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Fecha 04-07 Junio 2018

XII Curso Intensivo de Terapia Electroconvulsiva (2018)

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Último congreso

Fecha 20-21 Junio 2014

Relevance of Staging Psychotic disorders as a Paradigm-shift for understanding disease progression and stage-dependent treatment.

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Últimas Publicaciones

STRATEGIES FOR STUDYING BRAIN DISORDERS

Vol.9 Sistema Dopaminérgico y Trastornos Psiquiátricos

Vol.10 Staging Neuropsychiatric Disorders: Implications for Etiopathogenesis and Treatment

June 2013

ISBN: 978-1-4614-7263-6

Publications

Vol.6 Neurodevelopmental Liabilities in Brain Disease States

Vol.6 Neurodevelopmental Liabilities in Brain Disease States

December 2002

Editores: Tomás Palomo, Richard J. Beninger, Trevor Archer, Richard M. Kostrzewa

Editorial: Editorial CYM, General Oráa, 47, 28006 MADRID

ISBN: 84-921848-9-2

Páginas: 762

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Also found within the publications are contributions presented at the meeting held in Mojácar in 2001.

Prólogo

Amid the real or imagined, putative or punitive deities that may or may not embrace, control or alienate us, the 'now-there, now-gone', 'now-presence, now-absence' of the holy or deranged condition of war, an ancient poenic demeanour but nowadays popularly referred to as a Jihad, was to threaten our happy little world of intermittent camaraderie and collegiality ensconced in the series of Mojacar meetings to its very foundations, in the apparent anxieties of the carefully selected Invited Speakers. Never before, despite the intensive, wearisome and unending toil of one of us, the administrative-chronological-scientific logistics of bringing who-you-want, to-do-what-you-want, and when-and-how-you-want-to in the right place, on minute-mean program time, in a suitable frame-of-mind armed with the appropriate slides/power-points and notwithstanding the implacable workings of Murphy's law, had the final course and development of each fledgling program organisation not reached its maturity with each successive Mojacar meeting. Out of the blue, the eleventh of September (William's birthday, and fascinating in its 'spookiness' for gangster and warlord minds, his thirteenth) changed everything. Thousands of innocents, heroic firemen and a whole people were dragged into the whirlpool of agony and anguish as it spread. In the shocked aftermath the anticipation of Mojacar was shattered. All of a sudden, why this? And, why now? Had the Indalo abandoned us? What had we done? Or, not done? Had we become smug, too self-congratulatory, a banal cluster of self-entertaining, mutually-admiring, middle-aged complacents? Had we in the conjuring of concurrent Madrid 'brain-disease' meetings lost our fine touch for the pulse of disorder neuroscience? Was this to be the emergence of trouble 'not as a single spy, but in battalions'? No, not at all and quite the reverse . In many respects, the 11 th September may have been the catastrophic force that brought about the "finest hour", not only of New Yorkers, but also, albeit of lesser magnitude, of the cerebro y mente. Almost immediately, were the Foundation's resources invested, re-invested and then cast in the reassurance of the Invited Speakers and participants, whose families, naturally enough, were most concerned about foreign travel. Step-by-step we encountered great bravery: of our transatlantic Speakers, of their loved ones, and of the 'process' that maintained itself. Very slowly, doubts about attendance, suggestions – nay, even demands – for cancellation of the meeting, fear and anxieties about lurking terrorist groups (behind any bush, any cactus, any taxi) roaming the Andalusian country [verily, under completely different circumstances so must Soult 's Army of the South have felt, but with all the reason in the world, as they marched away to Madrid, abandoning the siege of Cadiz, with all their pimps, floppsies and floozies, 'demi-brigades', quartermasters, generals, sergeants and soldiers, hangers-on and minions, having snatched the unimaginable treasures of the great cities, towns and estates of Southern Spain and placed them in over a thousand oxen-drawn carts], were turned around to anticipation: for the benign hospitality, the familiar interaction of neuroscientific minds and the long-awaited sojourn in the reflective environment of the venue, Mojacar.

