The Neuro Week 19th June

Here's The Neuro Week.

Image of the week is this adorable, if anatomically not quite accurate, model of the brain which you can buy. It even has little eyes! This is not new, but what did come out this week was Google's image recognition search, which is how I found out about it.

You've probably heard of Bipolar 1 and 2, but 4 and 6? They're the next big thing, says a guy who's published no fewer than 155 papers in a journal he edits, as The Neurocritic reports.

What if autism Isn't a Neurodevelopmental Disorder? but rather a disorder caused by ongoing neurobiological processes in later life?

According to the BBC, children tend to be similar to their parents, presumably due to shared genes and/or environments. OK, they said that parents influence teenage drinking habits, but this is all the study showed. And maybe not even that. Not a great piece of journalism.

Two books about ethics are reviewed: Patricia Churchland's Braintrust is reviewed here while Blind Spots is covered here. I'm currently working on a joint review of both books so I won't comment further at this stage.

European neuroscientists including David Nutt warned this week that mental health research faces funding cuts, as pharmaceutical companies pull out of the psych market. It's certainly true that Pharma currently funds much of this research, however whether this has helped or hindered the progress of neuroscience and psychiatry is debatable.

"For the first time researchers have monitored the brain as it slips into unconsciousness", apparantly. Actually, people have been doing that for over 60 years, but this time around they did use an interesting new neuroimaging method.

Psych Your Mind blog has a list of psychology-based songs. Kind of. But it doesn't include any songs from the classic "The Mind's I", the only melodic death metal album named after a book about the nature of conciousness. Well, so far the only one. Rumours that In Flames are working on "Consciousness lost and found: A neuropsychological exploration" remain unconfirmed.

I can't read everything. So any tipoffs will be gratefully received. Either leave them in a comment or drop me an email.

The Neuro-Recession

Everyone's favourite British psychopharmacologist David "Ecstasy Vs Horseriding" Nutt joins four other leading neuroscientists to discuss the impact of the financial crisis on neuroscience, in an article over at NR:N: Neuroscience in recession?

It's interesting to get an international perspective. Susan Amara, President of the Society for Neuroscience, says that American scientists were encouraged by the surprise $10bn boost to NIH funds that made it into the 2009 economic stimulus package. But these funds are due to run out in 2012.

Meanwhile, in Europe, some countries have slashed funding as part of their austerity programmes - Greece most of all - while the larger and richer nations like France and Germany have protected science. Japan has also opted against major cuts, so far, but with a massive deficit, researchers fear that the axe will fall in coming years.

A repeated complaint is that biomedical research has faced a rate of inflation much higher than the rate experienced by the economy as a whole. Nutt says that if the overall inflation rate is 4% per year, the rate paid by scientists is more like 10%. As a result, even if nominal budgets are protected, the real budget will fall. The current British government has decided to keep nominal science funding flat, while cutting pretty much everything else, which is nice, but it still means falling real investment.

So everyone pretty much agrees that there are cuts, and cuts are bad. OK. Where things get more interesting is in the debate over what this means for individual scientists. Susan Amara says that she fears that investigator-initiated "R01" grants are in danger. These are when a scientist gets an idea, writes it up as a proposal and says "Isn't this cool? Can we have some money to do it?"

Amara warns that this kind of thing seems to be getting harder, while established, ongoing research programmes are being protected. But Tom Insel, head of the NIMH and, therefore, the guy with ultimate responsibility for these R01 grants, says the exact opposite. Insel claims that R01s are being protected in favour of the big programmes! "Where have we cut back in order to preserve R01 grants? ... We have reduced the budget of our intramural research programme."

Who's right on this point? I'm not sure. Maybe US readers might be able to comment.

The authors express particular worry that young neuroscientists (postdocs and PhD students) will suffer, either directly, as a result of not being able to find money, or indirectly in terms of poor morale and a sense that their talents might be better rewarded outside of science - leading to long-term harm to the next generation of neuroscientists.

They offer some words of encouragement, though, saying that the pendulum will swing back towards more investment in the future. Until then, hang on as best you can, even if it means being willing to move to find work with a supervisor, or in a country, which does have good funding prospects...

