Neuroscience Trend Forecasters

As 2022 draws to a close, the SNL Trend Forecasters have agreed to divulge their predictions for the most — and the least — exciting research fads for the New Year.

The Neurocritic: How do you guys predict today's most popular neuroscience trends? 

Trend Forecasters: Oh, well we have 4,000 computers, they're all big they all make charts and they beep LOUD.

TN: Let's get started!

In: posterior cingulate cortex

Hey Posterior Cingulate — we see you! You're fresh, you're mysterious, you're misunderstood. But we know you exist far beyond the default fashion mode. The new tripartite view proposes...

...that the broader PCC region contains three major subregions — the dorsal PCC, ventral PCC and retrosplenial cortex — that respectively support the integration of executive, mnemonic and spatial processing systems. This tripartite subregional view reconciles inconsistencies in prior unitary theories of PCC function and offers promising new avenues for progress.

Foster et al. (2022)

 

Out: anterior cingulate cortex

Get behind me, you tired brain region. Think you can do everything? Well the list of your supposed functions is wildly implausible. We've looked at PubMed and found mental fatigue, prediction of non-violent felony rearrest in women, amyloid-β-related increases in empathic concern, experimental odontogenic pain, gravitational perception, chronic itch, RDoC social constructs, and modulation of synaptic plasticity in exercise interventions for post-stroke pain.

 

 

In: claustrum

Claustrum, we're in love with you and it's not only because of the holidays. You're connected to everything and everyone.

Santa Claustrum

 

Initial speculation claimed you were responsible for consciousness (Crick & Koch, 2015), but subsequent studies in human epilepsy patients showed no alterations in consciousness with unilateral or bilateral electrical stimulation (Bickel & Parvizi, 2019). Instead, you're critical for cognitive control. The fresh functional model is called network instantiation in cognitive control (Madden et al., 2022).

Researchers at the University of Maryland School of Medicine ... now posit that Crick may have been incorrect: They developed a new theory — built on data — that the claustrum behaves more like a high-speed internet router, taking in executive commands from “boss” areas of the brain’s cortex that forms complex thoughts to generate “networks” in the cortex.

 

The most exciting recent work (in mice) has shown that claustro-cortical circuits are organized into functional modules (McBride et al., 2022)...

• Frontal areas are more inhibited, while posterior areas are more excited
• Upper layers are more excited, while deeper layers are more inhibited 

...and connect cortical network motifs (Qadir et al., 2022)

• Frontal cortices are synaptically connected to posterior cortices through claustrum
• Two claustrum projection neuron subtypes support trans-claustral circuits
• Trans-claustral circuits resemble a frontoposterior cortical network motif

Out: reinforcement learning and mesolimbic dopamine

 

Your superiority complex is tired, temporal difference error. We know you consider yourself the “biggest success story in computational neuroscience.” But every week a new finding prompts a mathematical tweak and an update of your impenetrable model.

‘teaching signal’ ‘learning model’ ‘model-free’ ‘cached values’ ‘ramps’ ‘bumps’ ‘belief states’ ‘vector RPE’ ‘DA dip of disappointment’

Go to bed, TD. You have to get up early. For a flight TO HELL!

 
 

In: HippoCamera

You spent years developing your brilliant smartphone app that improves memory in older adults, drawing on the basic science of hippocampal replay (e.g., speeding up 24 sec video clips by 3×).

Martin et al. (2022)

Autobiographical memory cues are created by recording an 8 sec audio cue to accompany a 24 sec video recording of a daily event, which is rated for significance. In your recent paper, fMRI scanning occurred after a two week or 10 week intervention. In comparison to baseline (non-reviewed) events, repeated replay of autobiographical memory cues enhanced episodic recollection and increased the differentiation of activity patterns in the hippocampus in older adults (Martin et al., 2022). Bravo, HippoCamera! Take a bow Barense, Honey, and Martin!

 

Out: Brain Behavior Quantification and Synchronization (BBQS)

BRAIN Initiative,² you're so far behind the times that YOU ARE OUT. Didn't you get the memo that Neuroscience Needs Behavior back in 2017? Or read the review on Quantifying Behavior [in worms and flies] to Solve Sensorimotor Transformations, which covered papers going back to 2008 and earlier? The patented HippoCamera was developed behind your back with funding from the Canadian government and private foundations. And the clever use of remote memories recorded by the 1 Second Everyday app (Bainbridge & Baker, 2022) was funded by NIH Intramural funds. The fact that you waited until 2023 to fully announce BBQS projects in humans and non-humans speaks volumes to the value you place on understanding behavior. GO TO BED!

In: neuropeptide maps of human prefrontal cortex

One recent uptick in human brain complexity was revealed from analysis of postmortem tissue in 17 subregions of prefrontal cortex (PFC). Zhong and colleagues (2022) found that 60 neuropeptides and 60 neuropeptide receptors are expressed in at least one of the PFC subregions. The data are freely available and incorporated into the Human Protein Atlas — which has about 5 million individual web pages. The authors encouraged efforts to explore these neuropeptide receptors as potential targets for drug development in neurology and psychiatry, which has been neglected by pharmaceutical companies in recent years.


