Functional connectivity changes related to cognitive and motor performance in spinocerebellar ataxia type 2.

BACKGROUND: Several neuropathological studies in spinocerebellar ataxia type 2 (SCA2) have revealed significant atrophy of the cerebellum, brainstem, sensorimotor cortex, and several regions in the frontal lobe. However, the impact of the neurodegeneration on the functional integration of the remaining tissue is unknown. To analyze the clinical impact of these functional changes, we correlated the abnormal functional connectivity found in SCA2 patients with their scores in clinical scales. To obtain the functional connectivity changes, we followed two approaches. In one we used areas with significant cerebellar gray matter atrophy as anchor seeds, and in the other we performed a whole-brain data-driven analysis. METHODS: Fourteen genetically confirmed SCA2 patients and aged-matched healthy controls participated in the study. Voxel-based morphometry and resting-state functional magnetic resonance imaging (fMRI) were done to analyze structural and functional brain changes. Independent component analysis and dual regression were used for intrinsic network comparison. Significant functional connectivity differences were correlated with the behavioral scores. RESULTS: Seed-based analysis found reduced functional connectivity within the cerebellum and between the cerebellum and frontal/parietal cortices. Cerebellar functional connectivity increases were found with parietal, frontal, and temporal areas. Intrinsic network analysis found a functional decrease in the cerebellar network, and increase in the default-mode and fronto-parietal networks. Further analysis showed significant correlations between clinical scores and the abnormal functional connectivity strength. CONCLUSION: Our findings show significant correlations between functional connectivity changes in key areas affected in SCA2 and these patients' motor and neuropsychological impairments, adding an important insight to our understanding of the pathophysiology of SCA2.

Neuroanthropology of shamanic trance: a case study with a ritual specialist from Mexico.

In Mexico, shamans are recognized for the gift of entering a deep trance that allows them to know the origin of the diseases and conflicts that afflict people. They commonly treat patients through limpias (cleansing) to extract negative elements sent by a witch or that were "collected" in places that harbor "evil winds." We present a case study of an 81-year-old Mexican shaman who noticed her gift in childhood. Electroencephalographic recordings were made while the shaman performed three activities: reading cards to diagnose a patient and answer the questions he posed; limpia with chicken eggs, stones, and bells to absorb adverse "things"; and the incorporation trance through which the deceased is believed to occupy the shaman's body to use it as a communication channel. Alpha activity was observed when concentrated, suggesting a hypnagogic-like state. Predominant beta and gamma oscillations were observed, suggesting a potential plastic phenomenon that modulates the assimilation of external and internal referents guiding temporal schemes for action, attention, and the integration of mnemonic, sensory, and imaginative elements. We used a neuroanthropological approach to understand shamanic trance as a biological potential of the human brain to induce non-ordinary states of consciousness linked to cultural beliefs and practices.

Case Report: "I got my brain back" A patient's experience with music-induced analgesia for chronic pain.

Listening to music has progressively been proposed as a complementary alternative for chronic pain; understanding its properties and its neurobiological bases is urgent. We show a phenomenological investigation of a woman who has lived 20 years with chronic pain. The inquiry involved her experience of the context in which she listens to music, the intensity and quality of pain, body mapping, memories, emotions, and cognition. The participant listens to music for different reasons, such as pain and anxiety relief, motivation to exercise, and quality of sleep, but all seem to revolve around different strategies for pain management. Experiences in physiological and cognitive aspects included perceived restorative sleep that may have improved the participant's general wellbeing and improved cognitive and motor performance as well as communication skills. The music enabled the participant not only to relieve pain but also withdrawal effects after discontinuing her opioid-based treatment. These effects may encompass endogenous opioid and dopamine mechanisms involving natural analgesia associated with pleasurable experiences. Future studies could consider phenomenological case studies and therapeutic accompaniment to reorient subjective properties of pain and expand quantitative and qualitative knowledge for more comprehensive reports on music and analgesia.

In ADHD patients performing the Counting Stroop task: a social neuroscience approach.

Attention Deficit/Hyperactivity Disorder (ADHD) symptoms are manifested in social dynamics. In this study, the brain activity of eight child and adolescent patients diagnosed with ADHD was examined while they performed the Counting Stroop task and results were interpreted using social neuroscience premises. Brain activity was identified in frontal, parietal, and temporal regions related to the orienting system of attention and with linguistic, facial recognition, and mnemonic processes. Consistent with previous reports, these patients showed no activation in prefrontal and anterior cingulate cortices related to the executive system of attention. Also, they manifested activation in the insular cortex involving interoceptive processes that may be associated with impulsiveness. Global brain activity involves a network formed during early development and includes experiential components such as learning of rules, reward systems, empathy, and decision making. An integrative assessment of ADHD should consider psychosocial and neurobiological causes integrated into an individual's own experiences assembled throughout life.

