Neuroeconomics and Public Health

Objective : To determine parameters of the frontal power of executive integration Method: Review of neuroeconomic and basal neurological fMRI trials. Results : The Power of Concentration (C) is a tripartite executive integrator, where: Limbic system ( L ) is a centre of primary consciousness based on a mesolimbic dopamine system serving the client in the brain stem with adaptive feedback as well as generating cognition and emotions towards Neocortex in a reciprocal autonomic balance. Prefrontal analysis by semantic recollection from Temporal ( R ) lobe is based on episodic memories. Volition in the medial Prefrontal Cortex ( c ) controls both cognitive prediction ( R*c ) and emotions ( L/c ) for a balanced integration that maximizes utility as a neural correlate to economic reasoning. An intuitive visuospatial Parietal sketchpad ( I ) integrates Hippocampal episodic memory mismatches complementary to the cognitive prediction function. Chronic stress limiting the capacity of C in L is indicated by baseline serum cortisol. Conclusion : Frontal executive integration ( C ) searches the best utility balancing emotional preferences ( L/c ) with predictions ( R*c ) while I is a stochastical knowledge component. The application of this unitary neuroeconomic model in the planning of complex bio-pcycho-social interventions in rehabilitation, psychiatry and complementary medicine are discussed from case studies on 1) neurorehabilitation and 2) meditation.


The International Institute for Advanced Studies in Systems Research and Cybernetics
ISSN 1813-4769 iii   TABLE OF CONTENTS  TABLE OF CONTENTS  TABLE OF CONTENTS  TABLE OF  A. Chowdhury present results of reliability assessment, which has used a new probabilistic reliability model that includes the stochastic characteristics in wind energy production, resource availability, generation facility outages and transmission line availability. The assessment demonstrates the impact of integrating wind energy source into an existing grid from a system adequacy and reliability viewpoint.
The second article on Complex Decision Making Problems in a Class of Transportation Systems by Prof. Jerzy Jozefczyk is studying new integrative systems approaches to solving decision problems that are treated as a generalization of standard task scheduling and raw material allocation when other aspects of these activities connected with transportation are taken into account. In particular, the following three problems are studied: routine-scheduling with motion control of moving executors; flow shop with routing of moving executors; and raw material allocation with transportation of a raw material and products.
The third article on Breakthrough in the Human Decision Making by Prof. Daniel M. Dubois deals with a breakthrough in the concept of free will in the human decision making. The article argues that decision making is unconsciously initiated in the human brain, and, eventually, becomes a conscious decision. So the free will is unconsciously prepared in the human brain. The author postulates a conjecture that s.c. human brain is just enlightening of some part of the unconscious human brain.
The fourth article on Triggering the Relational Potential of the Human Race is one of the most important articles of this issue. It was delivered as a Keynote Address by Prof. Ayten Aydin in which she reviews various aspects of human evolution in the contemporary world, and brings to our attention the seriousness of the situation in which we now live. She eloquently articulates what is needed within our own strength, to save the Earth in the first place, to ensure the survival of mankind and the wellbeing of coming generations. She argues that human relational living, which had been the major bond and formed the essential base for survival among people since the primitive societies, is gradually disappearing. She examines this process closely and explores new opportunities and a potential that can be taped to renew and restore these bonds and to improve human relational living and balanced development of mankind.

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The fifth article on Psychological Services in Macao by Dr. Gertina J. van Schalkwyk explores some of the ethical concerns that arise when providing psychological services in a multicultural society such as Macao. The life in this community is dominated by traditional belief system, tourism and the gaming industry. So the psychologists must re-evaluate traditional ethical constructs of respect, sensitivity to diversity, and responsibility for the consequences of professional judgments. Failing to do this may result in services that are anomalous to the local population and can result in marginalization of those most in need of psychological services.
The sixth article entitled When Time Slows Down: The Joys and Woes of De-Nesting by Prof. Susie Vrobel presents a model of the mechanism that controls the subjective distortion of time. Our brain merges stimuli it receives from different senses at different times and at different speeds within about one tenth of a second. The brain waits for the slowest signal to arrive and then generates noncontradictory image of the world. The delay allows for correctives, so that the incoming stimuli can be adjusted in order to meet our expectations. Temporal distortions such as time dilation correlate with a variety of contextual, psychological, behavioral, environmental and other factors, e.g. stressful situations, high contrast, anticipation of delays, reduced complexity and synchronization. Architectural design in the current environment of heightened uncertainty and complexity, which have to meet added dimensions of sustainability, modernity, integrity, agility and holism. He argues that architects and architecture students must be now far more comprehensive in their approaches, and far more learned in their knowledge; they must use interdisciplinary thinking and systems approaches, and be far more diligent in the execution of their duties. This issue of ACTA SYSTEMICA includes papers of authors from eleven different countries. These authors are prominent researchers, outstanding educators and internationally recognized scholars. I am very grateful to all of them for the time and effort, which they devoted to the preparation of their papers and for their significant contribution to the advancement of knowledge in the field.

