APRESENTAÇÃO

DE APOIO

E A EVOLUÇÃO CRIOU
O CÉREBRO HUMANO
 Ementa da disciplina
Estudo do cérebro humano à luz da evolução e das novas evidências que sugerem
explicações para o que torna as habilidades cognitivas do ser humano únicas.
 Professores
SUZANA HERCULANO-HOUZEL
Professora convidada
Suzana Herculano-Houzel é professora associada dos
departamentos de Psicologia e Ciências Biológicas da
Universidade Vanderbilt, em Nashville, nos Estados Unidos,
onde estuda a evolução da diversidade do cérebro e como o
cérebro humano se compara a outros. É bióloga formada
pela Universidade Federal do Rio de Janeiro e autora de
vários livros sobre neurociência, sendo o mais recente “A
Vantagem Humana”. Tem pós-doutorado pelo Instituto Max-
Planck de Pesquisa do Cérebro na Alemanha, doutorado pela
Universidade de Paris VI na França e mestrado pela
Universidade Case Western Reserve, nos Estados Unidos. É
scholar da Fundação James McDonnell, na qual foi a primeira
brasileira a receber o Scholar Award para financiar sua
pesquisa, além de colunista quinzenal do jornal Folha de
S.Paulo desde 2006. Sua palestra no TEDGlobal 2013, no qual
abordou o que é especial no cérebro humano, tem mais de 2
milhões de visualizações.
LUCAS SPANEMBERG
Professor PUCRS
Médico pela Universidade Federal de Ciências da Saúde
de Porto Alegre (UFCSPA). Psiquiatra pelo Hospital São Lucas
da Pontifícia Universidade Católica do Rio Grande do Sul
(HSL/PUCRS). Especialista em Psicoterapia de Orientação
Analítica pelo Centro de Estudos Luis Guedes (CELG) da
Universidade Federal do Rio Grande do Sul (UFRGS). Doutor
em Psiquiatria e Ciências do Comportamento pela UFRGS.
Pós-Doutorando Sênior e Pesquisador pelo Hospital de
Clínicas de Porto Alegre (HCPA-UFRGS). Professor Adjunto
do Núcleo de Neurociências da Escola de Medicina da PUCRS.
Preceptor de Residência em Psiquiatria no Hospital São Lucas
(HSL) da PUCRS. Professor do Curso de Especialização em
Psiquiatria da PUCRS. Autor de mais de 30 artigos científicos
internacionais e de mais de uma dezena de capítulos de livros
em psiquiatria e saúde mental, e autor do livro “Manual de
Internação Psiquiátrica” (Editora Manole, 2021). Possui vasta
experiência em psiquiatria hospitalar, ensino e pesquisa em
psiquiatria e saúde mental, e participa de projetos de pesquisa
de âmbito nacional, financiados pelo Ministério da Saúde.
 Encontros e resumo da disciplina
AULA 1 AULA 2 AULA 3

Quanto mais levamos o A neurociência apresenta

Capacidades biológicas outro em consideração, janelas de maturação e de
podem desenvolver melhor vivemos em oportunidades.
tecnologias que sociedade.
proporcionam o progresso.

Inteligência é exercer a
A evolução não deve ser capacidade de fazer
O ideal é termos uma
interpretada como diferente.
regulação emocional dos
aperfeiçoamento, mas sim componentes da ansiedade.
como mudança ao longo do
tempo. A experiência, o uso e o que
fazemos com o cérebro é que
faz toda a diferença. Quanto antes intervenções
O progresso é uma preventivas forem
consequência da implementadas, maior a
evolução. chance de recuperação.

SUZANA HERCULANO-HOUZEL SUZANA HERCULANO-HOUZEL LUCAS SPANEMBERG

Professora convidada Professora convidada Professor PUCRS
 Neurociências e Comportamento

E A EVOLUÇÃO CRIOU O
CÉREBRO HUMANO

LUCAS SPANEMBERG, MD, PHD

 E A EVOLUÇÃO CRIOU O CÉREBRO HUMANO
• A evolução filogenética do cérebro
1. A evolução do Sistema Nervoso
2. A evolução do cérebro
3. A vantagem humana

• A evolução ontogenética do cérebro

1. O desenvolvimento embrionário do cérebro humano
2. O desenvolvimento cerebral no ciclo de vida
3. Psicopatologia e a evolução do cérebro
1. O DESENVOLVIMENTO EMBRIONÁRIO
DO CÉREBRO HUMANO
Zigoto
Blastômeros Blastômeros

Mórula

Blástula
Gastrulação
Gástrula
 aproximar-se umas das outras; no final da terceira semana, elas começam
a fundir-se, formando o tubo neural.
Desenvolvimento embrionário cérebro

Posterior
Futura Visão dorsal
crista neural Placa neural
Anterior Somito
1
Placa neural Ectoderma
Pregas neurais
Notocorda Endoderma
Goteira neural Mesoderma
Crista Pregas neurais
1 Margem neural Ectoderma
2 cortada do âmnio
3 2
Somitos Tubo neural
(mesoderma)
Notocorda Mesoderma Endoderma
Goteira neural Goteira neural
Pregas neurais Crista Tubo neural
Placa neural neural Mesoderma
3
Ectoderma
Visão dorsal
Posterior
Notocorda
Endoderma
Cortes transversais

ura 2.2
 Desenvolvimento embrionário cérebro Bulbo
Mielencéfalo

Prosencéfalo Telencéfalo

Diencéfalo
Mesencéfalo
Metencéfalo

Metencéfalo
nberg & Akesson
Romboencéfalo Mielencéfalo

Mesencéfalo Medula Telencéfalo Córtex

espinal basal Tálamo
Cerebelo
Medula
o encéfalo.
espinal

Telencéfalo céfalo,
Romboencéfalo Bulbo a marcha na posição vertical
que, por fim, permitem Bulbo com os dois
Diencéfalo olfatório Hipotálamo
olhos olhando para frente, altera o arranjo simplesPonte
do tubo neural. No cé-
Mesencéfalo
rebro, a superfície ventral do encéfalo é também a superfície inferior, e a
dorsal é a superior. Na medula espinal e no tronco encefálico, a superfí-
Telencéfalo Hemisférios cerebrais
 Telencéfalo O Cérebro
Diencéfalo
Romboencéfalo Bulbo
olfatório Hipotálamo
Ponte
Bulbo

Mesencéfalo

Telencéfalo Hemisférios cerebrais

Prosencéfalo
Tálamo

Diencéfalo Hipotálamo

Subtálamo

Tubo neural Mesencéfalo Mesencéfalo Mesencéfalo

Ponte
Metencéfalo
Cerebelo

Romboencéfalo

Mielencéfalo Bulbo

Crista neural Prosencéfalo Telencéfalo

30 Krebs, Weinberg & Akesson

Hemisférios cerebrais

Telencéfalo

Estruturas profundas

Cérebro

Tálamo

Diencéfalo Hipotálamo

Subtálamo
Estágios do Figure
desenvolvimento cerebral
2. Stages of brain development before birth antes do nascimento

Cerebrum

Midbrain Cerebrum
Midbrain Hindbrain Hindbrain Cerebrum
Midbrain
Forebrain Ear bud
Eye bud Cerebellum Cerebellum
Pons Pons
Medulla Medulla Cerebellum
1 week Forebrain
Spinal chord Pons
Spinal chord
7 weeks 11 weeks Medulla

Spinal chord
7 months

neurulation
Mielinização = 28 semanas
Neuronal prolifertion 9 months (at birth)

Neuronal differentiation

Neuronal migration

Synapse formation

Programmed cell death

Synaptic pruning

Mylenation

4 8 12 16 20 24 28 32

Gestation (weeks) BIRTH Infancy

Ref.: Perspectives from Developmental Neuroscience, pp 113-150, In O'Connell, Boat and Warner, (Eds)
Source: Perspectives from Developmental Neuroscience, pp 113-150, In O'Connell, Boat and Warner, (Eds)
Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions, 2009
Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research
6
 Neurociências Ilustrada 31
Lobos cerebrais
Sulco central
Giro pós-central
Giro pré-central Sulco Lobo Lobo
Lobo Giro do central límbico frontal
parietal cíngulo
Lobo Joelho
Lobo
parietal do corpo
frontal
Lobo caloso
occipital Sulco
parie-
toccipital
Polo
frontal

Sulco lateral
Cerebelo Hipotálamo
Polo temporal Lobo Diencéfalo
Ponte occipital (tálamo) Lobo
Lobo temporal
temporal Bulbo

Fissura longitudinal
do cérebro
Lobo Bulbo olfatório
frontal Nervo óptico (NC I)
Lobo
(NC II)
frontal
Quiasma Polo
óptico temporal
Sulco Giro
central pré-central Lobo
límbico
Giro
pós-central Lobo
temporal Mesen-
Lobo céfalo
parietal

Lobo
occipital
Lobo
occipital Polo
Polo occipital
Fissura longitudinal do cérebro occipital

1. Krebs C, Weinberg J, Akesson E. (2013). Neurociência Ilustrada. Artmed, Porto Alegre.

Figura 2.8
Os hemisférios cerebrais, os principais sulcos e giros e os lobos do cérebro. NC ! nervo craniano.
28 Krebs, Weinberg & Akesson
Planos de orientação do cérebro

Horizontal

Coronal Sagital

Coronal Horizontal Sagital

 O Cérebro Neurociências Ilustrada 31

• 2 hemisférios cerebrais
Sulco central
Giro pós-central
Giro pré-central Sulco Lobo Lobo
Lobo Giro do central límbico frontal
parietal cíngulo
Lobo Joelho
Lobo

• Cristas = giros frontal

Lobo
occipital Sulco
parietal do corpo
caloso

parie-

• Ranhuras = sulcos ou fissuras (+ profundos) Polo

toccipital

frontal

• Fissura longitudinal (plano sagital) Sulco lateral

Cerebelo Hipotálamo
Polo temporal Lobo Diencéfalo

• Fissura sylviana (sulco lateral) Ponte occipital (tálamo) Lobo

Lobo temporal
temporal Bulbo

Fissura longitudinal
do cérebro
Lobo Bulbo olfatório
frontal Nervo óptico (NC I)

• Lobos
Lobo
(NC II)
frontal
Quiasma Polo
óptico temporal
Sulco Giro

• Lobo Frontal central pré-central Lobo

límbico
Giro
pós-central Lobo

• Lobo Parietal temporal Mesen-

Lobo céfalo
parietal

Lobo
• Lobo Occipital Lobo
occipital Polo occipital
occipital
Polo
Fissura longitudinal do cérebro occipital

• Lobo Temporal
Figura 2.8

• Lobo Límbico Os hemisférios cerebrais, os principais sulcos e giros e os lobos do cérebro. NC ! nervo craniano.

sempenham um papel essencial na inicialização e no controle da

motricidade voluntária.
1. Krebs C, Weinberg J, Akesson E. (2013). Neurociência Ilustrada. Artmed, Porto Alegre.
b. Estruturas límbicas: O sistema límbico é constituído por estru-
 Lobo Frontal Pré-motor
Motor Primário

• Maior do cérebro CPF Dorsolateral

ü Funções executivas
Área de Brocá
ü Controle motor voluntário
ü Cognição
ü Inteligência
ü Atenção
ü Processamento e expressão da linguagem
ü Motivação

CPF Ventromedial

CPF Dorsomedial
CPF Ventrolateral

CPF Orbitofrontal
 Lobo Frontal
Funções Regula a atenção e
resposta motora
a estímulos
Direcionamento e manutenção
da atenção
Moralidade Gânglios
da base
Resolução de problemas
Ajuste do comportamento às
normas sociais
Planejamento
Memória de trabalho
Decisões deliberadas
Cerebelo

Corpo amigdaloide
Dopamina Hipotálamo
Serotonina Nucleus accumbens
Acetilcolina Regulação e
Noradrenalina expressão da
emoção

1. Krebs C, Weinberg J, Akesson E. (2013). Neurociência Ilustrada. Artmed, Porto Alegre.

O caso de
Phineas Gage
(1823-1860) • Operário de 25 anos

• Acidente 1848

• Atingido por barra de ferro

• Barra penetrou seu crânio, mas ficou consciente

• Atendido pelo médico John Harlow

Kotowicz Z (2007). The strange case of Phineas Gage. Hystory of Human Sciences. 20(1):115-131.
 of the same type as Gage’s. He was photographed in the studio by Ivan
d. Lesões: As lesões no lobo frontal levam a mudanças de persona-
Coleman from the College’s Visual Arts Photography Department, usingum a comportamento
• “Gage
Cannon D60 6 Mega Pixel SLR camera.
deixou
lidade
Michael
adequado
de
sem, Riley
ser
e perda da capacidade
ele
necessariamente,
mesmo”
de demonstrar
of the Visual Arts
perda da capacidade intelec-
Department manipulated the digital images using
tual. O caso AdobedePhotoshop
mais famoso CS, é o de Phineas
lesão no lobo frontal
Gage, do século XIX. Uma explosão que ocorreu enquanto Gage
Adobe Illustrator CS software. He superimposed images of the life mask and
trabalhava em uma estrada de ferro impulsionou um pedaço de
• Mau
the engraving of Gage’s skull gênio,
on to the portraits
metal desrespeitoso,
contra to match
a órbita the size
esquerda e asand inconsequente
entry
partes frontais de seu crânio
of the pole. The degree of damage and the appearance
e cérebro were
(Fig. 13.12). derived
Gage from da
se recuperou thelesão, e o médico
description of the face given by Harlowlocal,
andJ.M. Harlow, as
Bigelow, documentou o caso.
well as from research
into imagery relating to scar tissue, trauma
Embora,andantes
fractures in medical
do acidente, journals.bem adaptado e,
Gage parecesse
Modern technology helps • Impulsivo
a great deal, bute
ao que it socialmente
tudo proved surprisingly
indica, capaz inadequado
difficult
de tomar decisões e planejar o futuro,
to imagine what the face looked like whensua personalidade
Gage firstmudou saw após a explosão:
it. After various“Ele não era mais o
Gage”. Muitos dos atributos das funções do lobo frontal desapa-
versions we settled for this image. receram ou foram severamente diminuídos. Ele parecia apresen-
“Ele não era mais o Gage” tar problemas para integrar grupos sociais, perdeu seu senso de
• Dificuldade de integração em grupos sociais
• Perda do senso de comportamento
socialmente aceitável
• Caso “seminal”
comportamentos socialmente aceitáveis, teve problemas para
planejar o futuro e dificuldades para conciliar seus impulsos com
• Dificuldade de planejamento as necessidades de outras pessoas.
• Impulsividade
2. Áreas de associação parietais: Essas áreas do lobo parietal es-

