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  • Well, as Chris pointed out, I study the human brain,

    譯者: Yesbydefault 倪文娟 審譯者: Adrienne Lin

  • the functions and structure of the human brain.

    是的,就如克里斯的介紹,我研究人類的腦

  • And I just want you to think for a minute about what this entails.

    人類大腦的功能和結構。

  • Here is this mass of jelly, three-pound mass of jelly

    請大家試想一下,這牽涉到什麼?

  • you can hold in the palm of your hand,

    人腦像一團三磅重的果凍,

  • and it can contemplate the vastness of interstellar space.

    它可以放在手掌裡,

  • It can contemplate the meaning of infinity

    它能思索浩瀚的星際空間,

  • and it can contemplate itself contemplating on the meaning of infinity.

    能思索『無限』的含義,

  • And this peculiar recursive quality that we call self-awareness,

    甚至能思索自身思索『無限』含義的這件事。

  • which I think is the holy grail of neuroscience, of neurology,

    這種獨特的遞迴自省特質,稱為自我意識。

  • and hopefully, someday, we'll understand how that happens.

    我認為這是神經科學和神經病學的終極目標和意義,

  • OK, so how do you study this mysterious organ?

    希望有朝一日,我們能夠解開這個謎題。

  • I mean, you have 100 billion nerve cells,

    那麼,我們要如何研究這個神秘的器官呢?

  • little wisps of protoplasm, interacting with each other,

    人腦有1000億個神經元細胞,

  • and from this activity emerges the whole spectrum of abilities

    每個都是一小束原生質,彼此交互作用,

  • that we call human nature and human consciousness.

    從這些活動中,產生出多不勝數的能力

  • How does this happen?

    即所謂人性和人的意識。

  • Well, there are many ways of approaching the functions of the human brain.

    這是怎麼產生的呢?

  • One approach, the one we use mainly,

    研究人腦功能的方法很多,

  • is to look at patients with sustained damage to a small region of the brain,

    其中,最常採用的方法

  • where there's been a genetic change in a small region of the brain.

    是觀察大腦中,一小部分區域遭受持續性損傷的病人,

  • What then happens is not an across-the-board reduction

    研究已經發生某種基因改變的這一小部分腦區,

  • in all your mental capacities,

    這並不是全面性喪失

  • a sort of blunting of your cognitive ability.

    所有的心智能力,

  • What you get is a highly selective loss of one function,

    而是認知能力變得遲鈍,

  • with other functions being preserved intact,

    這是一種特定功能的喪失,

  • and this gives you some confidence in asserting

    而其他功能則完好無損。

  • that that part of the brain is somehow involved in mediating that function.

    我們幾乎可以確定,

  • So you can then map function onto structure,

    大腦的這個區域影響該功能,

  • and then find out what the circuitry's doing

    我們便可把功能對應到結構上,

  • to generate that particular function.

    得知這部分神經迴路是如何產生

  • So that's what we're trying to do.

    這個特定的功能,

  • So let me give you a few striking examples of this.

    這就是我們的目標。

  • In fact, I'm giving you three examples, six minutes each, during this talk.

    讓我向大家說明幾個驚人的例子,

  • The first example is an extraordinary syndrome called Capgras syndrome.

    我要提出3個例子,每段說明6分鐘,

  • If you look at the first slide there,

    首先,是一種非常奇特的『凱卜葛拉斯症候群』(Capgras Syndrome)。

  • that's the temporal lobes, frontal lobes, parietal lobes, OK --

    在第一張幻燈片裡

  • the lobes that constitute the brain.

    顯示的是顳葉(temporal lobes)、額葉(frontal lobes)和頂葉(parietal lobes)

  • And if you look, tucked away inside the inner surface of the temporal lobes --

    這些是構成大腦的腦葉

  • you can't see it there --

    仔細看,你會發現顳葉的皮層內部

  • is a little structure called the fusiform gyrus.

    (這張圖裡看不出來)

  • And that's been called the face area in the brain,

    是一種稱為梭狀回(fusiform gyrus)的微小結構

  • because when it's damaged, you can no longer recognize people's faces.

    它被稱為腦的『臉部區域』

  • You can still recognize them from their voice

    如果這個區域損傷,你就會喪失辨識別面孔的能力

  • and say, "Oh yeah, that's Joe,"

    你還是可以從聲音辨識其人

  • but you can't look at their face and know who it is, right?

    例如,你會說:『對,這個人是喬』

  • You can't even recognize yourself in the mirror.

    但你卻無法看著別人的臉認出這是誰

  • I mean, you know it's you because you wink and it winks,

    你甚至認不出鏡中的自己

  • and you know it's a mirror,

    你對鏡中人眨眼,那人也會對你眨眼

  • but you don't really recognize yourself as yourself.

    而且你知道那是一面鏡子

  • OK. Now that syndrome is well known as caused by damage to the fusiform gyrus.

    可是卻認不出那個人就是你自己

  • But there's another rare syndrome, so rare, in fact,

    我們已知這種症候群是由於梭狀回損傷所導致

  • that very few physicians have heard about it, not even neurologists.

    但還有一種非常罕見的症候群

  • This is called the Capgras delusion,

    連許多醫生、甚至神經科醫生都未曾聽聞,

  • and that is a patient, who's otherwise completely normal,

    叫做『凱卜葛拉斯妄想症』(Capgras Delusion)

  • has had a head injury, comes out of coma,

    一個原本腦部功能正常的人

  • otherwise completely normal, he looks at his mother

    頭部受到損傷,從昏迷中醒來以後,

  • and says, "This looks exactly like my mother, this woman,

    其他腦部功能都很正常,但是他看到自己的母親

  • but she's an impostor.

    卻說:『這人看上去跟我母親一模一樣,

  • She's some other woman pretending to be my mother."

    但她是個冒牌貨,

  • Now, why does this happen?

    是個假扮我母親的女人。』

  • Why would somebody -- and this person is perfectly lucid and intelligent

    為什麼會這樣呢?

  • in all other respects, but when he sees his mother,

    為什麼這個人理智、且完全清醒

  • his delusion kicks in and says, it's not mother.

    其他各腦部功能均完好,但是看到自己的母親,

  • Now, the most common interpretation of this,

    卻產生錯覺,認為不是他的母親呢?