George E. Lasker
Editor-in-Chief

Introduction
Since the 1970s two alternative brain models have challenged the classical subdivision in a cortical sensory-motor integration function and a subcortical autonomic nervous system. The triune brain model by McLean [Cory, 2002] claims a 'Limbic System' (L2) by which the Anterior Cingulate Cortex (ACC) is a Paleomammalian link between what was previously considered independent subsystems. Another coherent CNS-model [Luria, 1973] claims a tri-division of the brain as well. Luria subdivides Neocortex in a perceptive-cognitive unit (L3) and the frontal executive integrator (L4). A combined McLean-Luria 4-level-model is illustrated in figure 1. New sensitive scanners as functional magnetic resonance imaging (fMRI) enable Figure 1. Brain Levels exploration of the neural correlates to the combined model. The present study aims to synthesize recent fMRI-studies to uncover how the Executive Integrator (L4) operates lower brain levels.

Method and materials
The brain is not a machine. It is ruled by complex feedback between specialized cell groups where a 'dependent' variable affects the 'independent' variable (client-server-integrator systems), too. Such second ordered cybernetic systems -searching for homeostasis -rely on the range of adaptation as stated by the cybernetic law of Requisite Variety [Ashby, 1960].

L1:
The Reticular Ascending Activation System in the brain stem (RAS) originates a fight-or-flightresponse which represents the Reptile base of the brain. Normal moderated task-responses back to L1 (client) are generated via the emotional system (L2) and the Orbitofrontal part of L4; strong control responses back to L1 are generated directly from the medial Prefrontal part of L4; Cerebellum at L1 contributes very actively to motor coordination, timing, precision and learning in both cases [Critschley, 2002] Sympaticus activation by RAS is indicated by bioelectrical skin conductance. Further, the Ventral Tegmentum (VT) is the neural root of hierarchical organization which means that respect for symbols of wealth and status dominates emotions [Erk et al, 2002]. L2: The concept of a 'Limbic system' has been controversial [McLachlan, 2009]. However, the root of reward seeking emotional behaviour is evidenced to be a mesolimbic dopamine system (MLDS) which modulates instincts by reinforcing or decreasing motivation in learning as well as decision-making [Alcaro et al, 2007]: MLDS passes from VT at L1 to Accumbens and ACC at L2 towards the Frontal Cortex at L4; Hypothalamus, as centre of Homeostasis, regulates the emission of neurotransmitters counting for the modulation by MLDS; Amygdala (Am) originates fear and rage inhibiting basal vegetative centres; Hippocampus with episodic memories (Hip) adjacent to the Temporal lobe is the root of agreeable emotions adding valence to recognized inputs; other basal centres add other valences i.e. sexual attraction (Septum) and smell (Olfactory Tractus). Thalamus centres sensory integration transmitting signals upwards the Anterior Cingulate Cortex (ACC) and Neocortex. Insula serves ACC with expectations [Naqvi et al, 2007]. A thesis by McLean is a primary Limbic centre of consciousness (L) in ACC which is central to optimal learning [Kennerley et al, 2006]. L moderates primitive fight-or-flight-responses transmitting upward by 'emotional' and 'cognitive' pathways in a reciprocal relationship where the cognitive path is rooted in Limbic detection of conflict [Mohanty et al, 2007]. A characteristic of primary consciousness is empathy as we are responding nearly as strongly observing the pain of others as to our own pain [Singer, 2007]. The dynamics of primary consciousness is empathic reward-seeking. L3: A network of brain regions, including the prefrontal cortex (PFC), is critical for the active maintenance of internal representations that are necessary for goal-directed behavior [D'Esposito, 2007]. Further, the semantic structuring of episodic memories is associated with activity in the anterior Superior Temporal Sulcus (STS) while the posterior portion is recruited by the perceptual memories in the medial temporal lobes [Hein, 2008]. STS is managed by the dorsolateral PFC. Linking signs to sensory perceptions is an AHA-experience correlated with increased activity in both medial PFC and temporal areas [Kounios et al, 2006]. Semantic recollection of memories (R) shows EEG-theta-waves.
The Intraparietal sulcus (IPS) is involved in numerical calculation [Cantlon, 2007] and serves as a visuospatial sketchpad (I) integrating unrecognized perceptions (mismatch in Hippocampus [Kumaran et al, 2007]) by spontaneous AHA-experiences arising from the occipital visual association area (Cuneus/Precuneus) [Kounios et al, 2006]. L4: The medial PFC (mPFC) controls both the dorsolateral part (dlPFC) and OFC: The OFC receiving emotional input from L serves as utility centre (U) [Stubhorn, 2005]. The left lateral part of OFC is activated from mPFC (c) and controls emotions [Beer et al, 2005] by a regret function [Camille, 2004]: facing consequences of a decision we may trigger emotions by relief or regret. So, U=f(L/c). The relationship between L and U is investigated in healthy males solving a (nonverbal) cartoon task [Völlm et al, 2007]: 'The results show that imagination and empathy are associated with overlapping but distinct neuronal networks. Figure 2. 'Binding' Empathy was associated with enhanced activations of ACC and Am (L2).
Imagination increased activations in lateral OFC, mPFC, Cuneus and STS (L3-4)'. The dlPFC is the most recent step of evolution. It is an analytical centre (A) served by semantic memories at L3 (R) [Robertson et al, 2007] 'binding' related semantic memories i.e. to a word [Canolty, 2007], see figure 2. So, A=f(R*c).
The mPFC integrates the other frontal parts by volition (c) to minimize errors between preferences and cognitive predictions as indicated by a EEG α-band Event-related potential [Oya et al, 2005]. Figure 3 summarizes the review findings:

