D. Pfaff – Neuroscience in the 21st Century (Second edition, 2016)

Автор: D. Pfaff
Название книги: Neuroscience in the 21st Century (2016)
Формат: PDF
Жанр: Нейронауки
Страницы: 4109
Качество: Изначально компьютерное, E-book

Edited and authored by a wealth of international experts in neuroscience and related disciplines, this key new resource aims to offer medical students and graduate researchers around the world a comprehensive introduction and overview of modern neuroscience.

Neuroscience research is certain to prove a vital element in combating mental illness in its various incarnations, a strategic battleground in the future of medicine, as the prevalence of mental disorders is becoming better understood each year. Hundreds of millions of people worldwide are affected by mental, behavioral, neurological and substance use disorders. The World Health Organization estimated in 2002 that 154 million people globally suffer from depression and 25 million people from schizophrenia; 91 million people are affected by alcohol use disorders and 15 million by drug use disorders. A more recent WHO report shows that 50 million people suffer from epilepsy and 24 million from Alzheimer’s and other dementias.

Because neuroscience takes the etiology of disease―the complex interplay between biological, psychological, and sociocultural factors―as its object of inquiry, it is increasingly valuable in understanding an array of medical conditions. A recent report by the United States’ Surgeon General cites several such diseases: schizophrenia, bipolar disorder, early-onset depression, autism, attention deficit/ hyperactivity disorder, anorexia nervosa, and panic disorder, among many others. Not only is this volume a boon to those wishing to understand the future of neuroscience, it also aims to encourage the initiation of neuroscience programs in developing countries, featuring as it does an appendix full of advice on how to develop such programs. With broad coverage of both basic science and clinical issues, comprising around 150 chapters from a diversity of international authors and including complementary video components, Neuroscience in the 21st Century in its second edition serves as a comprehensive resource to students and researchers alike.

Preface

The primary purpose of this project has been to produce a comprehensive, electronic
introduction to current-day neuroscience in a didactic form useful for upper-level
premedical students, entering medical students, and graduate students in a wide
variety of countries, with an emphasis on economically developing countries. The
Supervisory Editors and the authors, in their international distribution, reflect our
intention to recognize the growing interest in neuroscience and expertise across the
world.
Neuroscience Addresses Medical and Public Health Problems,
Worldwide
Neuroscience research provides basic discoveries about how the brain works and
how it controls behavior and how its disruption can result in neurological and
psychiatric disorders. These discoveries are of relevance for improving multiple
outcomes that span from health (i.e., how to maximize cognitive performance and
optimize well being) to education (i.e., how to use knowledge from neuroscience on
how the brain learns to improve the delivery of education). Neuroscience broadly
defined also offers pivotal components of both medical education and the delivery of
medical services. For example, depression and schizophrenia – once viewed as
purely “behavioral” problems – are now candidates for neurochemical/neuropharmacological
treatments. Similarly addiction, which was once viewed as a condition
of moral weakness, is now recognized as a disease of the brain with impairment
in specific brain circuits. Degenerative conditions such as neurosyphilis,
HIV-associated dementia, traumatic brain injury, and Alzheimer can now be delayed
by science-based treatments. Coma and persistent vegetative state are approached by
manipulating brain mechanisms responsible for arousal. Indeed, as neuroscience
explores the etiology of disease – the complex interplay between biological, psychological,
and sociocultural factors – it is increasingly valuable in understanding an
array of diseases. A recent report by the Surgeon General, in the USA, cites several
such diseases: schizophrenia, bipolar disorder, early onset depression, autism, attention
deficit/hyperactivity disorder, anorexia nervosa, substance use disorders, and
panic disorder, among many others.