  • which you find in all the psychiatry textbooks,

    目前最常見的解釋

  • is a Freudian view, and that is that this chap --

    所有精神病學教科書的見解

  • and the same argument applies to women, by the way,

    是佛洛伊德式的觀點:當這個男子

  • but I'll just talk about guys.

    (其實女性也有同樣的情形)

  • When you're a little baby, a young baby,

    (但我就以男性為例討論)

  • you had a strong sexual attraction to your mother.

    (佛洛伊德認為) 男性在嬰兒時期

  • This is the so-called Oedipus complex of Freud.

    對母親有強烈的性吸引力

  • I'm not saying I believe this,

    即佛洛伊德所謂的『伊底帕斯』(Oedipus)戀母情結

  • but this is the standard Freudian view.

    我並不支持這種論點

  • And then, as you grow up, the cortex develops,

    但這是典型的佛洛伊德觀點。

  • and inhibits these latent sexual urges towards your mother.

    隨著成長,腦皮層逐漸生長發育

  • Thank God, or you would all be sexually aroused when you saw your mother.

    抑制了對母親的潛在性慾。

  • And then what happens is,

    謝天謝地,否則你每次看到你母親就會性慾高漲。

  • there's a blow to your head, damaging the cortex,

    但是,當頭部受傷,

  • allowing these latent sexual urges to emerge,

    頭部的打擊損傷了腦皮層,

  • flaming to the surface, and suddenly and inexplicably

    釋放了潛在的性衝動

  • you find yourself being sexually aroused by your mother.

    浮現到最表層,突然間,莫名其妙地

  • And you say, "My God, if this is my mom,

    你感覺到自己對母親產生了性慾

  • how come I'm being sexually turned on?

    於是你想:『天啊,如果這是我媽,

  • She's some other woman. She's an impostor."

    我怎麼可能會有性衝動?

  • It's the only interpretation that makes sense to your damaged brain.

    她一定是別的女人,是個冒牌貨。』

  • This has never made much sense to me, this argument.

    你受傷的大腦認為,只有這樣解釋才合理。

  • It's very ingenious, as all Freudian arguments are --

    但我從不認同這種看法。

  • (Laughter)

    這個主張就像佛洛伊德所有的理論一樣,非常精闢

  • -- but didn't make much sense because I have seen the same delusion,

    (笑聲)

  • a patient having the same delusion, about his pet poodle.

    但是卻不合理,因為我曾經目睹同樣的錯覺

  • (Laughter)

    發生在一名病患對他的貴賓狗身上。

  • He'll say, "Doctor, this is not Fifi. It looks exactly like Fifi,

    (笑聲)

  • but it's some other dog." Right?

    他說:『醫生,這不是菲菲吧,牠長的跟菲菲一模一樣,

  • Now, you try using the Freudian explanation there.

    但牠是另一條狗。』對吧?

  • (Laughter)

    現在請你套用佛洛伊德的理論解釋看看,

  • You'll start talking about the latent bestiality in all humans,

    (笑聲)

  • or some such thing, which is quite absurd, of course.

    會認為人類有潛在的戀獸性,

  • Now, what's really going on?

    或是其他類似的論點,這都是非常荒謬的。

  • So, to explain this curious disorder,

    所以,實際情形究竟是怎麼回事呢?

  • we look at the structure and functions of the normal visual pathways in the brain.

    要解釋這種奇怪的症狀,

  • Normally, visual signals come in, into the eyeballs,

    我們來看看正常人腦視覺通路的結構和功能。

  • go to the visual areas in the brain.

    正常情況下,視覺訊號通過眼球,

  • There are, in fact, 30 areas in the back of your brain concerned with just vision,

    進入腦中的視覺區域。

  • and after processing all that, the message goes to a small structure

    事實上,腦後部有30個專門負責視覺的區域。

  • called the fusiform gyrus, where you perceive faces.

    經過這些區域處理之後,訊號會進入一個微小結構,

  • There are neurons there that are sensitive to faces.

    稱為『梭狀回』,就是感知面孔的地方,

  • You can call it the face area of the brain, right?

    那裡有對面孔敏感的神經元。

  • I talked about that earlier.

    我們可以稱它為『大腦的面部區』,

  • Now, when that area's damaged, you lose the ability to see faces, right?

    我稍早提過。

  • But from that area, the message cascades

    這個區域一旦損壞,你就失去了識別面孔的能力。對吧?

  • into a structure called the amygdala in the limbic system,

    但神經訊號還會通過那個區域,

  • the emotional core of the brain,

    進入大腦邊緣系統(limbic system)的杏仁核(amygdala),

  • and that structure, called the amygdala,

    這是腦的情緒核心,

  • gauges the emotional significance of what you're looking at.

    而這個稱為杏仁核的結構,

  • Is it prey? Is it predator? Is it mate?

    會判斷你所看見的物體在情緒上的重要性。

  • Or is it something absolutely trivial, like a piece of lint,

    在你眼前的,是獵物?掠食者?還是配偶?

  • or a piece of chalk, or a -- I don't want to point to that, but --

    還是完全無關緊要的東西,如衣服上的毛球,

  • or a shoe, or something like that? OK?

    或者一支粉筆。或是,我不想指出來了..

  • Which you can completely ignore.

    或者是一只鞋子等等,

  • So if the amygdala is excited, and this is something important,

    可以毫不理會的東西。

  • the messages then cascade into the autonomic nervous system.

    如果杏仁核變得興奮,表示這個東西對你很重要,

  • Your heart starts beating faster.

    神經訊號就會繼續傳到自主神經系統,

  • You start sweating to dissipate the heat that you're going to

    你的心跳會開始加速,

  • create from muscular exertion.

    你會開始出汗,排除因緊張而產生的體熱

  • And that's fortunate, because we can put two electrodes on your palm

    即肌肉緊繃引起的。

  • and measure the change in skin resistance produced by sweating.

    這樣便於偵測,因為我們可以在你的手掌心貼上兩個電極

  • So I can determine, when you're looking at something,

    來測量汗液導致的皮膚電阻變化。

  • whether you're excited or whether you're aroused, or not, OK?

    如此就能判斷,當你看著某樣東西,

  • And I'll get to that in a minute.

    是否感覺興奮?或是有沒有被挑起慾望。對吧?