Figura 13.12
• Importância do lobo frontal
tão localizadas posteriormente às áreas sensoriais primárias no giro
pós-central. As áreas de associação parietais são, por isso, também
Phineas Gage: danos às áreas de associa- chamadas de córtex parietal posterior. Esse é o local no qual as
ção frontais. sensações somáticas e visuais são integradas; é importante para a
integração de nível superior e interpretação de estímulos.
• Mitos e crendices
a. Função: O córtex parietal posterior é fundamental na atenção e
Atenção
na consciência de si mesmo e do espaço extrapessoal. Conside-
rando que os córtices visuais do lobo occipital processam a aná-
Concentrar-se Consciência de si
no estímulo;
lise e o reconhecimento visual, as áreas de associação parietais
filtrar distrações Consciência do processam a posição e o movimento de objetos, pessoas ou de
espaço extrapessoal si mesmo no espaço. O córtex parietal posterior direito orienta a
atenção no espaço, enquanto o córtex parietal posterior esquerdo
orienta a atenção no tempo. Essas áreas do córtex estão interco-
Kotowicz ZInformação
(2007). The strange case of Phineas Gage. Hystory of Human Sciences. 20(1):115-131.
visual nectadas com o córtex pré-frontal, que decide em qual estímulo
Lobotomia (leucotomia)
• António Egas Moniz

• Inventor da angiografia cerebral (1929)

• Leucotomia pré-frontal (psicocirurgia,1935)

• 5 x indicado ao Prêmio Nobel de Fisiologia ou Medicina António Egas Moniz

(vencedor em 1949)

• Indicada para psicoses com risco de suicídio ou agressão

• Difundida com excessivo entusiasmo nos EUA (>50.000 casos) e no Japão

Walter Freeman • Neurologista clínico

• Lobotomóvel

• Picador de gelo ->

Leucotomo -> Orbitoclast

• >3.500 procedimentos

• Rosemary Kennedy, inválida

aos 23 anos

• Licença médica revogada

 os receptores cutâneos de adaptação rápida. Por fim, na última

Lobo Parietal
Associação
Sulco Sensorial
sensorial
central primária
Homúnculo sensorial

Perna, genitais
Antebraços

Quadris
Cotovelos

Tronco
Braços
De

Mãos
dos
ind
De ado
ic
do res
s
Olhos
Nariz
Receptores cutâneos Face
de adaptação lenta Lábios
Receptores cutâneos Mandíbula
de adaptação rápida
Dentes
s
Receptores Receptores giva
Gen
musculares articulares ua
Líng
ü Atenção Sulco
ü Orientação espacial central
ü Percepção e na integração da
informação somatossensorial
(tato, pressão, temperatura e dor)
ü Processamento visuoespacial
ü Representação numérica
 a. Fu
Lobo Parietal Atenção
na
ra
Concentrar-se Consciência de si
no estímulo;
lis
filtrar distrações Consciência do pr
espaço extrapessoal si
at
Informação
or
visual ne
se

b. Le
nã
de
la
“n
Informação auditiva
pe
de
 A Negligência contralateral
Neurociências Ilustrada 253

M P
B
E A V A O M R Y L A
X W A O G
T U B
I L S C N N O
G M Z D
A F A A T X J P Q
N A
I G D U R T A W Y
P E
O D V K Y A A J F
A L M
A L V S B P
A L P O X C
A L H W U A
B K E I L A R
A Z H L N
T J M V K A H A A
A Y w B X
R Z C P H
M E A A Z O
F T K
Z X O P W
O O I L
I A A L T T M
H T A E A
U O D N N
M G A L A U
B M B X A L
O K G W S R C W
R M
W
D E
T I T H P O M
I H H R V
A A A A N C E
A H G U A
Y M I S
T L A T Z W
D A A
P O E X P
N K A H O F
R S A Z H
B M L J T

• Paciente comcomnegligência no no
lado lado esquerdo após lesão
A G P S Y
P S L A L R
I I P T I
O P
Paciente negligência
B
M
X esquerdo
E após lesão encefálica
A
P
W à direita
V A O M R Y
A L A O G
U B G M Z

encefálica à direita
T I L S C N N O D
A F A A T X J P Q A
U N Y
I G D R T A E W
V K Y P J F

• Paciente com negligência no lado esquerdo após lesão Paciente não veste o lado esquerdo do corpo, não barbeia o lado esquerdo
O D
A L
A A
V S
A L B P
M

Paciente não veste

comeoolado esquerdo do corpo, não barbeia o lado
A L P O X C
A L H W U A
da face e não que está
B no lado esquerdo
A do prato
K E I Z L A R
N
encefálica à direita
H L
Paciente com negligência no lado esquerdo após lesão encefálica T J M V K A H A A

esquerdo da face e não come o que está no lado esquerdo do

A Y w B X
Z C P H
à direita M R E A A Z O K
F X T W
A: Falha em em desenhar o lado esquerdo da figura
Z O O P I
O L
A: Falha desenhar o lado esquerdo da figura T

prato
I A A L T M T A E A
O H
U D N N
A
B: Falha em circundar a letra “A” no lado esquerdo da folha M G A L X U
A L
B: Falha em circundar a letra “A” no lado esquerdo da folha O G W B M B
K S R M C W
R W
T I T H P O M
I H H R V
A A A A N C E

Figura 13.14 A H G U A
Y M I S
T L A T Z W
D A A
P O E X P
Negligência contralateral. D ! direita; E ! esquerda.
N K A H O F
R S A Z H
B M L J T
A G P S Y
P S L A L R
I
 Lobo Temporal

ü Memória
ü Audição,
ü Pocessamento e percepção de
informações sonoras
ü Reconhecimento de faces e objetos,
ü Capacidade de entender a linguagem
(Wernicke)
ü Processamento visual de ordem
superior
ü Regulação das reações emocionais.
 Lobo Temporal
254 Krebs, Weinberg & Akesson

Reconhecimento de
padrões de linguagem

Danos levam a agnosia

(incapacidade de reconhecer)
Reconhecimento de
estímulos e padrões

Estímulos visuais são

ligados a significado
e reconhecimento

Giro occipitotemporal

Figura 13.15
Área de associação temporal dos hemisférios lateral esquerdo e medial direito.
 Lobo Occipital
• Córtex visual primário
• Associação visual
• Processamento linguagem escrita

ü Visão da cor
ü Visão do movimento
ü Visão da profundidade, da distância

Lesão nos lobos occipitais pode levar a

cegueira, alucinações e inabilidade em ver cores
 Neurociências Ilustrada 31
Lobo Límbico
• Não é lobo verdadeiro:
Sulco central abrange
Giro pós-central
partes
Giro dos lobos frontal, parietal
pré-central
Giro do
Sulco Lobo Lobo
Lobo central límbico frontal
e temporal parietal cíngulo
Lobo Joelho
o
parietal do corpo
al
• Se sobrepõe a estruturas do Lobo caloso
occipital
sistema límbico e está interligada Sulco
parie-
a elas toccipital
• Amígdala
• Hipocampo
• Giro do Cíngulo
o lateral
• Hopotálamo
Cerebelo Hipotálamo
Polo temporal Lobo Diencéfalo
Ponte occipital (tálamo) Lobo
Lobo temporal
temporal Bulbo

Fissura longitudinal
do cérebro
 Áreas Funcionais do Cérebro
Motor
function Motor
area function
Broca’s area area Sensory
area
Somatosensory
Association
area

Higher Auditory area

mental
functions

Visual area

Association area Wernicke’s area

erebrais.
Diencéfalo
do córtex de um hemisfério com as áreas correspondentes do
Tálamo • Tálamo: 2 massas ovoides de tecido
hemisfério oposto. De longe, o maior conjunto de fibras comis-
surais é o corpo caloso, que conecta os dois hemisférios. As
nervoso, unidos pela aderência
fibras de projeção transportam informações do/para o córtex
cerebral. O maior conjunto de fibras de projeção é a coroa ra-
intertalâmica
diada, que está na cápsula interna e contém todas as fibras
que se deslocam entre o córtex, a medula espinal e as estruturas
profundas do cérebro.
ü Portal de entrada para o córtex
3. Diencéfalo: O diencéfalo consiste em vários conjuntos de estrutu-
ü Processamento e integração de informações sensoriais,
ras pareadas em ambos os lados do terceiro ventrículo (Fig. 2.12). A
motoras, cognitivas
maior estrutura é o tálamo, que é composto de duas massas nuclea-

da base Estruturas límbicas

Hipotálamo Sistema ventricular • Hipotálamo: parte do sistema límbico

Tálamo
ü Coordenação e integração de funções
endócrinas, autonômicas e homeostáticas.

• Subtálamo: parte dos gânglios da base

Figura 2.12 Hipocampo no ü Modulação e integraç̧ão da motricidade voluntária
O diencéfalo (tálamo e hipotálamo)
Corpos
mamilares em assoalho do
um
ventrículo lateral
e do tônus muscular.
na parte
corte
me; hemissagital do encéfalo.
Corpo amigdaloide
 Lateralização cerebral
• Cérebro humano: assimetria anatômica e funcional

• Hemisférios cerebrais Direito e Esquerdo são ESPECIALIZADOS

DIREITO
Visoespacial
Não verbal
Atividades musicais “diretas”
Prosódia e entonação
Atividades “em paralelo” (“todo”)
Atividades imaginativas
Consciência corporal
Experiência artística não descritível
Processos criativos e intuitivos
ESQUERDO
Operações em códigos
Verbal
Habilidades musicais “codificadas”
Aspectos semânticos e gramaticais-sintéticos
Atividade serial, em sequência
Atividades analíticas
Percepção e consciência abstrata, simbólica
Arte como signo e símbolo
Processos lógicos e racionais
 Cerebelo

ü O cerebelo tem origem embrionária na

ponte

ü Possui dois hemisférios e uma área

central chamada verme do cerebelo

ü Papel importante no processamento

de informações sensoriais e na
coordenação da motricidade voluntária

ü Também atua na função cognitiva

(descoberta mais recente)
Consciência
A busca para
entender a
consciência
Tronco
 “Biestabilidade perceptiva”

• Diante de ambiguidades, o cérebro “toma uma decisão”

• Ela pode mudar, mas o cérebro não interpreta as 2 coisas ao mesmo

tempo

• Cérebro toma milhares de decisões todos os dias – maioria inconsciente

• Será mesmo que suas escolhas são produto de uma ação consciente?

1. David Eagleman. Cérebro: uma biografia (2015). Rio de Janeiro: Rocco

2. O DESENVOLVIMENTO CEREBRAL NO
CICLO DE VIDA
 Nascemos Incompletos
• A vida na natureza
• Golfinhos nascem nadando
• Girafas levam algumas horas para ficar em pé
• Zebras conseguem correr 45 min após nascerem
• Homem precisa de 1 ano só para dar os primeiros passos
• “Filhote humano”:
• Incapaz de se mover
• Incapaz de se alimentar sozinho
• Incapaz de se proteger
• Não se reconhece nem discrimina coisas
• Sistema imune imaturo
• Imaturidade cerebral
1. David Eagleman. Cérebro: uma biografia (2015). Rio de Janeiro: Rocco
 O que parece vantagem pode ser limitação?

• O que ganham em prontidão, perdem em flexibilidade ("circuito rígido")

• Cérebro humano = "circuito vivo"

• "Oportunidade" de adaptar-se melhor

• Janelas de maturação

• Momento de maior vulnerabilidade

1. David Eagleman. Cérebro: uma biografia (2015). Rio de Janeiro: Rocco

 Mudanças morfológicas
no cérebro humano

ü Aumento no tamanho do
cérebro

ü Aumento da superfície
cerebral (sulcos e giros)

ü Diferenças entre sexos

1. Dubois J et al. (2020). J Magn Reson Imag. 53(4):1-26

FIGURE 3: Brain morphological changes from pregnancy to adulthood. Cortical surface reconstructions are presen
0 a 3 meses
• Se assusta com sons altos

• Se acalma com a voz da mãe

• Emite sons com a garganta

• Sustenta a cabeça

• Visão focal de 30 com (distância do rosto da mãe)

• Gostam de cores contrastadas
3 a 6 meses

• Vira o rosto em direção ao som

• Se acalma coma voz da mãe

• Agarra objetos

• Gira sobre o corpo

6 a 9 meses
• Reage quando é chamado pelo nome

• Compreende o significado de “não”, “tchau”

• Imita sons da fala, repete sons como

“mama” e “papa”

• Pinça digital

• Fica sentado
 brain that recognise the difference between different vocal sounds are becoming specialised to the
language(s) the baby hears in its family of child-rearing. At the same time it is beginning to lose the
16

Períodos sensíveis para a formação sináptica

ability to recognise important sound distinctions that occur in other languages.

