Nerocognitive considerations
Indeed Nervous system is a the most complicated complex system throughout the whole universe. Since it contains of 86 × 10^9 neurons, and each neuron has a active relationship with averagely 10000 neurons. It means that there is at least 86 × 10^13 relation in your brain. This is an unprecedented event in the entire universe. By this over complex system, we could have perception, cognition, imagination and consciousness. Obviously the disease of such a complex system would be confusing. Human-being theory of reductionism.
It must be admitted that it is one of the most efficient theories that mankind has ever presented. The basis of this theory is to explain the functioning of systems based on their components. For example, if you want to know how a BMW car works, you just have to send it to a repair shop to completely tear the car down and put its parts on it. Now you can know how the car moves, brakes, cools itself and so on
The theory of complex systems entered the field when reductionists could not explain the functioning of complex systems based on breaking the systems into their component parts. Because the reductionists were oblivious to one of the main components of the systems, which was information. Information actually means how system components. communicate with each other.
There is no doubt that Nerocognitive area is the most complex area of diseases in the body. Apart from the incomplete information of neuroscience, the network function of neurons should be considered as the solution of evolution to provide the most economical organ of the body. This means that a neuron, by creating a network of 10,000 neurons around itself, sometimes participates in several complex brain functions at the same time, and this challenges the theory of reductionism. It means that neuroscientists could not localized these functional units due to their Anatomic / Physiologic coverage. It has been the most complicated problems since the foundation of neuroscience. It is very Tempting to isolate the functional units of nervous system, But we are not allowed to delay the treatment of patients until these physiological units are isolated. On the other hand, complex systems theory predicts that it is not possible to isolate functional units and reduce them to anatomical units. Because a complex system based on the theory of complex systems is more than the sum of its parts, and in other words, a complex system cannot be reduce to its parts.
The enormous complexity of the brain has finally convinced reductionists that it is better to reconsider their fundamental theory. Because in the traditional way, they were still trying to define different functional units for the brain that are separated from each other by specific anatomical boundaries. The method that had worked so far in solving many mysteries and neuroscientists hoped to unravel the problem of neurologists, psychologists and psychiatrists this time. But it did not happen.
We have an interesting proverb about this in Persian language.
"Enemy could be a cause of good if God wills". Brain complexity and its unsolved problems, assure neuroscientist to put aside the old theory of reductionism and start thinking is the way of Complex system theory (CST)
TLT application
TLT is established on the basis of CST.
- Since our nervous system is a complicated complex system, neuroscientists could not localized these functional units due to their Anatomic / Physiologic coverage. It has been the most complicated problems since the foundation of neuroscience. It is very Tempting to isolate the functional units of nervous system, But we are not allowed to delay the treatment of patients until these physiological units are isolated. On the other hand, complex systems theory predicts that it is not possible to isolate functional units and reduce them to anatomical units. Because a complex system based on the theory of complex systems is more than the sum of its parts, and in other words, a complex system cannot be reduce to its parts.
- TLT not only considers the body and of course the brain as a complex system, but also assumes that the diseases of the body and the brain are complex systems independent of each other. Obviously, TLT is not just playing with words to hide the complexity of diseases, but the purpose of accepting CST is to retell all its concepts in the body and its diseases. In other words, if I want to define one goal and only one goal for TLT, it is loading CST concepts in the body and its diseases. A goal that requires the translation of mathematical concepts of CST into the language of physiology and pathology
Brain vs Body functional units
In CTS elements and relations come together and construct a virtual unit which is responsible for a unique function. This is what TLT claim that is the basis of a distinct entity. On the other words entities are specific deviation of functional units.
Discovering body entities are very easy, since most of body functions are determined in physiology. But in neuroscience there are still many conflicts in this field. We have a lot of unknown brain disease, many unknown brain parts and many unknown function. That is time for TLT, to solve these complicated problems by CST spotlight.
In order to solve this problem, neuroscientists are trying to modeling different functional models. This is in progress and hoped to be completed soon. But relating these units to anatomic / Physiologic / Pathologic organs / Tissues is an unneeded responsibility which is is placed on scientist shoulders by reductionist philosophers. TLT claim that, it is enough for searching anatomic place for functional units. The only thing a medical doctor needs to know is the function and dysfunction of those units. That 's all. Now we can use this unit as an Entity, to find the miasm.