Whereas some or other of us may, at least tentatively, have been considering the calculated lunacy of certain misinformed miscreants misrepresenting the holy words of Allah, still others of us were playing out scenes of some bygone Marx brothers movie. [Epistle of St. Paul to Titus: "For a bishop must be blameless, as a steward of God, not self-willed, not quick-tempered, not given to wine, not violent, not greedy for money, but hospitable, a lover of what is good, sober-minded, just, holy, self-controlled"] . Thus, was the earthly representative of Our Lord Jesus Christ, Jean ---, erstwhile Bishop of some ecclesiastic backwater in Algeria [where the teachings of love, not hate, hope, not despair, faith, not cynicism were most needed] and former Bishop of Paris, 'kidnapped' at Almeria airport and transported to the Mojacar Parador. Identical with St. Paul's recommendations, Jean the Bishop is a mild and gentle soul with an engaging sweetness of disposition though, as it turned out, entirely without conversation in the English language and only very, very rudimentary in the Spanish. He was due to be attending a state-of-the-soul meeting of Global Bishoprics, and though not amused by being whisked away by a very strange-looking set of scoundrels indeed, but yet fortified like St. Peter, the first Bishop [ 1 st Epistle of Peter, verse 14: "But even if you should suffer for righteousness' sake, you are blessed: 'and do not be afraid of their threats, nor be troubled'" ], was brought to a state-of-the-art meeting consisting of brain-scientists [by any stretch of the imagination, a very dire gang of renegades, blasphemers and heathens, indeed] and then abandoned to the mercy of a beast [ The Book of Revelations of John: "Then I stood on the sand of the sea. And I saw a beast rising up out of the sea, having seven heads and ten horns, and on his heads a blasphemous name ]. More than any others, a Bishop, and particularly as fine a Bishop as our Bishop Jean , will live in awareness of Jesus' stations of the cross and thus fear no evil even though he may walk in the valley of the shadows, so, in his goodness and grace, he blessed the International Meeting on Neurodevelopmental Liabilities in Brain Disease States, that was held at the Mojacar Parador in October 2001, girded his loins and got back into the white van with a beast and the pious Serge to help him find his servant, the good and loyal Maximillian . Modern technology in the form of cell-phone instrumentation gave wings to the Godly Bishop's prayers as we made the 75-min trip back to Almeria airport and within minutes of searching discovered the comely face of the blessed Maximillian . And, so we took our leave of Bishop Jean , a true and humble servant of Christ who was removed from the Heights of the Parisian Diocese to the Christian anonymity of Muslim Algeria, because of his 'great love of the poor, needy and outcast'. [ 1 st Epistle of John, verse 18: "There is no fear in love; but perfect love casts out fear, because fear involves torment. But he who fears has not been made perfect in love"] , and in doing so received his blessings both for the hopes placed on a fruitful meeting of different conceptualisations of 'neurodevelopment' and for the hope that we ourselves may prove worthy of the task assigned to us [ 1 st Epistle of St. Paul to the Corinthians, verse 8: "Therefore let us keep the feast, not with old leaven, nor with the leaven of malice and wickedness, but with the unleavened bread of sincerity and truth ].

Neurodevelopmental liability is described from a great and swarming multitude of perspectives: in depressives states, prefrontal serotonergic malady, dysregulation of the hypothalamic-pituitary-adrenal axis in infancy, CRF-corticosteroid-monoamine collisions, aberrations of the immune system during development and risk factors underlying personality disturbances offered proliferations of alternatives to juggle with the emerging profusion of human genetic variation and sensory gating abnormalities. Indeed, here, if ever, was there scope for Occam's razor. Developmental accidents that may underlie schizophrenia involve a multitude of potential structural abnormalities, enlightened through neuroimaging studies, with neonatal disconnections in hippocampal circuits, or the ravages of potentiated apoptosis, or the necrotic effects of neurotoxic action. One may with some validity envisage a catastrophic situation, like Humboldt's current as it contends with El Niña a couple of times each century, a neurodevelopmental dilemma even for the best of genetic predispositions. The neurodegenerative disorders, too, were examined from their genetic and early childhood liabilities, apoptosis, hydroxyl radicals and iron overload. In addiction disorders, there have been, are being and will be great tragedies that unfold, none more terrible than those evolving through the infant, child and juvenile and further exacerbated by our own confused consternations and cowardly compliance. As we drum our breasts and bray our righteousness, let us first look to the qualities of the three Ignatius': stalwart Loyola , the soldier dedicated to eradicating the evils of complacency, Bishop Ignatius , the scourge of the unworthy and worldly authority of the Emperor Trajanus , and, the clever Ignatio , that diviner of horse sense, who knows that horses are good at thinking, well you see, they have big brains, and we, poor humans with our little brains, must put so much effort into that cerebral activity, and nevertheless, look where it gets us. Well, wherever all our thinking leads us, we shall get there despite the paths. The Meeting was dedicated, too, in memoriam to Bela Bohus , whose memory was honoured by David de Wied in a small commemoration of the Bohusian contributions to Behavioural Neuroscience. Like the good Bishop Jean, Bela was a kind and gentle man with great gifts as a scientist but even great gifts as caring person. We have been fortunate to participate at many meetings and conferences at which Bela , too, attended and enriched. His was a happy soul, the happiness of contentment, humility and fondness for the human animal in all its weakness. With Bela , the old adage was never more certain: Truly the meek shall inherit the earth .