Figure 4. Sensitive periods for synapse formation

Source: Shonkoff J, Phillips D (Eds) 200017

Referência: Shonkoff J, Phillips D (Eds) 2000
Because the brain prunes away the circuits that are not used, those that are used become stronger
and increasingly difficult to alter over time. This reduction in plasticity, or ability of the brain to grow
and change in response to its environmental circumstances, means that the early childhood years
9 a 12 meses
• Reage quando é chamado pelo nome

• Compreende o significado de “não”, “tchau”

• Imita sons da fala, aumento do repertório

• Bate palmas

• Engatinha

• Fica em pé
Desenvolvimento motor do 1º ano
A verdadeira função do CÉREBRO…

Daniel Wolpert
 A verdadeira função do CÉREBRO…

Produzir movimentos
complexos e adaptáveis

• Processos sensoriais, mnemônicos e cognitivos são

importantes, mas só são importantes para dirigir ou suprimir
futuros movimentos

• Ex: Tunicato. Quando se fixa, digere o cérebro!!!

Daniel Wolpert
A verdadeira função do CÉREBRO…

Deep Blue

• 1996: Gasparov 4 x 2 Deep Blue

Supercomputador da IBM com 256 co- • 1997: Gasparov 2,5 x 3,5 Deep Blue
processadores capazes de analisar
aproximadamente 200 milhões de
posições por segundo.
Protótipo promissor
 Desenvolvimento da linguagem

• “Linguagem dos bebês” (LDB)

• Mais intensamente utilizada entre o 3º e 5º m (até 3 anos)
aQUI
• Contornos de entonação exagerados
LINdo
• Repetições e perguntas de ritmo ascendente
boniTINHO
• Vocabulário simplificado
maMÁ
• Exagero em vogais
giRAFA
• Velocidade mais lenta

Contribui para o contato emocional com o bebê, para a

regulação afetiva da relação, a socialização e aquisição da
linguagem. Dá pistas prosódicas, favorecendo o sistema
atencional do bebê.
Interactions between White Matter Asymmetry and
Language during Neurodevelopment
Jonathan O’Muircheartaigh,1,2 Douglas C. Dean III,1 Holly Dirks,1 Nicole Waskiewicz,1 Katie Lehman,1 Beth A. Jerskey,3
and Sean C.L. Deoni1
1Advanced Baby Imaging Laboratory, School of Engineering, Brown University, Providence, Rhode Island 02912, 2Department of Neuroimaging, King’s
College London, Institute of Psychiatry, London WC2R 2 LS, United Kingdom, and 3Alpert Medical School of Brown University, Providence, Rhode Island

• Coorte de 108 crianças com desenvolvimento típico entre 1 e

02912

6 anos
The human de inidade
brain is asymmetric gross structure as well as functional organization. However, the developmental basis and trajectory of
this asymmetry is unclear, and its relationship(s) to functional and cognitive development, especially language, remain to be fully
elucidated. During infancy and early childhood, in concert with cortical gray matter growth, underlying axonal bundles become progres-
sively myelinated. This myelination is critical for efficient and coherent interneuronal communication and, as revealed in animal studies,
• RNM quantitativa para investigar quantidade de mielina in vivo
the degree of myelination changes in response to environment and neuronal activity. Using a novel quantitative magnetic resonance
imaging method to investigate myelin content in vivo in human infants and young children, we investigated gross asymmetry of myelin
in a large cohort of 108 typically developing children between 1 and 6 years of age, hypothesizing that asymmetry would predict language
abilities in this cohort. While asymmetry of myelin content was evident in multiple cortical and subcortical regions, language ability was
predicted only by leftward asymmetry of caudate and frontal cortex myelin content and rightward asymmetry in the extreme capsule.
Importantly, the influence of this asymmetry was found to change with age, suggesting an age-specific influence of structure and myelin
on language function. The relationship between language ability and asymmetry of myelin stabilized at !4 years, indicating anatomical

• Habilidade de linguagem foi prevista apenas pela assimetria esquerda

evidence for a critical time during development before which environmental influence on cognition may be greatest.
do
Figure 3. Significant asymmetry results rendered as a volume.
postcentral cortex (green). Leftward asymmetry (b) was detected

conteúdo de mielina no how

Introduction caudado e córtex
this relates to cognition frontal
and language development, is e assimetria direita naand the mesial frontal region (botto
(yellow), temporoparietal junction (yellow), and temporal and occip
anterior thalamus region (top)

cápsula
mark of human neuroanatomy extrema
Asymmetry of cortical size and function is a well established hall-
and neuropsychology (Bradshaw,
unclear.
Part of this explanation may come from white matter. Ana-
1978; Gannon et al., 1998; Toga and Thompson, 2003). Asymme-
try of cortical volume appears phylogenetically conserved and is
strongly heritable, particularly in brain regions underlying lan-
• Assimetria muda com a idade: relação entre a habilidade de linguagem e a
guage (Thompson et al., 2001; Toga and Thompson, 2003). The
asymmetric functional brain representation of language overlaps
assimetria da mielina estabilizou em 4 anos (período crítico)
with regions of strong cerebral left-sided lateralization of volume
in Broca’s area (Keller et al., 2009) and the planum temporale
(Shapleske et al., 1999; Hill et al., 2010). During prenatal devel-
opment, however, structural asymmetries are more evident on
the right side, with earlier gyrification of the superior frontal
portantly this changing relationship appears to
tomical connections within, and between, cortical and subcorti-
cal structures partly define neural structures functionally
years (Fig. 4), around the same time that m
(Passingham et al., 2002). The establishment and consolidation begins to slow substantially (Fig. 3c) and ove
of this structural architecture foreshadows functional and cogni-
tive development (Casey et al., 2005). Throughout postnatal de-
end of a putative language critical period (Lock
reflect the more intense functional asymmetry
velopment, neural axons become encased in a fatty myelin sheath
allowing rapid and coordinated interneuronal communication
guage networks in this age group, and theref
portance attributed to white matter underlyin
and providing a foundation for normal cortical functioning.
Moreover, during postnatal development myelin content shows a For the
16170 • The Journal of Neuroscience, putamen
October 9, 2013 •and mesial –16177
33(41):16170 frontal areas, a
dramatic increase across the whole brain, starting in thalamocortical negatively predicts language ability in the yo
Maturação cerebral, cognitiva e emocional

• Desenvolvimento ao longo do ciclo vital

• Primeira Infância:
• Rápido crescimento do cérebro
• Segue processo de mielinização e tamanho do cérebro aumenta
• Plasticidade cerebral
• Florescimento e poda neuronal
Maturação cerebral, cognitiva e emocional
• 1-2 anos:
• Aumento da consciência da própria resposta emocional
• Irritação quanto a limites sobre a autonomia
• Aumento da expressão verbal das emoções
• Autoconsciência: vergonha, orgulho, timidez
• Empatia e altruísmo rudimentares
Fenômeno da PODA NEURONAL
• A poda sináptica é o processo pelo qual essas sinapses extras são eliminadas,
(aumento da eficiência da rede neural)

• Da embriogênico até 2 anos = 40.000 sinapses formadas por segundo1.

• Mais neurônios que o necessário (aos 2 anos = 100 trilhões de sinapses)

• Todo o processo continua até 10 anos de idade, quando quase 50% das sinapses
presentes aos 2 anos de idade foram eliminadas

• A poda sináptica não é aleatória2.

• Conexões fracamente reforçadas e não funcionais ou redundantes com conexões

de força adequada são “podadas”3.

Referências: 1. Kolb, B., & Whishaw, I. Q. (2003). Fundamentals of human neuro-psychology (5th ed.). New York: Worth Publishers; 2. Zillmer, E. A., & Spiers, M. V.
(2001). Principles of neuropsychology. Belmont, CA: Wadsworth/Thomson Learning; 3. Gazzaniga, M., Ivry, R. B., & Mangum, G. R. (2009). Cognitive
neuroscience: The biology of the mind (3rd ed.). New York: W.W. Norton & Company.
Poda Neuronal na infância
Crescimento Cerebral

3 anos = 80%

5 anos = 90%
Controle e regulação emocional
• 3-5 anos:
• 4 anos: 80% vol. Cerebral
• Mielinização completa do lobo temporal
• 5 anos: Lobo occipital alcança níveis adultos
• Fala sozinha e comunica sentimentos
• Aumento da regulação do estado emocional
• Finge em brincadeiras e jogos
• Consciência das emoções dos outros
• Consciência que uma emoção falsa pode enganar (choro fingido)
Maturação cerebral, cognitive e emocional
• 5-7 anos:
• Estabilização do volume do cérebro
• Aumento de habilidades sociais
• Cumpre scripts sociais emocionais (fica quieta quando alguém chora; fica
feliz em festa de aniversário)
• Presença de frieza emocional com os pares
• 6-7: maturação do lobo occipital
• Sensibilidade a contraste e visão periférica em níveis adultos
Maturação cerebral, cognitive e emocional

• 7-10 anos anos:

• Prefere a regulação autônoma à dos cuidadores
• Estratégia de distanciamento para controle emocional
• Aumento do uso da expressão emocional para regular relacionamentos
• Consciência de que pode ter múltiplas emoções sobre a mesma pessoa
• 8: maturação do lobo temporal
 (1930-2018)

Universidade de Stanford (1970)

O teste do Marshmallow
Teste do Marshmallow

• “Zona quente”(sistema límbico) versus “Zona fria” (Córtex pré-frontal)

• Autocontrole, persistência, postergar gratificações
• Crianças de 3 anos: não entendem (comem o doce)
• Crianças de 4 anos: entendem, mas escolhem a pior estratégia
• Crianças de 5-6 anos: conseguem escolher a estratégia mais vantajosa
• Diferença entre sexos: meninas esperam mais do que meninos

Referências: 1. Mischel W (2016). Editora Objetiva, Rio de Janeiro.

 Preschoolers' Delay of Gratification Predicts their Body Mass HHS Public Access
Author manuscript
30 Years Later J Econ Behav Organ. Author manuscript; available in PMC 2021 January 08.

Author Manuscript
Tanya R. Schlam, PhD1, Nicole L. Wilson, PhD2, Yuichi Shoda, PhD2, Walter Mischel, PhD3, and Ozlem Ayduk, PhD4 Published in final edited form as:
J Econ Behav Organ. 2020 November ; 179: 743–756. doi:10.1016/j.jebo.2019.08.016.
Objective To assess whether preschoolers’ performance on a delay of gratification task would predict their body
doi:10.1093/scan/nsq081 SCAN (2011) 6, 252^256
mass index (BMI) 30 years later.

!Willpower" over the life span: decomposing

Study design In the late 1960s/early 1970s, 4-year-olds from a university-affiliated preschool completed the clas-
sic delay of gratification task. As part of a longitudinal study, a subset (n = 164; 57% women) were followed up ap- Behavioral and neural correlates of delay of Predicting mid-life capital formation with pre-school delay of
gratification and life-course measures of self-regulation ☆
self-regulation
proximately 30 years later and self-reported their height and weight. Data were analyzed using hierarchical
regression. gratification 40 years later
Results Performance on the delay of gratification task accounted for a significant portion of variance in BMI (4%;
B. J. Caseya,1, Leah H. Somervillea, Ian H. Gotlibb, Ozlem Aydukc, Nicholas T. Franklina, Mary K. Askrend, John Jonidesd,
Daniel J. Benjamina,b, David Laibsonb,c, Walter Mischeld, Philip K. Peakee, Yuichi Shodaf,
P < .01), over and above the variance accounted for byMarc sex G.alone (13%).
Berman d Each L.
, Nicole additional minute that
Wilsone, Theresa a preschooler
Teslovich a
, Gary Gloverf, Vivian Zayasg, Alexandra Steiny Wellsjog,*, Nicole L. Wilsonh
Walter Mischel,1 Ozlem Ayduk,2 Marc G. Berman,3 B. J. Casey,4 Ian H. Gotlib,5 John Jonides,3 Ethan Kross,3
delayed gratification predicted a 0.2-point reduction in BMI in
Walter adulthood.
Mischel h,1
, and Yuichi Shodae,1
Theresa Teslovich,4 Nicole L. Wilson,6 Vivian Zayas,7 and Yuichi Shoda6 aCenter for Economic and Social Research and Department of Economics, University of Southern
1 Conclusion Longer delay of gratification at age 4 years
Department of Psychology, Columbia University, 2Department of Psychology, University of California, Berkeley, 3Department of a
was associated with a lower BMI 3 decades later. Be-
Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, NY 10065; bDepartment of Psychology, Stanford University,
California, Los Angeles, CA 90089, United States
4 cause this study is correlational, it is not possible
Psychology, University of Michigan, Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, Cornell University,
to make causal inferences
c regarding the relationship between de- d
Stanford, CA 94305; Department of Psychology, University of California, Berkeley, CA 94720; Department of Psychology, University of Michigan, Ann Arbor,

