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Neuroimaging and intersubjectivity in psychiatry

Knut Schnell Dep. Of General Psychiatry Translational Psychiatric Therapy Research. Neuroimaging and intersubjectivity in psychiatry. Mission: Illustrate the principles of experimental Psychopathology of intersubjective functions. Concepts of Intersubjective functions

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Neuroimaging and intersubjectivity in psychiatry

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  1. Knut Schnell Dep. Of General Psychiatry Translational Psychiatric Therapy Research Neuroimaging and intersubjectivity in psychiatry

  2. Mission: Illustratetheprinciplesof experimental Psychopathologyofintersubjectivefunctions • ConceptsofIntersubjectivefunctions • Experimental psychopathologyofToM- andEmpathyfunctions: ToM, Empathy • Experimental modelofpsychotherapy-effects on intersubjectivefunctions in (chronic) Depression: Perceivedfunctionality

  3. Social brain Hypotheses (Brothers 1990, Dunbar 1998) Expansion of brain driven by social demands Positive correlation of neocortex expansion and size of social groups in primates (Dunbar 2003, reprinted from Barrett et al. 2002) (Adolphs 2003)

  4. Mission

  5. Proposed intersubjective functionsin humans • Imitation, RepresentationofIntentionsMirror Neurons • Sharing Feelings Empathy • Representing mental contentTheory of Mind • Recognizing interpersonal effectsPerceivedFunctionality • Joint attention …

  6. Mirrorneurons in primates Imitation Representation of Intentions Iacoboni & Dapretto NRN 2006 adapted from Rizzolatti et al. 2001

  7. Intention, not movement or objects coded Iacoboni & Dapretto NRN 2006 adapted from Iacoboni et al. 2005 Iacoboni & Dapretto NRN 2006 adapted from Iacoboni et al. 1999 Mirror-Neurons in Humans

  8. Motor contagion Interference with observed motion depends on self-reference (human/non-human) Fig. 1. Experimental design. Subjects made sinusoidal movements with their right arm at the same time as observing movements that were either congruent or incongruent with their own movements. In each condition, the subject (S) was instructed to make sinusoidal movements of their right arm from the shoulder, which were either vertical or horizontal at a rate of 0.5 Hz. While making these arm movements, the subject observed movements made by another effector situated facing the subject, either the right arm of the experimenter (E) or a robotic arm (R), that were either congruent or incongruent with the executed movements. In addition, there were two baseline conditions in which the subject moved their arm either horizontally or vertically without watching anything. Kilner, J. M., Paulignan, Y., & Blakemore, S. -J. Current Biology, (2003)

  9. Theory of Mind • Ability to understand, that other subjects have mental states (desires, beliefs, emotions), to recognize such mental states and to act on this basis • Develops between 3. and 4. years of age

  10. Imaging of ToM-functions in humans Stories(Fletcher et al., 1995) Cartoons (Gallagher at al., 2000) Comic strips (Brunet et al., 2000)

  11. Neuroanatomy of the ToM-network TPJ temporoparietal junction STS Sulcus temporalis superior OFC Lateral Orbitofrontal Cortex mPFC anterior medialPFC

  12. Empathie: Definition • The Ability to share the feelings of another human being without direct Stimulation by affective stimuli • For Basic Emotions like fear and happiness and complex emotions like guilt • Restrains humans from aggressve behaviour, can motivate altruistic behaviour

  13. Hein & Singer defineempathy “as an affectivestate, causedby sharingoftheemotionsorsensorystatesofanotherperson” (Hein and Singer, 2008).

  14. Empathy in mice?

  15. In contrasttoaffectivecontagion, empathyisboundtothe individual awarenessthat a specificemotion was primarilyinitiated in theotherperson (Hein and Singer, 2008).

  16. Empathy in Humans Singer et al. 2004 Shared activation for pain experience of the partner Empathy= SharedPain?

  17. In contrastto Hein & Singers restrictivedefinitionofempathy, mentalizingisdefinedby Frith & Frith as“theprocessbywhichwemakeinferencesabout mental states” (Frith and Frith, 2006) anddoes not onlyincludetheinferenceaboutanotherpersons’ motivational statesandbeliefs but also the immediate recognitionandthecognitiveinferenceaboutotherpersons’ emotional states.