Amara SG, Grillner S, Insel T, Nutt D, & Tsumoto T (2011). Neuroscience in recession? Nature reviews. Neuroscience, 12 (5), 297-302 PMID: 21505517

The Ethics of Getting as High as a Kite

Are drugs good or bad?

I mean, in the ethical sense. Medically, all drugs have potential harms variously associated with use, long-term use, overdose, etc. Politically, by buying illegal drugs, you're probably ultimately funding criminals and terrorists (although you might well blame prohibition, not drugs, for that). But setting that aside, assuming no-one gets harmed as a result: is it morally wrong to take recreational drugs per se?

It's an important question, because your opinion about this will influence your opinions about less abstract, more immediate issues: whether cannabis ought to be sold in coffee shops, how many years you should spend in jail for dealing coke.

However, no-one really asks this question, directly. The medical and the political aspects of drugs are endlessly debated, but after listening to these arguments for a while, you'll realize that while people on both sides talk about public health risks and harm reduction, most of the time they're really just disagreeing about the abstract question of whether taking drugs for fun is acceptable.

Here's the two major schools of thought as I see them. There are those who see no problem with recreational drug use, assuming no-one gets hurts. If it feels good, it is good. If it makes people happy, what's not to like? If people want to enjoy themselves in that particular way, it's no-one else's business. Call this the 'hedonist' view.

On the other hand, there are those who see drug use as a shameful escape from reality. There's more to life than "having fun", life is serious. You ought to be out there doing something, not just sitting around with a silly grin on your face. That's cheating, getting enjoyment for nothing. Call this the 'puritan' school.

People differ on which one they favour, but most of us identify with both to some extent. Few people are puritan enough to forgo all of life's pleasures, not even a quiet drink or a hot bath. Few hedonists would be happy if their own kids announced that they had no ambition to succeed in any kind of career, they'd just live off their inheritance and buy heroin.

As a whole, society has a mixed view. We have a puritanical objection to people who just take drugs and do nothing else with their lives; "junkies", "crackheads", "alkies". But we have no problem with drug use by people who clearly have engaged with the world, and succeeded.

Musicians, actors, and other stars take industrial quantities of drugs. Everyone knows it. It's not even an open secret in most cases, it's just open. Even gossip columnists don't notice unless someone gets so far gone that they do something funny. We don't care, because, whether or not we actually like their work, they're not just drug users, they're also doing their jobs.

New Neuroblogs!

It seems like every week nowadays that I find a new neuroscience or psychology blog. Which is great. So here's a list of blogs that have started since 2010... more or less. Or late 2009 in some cases. If I've missed one out, it is because I suck, not because it sucks, so let me know and I'll add it.

• David Nutt's Blog Evidence Not Exaggeration - the bad boy of British psychopharmacology now has a blog.
• BishopBlog - Another celebrity blog, this time from Oxford developmental psychologist Prof. Dorothy Bishop.
• NeuroKüz - the only neüroblog with an umlaut
• Reading the Papers - mostly about movement and perception so far
  
• Neuroconscience - that's neuroconscience.com to you
  
• Colonial Psychiatry - about the history of psychiatry in Africa
  
• The Shelled Walnut - sadly has not been posting much recently
  
• Neurobites - just a month old, seems to be focussed on food and appetite
  
• Quantimind - about quantitative psychology, not quantum physics
  
• Brain Posts - clinical neuroscience - Neuroskeptic readers should be especially interested in these.
• Sleeprunning - about brains and stuff, not sleep or running.
• Neuromancy - Research and ramblings of a neuroscience postgrad
• Mood Spectrum Indigo - Reflections on Mood Disorders
• Cerescan Imaging Blog - Imaging, neuroscience, psychiatric and neurodegenerative disorders
• Abby Noyce's Blog - Cognitive neuroscience, and lots of purple.
• rewireyourbrainforlove.com - A neuropsychologist's exploration of mindfulness meditation, relationships, and the brain.

