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cover of episode Inside The Disease That Changes Your Personality, with Bruce Miller

Inside The Disease That Changes Your Personality, with Bruce Miller

2025/5/29
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Big Brains
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Bruce Miller: 我认为，当人们在中年或晚年出现性格或行为的显著变化时，我们应该首先考虑大脑是否发生了变化。这对我来说是一个范式转变。当我们看到这些症状出现在我们所爱的人身上时，不应该立刻认为是心理问题，而应该考虑神经退行性疾病。多年来，我一直在治疗和研究患有特殊神经退行性疾病的患者，当我看到这些变化时，我立刻想到的是大脑。例如，如果有人突然对酒精或药物上瘾，我首先会认为这不是心理问题。我认为，如果我们的整个医疗系统要认识到这一点，就必须转变观念。我的研究表明，我们生活中的社交方面实际上与我们大脑中的生物学直接相关。我感兴趣的是大脑中一大片区域，它负责我们与他人交谈、联系、有时安慰和治愈他人的能力。我认为大脑中负责社交的部分被神经科学和社会所忽视。大脑的很大一部分区域，特别是右半球和前部区域，都致力于识别他人的面孔、痛苦或快乐，并能够设身处地为他人着想，以便成功地与他人互动。我认为利他主义是这部分大脑的重要组成部分。 Bruce Miller: 额颞叶痴呆攻击前额叶和前颞叶，导致患者无法延迟满足、无法自控、无法与人共情。我们看到的是一种衰退，我认为这是一种道德衰退，但这与特定区域的功能丧失有关。并非所有额颞叶痴呆患者的大脑变化都会导致负面结果，通常情况下，当大脑的某些部分萎缩时，其他部分实际上会增加。例如，Marcus是我见过的第一个病人，他最终患有所谓的语义性进行性失语症。他失去了很多词语的含义，突然对颜色着迷，并成为了一名艺术家。视觉上的专注和增强伴随着视觉创造力的发展。我开始努力理解为什么患有退行性疾病的人会成为视觉艺术家。我开始询问患者在患病期间出现的优势或新事物，并开始收集大量患者及其美丽的艺术作品。语言的丧失似乎释放了大脑后部负责绘画的回路。额颞叶痴呆是了解社会大脑的一个窗口，通过观察健康大脑恶化时发生的情况，我们可以更好地了解我们的人格是如何形成的。

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The episode starts by discussing how unexplained behavioral changes in individuals are often attributed to psychological factors. However, Dr. Bruce Miller emphasizes that such changes can also be indicative of underlying neurological conditions, particularly frontotemporal dementia (FTD). He highlights the importance of considering brain changes as a potential cause for personality shifts.
  • Unexplained personality changes in mid-late life may indicate brain changes.
  • Frontotemporal dementia (FTD) is a neurodegenerative disease affecting personality and behavior.
  • The medical system needs to shift its approach to recognizing neurological causes for behavioral changes.

Shownotes Transcript

When someone we know or love starts to develop psychological issues, we don't often associate it with a form of dementia. However, this trait is one of the most common signs of frontotemporal dementia (FTD) — the most common neurodegenerative disease in people under the age of 65. In his new book, Mysteries of the Social Brain: Understanding Human Behavior Through Science, Dr. Bruce Miller highlights his experiences observing people with FTD and what they have taught him about what he calls the "social brain."

Dr. Bruce Miller has been observing people with FTD for decades in the Memory and Aging Center at the University of San Francisco, where he is also Professor of Neurology and the Founding Director of the Global Brain Health Institute. He shares key insights on how to keep our "social brain" healthy and how it can even unlock our creative potential.