Zusammenfassung
Im Gegensatz zu anderen medizinischen Disziplinen zeichnet sich die Psychiatrie durch
die spezielle Berücksichtigung des subjektiven Erlebens der Patienten auf. Da das
subjektive Erleben an die Erste-Person-Perspektive gebunden ist und das Gehirn lediglich
in der Dritte-Person-Perspektive beobachtet werden kann, stellt sich die Frage nach
der Verknüpfung beider Perspektiven in der psychiatrischen Forschung. Es wird hier
daher ein neuer methodischer Ansatz, eine so genannte Erste-Person-Neurowissenschaft,
vorgestellt, wo das subjektive Erleben direkt mit neuronalen Prozessen in Verbindung
gebracht werden kann. Da die Komplexität der Strukturen und Inhalte des subjektiven
Erlebens eine Lokalisation desselbigen in bestimmten und spezifischen Hirnregionen
unmöglich erscheinen lässt, stehen hier das Zusammenspiel und Koordination der neuronalen
Aktivität über verschiedene Hirnregionen hinweg, die so genannte neuronale Integration,
im Vordergrund. Dieses wird anhand von zwei Prinzipien der neuronalen Integration,
der reziproken Modulation und der Top-Down-Modulation, bei Katatonie und Depression
exemplarisch erläutert. Es wird geschlussfolgert, dass eine Erste-Person-Neurowissenschaft
in diesem Sinne einen Beitrag zur Pathophysiologie psychiatrischer Erkrankungen und
ultimativ zur Entwicklung von diagnostischen und therapeutischen Markern leisten kann.
Abstract
Unlike other medical disciplines psychiatry can be characterized by the special importance
of subjective experience. Since subjective experience is tied to First-Person-Perspective
and investigation of the brain is possible only in Third-Person-Perspective, the question
how subjective experience can be linked to neuronal processes is raised in psychiatry.
We suggest a novel methodological approach, First-Person-Neuroscience where subjective
experience can be linked directly and systematically to neuronal processes. Due to
complexity of the structures and contents of subjective experience, localization in
specific brain regions seems inappropriate. Instead, the interplay and coordination
of neuronal activity across several brain regions, so-called neuronal integration,
should be considered in First-Person-Neuroscience. This is illustrated by two principles
of neuronal integration, top-down modulation and reciprocal modulation, whose abnormal
function can be related to subjective experience of patients with catatonia and depression.
It is concluded that First-Person-Neuroscience can contribute to reveal abnormal brain
function in psychiatric disorders and ultimately to development of diagnostic and
therapeutic markers.
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Prof. Dr. med. habil. Dr. phil. habil. Georg Northoff
Klinik für Psychiatrie, Psychotherapie und Psychosomatische Medizin · Universitätsklinikum
Magdeburg
Leipziger Straße 44
39120 Magdeburg ·
eMail: georg.northoff@medizin.uni-magdeburg.de
