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As I stared at the small frame hanging from the walls of my friend’s bedroom, I found myself entranced. I remember standing in awe as I took in the dark swirls of the painting’s dark blue sky; the bright yellow dots that represented the stars; and the calming landscape of the town in the background. The way that these aspects seemed to move and churn drew me in, unlike any other painting that I had previously encountered.

The painting that saw that day was Vincent Van Gogh’s The Starry Night, to this day, one of my favorite paintings of all time. When I stared at that painting for the first time, I initially appreciated the visual beauty of the work, taking it just as a simple piece of art. However, I recently had the opportunity to visit the mental asylum where he is said to have painted many of his most prolific pieces. While I was there, my individual perception of the painting began to change. Rather than a simple piece of art, Van Gogh’s style and painting began to reflect a deeper meaning, a look into his deteriorating madness.

Starry Night: One of Van Gogh’s most prolific paintings. Said to describe the view of a village from the east window of his mental asylum.

While Van Gogh is still remembered today by the many beautiful pieces of work, there is another aspect of Van Gogh himself that remains a hot topic of discussion, his mental instability. Throughout his life, Van Gogh had suffered through many psychotic symptoms. He was noted to have suffered from multitudes of mood swings between major depression and extreme highs, incoherent speech, and lapses of consciousness (Blumer, 2002). He was also noted to have suffered from visual and auditory hallucinations, although these were only within short durations (Strik, 1997). While there is a multitude of diagnoses surrounding the actual nature behind Van Gogh’s mental instability, the most prevalent of these is the diagnosis of bipolar disorder (Blumer, 2002). While understanding the nature of Van Gogh’s illness offers up an interesting line of discussion in itself, I believe this discussion is simply a platform for a greater line of questioning. That question is whether Van Gogh could be effectively treated with the techniques of today.

Since the time of Van Gogh, modern psychiatric treatments have developed far beyond what we could have imagined. With the development of mood stabilizers and antipsychotic medication, the effective treatment of these major mental disorders has increased dramatically (Lopez-Munoz et.al, 2018). However, one of the most effective treatments for the most popular diagnosis of Van Gogh, bipolar disorder, may not lie within the development of these modern antipsychotic medications but rather something rather shocking, electroconvulsive therapy.

Electroconvulsive therapy, otherwise known as ECT, is a form of treatment within patients with severe depressive or bipolar disorder. The technique relies on administering a brief electrical stimulation of the brain while the patient is under anesthesia. This brief electrical stimulation forces the patient into a brief seizure (McDonald, 2016). Though the exact mechanisms underlying the effectiveness of electroconvulsive therapy are unknown, there are still a variety of theories that are used to explain the phenomenon. One of the most common of these theories deals with ECT’s influence on the release of neurotransmitters. One study conducted in 2014 by Baldinger, found that after the implementation of ECT on patients suffering from bipolar disorder there was an overall increase in the release and binding of the neurotransmitters serotonin and dopamine, which are associated with the stability of one’s mood and the brain’s reward system respectively (Baldinger, 2014).

A picture of a patient going through electroconvulsive therapy. Unlike electroshock therapy, electroconvulsive therapy is generally very safe with few side effects.

While this particular treatment gets a horrible reputation by the press, often being cited as unethical and invasive, modern neuroscientific research seems to show a different story. In a recent study conducted in 2017, Perugi et.al aimed to investigate the influence that ECT had on the response rates of patients who suffered from Bipolar Disorder. By conducting an observational study on 522 patients who suffered from Bipolar Disorder before and after they had gone through ECT, Perugi found that around 344 (approximately 68.8%) of participating patients responded positively to the treatment. These results reflected Perugi, the greater effectiveness that ECT seemed to have with the response of the patients. He notes how with the improved rate of response along with the unlikelihood of future mood destabilization within his patients, that ECT should not be limited towards a finite amount of patients but used within a greater context (Perugi, 2017).

With the greater percentage of improvement that we see in modern-day patients with bipolar disorder, it can be easily inferred how the implementation of this treatment could have influenced the treatment of Van Gogh during his time. Techniques like ECT have pioneered a modern wave of mental illness treatment that allows for those suffering to live the best lives that they can possibly achieve. Who knows, if only this type of treatment were readily available to Van Gogh’s personal physicians, maybe there would have been greater amounts of Van Gogh’s work to fill the halls of museums all around the world.

Citations:

Baldinger P, Lotan A, Frey R, Kasper S, Lerer B, Lanzenberger R. Neurotransmitters and electroconvulsive therapy. J ECT. 2014;30:116–121.

