Future Challenges for NTUMCAA-NA: Turning Crises Into New Opportunities

Ming T. Tsuang, MD, PhD, D.Sc. Behavioral Genomics Endowed Chair and

University Professor, University of California; Distinguished Professor of Psychiatry and Director, Center for Behavioral

Genomics, Department of Psychiatry, University of California, San Diego and

Director, Harvard Institute of Psychiatric Epidemiology and Genetics, Harvard School of Public Health, Boston.

2012年北美臺大醫學院校友THE 32ND ANNUAL

CONVENTION, NTUMCAA-NA

NTU’s Integrated Brain and Mind Project

National Taiwan University (NTU) is the best university, and has the best hospital in Taiwan.

It attracts numerous clinical cases thanks to it’s reputation.

This offers excellent opportunities to all clinical, cognitive, neuroimaging, and basic neuroscientists.

NTU has the unique potential to study culture and cognition in the integrated context of “mind in a social brain” when we consider the expertise congregated in our medical, cognitive, and engineering departments.

NTU’s Integrated Brain and Mind Project

In 2009 I was asked by President Si-Chen Lee of National Taiwan University (NTU) and Chancellor Mary Anne Fox of UC San Diego to be the UCSD representative on a new and exciting collaborative project involving both institutions.

The project endeavored to integrate the disciplines of neurobiology, cognitive science, clinical neuroscience as well as behavioral sciences, within the six colleges of NTU.

NTU’s Integrated Brain and Mind Project

Between May 9th-11th, 2010, the first International Scientific Advisory Committee (ISAC) meeting for NTU’s Integrated Brain and Mind Project took place in Taipei.

Internationally renowned scholars were invited to join this committee to share their experiences and give advice on the development of the project.

Patricia Churchland Ph.DEmeritus Professor of Philosophy, UC San DiegoResearch Area: Neurophilosophy, Neuroethics.

Cheng Ming Chuong MD, Ph.DProfessor Pathology Dept.

University Southern California Research Area: Tissue Development and

Regeneration. Academician, Academia Sinica.

Larry R. Squire, Ph.D.Professor of Psychiatry, Neurosciences,

and Psychology, UCSD.Research Area: Structure and Organization of

Memory.

Ing-Kang Ho, Ph.D. Distinguished Investigator and Vice President

Institute of Population Health SciencesNational Health Research Institutes, Taiwan.

Research Area: Neurotoxicology, Neuropharmacology, Drug Abuse. Academician, Academia Sinica.

Trevor Robbins Ph.D, F.R.S.Professor of Cognitive Neuroscience

Downing College, University of Cambridge

Research Area: Cognitive Neuroscience, Psychopharmacology, Addiction

Ian Everall MD, Ph.DCato Professor of Psychiatry,

Department of Psychiatry,University of Melbourne, Australia

Research Area: Neuropathology and Psychiatry

Shu Chien, MD, Ph.D,Professor of Bioengineering and Medicine,

Director, Institute of Engineering in Medicine, UC San Diego

Research Area: Integrative Bioengineering and Physiology

Awardee: National Medal of Science, 2011.

William Mobley MD, PhDChair, Department of Neurosciences

UC San DiegoResearch Area: Neural Circuits, Neurobiology of

Down’s Syndrome, Alzheimer's Disease, and Compassion.

Academician, Academia Sinica.

Ming T. Tsuang, MD, PhD, D.Sc.Distinguished University Professor,

University of California;Behavioral Genomics Chair and Director,

Center for Behavioral Genomics,Department of Psychiatry,

University of California, San Diego andDirector, Harvard Institute of Psychiatric

Epidemiology and Genetics, Harvard Medical School and Harvard School of

Public Health.Chairman, International Scientific Advisory

Committee, NTU’s Integrated Brain and Mind Science Project

Academician, Academia Sinica.Research Area: Behavioral Genetics and

Genomics, Prevention of Mental Illness, and Well Being

National Taiwan University Front Gate

NTU’s Integrated Brain and Mind Project

Three autonomous institutions fall under the umbrella of the Integrated Brain and Mind Science Project.