  • So my idea was, when this chap looks at an object, when he looks at his --

    這點待會我會進一步說明。

  • any object for that matter, it goes to the visual areas and,

    所以我認為,當這個人看著某物時,

  • however, and it's processed in the fusiform gyrus,

    或者任何物體,訊號傳到視覺區

  • and you recognize it as a pea plant, or a table,

    傳入梭狀回處理

  • or your mother, for that matter, OK?

    便可認出這是一顆豌豆、一張桌子,

  • And then the message cascades into the amygdala,

    或是他的母親,對吧?

  • and then goes down the autonomic nervous system.

    接著,訊號繼續傳到杏仁核,

  • But maybe, in this chap, that wire that goes from the amygdala to the limbic system,

    再傳到自主神經系統。

  • the emotional core of the brain, is cut by the accident.

    但是,或許這個病患腦中,從杏仁核到邊緣系統的線路

  • So because the fusiform is intact,

    即連接大腦控制情緒核心的線路,在事故中被切斷了。

  • the chap can still recognize his mother,

    他的梭狀回完好無損,

  • and says, "Oh yeah, this looks like my mother."

    所以還能認出他的母親,

  • But because the wire is cut to the emotional centers,

    心想:『是啊,這女人長得跟我母親一樣。』

  • he says, "But how come, if it's my mother, I don't experience a warmth?"

    但由於通往情緒中心的線路被截斷了,

  • Or terror, as the case may be? Right?

    他就會懷疑:『如果真是我母親, 為什麼我看見她卻沒有溫暖的感覺?』

  • (Laughter)

    或者有些人可能會產生恐懼感,嗯?

  • And therefore, he says, "How do I account for this inexplicable lack of emotions?

    (笑聲)

  • This can't be my mother.

    於是他會想:『該如何解釋我的欠缺情緒反應呢?

  • It's some strange woman pretending to be my mother."

    她不可能是我的母親。

  • How do you test this?

    是某個陌生女人假裝是我的母親。』

  • Well, what you do is, if you take any one of you here, and put you in front of a screen,

    這種現象該如何驗證呢?

  • and measure your galvanic skin response,

    方法是,例如,請你們其中一位觀眾上來站在螢幕前,

  • and show pictures on the screen,

    我一邊測量你的皮膚電反應(GSR),

  • I can measure how you sweat when you see an object,

    一邊在螢幕上播放圖片給你看。

  • like a table or an umbrella. Of course, you don't sweat.

    我可以測量你看見各個物體時的出汗情形。

  • If I show you a picture of a lion, or a tiger, or a pinup, you start sweating, right?

    例如,看見桌子或雨傘時,你當然不至於出汗,

  • And, believe it or not, if I show you a picture of your mother --

    如果看到獅子、老虎或性感女郎,你就會冒汗了。對吧?

  • I'm talking about normal people -- you start sweating.

    信不信,如果我給你看你母親的照片,

  • You don't even have to be Jewish.

    我是指一般正常人,就會開始流汗,

  • (Laughter)

    不一定是猶太人才有這種反應。 (譯註:猶太媽媽的刻版印象是專橫嘮叨、管教甚嚴)

  • Now, what happens if you show this patient?

    (笑聲)

  • You take the patient and show him pictures on the screen

    同樣的實驗,對前述的病患,反應又是如何呢?

  • and measure his galvanic skin response.

    你把他帶到螢幕前,播放圖片給他看,

  • Tables and chairs and lint, nothing happens, as in normal people,

    測量他的皮膚電反應(GSR)。

  • but when you show him a picture of his mother,

    看桌子、椅子、毛球,沒有反應,跟正常人一樣;

  • the galvanic skin response is flat.

    但是當你給他看他母親的照片,

  • There's no emotional reaction to his mother,

    皮膚電圖像還是平的,

  • because that wire going from the visual areas to the emotional centers is cut.

    他對自己的母親也沒有情緒反應,

  • So his vision is normal because the visual areas are normal,

    因為從視覺區通往情緒中心的線路被切斷了。

  • his emotions are normal -- he'll laugh, he'll cry, so on and so forth --

    他的視覺沒有問題,因為視覺區功能正常,

  • but the wire from vision to emotions is cut

    他的情緒反應能力也沒有問題,他會哭會笑,等等

  • and therefore he has this delusion that his mother is an impostor.

    但是從視覺到情緒的線路卻阻斷了,

  • It's a lovely example of the sort of thing we do:

    因此他會產生錯覺,認為他母親是冒牌貨。

  • take a bizarre, seemingly incomprehensible, neural psychiatric syndrome

    這個有趣的例子可以說明我們從事的研究,

  • and say that the standard Freudian view is wrong,

    探究這類奇特、看似無法理解的神經精神症候群,

  • that, in fact, you can come up with a precise explanation

    來證明傳統佛洛伊德觀點的謬誤,

  • in terms of the known neural anatomy of the brain.

    事實上,你可以找到精確的解釋,

  • By the way, if this patient then goes,

    從已知的大腦神經解剖學找出答案。

  • and mother phones from an adjacent room -- phones him --

    順帶一提,如果這個病人離開,

  • and he picks up the phone, and he says, "Wow, mom, how are you? Where are you?"

    他母親從隔壁打電話來,

  • There's no delusion through the phone.

    他會接起電話說:『哇,媽,妳好不好?妳在哪裡?』

  • Then, she approaches him after an hour, he says, "Who are you?

    透過電話,不會產生錯覺。

  • You look just like my mother." OK?

    一小時後,當母親走到他面前,他又會問:『妳是誰呀?

  • The reason is there's a separate pathway

    妳長得跟我母親一模一樣!』

  • going from the hearing centers in the brain to the emotional centers,

    原因是,有另一條通路

  • and that's not been cut by the accident.

    從腦的聽覺中心通往情緒中心,

  • So this explains why through the phone he recognizes his mother, no problem.

    這條通路並沒有被事故切斷。

  • When he sees her in person, he says it's an impostor.

    這是為什麼他能透過電話認出母親,毫無問題;

  • OK, how is all this complex circuitry set up in the brain?

    但是當他看到母親本人,卻說她是假冒者。

  • Is it nature, genes, or is it nurture?

    大腦究竟是如何建構發展出如此複雜的迴路呢?

