Dr. Mark D'Esposito: How to Optimize Cognitive Function & Brain Health
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
My guest today is doctor and professor Mark D'Esposito.
今天我的客人是马克·德埃斯波西托博士兼教授。
Dr. Mark D'Esposito is a neurologist and a professor of neuroscience and psychology at the University of California, Berkeley.
Mark D'Esposito 博士是一位神经学家，也是加州大学伯克利分校的神经科学和心理学教授。
He is a world expert in the brain mechanisms controlling executive function and memory.
他是控制执行功能和记忆的大脑机制方面的世界专家。
Executive function is the way in which we are able to designate and carry out specific cognitive strategies, and it is fundamental to every aspect of our daily lives.
执行功能是我们能够指定和执行特定认知策略的方式，它是我们日常生活各个方面的基础。
And because so much of being effective in daily life involves using specific context-relevant batches of information in order to understand what to do and when, and what not to do and when, and to come up with strategies that are very adaptive for us to move forward in the context of relationships, work, school, and athletics, and on and on, there's really no separation between executive function and memory.
而且，由于在日常生活中保持高效，需要使用与特定环境相关的大量信息，以便了解该做什么、何时做什么、不该做什么以及何时做什么，并提出非常适合我们在人际关系、工作、学校和体育等背景下前进的策略，因此执行功能和记忆之间确实没有分离。
And today, Dr. D'Esposito explains the neural circuits controlling executive function and memory, how they interact, the key role of dopamine in executive function, and something called working memory, and teaches us ways to optimize executive function and memory.
今天，D'Esposito 博士解释了控制执行功能和记忆的神经回路、它们如何相互作用、多巴胺在执行功能中的关键作用以及所谓的工作记忆，并教我们优化执行功能和记忆的方法。
That is, how to optimize cognitive function.
也就是如何优化认知功能。
In addition to discussing how to optimize cognitive function in the healthy brain, today's discussion also centers around how to restore cognitive function in disease or injury conditions that deplete executive function and memory, such as traumatic brain injury, concussion, Alzheimer's, Parkinson's, and attention deficit disorders.
除了讨论如何优化健康大脑的认知功能外，今天的讨论还围绕如何在消耗执行功能和记忆的疾病或损伤条件下恢复认知功能，例如创伤性脑损伤、脑震荡、阿尔茨海默氏症、帕金森氏症和注意力缺陷障碍。
Dr. D'Esposito shares with us research findings both about behavioral and pharmacologic strategies to enhance executive function and memory.
D'Esposito 博士与我们分享了有关增强执行功能和记忆的行为和药理学策略的研究结果。
By the end of today's discussion, you will have learned from Dr. D'Esposito a tremendous amount about the modern understanding of cognition, that is, thinking and memory, and the carrying out of specific cognitive strategies.
在今天的讨论结束时，您将从 D'Esposito 博士那里学到大量关于认知的现代理解，即思维和记忆，以及特定认知策略的执行。
You will also learn a tremendous amount about how to optimize brain function and brain health.
您还将学到大量有关如何优化大脑功能和大脑健康的知识。
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
And now for my discussion with Dr. Mark D'Esposito.
现在我与 Mark D'Esposito 博士进行讨论。
Dr. D'Esposito, welcome.
D'Esposito 博士，欢迎光临。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Hey, Andrew.
嘿，安德鲁。
Thank you so much for inviting me.
非常感谢你邀请我。
I'm really looking forward to our conversation.
我真的很期待我们的谈话。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
You may not remember me, but I remember you when I was a first-year graduate student, and you showed up at Berkeley, one of the first people to really bring functional imaging of the human brain to Berkeley, bring a neurology and a clinical emphasis to the neuroscience studies there, and it's really just blossomed, and it's been a real thrill for me to see all the magnificent work out of your laboratory over the years.
你可能不记得我，但我记得你，当我还是一年级研究生时，你出现在伯克利，你是第一批真正将人脑功能成像带到伯克利的人之一，将神经学和临床重点带入那里的神经科学研究，它真的刚刚蓬勃发展，多年来看到你实验室的所有出色工作让我感到非常兴奋。
And I know you also still see patients, so the topics that are of interest to you I know are of great interest to our audience.
我知道您仍然会看望病人，因此我知道您感兴趣的话题也是我们的观众非常感兴趣的。
Maybe we'll just start off with a few of the basics and do a little functional neuroanatomy lesson for folks.
也许我们会从一些基础知识开始，为人们上一些功能性神经解剖学课程。
Not to scare anyone, don't worry.
不是为了吓唬谁，不用担心。
This will be accessible to everyone.
每个人都可以使用它。
And just talk about the frontal lobes and prefrontal cortex and a little bit of what those structures do, because many times on this podcast, I've said, "Okay, the neural real estate right behind your forehead is involved in context and planning, et cetera," but you're the real expert here.
只谈谈额叶和前额叶皮层以及这些结构的一些功能，因为在这个播客中我多次说过，“好吧，你额头后面的神经区域涉及背景和规划等，”但你是这里真正的专家。
How should we think about what the frontal lobes do and their various roles in health and disease?
我们应该如何思考额叶的作用及其在健康和疾病中的各种作用？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
So there's four lobes.
所以有四个叶。
There's the frontal lobes, parietal, temporal, occipital, and the frontal lobes do take up more territory than the other lobes, probably about a third of the cortex.
有额叶、顶叶、颞叶、枕叶，额叶确实比其他叶占据了更多的区域，可能大约占皮质的三分之一。
And within the frontal lobes, I'm going to use the frontal lobes probably in our conversation a lot, but what I really mean is the prefrontal cortex.
在额叶内，我可能会在我们的谈话中经常使用额叶，但我真正的意思是前额叶皮层。
So within the frontal lobes, there's also areas that are important for motor function as well.
因此，在额叶内，也有一些对于运动功能也很重要的区域。
But when we're talking about the frontal lobes, we're talking about its involvement in higher-level cognitive abilities.
但当我们谈论额叶时，我们谈论的是它与高级认知能力的关系。
We're really talking about the prefrontal cortex, and this is what's considered the highest level of cortex in the brain.
我们真正谈论的是前额皮质，这被认为是大脑中最高级别的皮质。
So yeah, when you think about it, people assign it all sorts of functions.
所以，是的，当你想到这一点时，人们会为它分配各种功能。
Almost every function you think of, people have put into the frontal lobes.