Women as users and dealers of inhalants in the streets of Mexico city: A study on empowerment, cooperation, and trust at the margins.

INTRODUCTION: People who live on the streets in Mexico commonly use inhalants to induce psychoactive effects. Research on the distribution, sale, and consumption of these substances is scarce and mostly focuses on men, which limits the understanding of their use and possible public policies. Our ethnographic research concentrates on women who live and work on the street under marginalized conditions in Mexico City. METHODS: A Grounded Theory approach was used to frame the two-year-long field work. A field diary was kept for the multi-sited ethnography and participant observations in street-based settings, as well as five in-depth interviews with female distributors, sellers, and/or users of inhalants. Data was analyzed based on four dimensions: biography, representation as a dealer or user, social dynamics, and geographical distribution of networks to distribute, sell, and use inhalants. RESULTS: Women involved in the distribution, sale and use of inhalants are motivated by gender violence and socioeconomic vulnerability. They shape reciprocity networks to purchase inhalants in dangerous urban areas and avoid being mugged and physically or sexually assaulted. Although men are the ones who offer protection, women employ women to sell the inhalants and strengthen trust in the community. Distribution begins in clandestine places where combinations of unknown solvents are prepared in 20-L containers. Each liter is supplied for 1.92 USD to be retailed in 9.58 USD per liter in the streets. Particular language and cultural street-codes are necessary conditions in distribution and sales points for safe use and protection from authorities and out-group members. CONCLUSION: Trust and cooperation are crucial in reciprocity networks formed by women who distribute, sell and use inhalants in the streets. These networks compensate for the lack of social security and safety, empower women in the street community, and provide income needed to survive marginality.

Affective and cognitive brain-networks are differently integrated in women and men while experiencing compassion.

Different theoretical models have proposed cognitive and affective components in empathy and moral judgments encompassing compassion. Furthermore, gender differences in psychological and neural functions involving empathic and moral processing, as well as compassionate experiences, have been reported. However, the neurobiological function regarding affective and cognitive integration underlying compassion and gender-associated differences has not been investigated. In this study, we aimed to examine the interaction between cognitive and emotional components through functional connectivity analyzes and to explore gender differences for the recruitment and interaction of these components. Thirty-six healthy participants (21-56 years; 21 women) were exposed to social images in an fMRI session to judge whether the stimuli elicited compassion. The results showed a different connectivity pattern for women and men of the insular cortex, the dorsomedial prefrontal cortex (dmPFC), the orbitofrontal cortex (OFC), and the cingulate cortex. The integration of affective and cognitive components follows a complex functional connectivity pattern that is different for both genders. These differences may indicate that men largely make compassionate judgments based on contextual information, while women tend to notably take internal and introspective processes into account. Women and men can use different affective and cognitive routes that could converge in similar learning of moral values, empathic experiences and compassionate acts.

Greater Empathic Abilities and Resting State Brain Connectivity Differences in Psychotherapists Compared to Non-psychotherapists.

In a therapeutic environment a proper regulation of the empathic response strengthens the patient-therapist relationship. Thus, it is important that psychotherapists constantly regulate their own perspective and emotions to better understand the other's affective state. We compared the empathic abilities of a group of 52 psychotherapists with a group of 92 non-psychotherapists and found psychometric differences. Psychotherapists showed greater scores in Fantasy and Perspective Taking, both cognitive empathy constructs, and lower scores in the use of expressive suppression, an emotional regulation strategy that hampers the empathic response, suggesting that psychotherapists exert top-down processes that influence their empathic response. In addition, the expected sex differences in empathic concern and expressive suppression were only present in the non-psychotherapist group. To see if such psychometric differences were related to a distinctive functional organization of brain networks, we contrasted the resting state functional connectivity of empathy-related brain regions between a group of 18 experienced psychotherapists and a group of 18 non-psychotherapists. Psychotherapists showed greater functional connectivity between the left anterior insula and the dorsomedial prefrontal cortex, and less connectivity between rostral anterior cingulate cortex and the orbito prefrontal cortex. Both associations correlated with Perspective Taking scores. Considering that the psychometric differences between groups were in the cognitive domain and that the functional connectivity associations involve areas related to cognitive regulation processes, these results suggest a relationship between the functional brain organization of psychotherapists and the cognitive regulation of their empathic response.