Blanco C., Laje G., Olfson M., Marcus S.C., Pincus H.A. 2002; Trends in the treatment of bipolar disorder by outpatient psychiatrists. Am. J. Psychiatry.159(6):1005–1010.

Blumer D. The illness of Vincent van Gogh. Am. J. Psychiatry. 2002;159:519–526. doi: 10.1176/appi.ajp.159.4.519.

López-Muñoz, F., Shen, W. W., D’Ocon, P., Romero, A., & Álamo, C. (2018). A History of the Pharmacological Treatment of Bipolar Disorder. International journal of molecular sciences, 19(7), 2143.

McDonald, W., & Fochtmann, L. (n.d.). 2016; What is Electroconvulsive therapy (ECT)? Retrieved from https://www.psychiatry.org/patients-families/ect

Perugi, G., Medda, P., Toni, C., Mariani, M. G., Socci, C., & Mauri, M. (2017). The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features. Current neuropharmacology, 15(3), 359–371.

Strik, Werner. (1997). [The psychiatric illness of Vincent van Gogh].. Der Nervenarzt. 68. 401-9.

https://en.wikipedia.org/wiki/The_Starry_Night#/media/File:Van_Gogh_-_Starry_Night_-_Google_Art_Project.jpg

https://www.cchrint.org/wp-content/uploads/2017/05/electroshock-2.jpg

In the English classes that I take at Emory, there often comes a discussion about what influence, if any, the life of the artist should have on our interpretation of the source material. In most instances, it is important to allow the work to speak for itself. JK Rowling has made headlines recently for angering fans by making proclamations about the Harry Potter universe which are not evident in the books. But sometimes the life and the art are intertwined; Sylvia Plath’s poetry for example is deeply personal, and it is difficult to avoid factoring in her suicide when discussing it. Of all the cases in which the life of an artist and their art are connected, the story of Vincent Van Gogh is probably the most famous. A brilliant painter, unappreciated in his time, struggles with his sanity, cuts his own ear off, and dies under mysterious and violent circumstances. This past week I have gotten the chance to see some of Van Gogh’s paintings first hand and to wander the town of Arles where he worked, but unfortunately following in his footsteps has not yielded much clarity. Van Gogh’s art speaks for itself, but a deep appreciation — and, I admit, some morbid curiosity — drove me to take a closer look.

Garten des Hospitals en Arles by Van Gogh.

Yours truly in the above garden, trying to figure out how it got so yellow.

Over the decades, a number of scientists have applied modern medical knowledge and a fair deal of detective work to try to better understand Van Gogh the man and his paintings. One study suggests that the increased amount of yellow in Van Gogh’s later work was the result of digitalis intoxication, a side effect of the foxglove plant he was prescribed to treat his epilepsy. Digitalis intoxication can cause yellow spots in an individual’s field of vision (Lee, 1981).

Van Gogh’s painting of Dr. Gachet, seen with the foxglove plant he likely treated the artist with. I was going to buy it, but I’m about $82 million dollars short.

It is not sound medical practice to posthumously diagnose a patient, and so much of what we know about Van Gogh’s mental health is based on records from his prolonged hospitalization in Arles. Van Gogh was diagnosed and treated for epilepsy, a disease that was likely made worse by his substance abuse (Lee, 1981). It is believed that Van Gogh may have suffered from an additional mental illness, as his bouts of mania and depression bear striking similarity to bipolar disorder (The Van Gogh Gallery: Vincent Van Gogh’s Mental Health; Lee, 1981). However, a diagnosis of epilepsy does account for many of the curious features in the artist’s work.

Temporal lobe epilepsy is a form of refractory focal epilepsy (Allone et al., 2017). In this version of epilepsy, neuronal misfiring in temporal lobe structures start seizures which may or may not spread throughout the brain (Engel, 1996; Engel 2001). This is likely the form of epilepsy which Van Gogh had, as it is the most common form of epilepsy and temporal lobe structures deal with auditory processing (Van Gogh suffered from auditory hallucinations) and object recognition (Engel, 2001). Interestingly, hallucinations or dream-like cognitive states are not uncommon in patients with the disease (Allone et al., 2017). One of the defining features of Van Gogh’s art is the dream-like blurring of objects; in the above painting of Dr. Gachet, the background and the doctor himself are distorted into surreal representations of the subject matter. This effect is common in impressionist paintings, but it is more pronounced in Van Gogh’s work than in most other’s. This artistic style may have been more potent for Van Gogh if he painted while in a state of delirium or if he had sustained damage to an area of the temporal lobe implicated in object recognition. The cognitive impairments arising from severe temporal lobe epilepsy can manifest in different ways. Patients commonly report memory deficits, but one feature may be a negative effect on “praxis”, defined as one’s ability to perform skilled actions like painting (Allone et al., 2017). Between hallucinations and delirium, seizures, brain damage, and loss of praxis one can begin to see why Van Gogh’s perception of the world differs so much from that of the average person.