几乎所有你能想到的功能，人们都已经放到了额叶中。
But I think what we've all moved towards is this idea of executive function, this ability to plan, to organize, to really transfer our thoughts into an action, and really to be guided by goals and intentions and not be ruled by just automatic behaviors.
但我认为我们所有人都在朝着执行功能的理念前进，这种计划、组织、真正将我们的想法转化为行动的能力，真正受到目标和意图的指导，而不仅仅是被自动行为所统治。
And a word we use in cognitive neuroscience is called cognitive control.
我们在认知神经科学中使用的一个词叫做认知控制。
So cognitive control, executive function is what we attribute to the frontal lobe.
因此，我们将认知控制、执行功能归因于额叶。
And so you can think of it as the CEO of the brain or the conductor of the orchestra, really the part of the brain that's really controlling the rest of the brain.
所以你可以把它想象成大脑的首席执行官或管弦乐队的指挥，实际上是大脑中真正控制大脑其他部分的部分。
So yeah, if you had to choose which part you wanted to not leave home, it's your frontal lobes.
所以，是的，如果你必须选择你不想离开家的哪个部分，那就是你的额叶。
Andrew Huberman:
安德鲁·休伯曼：
Speaking of which, what are some of the symptoms of mild frontal lobe damage and severe frontal lobe damage, damage brought about either through neurodegenerative disease or physical injury?
说到这里，轻度额叶损伤和严重额叶损伤（由神经退行性疾病或身体伤害引起的损伤）有哪些症状？
I know we're going to talk a bit about both today, or a lot about both.
我知道我们今天要稍微讨论一下这两个问题，或者更多地讨论这两个问题。
But how would lack of executive function show up maybe in a subtle level?
但是执行功能的缺乏会如何在微妙的层面上表现出来呢？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
First, I should say is that it shows up all the time, and frontal lobe behavior is probably much more prevalent than we realize.
首先，我应该说的是，它一直都会出现，而且额叶行为可能比我们意识到的要普遍得多。
Certainly, we think about it when you have a brain injury to the frontal lobes, and there's lots of neurological disorders like stroke and traumatic brain injury and Alzheimer's disease that can affect the frontal lobe, and there's a number of psychiatric disorders, obsessive-compulsive disorder, and schizophrenia, and depression that are thought to be frontal lobe dysfunction But when you're sleep deprived, and when you're stressed, and just normal aging, the frontal lobe seems to be the first system that's affected because it really is involved in the highest level.
当然，当你的额叶受到脑损伤时，我们会想到这一点，有很多神经系统疾病，如中风、创伤性脑损伤和阿尔茨海默氏病，都会影响额叶，还有许多精神疾病、强迫症、精神分裂症和抑郁症被认为是额叶功能障碍，但当你睡眠不足、有压力时，一切都正常随着年龄的增长，额叶似乎是第一个受到影响的系统，因为它确实涉及最高级别。
So when we're having a bad day, when we're having difficulty sort of setting priorities, when we're having difficulties achieving the goal that we've set out, when we get distracted, when we're not able to sort of adapt and be flexible, these are all the type of things that reflect that our frontal lobes are not functioning optimally.
因此，当我们度过糟糕的一天时，当我们难以确定优先事项时，当我们难以实现既定目标时，当我们分心时，当我们无法适应和保持灵活性时，所有这些都反映出我们的额叶功能未达到最佳状态。
Andrew Huberman:
安德鲁·休伯曼：
Approximately what age does the frontal lobe circuitry come online, so to speak?
可以这么说，额叶电路大约在什么年龄开始上线？
When I see a baby, babies can orient their eyes towards things, but they're rather reflexive in where they'll place their eyes.
当我看到婴儿时，婴儿可以将他们的眼睛转向物体，但他们对将眼睛放在哪里有相当的条件反射。
But by the time kids are three or four, they can certainly play with blocks or interact with other children or their parents.
但当孩子三四岁的时候，他们肯定可以玩积木或与其他孩子或他们的父母互动。
But it seems that full functionality of the frontal lobes is really gradual.
但额叶的全部功能似乎确实是渐进的。
At least that's my non-clinically trained assessment.
至少这是我未经临床训练的评估。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
It's a really tough question to know when they're fully developed because these studies haven't been done.
要知道它们何时完全发育是一个非常困难的问题，因为这些研究还没有完成。
When MRI was introduced and we were able to sort of image the brain in a non-invasive way, then studies did start to come out trying to sort of map out at what age does your frontal lobes fully develop, and it seemed like it was early into your 20s.
当 MRI 被引入时，我们能够以非侵入性的方式对大脑进行成像，然后研究确实开始出现，试图找出你的额叶在什么年龄完全发育，而且似乎是在 20 多岁时。
I always say that it's not surprising that you can't rent a car until you're 25.
我总是说，25 岁之前不能租车并不奇怪。
That the insurance companies knew before neuroscientists did as to when your decision-making skills are at their highest, and so that's probably about right.
保险公司在神经科学家之前就知道你的决策能力何时达到最高水平，所以这可能是正确的。
Into your 20s is probably before your frontal lobes are fully developed.
到了 20 多岁，你的额叶可能尚未完全发育。
And it's a really interesting question, is why does it take so long?
这是一个非常有趣的问题，为什么需要这么长时间？
It's the area of the brain that takes the longest to develop, and why is that?
这是大脑中发育时间最长的区域，为什么呢？
And I think there's a reason.
我认为这是有原因的。
I think that this sort of slow development of frontal lobes allows us to explore, allows us to think about novel ways of solving problems, allows us to take in the world.
我认为额叶的这种缓慢发展使我们能够探索，使我们能够思考解决问题的新方法，使我们能够了解世界。
If they were shut off earlier, it would lead to maybe a much more sort of rigid, kind of less flexible kind of behavior that we'd see in things.
如果它们早点关闭，可能会导致我们在事物中看到的更加僵化、缺乏灵活性的行为。
So I think that it helps to take a long time to develop, but also it obviously leads to some problems sometimes in adolescence as we see sometimes.
所以我认为，花很长时间来发展是有帮助的，但有时也会在青春期明显导致一些问题，正如我们有时看到的那样。
Andrew Huberman:
安德鲁·休伯曼：
Can one see a lack of frontal lobe maturity in just the sheer number of physical movements that a child makes?