Author Manuscript
5
Department of Psychology, Stanford University, 6Department of Psychology, Universitylayofduration andSeattle,
BMI.andIdentifying
7 children with greater difficulty in delaying
MI 48109; eDepartment of gratification could
Psychology, University ofhelp detectSeattle,
Washington, children at fLucas Imaging Center, Department of Radiology, Stanford University
WA 98195; b
School of Medicine, Stanford, CA 94305; gDepartment of Psychology, Cornell University, Ithaca, NY 14853; and hDepartment of Psychology, Columbia National Bureau of Economic Research, Cambridge, MA 02138, United States
Washington, Department of
Psychology, Cornell University risk of becoming overweight or obese. Interventions that improve self-control in young children have been devel-
University, New York, NY 10027
oped and might reduce children’s risk of becoming overweight and also have positive effects on other outcomes cDepartment of Economics, Harvard University, Cambridge, MA 02138, United States
Edited* by Michael Posner, University of Oregon, Eugene, OR, and approved July 26, 2011 (received for review May 27, 2011)
important to society. (J Pediatr 2013;162:90-3).
In the 1960s, Mischel and colleagues developed a simple !marshmallow test" to measure preschoolers" ability to delay gratifi- dDepartment of Psychology, Columbia University, New York, NY 10027, United States
We examined the neural basis of self-regulation in individuals had more difficulty suppressing inappropriate actions than did
cation. In numerous follow-up studies over 40 years, this !test" proved to have surprisingly significant predictive validity for
from a cohort of preschoolers who performed the delay-of- their low-temptation-focus counterparts, especially for the most
consequential social, cognitive and mental health outcomes over the life course. In this article, we review key findings from eDepartment of Psychology, Smith College, Northampton, MA 01063, United States

O
ver the last 30 years, the prevalence of overweight and gratification task
obesity has 4 decades
risen ago. Nearly
substantially, and we60now
individuals, difficult trials. Difficulty was manipulated by increasing the num-
now obesity
face a global in
the longitudinal work and from earlier delay-of-gratification experiments examining the cognitive appraisal and attention control
epidemic. 1 their mid-forties, were tested on “hot” and “cool” versions
Contributing factors include people adopting more sedentary lifestyles and consuming more calories than of a go/ ber of “go” trials preceding a “nogo” trial, thus making the “go”
fDepartment of Psychology, University of Washington, Seattle, WA 98195, United States
strategies that underlie this ability. Further, we outline a set of hypotheses that emerge from the intersection of these findings nogo task to assess whether delay of gratification in childhood response more salient and automated. Differences between the
with research on !cognitive control" mechanisms and their neural bases. We discuss in the past, due
implications in parthypotheses
of these to the readyforavailability of supersized portions of cheap, easily consumed, calorie-dense foods
predicts impulse control abilities and sensitivity to alluring cues high- and low-temptation-focus groups increased as the numbergof
1
decomposing the phenomena of !willpower" and the lifelong individual differences andinsweetened beverages.
self-regulatory Within
ability that werethis obesogenic environment,
identified (happyprotective factors—including
faces). Individuals who were lesshigh
ableself-control and ability to
to delay gratification Department of Economics, University of California, Berkeley, CA 94720, United States
preceding “go” trials increased, with the high-temptation-focus
in the earlier research and that are currently being pursued. delay gratification—may help some people resist overeatingin and maintain
preschool and aconsistently
healthy weight.
showed low self-control abilities in group having more difficulty, reflected in slower response times, hDepartment of Management, Lundquist College of Business, University of Oregon, Eugene, OR
The ability to delay gratification develops as children mature their twenties
and learn and tothirties performed more
forgo less-valued poorly than
short-term did high
pleasures in favor suppressing responses. These findings suggest that performance
Keywords: self-regulation; delay of gratification
of pursuing valued long-term goals. This ability depends delayers when function
on executive having to (ie,suppress
cognitive a response
control), to a thehappy face butfunc-
cognitive in preschool delay of gratification may predict the capacity,97403, in United States
not to a neutral or fearful face. This finding suggests that sensi- adulthood, to control thoughts and actions, as reflected in per-
tions underlying effective attention deployment, self-monitoring, and planning. The preschool delay of gratification task as-
tivity to environmental hot cues plays a significant role in individ- formance on cognitive control tasks, and that the ability to control

Author Manuscript
sesses preschoolers’ self-control by asking them to choose between a small
uals’ ability immediate
to suppress reward
actions toward (eg,such1 marshmallow)
stimuli. A subset or waiting
of Abstract
one’s thoughts and actions can vary by the potency of interfering
INTRODUCTION for an unspecified
course. Four decades time to earn
later, this research a somewhat
is continuing to more desirable reward
these (eg, 2 marshmallows).
participants (n = 26) underwent A longitudinal
functional imaging study for of children
the information (12). Likewise, alluring or social contexts can diminish
Resisting temptation in favor of long-term goals is an attending
reveal remarkable Stanford
patterns University’s
of coherence Bing Nursery School foundfirst
in consequential thattime to test
longer delayfor of
biased recruitment
gratification in theof frontostriatal
task at preschool circuitry age was self-control (4, 13, 14).
psychological, associated
behavioral,with important
health outcomes
and economic when required
(eg, adolescent academic
outcomes strength,to social
suppress responses toplanfulness,
competence, alluring cues. ability Whereas tothe handle Early experiments on delay of gratification demonstrated that
essential component of social and cognitive development
prefrontal cortex differentiated between nogo and go trials to ☆Authors are listed in alphabetical order. Sadly, our extraordinary friend and coauthor, Walter Mischel, who led the Bing study
and of societal and economic gain. In the late 1960s, stress).2 In
from early childhood to some children,current
mid-life!the it was age
alsoofassociated
the with higher Scholastic Aptitude Test scores in adolescence and less illegal part of the contextual effect was due to the different cognitive
3,4 a greater extent in high delayers, the ventral striatum showed strategies that individuals used. For example, “cooling” the hot,
drug use
original preschool in adulthood.
participants. Given these provocative starting with the first experiments in 1967, passed away during the editorial process. The Bing Longitudinal Project was supported by
Mischel and colleagues sought to identify and demystify exaggerated recruitment in low delayers. Thus, resistance to temp- 5-10
findings and theRecent
methodological
research inadvances
other samplesnow available
has identified a longitudinal appealing, or appetitive features of tempting stimuli by reap- a number of grants from NIMH and NSF to Walter Mischel and Yuichi Shoda, of which the most recent are National Institutes of
the processes that underlie ‘willpower’ or self-control tation asassociation between by
measured originally children’s self-control and task
the delay-of-gratification weight. is
for probing self-control with increasing depth praisal or reframing strategies to focus on their cool, cognitive Health Grant MH39349 and National Science Foundation Grant BCS-0624305. Research reported in this publication was also
in the face of temptation in preschoolers. With that Results from a longitudinal studyatfollowing
multiple children into aadolescence
relatively stable
found individual difference
that children that predicts
scoring low onreliable biases tasks
self-control features (e.g., to envision the marshmallow as a cloud or a little supported by the National Institute on Aging of the National Institutes of Health under Award Numbers P30AG034532 and
levels of analysis, this longitudinal sample provides a in frontostriatal circuitries that integrate
at age 3 and 5 years had higher body mass index (BMI) and greater increases in BMI through age 12 years compared with motivational and control
goal, Mischel developed the delay-of-gratification paradigm cotton ball, rather than as a sweet, delectable treat) has been P01AG005842 and the Pershing Square Fund for Research on the Foundations of Human Behavior. The content is the sole
unique opportunity forscoring
understanding 6 processes.
(popularized in the media as the ‘marshmallow test’). children high on the thesebasic cognitive
tasks. A study of 1000 New Zealanders found that levels of self-control in childhood (age shown to be highly effective in enhancing delay of gratification responsibility of the authors and does not necessarily represent the official views of any of these grant agencies. For her initial work
and neural mechanisms underlying preparing the economics survey, the authors thank Dawn DeGere. For helpful comments, the authors thank Constança Esteves-
This now-classic laboratory situation measures how long 3-11 years) predicted‘willpower’ and enabling
health outcomes at age 32 years, including having at least 3 of 6 metabolic risk factors
reward | behavioral suppression | functional MRI | inferior frontal gyrus |
(eg, being (e.g., 1, 15–17). The same preschool child who yielded immedi-
over-
Sorenson and Charlie Sprenger; participants at the Behavioral Economics Annual Meeting, the Drawing Links between Happiness,
a child can resist settling for a small, immediately avail- effective self-regulation.
weight). 10In this article, we highlight the im- ately to the temptation by representing the hot, appetitive fea-
longitudinal Health, and Self-regulation conference, the LABEL-IEPR Conference on Children’s Decision Making, the NBER Summer Institute,
portant early findings from this research program, and then tures of the reward (e.g., its yummy, sweet, chewy taste) could
able reward (e.g. one mini-marshmallow) in order to get In the present study, we used a longer (30-year) lag between assessment of self- and the RAND Summer Institute; and seminar participants at the University of California Berkeley, the University of California San
describe a newcontrol
era in this wait for long periods for the same tempting stimulus by focusing
and research currently beingtopursued
T
a larger reward later (e.g. two mini-marshmallows; measurement of BMI test the a priori hypothesishe ability to resist temptation in favor of long-term goals is an on its cool qualities (e.g., its shape). At the same time, there
that delaying Diego, and the University of Southern California.
by an interdisciplinary team of investigators working with essential
e.g. Mischel et al., 1972; Mischel et al., 1989; Mischel and gratification for a longer time in early childhood is associated with havingcomponent
a lower of individual, societal, and economical seem to be important, naturally existing individual differencesThis in is an open access article under the CC BY license. (http://creativecommons.org/licenses/by/4.0/)

Author Manuscript
1
samples from the original studies, now focused on the bio- From the Center for Tobacco Research and
Ayduk, 2004). BMI in middle adulthood. success. Developmentally, this ability has been assessed
Intervention and Department of Medicine, University of by the spontaneous use of such strategies (e.g., 5, 18).
*
Corresponding author. alexsteiny@berkeley.edu (A.S. Wellsjo).
What began as a set of experiments with preschoolers
logical substrates of self-regulation. measuring how long a young Wisconsin child can resist
School
2
an immediate
of Medicine and Public Health,re- Indeed, Metcalfe and Mischel (2) proposed “cool” and “hot”
Data availability
To describe our sample briefly, over 500 original partici- ward (e.g., a cookie) in favor Madison,of a larger,
Washington,
WI; Department of Psychology, University of
later
Seattle, WA;reward 3 (e.g.,
Department two
of Psychology, systems to explain the dynamics of resisting temptation during Data collection for the Bing Longitudinal Study now spans nearly 50 years. Due to a host of historical issues connected to the
turned into a life-span developmental study, providing a
unique behavioral archive for tracing the development and
pants, primarily children of faculty and graduate students Methods at cookies) (1). Even as adultsColumbia we vary in our
University, New ability
York, NY; toand resist
4
Department
the delay-of-gratification task. These two interacting neuro-
consenting procedures in this work and promises made to participants to protect both their privacy and the confidentiality of their
Stanford University during the late 1960s and early 1970s, temptations. Alluring situations can diminish our control (2–4);
of Psychology, University of California Berkeley,
Berkeley, CA cognitive systems are implicated in self-control. Whereas the responses, it has been a long-standing policy and IRB requirement that we not share the data connected with this work with outside
implications of early self-regulatory ability over the life what serves as an alluring situation that requires a capacity to
Supported by the National Institutes of Health (grant first, a “cool” system, involves cognitive control-related neural parties or agencies. We believe it is imperative that we honor the promises made to our participants who have generously provided
completed the Between 1968 and 1974,
delay-of-gratification task653 4-year-olds
at the (52% female) attending
age of 4 years the Bing Nurs-
control our impulses, however,MH039349), changeswhich as a hadfunction of age (e.g., input to the project over the years.
ery School
at Stanford’s Bing Nursery completed
School. Theat least
study one version
was not ori-of the delay of gratification task. This
no involvement in the
circuitry, the second, a “hot” system (19), involves desires and
study de-
from cookies to social acceptance). In the present study we ex-
sign, data collection, analysis, writing of the manuscript,
ginally designed as a longitudinal study; consequently, re- or the decision to submit the manuscript for emotions
publication. that are under stimulus control and are associated with
Code availability
amined the extent to which individual differences ininterest.
delay of
The authors declare no conflicts of
emotional brain regions. Recent brain imaging studies have Code for data analysis is available in the Online Appendix.
cords of participants’ addresses were not kept up-to-date. gratification assessed when participants were in preschool and in
Received 1 October 2009; Accepted 11 August 2010 provided evidence for dissociable brain systems related to im-
Declaration of Competing Interest
Advance Access publication 19 September 2010 Nevertheless, overBMIone-third
Body mass of index
the participants responded their 20s and 30s predict control over impulses and sensitivity to
0022-3476/$ - see front matter. Copyright ª 2013 Mosby Inc.
All rights reserved. http://dx.doi.org/10.1016/j.jpeds.2012.06.049mediate over long-term choice behavior consistent with the no- The authors declare no conflicts of interest.
The Bing Longitudinal Project was supported by a number of grants from NIMH and NSF to Walter Mischel to follow-up mailings sent to their original addresses and to social cues at the behavioral and neural level when the partic-
and Yuichi Shoda, of which the most recent and active are National Institutes of Health Grant MH39349 and
90
addresses identified through an Internet search about a ipants were in their 40s. Supplementary materials
National Science Foundation Grant BCS-0624305. Ayduk, Berman, Casey, Gotlib, Jonides, Kross, Teslovich,
Delay of gratification depends importantly on cognitive con- Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.jebo.2019.08.016.
Wilson and Zayas are listed alphabetically. Shoda served as the overall PI, funded by NSF, for the most recent decade after their initial testing, and once a decade there- Author contributions: B.J.C., O.A., J.J., M.G.B., N.L.W., G.G., V.Z., W.M., and Y.S. designed
wave of data collection from the Bing longitudinal study.
trol (5). Cognitive control refers to the ability to suppress com- research; I.H.G., O.A., M.K.A., J.J., M.G.B., N.L.W., W.M., and Y.S. performed research; B.J.C.,
after. The current data collection effort focuses on these peting inappropriate thoughts or actions in favor of appropriate
Correspondence should be addressed to Walter Mischel, Department of Psychology, Columbia University, N.L.W., T.T., G.G., V.Z., W.M., and Y.S. contributed new reagents/experimental tools; B.J.C.,
New York, NY, USA. E-mail: wm@psych.columbia.edu or Yuichi Shoda, Dept. of Psychology, University of participants, who now reside in a variety of locations ones (6–11). Previously, we have shown that performance on the L.H.S., N.T.F., N.L.W., T.T., W.M., and Y.S. analyzed data; and B.J.C., L.H.S., I.H.G., O.A., J.J.,
Washington, Seattle, WA, USA. Email yshoda@uw.edu throughout the USA and beyond. delay-of-gratification task in childhood predicts the efficiency M.G.B., N.L.W., V.Z., W.M., and Y.S. wrote the paper.
with which the same individuals perform a cognitive control task The authors declare no conflict of interest.
! The Author (2010). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com (the go/nogo task) as adolescents and young adults (5). Indi- *This Direct Submission article had a prearranged editor.
viduals who as preschoolers directed their attention toward re- Freely available online through the PNAS open access option.
warding aspects of the classic delay-of-gratification situation, 1
To whom correspondence may be addressed. E-mail: bjc2002@med.cornell.edu, wm@
such as focusing on the cookies (high-temptation-focus group), psych.columbia.edu, or yshoda@u.washington.edu.