Out: functional neuroimaging in psychiatry 

You're a failure, psychiatric neuroimaging!! Nour, Liu, and Dolan wrote a 20 page paper detailing your many shortcomings and faults. For instance, explanatory aspirations in resting-state studies are laughable:

“...bridging a gap between descriptive accounts of neural data and psychopathology requires a model that relates network properties ... to specific computational processes. Absent such a model, we argue that further large-scale data collection will be insufficient to yield breakthroughs in probing a fundamental understanding of cognition or psychiatric illness.”

 We needn't go further than listing other direct quotes from their paper:

• “...functional neuroimaging plays no role in clinical decision making.”

• “While the computational psychiatry literature has identified associations between model-informed neural activity and psychiatric variables, effective clinical translation has been lacking.” 
  

• “Casting a cold eye on the psychiatric neuroimaging literature invites a conclusion that despite 30 years of intense research and considerable technological advances, this enterprise has not delivered a neurobiological account (i.e., a mechanistic explanation) for any psychiatric disorder, nor has it provided a credible imaging-based biomarker of clinical utility.”

 

Ouch! You've done nothing for us, psychiatric neuroimaging. You haven't even embraced the correct level of analysis (i.e. manifolds). GO TO BED!

[In again: manifolds]

In: Synchron

Synchron, all the other billionaires are backing you, to the tune of $75 million! In a remarkable advance towards greater independence for paralyzed persons, the Stentrode, an endovascular brain computer interface (BCI), received Breakthrough Device designation from the FDA in August 2021. 

 

Stentrode™ (endovascular implant)

 

The minimally invasive BCI was developed with funding from DARPA (among others), and initial results from sheep were reported in Nature Biotechnology (Oxley et al., 2016). Its placement in the superior sagittal sinus (via the jugular vein) produces high-fidelity recordings from motor cortex without the need for risky cranial surgery. The brain.io™ motor neuroprosthesis transmits cortical signals from the Stentrode to a receiver implanted in the chest, and a machine learning algorithm decodes the neural activity and translates the signals to digital commands.

 

Oxley et al. (2021)

 

Two paralyzed participants with ALS achieved typing click selection accuracy of 93% within 86 days and 71 days of machine-learning supervised training (Oxley et al., 2021). Typing rate was relatively slow (13.8 and 20.1 correct characters per minute, respectively) in comparison to some other BCI cases, but those all entailed craniotomies.¹ Nonetheless, both participants were able to text, e-mail, browse the internet, shop online, and manage finances (Oxley et al., 2021). The COMMAND Early Feasibility Study is an ongoing clinical trial of the Synchron device that will enroll six patients.

In: Mastodon

Because everyone needs an alternative social media site.

Out: Neuralink

Neuralink, you're out! So go back to hell. Stop flaunting your wealth, Neuralink. We all know you have to die for your hubris. You think you'll have FDA approval in six months, but that's what you said in 2019. Many of your claims are sheer fantasy, like you'll be able to cure everything from addiction to strokes.

from Neuralink Progress Update, Summer 2020

 

Your Fall 2022 update was more technically impressive, but still claimed your device will be able to restore vision — prompting eminent vision scientist Brian Wandell to call out this BS:

He [Musk] specifically said this would work for the congenitally blind because they still have a visual cortex.

Two hundred years of experiments on site restoration in human, and many fundamental cellular experiments of visual development and the limits of adult plasticity, show this is false.

Potential ethical concerns have been noted by UPenn Prof Anna Wexler. Finally, you're under investigation for possible animal welfare violations. Neuralink, if I see you in the street I'll stab you in the face.

 

What are your favorite neuroscience trends for 2023? What should be kicked to the curb?

 

Footnotes

¹ Most notable was BrainGate participant T5, with an astonishing 90 characters per minute. Two microelectrode arrays were implanted in the hand area of the precentral gyrus, and neural activity produced by imagined handwriting was decoded and translated into text in real time (Willett et al., 2021).

² hat tip to Drug Monkey.

References

Bainbridge, W. A., & Baker, C. I. (2022). Multidimensional memory topography in the medial parietal cortex identified from neuroimaging of thousands of daily memory videos. Nature Communications, 13(1), 1-16.

Bickel, S., & Parvizi, J. (2019). Electrical stimulation of the human claustrum. Epilepsy & Behavior, 97, 296-303.

Calhoun, A. J., & Murthy, M. (2017). Quantifying behavior to solve sensorimotor transformations: advances from worms and flies. Current opinion in neurobiology, 46, 90-98.

Crick, F. C., & Koch, C. (2005). What is the function of the claustrum?. Philosophical Transactions of the Royal Society B: Biological Sciences, 360(1458), 1271-1279.