仅仅从孩子做出的大量身体动作就能看出额叶不够成熟吗？
So for instance, in a classroom of, let's say fourth graders, oftentimes there'll be a range of a parent ability of kids to sit still or to listen.
举例来说，在一个四年级学生的教室里，孩子们经常坐着不动或倾听，家长的能力往往有一定的差异。
Do we think that the kid that's having a hard time focusing and listening to instructions or steadying their body when they're told to sit still, I don't know if they still tell kids to sit still, but they were telling me to sit still-
我们是否认为，当孩子被告知要安静地坐着时，他们很难集中注意力、听指令或稳定身体，我不知道他们是否仍然告诉孩子们要安静地坐着，但他们告诉我要安静地坐着——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
when I was a kid.
当我还是个孩子的时候。
Is that somehow reflective of a slightly lagging frontal lobe function and maturity?
这是否反映了额叶功能和成熟度稍微滞后？
Whereas the kids that can sit still and stoic and focus, does that mean that they're a little bit more accelerated along that trajectory?
虽然孩子们可以安静地坐着、坚忍、专注，但这是否意味着他们沿着这条轨迹会更快一些？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, it's hard to say.
是的，这很难说。
The frontal lobe is a big territory, and we can get into it, but the frontal lobe probably has 25 different sub-regions within it, and so grossly, we think about the frontal lobes as the lateral portion of the frontal lobes, which is involved in these executive function, probably supports these executive function abilities.
额叶是一个很大的领域，我们可以进入它，但是额叶内部可能有 25 个不同的子区域，因此，粗略地讲，我们将额叶视为额叶的外侧部分，它参与这些执行功能，可能支持这些执行功能。
But then we've got another part of the frontal lobes called the orbitofrontal cortex, which is probably involved more in social and emotional behavior.
但额叶的另一部分称为眶额皮层，它可能更多地参与社交和情感行为。
So, again, when we think about frontal lobe behaviors, there's so many different type of frontal lobe behavior.
所以，当我们考虑额叶行为时，额叶行为有很多不同类型。
So that type of behavior, which may be involved in sort of being able to inhibit your motor movements or maybe not being distracted, may reflect that that system is a little bit delayed, but it could be that another system, the one that's involved in planning and organizes, is more developed.
因此，这种类型的行为（可能涉及抑制运动或不分心）可能反映出该系统有点延迟，但也可能是另一个系统（涉及计划和组织的系统）更加发达。
And I do think they develop at different trajectories.
我确实认为他们的发展轨迹不同。
Andrew Huberman:
安德鲁·休伯曼：
So with the frontal lobes essentially serving an executive or CEO type function, goal-directed behavior, intentions, cognitive control, these are the terms you used.
因此，额叶本质上服务于执行官或首席执行官类型的功能、目标导向的行为、意图、认知控制，这些就是你使用的术语。
Where are the rules?
规则在哪里？
What do the rules look like?
规则是什么样的？
When I think about brain function, which I've spent a lot of my life thinking about, think about chemical and electrical signaling between neurons, different neurons communicating more or less at a given moment, reflecting some sort of circuit, as we call it, and then some behavior or some decision comes out.
当我思考大脑功能时，我花了很多时间思考这个问题，思考神经元之间的化学和电信号，不同的神经元在给定时刻或多或少地进行通信，反映某种我们所说的电路，然后出现一些行为或一些决定。
And if I, for instance, I have to get my driver's license renewed soon.
例如，如果我，我必须尽快更新我的驾驶执照。
So if I go to the Department of Motor Vehicles, what a lovely experience that is.
所以如果我去机动车辆部，那是多么美好的经历啊。
The moment I get there, I sort of lock into a certain rule set.
当我到达那里的那一刻，我就锁定了一定的规则集。
When I'm home, I'm in a different rule set.
当我在家时，我遵循不同的规则。
When I'm with my friends versus when I'm with my parents, different rule sets.
当我和朋友在一起时和和父母在一起时，有不同的规则。
And it seems that the frontal lobe is really good at drawing on context based on knowledge of where one is, and then coming up with kind of algorithms that are appropriate or inappropriate to run in that context.
额叶似乎非常擅长根据自己所在位置的知识来利用上下文，然后提出适合或不适合在该上下文中运行的算法。
But what is the nature of these algorithms?
但这些算法的本质是什么？
Are they of the, "Okay, shut down all cursing in this environment.
他们是这样说的：“好吧，停止在这种环境下的所有咒骂。
Okay, you're free to just, quote-unquote, 'be you.'" When it really comes down to it, it has some interesting philosophical aspects, too, because just be yourself, be authentic, be vulnerable.
好吧，你可以自由地说，‘做你自己。’”当它真正归结为它时，它也有一些有趣的哲学方面，因为只要做你自己，保持真实，保持脆弱。
All these things make sense, but of course, one needs to be appropriate with the context.
所有这些都是有道理的，但当然，需要结合上下文。
So how does this work?
那么这是如何运作的呢？
What are the algorithms?
有哪些算法？
How does this work?
这是如何运作的？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Because that's a pretty common example of our patients, that they don't follow the rules.
因为这是我们患者的一个很常见的例子，他们不遵守规则。
If you're sitting in the doctor's office and the phone rings, you know not to pick up his phone, but the patients don't, and they may pick up the phone.
如果你坐在医生的办公室里，电话响了，你知道不要接他的电话，但病人不会，他们可能会接电话。
There's this Dr. Lhermitte, who's a neurologist from France, who published these beautiful papers in the '80s of all these things that patients did that broke the rules, and just kind of pulled to their environment without having any context to it.
Lhermitte 博士是一位来自法国的神经学家，他在 80 年代发表了这些精彩的论文，内容涉及患者所做的所有这些违反规则的事情，他们只是在没有任何背景的情况下融入了他们的环境。
If he put a pair of glasses on the table, and didn't ask them to put them on, they would put them on even if they had a pair of glasses on already.
如果他把一副眼镜放在桌子上，不让他们戴上，即使他们已经戴了一副眼镜，他们也会戴上。
Or he took them to their apartment and they saw the bed, and they'd jump into the bed and go under the covers.
或者他带他们到他们的公寓，他们看到床，然后跳上床，钻进被子里。
Or he had a nurse, and he put a blood pressure cuff there, and she picked up the blood pressure cuff and just started taking his blood pressure.