  • And we approach this problem

    是先天、基因、還是後天的作用?

  • by considering another curious syndrome called phantom limb.

    要解開這個謎題,

  • And you all know what a phantom limb is.

    可透過研究另一種奇特的症候群,稱為『幻肢』。

  • When an arm is amputated, or a leg is amputated, for gangrene,

    各位都知道幻肢是什麼

  • or you lose it in war -- for example, in the Iraq war,

    當一條手臂或腿因為壞疽被切除,

  • it's now a serious problem --

    或在戰爭(如伊拉克戰爭)中失去,

  • you continue to vividly feel the presence of that missing arm,

    我們發現這會產生嚴重的問題

  • and that's called a phantom arm or a phantom leg.

    傷者仍能強烈地感受到那條已經失去的手臂的存在,

  • In fact, you can get a phantom with almost any part of the body.

    這就是所謂的幻臂(phantom arm)或幻腿(phantom leg)。

  • Believe it or not, even with internal viscera.

    事實上,身體任何部位都有可能產生這種幻肢現象,

  • I've had patients with the uterus removed -- hysterectomy --

    甚至連內臟器官都有可能。

  • who have a phantom uterus, including phantom menstrual cramps

    我有位病人,做子宮切除術除去了子宮,

  • at the appropriate time of the month.

    她得了幻子宮症,還會有幻經痛

  • And in fact, one student asked me the other day,

    每個月都會定期感到經痛。

  • "Do they get phantom PMS?"

    甚至,前幾天還有學生問我,

  • (Laughter)

    她們有沒有幻經前症候群?

  • A subject ripe for scientific enquiry, but we haven't pursued that.

    (笑聲)

  • OK, now the next question is,

    這頗值得科學研究,但我們還沒有探討過。

  • what can you learn about phantom limbs by doing experiments?

    好了,接下來的問題是:

  • One of the things we've found was,

    我們能透過實驗,對幻肢現象獲得什麼了解?

  • about half the patients with phantom limbs

    我們發現,

  • claim that they can move the phantom.

    半數的幻肢病患,

  • It'll pat his brother on the shoulder,

    宣稱自己可以移動那條幻肢。

  • it'll answer the phone when it rings, it'll wave goodbye.

    能用幻肢拍兄弟的肩膀,

  • These are very compelling, vivid sensations.

    能在電話鈴響時拿起聽筒,還能揮手道別。

  • The patient's not delusional.

    這些感覺真實而強烈,

  • He knows that the arm is not there,

    病患並不是在妄想。

  • but, nevertheless, it's a compelling sensory experience for the patient.

    他們明知道手臂已經不在了,

  • But however, about half the patients, this doesn't happen.

    但感覺還是非常強烈。

  • The phantom limb -- they'll say, "But doctor, the phantom limb is paralyzed.

    不過,另一半病患倒是沒有這種現象。

  • It's fixed in a clenched spasm and it's excruciatingly painful.

    病患會說:『醫生,我的幻肢麻痺了,

  • If only I could move it, maybe the pain will be relieved."

    緊繃痙攣,無法動彈,劇烈疼痛。

  • Now, why would a phantom limb be paralyzed?

    如果我能移動它,疼痛或許會減輕。

  • It sounds like an oxymoron.

    奇怪的是,既然是幻肢,為什麼會麻痺癱瘓呢?

  • But when we were looking at the case sheets, what we found was,

    這不是自相矛盾嗎?

  • these people with the paralyzed phantom limbs,

    我們研究病歷表發現,

  • the original arm was paralyzed because of the peripheral nerve injury.

    這些感覺幻肢癱瘓的病患,

  • The actual nerve supplying the arm was severed,

    手臂還在時,曾經因為周圍神經受傷而癱瘓,

  • was cut, by say, a motorcycle accident.

    控制手臂的神經被切斷,

  • So the patient had an actual arm, which is painful,

    例如,若病患因機車事故,切斷實際的手臂神經,

  • in a sling for a few months or a year, and then,

    他(尚未切除)的手臂會感到疼痛,

  • in a misguided attempt to get rid of the pain in the arm,

    吊著繃帶好幾個月或一整年。後來,

  • the surgeon amputates the arm,

    為了消除疼痛,判斷失當,

  • and then you get a phantom arm with the same pains, right?

    被外科醫師做了截肢手術,

  • And this is a serious clinical problem.

    結果形成幻臂,而且疼痛還是存在。

  • Patients become depressed.

    這是非常嚴重的臨床問題。

  • Some of them are driven to suicide, OK?

    病患變得憂鬱沮喪,

  • So, how do you treat this syndrome?

    有些人甚至因而自殺。

  • Now, why do you get a paralyzed phantom limb?

    那麼,這種症候群該如何治療呢?

  • When I looked at the case sheet, I found that they had an actual arm,

    首先要問的是,為什麼有人會覺得幻肢麻痺?

  • and the nerves supplying the arm had been cut,

    我研究病歷,發現他們的手臂還確實存在時,

  • and the actual arm had been paralyzed,

    控制該手臂的神經被切斷,

  • and lying in a sling for several months before the amputation,

    導致該手臂麻痺,

  • and this pain then gets carried over into the phantom itself.

    吊在繃帶裡,癱瘓了好幾個月,才被截肢。

  • Why does this happen?

    截肢前的疼痛,卻持續延伸到幻臂裡。

  • When the arm was intact, but paralyzed,

    為什麼會這樣呢?

  • the brain sends commands to the arm, the front of the brain, saying, "Move,"

    當手臂尚未切除,但麻痺時,

  • but it's getting visual feedback saying, "No."

    前腦發送指令給手臂,命令它:『移動!』

  • Move. No. Move. No. Move. No.

    但視覺卻回應大腦說:『動不了。』

  • And this gets wired into the circuitry of the brain,

    『動!』『動不了。』『動!』『動不了。』...

  • and we call this learned paralysis, OK?

    這個反覆模式被固著在大腦的神經迴路中,

  • The brain learns, because of this Hebbian, associative link,

    這叫做『習得性癱瘓』(learned paralysis)。

  • that the mere command to move the arm

    大腦以為,因為這種海伯聯結(Hebbian associative link)

  • creates a sensation of a paralyzed arm.

