Derived through the dual focus of psychology and neuroscience, disciplines such as Affective Neuroscience and Neuropsychoanalysis may offer new directions of approach to many pathologies, which demonstrate psychical and somatic etiology. Insights gained from these two trustworthy yet still peripheral scientific disciplines, are deserving of consideration and exploration. It is the purpose of this paper to offer up several such possible new avenues of exploration, as they relate to depression, Obsessive Compulsive Disorder (OCD), and Parkinson’s Disease (PD). The basic therapeutic focus in deriving these proposed new clinical approaches is twofold: 1) Deep Brain Stimulation (DBS) and 2) Mnemic alteration via neuropeptide assisted therapy producing positive relative adjustment in the balance of basic sympathetic (dopaminergic) and parasympathetic affective circuitry independent of drugs or surgery. New conductance level and target strategies designed to prevent homeostatic degeneration are advanced under the concept of homeostatic conductance . New electrical stimulation targets are suggested, which restore basic rhythmic balance between pathologically affected and unaffected brain areas. In this way, we offer up new directions for research, strategies for noninvasive and nontoxic potential therapies and new targets/ approaches to DBS therapy.
New approaches to pathologies as diverse as depression, OCD and Parkinson’s may be derived through study of the interactivity between psyche and soma. There is a great wealth of information and work which has been accrued detailing well known DBS approaches to Parkinson’s [
1) First we will introduce in a general way the most basic and fundamental sympathetic dopaminergic and parasympathetic noradrenergic socio-affective circuitry associated with the SEEKING system [
2) Next, we will detail two new approaches which offer potential reorientation of systemic functioning without adversely affecting homeostasis, so as to minimize homeostatic reactive degenerative deterioration. The first new approach is a manual rhythmic entrainment of pathologically affected areas based on those unaffected by degeneration. The second, is a restorative homeostatic approach which stimulates and places demand on the substantia nigra (SN) via efferent projections arising from the nucleus accumbens-septi. Two related secondary approaches (designated a. and b.) are also discussed.
3) Lastly, a more detailed extensive psychological and developmental circuit analysis will clarify a new non- invasive, non-toxic methodology, which may allow the partial amelioration of these diverse pathologies, as a function of hippocampal mnemic instantiation (and memory consolidation) assisted in its process plasticity via safe neuropeptide, altering internal dopaminergic distributions.
We assert: Following an affective psychologically contextualized model of human development and distributed anatomical allocation is vital in securing new directions of approach.
Dopaminergic innervations projecting between the limbic and orbito-frontal regions are established as a product of neuroendocrine changes initiated via the dyadic exchange of (touch), gaze and glance shared by the mother and infant, forming the dopaminergically modulated sympathetic ventral tegmental limbic circuit within the first 18 months of life (Schore as cited in [
Most approaches to DBS use high frequency electrical stimulation to gain effective results. We propose that the homeostatic basis of coordinated systemic functioning is thereby disrupted, and an approach which suits conductance levels and targets to the maintenance of homeostatic priority, may yield positive long lasting results, with less treatment induced systemic deterioration. This is the meaning of “homeostatic conductance”. Conductance levels, targets and approaches for DBS should not disturb (and/or may reestablish) homeostasis and coordinated intrasystemic functioning. This is the principle of homeostatic conductance.
The mysterious fact that (bilateral) Deep Brain Stimulation (DBS) of the subthalamic nucleus, thalamus, or globus pallidus, which by the reasoning of cognitive neuroscience ( [
The Ventral Tegmental Area, unlike the Substantia Nigra, does not suffer degenerative necrosis in PD [
As stated above, we believe that there is a homeostatic factor such that feedback in the system has been a causally contributing dynamic element stemming from parasympathetic/repressive over-activity, and has all but “requested” the condition to emerge. So, if the dopaminergic motor contributions and those of the SEEKING system are stimulated with relatively intense electrical activity as it is now used in DBS regimens for Parkinson’s, OCD and depression, then the system once aided, will re-balance to decay further. Instead, the progression of disease and degeneration may hypothetically be aided to resuscitation, or at least to end further degeneration, by another more subtle approach. We suggest several possibilities: The SEEKING (A-10) dopaminergic neurons project from the ventral tegmental area. If the system were stimulated here, or along the usual MFB-LH circuitry as in animal studies, or better still, at the superolateral branch of the medial forebrain bundle [
a) Naturally occurring systemic intervention might be simulated with DBS. Along with therapy designed to lessen repressive psychological structuralization (see below), encouragement may be offered to the system. SEEKING activation is associated with heightened activity in the nucleus accumbens [
b) A neuropeptide may be formulated so as to be deliverable to neural targets which activate the system… neurotensin for example ( [
Pharmacology alters pathology by chemical influence of the electrochemical mediation of biological circuitry. DBS alters pathology by electro-conductive intervention altering the activity of biological circuitry. We wish to propose, that said circuitry may be altered to reduce pathology, by way of hippocampal plasticity, and mnemic instantiation. We will place this in the context of a condensed new theoretic structure [
The quality of experience, the hard problem of consciousness as it is known, might be understood rightly as a function of associative mnemic instantiation [
a) It requires the user to master a self-psychoanalytic technique which is psychically invasive.
b) Said technique is useful in cases of hysteria, but appears to be unavailable to many, specifically those who present with OCD due to high functioning repressive dynamism.
c) Said technique requires many deeply painful regressions to gain full efficacy.
d) Said technique requires the access of deeply repressed formative memories, so as to create regressions.
