Intentionality and "free-will" from a neurodevelopmental perspective

Modeling intentionality in the human brain

This paper is focusing on a rather neglected issue that concerns both aspects of philosophy and neurobiology in relation to the concept of intentionality. Intentionality is concerned with the 'directedness' or 'aboutness' of mental phenomena towards an object. Despite the fact that in philosophy both concepts of aboutness and directedness are conceptually identical with intentionality, a careful neuroscientific approach can demonstrate that these two phenomena represent two distinct conceptual and neurobiological aspects of intentionality with complementary functions. We described the interaction between a series of intentionality and pathogenetic psychobiological factors, the corresponding brain topography, and the resulting clinical manifestation and psychopathology. A permanent failure of intentionality dominates in psychosis, which includes an inappropriateness of the intentional object or connection, from the outset, or even from the prodromal phase of the disorder. Affective disorders may result from imprecise interoceptive prediction error signals, due to a confused identification of the intentional object. In suicidal patients there is an emotional intentionality failure, characterized by an absence of intentional object or a loss of conscious access to normal intentional objects. We may model an 'intentional system' as a higher order system, with a monitoring and regulatory role attributed to the brain and behavior. Also, we may consider mental disorders as the result of a radical disruption of intentionality, due to an inappropriateness or lack of the intentional object or due to an inappropriate connection in some points of the suggested brain pathways of intentionality.

A Three-Fold Integrated Perspective on Healthy Development: An Opinion Paper

Mental health and wellbeing are increasingly threatened in the current post-pandemic times, with stress, especially in students, reaching preoccupying levels. In addition, while many educational programs are unidimensional (i.e., lacking integration between physical, emotional and cognitive elements), there are ways to promote physical, social and mental health in children and adolescents. In this opinion paper, we will discuss the importance of an integrative approach for health development and examine relevant factors, such as awareness and emotional intelligence. We will highlight evidence ranging from behavioral to electrophysiological, structural and molecular, and report several recent studies supporting the effectiveness of a holistic approach in supporting wellbeing and creativity in children and adults, and detailing a specific paradigm named the Quadrato Motor Training (QMT). QMT is a specifically structured movement meditation, involving cognitive, motor and affective components. Finally, we will support a holistic view on education, integrating motion, emotion and cognition to develop a person-centered, or in this case student-centered, approach to wellbeing and health.

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders

We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.

Priority setting and personal health responsibility: an analysis of Norwegian key policy documents

BACKGROUND

The idea that individuals are responsible for their health has been the focus of debate in the theoretical literature and in its concrete application to healthcare policy in many countries. Controversies persist regarding the form, substance and fairness of allocating health responsibility to the individual, particularly in universal, need-based healthcare systems.

OBJECTIVE

To examine how personal health responsibility has been framed and rationalised in Norwegian key policy documents on priority setting.

METHODS

Documents issued or published by the Ministry of Health and Care Services between 1987 and 2018 were thematically analysed (n=14). We developed a predefined conceptual framework that guided the analysis. The framework included: (1) the subject and object of responsibility, (2) the level of conceptual abstraction, (3) temporality, (4) normative justificatory arguments and (5) objections to the application of personal health responsibility.

RESULTS

As an additional criterion, personal health responsibility has been interpreted as relevant if: (A) the patient's harmful behaviour is repeated after receiving treatment (retrospectively), and if (B) the success of the treatment is conditional on the patient's behavioural change (prospectively). When discussed as a retrospective criterion, considerations of reciprocal fairness have been dominant. When discussed as a prospective criterion, the expected benefit of treatment justified its relevance.

CONCLUSION

Personal health responsibility appears to challenge core values of equality, inclusion and solidarity in the Norwegian context and has been repeatedly rejected as a necessary criterion for priority setting. However, the responsibility criterion seems to have some relevance in particular priority setting decisions.

Alcohol Induced Brain and Liver Damage: Advantages of a Porcine Alcohol Use Disorder Model

Alcohol is one of the most commonly abused intoxicants with 1 in 6 adults at risk for alcohol use disorder (AUD) in the United States. As such, animal models have been extensively investigated with rodent AUD models being the most widely studied. However, inherent anatomical and physiological differences between rodents and humans pose a number of limitations in studying the complex nature of human AUD. For example, rodents differ from humans in that rodents metabolize alcohol rapidly and do not innately demonstrate voluntary alcohol consumption. Comparatively, pigs exhibit similar patterns observed in human AUD including voluntary alcohol consumption and intoxication behaviors, which are instrumental in establishing a more representative AUD model that could in turn delineate the risk factors involved in the development of this disorder. Pigs and humans also share anatomical similarities in the two major target organs of alcohol- the brain and liver. Pigs possess gyrencephalic brains with comparable cerebral white matter volumes to humans, thus enabling more representative evaluations of susceptibility and neural tissue damage in response to AUD. Furthermore, similarities in the liver result in a comparable rate of alcohol elimination as humans, thus enabling a more accurate extrapolation of dosage and intoxication level to humans. A porcine model of AUD possesses great translational potential that can significantly advance our current understanding of the complex development and continuance of AUD in humans.