Of all the Biannual Mojacar Meetings, held regularly since 1995, the strategy of studying the neurodevelopmental background to structural abnormalities and functional deficits evolved into a uniquely challenging, yet daunting, venture. Through the months, weeks and days bringing us nearer the meeting (attendance and logistically the most ambitious, too), and through the numerous trips between the Parador and Almeria airport (during two of which it developed that two Invited Speakers were otherwise detained due to family tragedy), the ever-mounting tensions began to take their toll of all concerned, and, indeed, did put an Herculean strain on the resources of the Local Organising Committee . Regrettably discordant with the scope and intensity of the tasks accruing to this truly admirable body, the recognition and appreciation that we, the visiting scientists, coddled, eccentric and (perhaps understandably so) self-centred, cocooned in the aura of well-being and instrumental security contrived for us, manage to demonstrate may never sufficiently meet all those flora of favours and friendliness that we are so excessively recipient of throughout the visitation. But, the Local Organising Committee would never expect recognition or appreciation. They do, as they always have, what has to be done, overt organisation, covert consciensciousness. Nevertheless, it is both overdue and high-time that one establishes the universal consensus of a contention that every single Invited Speaker/Participant over the years has indicated: "There never was a Local Organising Committee to compare with the one in Mojacar, bless them, viva, and may the sun of their collective virtues never set".

Yet again, did the benevolent ambience of the place, the season and the mental state rock the intrepid students of parkinsonism, dementias, depressive and anxiety states, genetic predispositions, disorders expressed in childhood, addiction and schizophrenia. In the last third of October, the setting 'afton' sun bathes the gentle gradient of sand and finely-rounded pebbles, cockles and shells on a long, amorphous strand running parallel with the front-face of the Parador and east-west, along the Garrhucha-Carboneras, Aguilas-Cabo de Gate-oriented avenue of interspersed bars, restaurants and hotels. "Forget Ipenema and the Copacabana, Kailua or whatever". This is the time of the day, immediately post-poster presentations, that accommodates a perfect synchrony with the termination of each day's urgent, energetic and exhaustive intellectual and cognitive effort by providing the fortunate few with ninety delicious minutes to grab a bathing-towel from that delightful Reception Staff, bathing trunks (now dry) from the balcony table and the once-familiar exuberance of end-of-school-day schoolboys and gather on the beach, with rapid change of costume and rush among the surging and frothing, sighing and murmuring sea. There, embraced by the insistent swells, stumbling on a pebble of irregular form and caressed by that warm, heavenly globe just fifteen degrees above the western horizon, one may converse with Johannes Paulus' 'window' into current understandings of what God in his Graciousness meant the soul to abode. Although, George Vetulani (here, tragically, irresponsibly, minus the magnificent Nalepa ) does not look at all like a 'window', rather more like the merging of a Hooker (on the field of rugby football!) with some displaced Dickensian Patriarch, who unfailingly discoursed a remarkable synopsis of one and every presentation of each day's lecturers, their strengths and weaknesses, implications and vagaries, take-home-messages and improbabilities. On the arrival of that mild and gentle gentleman from Tennessee , Richard Kostrzewa , discussions invariably turned philosophical, insights were divulged, ramifications and notions were exchanged and eventually the forthcoming culinary highlights of the next soon-to-be-experienced sumptuous Parador Dinner 'slickered' amid and betwixt saliva and the salty mediterrean (the mare nostra of Marcus Licenius, Gnaes Pompeius and Barbarossa ). The orchestration and choreography of every parador meal by our own Madonna Isabel becomes almost spiritual in its configuration of hedonia, health and Hippocratic care. Then, in a frenzy of anticipation, stagger back up to the beach to dry off and perform, as inconspicuously as possible, the famous (or hilarious) English Stork Towel-Dance (á la Mr. Bean ), followed by the wonderful luxury of a long, steamy shower and, at last, the welcoming smiles as one enters the refectory glass-doors to that affectionate, attentive company of the Parador dinning-room staff, and the bosom of warm-eyed friends and colleagues, all ready with the latest exploits of Bishops, Cardinals, Monsignors and Papal legates, masters and mistressed, 'sailing ships and sealing wax, cabbages and Kings' á la Mousse Youdim, our inimitable entertainer, sage and anchor to the real life. Another wonderful end to a perfect day!

Reminiscing, it is not unreasonable to imply, nostalgically or resignedly, that life may simply be a series of mundane, semi-mundane and banal academic and non-academic assignments interspersed with Mojacar meetings . Once again, the venue of the Speakers' dinner was arranged at "Don Tadeo's of Villarilos" to the expectant delight of previous partakers, the surprised wonderment of 'first-timers' and the consummate alimentary ecstasy of everyone. Our Host, and President of culinary science, Don Tadeo himself, was in his special element as if there-was-no-tomorrow, enticing, entertaining, cajoling, cosseting, captivating all the five senses of staid neuroscientists until like the crustaceans being devoured we shed our carapaces, releasing ourselves to the gentle charm of this 'Pied Piper' gourmé of Hortensian proportions, and drifted into that timeless state of utter well-being. Are these the essential gifts of the Indalo that one has wondered so much about? Is this a sign that there remains some hope of salvation for us? Or, is this why the 'terror' failed and instead God's courier, our Good Bishop Jean , set the scene for the latest, and most ambitious, meeting in Mojacar, and Don Tadeo completed the process? If we last long enough, if we appreciate our blessings and accept our crosses, if we remember always the bravery of our Speakers and participants, if we maintain our honest efforts in dedication to our science and if we nurture and nourish the friendships that Mojacar, and Spain , has donated us, well, we just might be lucky.

T. Archer R.J. Beninger T.Palomo

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