Taken together, Van Gogh’s epilepsy and treatment regimen can begin to account for some of the features of his art. The longer temporal lobe epilepsy persists, the more severe the cognitive impairments associated with the disease become, which explains why Van Gogh’s symptoms seem to have worsened over time (Allone et al., 2017). Epileptic activity may also explain Van Gogh’s hallucinations and his unorthodox depiction of objects in his paintings. Ironically, the treatment it is thought Van Gogh was prescribed can also negatively impact vision and cognition, even causing delirium in certain cases (Lee, 1981).

Wandering around Arles, I was struck by the notion that I didn’t see the town in the same way Van Gogh did. There is a gap between the landmarks I saw and his paintings of them that I found difficult to reconcile. I now know that only part of that gap should be attributed to artistic representation; Van Gogh’s world may have been one of blurred images, vibrant colors, and distorted objects. I believe that part of the function of art is to help the viewer see the world’s beauty in a different way, and Van Gogh certainly accomplishes that in all of his paintings. At the end of the day, it doesn’t matter if the artist’s masterpieces were fueled by imagination or misfiring neurons. The world is lucky that one man’s tragic suffering resulted in such incredible works of art, and I’m lucky to have been able to take a step closer to understanding that man’s incredible mind.

Works Cited

Allone C, Buono VL, Corallo F, Pisani LR, Pollicino P, Bramanti P, and Marino S (2017) Neuroimaging and cognitive functions in temporal lobe epilepsy: A review of the literature. Journal of the Neurological Sciences 381:7-15

Engel J (1996) Introduction to temporal lobe epilepsy. Epilepsy Research 26: 141-150

Engel J (2001) A Proposed Diagnostic Scheme for People with Epileptic Seizures and with Epilepsy: Report of the ILAE Task Force on Classification and Terminology. Epilepsia 42(6): 796-803

Lee TC (1981) Van Gogh’s Vision: Digitalis Intoxication? The Journal of the American Medical Association (JAMA) 245(7):727-729

The Van Gogh Gallery: Vincent Van Gogh Biography. https://www.vangoghgallery.com/misc/biography.html

The dreaded question by every parent – “why is the sky blue??”. It is a long-standing fact that the sky is classified as blue, but when it is put into question, this idea that has been so deeply ingrained in our brains begins to falter. Depending on so many factors, the sky can be garnished by so many other colors. This is especially true in terms of artwork and the abstraction that accompanies it. The constructs that we have grown up in have assigned very concrete terms to very abstract objects – without this, how would we begin to explain the color blue?

A Parisian sunset of orange, pink, purple, and lastly, blue.

As Norris notes in her review of Color in the Age of Impressionism (2019), artists such as Degas, Renoir, and Monet encouraged the use of brighter color palettes. Color became abstracted and independent – autonomized in a sense. This created a world in which color and object were not always married in comparison to those in the natural world…this became especially true in post-impressionism. Artists such as Van Gogh, Seurat, Cézanne, and Gauguin truly divorced color from form. In this case, the sky could be painted green but the context of the painting would still allow your mind to label it as the ‘sky’.

A Parisian rainstorm causing the sky to turn completely grey.

These painters began to venture into a more abstruse realm of color. Object-associated color is implicated in the left fusiform gyrus in the posterior temporal cortex; near here is also where color is perceived (Simmons et al., 2007). Through an fMRI study performed by the discussed paper, it was found that color knowledge is also stored in this area lending evidence to the theory that knowledge is contained in modality-specific brain regions (Simmons et al., 2007). In this case, color knowledge is stored where object recognition takes place. By this token, recognition of the sky in a painting stimulates both color knowledge and object-associated color simultaneously. This can be occasionally problematic when object-associated color does not match with color knowledge.

One of Monet’s many Water Lilies paintings that shows extreme abstraction of color where the ‘sky’ is magenta.

However, memory is also involved in the perception of color as it’s inherently involved in most everything we do (Hansen et al., 2006). These researchers asked participants to tweak the color of fruits until they appeared to be grey; this was typically when the grey point was manipulated to that of opposite the fruit’s natural color (Hansen et al., 2006). This demonstrates that perception of color is heavily regulated by visual memory. Seeing the sky as blue during a particularly beautiful day is not rare, it has been consolidated as a memory in the brain. Perceiving the sky as blue in a painting, therefore, is easy. Yet, a lime green sky is an incompatible scene to imagine. Therefore, the brain must use unconsciously use the surrounding context clues to fill in the gaps. Though we may not notice this, it is happening constantly within our minds to fill in small gaps within our world that may not make logical sense.