Hand fine motor skill disability correlates with dementia severity

BACKGROUND

The progression of dementia, which impairs motor skills and cognitive function, is a warning of greater disability. The present study investigated the association between hand fine motor skills, assessed according to the Functioning Disability Evaluation Scale - Adult Version (FUNDES-Adult), and dementia severity.

METHODS

People with mild and moderate to severe dementia were identified from the Taiwan Data Bank of Persons with Disability. The FUNDES-Adult was assessed for all enrollees, and the following hand fine motor skills were evaluated: pen-holding, buttoning, and knotting. Statistical analysis was performed using SAS, and P values < 0.05 were considered significant.

RESULTS

Disability in all the 3 fin. motor skills was significantly greater in patients with moderate to severe dementia than in those with mild dementia. Disability in any of the skills was sensitive to distinguish mild from moderate to severe dementia (sensitivity: 78.1 %, specificity: 55.2 %, area under the curve: 0.739, 95 % confidence interval [CI]: 0.734-0.745). Those with fine motor skill disability were at a significantly higher risk of moderate to severe dementia (odds ratio: 3.71, 95 % CI: 3.53-3.90, P <  .001).

CONCLUSION

Hand fine motor skill disability was more prevalent in patients with moderate to severe dementia than in patients with mild dementia. A straightforward motor skill assessment can serve as a screening tool in the community to detect the progression of dementia.

Strategies for the Treatment of Parkinson's Disease: Beyond Dopamine

Parkinson’s disease (PD) is the second-leading cause of dementia and is characterized by a progressive loss of dopaminergic neurons in the substantia nigra alongside the presence of intraneuronal α-synuclein-positive inclusions. Therapies to date have been directed to the restoration of the dopaminergic system, and the prevention of dopaminergic neuronal cell death in the midbrain. This review discusses the physiological mechanisms involved in PD as well as new and prospective therapies for the disease. The current data suggest that prevention or early treatment of PD may be the most effective therapeutic strategy. New advances in the understanding of the underlying mechanisms of PD predict the development of more personalized and integral therapies in the years to come. Thus, the development of more reliable biomarkers at asymptomatic stages of the disease, and the use of genetic profiling of patients will surely permit a more effective treatment of PD.

Verifying Feighner's Hypothesis; Anorexia Nervosa Is Not a Psychiatric Disorder

Mental causation takes explanatory priority over evolutionary biology in most accounts of eating disorders. The evolutionary threat of starvation has produced a brain that assists us in the search for food and mental change emerges as a consequence. The major mental causation hypothesis: anxiety causes eating disorders, has been extensively tested and falsified. The subsidiary hypothesis: anxiety and eating disorders are caused by the same genotype, generates inconsistent results because the phenotypes are not traits, but vary along dimensions. Challenging the mental causation hypothesis in Feighner et al. (1972) noted that anorexic patients are physically hyperactive, hoarding for food, and they are rewarded for maintaining a low body weight. In 1996, Feighner's hypothesis was formalized, relating the patients' behavioral phenotype to the brain mechanisms of reward and attention (Bergh and Södersten, 1996), and in 2002, the hypothesis was clinically verified by training patients how to eat normally, thus improving outcomes (Bergh et al., 2002). Seventeen years later we provide evidence supporting Feighner's hypothesis by demonstrating that in 2012, 20 out of 37 patients who were referred by a psychiatrist, had a psychiatric diagnosis that differed from the diagnosis indicated by the SCID-I. Out of the 174 patients who were admitted in 2012, most through self-referral, there was significant disagreement between the outcomes of the SCID-I interview and the patient's subjective experience of a psychiatric problem in 110 of the cases. In addition, 358 anorexic patients treated to remission scored high on the Comprehensive Psychopathological Rating Scale, but an item response analysis indicated one (unknown) underlying dimension, rather than the three dimensions the scale can dissociate in patients with psychiatric disorders. These results indicate that psychiatric diagnoses, which are reliable and valid in patients with psychiatric disorders, are less well suited for patients with anorexia. The results are in accord with the hypothesis of the present Research Topic, that eating disorders are not always caused by disturbed psychological processes, and support the alternative, clinically relevant hypothesis that the behavioral phenotype of the patients should be addressed directly.

Emotion regulation in patients with somatic symptom and related disorders: A systematic review

Background

Somatic symptoms and related disorders (SSD) are prevalent phenomena in the health-care system. Disturbances in emotion regulation (ER) are commonly observed in patients suffering from SSD.