    使這個移動手臂的簡單指令,

  • And then, when you've amputated the arm,

    導致麻痺手臂的疼痛感。

  • this learned paralysis carries over into your body image

    截除手臂以後,

  • and into your phantom, OK?

    這種『習得性癱瘓』蔓延到你的身體意象(body image),

  • Now, how do you help these patients?

    深入幻肢之中。

  • How do you unlearn the learned paralysis,

    那麼,該怎麼幫助這些病患呢?

  • so you can relieve him of this excruciating, clenching spasm

    怎樣拋卻已習得的癱瘓,

  • of the phantom arm?

    解除病患幻臂中劇痛的痙攣?

  • Well, we said, what if you now send the command to the phantom,

    .

  • but give him visual feedback that it's obeying his command, right?

    於是我們想,要是讓大腦對幻肢發送命令,

  • Maybe you can relieve the phantom pain, the phantom cramp.

    並讓視覺回應告知大腦,幻肢服從命令,如何?

  • How do you do that? Well, virtual reality.

    或許就會消除幻肢疼痛和痙攣了。

  • But that costs millions of dollars.

    要怎樣做呢?用虛擬實境(virtual reality)吧?

  • So, I hit on a way of doing this for three dollars,

    但那要花好幾百萬。

  • but don't tell my funding agencies.

    我想到一個辦法,只要花3美元,

  • (Laughter)

    不要告訴我的贊助機構。

  • OK? What you do is you create what I call a mirror box.

    (笑聲)

  • You have a cardboard box with a mirror in the middle,

    首先,要做一個『鏡盒』,

  • and then you put the phantom -- so my first patient, Derek, came in.

    在紙板盒中間放一面鏡子,

  • He had his arm amputated 10 years ago.

    然後放置幻肢。我的第一個病患,德瑞克進來,

  • He had a brachial avulsion, so the nerves were cut

    他在10年前截除手臂。

  • and the arm was paralyzed, lying in a sling for a year, and then the arm was amputated.

    之前曾經受了臂神經叢撕脫傷(brachial avulsion),神經被切斷,

  • He had a phantom arm, excruciatingly painful, and he couldn't move it.

    手臂從此癱瘓,掛著繃帶一年後,接受截肢手術。

  • It was a paralyzed phantom arm.

    接著產生幻肢,疼痛難當,而且無法自由移動。

  • So he came there, and I gave him a mirror like that, in a box,

    他這就是『習得性癱瘓』的手臂。

  • which I call a mirror box, right?

    他來看病時,我給他一面像這樣的鏡子,在盒子裡

  • And the patient puts his phantom left arm,

    我稱為鏡盒,對吧?

  • which is clenched and in spasm, on the left side of the mirror,

    我把病患的幻肢左臂

  • and the normal hand on the right side of the mirror,

    (繃緊痙攣的那隻) 放在鏡子左邊,

  • and makes the same posture, the clenched posture,

    正常的手臂放在鏡子右邊,

  • and looks inside the mirror. And what does he experience?

    並模仿左臂的姿勢,握緊的姿勢,

  • He looks at the phantom being resurrected,

    然後看著鏡子,你猜他感覺到了什麼?

  • because he's looking at the reflection of the normal arm in the mirror,

    他感覺幻肢又復活了。

  • and it looks like this phantom has been resurrected.

    因為他看到了鏡中正常手臂的反射鏡像,

  • "Now," I said, "now, look, wiggle your phantom --

    彷彿他的幻肢重生了。

  • your real fingers, or move your real fingers while looking in the mirror."

    然後我說:『現在,擺動一下你的幻臂,

  • He's going to get the visual impression that the phantom is moving, right?

    (更正)你真正的手指;一面看著鏡子,一面擺動你(左手)真正的手指。』

  • That's obvious, but the astonishing thing is,

    他的視覺印象會告訴他,幻肢正在擺動,對吧?

  • the patient then says, "Oh my God, my phantom is moving again,

    這是顯而易見的。但令人驚訝的是,

  • and the pain, the clenching spasm, is relieved."

    病患叫說:『天啊,我的幻臂居然可以移動了,

  • And remember, my first patient who came in --

    而且那繃緊痙攣的疼痛不見啦!』

  • (Applause)

    記得嗎?我的首位病患進來——

  • -- thank you. (Applause)

    (掌聲)

  • My first patient came in, and he looked in the mirror,

    謝謝(掌聲)

  • and I said, "Look at your reflection of your phantom."

    我的第一個病患來看病時,他看著鏡子,

  • And he started giggling, he says, "I can see my phantom."

    我說:『看著你幻肢的鏡像。』

  • But he's not stupid. He knows it's not real.

    他咯咯笑起來,說:『我看得見我的幻肢。』

  • He knows it's a mirror reflection,

    他並不笨,知道這不是真實的,

  • but it's a vivid sensory experience.

    他知道那只是個鏡像,

  • Now, I said, "Move your normal hand and phantom."

    但這卻是非常逼真的體驗。

  • He said, "Oh, I can't move my phantom. You know that. It's painful."

    然後我說:『移動你正常的手臂,和幻臂』。

  • I said, "Move your normal hand."

    他說:『我沒辦法移動我的幻臂,你知道,很痛啊!』

  • And he says, "Oh my God, my phantom is moving again. I don't believe this!

    我說:『那就移動正常的那隻手吧。 』

  • And my pain is being relieved." OK?

    他說:『天啊,我的幻臂又在動了,簡直不敢相信!

  • And then I said, "Close your eyes."

    手也不痛了! 』

  • He closes his eyes.

    接著我說:『閉上眼睛。』

  • "And move your normal hand."

    他閉上眼。

  • "Oh, nothing. It's clenched again."

    我說:『動一下你正常的那隻手。』

  • "OK, open your eyes."

    他說:『喔,動不了,又繃緊麻痺了。』

  • "Oh my God, oh my God, it's moving again!"

    我說:『睜開眼睛。』

  • So, he was like a kid in a candy store.

    他說:『天啊,又在動了!』

  • So, I said, OK, this proves my theory about learned paralysis

    他興奮地像個糖果店裡的孩子。

  • and the critical role of visual input,

    所以我說,這證明了我的習得性麻痺理論,

  • but I'm not going to get a Nobel Prize

    和視覺輸入的關鍵性。

  • for getting somebody to move his phantom limb.