The Sower by Vincent van Gogh, November 1888 adorning a green sky.

The general question, “what color is the sky?” opened a can of worms in the visual perception of color from an artistic viewpoint. As I explore Paris and learn of all its history and artwork, many of the paintings request a second longer to interpret. This was true especially for paintings from the post-impressionism movement as seen at the Musée d’Orsay. The uncoupling of objects from their natural color removes the ability of memory archives to be used contributing to the beauty and allure of these paintings.

References

Hansen T, Olkkonen M, Walter S, Gegenfurtner KR (2006) Memory modulates color appearance. Nature Neuroscience 9:1367-1368. doi: 10.1038/nm17

Pope N (2019) Color in the age of impressionism: commerce, technology, and art by laura anne kalba (review). Technology and Culture 60(1):330-33. doi: 10.1353/tech.2019.0018

Simmons WK, Ramjee V, Beauchamp MS, McRae K, Martin A, Barsalou LW (2007) A common neural substrate for perceiving and knowing about color. Neuropsychologia 45(12):2802-2810. doi: 10.1016/j.neuropsychologia.2007.05.002

Van Gogh V. (1888) The Sower. [Painting]. Retrieved from https://www.vangoghmuseum.nl/en/collection/s0029V1962?v=1

I met Eli almost exactly three years ago on a study abroad trip to Dharamsala, India. Tall, lanky and endearingly awkward, he was an easy target to befriend. Over the course of spicy tandoori and excessive amounts of naan, we became dear friends, friends in which comfort equates to honesty and judgment lacks. Despite our busy schedules, we always made time to see each other a few times a semester until of course he had to graduate. A year older and a fellow neuroscience major, Eli decided to take his talents overseas to the University of St. Andrews to complete his masters. Throughout the course of the year, we facetimed until one fateful day I told him of my upcoming plans to study in Paris. Excitedly, we planned to a day to see each other—-two months in advance.

The fateful day arrived this past Sunday, and my excitement could not be understated. I had been experiencing some unexpected culture shock and missing home, so I hoped our meeting would provide some ease and comfort as I continued adjusting to the city. We ended up in the Jewish quarter of Paris. Bakeries lined with challah and plates of hummus surrounded us, and my middle eastern self was having a field day. Eli recommended a falafel place with an exorbitant line which seemed promising. A brief exchange of broken Hebrew and soon we were walking to the Siene in with the biggest falafel sandwiches I had ever seen. The afternoon was spent eating delicious food, lying by the water, and talking about everything and nothing simultaneously. After lunch, we went to a crowded café and indulged in overpriced coffee and refreshing sorbets. And before I knew it, our day had ended. I walked him to the train, bid him au revoir, and left for home with newfound contentment and peace. Sunday brought back a realization I had made at graduation; having close friends is one of the most important and gratifying experiences of life. But what makes a close friend? Is it matter of respect and admiration of differences or similar worldly paradigm that draws us together?

Recent research led by Dr. Carolyn Parkinson set to solve these questions by testing whether within a social network the neural response to naturalistic audiovisual stimuli were more similar amongst close friends. Was my perception of the Parisian skyline more similar to Eli? Was this the real foundation of our friendship?  Parkinson et al., 2018 used 279 first year graduate students to test their theory and constructed a visual social network display for all for them, aka the social spider web (depicted below). Analysis of this image holds a variety of information due to self-reporting but, none was more interesting than the reciprocity rate, the rate in which two people name each other as a friend. A whopping 47.2%, which means probably over half of the “friends” we have aren’t friends (Parkinson et al., 2018).

Delving to the neural level, a subset of these students was placed into an fMRI machine and shown various movie clips in a predetermined order. Would the minds of friends show similar audio and visual firing patterns? If so, could we determine friendships merely by looking at these scans? Response patterns were gathered from 80 anatomical brain regions (Parkinson et al., 2018). Several brain regions such as the nucleus accumbens, inferior parietal cortex, and superior partial cortex showed statistically significant neural significance. The increased correlation with these areas is particularly interesting because the nucleus accumbens is linked to motivation, learning, and affective processing and the reward network while the inferior parietal cortex is playing a role in attentional allocation. These finding provide further scientific evidence of close friendships being rewarding and requiring a high degree of attention.

