Sunday, January 16, 2011

Endogenously Reducing Dopamine

An interesting article in Time magazine (January 12, 2011) regarding the enhancement of cognitive performance discussed the use of Adderall (a stimulant) to improve cognitive performance by increasing levels of dopamine. However, it was found that there was no statistically significant difference in cognitive performance of Adderall relative to a placebo, suggesting that you can get the same dopamine boosting benefits of the drug by believing you will do well which itself releases dopamine. This is an example of the mind coming into play to influence bodily functions (in this case, cognition which is a function of the brain).

In a previous post (Parkinsons Disease, Dopamine, and Stuttering), we pointed out that patients suffering from Parkinsons disease who received a placebo showed a substantial increase of dopamine activity according to brain imaging results. So we speculated that a nocebo-like effect of context on stuttering might also increase the level of dopamine activity in the brains of stutterers, thus negatively affecting their fluency.

We can turn this argument around and ask whether or not a placebo, which could be an endogenously influenced state of mind, might reduce dopaminergic activity and hence improve fluency. This endogenous mind state might be produced solely by the individual himself through some sort of mental manipulation.

Consider the case of King George VI as depicted in the film, The Kings Speech.  We should not automatically assume that the success of King George VI in giving his wartime speech with relative fluency was due solely from fluency shaping techniques and modifications in the mechanics of his speech suggested by his therapist. We should also consider the possibility that he harnessed his mind in such a way as to generate a placebo-like effect whereby the dopaminergic activity in the relevant parts of his brain actually decreased. Granted, the king had a cheerleader in the form of his therapist (who may be regarded as an exogenous influence), but nevertheless we must consider the possibility of purely endogenous influences as well.

There are anecdotal reports of individuals achieving similar effects--namely the attorney who was fluent in a professional setting but would stutter with friends and family, and the college professor who claimed to be able to "psyche himself up" prior to teaching a class through some sort of mental preparation so as to lecture fluently. The mechanisms by which this happens are obscure and resistant to simple codification such as "pop this pill one hour before..." The "buttons" that are pressed and the "switches" that are flipped in the mind to activate the "internal cheer leader" and to achieve these feats are unknown. Yet, consider the possibility that it could be done by some individuals.

The manipulation of dopaminergic activity through endogenous brain states might be comparable to the modification of the neurotransmitter endorphin levels claimed by practitioners of meditation techniques. But with meditation, there exists a well codified regimen, if practiced leads to the desired results.

It is not clear whether all stutterers can control their fluency by manipulating their endogenous mind states or if this approach is limited to a subset based perhaps on the intensity of the underlying physical cause of stuttering (rated on a scale of 1 to 10). It may be that only those individuals with relatively mild physical causes of stuttering (and presumably lower dopaminergic disfunction) can achieve fluency by endogenously manipulating their mind states.


Anonymous said...

Excellent post, I have never heard of this aspect of stuttering written about publicly. I have first hand experience with this phenomenon as a stutterer.

Several times throughout college, I would have to teach a class or lesson as part of a project. The class was around 75 people. At the time I was not taking any medication for my stuttering, or doing much about it. I agonized teaching that class for months before I actually had to do it, and I actually felt like I may pass out right before the class.

I spoke for nearly 45 minutes straight, and did not stutter at all.

This phenomena has happened to me at less than a handful of occasions in my life. I have always referred to it internally as being "too scared to stutter".

I'm sure that if someone gave me a placebo pill, and told me that this will "cure your stuttering", I would have a strong placebo effect for at least a while, and I would interpret that my speech was actually getting better.

stutter-mind-body said...

I think that this endogenous process might be akin to what professional athletes might do before a big game by getting "psyched up" or getting themselves into the "zone." This activity takes a lot of mental energy, but it does seem to work for some people.

It's not clear to me whether the excessive dopaminergic activity is actually reduced or if it is merely overridden.

Also, this approach is contrary to conventional speech therapy whereby the individual is encouraged to accept his disfluency. In some cases, this acceptance leads to greater disfluency.

Holger Stenzel said...

This interesting study is final:
Dopamine Function in Developmental Stuttering

stutter-mind-body said...

Unfortunately, the results of the study cited above have not yet been published. Will look forward to the results.

Anonymous said...

Excellent blog.
I'd like to be more specific about what "psyching up" means in my case and give a tentative explanation for it's effectiveness. I'd like to have some feedback about this opinion since i'm not a neuroscientist or psychiatrist.
"psyching up" means limiting imagination, blocking introspection, being assertive, paying attention, beeing almost alert, having some sort of script to recall, reasoning whith an inner voice.
Reading blogs about stuttering I realize that this strategies may increasing activity in the left hemisphere of my brain and decrease activity in the right hemisphere. Maybee, whithout knowing the exact reasons, I developed this strategies by trial and error and by comparing the direction in which my eyes tend to look. For example, when I speak a foreign language I recall words all the time and I make same effort in constructing a synthactically correct sentence. My eyes tend to look to the left and I don't stutter.
My guess is that the lawyer whas left-brained at work and right-brained whith family and close friends.
Sorry for my english,