Foster, B. L., Koslov, S. R., Aponik-Gremillion, L., Monko, M. E., Hayden, B. Y., & Heilbronner, S. R. (2022). A tripartite view of the posterior cingulate cortex. Nature Reviews Neuroscience, 01 Dec 2022.

Han, J. J. (2021). Synchron receives FDA approval to begin early feasibility study of their endovascular, brain‐computer interface device. Artificial Organs, 45, 1134-1135.

Krakauer, J. W., Ghazanfar, A. A., Gomez-Marin, A., MacIver, M. A., & Poeppel, D. (2017). Neuroscience needs behavior: correcting a reductionist bias. Neuron, 93(3), 480-490. 

Madden, M. B., Stewart, B. W., White, M. G., Krimmel, S. R., Qadir, H., Barrett, F. S., ... & Mathur, B. N. (2022). A role for the claustrum in cognitive control. Trends in Cognitive Sciences.

Martin, C. B., Hong, B., Newsome, R. N., Savel, K., Meade, M. E., Xia, A., ... & Barense, M. D. (2022). A smartphone intervention that enhances real-world memory and promotes differentiation of hippocampal activity in older adults. Proceedings of the National Academy of Sciences, 119(51), e2214285119.

McBride, E. G., Gandhi, S. R., Kuyat, J. R., Ollerenshaw, D. R., Arkhipov, A., Koch, C., & Olsen, S. R. (2022). Influence of claustrum on cortex varies by area, layer, and cell type. Neuron (Nov 4).

Nour, M. M., Liu, Y., & Dolan, R. J. (2022). Functional neuroimaging in psychiatry and the case for failing better. Neuron, 110(16), 2524-2544.

Oxley, T. J., Yoo, P. E., Rind, G. S., Ronayne, S. M., Lee, C. S., Bird, C., ... & Opie, N. L. (2021). Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience. Journal of neurointerventional surgery, 13(2), 102-108.

Qadir, H., Stewart, B. W., VanRyzin, J. W., Wu, Q., Chen, S., Seminowicz, D. A., & Mathur, B. N. (2022). The mouse claustrum synaptically connects cortical network motifs. Cell Reports, 41(12), 111860.

Zhong, W., Barde, S., Mitsios, N., Adori, C., Oksvold, P., Feilitzen, K. V., ... & Hökfelt, T. (2022). The neuropeptide landscape of human prefrontal cortex. Proceedings of the National Academy of Sciences, 119(33), e2123146119.

 

Frankenstein's Hand

Just in time for Halloween, I had a hideous surgery to repair a fractured elbow. This entailed receiving a nerve block that made my hand feel like a dead appendage, which was quite spooky indeed.

 

 Spooky Dead Hand

  

I'm supposed to keep the arm elevated above my heart (which isn't conducive to sitting here and typing), so that is all for now.

 

Happy Halloween!

Actual e-mail sent to the post-op contact person the night of my surgery:

 

Read more »

"And then a Plank in Reason, broke,"

 “I am dead.”

 

In terms of possible delusions in living human beings, Le délire des négations — the nihilistic delusion that one is dead — evokes the most harrowing existence imaginable. The French neurologist Jules Cotard first described the syndrome that bears his name (1882, English translation):

I hazard the name of delirium of negations to designate the state of the patients ... in whom the negative disposition is carried to the highest degree. [They are] asked their name – they have no name; their age – they are ageless; where were they born – they were not born; ... if they have a headache, stomach ache, pain in some part of their body – they have no head, no stomach, some even have no body... For some the negation is universal, nothing exists anymore, they themselves are nothing.

 

Cotard presented the case of Miss X, a 43 year old woman with severe “melancholic anxiety” who tried to end her own life (1880, English translation):

...She affirms that she has neither brain nor nerves, nor chest, nor stomach, nor intestines; all that remains is the skin and bones of the body, disorganized (these are [her] own expressions). This delirium of negation extends even to the metaphysical ideas which were formerly the object of [her] firmest beliefs; She doesn't have a soul, God doesn't exist, neither does the devil. Miss X… being no more than a disorganized body, does not need to eat to live, she cannot die a natural death, she will exist eternally unless she is burned, fire being the only end...

Cotard delusion has been observed in a wide variety of psychiatric and neurological conditions, including psychotic depression, schizophrenia, encephalitis, subdural hemorrhage, arteriovenous malformations, migraine, Parkinson's disease, stroke, and epilepsy (Gerrans, 2022). From a neurobiological perspective, it's nearly impossible to construct a unified theory of the dysfunctional brain systems that underlie the delusion. Hence, some studies have focused on patients who manifest Cotard delusion after stroke, brain injury, or anti-NMDA receptor encephalitis for clues on potential brain regions that may be implicated in these cases. 

Two new papers describe the role of depersonalization — an estrangement from one's body or self — in Cotard delusion (Davies & Coltheart, 2022; Gerrans, 2022).