Social closeness modulates brain dynamics during trust anticipation.

Anticipation of trust from someone with high social closeness is expected. However, if there is uncertainty in the interaction because a person is a stranger or because he has distrusted us on another occasion, we need to keep track of his behavior and intentions. Using functional Magnetic Resonance Imaging (fMRI) we wanted to find the brain regions related to trust anticipation from partners who differ in their level of social closeness. We designed an experiment in which 30 participants played an adapted trust game with three trustors: A computer, a stranger, and a real friend. We covertly manipulated their decisions in the game, so they trusted 75% of the trials and distrusted in remaining trials. Using a psychophysiological interaction analysis, we found increases in functional coupling between the anterior insula (AIns) and intra parietal sulcus (IPS) during trust anticipation between a high versus low social closeness partner. Also, the right parietal cortex was coupled with the fusiform gyrus (FG) and the inferior/middle temporal gyrus during trust anticipation of a friend versus a stranger. These results suggest that brain regions involved in encoding the intentions of others are recruited during trust anticipation from a friend compared to a stranger.

Perception of suffering and compassion experience: brain gender disparities.

Compassion is considered a moral emotion related to the perception of suffering in others, and resulting in a motivation to alleviate the afflicted party. We compared brain correlates of compassion-evoking images in women and men. BOLD functional images of 24 healthy volunteers (twelve women and twelve men; age=27±2.5 y.o.) were acquired in a 3T magnetic resonance scanner while subjects viewed pictures of human suffering previously verified to elicit compassion and indicated their compassionate experience by finger movements. Functional analysis revealed that while women manifested activation in areas involved in basic emotional, empathic, and moral processes, such as basal regions and cingulate and frontal cortices, activation in men was restricted mainly to the occipital cortex and parahippocampal gyrus. These findings suggest that compassion and its moral elements constitute gender-relative subjective phenomena emerging from differently evolved neural mechanisms and socially learned features possibly related to nurturing skills.

Nutritional Status Influences Oxidative Stress and Insulin Resistance in Preschool Children.

Background: Child malnutrition represents a major public health problem with physiological, psychological, and social short- and long-term implications. Objective: To compare the influence of nutritional status on oxidative stress (OS) markers in children aged 3-6 years. Methods: Children were categorized into four groups: underweight, normal weight, overweight, and obesity. Glucose (Glu), cholesterol (Chol), high-density lipoproteins, insulin, triacylglycerols (TG), triacylglycerols/glucose (TyG) index, and the homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed. In addition, OS [malondialdehyde (MDA) and 3-nitrotyrosine (3-NT)] and antioxidant defense markers [superoxide dismutase (SOD), catalase (CAT), and the ratio of reduced/oxidized glutathione (GSH/GSSG)] were quantified. Results: Children with obesity showed significantly higher levels of MDA and 3-NT, and increased SOD activity compared with normal weight children. Glu, Chol, TG levels, TyG indexes, HOMA-IR, MDA, 3-NT, and SOD positively correlated with body mass index (BMI) and Centers for Disease Control and Prevention percentiles (CDC PC). However, CAT concentration and the GSH/GSSG ratio correlated negatively with BMI and CDC PC. In children with underweight, we found a positive correlation of TG levels and TyG indexes with BMI, whereas both markers positively correlated with BMI and CDC PC in children with overweight. MDA negatively correlated with BMI in children with underweight, while a positive association was observed in children with overweight. Finally, SOD, CAT, and GSH/GSSG negatively correlated with both BMI and CDC PC in children with overweight. Conclusions: Malnutrition, especially obesity, is associated with metabolic and OS disturbances in preschool children. It is urgent to design strategies to prevent malnutrition in this age group since this stage of development is crucial to potentially avoid future co-morbidities.

Diverse sleep patterns, psychiatric disorders, and perceived stress in inhalants users living on the streets of Mexico City.

Homeless people face stressful circumstances influencing drug consumption, mental health, and sleep disorders. We performed an interdisciplinary study involving psychometric, polysomnographic, and ethnographic records to relate stress, psychiatric disorders, drug consumption, and sleep in ten people (four women, M = 32 y/o) living on the streets of Mexico City. Toluene-based inhalant dependence and suicidality were the more common psychiatric disorders among participants. They also presented sleep fragmentation; some manifested insomnia or sleep restriction, whereas others displayed extended rapid-eye movement sleep latencies associated with depression or inhalant consumption. Inhalants are used to improve mood, strengthen social bonds, and induce either sleep or alertness during the night. Inter-individual distinctions may be related to differential levels of intoxication, stress perception, backgrounds, and abilities to live and sleep on the street. Sleep restriction seems to be the more common factor, which may enhance the negative consequences of street situation.

