Tononi G, Edelman G M.
Schizophrenia and the mechanisms of conscious integration.
Brain Res Brain Res Rev.
2000;
31 (2 - 3)
391-400
-
32
Lamme V A.
Blindsight: the role of feedforward and feedback corticocortical connections.
Acta Psychol (Amst).
2001;
107 (1 - 3)
209-228
-
33
Phan K L. et al .
Functional neuroanatomy of emotion: a meta-analysis of emotion activation studies in PET and fMRI.
Neuroimage.
2002;
16 (2)
331-348
-
34
Murphy F C, Nimmo-Smith I, Lawrence A D.
Functional neuroanatomy of emotions: a meta-analysis.
Cogn Affect Behav Neurosci.
2003;
3 (3)
207-233
-
35
Pessoa L. et al .
Neural processing of emotional faces requires attention.
Proc Natl Acad Sci U S A.
2002;
99 (17)
11 458-11 463
-
36
Pessoa L, Ungerleider L G.
Neural correlates of change detection and change blindness in a working memory task.
Cereb Cortex.
2004;
14 (5)
511-520
-
37
Pessoa L, Ungerleider L G.
Neuroimaging studies of attention and the processing of emotion-laden stimuli.
Prog Brain Res.
2004;
144
171-182
-
38
Davidson R J.
Anxiety and affective style: role of prefrontal cortex and amygdala.
Biol Psychiatry.
2002;
51 (1)
68-80
-
39
Shin L M. et al .
A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder.
Arch Gen Psychiatry.
2005;
62 (3)
273-281
-
40
Nagai Y. et al .
Activity in ventromedial prefrontal cortex covaries with sympathetic skin conductance level: a physiological account of a “default mode” of brain function.
Neuroimage.
2004;
22 (1)
243-251
-
41
Ongur D, Price J L.
The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans.
Cereb Cortex.
2000;
10 (3)
206-219
-
42
Northoff G. et al .
Orbitofrontal cortical dysfunction in akinetic catatonia: a functional magnetic resonance imaging study during negative emotional stimulation.
Schizophr Bull.
2004;
30 (2)
405-427
-
43
Northoff G.
Catatonia and neuroleptic malignant syndrome: psychopathology and pathophysiology.
J Neural Transm.
2002;
109 (12)
1453-1467
-
44
Goel V, Dolan R J.
Explaining modulation of reasoning by belief.
Cognition.
2003;
87 (1)
B11-22
-
45
Goel V, Dolan R J.
Reciprocal neural response within lateral and ventral medial prefrontal cortex during hot and cold reasoning.
Neuroimage.
2003;
20 (4)
2314-2321
-
46
Northoff G. et al .
Functional dissociation between medial and lateral prefrontal cortical spatiotemporal activation in negative and positive emotions: a combined fMRI/MEG study.
Cereb Cortex.
2000;
10 (1)
93-107
-
47
O'Doherty J. et al .
Abstract reward and punishment representations in the human orbitofrontal cortex.
Nat Neurosci.
2001;
4 (1)
95-102
-
48
O'Doherty J. et al .
Representation of pleasant and aversive taste in the human brain.
J Neurophysiol.
2001;
85 (3)
1315-1321
-
49
Allison J D. et al .
Functional MRI cerebral activation and deactivation during finger movement.
Neurology.
2000;
54 (1)
135-142
-
50
Kleinschmidt A. et al .
Human brain activity during spontaneously reversing perception of ambiguous figures.
Proc R Soc Lond B Biol Sci.
1998;
265 (1413)
2427-2433
-
51
Liotti M. et al .
Unmasking disease-specific cerebral blood flow abnormalities: mood challenge in patients with remitted unipolar depression.
Am J Psychiatry.
2002;
159 (11)
1830-1840
-
52
Bush G, Luu P, Posner M I.
Cognitive and emotional influences in anterior cingulate cortex.
Trends Cogn Sci.
2000;
4 (6)
215-222
-
53
Laurienti P J. et al .
Deactivation of sensory-specific cortex by cross-modal stimuli.
J Cogn Neurosci.
2002;
14 (3)
420-429
-
54
Laurienti P J. et al .
Dietary caffeine consumption modulates fMRI measures.
Neuroimage.
2002;
17 (2)
751-757
-
55
Elliott R. et al .
The neural basis of mood-congruent processing biases in depression.
Arch Gen Psychiatry.
2002;
59 (7)
597-604
-
56
Gotlib I H. et al .
Attentional biases for negative interpersonal stimuli in clinical depression.
J Abnorm Psychol.
2004;
113 (1)
121-135
-
57
Mayberg H S.
Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment.
Br Med Bull.
2003;
65
193-207
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