或者他有一个护士，他把血压袖带放在那里，她拿起血压袖带，开始测量他的血压。
Again, not asking them to do any of these things.
再说一遍，不要求他们做任何这些事情。
And so they just don't follow sort of the social rules, but they're there.
所以他们只是不遵守某种社会规则，但他们就在那里。
They haven't lost rules.
他们并没有失去规则。
If you ask these patients, "Was that the appropriate thing to do?" They'll say, "No."
如果你问这些病人，“这样做合适吗？”他们会说：“不。”
Andrew Huberman:
安德鲁·休伯曼：
No, they know it's not appropriate.
不，他们知道这不合适。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
They know it's appropriate.
他们知道这是合适的。
Yeah.
是的。
They say, "No, I'm not supposed to answer your phone, but..."
他们说：“不，我不应该接你的电话，但是……”
Andrew Huberman:
安德鲁·休伯曼：
Oh, wow.
哦，哇。
So they know better, but they can't control the impulse.
所以他们更清楚，但他们无法控制冲动。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Exactly.
正是如此。
So it's not a breakdown that the rules disappear, it's that they can't apply the rules properly.
因此，规则消失并不是故障，而是他们无法正确应用规则。
And that's true for a lot of patients, even with kids.
对于很多患者来说都是如此，即使是孩子。
You tell them, "Don't have anything to eat before dinner because we're having dinner." And then they're sitting there having a sandwich, and you say, "What did I just tell you?" You said, "Well, don't eat, but I'm hungry." Another sort of example of sort of the frontal lobe's not completely kind of developed.
你告诉他们，“晚饭前不要吃任何东西，因为我们正在吃晚饭。”然后他们坐在那里吃三明治，你说：“我刚才告诉你什么了？”你说：“好吧，不吃，但我饿了。”额叶尚未完全发育的另一个例子。
So when I think about rules, I think about the brain.
所以当我想到规则时，我想到的是大脑。
The brain processes information, obviously, but it also stores information.
显然，大脑不仅处理信息，而且还存储信息。
The most important thing it does is store all sorts of information all over the brain.
它所做的最重要的事情就是在整个大脑中存储各种信息。
And I think what the frontal lobes do is they store rules.
我认为额叶的作用是存储规则。
And what's interesting about the way it stores rules, they seem to store the rules in a hierarchical fashion.
它存储规则的方式很有趣，它们似乎以分层方式存储规则。
And what I mean by that is that there's different levels to rules.
我的意思是，规则有不同的级别。
I like to give the example of playing golf.
我喜欢举打高尔夫球的例子。
I tell a story a lot about my good friend Bob Knight, when he hits a ball off into the woods, and he has to try and hit the ball out of the woods.
我讲了很多关于我的好朋友鲍勃·奈特的故事，当他将球击入树林时，他必须尝试将球击出树林。
He's holding on to all different levels of rules on how to successfully get his ball back towards the green.
他遵守所有不同级别的规则，了解如何成功地将球送回果岭。
So the most simplest one is just like where is the fla-- I've got to maintain the orientation to get to the flag.
所以最简单的一个就像旗帜在哪里——我必须保持方向才能到达旗帜。
So he's holding that.
所以他拿着这个。
He also, at a higher level rules, he knows that if he kicks the ball, it's a penalty, so he's not going to do that.
他还，在更高级别的规则中，他知道如果他踢球，就会受到处罚，所以他不会这样做。
And then another higher level rule might be if I just keep doing this, this is going to be healthy for me.
然后另一个更高级别的规则可能是，如果我继续这样做，这对我来说将是健康的。
And so he's storing all this information at sort of at different levels of hierarchy, and he's applying it to ultimately achieve this very simple act of, or not so simple act of, of hitting the golf ball.
因此，他将所有这些信息存储在不同的层次结构中，并应用它来最终实现击球这一非常简单的动作或不那么简单的动作。
So I think about sort of the frontal cortex is able to call upon the rule in the appropriate context, and if you don't have your frontal lobes, it doesn't get pulled up properly.
所以我认为额叶皮层能够在适当的环境中调用规则，如果你没有额叶，它就不会被正确地拉起。
Andrew Huberman:
安德鲁·休伯曼：
And those rules must be learned.
必须学习这些规则。
There's no way I can imagine that one can be born into the world with these rule sets intact.
我无法想象一个人降生到这个世界上时，这些规则是完好无损的。
I think about the two marshmallow experiment-
我想到了两个棉花糖实验——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
that's sort of famous now, where kids are offered to eat one marshmallow right away or-
现在有点出名了，孩子们可以立即吃一颗棉花糖，或者-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
defer and get two marshmallows.
推迟并得到两个棉花糖。
These adorable videos of the kids and the very strategies they use, like turning away-
这些孩子们的可爱视频以及他们使用的策略，比如转身走开——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
poking the marshmallow.
戳棉花糖。
And there's some debate ongoing as to whether or not success or lack of success in deferring to the two marshmallow reward is predictive of other things in life.
关于遵循两个棉花糖奖励的成功或不成功是否可以预示生活中的其他事情，目前存在一些争论。
But leaving that aside, am I correct in assuming that that task is a frontal lobe task?
但抛开这一点，我假设该任务是额叶任务是否正确？
The kids are given a novel rule.
孩子们被赋予了一条新颖的规则。
You can have one marshmallow now or wait patiently, and overcome the craving for that one marshmallow, and then you'll get two.
你现在可以吃一颗棉花糖，或者耐心等待，克服对一颗棉花糖的渴望，然后你就会得到两颗。
And presumably, that experiment is engaging the frontal lobes and we can only speculate, but some kids are able to defer, some are not.
据推测，该实验涉及额叶，我们只能推测，但有些孩子能够推迟，有些则不能。
And I can imagine that at that age, there's a lot of neuroplasticity, strengthening and weakening of connections in the brain in an experience-dependent way.
我可以想象，在那个年龄，有很多神经可塑性，大脑中的连接以依赖于经验的方式加强和减弱。
So does that mean that children, and perhaps adults as well, can train up their prefrontal cortical abilities to strategize and defer in a way that's adaptive?
那么，这是否意味着儿童，也许还有成年人，可以训练他们的前额皮质能力，以一种适应性的方式制定策略和推迟？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Absolutely.
绝对的。
Definitely you can learn strategies to not only sort of learn rules, but how to apply goals.