Anger and associated experiences of sadness, fear, valence, arousal, and dominance evoked by visual scenes.

Anger is a basic emotion experienced in several aversive situations. In this study, the relation between Anger, Fear, and Sadness, as well as the dimensions of Valence, Arousal, and Dominance, were examined. It was hypothesized that pictures showing an Intention to Harm would evoke not only Anger, but also Fear and Sadness, and that this would be correlated with low Valence, high Arousal, and high Dominance. To this end, 45 healthy volunteers (25 women and 20 men; M age = 27.2 yr., SD = 9.5) recorded appraisals for each of these emotional experience while viewing 120 pictures selected from the International Affective Picture System. Data were analyzed with a linear mixed model and a hierarchical classes approach to identify differences and correlations between emotional categories. Results indicate that those pictures showing Intention to Harm generate higher Anger and Fear, while pictures representing Frustration of Goals leads to higher Sadness. In addition, high Anger, Fear, and Sadness are associated with low Valence, moderate Arousal, and high Dominance. Same sex differences in emotional responses were also found. These findings suggest that the experience of Anger requires the inference of the other's mental and physical state and need the regulation of cognitive and affective systems acting together. The study of this emotion should consider both categorical and dimensional approaches in order to define its coherent features.

Effects of primatological training on anthropomorphic valuations of emotions.

Anthropomorphism implies the attribution of human like emotions and cognition to non-human animals. This tendency may be conditioned by similar morphologies between mammals and is particularly important in primatology. Some neurocognitive findings suggest that prefrontal brain activity associated to conceptual learning influences anthropomorphic judgments, nevertheless, individual differences are also presented indicating that training on primate behavior may influence anthropomorphism. We identified and interpreted brain activity registered by functional magnetic resonance imaging while seven trained primatologists (39.42 ± 10.86 yr.) inferred emotions in human primates, non-human primates and non-primate animals; comparisons were made with seven matched scholars with no primatological training (38.71 ± 9.34 yr.). Primatologists manifested cerebellar, occipital and frontal activity related to sensory and motor processes when valuating humans and non-human primates, but not for other animals. So, primatological training and experience may elicit brain plasticity processes allowing inner motor and sensory models through frontal and cerebellar interactions.

Definition of compassion-evoking images in a Mexican sample.

To assemble a calibrated set of compassion-eliciting visual stimuli, 60 clinically healthy Mexican volunteers (36 women, 24 men; M age = 27.5 yr., SD = 2.4) assessed 84 pictures selected from the International Affective Picture System catalogue using the dimensions of Valence, Arousal, and Dominance included in the Self-assessment Manikin scale and an additional dimension of Compassion. Pictures showing suffering in social contexts and expressions of sadness elicited similar responses of compassion. The highest compassion response was reported for pictures showing illness and pain. Men and women differed in the intensity but not the quality of the compassionate responses. Compassion included attributes of negative emotions such as displeasure. The quality of the emotional response was not different from that previously reported for samples in the U.S.A., Spain, and Brazil. A set of 28 pictures was selected as high-compassion-evoking images and 28 as null-compassion controls suitable for studies designed to ascertain the neural substrates of this moral emotion.

Police culture influences the brain function underlying compassion: a gender study.

Compassion is a prototypical moral emotion supporting cooperation and involves empathic decision-making and motor processes representing the interplay of biologically evolved and cultural mechanisms. We propose a social neuroscience approach to identify gender differences and to assess biological and cultural factors shaping compassion. We consider the police force as a cultural model to study this emotion, because it comprises a mixed-gender group using specific codes for collective safety that influence empathy and cooperativeness. From a sample of Mexican police officers working in a violent environment we integrated ethnographic data categorizing compassionate elements in the officers' activities, psychometric measures evaluating empathic attitudes, and fMRI scans identifying the brain activity related to compassionate experiences and decisions. The results suggest that the police culture influences genders equally with respect to empathic behavioral expressions. Nevertheless, women showed insular and prefrontal cortical activation, suggesting a more empathic experience of compassion. Officers manifested activity in the caudate nucleus, amygdala, and cerebellum, suggesting a more a highly accurate process to infer another's suffering and a reward system motivated by the notion of service and cooperation, both of which are cultural traits represented in the police force.