    但是諾貝爾獎不會頒給我

  • (Laughter)

    只因為我能讓人移動幻肢。

  • (Applause)

    (笑聲)

  • It's a completely useless ability, if you think about it.

    (掌聲)

  • (Laughter)

    仔細想想,這還真是毫無用處的能力哩!

  • But then I started realizing, maybe other kinds of paralysis

    (笑聲)

  • that you see in neurology, like stroke, focal dystonias --

    但是後來我開始意識到,也許其他類型的癱瘓,

  • there may be a learned component to this,

    神經病學中的癱瘓,例如中風、局部肌張力不全症(focal dystonia),

  • which you can overcome with the simple device of using a mirror.

    或許都有習得的成分,

  • So, I said, "Look, Derek" --

    都能藉助這種鏡盒來克服。

  • well, first of all, the guy can't just go around carrying a mirror to alleviate his pain --

    於是我說:『德瑞克,』

  • I said, "Look, Derek, take it home and practice with it for a week or two.

    病患總不能一直隨身帶著鏡盒,來減輕痛苦吧?

  • Maybe, after a period of practice,

    我說:『德瑞克,鏡盒讓你帶回家,自己練習一兩個禮拜,

  • you can dispense with the mirror, unlearn the paralysis,

    或許反覆練習一段時間,

  • and start moving your paralyzed arm,

    你就可以扔掉鏡子,擺脫癱瘓,

  • and then, relieve yourself of pain."

    自由移動幻肢,

  • So he said OK, and he took it home.

    跟疼痛說再見啦!』

  • I said, "Look, it's, after all, two dollars. Take it home."

    他說好啊,就帶著鏡盒回家了。

  • So, he took it home, and after two weeks, he phones me,

    我說:『反正只花我2塊錢而已,你就帶回家吧。』

  • and he said, "Doctor, you're not going to believe this."

    於是他把鏡盒帶回家。兩週後他打來電話來,

  • I said, "What?"

    說:『醫生,你一定不相信。』

  • He said, "It's gone."

    我說:『不相信什麼?』

  • I said, "What's gone?"

    他說:『它不見了。』

  • I thought maybe the mirror box was gone.

    我說:『什麼不見了?』

  • (Laughter)

    我還以為可能是鏡盒不見了。

  • He said, "No, no, no, you know this phantom I've had for the last 10 years?

    (笑聲)

  • It's disappeared."

    他說:『不不不,這個困擾了我10年的幻臂,

  • And I said -- I got worried, I said, my God,

    它不見啦! 』

  • I mean I've changed this guy's body image,

    我有點擔心,我說,天哪!

  • what about human subjects, ethics and all of that?

    我改變了他的身體形像,

  • And I said, "Derek, does this bother you?"

    但是有關人體主體、倫理道德等等議題呢?

  • He said, "No, last three days, I've not had a phantom arm

    我說:『德瑞克,你覺得困擾嗎?』

  • and therefore no phantom elbow pain, no clenching,

    他說:『不會呀!這三天來,我的幻臂消失了,

  • no phantom forearm pain, all those pains are gone away.

    幻肘關節痛也沒了,也不再肌肉緊繃,

  • But the problem is I still have my phantom fingers dangling from the shoulder,

    幻肢上臂疼痛也沒了,所有疼痛都消失了!

  • and your box doesn't reach."

    不過問題是,我的幻手指還接在肩膀上,

  • (Laughter)

    你的鏡盒搆不到耶!』

  • "So, can you change the design and put it on my forehead,

    (笑聲)

  • so I can, you know, do this and eliminate my phantom fingers?"

    『你能不能改一下設計,把鏡盒放在我的前額,

  • He thought I was some kind of magician.

    讓我練習消除我的幻手指? 』

  • Now, why does this happen?

    他以為我會變魔術呢!

  • It's because the brain is faced with tremendous sensory conflict.

    為什麼會發生這種現象呢?

  • It's getting messages from vision saying the phantom is back.

    這是因為大腦受到極大的知覺衝突,

  • On the other hand, there's no proprioception,

    它收到視覺訊號,說幻肢長回來了;

  • muscle signals saying that there is no arm, right?

    但另一方面,卻沒有接收到實際的相應訊號,

  • And your motor command saying there is an arm,

    來自肌肉的訊號說手臂不存在,不是嗎?

  • and, because of this conflict, the brain says, to hell with it,

    可是運動神經指令也在說手臂存在。

  • there is no phantom, there is no arm, right?

    由於這種衝突,大腦乾脆說:『管他的,

  • It goes into a sort of denial -- it gates the signals.

    根本沒有幻肢、沒有手臂啦!』

  • And when the arm disappears, the bonus is, the pain disappears

    大腦陷入某種否認狀態,否認這些訊號。

  • because you can't have disembodied pain floating out there, in space.

    當幻臂消失時,好處是疼痛也一併消失,

  • So, that's the bonus.

    因為總不可能有無形體疼痛在空中漂浮吧?

  • Now, this technique has been tried on dozens of patients

    所以這是它的好處。

  • by other groups in Helsinki,

    這種療法已經在幾十個病患身上試驗過,

  • so it may prove to be valuable as a treatment for phantom pain,

    由赫爾辛基的其他醫療團體,

  • and indeed, people have tried it for stroke rehabilitation.

    以證實它有助於治療幻肢疼痛。

  • Stroke you normally think of as damage to the fibers,

    的確,它已被試用於中風復健。

  • nothing you can do about it.

    一般認為,中風是神經纖維受損,

  • But, it turns out some component of stroke paralysis is also learned paralysis,

    無方可治。

  • and maybe that component can be overcome using mirrors.

    但是我們發現,其實中風癱瘓也含有習得的成分,

  • This has also gone through clinical trials,

    或許這種鏡療法可以用來療癒其習得成分。

  • helping lots and lots of patients.

    這也已經臨床試驗,

  • OK, let me switch gears now to the third part of my talk,

    幫助過許多病患。

  • which is about another curious phenomenon called synesthesia.

    接下來是我要講的第三部分,

  • This was discovered by Francis Galton in the nineteenth century.

    是關於另一種奇特的現象,叫做『聯覺』(Synesthesia)。

  • He was a cousin of Charles Darwin.