当然，您不仅可以学习策略来学习规则，还可以学习如何应用目标。
When you start to think about that task in particular, some of it has to do with sort of maintaining a goal, and maintaining a goal at different timescales.
当你开始特别考虑这项任务时，其中一些与维持目标以及在不同时间尺度维持目标有关。
And children tend to sort of act on goals that are much more on a shorter timescale.
孩子们倾向于在更短的时间内实现更多的目标。
I'm going to have this sandwich right now because I'm hungry, as opposed to wait till dinner, which is a longer-term goal.
我现在就吃这个三明治，因为我饿了，而不是等到晚餐，这是一个长期目标。
And so yeah, this default to sort of the short-- You can learn that maintaining a longer type goal can be much more beneficial than the short-term goal, even though it doesn't seem obvious.
所以，是的，这种默认的短期目标——你可以了解到，维持长期目标可能比短期目标更有益，尽管它看起来并不明显。
And we all learn that.
我们都知道这一点。
As we get older-
随着我们年龄的增长——
Andrew Huberman:
安德鲁·休伯曼：
Most of us.
我们大多数人。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
We keep our eye on the ball of sort of more long-term goals, and that's very predictive of how successful we can be, the farther out we can maintain a goal.
我们密切关注更长期的目标，这非常能预测我们能取得多大的成功，我们能保持目标越远。
And that's what the prefrontal cortex does.
这就是前额皮质的作用。
It maintains goals and then applies those goals.
它维护目标，然后应用这些目标。
And if you don't apply them, then all of this executive function breaks down.
如果你不应用它们，那么所有这些执行功能都会崩溃。
Andrew Huberman:
安德鲁·休伯曼：
Do you think that these algorithms and rules that the prefrontal cortical circuitry can learn, and indeed does learn, can generalize?
您认为前额皮质电路可以学习并且确实可以学习的这些算法和规则可以概括吗？
So for instance, my first year of college was a disaster, for reasons that aren't interesting right now.
举例来说，我的大学第一年是一场灾难，其原因现在并不有趣。
But then when I came back my sophomore year, really spring of my freshman year, I was like, "Okay, it's on." I had to rescue myself.
但当我大二那年回来时，实际上是大一的春天，我就想，“好吧，开始了。”我必须拯救自己。
And so one of the things I used to do was I would study, and I would set a timer, so I refused to get up, even if I had to use the restroom very badly.
所以我以前做的一件事就是我会学习，我会设置一个计时器，所以我拒绝起床，即使我不得不非常严重地使用洗手间。
I would set up all sorts of behavioral constraints And I like to think that I was building up my prefrontal ability to refocus on the material, and fortunately for me, there were no smartphones back then.
我会设置各种行为限制，我喜欢认为我正在增强我的前额叶能力，以重新专注于材料，对我来说幸运的是，当时没有智能手机。
It was much easier.
这要容易得多。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
The internet.
互联网。
Now we had email-
现在我们有了电子邮件-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
but no real internet browsing to speak of.
但没有真正的互联网浏览可言。
And I like to think that the, I sometimes call it, and this is terrible to call it this because it's not nearly exhaustive of the underlying function, but I call it sort of like limbic friction.
我喜欢认为，我有时会这样称呼它，这样称呼它很糟糕，因为它几乎没有详尽地描述底层功能，但我称它有点像边缘摩擦。
It's like there's this friction that one feels mentally like you want to get up, you want to use the restroom, you want to eat something, you want to call a friend, but you stay focused on the task at hand.
就好像有一种摩擦，让人在精神上感觉你想起床，你想上厕所，你想吃点东西，你想给朋友打电话，但你仍然专注于手头的任务。
Do you think that that business of, quote-unquote, "staying focused on the task at hand" can generalize because of the sensations it generates in the body, and then you go, "Oh, yeah, this is familiar.
你是否认为“专注于手头的任务”这句话可以概括，因为它在身体中产生的感觉，然后你会说，“哦，是的，这很熟悉。
This is just like studying," but in a different context, one stays focused?
这就像学习一样”，但在不同的环境下，人们还能保持专注吗？
Or do you think that the prefrontal cortex is so context-specific that it needs to learn the rules for every individual situation?
或者您是否认为前额叶皮层的环境特定性如此之高，以至于它需要学习每种情况的规则？
And then this has all sorts of implications for behavioral restraint and focus, and attention deficit.
这会对行为克制、注意力集中以及注意力缺陷产生各种影响。
So, if you could just speculate.
所以，如果你能推测的话。
I know a number of people-
我认识很多人——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, no
是的，不
Andrew Huberman:
安德鲁·休伯曼：
...
...
are interested in how they can be more focused, and people often defer to, "What supplement?
对如何才能更加专注感兴趣，人们经常会问：“什么补充品？
What drug?" Okay, those are interesting conversations, but I think ultimately, we're talking about neural circuitry.
什么药？”好吧，这些都是有趣的对话，但我认为最终我们讨论的是神经回路。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, it absolutely can generalize.
是的，它绝对可以概括。
That's been a frustrating thing, and of trying to develop what we call cognitive therapy, where we try to improve someone's memory ability, or we try to improve someone's executive function ability.
这是一件令人沮丧的事情，试图开发我们所谓的认知疗法，我们试图提高某人的记忆能力，或者我们试图提高某人的执行功能。
The disappointing early results was always that, yeah, they get very good at the task that you've trained them at, but it doesn't seem to generalize to anything else.
令人失望的早期结果总是，是的，他们非常擅长你训练他们完成的任务，但这似乎并不能推广到其他任何事情。
So if you teach them a task, they can do amazing things like match a finger to a color, to a shape, and put together all sorts of rules.
因此，如果你教他们一项任务，他们可以做出令人惊奇的事情，例如将手指与颜色、形状相匹配，并将各种规则组合在一起。
And they're really good at that task very quickly, and then nothing's really changed in their real life.
他们很快就擅长这项任务，然后他们的现实生活就没有真正改变。
But I think we've learned on how to try and make it translate to real life.
但我认为我们已经学会了如何尝试将其转化为现实生活。
And so for example, there's a therapy called goal management training, which is developed by Brian Levine and colleagues at the Rotman Research Institute, Toronto, where they've been very successful in teaching patients how to improve your executive function, and how to make that translate into your real world.