Parahippocampal gray matter alterations in Spinocerebellar Ataxia Type 2 identified by voxel based morphometry.

Spinocerebellar Ataxia Type 2 (SCA2) is a genetic disorder causing cerebellar degeneration that result in motor and cognitive alterations. Voxel-based morphometry (VBM) analyses have found neurodegenerative patterns associated to SCA2, but they show some discrepancies. Moreover, behavioral deficits related to non-cerebellar functions are scarcely discussed in those reports. In this work we use behavioral and cognitive tests and VBM to identify and confirm cognitive and gray matter alterations in SCA2 patients compared with control subjects. Also, we discuss the cerebellar and non-cerebellar functions affected by this disease. Our results confirmed gray matter reduction in the cerebellar vermis, pons, and insular, frontal, parietal and temporal cortices. However, our analysis also found unreported loss of gray matter in the parahippocampal gyrus bilaterally. Motor performance test ratings correlated with total gray and white matter reductions, but executive performance and clinical features such as CAG repetitions and disease progression did not show any correlation. This pattern of cerebellar and non-cerebellar morphological alterations associated with SCA2 has to be considered to fully understand the motor and non-motor deficits that include language production and comprehension and some social skill changes that occur in these patients.

Brain activity correlated with food preferences: a functional study comparing advanced non-small cell lung cancer patients with and without anorexia.

OBJECTIVE: The aim of this study was to examine the brain activity manifested while non-small cell lung cancer (NSCLC) patients with and without anorexia were exposed to visual food stimuli. METHODS: We included 26 treatment-naïve patients who had been recently diagnosed with advanced NSCLC. Patients with brain metastasis were excluded. The patients were classified into anorectic and non-anorectic groups. Data from functional magnetic resonance imaging based on blood oxygen level-dependent (BOLD) signals were analyzed while the patients perceived pleasant and unpleasant food pictures. The brain records were analyzed with SPM 5 using a voxelwise multiple regression analysis. RESULTS: The non-anorexic patients demonstrated BOLD activation, comprising frontal brain regions in the premotor and the prefrontal cortices, only while watching unpleasant stimuli. The anorectic patients demonstrated no activation while watching the pleasant and unpleasant food pictures. CONCLUSIONS: Anorectic patients with lung cancer present a lack of activation in the brain regions associated with food stimuli processing. These results are consistent with experiences in the clinical environment: Patients describe themselves as not experiencing sensations of hunger or having an appetite.

Violence and compassion: a bioethical insight into their cognitive bases and social manifestations.

This article considers the social problem of violence and the alternative of resolution through cooperation and compassion from the perspective of cognitive neuroscience. Violence is a social problem, the manifestations of which have a biological basis reflected in the development of aggression and the neural mechanisms that regulate it. Cooperation and compassion are two forms of behaviour with similar developmental, cognitive and cerebral regulatory bases to the mechanisms activated in violence, even though they result in radically different forms of behaviour. The article examines violence and compassion as two mechanisms that lead to moral action that depends on whether sociocultural contexts are adverse or favourable to human well-being. It concludes that the neuro-cognitive system is a flexible and adaptable mechanism that regulates behaviour directly, according to the sociocultural context in which individuals live. Against that background, the UNESCO Declarations on the culture of peace refer to concepts relating to cognition or the human mind. Cognitive neuroscience therefore provides tools for creating and changing mental concepts that could eventually enable human beings to live together in peace.

Resonancia magnética funcional en el diagnóstico clínico del déficit de atención y de la agresión impulsiva infantil: Una propuesta exploratoria / Functional magnetic resonance imaging in the clinical diagnostic of the attention deficit disorder and the impulsive aggression in children: An exploratory proposal

