Causality in Mental Disturbance: A Review of the Neuroscience

“To be clear: there is no neuroscience to suggest that any mental function would be improved by ablating or stimulating a particular structure in the prefrontal cortex or its associated subcortical regions. To the contrary, what we know of the intrinsic organization of the prefrontal cortex suggests that mucking with it is unlikely to help. “

This research article by Peter Sterling (Professor of Neuroscience) has been published by Mad in America. It begins:

“Here I comment on the 2022 review, “Causal Mapping of Human Brain Function” by Siddiqi et al., which appeared in Nature Reviews Neuroscience. I place its reasoning in the historical context of psychosurgery and other physical manipulations of brain function—and also in the present context of new understandings from brain imaging, genome-wide studies, and longitudinal studies of mental disturbance. Here are the Review’s stated goals:

This Review focuses on the objective of symptom localization, which aims to identify causal links between symptoms and neuroanatomy. When a symptom is successfully localized, it may potentially be treated by modulating the corresponding neuroanatomy. The second objective, mapping the direction of information flow, aims to understand how one brain region can causally influence another. These experiments attempt to estimate the direction of information flow between two or more nodes in the brain using various measures of effective connectivitySimilar approaches have now been used to map the causal neuroanatomy of movement disorders, mood disorders, anxiety-related disorders, psychotic disorders, disorders of consciousness and various other neuropsychiatric phenomena.

The Review opens by considering identified neurological disorders with identified causes and identified therapies grounded in identified neuroscience. Its primary exemplar is Parkinson’s disease, whose immediate cause is loss of dopaminergic neurons in the substantia nigra, and whose treatment involves providing the dopamine precursor to the remaining dopaminergic synapses so that they continue making and releasing dopamine in response to natural stimuli as part of the natural circuit. All good. But then the Review pulls a fast one: it inverts the argument.

Whereas neurology starts with known damage that causes known symptoms and finds effective therapies based on known neuroscience, this Review starts with mental disturbances that it claims to be symptoms of an underlying ‘brain disorder’, which it claims to ‘localize neuroanatomically’ in order to ‘treat’ with brain manipulations for which there is no foundation in neuroscience. ­­Thus, the Review reasons by asserting an equivalence between something not known to something that is known, apparently hoping that the difference will go unnoticed …”

You can read more from here.

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