例如，有一种名为“目标管理训练”的疗法，由多伦多罗特曼研究所的布赖恩·莱文（Brian Levine）及其同事开发，他们在教导患者如何提高执行功能以及如何将其转化为现实世界方面非常成功。
But it's very hard work.
但这是非常辛苦的工作。
It's very therapist-driven.
这是非常由治疗师驱动的。
It requires a series of trainings.
这需要一系列的训练。
For example, people develop individual projects like planning a meal, or planning a family vacation, or planning a podcast, and then they work through what's involved in that sort of very specific project.
例如，人们开发个人项目，例如计划一顿饭、计划一次家庭度假或计划一个播客，然后他们完成此类非常具体的项目所涉及的内容。
How you stay focused, how you don't just get distracted, how you keep your eye on the ball, how you break it down to sub-goals, how you monitor what you're doing, how you don't let anxiety and procrastination get involved.
如何保持专注，如何不分心，如何保持注意力集中，如何将其分解为子目标，如何监控自己正在做的事情，如何不让焦虑和拖延卷入其中。
But it's a very active sort of process.
但这是一个非常活跃的过程。
But when you add all that to it in a very disciplined way over the course of many hours, many weeks, it does translate.
但当你在数小时、数周的时间内以一种非常有纪律的方式将所有这些添加到其中时，它确实会转化。
Patients and individuals just say, "Yeah, I'm just better at doing things." The whole goal is to do things, right?
患者和个人只是说：“是的，我只是更擅长做事。”整个目标就是做事，对吧？
"And I'm just better at it.
“而且我只是更擅长而已。
I don't know what it is, but I'm not just better at what you taught me, I'm just better at other things." So I do have a lot of hope that these kind of therapies will generalize to people's real life.
我不知道那是什么，但我不只是在你教我的事情上做得更好，我只是在其他事情上做得更好。”所以我确实非常希望这些疗法能够推广到人们的现实生活中。
Andrew Huberman:
安德鲁·休伯曼：
I threw out the term limbic friction.
我抛弃了边缘摩擦这个词。
Again, not a technical or clinical or official term in any way, but just a way to kind of capture some of the interactions of the frontal cortex with other circuitry.
再说一遍，无论如何，这都不是一个技术、临床或官方术语，而只是一种捕捉额叶皮层与其他电路相互作用的方法。
There's far more involved in agitation and challenges focusing than the limbic system, but it certainly is involved.
与边缘系统相比，激动和注意力集中的挑战更多地涉及到，但它确实参与其中。
When thinking about the frontal cortex, I often think about its connections with other areas of the brain, so maybe we could talk a little bit about those connections, and in particular, the connections from the frontal cortex to, let's call it, circuitry that controls reflexive behaviors.
当思考额叶皮层时，我经常想到它与大脑其他区域的连接，所以也许我们可以谈谈这些连接，特别是从额叶皮层到控制反射行为的电路的连接。
What is the nature of that circuitry, and can we make any general statements, like does the frontal cortex really serve to provide a quieting, suppressive function on reflexes, or is it more of an orchestra conductor where it's saying, "Okay, a little bit of that and a little bit of that." And then what comes out in behavior or speech is something that looks very organized, but is actually the reflection of a lot of selective filtering.
该电路的本质是什么，我们能否做出任何一般性的陈述，比如额叶皮层是否真的可以提供安静、抑制反射的功能，或者它更像是一个管弦乐队指挥，它会说：“好吧，一点点，一点点。”然后，行为或言语中出现的东西看起来很有组织性，但实际上是大量选择性过滤的反映。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yes.
是的。
The prefrontal cortex, what's so fascinating about it is that I would say it connects to every part of the brain, cortex, and the subcortex, and almost every part of the brain connects to it.
前额叶皮层，它的迷人之处在于，我想说它连接到大脑的每个部分、皮层和皮层下层，并且几乎大脑的每个部分都与其连接。
So that right there tells you it's a pretty important area.
所以这告诉你这是一个非常重要的领域。
And it has to if it's going to be in this CEO, conductor type experience role.
如果要担任首席执行官、指挥类型的经验角色，就必须这样做。
And so it's in this privileged position just anatomically, so that gives us great insight to how important it is.
因此，从解剖学上来说，它处于这个优越的位置，这让我们深刻地认识到它的重要性。
And so it is connecting.
所以它正在连接。
And then, of course, we could talk about how it's connected to the body as well, how it controls heart rate and respirations as well.
当然，我们还可以讨论它如何与身体连接，如何控制心率和呼吸。
So it's not just the brain.
所以这不仅仅是大脑。
But it's really interesting.
但这真的很有趣。
Like you said, is it really just sort of maintaining, telling you what's relevant and what's not relevant, or is it allowing you to switch?
就像你说的，它真的只是一种维护，告诉你什么是相关的，什么是不相关的，还是它允许你进行切换？
I think it does all those things.
我认为它可以做所有这些事情。
It definitely what we call sends these top-down signals.
它绝对是我们所说的发送这些自上而下的信号。
It's sending signals to the other brain about what you should be paying attention to and what you shouldn't be paying attention to.
它向另一个大脑发送关于你应该注意什么和你不应该注意什么的信号。
So, for example, we've done studies with functional imaging where we have them look at pictures of faces and scenes, and that lights up the back of your brain.
例如，我们进行了功能成像研究，让他们观察面部和场景的图片，这会照亮你的大脑后部。
Your visual cortex has areas that can process faces and process scenes.
您的视觉皮层具有可以处理面孔和处理场景的区域。
But sometimes we have you just want to pay attention to the faces and not the scenes, and other times we want you to pay attention to the scenes and not the faces.
但有时我们让你只想注意面孔而不是场景，而有时我们希望你注意场景而不是面孔。
Well, even though it's getting the same bottom-up visual input, the prefrontal cortex will show greater activity to the relevant information.
好吧，即使它获得相同的自下而上的视觉输入，前额叶皮层也会对相关信息表现出更大的活动。
It's sending a signal to say, "Pay attention to the faces, ignore the scenes," or vice versa.
它发出一个信号：“注意面孔，忽略场景”，反之亦然。
So it's directing all of this information that we're bombarded with to what's relevant.
因此，它将我们收到的所有这些信息引导到相关的内容上。
But at the same time, it's also allowing us to switch.
但与此同时，它也让我们能够进行转换。
If we now have to go switch to another task, it says, "Okay, this is not important now.