Absence disembodies — so does Death
Hiding individuals from the Earth
Superposition helps, as well as love —
Tenderness decreases as we prove —

– Emily Dickinson

One prominent account of Cotard holds that people suffering from the delirium of negation are completely devoid of emotional responses. The nihilistic delusion is an attempt to make sense of this anomalous experience. Davies and Coltheart (2022) are critical of this view because there's no evidence that emotional reactivity is abolished in Cotard delusion. They also cite 12 case reports of patients who show a variety of affective states that collectively encompass anxiety, fear, guilt, distress, paranoia, aggression, agitation, anguish, despair, euphoria, grandiosity, irritability, sadness, and worry.

An alternate account places the anomalous experiences of depersonalization and derealization, rather than lack of emotion, as the central “surprising events” that trigger nihilistic delusions (Billon, 2016; Davies & Coltheart, 2022). These patients describe phenomena such as “I feel myself detached from my own body” and “feelings of unreality and difficulties in deciding whether events ... were real or just imagined”. The injured brain areas in these patients included insular cortex and right temporal-parietal regions.

A Death blow is a Life blow to Some
Who till they died, did not alive become —
Who had they lived, had died but when
They died, Vitality begun.

– Emily Dickinson

In contrast, Gerrans (2022) proposes that depersonalization and Cotard delusion result from different ruptures in the sense of self. He provides an extensive and accessible review of the interoceptive active inference model and predictive coding of bodily states in the anterior insula cortex. Depersonalization may arise from imprecise interoceptive predictions, but reality testing remains intact. On the other hand, Cotard delusion represents a complete rupture from reality.

Within this framework, depersonalisation experience involves a selective failure to annex a class of experience to a largely intact hierarchical self-model. The Cotard delusion is a result of the destruction or degradation of that model. It is consistent with this view that there can be overlap between symptoms of depersonalisation disorder and Cotard syndrome, especially while the delusion develops because of nature of self-modelling. However the delusion reports the experience of human life without an intact regulatory self-model whereas in depersonalisation the self-model is largely intact.

A key component of the “depersonalization first, Cotard second” view should account for why the former is relatively common, while the latter is quite rare.

 

References

Billon, A. (2016). Making sense of the Cotard syndrome: Insights from the study of depersonalisation. Mind & Language, 31(3), 356-391.

 

Cotard, J. (1880). Du Délire hypocondriaque dans une forme grave de la mélancolie anxieuse, mémoire lu à la Société médico-psychologique dans la séance du 28 juin 1880, par M. le Dr Jules Cotard.

Cotard, J. (1882). Du délire des négations. Arch de Neurol, 4, 282-296.

 

Davies, M., & Coltheart, M. (2022). Cotard delusion, emotional experience and depersonalisation. Cognitive Neuropsychiatry, 1-17.

 

Gerrans, P. (2022). A vessel without a pilot: Bodily and affective experience in the Cotard delusion of inexistence. Mind & Language.

 

I felt a Funeral, in my Brain,

By Emily Dickinson

 

I felt a Funeral, in my Brain,

And Mourners to and fro

Kept treading - treading - till it seemed

That Sense was breaking through -

And when they all were seated,

A Service, like a Drum -

Kept beating - beating - till I thought

My mind was going numb -

And then I heard them lift a Box

And creak across my Soul

With those same Boots of Lead, again,

Then Space - began to toll,

As all the Heavens were a Bell,

And Being, but an Ear,

And I, and Silence, some strange Race,

Wrecked, solitary, here -

And then a Plank in Reason, broke,

And I dropped down, and down -

And hit a World, at every plunge,

And Finished knowing - then -

 

The Human Protein Atlas (Neuropeptide Edition)

The more you study the brain, the more unknowable it becomes. The level of complexity is baffling, and this is true whether the brain belongs to a human or a crab.¹ The latest uptick in human brain complexity was revealed from analysis of postmortem tissue in 17 subregions of prefrontal cortex (PFC). Zhong and colleagues (2022) found that 60 neuropeptides and 60 neuropeptide receptors are expressed in at least one of the PFC subregions.

 

All the data are freely available (links are in the open access article) and incorporated into the Human Protein Atlas — which has about 15 million individual web pages (according to Wikipedia).

Footnote

¹ Marder et al., 2022:

There is a growing literature that suggests that circuits can have degenerate solutions, that is similar looking behavior with different underlying parameters across individuals. ...  Moreover, repeated performance of the same task is often associated with variable activity in the network generating this task [57∗∗].

 

Reference

Zhong, W., Barde, S., Mitsios, N., Adori, C., Oksvold, P., Feilitzen, K. V., ... & Hökfelt, T. (2022). The neuropeptide landscape of human prefrontal cortex. Proceedings of the National Academy of Sciences, 119(33), e2123146119. 

modified from Fig. 2 (Zhong et al., 2022). Expression levels of (A) Neuropeptides (NP) and (B) Neuropeptide Receptors (NPR) in human PFC. The color code indicates the type of genes (orange, precursor; green, NP; blue, NPR). Red arrows in A and B point to the transcripts studied with ISH (in situ hybridization).

Extracting reliable neurobiological biomarkers for complex subjective experiences isn't easy

"The self is the psychological counterpart of the default mode functionality of the brain." (Scalabrini et al., 2021).