14998e15003 | PNAS | September 6, 2011 | vol. 108 | no. 36 www.pnas.org/cgi/doi/10.1073/pnas.1108561108

O contexto e o ambiente importam
para a maturação cerebral
 PAPER (A) (A)
(A) (B)
Neural correlates of socioeconomic status in the developing (B)
human brain
Kimberly G. Noble,1,2,3 Suzanne M. Houston,4,5,6 Eric Kan4,5
and Elizabeth R. Sowell4,5 Developmental Science (2012), pp 1–12 DOI: 10.1111/j.1467-7687.2012.01147.x
1 . Department of Pediatrics, Columbia University, USA
2. GH Sergievsky Center, Columbia University, USA
Mecanismos hipotéticos pelos quais o SES opera para
3 . New York Presbyterian Hospital/Columbia University Medical Center, USA
SES familiar
4 . Keck School of Medicine, University of Southern California, USA
influenciar o desenvolvimento cognitivo.
5 . Department of Pediatrics, Children's Hopsital Los Angeles, USA
PAPER prediz volume de (B)
6 . Department of Psychology, University of Southern California, USA
L. temporal, AMIGDALA e
Abstract
Linguistic
environment Neural correlates of socioeconomic status in the developing
temporo-
occipital,
Language 8 HIPOCAMPO
Kimberly G. Noble et al.
SES inferior frontal
(includes
during
human brain
Socioeconomic disparities in childhood are associated with remarkable differences in cognitive and socio-emotional development
a time when dramatic changes are occurring in the brain. Yet, the neurobiological pathways through which socioeconomic
parent
status (SES) shapes development remain poorly understood. Behavioral evidence suggests Memory
that language, memory, social- language-supporting regions. In particular, we obser
education & Hippocampus (A) (C)
Kimberly G. Noble, Status socioeconômico (SOS),
an SESdefinido como nível
emotional processing, and cognitive control exhibit relatively large differences across SES. Here we investigated1,2,3 whether 4,5,6 4,5interaction
· age in the left superior tempo
income-to-
volumetric
needs)
Suzanne M. Houston, Eric Kan
differences could be observed across SES in several neural regions that support these skills. In a sample of 60
socioeconomically gyrus (an area that is largely related to the developm
diverse children, highly significant SES differences in regional brain volume were observed in the hippocampus 4,5
and Elizabeth R. Sowell de educação (C) parental + necessidades
Social-
of phonologic skill, ade
and the amygdala. In addition, SES · age interactions were observed in the left superior temporal gyrus and left inferior frontal renda,
critical precursor to reading abi
Stress Amygdala emotional
gyrus, suggesting increasing SES differences with age in these regions. These results were not explained by differences in gender,
processing McCandliss & Noble, 2003), as well as in the left infe
8 Kimberly G. Noble et al. Anterior
targets for intervention at a time of high neural plasticity.
1 . Department of Pediatrics,
influencia volume de estruturas
race or IQ. Likely mechanisms include differences in the home linguistic environment and exposure
cerebrais
to stress, which may serve as
frontal gyrus (which has been (RNM,
implicated in the de
Cognitive Columbia University, USA opment of both phonologic and semantic process
2. GH SergievskyControl/self-
Cingulate
Cortex
Center, Columbia University, USA
regulation
m=11,4 anos, entre 5 e 17 anos)
Dehaene-Lambertz et al., 2006; Turkeltaub et al., 20
Introduction 3 . New York Presbyterian Hospital/Columbia University Medical Center, USA
generalized cognitive and academic milestones, such as
Vannest et al., 2009).
4child IQ, grade
. Keck School retention, and school
of Medicine, graduationofrates
University Southern California, USA
Currently, over one in five US children live below the (Brooks-Gunn & Duncan, 1997). These outcome mea-
(B)
In a separate literature, SES disparities in the exp
Figure 1 line
federal poverty Hypothesized
(National Center for
(A) mechanisms
Children in
Poverty, 2011). For decades, it has been recognized that
5 . Department
by are
sures which
6variability
. Department
of
likely to SES Pediatrics,
operates
be at least Children's Hopsital
partially accounted for by
of Psychology,
in the developing University
brain. However, until of
language-supporting
Los Angeles, USA
Southern California, USA
very
regions. In particular, we observed
(C)
ence of stress have also been well described. As review
above, stress has important effects on the develop
to influence
socioeconomic cognitive
disadvantage development.
in childhood is associated
with negative effects on cognitive and socio-emotional
See text
recently, for details.
the study of SES disparities in child develop-
ment operated with scarce input from neuroscience.
an SES · age interaction in the left superior temporal
hippocampus (critical for memory) and the amygd
Giro
development (McLoyd, 1998).These effects are both frontal inferior esquerdo
While classic academic milestones like school graduation
Abstract gyrus (an area that is largely related to the development
(supporting social-emotional processing). Thus, dif
statistically substantial and clinically meaningful. By the can tell us broadly about global effects of socioeconomic ences in the experience of stress may mediate our fi
well
time of described (Hart
school entry, children from &lowerRisley,
SES back- 1995;
grounds typically score between one-half and one full
Whitehurst,
disparities on achievement, 1997),
Socioeconomic
‘achievement’ disparities
is the complex
we know in fact that
output ofinmultiple
childhood
of phonologic skill, a critical precursor to reading ability;
ings of SES differences in hippocampal and amygd
are associated with remarkable differences in cognitive and socio-emotional development
cognitive
with
standardhigher SESthanfamilies more
on mostlikely towhichspeak to volumes.
deviation lower other children systems
during a are
time whenchildren
supported by different
dramatic brain regions
changes McCandliss & Noble, 2003), as well as in the left inferior
are occurring in the brain. Yet, the neurobiological pathways through which socioeconomic
academic achievement tests (Rouse, Brooks-Gunn & and networks. Thus, although classic measures of aca- The directionality of these results, and the spec
with
McLanahan,greater frequency
2005). Such and
disparities in child complexity
develop- demicstatus (Hart
(SES)
achievement must &at some
shapes Risley,
development
level reflect theremain
func- poorly understood. Behavioral evidence suggests components
that language, memory, social-
frontal gyrus (which has been implicated in the devel- of SES involved, bears comment. In
ment in turn have long-lasting ramifications for physical tion emotional
of the brain, processing, and cognitive
they are relatively control exhibit relatively large differences across SES.amygdala,
uninformative Here we fewer
investigated
years whether
of parent education – but
1995);
and mental spend more &hours
health (Brooks-Gunn in parent–child
Duncan, 1997). Yet, concerning reading
perturbations in activi-
specific cognitive and neural
volumetric differences could be observed across SES in several neural opment of both phonologic and semantic processing;
(D)regions that support family
these skills.
income In –a was
sample of 60 with larger amygd
associated
the neurobiological pathways through which socioeco- processes. A cognitive neuroscience approach, in con-
ties
nomic (Adams,
disadvantage shapes 1990); and processes
developmental providetrast,increased
socioeconomically access
reflects the fact that
diverse to structures and
children,
different neural
highly significant SES differences in regional brain volume were observed
Dehaene-Lambertz et al., 2006; Turkeltaub et al., 2003;
in the hippocampus
volumes. Studies in both animals and human child
andsupport
the amygdala. In addition, · age interactions were observed in the left superior temporal
SEScognitive havegyrus and leftthat
suggested inferior frontal
the experience of stressful event
books (Bradley,
status (SES)Corwyn,
remain poorly understood.
Giro Burchinal,
temporal McAdoo
circuits
superior esquerdo &increasing
the development
Garcia of distinct
Socioeconomic is typically characterized and gyrus, suggesting
socio-emotional skills, improvingSES our differences
Vannest et al., 2009).
efforts to with age in these regions. These results were not explained by differences in gender,
associated with larger amygdala size (Tottenham et
Coll, 2001; Raz, 1990; Whitehurst,provide
by factors including family educational attainment,
1997)
race and
or IQ. other
Likely lan- include differences in the home linguistic environment and exposure
targeted educational interventions.
mechanisms to stress,
2010). which may
Our findings are serve
thus as
consistent with the in
 O afeto é fundamental para o
desenvolvimento adequado do cérebro
Experimento sobre isolamento
O Experiment de Harlow
(1963-1968)
Harry Harlow

• Macacos Rhesus filhotes podiam escolher

“Mães de arame” (com leite) e “mães de pano”

• Macacos criados sem as mães tornavam-se

medrosos, assustados, inseguros e submissos
 Os Órfãos da ROMÊNIA

1966: Plano era elevar o

número de romenos de 23
milhões para 30 milhões até
2000.

Nicolae Ceausescu

https://saude.abril.com.br/blog/tunel-do-
tempo/a-historia-bizarra-das-criancas-
romenas-que-nao-eram-amadas/
Os Órfãos da ROMÊNIA
• Proibiu métodos contraceptivos, como a camisinha e a pílula

• Criminalizou todo tipo de aborto

• Leis que obrigavam todas as mulheres a serem examinadas por médicos Nicolae Ceausescu

• “Polícia da menstruação”

• Mulheres que não engravidavam (ou <5 filhos) eram obrigadas a pagar um “imposto do celibato”

• Médicos responsáveis pelos bairros com casos de morte infantil eram punidos

Taxa de natalidade passou de

1,9 nascimentos por mulher em
1966 para 3,6 em 1967
h8ps://saude.abril.com.br/blog/tunel-do-tempo/a-historia-bizarra-das-criancas-romenas-que-nao-eram-amadas/
EFEITOS…
• Mortalidade infantil de 83/1.000 nascimentos (média da Europa estava em 10 à época)

• Cerca de 10% dos bebês nasciam abaixo do peso

• Crianças com menos de 1,5 Kg não recebiam qualquer tratamento médico para
conseguir sobreviver

• >10.000 mortes de mulheres por aborto

• Abandono de crianças nas ruas

• Criação de abrigos públicos (“creches”)

• 770 creches (170.000 crianças!)

EFEITOS…
• Nas creches...