An additional point of interest is whether there were factors beyond friendship driving similar neural responses. In the control group, the weighted average of neural response similarities and dissimilarities were compared for five factors: nationality, handedness, gender, ethnicity, and age. Age and ethnicity surprisingly showed little similarity in neural responses, while nationality, handedness and gender all were statistically significant in correlation with neural response similarity (Parkinson et al., 2018). The fact that amongst close friend’s nationality has more influence on how they interpret the world over ethnicity is mind boggling. Yet, I would be lying if I don’t perk up when I hear English in the subways. The stark differences in Parisian and American culture has proved to me the substantial role culture plays in determining our behavior and world view. Coming from the South, I have come to expect bubbly greetings upon entering restaurant and now I meagerly whisper a “Bonjour” through a tight smile and quickly avert my eyes. Perhaps of the comfort of Eli’s Sunday’s visit was less to do with us as individuals but in how we saw Parisian life similarly, how in awe we were at the leisurely lifestyle, and how little French we understood. And for four short hours with the Eiffel Tower overlooking, I was home.

Eli back row with grey collar, Me last on left 

From the study

Citation:

Parkinson C, Kleinbaum AM, Wheatley T. Similar neural responses predict friendship. Nat Commun. 2018;9(1):332. Published 2018 Jan 30.

Upon arrival in Paris, all students part of the NBB Paris Program sat through an orientation, during which we essentially received a crash course on French culture and its intricacies. One of the tips we were given was to observe the facial expressions of daily metro riders and to adopt their expressions so as to not look like wide-eyed tourists trying to take in all of our surroundings. I adopted their expressions, but I also found myself eavesdropping on other’s conversations.

Figure 1:Photo of me at The Mazet. Hopefully this confused expression is not the one I have on the metro…

One of the more interesting conversations I heard was between a lady who seemed quite irritated, and her husband. Her words essentially translated to “I’m dying to smoke a cigarette”. It is quite apparent that smoking is fairly common in France, or at least in Paris. I became curious to better understand the neurological effects of smoking.

We all have all too often seen not so subtle “Smoking kills!” warnings in movie scenes. But why exactly is smoking “bad” for you and more specifically, your brain? Before diving into how smoking negatively impacts the brain, it may be helpful to gain a brief overview of the parts of the main parts of the brain involved. The increased activation of the ventral striatum and the nucleus accumbens, in smokers, has been of immense interest because addictive substances such as nicotine, stimulate dopaminergic neurons in these structures, which triggers the brain to think of nicotine as a rewarding stimulus (Benwell et al., 1995). Essentially the brain begins to crave this “reward”.

Figure 2: The Reward Pathway

But in exactly what way does smoking cause damage to the brain? A recent study suggested that smoking decreases brain connectivity. Firstly, what does “brain connectivity” really mean and how it is measured?  Brain connectivity refers to how closely different parts of the brain are “interacting” with each other (Cheng et al., 2019). This can be measured using fMRI (functional magnetic resonance imaging), which measures brain activity when a person is at rest, allowing researchers to analyze patterns of activity in the brain (Cheng et al., 2019). The study by Cheng et al. (2019) used fMRI data of 831 subjects from the Human Connectome Project. The study suggested that smokers had low overall functional connectivity between brain regions as opposed to drinkers who had high overall functional connectivity between brain regions (Cheng et al., 2019).

One of the most interesting findings from the by Cheng et al. (2019) study was that the smoker’s brain regions impacted the most included the lateral orbitofrontal cortex (OFC) and inferior frontal gyrus (IFG). The lateral OFC plays a significant role in modifying and inhibiting behavior. So it makes sense that decreased connectivity of the lateral OFC to other parts of the brain, is associated with increased impulsivity (Cheng et al., 2019). Impulsivity was measured using stop-signal tasks that measure response inhibition. Additionally, the researchers make an important point that it is important to consider the possibility that decreased functional connectivity may not just be a result of smoking, but instead could have an impact on the likelihood of smoking (Cheng et al., 2019).This is only the tip of the iceberg in terms of the various neurological changes that may occur as a result of smoking.

All these negative impacts yet people still continue to smoke. Is it due to unawareness? Is it due clever advertising? Since I am interested in neuromarketing, I wondered about the history of tobacco advertisements in France. This past semester, I took part in the Intramural Emory Global Health Case Competition and the goal was to offer solutions to address the use of electronic nicotine delivery systems in China’s Guandong Province. Advertising and marketing were essential considerations. I was surprised but at the same time not really surprised by the amount of recent literature and research that exists on “Using Neuroscience to Inform Tobacco Policy Control” (Maynard et al., 2019).

