NBB in Paris

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