• Ignorar necessidades afetivas (não dar carinho, deixar chorar)

• Proibidos abraços, afagos ou qualquer “manifestação familiar burguesa”

• Roupas, cortes de cabelo e berços iguais (inibindo a individualidade)

• Observação de pesquisadores americanos:

• Problemas cognitivos, emocionais e de saúde mental

• Crianças não choravam

Os Órfãos da ROMÊNIA
O fuzilamento de Elena e Nicolau Ceausescu, na Romênia, em 1989 | Foto: Reprodução
 depr
deprivation and polygenic scores for intracranial volume [β = medi
0.09, t (46) = 0.58, P = 0.56] (SI Appendix, Fig. S2), providing no
Early childhood deprivation is associated with evidence for the possibility that individuals with a genetic pro-
or A
nond
alterations in adult brain structure despite pensity toward smaller brains were adopted later, and covarying
for these scores did not change the results.
level
and l
subsequent environmental enrichmentLocal Alterations in Cortical Structure following Institutionalization. was
F(1,7
Adopting
Nuria K. Mackesa,b,1, Dennis Golmc, Sagari Sarkard, Robert Kumstae, Michael Rutter f a whole-brain
, Graeme Fairchildg, surface-based morphometry (SBM) ap-
pend
proach,
Mitul A. Mehtab,2, and Edmund J. S. Sonuga-Barkea,h,1,2, on behalf of the ERA Young we identified
Adult Follow-up team32 additional deprivation-related regional
In
alterations after including TBV as a covariate in the cortical
a
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, United bias-
c
b
Kingdom; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College volume, surface
London, London area,
SE5 8AF,
d
and
United gyrification analyses (as these, but not
Kingdom;
signi
Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton SO17 1BJ, United Kingdom; Cognitive
Neuroscience & Neuropsychiatry, Great Ormond Street Institute of Child Health, University College London, London WC1E 6BT, United Kingdom; eGenetic tion
Psychology, Department of Psychology, Ruhr University Bochum, Bochum 44801, Germany; fSocial, Genetic & Developmental Psychiatry Centre, Institute of
−1.67
• 67 órfãos romenos adotados (3 a 41
Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, United Kingdom; gDepartment of Psychology, University of Bath, Bath
BA2 7AY, United Kingdom; and hDepartment of Child & Adolescent Psychiatry, Aarhus University, Aarhus DK-8200, Denmark
izatio
meses de privação) vs. 21 crianças
Edited by Nim Tottenham, Columbia University, New York, NY, and accepted by Editorial Board Member René Baillargeon November 11, 2019 (received for
review July 1, 2019)
the m
also
inglesas
Early adotadas
childhood deprivation is associated with higher rates of It is challenging to interpret findings from human early mal- ADH
neurodevelopmental and mental disorders in adulthood. The treatment studies, which cannot experimentally manipulate ex- 2.24]
impact of childhood deprivation on the adult brain and the extent posure to adversity for obvious ethical reasons. This is because
to which structural changes underpin these effects are currently design limitations restrict the ability to assign a causal role to
instit
• 8.6% de redução do volume cerebral
unknown. To investigate these questions, we utilized MRI data such exposures (6). For instance, in many observational studies, in th

NEUROSCIENCE
collected from young adults who were exposed to severe depri- maltreated individuals remain with their families—often the instit
total
vation in early childhood in the Romanian orphanages of the
Ceauşescu era and then, subsequently adopted by UK families; 67
perpetrators—making it difficult to isolate early from later adverse with
exposures (7). Even in cases where children escape maltreatment signif

IDADE DO RIO GRANDE DO SUL on May 5, 2021

Romanian adoptees (with between 3 and 41 mo of deprivation)
by parents through adoption or fostering, effects of maltreatment
were compared with 21 nondeprived UK adoptees. Romanian
are genetically confounded: environmental exposures, correlated
and
• <QI e >sintomas de TDAH
adoptees had substantially smaller total brain volumes (TBVs) than
brain alterations, and associated psychopathology may all be 95%

PSYCHOLOGICAL AND
COGNITIVE SCIENCES
nondeprived adoptees (8.6% reduction), and TBV was strongly
negatively associated with deprivation duration. This effect per- driven by common genetic risk factors passed from parent to child W
sisted after covarying for potential environmental and genetic (6). In addition, the majority of findings are based on retrospective ated
confounds. In whole-brain analyses, deprived adoptees showed ASD
lower right inferior frontal surface area and volume but greater Significance Fig. 1. Deprivation-related differences in TBV. (A) Point and swarm plot
right inferior temporal lobe thickness, surface area, and volume depicting distributions of TBV in deprived and nondeprived groups (n = 88).
3 co
than the nondeprived adoptees. Right medial prefrontal volume Black whiskers
Millions of children worldwide show 95%institutions.
live in nonfamilial CIs around the means (black dots). (B) Negative (infe
Referências: 1. Mackes N et al. (2020). Proc Natl Acad Sci 17(1):641-49.
and surface area were positively associated with deprivation du- We studied impact oncorrelation
adult brainbetween
structuredeprivation
of a particularly
duration and TBV (n = 67). The shaded area ters)
 avidson, R. O’Dell, V. Chan, M. H. Schieber, 27 August 2007; accepted 16 November 2007
osci. Methods 163, 283 (2007). recovery becomes significantly Crianças pequenas
more difficult. The and quegenderviviam em instituições
to the institutionalized sample.deThe al

Downloaded from www.sciencem

Downloaded from www.scie

10.1126/science.1149774

Cognitive Recovery in Socially Deprived Bucharest Early Intervention Project (BEIP) was
Bucareste final sampleforam
(n=136) of the NIG consisted of 72 children
aleatoriamente
Young
nitive Children:inThe
Recovery Bucharest
Socially Early
Deprived designed, in part, to address the issue of timing of (eight families declined further participation after fo
intervention on remediationdesignadas of cognitive delay asdiferentes estratégias
a initial recruitment e Alle fell seu
into the study). within m
ngIntervention Project
Children: The Bucharest Early result of early deprivation.desenvolvimentoTo address this issue, cognitivo foi monitorado até os 54
Charles A. Nelson III,1* Charles H. Zeanah,2 Nathan A. Fox,3
we designed a randomizedmeses controlled de idade:
trial of foster
rvention Project
Peter J. Marshall,4 Anna T. Smyke,2 Donald Guthrie5 care versus institutional care for young children Table 2. DQ and IQ of FCG by entry age group. h
who had been abandoned at or shortly after birth standard deviation, and Y is younger than and O is ol
A. Nelson III, * Charles H. Zeanah, Nathan A. Fox,
In a 1
randomized controlled trial, 2
we compared 3
abandoned children reared in institutions to
Marshall, 4
Anna T. Smyke, Donald Guthrie5 then moved to foster
2 in institutions but
•institutions
Cuidados institucionais and placed
to continued institutional care or tocontinuados
in institutions. We(n=68)
avoided theIG selection 42 months (BSID-II)
abandoned children placed care. Young children living in

Age cutoff
were randomly assigned placement in foster care,
bias of previous studies (11–15) by random assign-
Y O t(59) P
and their
omized cognitive
controlled development
trial, we compared was abandoned
tracked through 54 months
children rearedofinage. The cognitive
institutions to outcome of
mentchildren
of children
living in to the two groups. We assessed h
•
children
Colocação
who remained in the
em
institution was
um
markedly
institution orfanato
below
d children placed in institutions but then moved to foster care. Young
children and children taken out of the and placed
ns were randomly assigned to continued institutional care or to placement
that of
(n=68)
never-institutionalized
into foster care. The
the children improved
in fosterbefore
FCG
care, the start of intervention, while
cognitive outcomes we observed at 42 and 54 months were most marked
cognitive development was tracked through 54 months of age. The cognitive outcome of
for the youngest children 20 months 93.5 82.6 2.82 0.81 0.0
placed in foster care. These results point to the negative sequelaethey were
of early still living in institutions, followed by 22 months NIG
institutionalization,
•remained
whosuggest
Comparadas
in the institution
a possible was markedly
sensitive period com below
in cognitive crianças and underscorenunca
that of never-institutionalized
development, the advantages ofinstitucionalizadas (n=72)
90.4 83.0 2.01 0.54 0.0
and family
children taken outforofyoung
placements the institution
abandonedand placed into foster care. The improved
children. 24 months 91.5 80.0 3.46 0.89 0.0
outcomes we observed at 42 and 54 months were most marked for the youngest children
earlyTable
(e.g., all 1. DQeat,
and IQand
at 42 and 54 months of age. 26 months 90.9 79.1 3.53 0.91 0.0

F
foster care. These development,
or normal results pointmammalian
to the negative
brains sequelae
mentedofroutines institutionalization,
children sleep,
possible require
sensitive period in cognitive development, and underscore the advantages of
an optimal level of environmental toilet at the same time); impoverished sensory, 28 months 89.8 78.8 3.14 0.83 0.0
acements input,
for young abandoned
a so-called children.
“expectable” Evaluation
environment cognitive, and linguistic stimulation; and unre-
(1, 2). Examples of an expectable environment sponsive caregiving practices. These issues af-
N Mean DQ and IQ SD SE
might include exposure
normal development, to patterned
mammalian brainslightmented
infor- routines (e.g., all children eat, sleep, and
uiremation, normal
an optimal language
level exposure, and access
of environmental
1
toilettoat theHarvard
sameMedical
time); School
impoverished Hospital, Boston, MA IG
and Children’s sensory, Table 3. DQ and IQ of FCG by entry age group.
42 3 months 57College Park, 77.1 13.3 1.8
2
ut, aresponsive caregivers. Unfortunately,
so-called “expectable” environmentnot all chil- 02215,
cognitive,
USA. Tulane University Health Sciences Center, New
and linguistic stimulation;
Orleans, LA 70112, USA. University ofand unre-
Maryland,
42 months (BSID-II)
dren are exposed to such environments. Insti-
xamples of an expectable environment sponsive caregiving MD 20742, USA. 54 months
practices.
4
Temple issues51
These Philadelphia,
University, af-PA 19122, 73.3 13.1 1.8
ludetutional
Age at placement
settings
exposure vary bothlight
to patterned within and between USA. 5University of California, Los Angeles, CA 90095, USA.
infor-
MA E-mail: FCG
N Mean SD
countries, but many are characterized 1by un- Medical
Harvard *To whom
Schoolcorrespondence should beBoston,
and Children’s Hospital, addressed.
ormal language exposure, and access to
favorable caregiver-to-child ratios; highly regi-USA.charles.nelson@childrens.harvard.edu
02215, 2
Tulane University Health Sciences Center, New
e caregivers. Unfortunately, not all chil- 42 months 61
Orleans, LA 70112, USA. 3University of Maryland, College Park,
85.7 14.2 1.8
exposed to such environments. Insti- MD 20742, USA. Temple University, Philadelphia, PA 19122,
4
54 months 59 81.0 18.5 2.4 0–18 months 14 94.4 11.9
ettings vary both
ncemag.org within andVOL
SCIENCE between
318 21USA.
DECEMBER
5
2007 Los Angeles, CA 90095, USA.
University of California, 1937
but many are characterized by un- *To whom correspondence should be addressed. E-mail: NIG 18–24 months 16 89.0 11.3
caregiver-to-child ratios; highly regi- charles.nelson@childrens.harvard.edu
42 months 52 103.4 11.8 1.6 24–30 months 22 80.1 13.3
54 months 45 109.3 21.2 3.2 30+ months 9 79.7 17.1
SCIENCE VOL 318 21 DECEMBER 2007 1937
 J. Neurosci. Methods 163, 283 (2007).
activity, and/ormotoneuron
synchrony in the pools—reflected
SpikeTA effect—by the firing rate of 10.1126/science.11

Cognitive Recovery in Socially Deprived

contributed tothethe presence of effective
trigger neuron, the throughput
level of ongoing EMG
during some behavioral epochs and not others.
In about 10%activity,
(8 of 82)and/or synchrony
of cases, however, none in the SpikeTA effect—

Conclusões of these factorscontributed

versus absenceduring
to the muscle’s In
could account

EMG
to the
some behavioral
of throughput
about activity.
forpresence
the presence
from the M1 epochs
10% (8Weof therefore
Young Children:
neuron and not others.
The Bucharest
Cognitive
Intervention Project
82) of cases, however, none
RecoveryEarly
of effective throughput
in Soci
speculate that three subcortical factors may have

may be mediated
of these factors could account for the presence
contributed as well. First, some SpikeTA effects
versus absence
through of throughput
disynaptic linkages thatfrom Charles
the M1 A. neuron
Young Children: The Bucha
Nelson III,1* Charles H. Zeanah,2 Nathan A. Fox,3
to the
involve rubrospinal
or spinal interneurons
muscle’s
neurons,
speculate(20–22).
EMG
reticulospinal
that three
activity.Peter
neurons,
subcortical
Such effects
WeJ. Marshall,
may factors may have Intervention Project
therefore4 Anna T. Smyke,2 Donald Guthrie5

contributed as well. First, some InSpikeTA

have been blocked during some epochs by inactivity a randomized controlled trial, we compared abandoned children reared in institutions to
effects
1. Crianças criadas em instituições apresentaram desempenho intelectual muito that Charles A. Nelson III,institutional* Charlescare H. orZeanah, Nathan A. care,
Fox,
of the interposed neuron. This mechanism seems abandoned children placed in institutions but then1 moved to foster care. Young 2 children living in 3
may be mediated through disynaptic linkages
likely for suppressive effects, all of which are institutions were randomly assigned to continued to placement in foster
involve rubrospinal neurons, reticulospinal neurons, Peter J. Marshall, 4
Anna T. Smyke,
mediated through inhibitory interneurons, and may and their cognitive development was tracked through 54 months of age. The cognitive outcome of
2
Donald Guthrie 5

diminuído (retardo mental limítrofe) em relação às criadas em suas famílias de

have contributedor tospinal
effects as well.have
Second,
interneurons
the absence
single CM cell
(20–22). Such
of some facilitative
EPSPs in
children
been blocked during some epochs by inactivity taken
children
effects
and
may in the institution was markedly below that of never-institutionalized
who remained
children In a out of the institution
randomized and placed
controlled trial,into
wefoster
comparedcare. The improved childre
abandoned
motoneurons may be relatively small (23, 24). cognitive outcomes we observed at 42 and 54 months were most marked for the youngest children
origem. may have been
of the interposed neuron. This mechanism seems abandoned children placed in institutions but then moved to fost
Within motoneuron dendrites, small synaptic inputs placed in foster care. These results point to the negative sequelae of early institutionalization,
likely for suppressive
amplified by persistent effects,
inward all of which
suggest a possible institutions
aresensitive period inwere randomly
cognitive assigned
development, to continued
and underscore institutional
the advantages of car
mediated through inhibitory
currents during some behavioral epochs but not interneurons,
family and
placementsmay for and
young their cognitive
abandoned development
children. was tracked through 54 months
haveThird,
during others (25). contributed
the synaptic to input
the absence
from an of some facilitative children who remained in the institution was markedly below tha