Objectives

This review aimed to examine ER processes that characterize SSD by a systematic analysis of the available empirical studies.

Data sources

PsycINFO and PubMed databases for the articles published between January 1985 and June 2018.

Search terms

“emotion/al regulation” or “affect regulation” and various forms of SSD.

Study eligibility criteria

Empirical studies that a) assigned adolescent or adult patients suffering from SSD based on a clinical diagnosis, and b) examined the relationship between ER and SSD, were included.

Study synthesis methods

A tabular summary of the articles was generated according to study characteristics, study quality, variables, and findings. The findings were organized based on ER variables used in the articles and diagnoses of SSD, which were then re-organized under the main constituents of ER (attention, body, and knowledge).

Results

The findings of the 64 articles largely supported the association between SSD and disturbances in ER, which are usually shared by different diagnoses of SSD. The results indicate that patients show a reduced engagement with cognitive content of emotions. On the other hand, bodily constituents of ER seem to depict an over-reactive pattern. Similarly, the patients tend to encounter difficulties in flexibly disengaging their (spontaneous) attention from emotional material.

Limitations

There is a scarcity of longitudinal designs, randomized controlled trials, experiments, and diary studies suited to investigate the short- and long-term causal relationship between ER and SSD. Symptoms of SSD and measures to assess emotion regulation are heterogeneous.

Conclusions and implications

Assessment of ER processes is potentially useful to understand SSD and for treatment planning. Furthermore, a concurrent investigation of the dynamic interaction of the ER modalities promises insights for better understanding of the role of ER in development, course, and maintenance of SSD.

Shared genetic aetiology between cognitive performance and brain activations in language and math tasks

Cognitive performance is highly heritable. However, little is known about common genetic influences on cognitive ability and brain activation when engaged in a cognitive task. The Human Connectome Project (HCP) offers a unique opportunity to study this shared genetic etiology with an extended pedigree of 785 individuals. To investigate this common genetic origin, we took advantage of the HCP dataset, which includes both language and mathematics activation tasks. Using the HCP multimodal parcellation, we identified areals in which inter-individual functional MRI (fMRI) activation variance was significantly explained by genetics. Then, we performed bivariate genetic analyses between the neural activations and behavioral scores, corresponding to the fMRI task accuracies, fluid intelligence, working memory and language performance. We observed that several parts of the language network along the superior temporal sulcus, as well as the angular gyrus belonging to the math processing network, are significantly genetically correlated with these indicators of cognitive performance. This shared genetic etiology provides insights into the brain areas where the human-specific genetic repertoire is expressed. Studying the association of polygenic risk scores, using variants associated with human cognitive ability and brain activation, would provide an opportunity to better understand where these variants are influential.

Effects of Low-Level Laser Therapy in Autism Spectrum Disorder

The study examined the efficacy of low-level laser therapy, a form of photobiomodulation, for the treatment of irritability associated with autistic spectrum disorder in children and adolescents aged 5-17 years. Twenty-one of the 40 participants received eight 5-min procedures administered to the base of the skull and temporal areas across a 4-week period (test, i.e., active treatment participants). All the participants were evaluated with the Aberrant Behavior Checklist (ABC), with the global scale and five subscales (irritability/agitation, lethargy/social withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech), and the Clinical Global Impressions (CGI) Scale including a severity-of-illness scale (CGI-S) and a global improvement/change scale (CGI-C). The evaluation took place at baseline, week 2 (interim), week 4 (endpoint), and week 8 (post-procedure) of the study. The adjusted mean difference in the baseline to study endpoint change in the ABC irritability subscale score between test and placebo participants was -15.17 in favor of the test procedure group. ANCOVA analysis found this difference to be statistically significant (F = 99.34, p < 0.0001) compared to the baseline ABC irritability subscale score. The study found that low-level laser therapy could be an effective tool for reducing irritability and other symptoms and behaviors associated with the autistic spectrum disorder in children and adolescents, with positive changes maintained and augmented over time.

Mommy or me? Who is the agent in a sense of agency in infant orofacial stereotypies?

That neonates imitate is an assertion that lacks supporting evidence. Orofacial stereotypies are critical to optimizing food rejection. Matching of tongue-protrusion is not imitation, but a manifestation of the infant's arousal by the modeler's exhibition of the same behavior. The support for the nativist assertion that newborn infants imitate is not compelling, and we should proceed on the assumption that they do not.

Thinking, Walking, Talking: Integratory Motor and Cognitive Brain Function

In this article, we argue that motor and cognitive processes are functionally related and most likely share a similar evolutionary history. This is supported by clinical and neural data showing that some brain regions integrate both motor and cognitive functions. In addition, we also argue that cognitive processes coincide with complex motor output. Further, we also review data that support the converse notion that motor processes can contribute to cognitive function, as found by many rehabilitation and aerobic exercise training programs. Support is provided for motor and cognitive processes possessing dynamic bidirectional influences on each other.