However, much can be gained by close examination and analysis of the functional end of re-polarization theory. These insights will serve us well as we tread this new pathway.
It will be helpful to create a working analogy, a schematic model for ego processes, which can be functionally ascribed to neuroanatomical coordinations extending systemic connectivity associated with the Default Mode Network [
The designation non-commutative refers to the notion that the order of topographic assembly and relation is a functional contributor to manifest outcome. Ego often carries out the repressions of super-ego, and is therefore structured so as to mediate resistance to, and distributions of, affect. As the process of mnemic re-polarization takes place, we can learn much by examining the particulars of the process. It is to be noted that although even one or two regressions are therapeutically demonstrable in the amelioration of pathology to some substantial degree, 30 or more regressions are needed for the full effect to become solid. A full mnemic re-consolidation then, simply by looking at those familiar numbers, is likely a function of hippocampal mnemic instantiation, and subsequent hippocampal-neocortical consolidation ([
We wish to suggest a new method whereby the “experiential template” may be topographically re-defined and pathology lessened, without need for direct regressions, drugs, DBS or the direct access to unconscious repressed material. A process of substitutive mnemic alteration by partial regressive augmentation is implied. This may well allow some great measure of healing, by closely approaching the cause.
Schore has discovered two circuits which are primary in development, and function in opposition to each other: the dopaminergically modulated sympathetic ventral tegmental limbic circuit, and the noradrenergically modulated lateral parasympathetic tegmental limbic circuit [Schore as cited in [
“It is hypothesized that maternal regulated high intensity socioaffective stimulation provided in the ontogenetic niche, specifically occurring in dyadic psychobiologically attuned, arousal amplifying, face to face reciprocal gaze transactions, generates and sustains positive affect in the dyad. These transactions induce particular neuroendocrine changes which facilitate the expansive innervation of deep sights in orbitofrontal areas, especially in the early maturing visuospatial right hemisphere, of ascending subcortical axons of a neurochemical circuit of the limbic system??the sympathetic ventral tegmental limbic circuit.” (Schore as cited in [
The famous studies from the 1940’s conducted by Spitz ( [
The contrary circuit, the parasympathetic lateral limbic circuit, is to be thought of as a balance, a cut off, a competing inhibitory system to counter the rewarding energetic expression of the sympathetic circuit ( [
As we have stated, we propose improper excessive repressive/parasympathetic balance between these two circuits, may well have a fundamental and in some degree causative influence in creating pathology [
Why access memory with symbolism, and what would such a symbol associated with primary dopaminergic circuitry be?
As the infant progresses through the initial 18 month period during which the sympathetic and parasympathetic limbic circuits are fully formed, the infant masters several stages of differentiation. It is now accepted through the work of Klein (1952) [
Next please recall that all the world is given its quality and definition by way of symbolism [
“Please relax, hear, the water, and listen to my voice. There is a meadow, within the forest, surrounded by trees, stirring, a distant breeze. The day is still and quiet. Listen to the shining brook, spilling itself, over smooth rock and sand, listen, as it splashes, so near the meadow.
The sun is pouring down upon your face, shining and warm, golden and loving is this light, a light you are folded into, and have created, shining, pouring back up into the arch of heaven, spilling up from your glad face, and again down to fill you, the trees nodding as you dream them, the sky golden and warm as you have poured it??and back around??for it has dreamt you…now as the world, of the world, nourished and warmed, the circle complete, a round of golden warmth and light, spilling into the world and returning again, unto you, and again, you unto it…and all the world is eternal, safe, nourished and nourishing, a circle of happiness, pouring down and returning, warm and sweet, the circle glowing, life spilled round into warmth??and golden light.”
We will note at this point that this approach in the context of re-polarization has proven highly effective, and add that the image may be associated with a piece of music, and that this music once brought to mind, creates the effect as easily as the image. We will clearly admit that it may be possible to use the unsymbolized image, although we believe it is unlikely.
Oxytocin has been demonstrated to induce hippocampal plasticity and augment social bonding [
1) The patient is given Oxytocin, and perhaps a light dose of hypnotic sedative or other compound to encourage a hypnoid state.
2) Once positioned in a reclined posture under dim light with eyes closed, the image is (hypnotically) presented, perhaps along with a piece of favored music.
3) The patient is instructed to recall the image and music, and keep the image and music in the back of their mind at all times. The patient is instructed to invigorate the image in their mind under conditions of stress, as a coping strategy.
4) The therapy is repeated as often as needed to add new layers of increased cathexis to the formative maternal attachment dynamic.