Attention deficit disorder (ADD) refers to a neurobehavioral condition commonly initiated in childhood. Its clinical diagnosis involves poor attention, distractibility, difficulties to inhibit motor behaviors and cognitive impulsivity. It is suggested that ADD is classified in two general types correlated with different neurocognitive qualities. One is manifested in executive frontal dysfunctions (ADD). In the other type dominates hyperactivity/ impulsivity (ADHD) and it is associated with deficiencies in working memory and alterations in the dorsolateral prefrontal cortex. Results obtained by using electroencephalography, event-related potential paradigms and voxel brain morphometry suggest anomalies in the brain structure and function correlated with ADD, particularly in the frontal, parietal and temporal cortices, in addition to regions involved in the fronto-estriatal connections. On the other hand, functional magnetic resonance imaging (fMRI) constitutes a technique to obtain brain images which can be interpreted as regions and networks of neural activity elicited during the performance of a cognitive process. Based on the information that the ADD patients are susceptible to cognitive interferences, some researches have applied the classical and the counting versions of the Stroop task paradigms in fMRI. In comparison with control subjects, adult patients show alack of neural activation in the anterior cingulated cortex. Nevertheless, results in children are more controversial and attribute neurobiological and social factors in the ADD etiology. The anterior cingulated cortex and prefrontal region of the human brain conform the execution system of attention and their function is essential for emotional processes. The neurocognitive relation between attention and emotion involves the influence of the affective system in the alert and execution systems of attention through reciprocal connections between limbic and frontal regions, which permit a mnemonic and affective valuation of the attended environment. Understanding the relations between attention and emotion is essential in basic and clinical approaches, due to the co-morbidity of ADD with some emotional disorders, such as the oppositional defiant disorder, anxiety and impulsive aggression, the last one elicited by uncontrolled experiences of anger. In this sense, some studies describe that the metabolic brain activity correlated with the experience of anger is manifested in the frontal, anterior cingulated and insular cortices and the temporal pole. Clinical situations require individualized decisions on the immediate and emergent treatment of one case. Furthermore, when the clinical case refers to a behavioral disorder probably related with neurobiological dysfunctions, a comparison of test with control subjects is necessary. In this sense, the present work constitutes an fMRI study designed to evaluate neurological functional alterations in a child patient diagnosed with ADHD, with persistent severe impulsive aggression behaviors that required a swift evaluation to enhance the diagnosis and treatment proposed by other clinical techniques. Besides the patient, three infant participants were evaluated. One of them was diagnosed with ADD but did not manifest aggressive or impulsive behaviors and was not under any pharmacological treatment. The other two healthy children had no neurological and psychiatric disorders history. All the participants presented similar intellectual coefficient and performed the same cognitive and emotional tests. In the case of the patient, test were applied in two conditions: under the proposed pharmacological treatment and without medication. The attention test consisted in a version of the counting Stroop task in Spanish language, presented in a block design through the E-Prime software. Subjects practiced the task in a personal computer before the functional image acquisition and were trained to answer by using a bottom response system that will be used in the scanner. For the emotional-anger paradigm, children were interviewed about scenes and situations of their personal experience which elicited anger and calm. Situations were ordered and planned in a block design to be executed in the magnetic resonance instrument. During the functional images acquisition children listened to the situations conducted by imaginery techniques. Functional images were acquired in a 1.5 T G.E. instrument in the Magnetic Resonance Unit of the Hospital Ángeles Metropolitano in Mexico City. Data were analyzed by using the SPM 5 software applying a contrast using FWE with p < 0.05. Brain coordinates obtained in SPM 5 were converted to the Talairach Deamond system in order to obtain the Brodmann areas related to those coordinates. During the performance of the counting Stroop task, the patient with ADHD under medication manifested activation in frontal areas, but not during the medication suspension trial. Frontal activity identified in this patient in the treatment trial was similar to that identified in the unaggressive ADD patient. In both cases, ADHD without medication and ADD, a lack of activity was identified in the anterior cingulate cortex (ACC). Nevertheless, activation in ACC, in parietal and temporal regions was present in the aggressive patient under treatment but not in the suspension condition. These results may suggest that an inadequate attention process distort the environment stimuli, which is necessary for the subject's correct affective evaluation of the situation. During the experience of anger, the patient under treatment manifested activity in the parahippocampal region, as well as in the anterior and posterior cingulate cortices. Results discussed in this work agree with those previously reported and offer cues to complement the diagnosis and treatment of ADD/ADHD and their relations with emotional disorders. Particularly, the design used here could be used for the analysis and evaluation of some pharmacological and behavioral treatments clinically applied in ADD. In addition, it helps to understand the participation of multipotential brain regions and neural networks involved in several cognitive processes, such as attention, working memory and emotion. Finally, we proposed some ideas to interpret these results using fMRI and ADD: 1. It is necessary a consensual and standard integration of neuropsychological tests which identify different cognitive qualities of ADD. 2. The selection of children samples to study the neurobiology of ADD must include several variables associated with its etiology, such as parental relations, social and scholar environments. 3. Experimental paradigms could be designed to be performed using different neuroimaging techniques, such as fMRI or event-related potential. Thus, the results of the same test can be used to complement different approaches. 4. Results obtained by fMRI must not be understood in a phrenologycal and deterministic approach, but as brain region activations indicating dynamic neural networks.