The Politics of Psychopharmacology

It's always nice when a local boy makes good in the big wide world. Many British neuroscientists and psychiatrists have been feeling rather proud this week following the enormous amount of attention given to Professor David Nutt, formerly the British government's chief adviser on illegal drugs.

Formerly being the key word. Nutt was sacked (...write your own "nutsack" pun if you must) last Friday, prompting a remarkable amount of condemnation. Critics included the rest of his former organisation, the Advisory Council on the Misuse of Drugs (ACMD), and the Government's Science Minister. The UK's Chief Scientist also spoke in favour of Nutt's views. Journalists joined in the fun with headlines like "politicians are intoxicated by cowardice".

Even Nature today ran a bluntly-worded editorial -

"The sacking of a government adviser on drugs shows Britain's politicians can't cope with intelligent debate... the position of the Labour government and of the leading opposition party, the Conservatives, which vigorously supported Nutt's sacking, has no merit at all. It deals a significant blow both to the chances of an informed and reasoned debate over illegal drugs, and to the parties' own scientific credibility."

They also have an interview with the man himself.

*

What happened? The short answer is a lecture Nutt gave on the 10th October, Estimating Drug Harms: A Risky Business? I'd recommend reading it (it's free). The Government's dismissal e-mail gave two reasons why he had to go - firstly, "Your recent comments have gone beyond [matters of evidence] and have been lobbying for a change of government policy" and secondly, "It is important that the government's messages on drugs are clear and as an advisor you do nothing to undermine public understanding of them."

Many people believe that Nutt was fired because he argued for the liberalization of drug laws, or because he claimed that the harms of some illegal drugs, such as cannabis, are less severe than those of legal substances like tobacco and alcohol. On this view, the government's actions were "shooting the messenger", or dismissing an expert because they didn't like to hear to the facts. It seems to me, however, that the truth is a little more nuanced, and even more stupid.

*

Nutt's lecture, if you read the whole thing as opposed to the quotes in the media, is remarkably mild. For instance, at no point does he suggest that any drug which is currently illegal should be made legal. The changes he "lobbies for" are ones that the ACMD have already recommended, and this lobbying consists of nothing more than tentative criticism of the stated reasons for the rejection of the ACMD's advice. The ACMD is government's official expert body on illicit drugs, remember.

The issue Nutt focusses on is the question of whether cannabis should be a "Class C" or a "Class B" illegal drug, B being "worse", and carrying stricter penalties. It was Class B until 2004, when it was made Class C. In 2007, the Government asked the ACMD to advise on whether it should be re-reclassified back up to Class B. This was in response to concerns about the impact of cannabis on mental health, specifically the possibility that it raises the risk of psychotic illnesses.

The resulting ACMD report is available on the Government's website. They concluded that while cannabis use is certainly not harmless, "the harms caused by cannabis are not considered to be as serious as drugs in class B and therefore it should remain a class C drug."

Despite this, the Government took the decision to reclassify cannabis as Class B. In his lecture Nutt criticizes this decision - slightly. Nutt quotes the Home Secretary as saying, in response to the ACMD's report -

"Where there is a clear and serious problem [i.e. cannabis health problems], but doubt about the potential harm that will be caused, we must err on the side of caution and protect the public. I make no apology for that. I am not prepared to wait and see."

Nutt describes this reasoning as -

"the precautionary principle - if you’re not sure about a drug harm, rank it high... at first sight it might seem the obvious decision – why wouldn’t you take the precautionary principle? We know that drugs are harmful and that you can never evaluate a drug over the lifetime of a whole population, so we can never know whether, at some point in the future, a drug might lead to or cause more harm than it did early in its use."

But he says, there's more to it than this. Firstly, we don't know anything about how classification affects drug use. The whole idea of upgrading cannabis to Class B to protect the public relies on the assumption that it will reduce drug use by deterring people from using it. But there is no empirical evidence as to whether this actually happens. As Nutt points out, stricter classification might equally well increase use by making it seem forbidden, and hence, cooler. (If you think that's implausible, you have forgotten what it is like to be 16.) We just don't know.

