Psychosomatic? Motor, cognitive, affective areas of the cerebral cortex influence adrenal medulla

[JohntheJack]

http://www.pnas.org/content/113/35/9922.full

Prof Coyne linked to this study on Twitter.

One of the comments mentions 'CFS'.

There is also an attempt to claim this as a way CBT can help.

I have another theory. My ME started with a virus. I ignored it and 'something happened'. The illness took on a qualitatively different form. I'm most affected neurologically and in my immune system, which is notably weaker.
My take has always been that by not resting (or returning to activity too soon) the body doesn't have the resources to combat the virus, the immune system is damaged and the virus penetrates into parts of the body it normally wouldn't ie the nervous system.

So does this study offer a possible explanation for some of the symptoms: that part of the nervous system is infected, inflamed, damaged in some way (possibly low-grade & so difficult to find evidence for it) and hence the effects throughout the body. Could this study help explain things?

Note: I would then point out that while psychotherapies (and learning the London knowledge etc) are shown to bring about changes in the brain, there is no evidence that they can reverse organic damage, so this theory would not open the door to CBT.

My illness-fogged brain can't really get into the details of this study. Anyone care to comment? I'd be especially interested in hearing from the biologists, doctors, scientists etc.

 

[Simon]

Comments, anyone? @Woolie ?

Significance
How does the “mind” (brain) influence the “body” (internal organs)? We identified key areas in the primate cerebral cortex that are linked through multisynaptic connections to the adrenal medulla. The most substantial influence originates from a broad network of motor areas that are involved in all aspects of skeletomotor control from response selection to motor preparation and movement execution. A smaller influence originates from a network in medial prefrontal cortex that is involved in the regulation of cognition and emotion. Thus, cortical areas involved in the control of movement, cognition, and affect are potential sources of central commands to influence sympathetic arousal. These results provide an anatomical basis for psychosomatic illness where mental states can alter organ function.

 

[A.B.]

It would be good to disprove the null hypothesis (that psychosomatic illness does not exist) before trying to figure out the mechanisms. Psychosomatic illness seems to be nothing more than a hypothesis supported by anecdotes, expert opinion, and extrapolation from ordinary physical sensations during various states of emotional arousal (the "erection argument").

 

[Large Donner]

These results provide an anatomical basis for psychosomatic illness where mental states can alter organ function.

Psychology etc can barely define a "mental state" and agree on what they mean by it let alone then go on to ignore the cause and effect issue that is inherit in subjective labels.

If this above conclusion relies on the mental state being the causative factor to the change of organic function all they have achieved is the observation of a set of situational differences, not proved the notion of showing that a given "mental state" is non organic and then becomes organic.

Don't even get me started on having to rule out all known causes etc of the illness and then just ignoring the fact that there is so much they don't have a clue how to test for.

 

[Cheesus]

@A.B.

Hypothetically speaking, if psychosomatic illnesses did exist, how would someone go about proving it? It strikes me as something that would be very difficult to gather evidence on, regardless of whether or not they exist.

 

[A.B.]

@A.B.

Hypothetically speaking, if psychosomatic illnesses did exist, how would someone go about proving it? It strikes me as something that would be very difficult to gather evidence on, regardless of whether or not they exist.

I'm not sure you can, and that is the point. A pragmatic approach might consist in judging the validity of this concept based on treatment results, and as far as I know, those are poor.

 

[JohntheJack]

Investigators have shown the effects throughout the body of neurological infection. They then speculate that mental states can bring about the same changes. So far comments have focussed on this speculation, which I find uninteresting not least because there is no evidence mental states can have the same effect.

I am much more interested in the actual science: evidence that neurological infection can cause such symptoms throughout the body.

Is that, or something similar, what is happening for some people with ME?

 

[alex3619]

Don't even get me started on having to rule out all known causes etc of the illness and then just ignoring the fact that there is so much they don't have a clue how to test for.

Correct. History shows, overwhelmingly, that claims to psychological causation of disease states have only ever been shown to be physical. Its presumed psychological until proven otherwise, and every few years another disease is removed from the presumed psychological group due to physical causation. Not one psychological causation model has even been proven for any disease.

 

[alex3619]

@A.B.

Hypothetically speaking, if psychosomatic illnesses did exist, how would someone go about proving it? It strikes me as something that would be very difficult to gather evidence on, regardless of whether or not they exist.

Which is the very definition of things that are not science, or are nonscience. Lots of things defy scientific explanation, not just supernatural things like souls, but societal concepts like justice. There is a place for such things, but they do not belong in rational medicine.

 

[Cheesus]

Which is the very definition of things that are not science, or are nonscience. Lots of things defy scientific explanation, not just supernatural things like souls, but societal concepts like justice. There is a place for such things, but they do not belong in rational medicine.

Though being impossible to study doesn't therefore make them non-existant, surely? A lack of evidence is not evidence against.

I'm not defending psychosomatic illnesses. I'm establishing that it is impossible to gain a definitive answer one way or the other with existing technology. We have been attempting to study consciousness for a century yet have so far been unable to identify what or where it is in scientific terms, but i am 100% certain that my own consciousness exists and is an objective phenomenon, and I am fairly confident that exists for the rest of humanity too.

 

[alex3619]

Though being impossible to study doesn't therefore make them non-existant, surely? A lack of evidence is not evidence against.

Correct. I have no issues with psychosomatic illness being considered as an unproven hypothetical construct. That is not how its usually treated though. Its treated as a valid established entity, largely by dogmatic fiat - they defined it therefore its real.

I think a big part of the lack of scientific legitimacy of so very much psychiatry is due to how the research often uses standards far below the usual scientific standards. To advance as a scientific discipline the standards cannot be lowered. Even though the brain is about as complex a thing as we have ever tried to study this is a challenge and not an excuse for poor science and nonscience.

 

[Cheesus]

@alex3619 That seems like a very sensible answer, thanks!

 

[Snow Leopard]

Emotional states have well known effects on bodily function, for example when feeling tired, I decide to lie down.

 

[alex3619]

There is no question that emotions can have a physical impact on brain and behaviour. The issue is what is claimed. The arguments usually used are similar to saying that if one can step a half meter ahead, then one can step from here to Alpha Centauri. If someone wants to make a causal claim they have to show its a valid mechanism, the onus is on them. Otherwise it remains hypothetical.

There is also the issue of making category mistakes. I think depression can be devastating, but I would not want to claim the emotion is a disease. I suspect the opposite is often correct though, that disease can cause the emotion.

I also do not dispute that emotions can induce changes in brain state, and lead to other brain issues, such as with grieving and depression. However I would not want to claim that grieving, or indeed any human emotion or direct consquence, is a disease. Nor would I want to claim that false belief systems are a disease or can cause disease. Otherwise everyone who does not back the same political party / sports team / singer / medical treatment etc. as I do is ill. Clearly.

There is also no doubt that behaviours can modify disease risk. Smoking, sharing of needles for drug users, etc., are behaviours that increase risk. Yet while the behaviour leads to risk, the actual causal factor is the tobacco smoke or contaminants on a shared needle.

Social issues also modify risk. The three big issues in BPS theory are obvious, but again the problem is whether or not they overstate the claims. I would also like to add that the physical environment, not just the social environment, also modifies risk.