5) This should increase the coveted psychical contributions of alpha function, through reorientation of the pathogenic topography of the ego itself, by substituting healthy unconscious dynamics in the non-commutative template hierarchy for unhealthy contributions forming the transference: alteration of the basic sympathetic/ parasympathetic limbic/orbitofrontal circuitry balance toward dopaminergic predominance.
1) Although it is not necessary for the technique to be effective, we predict that if tested, this method will reveal specific pieces of epigenetic (unconscious/phylogenetic) information to be suppressed by way of this procedure, and others expressed [
2) We predict that this method will not require the addition of toxic drugs in the usual high doses, as the persistence and presentation of memory are the efficacious therapeutic mechanisms.
3) We predict in cases of LRRK2 mutation, this therapy may well have a prophylactic effect in preventing, or perhaps delaying, the onset of active Parkinsonian symptoms.
1) Sympathetic/parasympathetic dopaminergic/noradrenergic balance between opposing basic affective regulatory circuitry associated with the “SEEKING system”, guilt and repression, may well be an unacknowledged causal contributing element in diverse pathologies such as depression, OCD, and PD: This “parasympathetic pathological genesis” is the parasympathetic basis of pathology to be curatively altered.
2) Conductance levels, targets and approaches for DBS should not disturb (and/or may reestablish) homeostasis and coordinated intrasystemic functioning. This is the principle of homeostatic conductance.
3) Re-entrainment of the pathologically degenerative SN rhythmic output in PD via DBS, to the rhythm of the unaffected VTA (or mutual SN/VTA electro-rhythmic re-entrainment) is predicted to ameliorate pathology.
4) Efferent projections from the nucleus accumbens-septi to the SN may account for predicted improvement in PD and other pathologies over time when DBS is applied to the superolateral branch of the medial forebrain bundle under conditions of homeostatic conductance.
5) a) Low level septal stimulation in keeping with homeostatic conductance may improve PD and other pathology; b) Delivery of neurotensin or kappa blockers may improve PD and other pathology.
6) Hippocampal plastic mnemic therapy may ameliorate the diverse pathologies specified, by way of internal mnemic restructuralization and subsequent up-mediation of coordinated dopaminergic and endogenous opioid distributions without necessitating recourse to surgery or toxic drugs.
DBS sections:
a) For OCD, the ventral capsule/ventral striatum is the typical DBS target. It is known that the ventral capsule/ ventral striatum are also stimulated from DBS applied to the superolateral branch of the medial forebrain bundle [
How long will it take for a low level homeostatic approach to take effect, and how effective will it be?
b) Studies have demonstrated extensive dopaminergic systemic destruction yielding depressive symptomatology in rodents, can be ameliorated via bilateral MFB DBS [
c) Is it possible to establish a baseline subject specific metric for sympathetic/parasympathetic limbic/orbito- frontal balance [
d) Some studies seem to indicate that chronic DBS may have little deleterious effect [
Hippocampal plastic mnemic therapy section:
a) It is possible that an unsymbolized version of the image will be more effective.
b) It is possible that a surrogate therapist may provide physical contact to augment the process to greater effect in some cases.
c) It is possible that this approach could help schizophrenics. If maternal inconsistency is at the fount of schizophrenia, patients may be aided in intensive therapy. Schizophrenia appears in some studies to be responsive to Oxytocin [
d) Other images each detailed to meet the specific maternal and paternal infantile needs of the particular patient may be used.
e) Other images of maternal interactivity resonant with the innervation of the primary dopaminergic sympathetic circuitry can be derived.
f) Default Mode Network (ego) [
g) Head gear which uses sound and visual imagery may be effective.
h) Full regressions used to augment re-polarization proper may possibly be encouraged with the use of 5-HT blocking agents, or other psychoactive compounds if closely supervised.
i) Additive cathexis associated with therapeutically derived archetypal structure may be augmented [
j) In the case of “h” above, secondary therapeutic mnemic content may counteract pathology associated with neurotic super-ego at the source level.
New approaches based on the trustworthy disciplines of Affective Neuroscience and Neuropsychoanalysis are worthy of serious exploration. Homeostatic conductance may offer us a guideline for new directions and strategies using DBS for OCD, depression and Parkinson’s. Reorientation of the basic affective regulatory circuitry in man, through chemical, electro-stimulatory and new noninvasive means, may offer productive avenues of approach yielding pro-dopaminergic adjustment of a heretofore unacknowledged causal element in pathology: Limbic/Orbitofrontal parasympathetic activational predominance in basic affective circuitry. To address this neglected element may provide new fruitful directions toward the treatment of a variety of somatic, psychological and interrelated pathologies.
Richard LawrenceNorman, (2016) Homeostatic Conductance and Parasympathetic Basis Alteration: Two Alternative Approaches to Deep Brain Stimulation in Parkinson’s, Obsessive Compulsive Disorder and Depression. World Journal of Neuroscience,06,52-61. doi: 10.4236/wjns.2016.61007