Second, he says, the precautionary principle devalues the evidence and is thereby self-defeating because it means that people will not take any warnings about drug harms seriously - "[it] leads to a position where people really don’t know what the evidence is. They see the classification, they hear about evidence and they get mixed messages. There’s quite a lot of anecdotal evidence that public confidence in the scientific probity of government has been undermined in this kind of way." Can anyone really dispute this?

Finally, he raises the MMR vaccine scare as an example of the precautionary principle ironically leading to concrete harms. Concerns were raised about the safety of a vaccine, on the basis of dubious science. As a result, vaccine coverage fell, and the incidence of measles, mumps and rubella in Britain rose for the first time in decades. The vaccine harmed no-one; these diseases do. We just don't know whether cannabis reclassification will have similar unintended consequences.

That's what the Home Secretary described as "lobbying for a change of government policy". I wish all lobbyists were this reasonable.

The Home Secretary's second charge against Nutt - "It is important that the government's messages on drugs are clear..." - is even more specious. Nutt's messages were the ACMD's messages, and as he points out, the only lack of clarity comes from the fact that the government and their own Advisory Council disagree with each other. This is hardly the ACMD's fault, and it's certainly not Nutt's fault for pointing it out.

All of this is doubly ridiculous because of one easily-forgotten fact - cannabis was downgraded from Class B to Class C in 2004 by the present Labour Party government. Nutt's "lobbying" therefore consists of a recommendation that the government do something they themselves previously did. And if the government are worried about the clarity of their message, the fact that they themselves were saying that cannabis was benign enough to be a Class C drug just 5 years ago might be somewhat relevant.

*

Nutt has said that he was surprised to learn that he had been sacked. I'm sure this surprise was genuine because Nutt is an academic, and in academia, Nutt's "criticisms" would hardly even be considered as such. Here by contrast is an extract from a peer review comment I got a couple of days ago regarding a scientific paper I wrote:

The manuscript falls short of its goals in several respects: The basic phenomenon ... is barely presented... The style and language of the review leave a lot to be desired... The citations and reference list are appalling.

The same reviewer also criticized the basic argument of my article, implicitly branding the whole paper - all 10,000 words of it, which took dozens of hours to write - a complete waste of time.

Ouch. But as an academic, giving, and receiving, this kind of treatment is all part of the job, and that's just as it should be. I'm confident that my argument is sound, so I'm going to take the criticisms on board, rewrite the paper appropriately, and submit it to another journal. What I'm not going to do is bear a grudge against the reviewer. (Well maybe a little: the references weren't that bad.) To be fair, unlike Nutt's, this review was not made in the public domain, but then, I'm not a Government elected by the public.

Nutt's mistake was to think that it's possible to have a serious debate about a serious political issue. In fact, it was probably not such a bad mistake, since the job of the ACMD, as the Government sees it, is a fairly pointless one: their job is to give expert advice and then let it be ignored. As various ACMD members have noted, they work for free, in the public interest. If I were on the Committee, I would resign now, not just out of sympathy for Nutt, but because it's a crap job.

In his dismissal letter, the Home Secretary told Nutt, "It is not the job of the Chair of the Government's advisory Council to initiate a public debate on the policy framework for drugs". I would have thought he was exactly the person who should do this if such a debate was necessary, as it obviously is. Well, now we know better. It wasn't his job. Although, thanks to the government who sacked him, a drug debate is now going on in the British media for the first time in years. In the long run, Nutt's most important action as Chair of the ACMD may well have been getting sacked from it.

[BPSDB]

Nature (2009). A drug-induced low Nature, 462 (7269), 11-12 DOI: 10.1038/462011b

Daniel Cressey (2009). Sacked science adviser speaks out Nature

Ecstasy vs. Horseriding

Which is more dangerous, taking ecstasy or riding a horse?

This is the question that got Professor David Nutt, a British psychiatrist, into a spot of political bother. Nutt is the Editor of the academic Journal of Psychopharmacology. He recently published a brief and provocative editorial called "Equasy".

