Biopsychiatry and the Mind Douwe Draaisma Weighs up Eric Kandel’S Study on Mental Illnesses As Brain Diseases

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NEUROSCIENCE Biopsychiatry and the mind Douwe Draaisma weighs up Eric Kandel’s study on mental illnesses as brain diseases.

n 1939, nine-year-old Eric Kandel and his family fled Nazi-occupied Vienna for the United States. Eventually entering IHarvard University in Cambridge, Massachu- setts, he intended to train as a psychoanalyst. But he felt that understanding mechanisms such as repression, conceived by fellow Viennese exile Sigmund Freud, demanded knowledge of their neurological under pinnings. So he turned to brain research. RICARDO FUNARI/LIGHTROCKET VIA GETTY RICARDO FUNARI/LIGHTROCKET Kandel’s work in the 1960s — uncovering the circuitry of learning processes by measur- ing neuronal activity in the marine mollusc Aplysia — earned him a Nobel prize. But his first intellectual passion never left him. Over the past 15 years or so, he has attempted to restore prestige and influence to psycho analysis by wedding it to a “new biology of mind”. This, he argues in The Disordered Mind, is aided by three advances: brain imaging, study of how psychiatric disorders are Brain imaging, including magnetic resonance scans, can provide information on psychiatric disorders. inherited and animal models for conditions such as autism spectrum disorder (ASD). schizophrenia, the figure is about 50%, even pharmacological or otherwise. A potentially Like Freud, he probes the unconscious. for twins raised apart. However, genetic stud- beneficial discovery, Kandel shows, is that But for Kandel, these are processes of genetic ies have pointed out that a single mutation on healthy bones make osteocalcin, a hormone development and dysfunctions of neurologi- chromosome 7 increases the chances of devel- that stimulates proteins needed for memory cal circuits. Clearly and concisely, he leads oping autism and schizophrenia. Other, spon- formation. Studies by him and his colleagues us through recent findings and hypotheses taneous, types of mutation are more frequent show that age-related memory decline can on various disorders. Some are neurologi- in the sperm of older fathers, again raising the be reversed when old mice are injected with cal, such as Alzheimer’s, Huntington’s and chances of developing ASD and schizophre- osteocalcin. In humans, exercise builds bone Parkinson’s diseases. Some have been inter- nia. At the genetic level, there might be a close mass, which could improve memory. (To mis- preted as psychiatric, such as depression, relationship between the conditions that fails quote US President John F. Kennedy: “Ask not bipolar disorder and schizophrenia. The to manifest in their expression. what your memory can do for you; ask what modern perspective, he asserts, is that these Kandel notes, however, that in terms of you can do for your memory.”) are ultimately brain disorders. ‘Modern’ brain development, ASD and schizophrenia Kandel’s attempt to biologize psychiatry might be a misnomer: as long ago as 1845, are polarized. From the age of two, children is not for the sensitive; his focus is medica- German psychiatrist Wilhelm Griesinger with autism have been found to have more tion and compensating for faulty wiring, issued the dictum Geisteskrankheiten sind synapses (the contacts between neurons) than not gaining psychological insight into inner Gehirnkrankheiten (mental illnesses are neurotypical children. Thus, autism might be turbulence. At times, he proposes a less-than- brain diseases). But Kandel is right about correlated with insufficient ‘pruning’ of dis- convincing reframing: that because psycho the importance of new tools — the methods, used connections; an excess of synapses could analysis is a learning process, which involves instruments and theories now available that explain the extraordinary long-term memory synaptic changes, the therapy is essentially might open promising of some people with ASD. By contrast, people a biological treatment. However, reading a avenues into psychiat- with schizophrenia have fewer synapses than book or watching a film will bring about syn- ric disorders. do those without, raising the possibility that aptic changes, too — and we wouldn’t count The genetics of ASD excessive pruning could underlie the disorder. either as primarily biological activities. and schizophrenia are A shortage of connections in the prefrontal Bold propositions such as Kandel’s in The a case in point. Autism cortex could cause problems with working Disordered Mind blur the distinction between is often diagnosed memory and higher cognitive functions. therapies involving medication or surgery when a child is three Kandel explores another case in which a and those that use behavioural and cognitive or four. Schizophrenia common genetic change might cause very means. Still, one should appreciate Kandel’s is mostly late-onset, different symptoms: Alzheimer’s and Parkin- humanistic aims: knowing more about dis- developing in The Disordered son’s disease. Mutations associated with Alz- orders makes us less likely to stigmatize those adolescence or early Mind: What heimer’s might result in clumps of misfolded who think or act differently. ■ adulthood. When Unusual Brains proteins in the brain, causing severe memory Tell Us About one identical twin has Ourselves loss. Those associated with Parkinson’s could Douwe Draaisma is professor of the history autism, the chances ERIC R. KANDEL lead to the death of cells that make dopamine, of psychology at the University of Groningen are about 90% that the Farrar, Straus and the neurotransmitter vital for movement. in the Netherlands. other has, too; with Giroux (2018) None of these insights has brought relief, e-mail: [email protected]