El trastorno por déficit de atención (TDA) es un padecimiento neuroconductual iniciado en la infancia, cuyos criterios diagnósticos incluyen dificultades en la inhibición motora e impulsividad conductual. Tomando en cuenta la evidencia de que los pacientes con TDA son susceptibles a la interferencia cognitiva, la técnica de resonancia magnética funcional ha permitido la obtención de imágenes cerebrales que pueden interpretarse como redes de actividad neuronal, las cuales fueron desencadenadas durante la realización de la tarea Stroop o de interferencia. Algunos hallazgos en individuos sanos sugieren actividad predominante en la corteza anterior del cíngulo durante el proceso de atención selectiva requerido en la ejecución de esta tarea, en tanto que pacientes diagnosticados con TDA muestran ausencia de tal actividad. Diversos autores han señalado la relación neurocognitiva entre la atención y la emoción, a partir de la interacción entre estructuras límbicas y regiones frontales del cerebro. En el caso del TDA, esta relación es relevante debido a su comorbilidad con trastornos de tipo emocional, en particular en el caso de la agresión impulsiva. Ésta es desencadenada por estados incontrolables de ira, cuya experiencia inducida se ha correlacionado con la actividad cerebral de la región frontal, del polo temporal, de la corteza anterior del cíngulo y de la ínsula. Ahora bien, en el ámbito clínico es recurrente la necesidad de una evaluación individualizada y la decisión del tratamiento inmediato y urgente de un caso. El presente trabajo muestra un diseño utilizado en la valoración de alteraciones neurológicas funcionales en un paciente infantil diagnosticado con TDA, cuyos repetidos episodios de comportamientos agresivos requerían una evaluación pronta que complementara el diagnóstico y tratamiento provenientes de otras herramientas clínicas. Con un equipo de resonancia magnética de 1.5 T se registró la actividad cerebral del paciente durante la ejecución de una versión en español de la tarea Stroop por conteo y de un paradigma emocional que consistió en la evocación dirigida de escenas que desencadenaran ira en el sujeto. La obtención de imágenes funcionales se real izó tanto bajo el efecto del tratamiento farmacológico que seguía el paciente, como bajo la suspensión del mismo. Después, se comparó la actividad cerebral del paciente con otro caso infantil diagnosticado con TDA, pero sin presencia de comportamientos agresivos. La actividad cerebral de ambos casos de TDA se comparó con la registrada en dos niños con edad y coeficiente intelectual homogéneos, carentes de historial neurológico y psiquiátrico. Ninguno de los participantes manifestó alteraciones estructurales cerebrales. Los resultados funcionales durante la ejecución Stroop identificaron menor actividad en la corteza anterior del cíngulo en los dos casos diagnosticados con TDA. Durante la experiencia del estado de ira y en comparación con los otros participantes, el paciente bajo efecto del tratamiento manifestó actividad en la región parahipocampal, así como en las cortezas anterior y posterior del cíngulo. Los resultados coinciden con hallazgos reportados sobre la neurobiología del TDA y de la experiencia de ira. Además, otorgan herramientas para el diagnóstico y tratamiento de trastornos de la atención y su relación con trastornos emocionales. Este tipo de diseños contribuye al análisis y observación del efecto de algunos tratamientos, tanto farmacológicos como conductuales, aplicados en la clínica del TDA. En este caso, el tratamiento aplicado al paciente parece actuar a nivel del proceso de atención, pero no en el ámbito del control de la ira. También, proporciona pautas para comprender la participación de regiones cerebrales multipotenciales y las redes neuronales que involucran diferentes procesos cognitivos, como la emoción y la atención.