• The three institutions are: – The NTU Neurobiology and Cognitive Science

Center (NCSC).– The NTU Graduate Institute of Brain and Mind

Science (GIBMS).– The National Taiwan University Hospital Clinical

Center of Neuroscience and Behavior (CCNB).

President Lee at the Neurobiology and Cognitive Science Center’s Opening.

The Graduate Institute of Brain and Mind Sciences (GBMS) is the newest institution authorized by the Ministry of Education.

It was established with the following purposes:• Doctoral/post doctoral education.• Advanced research.• Multi disciplinary collaborations.

Researchers at the GIBMS are attempting to bridge disciplinary boundaries to further the understanding of the origins, evolution and mechanisms of human cognition.

They will explore the brain's physical and biochemical machinery to the experiences and behaviors we call the mind.

National Taiwan University Hospital, Old Campus

The NTUH Clinical Center of Neuroscience and Behavior (CCNB).

The mission is to integrate and collaborate (inter and extra-institutionally) on various fields of clinical neuroscience and psychiatry.

These fields include:NeuroradiologyNeurosurgeryCerebrovascular diseasesNeuro-OncologyNeuroimpairment and RecoveryNeuropsychiatryNeurodegeneration and DementiaChild Neurological Diseases

Clinical Center of Neuroscience and Behavior (CCNB)

Opening Ceremony, May 27th, 2011.

The Brain

The Brain

Gray matter is a major component of the central nervous system.

It contains neural cell bodies, in contrast to white matter, which does not and mostly contains myelinated axon tracts.

Significant positive correlations have been found between grey matter volume in elderly persons and measures of semantic and short-term memory.

Some structural differences in grey matter may be associated with psychiatric disorders such as schizophrenia.

Brain Atrophy and its Effects

Healthy Brain Brain Atrophy

Hippocampus

Amygdala

Prefrontal Cortex (Executive Function)

(Emotion)

For more information:

The National Taiwan University Hospital Clinical Center of Neuroscience and Behavior (CCNB).

o http://www.ntuh.gov.tw/en/ccnb/default.aspxThe NTU Graduate Institute of Brain and Mind

Science (GIBMS).o http://gibms.mc.ntu.edu.tw/The NTU Center for Neurobiology and Cognitive

Science (CNCS).o http://neuroscience.ntu.edu.tw/

Subjective Well-Being (SWB) and Health

1. What constitutes health?2. What is Wellbeing? Why is it important?3. Introduction to Subjective Well-Being (SWB)

4. Factors of SWB - Genetics, Environmental,

Spiritual aspects.5. Current and Future Research Perspectives.

What Constitutes Health?

Universally accepted definition of health: a state of complete physical, mental and social wellbeing and not merely the absence of disease or disability.

Health also refers to the presence of positive characteristics.

MindMind

SpiritSpirit

Well-being generally means a healthy balance of :

BodyBody

Mind and Body: Mental Wellbeing affects Physical Wellbeing

Positive emotions have positive effects on physiology; especially in the case of the immune and cardiovascular system.

Negative emotions increase susceptibility to illness.

Mood can motivate healthy behaviors.Positive emotions create social support.

Introduction to Subjective Wellbeing (SWB)

How do researchers objectively evaluate emotional well-being?

In the past, several scales were developed to accurately measure our self-perceived wellbeing.

Subjective Wellbeing (SWB): Taking place in the mind of an individual

Subjective wellbeing consists of two components:

1) Life Satisfaction – an evaluation of a persons overall life.

2) Emotions - the presence of positive emotions and the absence of negative emotions.

Determinants of SWB

Genetics

Environmental factors

Spiritual factors

Determinants: Genetics

• Feeling of wellbeing or lack of wellbeing can be inherited.