The self studying how "The Self" is represented and constructed by the brain is apex meta-neuroscience.¹ We can say that the self is a manifestation (or an illusory byproduct) of activity in the default mode network (medial prefrontal cortex, posterior cingulate cortex/precuneus, and angular gyrus), but what does this really mean? How do we relate specific neural states to aspects of a changeable self? In a field increasingly focused on remote control of genetically-defined microciruits, pinning down subjective internal phenomena seems presumptuous and hopelessly overambitious.

But of course, the inherent challenge of studying complex subjective experiences hasn't stopped scientists from trying. One active area of research involves characterizing the neural correlates of internal responses to traumatic events. This is of great clinical relevance, because the long-term persistence of fear, hypervigilance, negative affect, and intrusive memories after trauma can be disabling (post-traumatic stress disorder, PTSD). Alterations in one's sense of self (dissociation) can also occur in PTSD, and is the focus of the rest of this post. Dissociative symptoms can include:

1. Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly).
    
2. Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted). 

In states of depersonalization/derealization (which can occur independently of PTSD), one feels disconnected from the self and/or external reality. Dissociative symptoms are considered a maladaptive (but protective) response to stress and trauma. The standard method of eliciting dissociative symptoms during fMRI scanning is script-driven imagery (SDI), a highly unpleasant manipulation. Before the experiment, the participant recounts a narrative of the traumatic event, which is subsequently read back to them in the scanner. The presence of acute dissociative symptoms is determined by questionnaires and interviews before, during, and after the scan.

Early studies reported increased activity in prefrontal (and other) cortical regions in the SDI condition compared to baseline (Lanius et al., 2002) or a neutral script condition (Hopper et al., 2007), which was related to the severity of dissociative symptoms. This fits a theoretical perspective where higher cortical regions are tamping down limbic (and emotional) responses to the trauma induction. It should be mentioned that dissociative responses to SDI are generally less common than vivid re-experiencing of the trauma (30% vs. 70% in Lanius et al., 2002). Drawbacks of these studies include small samples sizes and inconsistencies in the fMRI results.

Mertens and colleagues (2022) set out to replicate these findings in a larger, more homogeneous population of 51 female survivors of childhood abuse. The study included additional questionnaires and separation of the SDI condition into “script listening” and “focused recall” phases (previous studies only included the latter). The experimental design included three runs of neutral script (30 sec each of listening/imaging and focused recall of the event) and three runs of trauma script, which was effective in increasing self-reported ratings of dissociative symptoms, e.g. “Did what you were experiencing seem unreal to you, like you were in a dream or watching a movie or play?” and “Did you feel like you were a spectator watching what was happening to you, like an observer or outsider?” (rated on a 0-6 scale).

– click on image for a larger view –

 

The fMRI results indicated that a wide swath of left cerebellum, occipital cortex, and supramarginal gyrus (parietal lobe) were more active in the trauma script than neutral condition, and this was specific to the script listening phase (no differences were observed during the focused recall phase). The same pattern was seen in the amygdala in a region of interest analysis. Importantly, there was no relationship between any of the clusters and any dissociation measure (amygdala and insula shown below).²

Fig. 2 (Mertens et al., 2022). Script-elicited signal activation clusters and corresponding brain-behaviour correlates (N = 51).

The authors tried a number of different analytic techniques to try and find a relationship between activation clusters and dissociative symptoms, but they could not. In their conclusions, they mentioned the significance of the replication crisis in neuroimaging and noted that “the current (null) findings highlight the difficulty of extracting reliable neurobiological biomarkers for complex subjective experiences such as dissociation.” Identifying who we are and what we experience via spatio-temporal patterns of brain activity are problems that do not have an imminent solution.

Footnotes

¹ Self = a self-aware entity with fully-realized consciousness (whatever this means) 

² Here, the number of self-report and clinician-rated measures was impressive, e.g. Dissociative Experiences scale (trait dissociation), Cambridge Depersonalization Scale, Clinician Administered Dissociative States Scale, Responses to Script-Driven Imagery, etc.

 

Further Reading

Feeling Mighty Unreal: Derealization in Kleine-Levin Syndrome

A Detached Sense of Self Associated with Altered Neural Responses to Mirror Touch

Role of the Vestibular System in the Construction of Self

Derealization / Dying

'I Do Not Exist' - Pathological Loss of Self after a Buddhist Retreat

The Stranger in the Mirror

Writing-Induced Fugue State

References

Hopper JW, Frewen PA, van der Kolk BA, Lanius RA. (2007). Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: Symptom dimensions and emotion dysregulation in responses to script‐driven trauma imagery. Journal of Traumatic Stress 20(5):713-25.

Lanius RA, Williamson PC, Boksman K, Densmore M, Gupta M, Neufeld RW, Gati JS, Menon RS. (2002). Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation. Biological Psychiatry 52(4):305-11.

