The Copernican revolution in psychiatry will come when mental disorders will be defined by their underlying brain disturbances. In other words, when the causes of mental disorders are discovered.
This is a true revolution because once known, mental disorders can be more effectively treated and could lead to cures for psychiatric illnesses.
NeuroAnalysis with Clinical Brain Profiling (CBP) is a novel diagnostic method that reformulates mental disorders neuroscientifically by assigning specific globalopathies to the phenomenology of mental disorders.1,2
Globalopathies are disturbances to whole-brain organizations, and thus can spread among vast brain neural networks.3 Detailed descriptions of CBP diagnosis of mental disorders have previously been published.4,5 A brief summary of the method follows.
Current neuroscientific knowledge allows for the formulation of brain-related diagnoses for mental disorders. The brain develops from infancy to adulthood, and beyond, by a process of “experience dependent plasticity.”
This process enables synapses to form connections among neurons (i.e., plasticity) based on their activations by the experience of incoming stimuli. Such activity enables experience to shape neuronal network organizations in the brain and encode life experiences in the form of memories which are actually synaptic connection strengths.
Thus, every brain develops an internal model (or representation) of the outer world, or internal “object relationships” as psychologists term them, to explain personality traits, behaviors, and reactions. These internal representations serve as guiding maps of our experiences and predictions of actual occurrences.
“Optimization” is when internal predictions match real occurrences (for example, predictive errors ).6 Inversely, in “de-optimization,” there is a mismatch between internal expectation and actual occurrences. Optimization dynamics are considered a characteristic of global plasticity. Any reduction in plasticity will hamper optimization dynamics and cause depression.7
This link to plasticity is evident from antidepressant medications that are known to have plasticity inducing effects.8 Plasticity also stabilizes the brain system, producing a calm tranquil sensation as opposed to anxious sensations that emerge from perturbed unstable neuronal networks.9
Finally the brain needs to function and maintain optimization in the face of continued perturbations and instabilities generated by the computational load. The optimal (healthy) brain archives small-world network organization, which balances connectivity and hierarchy. When connectivity is disturbed, it can cause disconnection and over-connection disturbances.
These are clinically expressed as disorganization psychosis, or perseverative stereotype deficiency syndromes, respectively. When hierarchy is disturbed, it can collapse leaving the brain deprived of higher level functions. Alternatively, top-down biases can create delusions that may even become systemic.10
When translating clinical phenomenology to brain disturbances, we assign the diagnosis of schizophrenia and psychosis to connectivity perturbations of the brain. We assign mood and anxiety disorders to disturbances of brain plasticity resulting in disturbed optimization dynamics. Finally, we assign the phenomenology of personality disorders to immature, biased unstable resting state networks.
|Clinical Brain Profiling Parameters|
|Symbol||Brain Disturbance||Assumed Clinical Correlate|
|RS DMN||Undeveloped disturbed resting state (RS) default mode network (DMN) organization||Personality disorders|
|D||Deoptimization dynamic shift||Symptoms and signs of depression|
|O||Hyper-optimization dynamic shift||Symptoms and signs of mania|
|CF||Constrain frustration||Symptoms and signs of anxiety|
|CFb||Stimulus bound constrain frustration||Symptoms and signs of phobias|
|Cs||Disconnectivity dynamics||Psychosis and positive signs schizophrenia|
|Ci||Overconnectivity dynamics||Repetitive poverty ideation perseverations|
|Hbu||Hierarchical bottom-up insufficiency||Avolition and negative signs schizophrenia|
|Htd||Hierarchical top-down shift||Systemized organized delusions|