    由弗朗西斯.高爾頓在十九世紀所發現。

  • He pointed out that certain people in the population,

    他是達爾文的表親。

  • who are otherwise completely normal, had the following peculiarity:

    他發現有些人,

  • every time they see a number, it's colored.

    其他方面均無異於常人,卻有如下奇特之處——

  • Five is blue, seven is yellow, eight is chartreuse,

    他們看到一個數字時,就能感受到色彩。

  • nine is indigo, OK?

    5是藍色;7是黃色;8是黃綠色;

  • Bear in mind, these people are completely normal in other respects.

    9是紫藍色。

  • Or C sharp -- sometimes, tones evoke color.

    記住,這些人其他方面完全正常。

  • C sharp is blue, F sharp is green,

    有時,音調也能喚起色彩,

  • another tone might be yellow, right?

    升C是藍色,升F是綠色,

  • Why does this happen?

    其他音調可能是黃色等等。

  • This is called synesthesia. Galton called it synesthesia,

    為什麼會這樣?

  • a mingling of the senses.

    高爾頓把這稱為『聯覺』(synaesthesia),

  • In us, all the senses are distinct.

    這是一種感覺的混合。

  • These people muddle up their senses.

    對我們一般人來說,感覺是各自獨立的,

  • Why does this happen?

    這些人的多種感覺卻會混合。

  • One of the two aspects of this problem are very intriguing.

    為什麼會這樣?

  • Synesthesia runs in families,

    這種現象有兩個有趣之處,

  • so Galton said this is a hereditary basis, a genetic basis.

    聯覺有家族遺傳,

  • Secondly, synesthesia is about -- and this is what gets me to my point

    因此高爾頓認為這跟遺傳基因有關。

  • about the main theme of this lecture, which is about creativity --

    其次,『聯覺』與某特質有關——(這就是我要傳達的重點)

  • synesthesia is eight times more common among artists, poets, novelists

    就是這個演講的主題:創造力——

  • and other creative people than in the general population.

    『聯覺』在藝術家、詩人、作家,以及其他創意人中更普遍,

  • Why would that be?

    是普通人的8倍。

  • I'm going to answer that question.

    為什麼會這樣?

  • It's never been answered before.

    我要回答這個問題,

  • OK, what is synesthesia? What causes it?

    這個問題之前無人解答過。

  • Well, there are many theories.

    究竟什麼是『聯覺』,成因是什麼?

  • One theory is they're just crazy.

    相關的理論很多。

  • Now, that's not really a scientific theory, so we can forget about it.

    一種理論認為,這些人瘋了,

  • Another theory is they are acid junkies and potheads, right?

    這算不上科學理論,所以不多談了。

  • Now, there may be some truth to this,

    另一個理論是這些人是吸毒者,大麻癮君子。

  • because it's much more common here in the Bay Area than in San Diego.

    這或許有點道理,

  • (Laughter)

    因為『聯覺』人口在灣區比在聖地牙哥多得多。

  • OK. Now, the third theory is that --

    (笑聲)

  • well, let's ask ourselves what's really going on in synesthesia. All right?

    第三個理論是,

  • So, we found that the color area and the number area

    我們要問:『聯覺』到底是怎麼產生的?

  • are right next to each other in the brain, in the fusiform gyrus.

    我們發現,圖中的顏色區和數字區

  • So we said, there's some accidental cross wiring

    在大腦的梭狀回裡彼此相鄰,

  • between color and numbers in the brain.

    因此,腦中可能發生意外的線路叉接(cross-wiring),

  • So, every time you see a number, you see a corresponding color,

    即顏色區與數字區之間的線路。

  • and that's why you get synesthesia.

    所以,每次看見某個數字,就會同時看見相應的顏色,

  • Now remember -- why does this happen?

    於是產生所謂的『聯覺』。

  • Why would there be crossed wires in some people?

    記住,為什麼會發生這種現象呢?

  • Remember I said it runs in families?

    為什麼有些人腦中會發生線路叉接呢?

  • That gives you the clue.

    我剛說過,這是家族遺傳的,

  • And that is, there is an abnormal gene,

    這就提供了線索。

  • a mutation in the gene that causes this abnormal cross wiring.

    有某個異常的基因,

  • In all of us, it turns out

    一種基因突變,引起了異常的線路叉接。

  • we are born with everything wired to everything else.

    其實,我們每個人

  • So, every brain region is wired to every other region,

    出生時,腦中線路彼此相連,

  • and these are trimmed down to create

    所有腦部區域都彼此互通,

  • the characteristic modular architecture of the adult brain.

    然後逐漸修整區別,

  • So, if there's a gene causing this trimming

    劃分形成成人腦中,各具不同特徵的模塊。

  • and if that gene mutates,

    如果有一個基因控制這種修整過程,

  • then you get deficient trimming between adjacent brain areas.

    而它產生突變,

  • And if it's between number and color, you get number-color synesthesia.

    那麼相鄰腦區間的修整就不充分了,

  • If it's between tone and color, you get tone-color synesthesia.

    若發生在數字和顏色之間,就產生『數字—顏色聯覺症』。

  • So far, so good.

    若發生在音調和顏色之間,就產生『音調—顏色聯覺症』。

  • Now, what if this gene is expressed everywhere in the brain,

    這些解釋都合理。

  • so everything is cross-connected?

    要是這個突變基因,在腦中的所有地方都起了作用呢?

  • Well, think about what artists, novelists and poets have in common,

    所有的腦區都相聯的話呢?

  • the ability to engage in metaphorical thinking,

    想想看,藝術家、作家和詩人之間有什麼共通處?

  • linking seemingly unrelated ideas,

    他們都具備隱喻思維 (metaphorical thinking) 能力,

  • such as, "It is the east, and Juliet is the Sun."

    把看似無關的概念,加以聯結。

  • Well, you don't say, Juliet is the sun,

    例如,『這是東方,茱麗葉就是太陽。』

  • does that mean she's a glowing ball of fire?

    你不會說茱麗葉是個太陽,

  • I mean, schizophrenics do that, but it's a different story, right?

    這話難道是指『她是團炙熱的火球』嗎?

  • Normal people say, she's warm like the sun,

    精神分裂的人會這麼想,但那當別論。

  • she's radiant like the sun, she's nurturing like the sun.