如果我们现在必须切换到另一项任务，它会说：“好吧，现在这并不重要。
We're going to move over to this other task." So there's many different components of how it can kind of control behavior, but it does all of these things in this incredible way that we still don't completely understand, but we know that the source of all of this control is coming from the prefrontal cortex.
我们将转向另一项任务。”因此，它如何控制行为有很多不同的组成部分，但它以一种令人难以置信的方式完成所有这些事情，我们仍然没有完全理解，但我们知道所有这些控制的来源都来自前额叶皮层。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned connections between the prefrontal cortex and the body.
您提到了前额叶皮层和身体之间的联系。
That's the first I've heard of that, and I'm not challenging that.
这是我第一次听说这一点，我不会对此提出质疑。
To the contrary, I'm just intrigued by it.
相反，我只是对此感兴趣。
I'm aware that the hypothalamus and some of these deeper brain structures associated with more, let's call them primitive drives, temperature regulation, hunger, et cetera, connect to the body.
我知道下丘脑和一些更深层的大脑结构与身体有更多的联系，我们称之为原始驱动力、温度调节、饥饿等等。
But what's the nature of some of the connections with the frontal lobes to the body?
但是额叶与身体之间的一些联系的本质是什么？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I was just sort of talking in terms of our knowledge of how changing-- In one of your podcasts, you talked about how TMS to the prefrontal cortex can slow heart rate.
是的，我只是在谈论我们对如何变化的了解——在您的一个播客中，您谈到了前额皮质的 TMS 如何减慢心率。
So I meant in that sort of way.
所以我的意思是这样的。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
That by influencing cortical function, obviously we can influence organs.
通过影响皮质功能，显然我们可以影响器官。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
So through some intermediate stations.
所以要经过一些中间站。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Not to be hyperbolic, but it seems like the prefrontal cortex, here we're referring to as the frontal lobes, are essentially the seat of what makes us human and what makes us functional or dysfunctional in a given context.
并不是夸张，但看起来前额叶皮层（这里我们称之为额叶）本质上是使我们成为人类以及使我们在特定环境下发挥功能或功能障碍的所在地。
Right?
正确的？
I recall there's a syndrome, Kluver-Bucy syndrome, which has some vague similarities to how you describe frontal cortex damage.
我记得有一种综合症，克鲁弗-布西综合症，它与您描述的额叶皮层损伤有一些模糊的相似之处。
But there, as I recall, humans or animals with that syndrome will act in a way that's not appropriate to context, but more inappropriate.
但据我记得，患有这种综合症的人类或动物的行为方式与背景不符，甚至更不恰当。
Like they'll try and eat a ceramic cup or draw with a piece of paper, which obviously won't work.
就像他们会尝试吃陶瓷杯或用一张纸画画一样，这显然是行不通的。
It seems like with the frontal cortex, it knows that a pen is for writing, the person might say, "Yeah, I know I'm not supposed to write this, or write with it, but I'm going to take your pen and write something inappropriate with it." But it's not that the people forget that it's a pen.
似乎额叶皮层知道笔是用来写字的，这个人可能会说，“是的，我知道我不应该写这个，或者用它写，但我会拿走你的笔，用它写一些不合适的东西。”但这并不是人们忘记了它是一支笔。
So it seems like it's drawing on rule sets, but that something's intact.
所以看起来它是在借鉴规则集，但有些东西是完整的。
It's not like Kluver-Bucy syndrome where animals and people can try and mate with inanimate objects, which is one of the more salient symptoms.
它不像克鲁弗-布西综合症，动物和人可以尝试与无生命的物体交配，这是更显着的症状之一。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
I'll never forget that.
我永远不会忘记这一点。
Never forget that from my cognitive neuroscience course, which you taught, by the way.
顺便说一句，永远不要忘记你教的我的认知神经科学课程中的这一点。
Just throw that in there.
只要把它扔进去就可以了。
So, how should we think about this?
那么，我们应该如何思考这个问题呢？
And here I'm trying to get at a kind of a broader understanding of brain function and context-specific behavior.
在这里，我试图对大脑功能和特定环境的行为有更广泛的理解。
So frontal cortex is super sophisticated, but it doesn't have all the information, right?
所以额叶皮层非常复杂，但它并不拥有所有信息，对吗？
It seems like someone without a frontal cortex probably knows that you write with a pen, you don't write with a piece of paper.
似乎没有额叶皮层的人可能知道你用笔写字，而不是用纸写字。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
We think about it as the frontal cortex allows us to take thought and move it towards action, and there's this disconnect between the knowledge and action, and the separation of action from knowledge.
我们认为，额叶皮层使我们能够思考并将其转化为行动，而知识和行动之间存在脱节，行动与知识是分离的。
And I guess I can reflect on my patients.
我想我可以反思我的病人。
I've seen a lot of patients with damage all over the brain, and all of the families of patients who have frontal lobe injury always say the same thing.
我见过很多全脑损伤的患者，所有额叶损伤患者的家属总是说同样的话。
They're just no longer that person.
他们只是不再是那个人了。
They're no longer my spouse.
他们不再是我的配偶了。
They're no longer my best friend.
他们不再是我最好的朋友了。
They're no longer my father.
他们不再是我的父亲了。
They can't put it into words, but they're not them anymore.
他们无法用言语表达，但他们不再是他们了。
Something has changed.
有些事情发生了变化。
Whereas if you talk to a patient with Broca's aphasia who has this inability to speak, they can't get any words out, this is a devastating problem, they're still the same person.
然而，如果你与布罗卡失语症患者交谈，他无法说话，他们无法说出任何话，这是一个毁灭性的问题，他们仍然是同一个人。
Their personality hasn't changed.
他们的性格没有改变。
They feel the same person.
他们感觉是同一个人。
They just can't speak.
他们只是不会说话。
The way they get around in the world is different.
他们在世界上的生活方式是不同的。
Or if you take a patient with prosopagnosia, which is this inability to recognize faces, of course, the way they navigate around the world is difficult, and it's not the same, but they're still the same person.
或者，如果你有一个患有面部失认症的患者，即无法识别面孔，当然，他们在世界各地的导航方式很困难，而且不一样，但他们仍然是同一个人。
So there's something really special about the frontal cortex that allows us to be, as you said, sort of who we are.
