HEALTH BEGINS WITH THE BRAIN Professor SW Tang Emeritus Professor of Psychiatry, UC Irvine , USA Director, Institute of Brain Medicine
Jun 18, 2015
HEALTH BEGINS WITH THE BRAIN
Professor SW TangEmeritus Professor of Psychiatry,
UC Irvine , USADirector, Institute of Brain Medicine
THE MEANING OF LIFE MANY MILLION YEARS AGO:THE PRIMITIVE LIFE FORMS
Survival was the meaning of Life To Survive:
Food Then to preserve species :
Reproduction
Food & SexKnown for thousands of years:a. “The desire for food and sex is basic to
animals, & is human nature” (Mencius) 孟子 ( 告子 ) “ 告子曰 : 食色性也” b. “Eating and Sex are human wants”
(Confucius)孔子 : 礼记“饮食男女,人之大欲存焉”
CNS CORE WAS A SURVIVAL
CO-ORDINATION CENTER ONLY & STILL IS
THE BRAIN OF LOWER ANIMALS MAY NOT EVEN BE ESSENTIAL FOR SHORT TERM
SURVIVAL
Insects can live for a short term without the brain and to fulfill the
purpose of reproduction e.g. praying mantis
Mantis Mating
“Thinking” is NOT necessaryfor the continuation of Life
Insects Mammals
Limbic brain added :(hippocampus, amygdala, nucleus
accumben and other limbic circuit components)
To: Sense danger , eat or runSpatial orientation and memory for food
and escape (Hippocampal function, Serotonin (5HT) function)
Pleasure (Dopamine (DA) function) : to repeat behavior which are rewarding
Higher Mammals
Addition of Cortex to integrate the Limbic and the core brain :
Cortex needed for the Analysis of a complex world :
To find the best way to carry on with the species:
a. strong mate for strong genetics strong off-springs for best survival
b. Analysis of the othersc. Build a stable environment for bring up the
off-springs (society/civilization)
MAJOR DIFFERENCE BETWEEN THE HUMAN
BRAIN & BRAINS OF LOWER
ANIMALS
Addition of the 1. (Cortex) to
2. (Limbic brain) & 3. (Brain core)
SOME DO NOT USE THEIR CORTEX (THOSE WHO’S LIFE PURPOSE WAS ONLY
“EAT AND REPRODUCE” )
“The Wisest and the Most Stupid are NOT Changeable ” (Confucius )
子曰: “唯上智與下愚不移” (論語 ‧ 陽貨第
十七)
Evolution of The Tri- Brain
1. Brain Core : co-ordination center , …. All animals (e.g. insects have only brain core)
2. Limbic Brain : emotion, pleasure, fear, …..All
animals (e.g. reptiles have largely limbic brain)
3. The Cortex : a. Lower animals (small cortex, e.g.
rats) b. Primates (large cortex, e.g. human)
The Rise of the Cortex : Analysis of Complex environment (dangers abound)
Cortex
Pallium
subpallium
A
ACortex
A
Rat
PrimateAvian
The functions of the Tri-brain are same but forms differ in Human
1. Feeding ( job earning enough eat well) [DA, 5HT]
2. Love & Defense (love, attachment, fear, anger, aggression) [5HT, DA, sex hormones]
3. Reproduction ( sensation seeking, attracted to the right mate ) [DA, oxytocin, vasopressin]
4. Continuation of life ( commitment, family function, maternal behavior) [oxytocin, vasopressin]
5. Social Interaction (civilization) [cortisol]
Hippocampus
OB
MidbrainThalam
us
Sensory Inputs e.g. eye
Reproductive,Sexual attraction
Fear,Anxiety
Vocalization.e.g. Song
Motor OutputAppetitive Reward
Amygdala remains an important Structure in evolution and is the basis for psychosomatics
Avian Brain
Inputs
Sensory cortex
FrontalPre frontal cortex
Hippocampus(contextual input)
Olfactory(pheromones)ThalamusInsular Cortex
Hormonal
Outputs
Thalamus
Cortex
Striatum
Hippocampus
Hypothalamus
Brain Stem
Vagal
Role of Amygdala in psychosomatics
+ +
+
-
Vertebrate Cerebrum organization Using More Chemicals
Cortex
Striatum,Limbic
ThalamusHypothalamusTegmentumBrain Stem
DA
GABAPeptides
Ach
Glu
Amygdala/Hippocam
pus
Executive function
Cognitive function
DA reward Pathways
Core
Q: To what extent the frontal cortex can modulate amygdala activities ?
• 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.”
• Menzi : Mother moving thrice to ensure the best environment
• Shunzi : Human’s evil nature modifiable by learning
Amygdala & Batman
Amygdala
alias of a character in Batman comicsa sometime opponent of Batmanhas 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
AUTISM, ASPERGER’S AND SENSELESS CRUELTY &
VIOLENCE Amygdala, Insula and Mirror
Neuron Implicated
Early Life Resilience Formation
Quality and Quantity of early-life maternal care : a predominant signal triggering gene expression in glucocorticoids and corticotropin releasing factor (CRH)
development of resilience or vulnerable phenotypes
Amygdala
Cortex
Hypothalamus Pons
Amygdala
Weak CortexInsula
Strong CortexInsula(Aristotle,Shunzi)
Insensitive Amygdala Amygdala
Un-buffered emotionSolution direct
Highly Buffered EmotionSolution after filtering
HUMAN The strength of Cortex over Limbic and
Brain Core center:: basis for civilization and social behavior but
also the basis for many important human health problems
HEALTH BEGINS WITH THE BRAIN
MANY BODY FUNCTIONS ARE UNDER SUBTLE BRAIN
CONTROL
Some commonly known (e.g. cannot use your fingers, walk after stroke),
some not so much known (e.g. immunological system)
But many related to human social interaction and psychosomatics
Psychosomatic
Common Brain based health presentations: a. Aches & Pains [Sciatica (special case of psychosomatic: Floating anxiety sleep disturbances muscle tension, back pain
b. GI disturbances (very high % of patients in GI clinics)
c. Chest discomfort (very high % of patients in cardiac clinics)
d. Dermatological (ezcema …) e. Medically unexplained symptoms
ANNUAL PHYSICAL CHECK UPS:
Begins with the Brain
Thank You !