  18. Empathy for pain subsequent to social interaction in women and men Activation of Nc. Acc. by pain of unfair players in women and men Empathie after social Interaction Singer et al. 2006 Relation between Self-Reported Empathy and Motor IdentificationwithImaginedAgents Marzoli et al., 2011

  19. Simulation-Systems: Sharedexperiencebyisofunctionalactivationoflimbicandsensorimotorregions (AI, ACC, or SII) duringobservationof a feeling, actingandperceiving human subject Theory-Systems: Mental State Attribution/Mentalisingbyfunctionalnetworkofsocialinference: medialem PFC , inferior parietal and superior temporalem Cortex andesp. TPJ

  20. EmpathicAccuracy: Correlationbetweenratedtimecourseofaffectivestatesfromfilmedtargetparticipantsandperceivers (viewers)

  21. AccuracyiscorrelatedwithbrainactivityduringvideopressentationAccuracyiscorrelatedwithbrainactivityduringvideopressentation

  22. Theory of Mind regionsoverlapwithemotionprocessingregions Brunet-Gouet & Decety, 2006

  23. Isthere an overlapbetweenToMandEmpathy? Doesthetermterm “cognitive empathy” (Preston and de Waal, 2002) represent a meaningfulneurofunctionalconcept WhatarethefunctionsofSTS, TPJ, OFCandmPFC? TPJ temporoparietal junction STS Sulcus temporalis superior OFC Lateral Orbitofrontal Cortex mPFC anterior medialPFC

  24. Paradigm Demands • A Paradigm: • Distinctionofperspectiveandaffectivecontent • Noimmediatelycontagiousaffectivecontent • Randomizedstories/instructions Design difference? - = + difference? - = + „Instruktion“ 32 stories 6.5 sec 8.5 sec 8.5 sec 8.5 sec

  25. Nur für Bild 2 und 3 relevant!

  26. - = +

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  28. Design (questions / storiesrandomised)

  29. Nur für Bild 2 und 3 relevant!

  30. - = +

  31. - = +

  32. Nur für Bild 2 und 3 relevant!

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  35. Nur für Bild 2 und 3 relevant!

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  38. Results Main effectofaffectivecontent: Activationof anteriorer partsofToMnetwork

  39. Results Main effectof 3rd Person Perspective Activationof posterior ToM Network, TPJ, FEF, Precuneus

  40. Results Simple effects V isuospatial; A ffective 1. Person; 3. Person

  41. Results Interaktion V isuospatial; A ffektiv 1. Person; 3. Person

  42. Finally:„cognitive empathy“ can be renderered as a defined neurophysiological functional state, which is not „cold“ but rather linked to the activation of the amygdala.

  43. Experimental psychopathologyofToM- andEmpathy-functions • Impaired Inference on the mental states of others: • in autismspectrumdisorders (Baron-Cohen, 2001) • in affectivedisorders (Inoue et al., 2006; Kerr et al., 2003) • in schizophrenia (Brunet-GouetandDecety, 2006; Walter et al., 2009) • defined as an explicit target for psychotherapy (Bateman and Fonagy, 2008).

  44. soziale Kognition Störungen der selektiven sozialen Selbst-/Fremdreferenz • Paranoid delusions associated mit Attributional Bias: Erklärung von aversiven Ereignissen durch den Einfluss anderer. Martin & Penn 2002 • Störung der mentalen Perspektivübernahme bei schizophrenen Patienten. Sprong et al. 2007, Bora et al. 2009 - = + - = + Fühlt sich die Hauptperson besser, genauso oder schlechter als im Bild zuvor? > Sind mehr, gleichviele oder weniger lebende Wesen abgebildet als im Bild zuvor?

  45. soziale Kognition Effectof a geneticPolymorphismu (rs1344706) associatedwithincreasedriskforschizophreniaduringselectiveperspectivetaking > Main Effect n=109 Gesunde Geneticallydeterminatedfunctioanlimpairmentofselective Selbst-/Other-perspectivetakingas a mediatorofschizophreniarisk? Walter*, Schnell*, Erk* et al, 2010, Mol. Psychiatry

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