Neurobiología de las emociones morales

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Summary This work presents a critical review of the historical, theoretical, and neurobiological bases of the theory of moral emotions. Neuroimaging methods and protocols used to study the neural correlates of moral emotions and the analysis of the brain functions involved in their processing, permit the formulation of hypotheses that attempt to understand some emotional and cognitive processes related to moral emotions. One such hypothesis refers to a neuro-matrix involving sensory systems, brainstemmediated physiological reactions and frontal brain regions processing the interaction between moral and emotional stimuli. Cross-cultural research on human facial expression has identified universal patterns to express basic emotions such as fear, anger, or happiness. Nevertheless, the experience of some emotions and their facial expressions are regulated by social and cultural mechanisms. This type of regulation is observed in moral emotions since they are linked to the interests or welfare either of society as a whole, or of persons other than the judge or agent. Two typical features that identify moral emotions are their typical elicitors and tendencies towards specific actions. The release of a moral emotion is the perception of implicit and explicit violations of social norms and stereotypes included in personal codes, attitudes, and beliefs. In turn, the actions ensuing from moral emotions are communal or prosocial, because they promote a benefit in others and/or in the social order. Although there is not a definitive taxonomy of moral emotions, four families of prosocial feelings are suggested: a) other-condemning emotions (contempt, anger, disgust); b) self-conscious emotions (shame, embarrassment, guilt); c) other-suffering emotions (compassion); d) other-praising emotions (gratitude, awe, elevation). Such emotions are relevant to the concept of morality because this is a complex representation that includes models of prohibited actions, notions of good and bad, concepts of fairness, ideals of justice, or justifications of punitive actions. Moreover, the cognitive processes and behaviors involved in moral emotions are related to the theory of mind that refers the ability to represent the mental and emotional states of others, such as their thoughts, desires, beliefs, intentions, and knowledge. The neurobiological substrate of this capacity involves cerebral regions related to the experience of basic emotions, such as the amygdala and the cingulated cortex, and regions related to complex cognition and emotional-social contexts, such as the prefrontal cortex and the superior temporal sulcus. Neurobiological approaches to moral emotions have become relevant to study psychopathologies linked to antisocial behaviors, particularly the psychopathic or Antisocial Personality Disorder. Psychopaths show decreased emotional and physiological reactions to emotional stimuli and deficiencies to identify emotional expressions. However, they do not fail to represent or to infer others mental states or theory of mind. Therefore, the psychopathic disorder is not only linked to distortions in interpreting socially-learned moral values, but also to alterations of cognitive processes required to link the affective system to moral values. This assumption is supported by brain-imaging studies demonstrating the involvement of areas associated to the processing of complex social stimulus and language, such as prefrontal cortex, orbitofrontal cortex, polar frontal cortex, and anterior temporal lobe in psychopathic patients. The affected areas also include regions such as the amygdala, ventromedial hypothalamus, thalamus, and caudate nucleus involved in the experience or expression of emotions. Scientific publications directly referring to the neurobiological research of moral emotions and the evaluation of moral judgments occupy a period between 2001 and 2005. The neurobiology of moral emotions has evolved rapidly by the use neuro-imaging techniques such as Functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography (PET). Brain images related to moral emotions are obtained by the use of moral stimuli in three types of situations: (a) while subjects resolve cognitive tasks, for example, reading moral emotional statements, (b) during passive or instructed viewing of affective pictures, or (c) during the resolution of moral dilemmas. The brain areas that become significantly active during these tasks provide a neurobiological interpretation of the mental operations involved in moral emotions. Thus, the medial frontal gyrus is activated during the elaborate personal and impersonal moral judgments produced by viewing moral pictures, attributing intentionality of movement, processing of facial expressions, and during the attribution of mental states (theory of mind). The posterior cingulated, restrosplenial, and precuneus cortex are associated with the elaboration of moral judgments elicited by viewing moral pictures and theory of mind. The superior temporal sulcus and the parietal lobe are related with moral judgments while viewing moral and emotional pictures and films, and attributing intentional movements. The superior temporal sulcus is also associated with the processing of social contexts. Orbitofronal and ventromedial frontal cortex is associated with the processing of simple moral judgments while viewing moral pictures, the evaluation of emotionally-charged social events, during empathy and attribution. The temporal pole is also associated with theory of mind, the elaboration of simple moral judgments and with the recalling of emotional situations. The amygdala is activated during the processing of moral pictures and social events based on facial expressions. Other empirical investigations involving a moral interpretation of data such as studies of general emotions, empathy, theory of mind, neurological disorders, and antisocial behavior, are also relevant to understand the brain activation patterns associated to cognitive and emotional social functions. Working models of psychopathologies that manifest antisocial behaviors are also required to interpret neuroimaging data. Meta-analyses of human behavior and proto-moral behavior in non-human species related to the elaboration of moral judgments and emotions are also relevant for the same purpose. Finally, moral emotion research requires the elaboration of accurate protocols based on psychological approaches directed to elicit particular moral emotions which enable the definition and neural substrates of its specific qualities.