Listen up, doc: Empathy raises patients’ pain tolerance

A doctor-patient relationship built on trust and empathy doesn’t just put patients at ease – it actually changes the brain’s response to stress and increases pain tolerance, according to new findings from a Michigan State University research team.

Medical researchers have shown in recent studies that doctors who listen carefully have happier patients with better health outcomes, but the underlying mechanism was unknown, said Issidoros Sarinopoulos, professor of radiology at MSU.

“This is the first study that has looked at the patient-centered relationship from a neurobiological point of view,” said Sarinopoulos, the lead researcher. “It’s important for doctors and others who advocate this type of relationship with the patient to show that there is a biological basis.”

Published in the journal Patient Education and Counseling, the study was part of a broader effort at MSU, led by professor of medicine Robert Smith, to establish standards for patient-centered health care and measure its effectiveness.

“Medicine has for too long focused just on the physical dimensions of the patient,” said Smith, who co-authored the paper. “Those clinical questions are important and necessary, but we’re trying to demonstrate that when you let patients tell their story in an unfettered way, you get more satisfied patients who end up healthier.”

Your Brain in Love

Men and women can now thank a dozen brain regions for their romantic fervor. Researchers have revealed the fonts of desire by comparing functional MRI studies of people who indicated they were experiencing passionate love, maternal love or unconditional love. Together, the regions release neuro­transmitters and other chemicals in the brain and blood that prompt greater euphoric sensations such as attraction and pleasure. Conversely, psychiatrists might someday help individuals who become dan­gerously depressed after a heartbreak by adjusting those chemicals.

Passion also heightens several cognitive functions, as the brain regions and chemicals surge. “It’s all about how that network interacts,” says Stephanie Ortigue, an assistant professor of psychology at Syracuse University, who led the study. The cognitive functions, in turn, “are triggers that fully activate the love network.”

(Graphics by James W. Lewis, West Virginia University (brain), and Jen Christiansen)

Human Evolution Enters an Exciting New Phase

“Most of the mutations that we found arose in the last 200 generations or so. There hasn’t been much time for random change or deterministic change through natural selection,” said geneticist Joshua Akey of the University of Washington, co-author of the Nov. 28 Nature study. “We have a repository of all this new variation for humanity to use as a substrate. In a way, we’re more evolvable now than at any time in our history.”

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Alcoholic fly larvae need fix for learning

Fly larvae fed on alcohol-spiked food for a period of days grow dependent on those spirits for learning. The findings, reported in Current Biology, a Cell Press publication, on November 29th, show how overuse of alcohol can produce lasting changes in the brain, even after alcohol abuse stops.

The report also provides evidence that the very human experience of alcoholism can be explored in part with studies conducted in fruit flies and other animals, the researchers say.

"Our evidence supports the long-ago proposed idea that functional ethanol tolerance is produced by adaptations that counter the effects of ethanol, and that these adaptations help the nervous system function more normally when ethanol is present," says Brooks Robinson of The University of Texas at Austin. "However, when ethanol is withheld, the adaptations persist to give the nervous system abnormal properties that manifest themselves as symptoms of withdrawal."

Robinson and his colleagues found that alcohol consumption, at a level equivalent to mild intoxication in humans, at first impeded learning by fly larvae. More specifically, those larvae had some trouble in associating an unpleasant heat pulse with an otherwise attractive odor in comparison to larvae that had not been drinking alcohol.

After a six-day drinking binge, however, those larvae adapted and could learn as well as normal larvae could. In fact, the alcohol-adapted animals learned poorly when their ethanol was taken away from them. And, when given alcohol back, their learning deficit was erased.

Robinson says that the findings are the first proof of cognitive ethanol dependence in an invertebrate, suggesting that some of ethanol’s ability to change behavior must begin at the cellular level. After all, flies and humans share many of the same features at the level of individual neurons, and not so much in terms of the way those neurons are put together into working circuits.

Origin of intelligence and mental illness linked to ancient genetic accident

Scientists have discovered for the first time how humans – and other mammals – have evolved to have intelligence. Researchers have identified the moment in history when the genes that enabled us to think and reason evolved.

This point 500 million years ago provided our ability to learn complex skills, analyse situations and have flexibility in the way in which we think. Professor Seth Grant, of the University of Edinburgh, who led the research, said: “One of the greatest scientific problems is to explain how intelligence and complex behaviours arose during evolution.”

The research, which is detailed in two papers in Nature Neuroscience, also shows a direct link between the evolution of behaviour and the origins of brain diseases. Scientists believe that the same genes that improved our mental capacity are also responsible for a number of brain disorders.

"This ground breaking work has implications for how we understand the emergence of psychiatric disorders and will offer new avenues for the development of new treatments," said John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, one of the study funders.

The study shows that intelligence in humans developed as the result of an increase in the number of brain genes in our evolutionary ancestors. The researchers suggest that a simple invertebrate animal living in the sea 500 million years ago experienced a ‘genetic accident’, which resulted in extra copies of these genes being made.

This animal’s descendants benefited from these extra genes, leading to behaviourally sophisticated vertebrates – including humans. The research team studied the mental abilities of mice and humans, using comparative tasks that involved identifying objects on touch-screen computers.

Researchers then combined results of these behavioural tests with information from the genetic codes of various species to work out when different behaviours evolved. They found that higher mental functions in humans and mice were controlled by the same genes.

Childhood trauma leaves mark on DNA of some victims

Abused children are at high risk of anxiety and mood disorders, as traumatic experience induces lasting changes to their gene regulation. Scientists from the Max Planck Institute of Psychiatry in Munich have now documented for the first time that genetic variants of the FKBP5 gene can influence epigenetic alterations in this gene induced by early trauma. In individuals with a genetic predisposition, trauma causes long-term changes in DNA methylation leading to a lasting dysregulation of the stress hormone system. As a result, those affected find themselves less able to cope with stressful situations throughout their lives, frequently leading to depression, post-traumatic stress disorder or anxiety disorders in adulthood. Doctors and scientists hope these discoveries will yield new treatment strategies tailored to individual patients, as well as increased public awareness of the importance of protecting children from trauma and its consequences.

The Brain: The Charlie Brown Effect

I am sitting in a darkened, closet-size lab at Tufts University, my scalp covered by a blue cloth cap studded with electrodes that detect electric signals from my brain. Data flow from the electrodes down rainbow-colored wires to an electroencephalography (eeg) machine, which records the activity so a scientist can study it later on.

Wearing this elaborate setup, I gaze at a television in front of me, focusing on a tiny cross at the center of the screen. The cross disappears, and a still image appears of Snoopy chasing a leaf. Then Charlie Brown takes Snoopy’s place, pitching a baseball. Lucy, Linus, and Woodstock visit as well. For the next half hour I stare at Peanuts comic strips, one frame at a time. The panels are without words, and while sometimes the action makes sense from frame to frame, at other times the Peanuts gang seems to be engaging in a series of unconnected shenanigans.

At the same time, a freshly minted Ph.D. named Neil Cohn is watching the readout from my brain, an exercise he has repeated with some 100 subjects to date. Many people would consider tracking Peanuts or Calvin and Hobbes comic strips unworthy of scientific inquiry, but Cohn begs to differ. His evidence suggests that we use the same cognitive process to make sense of comics as we do to read a sentence. They seem to tap the deepest recesses of our minds, where we bring meaning to the world.

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