F
as well. Second, single CM cell EPSPs in children and children
M1 neuron toeffectsa motoneuron pool commonly is or normal development, mammalian brains taken
mentedout of the
routines (e.g.,institution
all children and placed
eat, sleep, and into
2. Crianças designadas aleatoriamente para um orfanato experimentaram ganhos
assumed to remain constant. Although synaptic
motoneurons may be relatively smallinput,
efficacy might be altered by presynaptic inhibition,
require an optimal level of environmental toilet at the same time); impoverished sensory,
(23,a so-called cognitive outcomes we observed at 42 and 54 months were most m
24). “expectable” environment cognitive, and linguistic stimulation; and unre-
of an placed in environment
foster care. These results pointpractices.
to the These
negative sequela
significativos na função cognitiva does not affect
Within
available evidence
may
motoneuron
indicates
have been
corticospinal
that thisdendrites,
mechanismsmall
amplified
terminals (26, 27).
(1,synaptic
2). Examples
by persistent
might include
inputs expectable
exposure suggest
inward a possible
to patterned
sponsive caregiving
light infor-sensitive period in cognitive development, and
1
issues af-

Plastic changes can occurduring

currents in spinal cord synapses
some behavioralmation,epochsnormal not family
but language placements
exposure, and access tofor young abandoned
Harvard Medical
2
School andchildren.
Children’s Hospital, Boston, MA
(28), however, and dendritic spines have been responsive caregivers. Unfortunately, not all chil- 02215, USA. Tulane University Health Sciences Center, New
during others (25). Third, the synaptic input from an 3
Orleans, LA 70112, USA. University of Maryland, College Park,

F
observed to be remodeled over minutes (29). We dren are exposed to such environments. Insti- MD 20742, USA. 4Temple University, Philadelphia, PA 19122,
M1 that neuron to aofmotoneuron
CM synapses pool commonly is both within or normal development, mammalian brains mented routine
3. Período sensível (primeiros 2 anos de vida), no qual o acolhimento familiar
therefore speculate
on motoneurons assumed
the efficacy
might haveto remainchangedconstant.
tutional
in some Although
settings vary
countries, synaptic
and between
require an
but many are characterized by optimal
USA. 5University of California, Los Angeles, CA 90095, USA.
un- *To level of environmental
whom correspondence toilet atE-mail:
should be addressed. the sa
efficacy
behavioral epochs. mightfactors
Subcortical be altered
such asby presynaptic
these, favorableinhibition, input,
caregiver-to-child ratios; a so-called
highly regi- “expectable” environment cognitive, and
charles.nelson@childrens.harvard.edu

exerce um efeito máximo no desenvolvimento cognitivo

available evidence indicates that this mechanism (1, 2). Examples of an expectable environment
does not affect corticospinal terminals (26, 27). might include exposure to patterned light infor-
sponsive careg
www.sciencemag.org SCIENCE VOL 318 21 DECEMBER 2007 19
1
Plastic changes can occur in spinal cord synapses mation, normal language exposure, and access to Harvard Medical S
(28), however, and dendritic spines have been responsive caregivers. Unfortunately, not all chil- 02215, USA. 2Tula

• Quanto mais jovem for a criança quando colocada em um orfanato, melhor

Orleans, LA 70112,
observed to be remodeled over minutes (29). We dren are exposed to such environments. Insti- MD 20742, USA. 4T
therefore speculate that the efficacy of CM synapses tutional settings vary both within and between USA. 5University of
será o resultado on motoneurons might have changed in some
*To whom corresp
behavioral epochs. Subcortical factors such as these,
charles.nelson@ch
countries, but many are characterized by un-
favorable caregiver-to-child ratios; highly regi-

www.sciencemag.org SCIENCE VOL 318 21 DECEMBER 2007

O cérebro adolescente
Adolescência
• Período de desenvolvimento
caracterizado por decisões e ações
subótimas que dão origem a:
• Aumento na incidência de lesões
e violência não intencionais
• Abuso de álcool e drogas
• Gravidez indesejada
• Doenças sexualmente
transmissíveis.

Casey BJ et al. (2008). Developmental Review 28:62-77

 Cérebro e adolescências
B.J. Casey et al. / Developmental Review 28 (2008) 62–77

Núcleo Accumbens
• Busca de sensações
• Comportamentos de
risco
• Impulsividade
• Circuito do prazer

The traditional explanation of adolescent behavior has been suggested to be due to the protracted
ment of the prefrontal cortex (A). Our model takes into consideration the development of the prefrontal
ogether with subcortical limbic regions (e.g., nucleus accumbens) that have been implicated in risky
and actions (B).
Casey BJ et al. (2008). Developmental Review 28:62-77
 205 105

Maturação 17cerebral da substância cinzenta

190
90
7 9 11 13 15 19
7 9 11 13 15 17 19

(c) Temporal Gray Matter (cc) (d) Occipital Gray Matter (cc)
75
205
70

190 65

60

175
55

50
160
Gogtay N &Thompson PM (2010). Brain and Cognition 6-15.
7 9 11 13 15 17 19
7 9 11 13 15 17 19
(c) Temporal Gray Matter (cc) (d) Occipital Gray Matter (cc)
75
al GM development in healthy children between ages 4 and 22. Right lateral and Top views of the dynamic sequences of cortical GM maturation in he
205
4–22 (n = 13; 54 scans; upper panel) rescanned every 2 years. Scale bar70 shows GM amount at each of the 65,536 cortical points across the entire c
O cérebro maduro segue aprendendo...
articles
• Mudanças no cérebro se estabilizam aos 25 anos

• Cérebro segue aprendendo, mas perdendo substância cinzenta

atureneuroscience

Fig. 6. Volume graphs. Scatterplots of the nonlinear effects of age on total brain white matter, tot
 Maturidade e diminuição do cérebro

• Volume total do cérebro muda ao longo da vida.

• Crescimento na infância / adolescência, 9 anos =

crescimento anual de 1%, que se estabiliza até os
13 anos de idade, ocorre uma diminuição gradual do
volume.

• Durante a idade adulta jovem, entre ∼18 e 35 anos de idade outra onda de crescimento
Figure 2. ou
Fits that show the association between relative rate of whole
pelo menos um período sem perda de tecido cerebral. brain volume change and age. Whole brain volume change data
from the individual studies are shown as circles. The area of the
• Após os 35 anos, uma perda de volume constante decircles
0,2% aowith
scales ano, que acelera
the number of subjects in the study (a larger
gradualmente para uma perda de volume cerebral anualarea
de 0,5% aos 60 anos.
of the circle corresponds to more participants). Fits (with
3 degrees of freedom) were calculated to the data below and
above age 19 separately (thick lines). Two studies reported their
• Os cérebros de pessoas com mais de 60 anos de idadedata
mostram uma[Lenroot
as trajectories perdaetde al., volume
2007; van Haren et al.,
constante de mais de 0,5%. 2008], and these are made visible (thin lines).

Ref.: Hedman AM et al. (2002). Hum Brain Mapp 33:1987-2002.

I am my connectome
ARTICLE 1º Conectoma Mapeado https://doi.org/10.1038/s41586-019-1352-7

Whole-animal connectomes of both

Caenorhabditis elegans sexes
Steven J. Cook1,7, Travis A. Jarrell2,7, Christopher A. Brittin2, Yi Wang2, Adam E. Bloniarz3, Maksim A. Yakovlev2,
Ken C. Q. Nguyen1, Leo T.-H. Tang2, Emily A. Bayer4, Janet S. Duerr5, Hannes E. Bülow1,2, Oliver Hobert4,6, David H. Hall1
& Scott W. Emmons1,2*

RESEARCH ARTICLE

1 mm de comprimento
Knowledge of connectivity in the nervous system is essential to understanding its function. Here we describe connectomes
a
Amphid nerves VG
Dorsal cord
Ventral cord DRG
Fig. 1 | The C. e
neuroanatomy

302 neurônios
PAG major nerve tra
for both adult sexes of the nematode Caenorhabditis elegans, an important model organism for neuroscience research. left) of adult he
Not shown are
We present quantitative connectivity matrices that encompass all connections from sensory input to end-organ output
LG (L)

Nerve ring Ventral sublateral cord

the processes o
with the canal c

7000 conexões
across the entire animal, information that is necessary to model behaviour. Serial electron microscopy reconstructions
Dorsal sublateral cord LG (L)
RVG DRG touch neurons.
a larger numbe
that are based on the analysis of both new and previously published electron micrographs update previous results and Amphid nerves PAG
Rays the male tail th
primary centre
include data on the male head. The nervous system differs between sexes at multiple levels. Several sex-shared neurons
12 anos para mapear
VG Dorsal cord CG (L) are the nerve ri
anal ganglion. C
that function in circuits for sexual behaviour are sexually dimorphic in structure and connectivity. Inputs from sex-
Ventral cord

dorsorectal gan

specific circuitry to central circuitry reveal points at which sexual and non-sexual pathways converge. In sex-shared PAG, pre-anal g
ganglion; VG, v
central pathways, a substantial number of connections differ in strength between the sexes. Quantitative connectomes diagrams, neur
In the interactiv
b
that include all connections serve as the basis for understanding how complex, adaptive behavior is generated. Supplementary
the worm are co
network, and in
given along wit
b, c, Adult herm
(c). The top rig
The worm diag
Animals are capable of a wide range of behaviours that collectively must Supplementary Information 2, 3), thus making graph and network cell nuclei (left
the right-side h
be controlled and tightly integrated to promote survival and repro- analysis possible. Our annotation method of the digitized images ena- are not shown)
mc2DR

DA08

the layout of th
duction. To understand animal behaviour, it is necessary not only to bled us to score more synapses than the previous efforts (Extended ALMR
an algorithm th
connected cell p
identify the cellular substrates and circuits that underlie particular Data Fig. 1 and Methods). directed strong
The display is b
responses and actions, but also to describe how these circuits are inte- As none of the EM series cover an entire single animal, to generate cytoscape.org/)
A3 and interact
grated to generate a cohesive and prioritized adaptive output. A con- whole-animal connectomes, data from different reconstruction series Supplementary
(black arrows)
nectivity diagram that covers the entire nervous system is necessary to were combined and the remaining gaps were filled by extrapolating undirected edg
junctional conn
investigate how such integration is implemented. To date, synapse-level known connectivity across repetitive regions (Methods). The graph transparencies
weights. A sing
neural maps derived from electron micrographs have been published of the hermaphrodite connectome has 460 nodes (302 neurons, 132 used throughou
hexagons, inter
for the nematodes C. elegans1–4 and Pristionchus pacificus5, the ret- muscles, and 26 non-muscle end organs), whereas the male graph has
C. Elegans
c neurons; rectan

ina and portions of the neocortex of the mouse6–10, the visual system,
various categor
579 nodes (385 neurons, 155 muscles, and 39 non-muscle end organs). indicate categor
by modality and
mushroom body, locomotion and larval escape response circuits of Complete cell lists are given in Supplementary Information 4. The (Fig. 3); various

(Nematódeo multicelular)
Drosophila11–15, the larval visual system of the annelid Platynereis16 and
the central nervous system of larva of the ascidian Ciona17. Here we
respective graphs have 4,887 chemical (or directed) edges and 1,447 gap
junction (or undirected) edges in the hermaphrodite and 5,315 chemical
interneuron cat
assignment to a
in the case of IN
classes (various
present connectomes that encompass the entire animal for the nervous and 1,755 gap junction edges in the male (Extended Data Fig. 3 and are described in
organs are whit
systems of the two adult sexes of the nematode C. elegans. Supplementary Information 5). They are sparse graphs with respectively neurons are pin
additional colo
3.2% (for the hermaphrodite) and 2.4% (for the male) of all possible specific networ
the modules de
Whole-animal connectomes edges. Although sparse, if all edges for both sexes are considered to
Connectivity has been described previously for sections of the C. ele-
gans nervous system that encompasses the major neural centres, includ-
be undirected, both chemical and gap junction graphs are connected,2019|Vol
meaning that there is a path connecting every pair of nodes (weakly con-
571|NATURE|63
3. A PSICOPATOLOGIA NA PERSPECTIVA
DA EVOLUÇÃO DO CÉREBRO
Frenologia
• Francis Joseph Gall (1796)

• Protuberâncias do crânio como indicativas de

faculdades aptidões humanas

• Difundida na Inglaterra e EUA nos anos (1820-

1842) – usada para tudo!