Figure 3: Commonly seen “No smoking” sign in Paris metro stations

In 2010, in France, the Droits des Non-Fumeurs association (Non-Smokers Rights Association) used a suggestive analogy, comparing smoking to sexual slavery, to convey the message that – “Smoking is equivalent to being a slave to tobacco”. It is provocative so fair warning. I will link the image of the advertisement here for those who want to see what the controversy was about. While this advertisement created quite a stir, the ad came to be known as a “prevention flop” (Oullier & Sauneron, 2010).

Figure 4 and 5: Different approaches to anti-smoking advertisements – Non graphic vs. graphic

Dr. Langleben is known for his research on investigating what type of ads have the potential to actually change behavior and not to simply shock the viewer. Dr. Langleben, in collaboration with Wang et al. (2013) observed increased activation in the dorsomedial prefrontal cortex (dMPFC) when smokers watched an anti-smoking ad with a strong argument as compared to one with a weak argument. “Smoking causes disease and/or death” qualifies as a strong argument whereas “Smoking makes you less attractive to potential partners” qualifies as a weak one (Penn Medicine News, 2013). Increased activation of the dMPFC, which mediates future behavior, may be associated with the study’s finding that the participants who watched the strong argument ads had significantly less of a metabolite of nicotine in their urine, one month later (Wang et al., 2013).

These findings suggest that neuroscience is an extremely useful tool not only in terms of understanding the impacts of smoking on the brain but also in terms of informing the creation of media content. Supporting my (definitely biased) viewpoint that neuroscience applies everywhere!

I guess now I’ll start handing out copies of this blogpost to smokers in the streets of Paris? Stay tuned to see how that goes..

Shelby Walia

References

Benwell, M. E., Balfour, D. J., & Birrell, C. E. (1995). Desensitization of the nicotine-induced mesolimbic dopamine responses during constant infusion with nicotine. British journal of pharmacology, 114(2), 454–460. doi:10.1111/j.1476-5381.1995.tb13248.x

Cheng, W., Rolls, E. T., Robbins, T. W., Gong, W., Liu, Z., Lv, W., … Feng, J. (2019). Decreased brain connectivity in smoking contrasts with increased connectivity in drinking. eLife, 8, e40765. doi:10.7554/eLife.40765

Karama, S., Ducharme, S., Corley, J., Chouinard-Decorte, F., Starr, J. M., Wardlaw, J. M., …

Deary, I. J. (2015). Cigarette smoking and thinning of the brain’s cortex. Molecular psychiatry, 20(6), 778–785. doi:10.1038/mp.2014.187

Oullier, O., & Sauneron S. (2010). Dans le cerveau du fumeur : neurosciences et prévention du tabagisme. In Nouvelles approches de la préventionen santé publique : L’apport des sciences comportementales, cognitives et des neurosciences (pp. 86-104). Centre d’analyse stratégique, AWS Édition Paris. https://www.ladocumentationfrancaise.fr/var/storage/rapports-publics/104000139.pdf (French) http://oullier.free.fr/files/2010_Calvert-Gallopel-Morvan-Sauneron-Oullier_Neuroscience-Prevention-Public-Health_Prevention-Public-Health-Neuroscience-Book_Antismoking-Tobacco.pdf (English)

Penn Medicine News. (2013, April 23). Anti-Smoking Ads with Strong Arguments, Not Flashy Editing, Trigger Part of Brain That Changes Behavior, says Penn Study [Press release]. Retrieved from https://www.pennmedicine.org/news/news releases/2013/april/antismoking-ads-with-strong-ar

Wang, A. L., Ruparel, K., Loughead, J. W., Strasser, A. A., Blady, S. J., Lynch, K. G., Langleben, D. D. (2013). Content matters: neuroimaging investigation of brain and behavioral impact of televised anti-tobacco public service announcements. The Journal of neuroscience : the official journal of the Society for Neuroscience, 33(17), 7420–7427. doi:10.1523/JNEUROSCI.3840-12.2013

Figure 1 – Photo of me taken by friend

Figure 2 – Dopamine Reward Pathway, Indiana Prevention Resource Center, taken from http://desalledesigns.com/cdesalle/Tobacco1/development/a_04_05_01.html

Figure 3 – France, ile de france, paris 20e arrondissement, bd de menilmontant, station du metro pere lachaise, ratp, Hector Guimard, Date : 2011-2012, taken from https://www.alamy.com/stock-photo-france-ile-de-france-paris-20e-arrondissement-bd-de-menilmontant-station-72247555.html

