Study examines the neural correlates of wisdom.
The first step was to search some 200 papers in the literature for definitions and descriptions of wisdom by clinical investigators. The search yielded 10 major definitions from which six key subcomponents were identified by study coauthors Dr. Thomas W. Meeks and Dr. Dilip V. Jeste, both of the division of geriatric psychiatry at the University of California, San Diego (Arch. Gen. Psychiatry 2009;66:355-65).
They are: prosocial attitudes and behaviors, social decision making and pragmatic knowledge of life, emotional homeostasis, reflection and self-understanding, value relativism and tolerance, and acknowledgment of and dealing effectively with uncertainty. Interestingly, a separate study of the Bhagavad Gita by Dr. Jeste and Dr. Ipsit Vahia revealed that the modern descriptions of wisdom were remarkably similar to those found in this sacred Hindu scripture written centuries ago (Psychiatry 2008;71:197-209).
"This idea that the construct of wisdom had really not changed significantly over centuries or geographic boundaries suggested to us that wisdom is a biologically rooted concept and that probably there are specific sites in the brain involved in wisdom," Dr. Jeste said during a workshop on wisdom and successful aging at the annual meeting of the American College of Psychiatrists.
The authors then reviewed biological studies including those using functional magnetic resonance imaging of the brain or focusing on neurotransmitters and genetics. Again, some common themes emerged that might help explain how interactions between distinct brain regions might contribute to the subcomponents of wisdom, said Dr. Jeste, chief of the geriatric psychiatry division and a distinguished professor of psychiatry and neurosciences.
Broadly stated, the lateral/dorsolateral prefrontal cortex interacts with the anterior cingulate cortex and on occasion the orbitofrontal cortex and medial prefrontal cortex to regulate the activities of brain areas such as the amygdala and ventral striatum associated with emotionality and immediate rewards. In doing so, these connections serve to promote the subcomponents of social decision making and pragmatic life knowledge, emotional homeostasis, value relativism, and dealing with uncertainty.
An interaction between the medial and lateral prefrontal cortex is thought to be critical for self-reflection, while several regions of the brain, most notably the medial prefrontal cortex, promote the prosocial behaviors of empathy, social cooperation, and altruism, said Dr. Jeste, who is also director of the university's Sam and Rose Stein Institute for Research on Aging. In addition, genetic studies have reported that prosocial behaviors including altruism are heritable in up to 60% of cases. Although the data on neurotransmitters were limited, there appears to be a role for dopamine, serotonin, and the neuropeptides vasopressin and oxytocin in prosocial attitudes and behaviors, he said.
Dr. Jeste suggested that these neuro-biologic pathways help balance the phylogenetically older portions of the brain such as the limbic cortex with the more recently evolved prefrontal cortex. This prompted a discussion during the workshop on whether aging facilitates wisdom. Some attendees noted that Mr. Gandhi was at his wisest in his 40s and 50s and that Leo Tolstoy was less wise in his 70s and 80s than when he wrote "War and Peace."
Those in attendance also questioned whether people who are mentally ill or those who do not traverse developmental milestones can possess wisdom. It was noted that a 4-year-old can exhibit altruism in the sand box, while research just a decade ago reported that sociopaths could be empathetic. Cognition was the focus of wisdom research during the 1970s and 1980s, but now the discussion includes emotion and related characteristics unique to wisdom such as the use of knowledge for the common social good and the integration of knowledge with affect, Dr. Jeste said.
A recent review of functional and structural neuroimaging studies related to intelligence and reason identified areas of the brain that overlap with those in the proposed model of wisdom such as the anterior cingulate and dorsal prefrontal cortex, but this network in the brain, coined the Parieto-Frontal Integration Theory, did not feature areas such as the limbic cortex, striatum, and medial prefrontal cortex involved with wisdom (Behav. Brain Sci. 2007;30:135-54). "What sets the wise person apart is behavior," Dr. Jeste said.
Dr. Jeste has received research support from the National Institute of Mental Health, the National Institute on Aging, the U.S. Health Rescources and Services Administration, and the Stein Institute for Research on Aging at the University of California, San Diego. AstraZeneca, Bristol-Myers Squibb, Eli Lilly & Co., and Janssen Pharmaceuticals donate antipsychotic medications to his research.
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|Title Annotation:||ADULT PSYCHIATRY|
|Publication:||Clinical Psychiatry News|
|Date:||May 1, 2010|
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