Lebois LA, Harnett NG, van Rooij SJ, Ely TD, Jovanovic T, Bruce SE, House SL, Ravichandran C, Dumornay NM, Finegold KE, Hill SB et al. (2022). Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure. American Journal of Psychiatry Jun 22.

Mertens YL, Manthey A, Sierk A, Walter H, Daniels JK. (2022). Neural correlates of acute post-traumatic dissociation: a functional neuroimaging script-driven imagery study. BJPsych Open 8(4).

Northoff G, Scalabrini A. (2021). “Project for a Spatiotemporal Neuroscience”–Brain and Psyche Share Their Topography and Dynamic. Frontiers in Psychology 2021:4500.

Scalabrini A, Schimmenti A, De Amicis M, Porcelli P, Benedetti F, Mucci C, Northoff G. (2022). The self and its internal thought: In search for a psychological baseline. Consciousness and Cognition 97:103244.

 

Fig. 4 (Northoff & Scalabrini, 2021). Nested hierarchy of self in the brain.

ABCT Apologizes for Past Support of Gay Conversion Therapy

It's 2022, and the Association for Behavioral and Cognitive Therapies (ABCT) has just issued a belated apology because two of their past Presidents published papers on “aversion therapies” for “converting” gay and transgender individuals to the socially prescribed norms of sexuality and gender identity. 

Well, they didn't actually say this, nor did they name the prominent and distinguished clinical psychologists who authored these papers. Although these luminaries signed on to the mea culpa, there was no direct admission of the harm caused by these ill-advised practices. Instead, the document focused on “the courageous and historic role that some of our members have played in advancing SGM [sexual and gender minority] rights and mental health (e.g., Drs. Charles Silverstein and Gerald Davison).” 

Which is great and all.

But. 

This covert history has been hiding in plain sight for 50 years, and I'm surprised the reckoning hasn't come any earlier. I'm not a clinician, nor am I in the field of cognitive behavior therapy research. But in 2013 I wrote a post on Dr. David H. Barlow and Aversion Therapy for Gays. Dr. Barlow had received a prestigious award for his contributions to clinical psychology, which are indeed extensive. But he was also an author on papers that examined aversion therapy in gay men (Barlow et al., 1969; Barlow, 1973; Barlow et al., 1975; Herman et al., 1974; Barlow et al., 1975; Hayes et al., 1983) and exorcism for transsexualism (Barlow et al., 1977). Dr. Barlow and Dr. Steven C. Hayes were Past Presidents of ABCT in 1978-1979 and 1997-1998, respectively. Hayes subsequently developed Acceptance and Commitment Therapy (ACT) and Barlow is known for his work on the treatment of anxiety disorders.

Sorry Seems to Be the Hardest Word

I first learned about the ABCT apology on Twitter, via Lorenzo Lorenzo-Luaces, PhD (@lluaces) and Aaron Fisher (aaronjfisher).

ABCT Apology for Behavior Therapy’s Contribution to the Development and Practice of Sexual Orientation and Gender Identity and Expression Change Efforts

The ABCT Board of Directors and past leadership have released an apology for behavior therapy’s contributions to the development and practice of sexual orientation and gender identity and expression change efforts [SOGIECEs].

More details are in the Full Apology PDF.

...[ABCT] apologizes for our historic role in the development and use of so-called “conversion therapies,” practices that have caused untold harm to members of the sexual and gender minority (SGM) community for over 50 years. To this day, publications written by ABCT members – including members in prominent leadership roles – are used by anti-SGM activists to justify their ongoing use of these damaging so-called “therapies.” ABCT deeply regrets behavior therapists’ role in the creation, study, and use of these practices, and recognizes and accepts responsibility for the ways in which both our actions and inactions have harmed SGM people. ABCT recognizes it is time for us to document our history and legacy and say that we are truly sorry.¹

But documentation of this history and legacy is rather sketchy... Without naming names, the Apology cited the recent review of Capriotti and Donaldson (2022), which in turn asked “Why don’t behavior analysts do something?” about retracting the unethical paper of Rekers and Lovaas (1974). The conversion therapy work of Barlow and Hayes was mentioned here as well. 

 

I wrote to Barlow in 2013 to ask him about this early research on SGM people.²  I didn't really expect an answer, especially since I'm an obscure anonymous blogger. Nonetheless, I wanted to give him the opportunity to respond before I posted about his work.

Dear Dr. Barlow,

Congratulations on your receipt of the 2012 James McKeen Cattell Fellow Award from the APS for your distinguished contributions to the field.

I am a blogger writing a post about past treatments for homosexuality and came across references to your early work on aversion therapy in gay men, which I found unfortunate.

I wondered whether you had a statement about that work in light of contemporary views of homosexuality, or whether you had issued such a statement in the past.

Thank you very much for your time.