Since the goal of TLT theory is to provide a solution to simplify the understanding of disease patterns, and this goal was met with significant success in pilot studies on other body organs except the brain, I was encouraged to implement this model on the brain as well. Which, of course, was a wonderful dream that is gradually turning into a deadly nightmare. Until I realized that there are special rules in the brain that make it dependent on other organs. It is better to say that it may not be possible to claim with certainty that such laws are inherent in the brain, but these laws can be included in brain modeling to simplify and understand the controversy in the brain.
The first thing that comes to the mind of every viewer is the multiple dimensions of brain activity.
Movement - Sense - Cognition - Emotion - perception
This area is well known in neuroscience and I will use it as much as possible, of course, on the condition that I organize my toolbox first.
The next area is the quantification of brain function. The key question in any brain disorder is whether this disorder causes a decrease or an increase in brain function. Obviously, this ruler can be used in all the areas mentioned above
Thus, with these two tools, I will be able to classify all brain diseases in a simple way. For example, depression slows down everything, especially in the field of emotion, perception, cognitive functions, etc., and the difference with catatonia is that catatonia obviously slows down the motor system and Depression leads the emotional system and hypomania leads the patient to the rhythmic increase and decrease of the emotional system
Functional oriented study
There are different ways to classify the disease. Classification based on etiology, structural disorder, histologic deviation or pathology and functional classification. The ultimate goal is that these categories eventually reach the same conclusion. For example, in pharyngitis, pharyngeal tissue is inflamed and inflammatory cells can be seen in sampling. The structure of the tissue changes macroscopically and becomes covered with exudative secretion. Its function in swallowing and breathing is also disturbed, and this becomes a clean disease called pharyngitis
This happens in most diseases except brain diseases. Brain has another story. Of course, the ideal is what was said, but this goal still seems unattainable. Moreover, the etiology of most brain diseases is still unclear. The symptoms of brain diseases overlap a lot, and the course of symptoms is so variable that it is difficult to imagine a clear rule for them. One way is to tell patients to wait until the exact cause of their illness is determined. But since no one has the patience of Job, it is necessary to start the treatment of brain diseases with this little wealth.
Today, most brain diseases are diagnosed in the clinical field rather than depending on para clinical diagnosis. Neuropsychologists are not waiting for para clinical documentation to start treatment
This means that brain function takes precedence over its structure. If we add the Compensation ability of brain parts which is now known as neuroplacticity, we simply give the right to this view.
The second point is the emphasis of TLT theory on the dynamics of diseases. In fact, according to the definition of miasm, the repeating pattern is the function of the disease. Although the role of histological destruction in occurrence of diseases is not deniable, what is observed by the miasm and considered as the goal of treatment is not the change of the tissue structure, but the improvement of its function.
These are two good reasons why I prefer a functional approach to categorizing brain diseases.
| Central | Peripheral | ||
|---|---|---|---|
| Cranial nerves palsy
|
Trigeminal neuralgia
Diplopia (3, 4, 6) Bels palsy |
||
| Cortical Blindness | Peripheral Blindness | ||
| Central labyrintitis (Hearing + Ataxia) | only ataxia | ||
| Anosemia | Coryza, Rhinitis | ||
| / |
| Decreased | Increased | Changeable | |
|---|---|---|---|
| Cognition impaired | |||
| Perception | Impaired | Hallucination | |
| Thought | Dementia | Delusion | |
| Memory / Concentration | Impaired | Anxiety / Obsession | |
| Mood | Depression | Agitation / Anger/ Fear | Changeable |
| Peripheral | Central | ||
|---|---|---|---|
| Decreased | Hypostasia | ||
| Increased | Hyper stasia | Central sensitization | |
| Deviared | Dysesthesia
Pruritis |
| LMN | UMN | Central | |
|---|---|---|---|
| Decreased | LMN | Brady kinesia | |
| Increased | Myoclonous
Clonous Jerking / Twitching
|
Hyper kinetics | |
| Rhythmic | Non-Rhythmic | ||
|---|---|---|---|
| Simple | Tremor | ||
| Complex | Chorea / Sterotypia / Preservation / Tic/ | ||
| Peripheral | |||
| Central | Rigidity |
| Reflexes | Tonocity | Hyper kinetics | Muscular bulk | |
|---|---|---|---|---|
| UMN | Hyper reflexia | Spasticity
Hypertonia |
Clonus | --- |
| LMN | Hypo reflexia | Hypotonia | Fasciculations | Atrophy |
| Hyper | |||
|---|---|---|---|
| Central | |||
| Peripheral | LMN | ||
| UMN |