Equasy is a fun read with a serious message. (It's open access so you can read the whole thing - I recommend it.) Nutt points out that the way in which we think about the harms of illegal drugs, such as ecstasy, is unlike the way in which we think about other dangerous things such as horseriding - or "equasy" as he dubs it:

The drug debate takes place without reference to other causes of harm in society, which tends to give drugs a different, more worrying, status. In this article, I share experience of another harmful addiction I have called equasy...

He goes on to describe some of the injuries, including brain damage, that you can get from falling off horses. After arguing that horseriding is in some ways comparable to ecstasy in terms of its dangerousness he concludes:

Perhaps this illustrates the need to offer a new approach to considering what underlies society’s tolerance of potentially harmful activities and how this evolves over time (e.g. fox hunting, cigarette smoking). A debate on the wider issues of how harms are tolerated by society and policy makers can only help to generate a broad based and therefore more relevant harm assessment process that could cut through the current ill-informed debate about the drug harms? The use of rational evidence for the assessment of the harms of drugs will be one step forward to the development of a credible drugs strategy.

Or, in other words, we need to ask why we are more concerned about the harms of illicit drugs than we are the harms of, say, sports. No-one ever suggests that the existence of sporting injuries means that we ought to ban sports. Ecstasy is certainly not completely safe. People do die from taking it and it may cause other more subtle harms. But people die and get hurt by falling off horses. Even if it turns out that on an hour-by-hour basis, you're more likely to die riding a horse than dancing on ecstasy (quite possible), no-one would think to ban riding and legalize E. But why not?

This attitude raises the critical question of why society tolerates –indeed encourages – certain forms of potentially harmful behaviour but not others, such as drug use.

Which is an extremely good question. It remains a good question even if it turns out that horse-riding is much safer than ecstasy. These are just the two examples that Nutt happened to pick, presumably because it allowed him to make that cheeky pun. Comparing the harms of such different activities is fraught with pitfalls anyway - are we talking about the harms of pure MDMA, or street ecstasy? Do we include people injured by horses indirectly (e.g. due to road accidents?)

Yet the whole point is that no-one even tries to do this. The dangerousness of drugs is treated as quite different to the dangerousness of sports and other such activies. The media indeed seem to have a particular interest in the harms of ecstasy - at least according to a paper cited by Nutt, Forsyth (2001), which claims that deaths from ecstasy in Scotland were much more likely to get newspaper coverage than deaths from paracetemol, Valium, and even other illegal drugs. It's not clear why this is. Indeed, when you make the point explicitly, as Nutt did, it looks rather silly. Why shouldn't we treat taking ecstasy as a recreational activity like horse-riding? That's something to think about.

Professor Nutt is well known in psychopharmacology circles both for his scientific contributions and for his outspoken views. These cover drug policy as well as other aspects of psychiatry - for one thing, he's strongly pro-antidepressants (see another provocative editorial of his here.)

As recently-appointed Chairman of the Advisory Council on the Misuse of Drugs - "an independent expert body that advises government on drug related issues in the UK" - Nutt might be thought to have some degree of influence. (He wrote the article before he became chairman). Sadly not, it appears, for as soon as the Government realized what he'd written he got a dressing down from British Home Secretary Jacqui Smith - Ooo-er:

For me that makes light of a serious problem, trivialises the dangers of drugs, shows insensitivity to the families of victims of ecstasy and sends the wrong message to young people about the dangers of drugs.

I'm not sure how many "young people" or parents of ecstasy victims read the Journal of Psychopharmacology, but I can't see how anyone could be offended by the Equasy article. Except perhaps people who enjoy hunting foxes while riding horses (Nutt compares this to drug-fuelled violence). Nutt's editorial was intended to point out that discussion over drugs is often irrational, and to call for a serious, evidence-based debate. It is not really about ecstasy, or horses, but about the way in which we conceptualize drugs and their harms. Clearly, that's just a step too far.

[BPSDB]

D. Nutt (2008). Equasy -- An overlooked addiction with implications for the current debate on drug harms Journal of Psychopharmacology, 23 (1), 3-5 DOI: 10.1177/0269881108099672