Figure 4 – Tobacco Teeth Anti-smoking Advertising by Miroslav Vujovic, taken from https://competition.adesignaward.com/design.php?ID=55730

Figure 5 – Graphic Anti-Smoking Ads May Backfire, Pacific Standard (2017), taken from https://psmag.com/economics/graphic-anti-smoking-ads-may-backfire

One of the first things I noticed when I arrived in Paris is the amount of traffic and the prevalence of people who use the Metro to get around. Even though I’ve lived in Atlanta my whole life, I think I had been on MARTA once when it was full to standing room only, and that was only because two big events ended around the same time. However, every morning on my commute to class in Paris it seems like we are fighting to be able to get a spot on the train. Another major difference that I’ve noticed between these train systems is that the Metro trains tend to have more turns in the tracks, which never fails to make a large group of the people standing momentarily lose their balance.  Here are the maps so that you can compare the two.

Image from the French Metro map website

Image from Marta guide website

Whenever the train goes around a bumpy turn, you always see people taking a step or people who weren’t previously holding onto anything reach out to the nearest pole. Considering the number of ways the train can throw you off balance, it’s almost surprising that people never fall over. This made me wonder, why is it that we are able to balance so easily even when the ground beneath us is moving?

According to Chiba et al. (2016), your body uses information like vision, the location of your body and limbs, touch, and the position of your head to maintain its balance. Together, these all allow the central nervous system to help control your posture and if one of the inputs becomes less reliable, then the body compensates for it by paying more attention to the other inputs. According to Takakusaki (2017), these inputs all enter the brain where they are processed in various regions. These signals can then follow either automatic or cognitive pathways in order to then exit the brain through the spinal cord so that the signal can be delivered to the body. The automatic pathway, which controls balance, is much more direct which allows you to respond faster.

Coelho et al (2016)’s study added an extra layer to understanding balance by giving people an extra task while testing their balance. They tested balance while an individual was holding a tray with a cylinder either standing on the flat side or lying on the round side balancing on it. This reminded me of when I’m on the metro trying to hold onto my bag, phone, wallet, etc. Because of the risk of pickpocketing, I try to keep everything in front of me and I keep my wallet and phone in my hand rather than putting my phone in my pocket or letting my wallet hang off my wrist. I see others on the Metro holding items in their hands all of the time as well. While the cylinder on a tray is definitely more complicated to keep balanced than a phone or bag, I felt like this extra aspect would help to see what is going on when people are staying steady on the Metro.

They placed a harness around the participants’ stomachs which applied a constant pressure pulling them backward. They then asked them to count down from a random number by threes while they were holding the tray. They then released the harness causing them to move forward. This would cause them to have to readjust so that they wouldn’t drop the cylinder. They also tested the participants using the same procedure except without making them count down.

Both counting down and the direction the cylinder was placed in affected how fast the tray moved, how fast their upper body moved, and how much their upper body moved. Additionally, counting down but not the direction of the cylinder affected how much their center of mass moved. These results show that when the cylinder was in a more unstable position, they were able to adjust so that it moves less. They also showed that having the cognitive task seemed to make them move more.

I found these results interesting because it means that having something unstable seems to make you balance more. This seemed a little counter-intuitive to me at first, but it makes sense that the amount of attention you are spending on balancing could impact how well you balance. This is evident in how the cognitive task appeared to make balance worse. I think it would be interesting to see if the people who are hold ing objects in their hands or the ones that are zoning out are the ones that stumble more on the Metro. I also think it would be interesting to see if repetition affects balance. For example, if the people who rode the metro everyday stumbled less on the turns than visitors from cities that don’t rely as heavily on a train system or if the harness being released would cause the participants to be better prepared for it.
Works Cited

Chiba, R., Takakusaki, K., Ota, J., Yozu, A., & Haga, N. (2016). Human upright posture control models based on multisensory inputs; in fast and slow dynamics. Neuroscience Research, 104, 96-104. doi:10.1016/j.neures.2015.12.002

Coelho, D. B., Bourlinova, C., & Teixeira, L. A. (2016). Higher order balance control: Distinct effects between cognitive task and manual steadiness constraint on automatic postural responses. Human Movement Science, 50, 62-72. doi:10.1016/j.humov.2016.10.008

https://martaguide.com/rail-station-map/

http://metromap.fr/en

Takakusaki K. (2017). Functional Neuroanatomy for Posture and Gait Control. Journal of movement disorders, 10(1), 1–17. doi:10.14802/jmd.16062

Before I left, I probably heard my parents say, “be careful of the pickpockets in France!” more than a hundred times. But I’ll admit, I didn’t really take it to heart. After all, it’s not like this is my first time in a foreign city, and I felt confident in my ability to manage myself—until one of my roommates told me how she had gotten pickpocketed coming right off the metro from the airport. On the first day!

