The Asklepios Cult: Where Brains, Minds, and Bodies Interact With the World, Creating New Realities

Inappropriate social behaviours are early and distinctive symptoms of the temporal and frontal variants of frontotemporal lobar degeneration (FTLD). Knowledge of social behaviour is essential for appropriate social conduct. It is unknown, however, in what way this knowledge is degraded in FTLD. In a recent functional MRI study, we have identified a right-lateralized superior anterior temporal lobe (aTL) region showing selective activation for 'social concepts' (i.e. concepts describing social behaviour: e.g. 'polite', 'stingy') as compared with concepts describing less socially relevant animal behaviour ('animal function concepts': e.g. 'trainable', 'nutritious'). In a further fMRI study, superior aTL activation was independent of the context of actions and feelings associated with these social concepts. Here, we investigated whether the right superior sector of the aTL is necessary for context-independent knowledge of social concepts. We assessed neuronal glucose uptake using 18-fluoro-deoxy-glucose-positron emission tomography (FDG-PET) and a novel semantic discrimination task which probed knowledge of social and animal function concepts in patients with FTLD (n = 29) and corticobasal syndrome (n = 18). FTLD and corticobasal syndrome groups performed equally poorly on animal function concepts but FTLD patients showed more pronounced impairments on social concepts than corticobasal syndrome patients. FTLD patients with right superior aTL hypometabolism, as determined on individual ROI analyses, were significantly more impaired on social concepts than on animal function concepts. FTLD patients with selective impairments for social concepts, as determined on individual neuropsychological profiles, showed higher levels of inappropriate social behaviours ('disinhibition') and demonstrated more pronounced hypometabolism in the right superior aTL, the left temporal pole and the right lateral orbitofrontal and dorsomedial prefrontal cortex as compared with FTLD patients showing selective impairments of animal function concepts. Combining both FTLD subgroup analyses, based on anatomical and neuropsychological criteria, by using inclusive masks, revealed the right superior aTL as associated with selective impairments of social concepts in both analyses. These results corroborate the hypothesis that the right aTL is necessary for representing conceptual social knowledge. Further, we provide first evidence for the potential importance of conceptual social knowledge impairments as contributing to behavioural symptoms of FTLD.

Recent findings in neuroscience have shown differential patterns in brain activity in response to similar stimuli and activities across cultural and social differences. This calls for a framework to understand how such differences may come to be implemented in brains and neurons. Based on strands of research in social anthropology, we argue that human practices are characterized by particular patterns, and that participating in these patterns orders how people perceive and act in particular group- and context-specific ways. This then leads to a particular patterning of neuronal processes that may be detected using e.g. brain imaging methods. We illustrate this through (a) a classical example of phoneme perception (b) recent work on performance in experimental game play. We then discuss these findings in the light of predictive models of brain function. We argue that a 'culture as patterned practices' approach obviates a rigid nature-culture distinction, avoids the problems involved in conceptualizing 'culture' as a homogenous grouping variable, and suggests that participating as a competent participant in particular practices may affect both the subjective (first person) experience and (third person) objective measures of behavior and brain activity. Copyright © 2010 Elsevier Ltd. All rights reserved.

This volume makes available in English translation a selection of Jacques Jouanna's papers on Greek and Roman medicine, ranging from the early beginnings of Greek medicine to late antiquity.