The Surgeon General states that in the USA, the 1-year prevalence rate for mental
illness is about 21 %. The figure was derived by synthesizing two major studies
indicating that within a 1-year period this percentage of the adult population has a
diagnosable mental disorder based on “reliable, established criteria.” Based on 2010
census figures, this means that over 45 million individuals are affected. Moreover,
the Surgeon General indicates that almost half these individuals – 9 % of US adults –
experience some significant functional impairment. A subpopulation of 5.4 % of
adults has a “serious” mental illness that interferes with some area of social
functioning.
Most distressingly, none of these huge figures included even the approximately
20 % of children and adolescents estimated to have mental disorders with at least
mild functional impairment, or the 5–9 % who suffer “serious emotional disturbance.”
Adults 55 and older are another subpopulation. Though not as extensively
documented, the Surgeon General cites figures indicating that almost 20 % have
some diagnosable mental disorder during a 1-year period, and that almost 4 % have a
serious mental illness.
Various reports from the World Health Organization (WHO) demonstrate that
mental health problems in the USA are mirrored in other countries, often in an
extreme form because there is less help available. Here are some of the findings:
• Mental, neurological, and behavioral disorders are common to all countries and
cause immense suffering. People with these disorders are often subjected to social
isolation, poor quality of life, and increased mortality. These disorders are the
cause of staggering economic and social costs. That is, because mental disorders
often strike early, their total economic cost to society is almost as large as all other
illnesses combined.
• Hundreds of millions of people worldwide are affected by mental, behavioral,
neurological, and substance use disorders. For example, estimates made by WHO
in 2002 showed that 154 million people globally suffer from depression and
25 million people from schizophrenia; 91 million people are affected by alcohol
use disorders and 15 million by drug use disorders. A recently published WHO
report shows that 50 million people suffer from epilepsy and 24 million from
Alzheimer and other dementias.
• In addition to the above figures, many other disorders affect the nervous system or
produce neurological sequelae. Projections based on a WHO study show that
worldwide in 2005, 326 million people suffered from migraine; 61 million from
cerebrovascular diseases; 18 million from nervous system infections or neurological
sequelae of infections. The number of people with neurological sequelae
of nutritional disorders and neuropathies (352 million) and neurological sequelae
secondary to injuries (170 million) also add substantially to the above burden.
Uncounted are the large number of people who suffer from chronic pain. In the
USA alone it is estimated that at least 100 million Americans suffer from a
chronic pain condition.
• About 877,000 people die by suicide every year. In at least two thirds of these
cases, a treatable mental illness is deemed to be causal.
• One in four patients visiting a health service has at least one mental, neurological,
or behavioral disorder, but most of these disorders are neither diagnosed nor
treated.
• Mental illnesses affect and are affected by chronic conditions such as cancer,
heart and cardiovascular diseases, diabetes, and HIV/AIDS. Untreated, they bring
about unhealthy behavior, noncompliance with prescribed medical regimens,
diminished immune functioning, and poor prognosis. Some common disorders,
such as lung cancer, are the consequence of mental disorders (in this case,
nicotine addiction).
• Cost-effective treatments exist for most disorders and, if correctly applied, could
enable most of those affected to become functioning members of society.
• Barriers to effective treatment of mental illness and substance use disorders
include lack of recognition of the seriousness of mental illness and lack of
understanding about the benefits of services. Policy makers, insurance companies,
health and labor policies, and the public at large – all discriminate between
physical and mental problems.
• Most middle- and low-income countries devote less than 1 % of their health
expenditure to mental health. There are as many as 200 times more psychiatric
workers in high-income as opposed to low-income countries. Consequently
mental and behavioral health policies, legislation, community care facilities,
and treatments for people with mental illness are not given the priority they
deserve.
• War and other disasters have a major influence on mental health and psychosocial
well-being. Rates of mental health disorder tend to double after emergencies.
Early support for the ideas underlying this project came through letters
expressing clear understanding and encouragement from the Society for Neuroscience
(the President and the Chair of the Education Committee), the Federation
of European Neuroscience Societies (FENS), the Japanese Neuroscience Society,
the Indian Academy of Neuroscience, from UNESCO, from the International
Brain Research Organization (IBRO, whose regional offices will assist with
dissemination of the text), from the Director of the Earth Institute, Jeffrey
D. Sachs (Professor of Sustainable Development, Columbia University), from
the American expert on education Professor Howard Gardner (Harvard University),
and from the Chinese Academy of Sciences (three members are among our
editors).
Insofar as professors in developing countries want to use this text as part of their
efforts to launch neuroscience programs, they might want to see the Appendix by
Richard Brown (Dalhousie University, Canada), a paper that gives tips about
developing such programs. In addition, a few authors have supplied videos to let
students in developing countries know how these authors became interested in
neuroscience and to give an idea of what their laboratories look like.
Finally, we consider this large volume to comprise a “feeder text” for other, more
detailed treatments such as those edited by Eric Kandel et al. (Principles of Neural
Science, 5th edition, McGraw-Hill), Larry Squire et al. (Fundamental Neuroscience
3rd edition, Elsevier), and Dale Purves et al. (Neuroscience, 4th edition, Sinauer). At
spots in the current text, we have referred to specific chapters in one or more of these
texts in order to make up for any potential deficit.
We gratefully acknowledge financial support for the first edition from three
foundations: the Nour, Moos, and New York NeuroScience Foundations and from
Pfizer, Inc. All authors and editors agreed to do their work without compensation.
This entire project benefitted from the wise counsel and foresight of the Neuroscience
editor at Springer, Ann Avouris. With a high level of skill, Ann has encouraged
and guided this project from its inception to its completion. Special thanks to the
International Brain Research Organization (Pierre Magistretti and Sten Grillner,
Secretary-Generals) for assisting the free international distribution of this text, in
electronic form, to universities in developing countries