Drs. Torous, Stern, Padmanabhan, Keshavan and Perez are to be congratulated for defining and describing a psychiatric resident training program to encourage neuroscience learning. As these authors eloquently describe, specific knowledge of brain function is beginning to clarify our understanding of some, if not many, psychiatric disorders. The authors are careful to point out that our expanding neuroscience information base has not yet yielded reliable and always reproducible clinical treatment results, but the emerging data are encouraging. As the authors indicate, we now understand specific functions of many brain anatomical sites, their inter-site circuitry, their genetic origin, as well as the micro-circuitry that is necessary for the extraordinary communication between neuronal pathways throughout the brain. The authors then provide a clinical example of neuroscience teaching using a clinical example: the neurological basis of symptoms of a depressed patient and the application of this information to suggest new and more specific therapeutic approaches. I was particularly taken by the analogy of impaired brain circuitry with an urban traffic jam that may have many causes: dysfunctional traffic signals (circuit nodes), street and highway construction (pathways), impaired road materials (neurotrans-mitters), and planning (genes). Together, dysfunction in these areas can bring traffic to a standstill, somewhat like some psychiatric disorders. Other traffic problems may contribute to broken restraints and traffic guidelines leading to wild and disorganized driving and potential mayhem. But here is where the analogy may become simplistic and potentially misleading, as is, I believe, the forecast of neuroscience based treatment that will finally bring about development of more effective psychiatric treatments.
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