Study discovers how brain controls accents and impersonations

http://www.sciencedaily.com/releases/2013/06/130618113854.htm

when a voice is deliberately changed, it brings the left anterior insula and inferior frontal gyrus (LIFG) of the brain into play. The researchers also discovered that when comparing impersonations against accents, areas in the posterior superior temporal/inferior parietal cortex and in the right middle/anterior superior temporal sulcus showed greater responses.While past work has found that listening to voices activates regions of the temporal lobe of the brain, no research had explored the brain regions involved in controlling vocal identity before this study.

Scan of the Insula Predicts Whether CBT or SSRI's Will Best Lift Depression

Scan Predicts Whether Therapy or Meds Will Best Lift Depression
http://www.sciencedaily.com/releases/2013/06/130612162358.htm

Currently, determining whether a particular patient with depression would best respond to psychotherapy or medication is based on trial and error. In the absence of any objective guidance that could predict improvement, clinicians typically try a treatment that they, or the patient, prefer for a month or two to see if it works. Consequently, only about 40 percent of patients achieve remission following initial treatment. This is costly in terms of human suffering as well as health care spending.

one specific brain area emerged as a pivotal predictor of outcomes from two standard forms of depression treatment: cognitive behavior therapy (CBT) or escitalopram, a serotonin specific reuptake inhibitor (SSRI) antidepressant. If a patient's pre-treatment resting brain activity was low in the front part of an area called the insula, on the right side of the brain, it signaled a significantly higher likelihood of remission with CBT and a poor response to escitalopram. Conversely, hyperactivity in the insula predicted remission with escitalopram and a poor response to CBT.


What I find most intersting about this, is that one is a hyperreactivity and the other a hyporeactivity, it almost suggests two inverse conditions. One which CBT talk therapy will help, and another where drug treatment with an SSRI and probable increases in seretonin or BDNF will help?! Most of us would predict them to work on similar pathways, not for distinct conditions! Indeed, I was always under the impression that CBT WITH and SSRI would be most efficacious, this suggests otherwise, and that both together would be pointless for most people, with people's treatment choice depending on their insula reactivity.


Among several sites of brain activity related to outcome, activity in the anterior insula best predicted response and non-response to both treatments. The anterior insula is known to be important in regulating emotional states, self-awareness, decision-making and other thinking tasks. Changes in insula activity have been observed in studies of various depression treatments, including medication, mindfulness training, vagal nerve stimulation and deep brain stimulation.

"If these findings are confirmed in follow-up replication studies, scans of anterior insula activity could become clinically useful to guide more effective initial treatment decisions, offering a first step towards personalized medicine measures in the treatment of major depression" said Mayberg.

Anorexia and bulimia correlate with altered neural circuitry

http://www.sciencedaily.com/releases/2013/06/130604093835.htm

Anorexia and bulimia correlate with altered neural circuitry

"However, this study confirms earlier studies by our group and others that establish a clear link between these disorders and neural processes in the insula, an area of the brain where taste is sensed and integrated with reward to help determine whether an individual hungry or full."

"One possibility is that restricted eating and weight loss occurs in anorexia because the brain fails to accurately recognize hunger signals," said Oberndorfer. "Alternately, overeating in bulimia could represent an exaggerated perception of hunger signals."

"It may be possible to modulate the experience by, for example, enhancing insula activity in individuals with anorexia or dampening the exaggerated or unstable response to food in those with bulimia," said Kaye. Studies indicate that healthy subjects can use real-time fMRI, biofeedback or mindfulness training to alter the brain's response to food stimuli. For patients with anorexia who have an overly active satiety signal in response to palatable foods, the researchers suggest bland or even slightly aversive foods might prevent the brain's overstimulation. Medications may also be found that enhance the reward response to food, or decrease inhibition to food consumption in the brain's reward circuitry.”