• Extrapola conclusões além de evidências

empíricas

• Considerada pseudociência
Órgãos e Faculdades Mentais e Morais de Acordo com a Frenologia
1 Amorosidade O amor físico
2 Filoprogeniedade/Amor paternal Um sentimento particular que protege e acalenta a nossa progênie, ou amor paternal
3 Adesão/Amizade Um sentimento ou atração para se tornar amigável com outras pessoas ou aumentar os contatos sociais
4 Combatividade Disposição para lutar e guerrear
5 Destrutividade Propensão para a destruição
6 Secretividade A propensão para ocultar, que predispõe o indivíduo para tramar e trair.
7 Aquisitividade Propensão a adquirir
8 Auto-estima Sentimento que nos dá uma opinião favorável sobre nós mesmos, constituindo o amor próprio
9 Aprovatividade Esta faculdade procura a aprovação dos outros.
10 Cautela Este órgão nos ensina a tomar precauções
11 Individualidade Esta faculdade contribui para o reconhecimento da existência de seres humanos e facilita o encorporamento de vários elementos neles
12 Localidade Esta faculdade concebe lugares ocupados pelos objetos circundados por nós
13 Forma Isto nos permite entender as formas dos objetos
14 Memória verbal A memória das palavras
15 Linguagem Filologia em geral
16 Coloração Este órgão reconhece, coleta e julga as relações de cores
17 Tonalidade O órgão da percepção musical
18 Calculatividade/Numerosidade O órgão responsável pela habilidade de calcular e manipular números
19 Construtividade A faculdade de construir alguma coisa
Esta faculdade compara as sensações e noções excitadas pelas outras faculdades, apontar suas semelhanças, analogias, diferenças ou identidades, e compreender suas relações, harmonia
20 Comparação
ou discórdia
21 Causalidade Esta faculdade nos permite entender a razão dos eventos
22 Vitalidade Esta faculdade vivifica outras faculdades
23 Idealismo Esta faculdade predispõem os homens ao bem e imprime uma peculiar característica chamada ideal
24 Benevolência Este poder produz equilíbrio e bondade, compaixão e humanidade
25 Imitatividade Este órgão produz o dom da representação dramática
26 Generatividade Estas faculdade nos permite criar novas idéias
27 Firmeza Esta faculdade atribui constância e perseverança às outras faculdades, contribuindo para manter sua atividade.
28 Temporalidade Esta faculdade de tempo concebe a duração dos fenômenos
29 Eventualidade Esta faculdade reconhece a atividade de cada um e atua sobre ele
30 Habitatividade O instinto que nos leva a selecionar um lugar para ficarmos, ou nosso lar
31 Reverência/Veneração Através da ação deste órgão, adoramos Deus, veneramos os santos, e respeitamos pessoas e lugares
32 Consciensiosidade Este órgão produz um sentimento de justiça e consciência, ou o amor pela verdade e pelo dever
33 Esperança A esperança induz uma crença na possibilidade de qualquer coisa que seja desejada pelas outras faculdades. Ela inspira otimismo a respeito de eventos futuros
34 Maravilhosidade Este sentimento inspira a fé nos profetas falsos ou verdadeiros, e auxilia a superstição, mas também é esencial para a fé na doutrina da religião
35 Tamanho Este órgão nos dá a noção das dimensões e tamanho de objetos externos
36 Peso e resistência Esta faculdade nos dá o conhecimento acerca da gravidade específica dos objetos e seu uso cada vez que peso ou resistência são trabalhados com as mãos ou por meio de ferramentas
37 Ordem Esta faculdade dá um método e uma ordem aos objetos na medida que eles são fisicamente correlacionados

https://cerebromente.org.br/n01/frenolog/frenorg_port.htm
 5 • Esquizofrenia e transtornos relacionados 101

ESQUIZOFRENIA ƒ Fase pré-mórbida: disfunção ausente ou sutil da cognição, motricidade e/

ou social.
ƒ Fase prodrômica: sintomas positivos atenuados e declínio funcional.
• Transtorno psicótico, caracterizado por um conjunto de alterações de pensamento
ƒ Fase psicótica: primeiro episódio psicótico marcando a doença. Década
(delírios e/ou desorganização), comportamentos (isolamento, desorganização e inicial geralmente marcada por episódios psicóticos com graus variados de
gravidade e duração dos sintomas. O declínio funcional é mais acentuado
alterações) e percepções (alucinações)1 nos primeiros cinco anos após o primeiro episódio psicótico.

• Doença grave, crônica e progressiva Curso natural da esquizofrenia

Primeiro

• Associada a mortalidade precoce episódio

psicótico Graus variáveis
de recuperação

• Frequente causa de internações e Fase

pré-mórbida
Fase
prodrômica Fase Fase
incapacidade psicótica estável

Infância Adolescência/jovem adulto

Linha do tempo

Figura 1 Evolução da esquizofrenia. Fonte: adaptado de Tandon et al., 2009.16

ƒ Fase
Referências: 1. Spanemberg e col. (2021). Manual de Internação Psiquiátrica. Manole, estável:
Santana deos sintomas positivos são menos presentes, enquanto os sinto-
Parnaíba.
 Alterações cerebrais da esquizofrenia
• Alterações morfológicas1,2

• Alargamento dos ventrículos

• ⇩ espessura do córtex pré-frontal

• ⇩ volume hipocampo

• ⇩ volume do pulvinar do tálamo

• Neuroimagem funcional3,4

• Alterações em feixes de substância branca em vias frontais, temporais e límbicas

(alterações na conectividade funcional)

Referências: 1. Quevedo J & Isquierdo I. (2020). Artmed, Porto Alegre. 2. Sadock et al. (2017). Lippincott Williams & Wilkins,
Philadelphia. 3. Vitolo E et al. (2017). Psychiatry Res Neuroimaging 2170:8-21. 4. Wang F et al. (2016). Schizophrenia Bull 43(2:436-448.
 ctivity at different stages of schizo-
ndent datasets. To our knowledge,
study to directly examine the effect
data from drug-naive FE patients with schizophrenia. The
Conectividade functional na esquizofrenia
FE schizophrenia patients demonstrated most prominently
localized changes in the frontal lobes, especially Broca’s

Conectividade
funcional alterada
em estágio crônico
da esquizofrenia
(por fMRI)

Fig. 2. Significantly altered functional connectivity for chronic stage schizophrenia by meta-analysis involving
a. Alterações da conectividade envolvendo o tálamo B. Alterações
(a) illustrates altered links involving da(58conectividade
the thalamus links), and (b) isenvolvendo o córtex
for links involving cingulado
the cingulate cortex (
remaining significantly different links.

442
Referências: 1. Wang F et al. (2016). Schizophrenia Bull 43(2):436-448.
 Em 1976, Gottesman e colaboradores realizaram revisão dos estudos que abordaram herança
familiar na esquizofrenia e concluíram que há aumento evidente nos casos da doença em
Risco de esquizofrenia por grau de parentesco
parentes de pacientes com o transtorno.2 Os autores observaram riscos tão altos quanto o de
46,3% nos indivíduos em que ambos os pais tinham o diagnóstico da doença (Fig. 16.1).

Referências: 1. Quevedo J & Isquierdo I. (2020). Artmed, Porto Alegre. 2. Gottesman II et al. (1976). Schizophr Bull 2(3):360-401; 3. Sadock
[FIGURA 16.1 ]
et al. (2017). Lippincott Williams & Wilkins, Philadelphia.
Risco de esquizofrenia por grau de parentesco (prevalência durante a vida, %).
Esq: esquizofrenia.
Fonte: Gottesman e colaboradores2 e Sadock e colaboradores.3
 Herdabilidade da Esquizofrenia (Metanálise)
A
Essen-Møller, 194119

Kallmann, 194620

Slater and Shields, 195321 One principal resu

Kringlen, 196723 12 published twin s
Fischer et al, 196924 and the other was q
Tienari, 197525 summaries of the tw
Kendler and Robinette, 198326 analytic summary e
Onstad et al, 199127
estimate, 81%; 95%
vide a useful summ
Kläning, 199628
we also determined
Franzek and Beckman, 199929
mon environmenta
Cannon et al, 199830
(point estimate, 11
Cardno et al, 199931 mate is unexpected
All Studies

0 20 40 60 80 100

Referências: Sullivan PF et al. (2003). Arch Gen Psychiatr 60:1187-92.

Before discussing t
B that we consider 2
Por que a ESQUIZOFRENIA não desaparece?

• Prevalência estável ao longo da história ⇨ vantagem evolutiva?1

• Estudos mostram aumento da criatividade em familiares de pacientes

esquizofrênicos2,3,4
• Tim Crow: esquizofrenia como específica da espécie humana, ligada a
deficiências na lateralização no cérebro
• Ligada ao surgimento da linguagem articulada e
simbólica (distintiva da espécie humana)

Referências: 1. Dalagalarrondo P. (2011). Artmed, Porto Alegre; 2. Karlsoon JL. (1970). Hereditas 66:177-82; 3. Andreasen NC. (1996). John Wiley,
Chichester; 4. Polimeni J, Reiss. (2003). Can J Psych 48(1)34-9.
TRANSTORNOS ANSIOSOS

• ANSIEDADE: experiência subjetiva de desconforto, fisiológica e

adaptativa

• Quando desproporcional, muito intensa, muito frequente e disfuncional

(sofrimento e prejuízos) = TRANSTORNO DE ANSIEDADE1,2

• Tipos de transtornos ansiosos

• Transtorno de ansiedade generalizada
• Transtorno do pânico
• Transtorno de ansiedade social
• Transtorno de ansiedade de separação
• Fobias específicas

Referências: 1. Meleiro A. (2018). Guanabara Koogan, São Paulo; 2. American Psychiatric Association (2013). APA, Arlington.
Modelo de desempenho versus excitação
(Yerkes & Dodson)

Referências: 1. Yerkes & Dodosn (1908). J Comp Psychol, 18:459-82.

Ansiedade: Luta ou Fuga

X Fight
Luta

Faint
Desfalecer
Freeze
Congelar

Flight
Fuga
 Sistema límbico e a ansiedade
Giro do Cíngulo

Fórnix

Amigdala
Hipocampo Corpo mamilar

Após resposta inicial, algumas vias

sensoperceptivas chegam ao tálamo, e
partem para o córtex (informação pode ficar
Referências: 1. Meleiro A. (2018). Guanabara Koogan, São Paulo;
8.2 Neuroanatomia das estruturas relacionadas com a ansiedade. A. Alça de resposta curta: o centro consciente e passível de regulação cortical
o do medo, a amígdala, ao receber estímulo direto das vias sensoperceptivas, imediatamente dispara, da amígdala)
Perspectiva EVOLUCIONISTA dos transtornos ansiosos
• Evolução = múltiplos sistemas de reconhecimento de perigos e ameaças1
• Sistema de detecção de perigo
• Resposta geral de alarme
• Sistema motor para uma resposta de luta/fuga/submissão

• Nesse e Williams2:

“O custo de morrer uma só vez é muito superior ao

custo de centenas de alarmes falsos”

• Nos últimos séculos, diminuição de ameaças externas vs. nenhuma

mudança no cérebro (descompasso)

Referências: Dalagalarrondo P. (2011). Artmed, Porto Alegre; 2. Nesse RM & Williams GC. (1995). Weidenfeld & Nicolson, London.
Perspectiva EVOLUCIONISTA dos transtornos ansiosos

• Ex: Fobias

• Medos ancestrais e simbolizações

• Fobia simples: medo de animais e situações de ameaças ancestrais

• Fobia social: perda de status e humilhação

• Agorafobia: proteção contra territórios desconhecidos

Referências: Dalagalarrondo P. (2011). Artmed, Porto Alegre

DEPRESSÃO

• Estado afetivo de tristeza X Síndrome cínica

• Transtorno(s) depressivo(s): condição

heterogênea e complexa

• Envolvimento de múltiplos sistemas

• Neuroendócrino
• Imunológico
• Inflamatório
• Neurotrofinas
• Monoaminas

• Condição de maior “carga de doença”, com grande morbi-mortalidade

Referências: 1. Meleiro A. (2018). Guanabara Koogan, São Paulo; 2. American Psychiatric Association (2013). APA, Arlington.
A DEPRESSÃO e o cérebro

• Depressões graves e crônicas

• Marcada diminuição volumétrica em
hipocampo, gânglios da base, córtex
orbitofrontal (COF) e córtex pré-frontal
sub-genual1

• Alterações funcionais em circuitos pré-frontais-cingulado anterior, circuitos

pré-frontal-hipocampal, circuito frontotalâmico (“circuito suicida”)2

Referências: 1. Lorenzetti V et al. (2009). J Affect Dis 117:1-17; 2. Zhang F et al. (2018). CNS Neurosc Ther 24:994-1003.
Por que a evolução não seleciona só os não-deprimidos?

• Homem é uma das espécies de animais sociais com sistema de hierarquia

• Submissão e dominação

• Assimetria de status sociais • Negociação permanente

• Competição por recursos • Sistemas flexíveis para evitar

lutas fatais
• Competição por parceiros

• Dominador: comportamento de ameaça, irritação e agressão

• Subalterno: atitude de evitação, ansiedade e submissão

Referências: Dalagalarrondo P. (2011). Artmed, Porto Alegre

Por que a evolução não seleciona só os não-deprimidos?

• Ascender e descender no ranking social = euforia e depreciação/depressão

(respectivamente)1

• Depressão: inibe a conduta de ameaça do animal e previne uma luta inútil

• Quando esforços contínuos para alcançar determinados objetivos conduzem a

perigos ou perda de recursos importantes ⇨ depressão como forma de
adaptação

• Ex: após perda em um conflito; situações de carência de recursos ou privações de

cuidado (evitar a perda de energia)1,2

Referências: 1. Dalagalarrondo P. (2011). Artmed, Porto Alegre; 2. Nesse RM. (2000). Arch Gen Psychiatry 57:14-20.
O caso da OBESIDADE
• Rara até 10.000 anos atrás

• Suposição: relação entre seleção de genes para

obesidade e encefalização (a partir do Home erectus)

• História primata: marcada por distribuição sazonal da disponibilidade de

alimentos (avidez pela conservação de energia)

• A maior disponibilidade de alimento de alto valor calórico, somado a um estilo

de vida sedentário e estratégias de enfrentamento de problemas emocionais
= 1 bilhão de pessoas com IMC ≥ 25 (300 mi ≥ 30).

• Outros transtornos alimentares: especulações pouco plausíveis

CONCLUSÕES…
• CÉREBRO: órgão especializado, que apresenta-se imaturo ao nascimento na
raça humana e apresenta crescimento progressivo e complexo

• Fatores genéticos, ambientais e internos podem modificar o desenvolvimento

cerebral

• Quanto antes intervenções preventivas forem implementadas, maior a chance

de o cérebro responder e se recuperar

• Apesar da fisiopatologia dos transtornos mentais não esteja esclarecida, a

evolução do cérebro e as adaptações contemporâneas da humanidade podem
explicar os transtornos psiquiátricos