QEEG spectral and coherence assessment of autistic children in three different experimental conditions

We studied autistics by quantitative EEG spectral and coherence analysis during three experimental conditions: basal, watching a cartoon with audio (V–A), and with muted audio band (VwA). Significant reductions were found for the absolute power spectral density (PSD) in the central region for delta and theta, and in the posterior region for sigma and beta bands, lateralized to the right hemisphere. When comparing VwA versus the V–A in the midline regions, we found significant decrements of absolute PSD for delta, theta and alpha, and increments for the beta and gamma bands. In autistics, VwA versus V–A tended to show lower coherence values in the right hemisphere. An impairment of visual and auditory sensory integration in autistics might explain our results.

The neural correlates of tic inhibition in Gilles de la Tourette syndrome

Tics in Gilles de la Tourette syndrome (GTS) resemble fragments of normal motor behaviour but appear in an intrusive, repetitive and context-inappropriate manner. Although tics can be voluntarily inhibited on demand, the neural correlates of this process remain unclear. 14 GTS adults without relevant comorbidities participated in this study. First, tic severity and voluntary tic inhibitory capacity were evaluated outside the scanner. Second, patients were examined with resting state functional magnetic resonance imaging (RS-fMRI) in two states, free ticcing and voluntary tic inhibition. Local synchronization of spontaneous fMRI-signal was analysed with regional homogeneity (ReHo) and differences between both states (free ticcing<tic inhibition) were contrasted. Clinical correlations of the resulting differential ReHo parameters between both states and clinical measures of tic frequency, voluntary tic inhibition and premonitory urges were also performed. ReHo of the left inferior frontal gyrus (IFG) was increased during voluntary tic inhibition compared to free ticcing. ReHo increases were positively correlated with participants׳ ability to inhibit their tics during scanning sessions but also outside the scanner. There was no correlation with ratings of premonitory urges. Voluntary tic inhibition is associated with increased ReHo of the left IFG. Premonitory urges are unrelated to this process.

A Neuroscientific Renaissance of Humanistic Psychology

Advances in cognitive neuroscience are creating a significant theoretical rapprochement between neuroscience and humanistic psychology. Since the decade of the brain, there has been a steady increase in neuroscientific research on characteristically humanistic topics such as selfhood, choice, and collaborative meaning making. Moreover, the fundamental postulates of humanistic psychology are playing a central role in a host of contemporary viewpoints within neuroscience. As a result, neuroscience is paving the way for a renewed appreciation of humanistic psychology. The purpose of this article is to provide an overview of the contemporary currents of neuroscientific thought that are most notably supportive of humanistic psychology’s general understanding of human existence. The theoretical rapprochement between neuroscience and humanistic psychology suggests that humanistic psychology may benefit from enhancing its developmental and multicultural aspects. Humanistic psychology stands to further benefit from the development of an integrated, distinctly humanistic neuroscience viewpoint.

Cognitive-motor interactions of the basal ganglia in development

Neural circuits linking activity in anatomically segregated populations of neurons in subcortical structures and the neocortex throughout the human brain regulate complex behaviors such as walking, talking, language comprehension, and other cognitive functions associated with frontal lobes. The basal ganglia, which regulate motor control, are also crucial elements in the circuits that confer human reasoning and adaptive function. The basal ganglia are key elements in the control of reward-based learning, sequencing, discrete elements that constitute a complete motor act, and cognitive function. Imaging studies of intact human subjects and electrophysiologic and tracer studies of the brains and behavior of other species confirm these findings. We know that the relation between the basal ganglia and the cerebral cortical region allows for connections organized into discrete circuits. Rather than serving as a means for widespread cortical areas to gain access to the motor system, these loops reciprocally interconnect a large and diverse set of cerebral cortical areas with the basal ganglia. Neuronal activity within the basal ganglia associated with motor areas of the cerebral cortex is highly correlated with parameters of movement. Neuronal activity within the basal ganglia and cerebellar loops associated with the prefrontal cortex is related to the aspects of cognitive function. Thus, individual loops appear to be involved in distinct behavioral functions. Damage to the basal ganglia of circuits with motor areas of the cortex leads to motor symptoms, whereas damage to the subcortical components of circuits with non-motor areas of the cortex causes higher-order deficits. In this report, we review some of the anatomic, physiologic, and behavioral findings that have contributed to a reappraisal of function concerning the basal ganglia and cerebellar loops with the cerebral cortex and apply it in clinical applications to attention deficit/hyperactivity disorder (ADHD) with biomechanics and a discussion of retention of primitive reflexes being highly associated with the condition.