Sincerely,
The Neurocritic

Then a reader (Jordon) commented on my post in 2015, saying Barlow wrote back when he was asked about aversion therapy. Barlow sent a forthcoming book chapter from his 2016 retrospective, The Neurotic Paradox, Volume 1: Progress in Understanding and Treating Anxiety and Related Disorders. A sort-of not-really apology appeared on p. 6-7:

But it was also during this time [late 60s-early 70s] that I undertook what has come to be from my own personal point of view the most regrettable initiative in my clinical research career. Specifically ... I began treating and evaluating the effects of [covert sensitization]  treatment in individuals with what came to be called paraphilias but what was then called sexual deviation (Barlow, 1974a). While our focus was mostly on pedophilia (e.g. Barlow, Leitenberg, & Agras, 1969), the aggressive behavior of rapists (e.g. Abel, Barlow, Blanchard, & Guild, 1977), and other paraphilias (e.g. Hayes, Brownell, & Barlow, 1978), included in this series of studies were participants presenting with same-sex arousal patterns with consenting adults. (e.g., Barlow, Leitenberg, & Agras, 1969). At that time homosexuality was considered a disorder in all systems of nosology and, under extreme pressures from society and the associated stigma, these individuals sought out treatment; so very few clinicians even gave it a second thought. But by the mid-1970s several individuals began questioning these treatment goals.

 

These practices were “embedded in the continually shifting landscape of cultural values and mores” and homosexuality wasn't de-pathologized until “later in the decade” of the 1970s [it was actually 1973] and “most of the work was on paraphilias” [but many papers were on attempted conversion of gay men and transgender women (who were called male transsexuals)]. Most importantly, Barlow did not acknowledge the harm inflicted on the recipients of his treatments.

Besides the bizarre exorcism in a transsexual article, three more papers described covert modeling procedures and a “therapeutic package” to change the gender identity of transgender youth and young women (Barlow et al., 1973, 1979; Hay et al., 1981). Given the Increasing Criminalization of Gender-Affirming Care for Transgender Youth in many Southern states, it's critical for all psychological organizations to disown past practices used to justify such discriminatory and inhumane treatment.

 

What else should I be?
All apologies
What else could I say?
Everyone is gay

--Nirvana

Footnotes

¹ One of the action items is that disclaimers will be added to SOGIECE papers previously published in ABCT journals. My initial search turned up only one. Barlow DH (1973). Increasing heterosexual responsiveness in the treatment of sexual deviation: A review of the clinical and experimental evidence. Behavior Therapy 4:655-671

² The SGM terminology was unfamiliar to me before now. I also wondered whether the acronym SOGIECE was real, but apparently it is.

 

ADDENDUM (June 12 2022): Dr. Hayes has issued a personal apology for his role in conversion therapy. Also, he has published on ACT to lessen the impact of internalized homophobia (which is quite common in LGBTQ+ persons, as I know from personal experience).

Yadavaia JE, Hayes SC. (2012). Acceptance and commitment therapy for self-stigma around sexual orientation: A multiple baseline evaluation. Cognitive and behavioral practice 19(4):545-59.

 

Bibliography
(refs discussed in Dr. David H. Barlow and Aversion Therapy for Gays)

Barlow DH (1973). Increasing heterosexual responsiveness in the treatment of sexual deviation: A review of the clinical and experimental evidence. Behavior Therapy 4:655-671.

Barlow DH, Abel GG, & Blanchard EB (1977). Gender identity change in a transsexual: an exorcism. Archives of sexual behavior, 6 (5), 387-95. PMID: 921523

Although the prevention of transsexualism is the ideal, work in this area has been fraught with ethical problems, and data on the possibility of prevention, or even what to prevent, are not available...

Barlow DH, Agras WS, & Leitenberg H (1972). The contribution of therapeutic instruction of covert sensitization. Behaviour research and therapy, 10 (4), 411-5. PMID: 4637499

Barlow DH, Agras WS, Abel GG, Blanchard EB, Young LD. (1975). Biofeedback and reinforcement to increase heterosexual arousal in homosexuals. Behav Res Ther. 13:45-50.

The patient descriptions are distressing, e.g. a boy raped by a male relative: “The first S was a 15-yr-old male who had engaged in homosexual behavior for 4 yr after being seduced [sic] by an uncle.”

Barlow DH, Leitenberg H, & Agras WS (1969). Experimental control of sexual deviation through manipulation of the noxious scene in covert sensitization. Journal of abnormal psychology, 74 (5), 597-601. PMID: 5349402

Hayes SC, Brownell KD, & Barlow DH (1983). Heterosocial-skills training and covert sensitization. Effects on social skills and sexual arousal in sexual deviants. Behaviour research and therapy, 21 (4), 383-92, PMID: 6138027

Herman SH, Barlow DH, Agras WS. (1974). An experimental analysis of exposure to "explicit" heterosexual stimuli as an effective variable in changing arousal patterns of homosexuals. Behav Res Ther. 12:335-45.

Additional References

Barlow DH, Abel GG, Blanchard EB. (1979). Gender identity change in transsexuals: Follow-up and replications. Archives of General Psychiatry 36(9):1001-7.