With crowds like this though, are you surprised?

I was shocked, but I still naively believed I would be okay. If anyone tried to reach into my pockets I would definitely feel it, I thought.

Then came Day 2. As my friends and I were walking to a group picnic at the Eiffel Tower—in fact, just as we were about to pass our own apartment on Avenue de Suffren—a man on the phone suddenly dropped a bunch of coins onto the ground right in front of me. This drew my attention as I sidestepped to the right and kept walking, even commenting that I should have stopped to help him pick up the coins. Suddenly, one of my friends turned and whispered that she thought she saw another guy pass to my right and take his hand out of my pocket. I immediately patted my pockets and realized my phone was gone! Instantly I felt my heart rate pick up as I turned and ran after the guy to confront him, and later on his partner too.

The downsides of living right next to the Eiffel Tower: the tourists lure more pickpockets!

Pickpockets are known for taking advantage of inattentional blindness, a phenomenon that you may have even seen in the famous “gorilla” study (video linked here) that showed the extent of how much our perception can be manipulated by directing our attention towards certain things (Simons and Chabris, 1999). You have probably also experienced this in your daily life: for example, as a pedestrian, you are more likely to notice the other pedestrians walking around you or the smell of the coffee shop you’re passing by; as a driver though, you probably wouldn’t notice any of that, but rather notice things like traffic lights, speed limits, and other cars. Even though the pedestrian and the driver have the same things in their environment, the brain filters and processes them differently. A recent publication found that human subjects were more likely to notice unexpected objects in close areas with some risk detected and fail to notice similar objects in areas where there was no threat detected (Wood and Simons, 2019). For me, the first man who dropped his change on the ground immediately diverted my attention–both visually and aurally–to the situation on my left, which I had identified as more of an immediate risk to me than the man on my right, which I had not even noticed passing by me (even though he was wearing a bright blue shirt).

They also suggest that it is not only the context of what is around you, but also how you can interact with those objects that influence how you focus your attention (Wood and Simons, 2019). Even though both subjects in the environment were younger men, I was forced to interact with the man who dropped his coins to step out of the way, right into the proximity of the pickpocket who I was not forced to engage with and so did not pay any attention to, allowing him to slip his hand into my pocket.

However, now that I reflect on my actions in response to the theft, I also see where I may have acted a little irrationally. After I told my parents that night, they did give me an angry lecture, but more about my decision to chase after someone who could possibly be dangerous (in my defense, what else could I have done? Flag down a police officer with my non-existent French skills?)

I’d argue that my actions may have to do with the idea that under acute stress, people seem to make more instinctive, less logical decisions. In dangerous situations, animals may show signs of sympathetic nervous system activation (the “fight or flight” response) including increased heart rate, sweating, and respiration (Graham, 1953)—all of which I experienced. There also seems to be two decision-making pathways that evolved in the brain: one, a fast, automatic processing that relies mostly on instinct and involuntary habits, while the other is slower and requires more effortful, goal-directed cognition (Yu, 2016).

A basic schematic of the idea Yu is adapting her model from.

In her “stress induced deliberation-to-intuition” model, Yu proposes that under high pressure situations, people tend to fall back on emotional or innate responses to make decisions—going with your “gut”—rather than higher-order analytic reasoning (2016). In that split second that I realized my phone was gone, my mind blanked and my instincts told me to chase after the person and get it back. Had I hesitated, I may have thought about potential dangers and other alternatives I could have done, in order to determine the best way forward. But in the end, I was able to get my phone back, so lesson learned!

References:

Graham B.F. (1953). Neuroendocrine components in the physiological response to stress. Ann. N. Y. Acad. Sci. 56(2):184–199.

Simons D. J., Chabris C. F. (1999). Gorillas in our midst: sustained inattentional blindness for dynamic events. Perception 28, 1059–1074. doi:10.1068/p2952

Wood, K., & Simons, D. J. (2019). The spatial allocation of attention in an interactive environment. Cognitive research: principles and implications, 4(1), 13. doi:10.1186/s41235-019-0164-5

Yu R. (2016). Stress potentiates decision biases: A stress induced deliberation-to-intuition (SIDI) model. Neurobiology of stress, 3, 83–95. doi:10.1016/j.ynstr.2015.12.006

Image 1 taken by Jean-Pierre Dalbéra

Image 2 taken as a screenshot from Google maps

Image 3 taken from Peter Fisk