Phineas Gage

In 1848, as the result of a bizarre accident, Phineas Gage had most of the left frontal lobe of his brain destroyed. Although his surviving the injury by some 11.5 years made him a considerable medical curiosity, it was the changes to his behavior that made him important in the neurosciences. Gage's is actually one of the most important cases in the history of the neurosciences: it revealed for the first time that complex functions might be localized in the brain. Its status is indexed by its still being cited in about two-thirds of all psychology and related neuroscience textbooks and by the fact that studies were still being undertaken some 150 years after the accident to establish which parts of Gage's brain were damaged.

John Martyn Harlow: 'obscure country physician?'

If John Martyn Harlow is known at all in the neurosciences, it is because he was the physician who attended Phineas Gage and followed up his case. Although Harlow's brief but insightful accounts of the changes in Gage's personality are fairly well recognized, and his skill in treating Gage often acknowledged, Harlow himself is, for the most part, the shadowy figure caught by the self-depreciatory characterization of the subtitle of this paper. Although his contribution to the neurosciences was singular, literally and figuratively, he deserves a place in the history of the subject. Harlow's training in antiphlogistic therapy can be seen in his treatment of Gage and in his evaluation of its results. As a medical student, he was also exposed to phrenological doctrine, the influence of which can also be seen in his  appreciation and explanation of some aspects of Gage's behaviour.  Manuscript materials, newspaper reports, and other little known material are used here to evaluate Harlow's contributions to medicine and to the medical, political, and civic life of Cavendish, Woburn, and the Commonwealth of Massachusetts.

The brain in the jar : troubling the truths of discourses of adolescent brain development

Ideas about adolescent brains and their development increasingly function as powerful truths in making sense of young people. And it is the knowledge practices of the neurosciences and evolutionary and developmental psychology that are deemed capable of producing what we have come to understand as the evidence on which policy, interventions and education should be built. In effect these discourses reduce young people to little more than a brain in a jar. The paper examines how the evidence about adolescent brains - their volume, and the functioning and activity of different regions - from neuroscience and evolutionary and developmental psychology works as truth. What knowledge practices are used to produce this evidence, or are deemed capable of producing this evidence? What truth claims are able to attach to this evidence? What makes it true and why is it imagined as evidence of something that is true in policy, public and other research settings that are often far removed from where it was produced? I argue that the discourses of adolescent brain development disembody, reduce and simplify the complexities of these figures we know as adolescents. In effect they render the adolescent as a brain in a jar.

Stage managing bipolar disorder

Clinical staging is widespread in medicine - it informs prognosis, clinical course, and treatment, and assists individualized care. Staging places an individual on a probabilistic continuum of increasing potential disease severity, ranging from clinically at-risk or latency stage through first threshold episode of illness or recurrence, and, finally, to late or end-stage disease. The aim of the present paper was to examine and update the evidence regarding staging in bipolar disorder, and how this might inform targeted and individualized intervention approaches.

The impact of insight in a first-episode mania with psychosis population on outcome at 18 months

To explore whether poor initial insight during a first episode of mania with psychotic features was predictive of poor psychosocial and clinical outcomes at 18 months.

Application of the gradient boosted method in randomised clinical trials: participant variables that contribute to depression treatment efficacy of duloxetine, SSRIs or placebo

Randomised, placebo-controlled trials of treatments for depression typically collect outcomes data but traditionally only analyse data to demonstrate efficacy and safety. Additional post-hoc statistical techniques may reveal important insights about treatment variables useful when considering inter-individual differences amongst depressed patients. This paper aims to examine the Gradient Boosted Model (GBM), a statistical technique that uses regression tree analyses and can be applied to clinical trial data to identify and measure variables that may influence treatment outcomes.

The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study.

There are no established tools to identify individuals at risk for developing bipolar disorder. We developed a set of ultra-high-risk criteria for bipolar disorder [bipolar at-risk (BAR)]. The primary aim of the present study was to determine the predictive validity of the BAR criteria.

An examination of the influence of visuomotor associations on interpersonal motor resonance

The adaptation account of mirror neurons in humans proposes that mirror systems have been selected for in evolution to facilitate social cognition. By contrast, a recent "association" account of mirror neurons in humans argues that mirror systems are not the result of a specific adaptation, but of sensorimotor learning arising from concurrent visual and motor activity. Here, we used transcranial magnetic stimulation (TMS) and electromyography (EMG) to evaluate whether visuomotor associations affect interpersonal motor resonance, a putative measure of mirror system activity. 18 participants underwent two TMS sessions exploring whether visuomotor associations established throughout one׳s lifespan, namely common movements and movements generated from one׳s own perspective, are associated with increased putative mirror system activity. Our results showed no overall difference in interpersonal motor resonance to common versus uncommon actions, or actions presented from an egocentric (self) versus an allocentric (other) perspective. We did, however, observe increased interpersonal motor resonance within the abductor digiti minimi (ADM) muscle in response to allocentric compared to egocentric movements. As the association model predicts stronger mirror system response to actions with stronger visuomotor associations, such as common movements and those presented from an egocentric perspective, our findings provide little evidence to support the association model.

The association between dietary patterns, diabetes and depression.

Type 2 diabetes and depression are commonly comorbid high-prevalence chronic disorders. Diet is a key diabetes risk factor and recent research has highlighted the relevance of diet as a possible risk for factor common mental disorders. This study aimed to investigate the interrelationship among dietary patterns, diabetes and depression.

Medulloblastoma Down Under 2013 : a report from the third annual meeting of the International Medulloblastoma Working Group.

Medulloblastoma is curable in approximately 70% of patients. Over the past decade, progress in improving survival using conventional therapies has stalled, resulting in reduced quality of life due to treatment-related side effects, which are a major concern in survivors. The vast amount of genomic and molecular data generated over the last 5-10 years encourages optimism that improved risk stratification and new molecular targets will improve outcomes. It is now clear that medulloblastoma is not a single-disease entity, but instead consists of at least four distinct molecular subgroups: WNT/Wingless, Sonic Hedgehog, Group 3, and Group 4. The Medulloblastoma Down Under 2013 meeting, which convened at Bunker Bay, Australia, brought together 50 leading clinicians and scientists. The 2-day agenda included focused sessions on pathology and molecular stratification, genomics and mouse models, high-throughput drug screening, and clinical trial design. The meeting established a global action plan to translate novel biologic insights and drug targeting into treatment regimens to improve outcomes. A consensus was reached in several key areas, with the most important being that a novel classification scheme for medulloblastoma based on the four molecular subgroups, as well as histopathologic features, should be presented for consideration in the upcoming fifth edition of the World Health Organization's classification of tumours of the central nervous system. Three other notable areas of agreement were as follows: (1) to establish a central repository of annotated mouse models that are readily accessible and freely available to the international research community; (2) to institute common eligibility criteria between the Children's Oncology Group and the International Society of Paediatric Oncology Europe and initiate joint or parallel clinical trials; (3) to share preliminary high-throughput screening data across discovery labs to hasten the development of novel therapeutics. Medulloblastoma Down Under 2013 was an effective forum for meaningful discussion, which resulted in enhancing international collaborative clinical and translational research of this rare disease. This template could be applied to other fields to devise global action plans addressing all aspects of a disease, from improved disease classification, treatment stratification, and drug targeting to superior treatment regimens to be assessed in cooperative international clinical trials.