Barlow DH, Agras WS. (1973). FADING TO INCREASE HETEROSEXUAL RESPONSIVENESS IN HOMOSEXUALS. Journal of Applied Behavior Analysis. 6(3):355-66.

“Heterosexual responsiveness, measured by penile responses and reports of behavior, was strengthened in three homosexuals through a fading procedure [slides of nude females superimposed on slides of nude males.]. ... The results suggest that fading was responsible for altering stimulus control of sexual arousal and that aversive techniques may not be necessary in the treatment of sexual deviation.” [well that's a relief...]

Barlow DH, Hayes SC, Nelson RO, Steele DL, Meeler ME, Mills JR. (1979). Sex role motor behavior: A behavioral checklist. Behavioral Assessment. 1:119-38. [I could not find a copy of this; however, the items appear in Hayes et al. 1984].  Examples:

• Firm Wrist Action Versus Limp Wrist Action.
• Hand(s) in Pocket. 
• Frequent or Exaggerated Hand or Arm Movements.

Barlow DH, Reynolds EJ, Agras WS. (1973). Gender identity change in a transsexual. Archives of General Psychiatry 28(4):569-76.

Brownell KD, Hayes SC, Barlow DH. (1977). Patterns of appropriate and deviant sexual arousal: the behavioral treatment of multiple sexual deviations. Journal of Consulting and Clinical Psychology 45(6):1144.

• one cis-male cross-dresser into BDSM (among the rapists, pedophiles, and exhibitionists) listened to arousing scenarios followed by humiliating consequences while his penile circumference was measured.
  
• no gay or trans subjects here, but other papers have used the D word (“deviant”).

Hay WM, Barlow DH, Hay LR. (1981). Treatment of stereotypic cross-gender motor behavior using covert modeling in a boy with gender identity confusion. Journal of consulting and clinical psychology 49(3):388.

Hayes SC, Nelson RO, Steele DL, Meeler ME, Barlow DH. (1984). Instructional control of sex-related motor behavior in extremely masculine or feminine adults. Sex Roles 11(3):315-31.

Leonard SR, Hayes SC. (1983). Sexual fantasy alternation. Journal of behavior therapy and experimental psychiatry. 14(3):241-9.

• four bisexual men (three white, one black) who were “confused” about their sexual orientation
• but only the black man was medicated (with a potent antipsychotic)
  

“Subject 3 was a 32 yr old, black, married, blue collar worker and father of five. His heterosexual history was extensive. He reported a 3 yr history of homosexual activity ocurring during drinking episodes. At the time of referral and throughout the study, he received medication (Thorazine 25 mg daily) from a physician at the referring agency.”

 

I have THOUGHTS. Some on how some therapy orientations get a pass in criticism but more on ABCT having a statement signed by its presidents when at least two (Barlow and Hayes) have published papers on behavioral modification of sexuality https://t.co/1JdyaN6YEq

— Lorenzo Lorenzo-Luaces, PhD (@lluaces) June 9, 2022

 

While I applaud @ABCTNOW's proactivity and (relative) transparency, this letter fails to name two current high-profile members: David Barlow and Steven Hayes. Encouraging readers to 'educate themselves' falls short of the work this letter intends to do.https://t.co/f6Wuv6ObUu

— Aaron Fisher (@aaronjfisher) June 9, 2022

 

Thank you for your belated apology. If I may humbly ask, why did it take so long, when members of the LGBTQ+ community have been seeking such acknowledgments for years? https://t.co/UISL0haq

— The Neurocritic (@neurocritic) June 9, 2022

THIS device may not nudge your brain into deep sleep

The Washington Post used this picture of a saline-filled 280-channel Geodesic Head Web¹ to illustrate a new wearable device that aims to enhance slow wave sleep (SWS). The device delivers low-level current (0.5 mA) at 0.5 Hz to mimic the frequency of EEG naturally recorded during SWS (0.5-1 Hz). However, this is impossible with saline sensors, which would also dry out well before the night is over. 

 

The WaPo article accurately showed different stages of applying the net, including measuring the head, checking impedences, and filling sensors with saline (above). A published journal article used similar Geodesic technology but using 256 electrodes filled with conductive gel (Hathaway et al., 2021). This setup was able to deliver transcranial electrical stimulation (TES) at 0.5 Hz.  Time spent in deep sleep was increased by 13% for active vs. sham stimulation. The BEL website shows people snoozing while wearing this headgear.

 

Footnote

¹ This net is made by BEL Company and is the latest iteration of the 256-channel Geodesic Sensor Net made by EGI/Philips. Both designs were developed by Dr. Don Tucker at the University of Oregon. In 2017 he sold his company Electrical Geodesics, Inc. to Philips for $37 million. He now runs Brain Electrophysiology Laboratory (BEL) Company.

Reference

 

Hathaway E, Morgan K, Carson M, Shusterman R, Fernandez-Corazza M, Luu P, Tucker DM. (2021). Transcranial Electrical Stimulation targeting limbic cortex increases the duration of human deep sleep. Sleep Medicine 81:350-7.