    正常人會說:『她像太陽一樣溫暖』

  • Instantly, you've found the links.

    『她像太陽一樣明艷照人』、『她像太陽一樣撫慰心靈』

  • Now, if you assume that this greater cross wiring

    其中的聯繫顯而易見。

  • and concepts are also in different parts of the brain,

    現在,若假設更大規模的這種線路叉接,

  • then it's going to create a greater propensity

    以及概念,也位於腦的不同區域,

  • towards metaphorical thinking and creativity

    就會形成更強烈的傾向

  • in people with synesthesia.

    突顯有聯覺症者的隱喻思維和創造性。

  • And, hence, the eight times more common incidence of synesthesia

    .

  • among poets, artists and novelists.

    因此,(某類人群)聯覺症比例是常人的8倍

  • OK, it's a very phrenological view of synesthesia.

    包括藝術家、詩人和作家等。

  • The last demonstration -- can I take one minute?

    好,這是非常顱相學(phrenological)的聯覺理論。

  • (Applause)

    最後再做個實驗——再給我一分鐘好嗎?

  • OK. I'm going to show you that you're all synesthetes, but you're in denial about it.

    (掌聲)

  • Here's what I call Martian alphabet. Just like your alphabet,

    我要向各位展示:你們全都有聯覺症,只是自己不自知罷了。

  • A is A, B is B, C is C.

    這張圖,我稱為『火星字母表』,就像英文字母表。

  • Different shapes for different phonemes, right?

    A是A、B是B、C是C

  • Here, you've got Martian alphabet.

    不同音素對應不同的形狀,對吧?

  • One of them is Kiki, one of them is Bouba.

    這是『火星字母表』,

  • Which one is Kiki and which one is Bouba?

    其中一個是『Kiki』,另一個是『Buba』。

  • How many of you think that's Kiki and that's Bouba? Raise your hands.

    請問哪一個是『Kiki』,哪一個是『Buba』呢?

  • Well, it's one or two mutants.

    有多少人覺得這邊是『Kiki』,那邊是『Buba』?請舉手。

  • (Laughter)

    嗯,有一、兩位突變。

  • How many of you think that's Bouba, that's Kiki? Raise your hands.

    (笑聲)

  • Ninety-nine percent of you.

    有多少人覺得這邊是『Buba』,那邊是『Kiki』?請舉手。

  • Now, none of you is a Martian. How did you do that?

    在座百分之九十九的人。

  • It's because you're all doing a cross-model synesthetic abstraction,

    各位都不是火星人,你們是怎麼認出來呢?

  • meaning you're saying that that sharp inflection -- ki-ki,

    因為各位都在進行跨模塊的『聯覺抽象』,

  • in your auditory cortex, the hair cells being excited -- Kiki,

    你覺得那尖尖的形狀看起來像『Kiki』,

  • mimics the visual inflection, sudden inflection of that jagged shape.

    在你的聽覺腦皮層中,聽毛細胞受刺激,『Kiki』

  • Now, this is very important, because what it's telling you

    就像那個鋸齒形狀的視覺曲折,生硬而突然。

  • is your brain is engaging in a primitive --

    這點非常重要,因為它說明

  • it's just -- it looks like a silly illusion,

    你的大腦正在進行一種原生的程序

  • but these photons in your eye are doing this shape,

    雖然它看起來有點可笑,

  • and hair cells in your ear are exciting the auditory pattern,

    但這些光子在你眼中形成這個形狀,

  • but the brain is able to extract the common denominator.

    同時你耳中的聽毛細胞刺激這個聽覺模式,

  • It's a primitive form of abstraction,

    但是大腦能夠抽取兩者的共性。

  • and we now know this happens in the fusiform gyrus of the brain,

    這是一種原始形式的抽象。

  • because when that's damaged,

    我們現在知道,這發生在大腦的梭狀回,

  • these people lose the ability to engage in Bouba Kiki,

    因為那裡如果受損,

  • but they also lose the ability to engage in metaphor.

    病患就無法判斷『Buba、Kiki』,

  • If you ask this guy, what -- "all that glitters is not gold,"

    也失去隱喻的能力。

  • what does that mean?"

    若問他:『發亮的未必都是黃金』(譯註:英諺,意同『金玉其外,敗絮其中』)

  • The patient says, "Well, if it's metallic and shiny, it doesn't mean it's gold.

    這話什麼意思?

  • You have to measure its specific gravity, OK?"

    他會說:『意思是,若是金屬且發亮,不表示一定是黃金,

  • So, they completely miss the metaphorical meaning.

    得測試它的比重。』

  • So, this area is about eight times the size in higher --

    這個病患無法明白其中的比喻涵義。

  • especially in humans -- as in lower primates.

    這個腦區的體積,在高等靈長類

  • Something very interesting is going on here in the angular gyrus,

    尤其是人類,是低等靈長類的8倍。

  • because it's the crossroads between hearing, vision and touch,

    角形腦回(angular gyrus)是個很有趣的區域,

  • and it became enormous in humans. And something very interesting is going on.

    它是視覺、聽覺和觸覺的交匯處,

  • And I think it's a basis of many uniquely human abilities

    人類的角形腦回特別大,因此具備非常複雜的功能。

  • like abstraction, metaphor and creativity.

    我認為它是許多人類特有能力的基礎,

  • All of these questions that philosophers have been studying for millennia,

    例如抽象、隱喻,和創造。

  • we scientists can begin to explore by doing brain imaging,

    這些問題,哲學家已經研究上千年了,

  • and by studying patients and asking the right questions.

    現在,我們科學家可以利用腦部造影,

  • Thank you.

    研究病患,並提出正確的問題,加以探索。

  • (Applause)

    謝謝。

  • Sorry about that.

    (掌聲)

  • (Laughter)

    抱歉。

Well, as Chris pointed out, I study the human brain,

譯者: Yesbydefault 倪文娟 審譯者: Adrienne Lin

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B2 US TED 病患 手臂 聯覺 母親 大腦

TED】VS Ramachandran:瞭解你的大腦的3個線索(瞭解你的大腦的3個線索|VS Ramachandran)。 (【TED】VS Ramachandran: 3 clues to understanding your brain (3 clues to understanding your brain | VS Ramachandran))

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    Zenn posted on 2021/01/14
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