• Genes can be responsible for both positive and negative emotions.

• 80% of long-term SWB is heritable.

Genetics (cont): Personality

Personality is a very powerful way of predicting how a person will cope with positive and negative life events.

Personality leads different individuals to experience the same life events in a more positive or negative fashion

Genetics (cont): Personality

Each person has a normal level of SWB.This level is predicted by personality

characteristics (Introverted vs Extroverted etc).

Emotional stability and extroversion were positively related to SWB.

Neurotic personalities were negatively related.

Environmental Factors

• Socioeconomic status: Education and income are strong predictors of SWB.

• Health: Health is an important predictor of SWB at all ages and the strongest predictor of SWB during late life.

• Social integration: Attachments to the social structure via community roles.

• Social relationships and social support: Good relationship in marriage and with friends.

Interaction Between Genetic and Environmental Factors

Genes may interact with environmental factors:

• The same genes that affect early anxiety also influence later depression.

• Early genetic effects of anxiety increase exposure to life events that increase risk to depression.

• The genes that create early anxiety also make young people more prone to depression due to the effects of environmental adversity.

Spiritual Well-Being and Health

• Higher levels of religious commitment are linked to longer lifespan.

• Religious people may be less likely to make unhealthy lifestyle choices such as substance abuse and gambling.

• Religion may facilitate healing through fostering spiritual growth.

• Spirituality may enhance quality of life and help in the psychological recovery from cancer, cardiovascular disease, and even wound healing.

Spiritual Well-Being and Health

• Both genetic and shared environmental

influences contributed to the stability of religious values and religious attendance.

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Current and Future Research Perspectives

People are living longer and an important public health goal is to find ways to ensure these years are happy and healthy.

The identification of genetic and environmental factors associated with well- and ill- being will help develop targeted interventions.

These interventions aspire to foster greater health and happiness.

Research Perspectives

• Our Center for Behavioral Genomics at UC San Diego hopes to conduct extensive measurement work on a large set of subjective well-being measures.

• We hope to generate excellent well-being measures, and examine them throughout the life of a person.

• It will enable us to apply these characteristics to genetic analyses in order to identify specific genes that are associated with dimensions of well-being.

Research Perspectives• The derived genetic data will be utilized to

identify inherited well-being measures. • We will use already collected DNA and

phenotypic data, which are enriched with well-being measures such as:

General wellbeingPhysical healthPsychological health

Research Perspectives• Molecular genetic studies may eventually

discover biological reasons why some people remain happy and mentally healthy even in

the face of adversity. • If so, that could lead to pharmacologic

strategies and environmental interventions to advance well-being in our aging population and help contain health care costs.

1 2 3 4 50

50

100

150

200

250

300

350

400

=2012 (924)

=2009 (939)

>70 65-70 60-64 55-59 <55

Age Distribution OF NTUMCAA Membership

Older than 70 Members

(41%)

Between 65-70

215 members(23% )

Between 60 and 64

127 members (14%)

Between 55 and 59 93 members (10%)

Between 45 and 49 17 members (2%)

Age Distribution of NTUMCAA-NA Alumni in 2012

Between 50 and 54 27 members (3%)

Between 35 and 39 21 members (2%)

Between 40 and 44 9 members (1%)

Under 3540 members (4%)

Geographical Distribution of NTUMCAA-NA Alumni in 2012 (n=924)

East Coast

West Coast

Central

Canada

South

NTUMCAA-NA: Our Future We have reached a critical time in the history of our

great organization. How to keep a bridge open between NTU-MC and the

alumni in North America after 2012?How to provide guidance to NTUMC graduates who

wish to advance their medical learning in North America?

How to provide assistance to NTUMC alumni in North America who wish to visit their alma mater?

What can alumni in North America do to assist NTUMC scholars from Taiwan?

How can we develop a plan for fundraising?Any other suggestions or recommendations?