Figure 3. Central pathways moderating instinctual responses A model of frontal executive integration
The Ultimatum Game (UG) illustrates frontal integration (C): the buyer can accept or reject an offer from an investor i.e. a share of an amount of money. If the buyer rejects both players receive nothing. The UG is correlated with a simultaneous activity in both A (dlPFC) and L (ACC/Insula) [Sanfey, 2003]. L responds weakly to acceptable and strongly to unacceptable offers while A responds moderately in both cases. UG is a prototype of economic choices to maximize utility comparing alternative preferences (U=L/c) and predictions (A=R*c). An indifference curve between A and U -representing minimal frontal tension -is indicated by the 45º-line in figure 4. An antagonist L-A relationship [Oldrich et al, 2009] is indicated by a concave substitution curve in figure 4. Ad C=A/U<1:A neuroeconomic study of rewards finds that the relative activity of A (dlPFC) and L (Am) is crucial to the time horizon of decisions. C<1 is a state of risk aversion with present bias which is bad for long term decision making [Mclure, 2004]. Ad C=A/U>1:The CNS accumulates stress when mPFC persistently suppresses emotions by hemispheric dominance (C>1) i.e. to pursue a frontopolar long term goal [Koechlin, 2000]. This causes a negative feedback loop for temporary stabilisation [Eggers, 2007]. A review of PTSD characterizes chronic stress as a pattern of a hyperactive Am which damages Hip in a way that volition activity (vmPFC) fades out [Bremner, 2007]. Chronic stress (B) includes besides PTSD frequent conditions as migraine, essential hypertension, depression and the metabolic syndrome and is indicated by an elevated level of cortisol. Left Hemispheric dominance is too rigid for optimal decisions in an uncertain and changing world even before it becomes chronic shows a study of patients with lateralized focal lesions [Goel et al, 2006].
An integrated decision making mode do exist. Interviews with entrepreneurs uncover that they in addition to calculation of a knowledge-based prediction calculates a worst-case-scenario, too. This type of secured risk-taking (C=1) is a neuroeconomic optimum (E) combining preferences and predictions. The dynamics of E is derived from figure 4: C = R*c/(L/c) + ε I = R*c 2 /L + ε I → 1

Discussion
The models of Luria and McLean are widely used within rehabilitation and psychiatry. The combined model should apply even better here and in complementary medicine as well: 1. Home rehabilitation as an example of patient-centric health care Moving a patient from a clinic to his home reduces BP 5-7 mmHg [Verberk et al, 2005]. Referring to figure 4, relaxation (L↓, especially Am) gives a feeling of security which facilitates cognitive executive functions (R*c). So, home rehabilitation of stroke patients which represents a state of C<1 in figure 4 is supposed to be an effective alternative to hospital rehabilitation. Effects include less hospital days and reduced risk of referral to nursing home [Langhorne et al, 2005]. Actually, the European Commission grants completion of this line of research and dissemination of the results to EU member states [Larsen, 2009].
In summary, home rehabilitation may be seen as an introduction of patient-centric care on line with the human-relations school of management developed in industry after WW2.

Meditation as a complementary medical de-stressing intervention
Coping with stress is a most urgent challenge to modern man. Comparing stress-responses of males and females, males respond in accordance with figure 4 with hemispheric dominance indicating peakmobilisation of cognitive fighting resources; However, female tend-to-befriend responses are better [Wang et al, 2007]; Also, females frequently attend classes of yoga and meditation to manage their stress. Volitional relaxation procedures (c↓) are hypothesized to reinforce preferences (R*c↓ and L/c↑). Presupposing C>1, this is a mental stabilization towards C=1. A meta-analysis confirms that relaxation procedures do reduce stress and anxiety [Manzoni et al, 2008]. According to a systematic review meditation is an efficient relaxation procedure without significant adverse effects [Arias et al, 2006]. Medical meditation (MM) is defined as a period of 15-20 minutes combining 1) a relaxed sitting position preferably with closed eyes, 2) logical relaxation, 3) autogenic emotions and 4) anchoring of thoughts i.e. to breathing or a sound word [Cardoso et al, 2004] (c→0). A case study of acem meditation fulfilling the criteria of MM demonstrates: 1) increased posterior α-band activity (L↓) indicating extra destressing/resetting and 2) increased Φ-band activity was documented in Frontal and Temporal-central regions [Lagoupolos et al, 2009]. This indicates deactivation of the Default Mode Network which enables increased processing of non-integrated perceptions as a key effect of meditative de-stressing.
In conclusion, MM is an effective LowTech de-stressing procedure for persons with C>1.