因此，额叶皮层有一些非常特别的东西，正如你所说，它使我们能够成为我们自己。
And that's the difficult part.
这就是困难的部分。
How does the frontal lobes allow us to sort of take who we are and translate that into knowledge?
额叶如何让我们了解自己并将其转化为知识？
I guess another way of saying it, just having knowledge isn't what makes us who we are, right?
我想换一种说法，仅仅拥有知识并不能让我们成为我们自己，对吗？
It's to be able to take that knowledge and present it in a way that allows us to live life based on our intentions and our goals and our desires.
它能够获取这些知识，并以一种让我们能够根据我们的意图、目标和愿望来生活的方式呈现它。
Andrew Huberman:
安德鲁·休伯曼：
So much of things like stoic philosophy and even online wellness culture are about having routines, overcoming reflex by just having recipes, scripts to follow each day.
像坚忍哲学甚至在线健康文化这样的很多东西都是关于有规律的，通过每天遵循的食谱、脚本来克服条件反射。
I certainly try to have my mornings be as, what I call, linear as possible.
我当然会尽量让我的早晨尽可能地线性。
And I find it's much easier in the earlier part of the day to just decide, here's what I'm going to do, write out a list, do things in a certain sequence.
我发现在一天的早些时候做出决定要容易得多，这就是我要做的事情，写下一个清单，按一定的顺序做事。
If I don't do that, I go nonlinear, as I refer to it, and will get distracted and things of that sort.
如果我不这样做，我就会变得非线性，正如我所说的那样，并且会分心以及诸如此类的事情。
But earlier you mentioned sleep deprivation can impair frontal lobe function.
但您之前提到睡眠不足会损害额叶功能。
It does seem that as the day progresses, and certainly in the middle of the night, it just becomes much harder to control our thinking, maybe even our behavior.
似乎随着时间的推移，尤其是在半夜，控制我们的思维甚至行为变得更加困难。
And certainly our emotions.
当然还有我们的情感。
Is there a frontal lobe regulation of emotional states as well?
额叶也对情绪状态有调节作用吗？
I know you have some recent work on this, so I'd love to hear more.
我知道您最近在这方面做了一些工作，所以我很想听听更多。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
As I was saying earlier, the frontal lobes is a big place, and half of it is involved in these high-level executive functions, but the other half of it is part of the limbic system, or we call it the paralimbic system, that's involved in social and emotional behavior.
正如我之前所说，额叶是一个很大的地方，它的一半涉及这些高级执行功能，但另一半是边缘系统的一部分，或者我们称之为副边缘系统，涉及社会和情感行为。
And so, there's this intimate back and forth between these two areas of the cortex.
因此，这两个皮质区域之间存在着这种亲密的来回联系。
If you have just damage to these areas that are kind of in the overall frontal lobe, you will have many different impairments that we would call sort of social or emotional impairments, and their executive function will be quite normal.
如果你只是对整个额叶中的这些区域造成了损害，你就会有许多不同的障碍，我们称之为社交或情感障碍，而它们的执行功能将是相当正常的。
And then you'll have the opposite where patients with the lateral damage will have executive functions, but they seem emotionally intact.
然后你会得到相反的结果，横向损伤的患者将具有执行功能，但他们的情感似乎完好无损。
But in real life when we have both these intact, they're communicating with each other.
但在现实生活中，当我们两者都完好无损时，它们就会相互交流。
So right emotion and context is going to influence our executive function.
因此，正确的情绪和环境将影响我们的执行功能。
We make bad decisions in stressful situations or situations we're not comfortable with.
我们在有压力的情况下或在我们不舒服的情况下做出错误的决定。
It's where we might make a better decision if it's a quiet place.
如果这是一个安静的地方，我们可能会做出更好的决定。
But it is something that we can, I think you're right, you can sort of get into a routine and learn how to do things if you have them very much planned out.
但这是我们可以做到的，我认为你是对的，如果你有很好的计划，你可以进入常规并学习如何做事情。
But what's so unique about us is how we can be flexible and adaptable, right?
但我们的独特之处在于我们如何灵活和适应，对吗？
When something novel comes up or there's something unexpected comes up, we can adapt to it.
当出现新奇的事情或意想不到的事情时，我们可以适应它。
And that's really what the frontal cortex is really important for, not just sort of making these plans, routines, and setting all the rules, but being able, when things don't go right, how to right the ship, right?
这确实是额叶皮层真正重要的作用，不仅仅是制定这些计划、例行公事和制定所有规则，而且能够在事情进展不顺利时如何纠正错误，对吗？
Andrew Huberman:
安德鲁·休伯曼：
I will never ask you to demonize technology.
我永远不会要求你妖魔化技术。
I certainly use a smartphone from waking till sleep, generally not in the middle of the night if I can avoid it, and I generally avoid it.
我当然从起床到睡觉都使用智能手机，如果可以避免的话，通常不会在半夜使用，而且我通常会避免使用它。
But I'm trying to take what we've discussed thus far and superimpose the notion of smartphones and ask, what are the rules?
但我试图将我们迄今为止所讨论的内容与智能手机的概念相结合，并问，规则是什么？
What are the algorithms that we're learning when we use these devices?
当我们使用这些设备时，我们正在学习哪些算法？
And I'm not calling them adaptive or maladaptive.
我并不是说它们是适应性的或适应不良的。
They're clearly here to stay.
他们显然会留下来。
They've assisted in medicine.
他们在医学上提供了帮助。
I'm sure it makes it easier for doctors to communicate on the ward and for clinic and it's so useful, right?
我确信它使医生在病房和诊所的沟通更加容易，而且非常有用，对吗？
But contained in this small device, there are things like, for instance, text messaging where unlike 20 years ago, we can have four or five different conversations very quickly while boarding a flight.
但这个小型设备中包含诸如短信之类的功能，与 20 年前不同，我们在登机时可以很快进行四到五个不同的对话。
There's a task-switching element that was just not present in our life prior to that.
在此之前，我们的生活中并不存在任务切换的元素。
Social media in particular, this notion of being able to scroll, so if we really step back from this, move one's thumb and access hundreds if not thousands of video content, each of which has a distinct context.
特别是社交媒体，这种能够滚动的概念，所以如果我们真的退后一步，移动拇指并访问数百甚至数千个视频内容，每个视频内容都有不同的上下文。
And so I have to imagine that kids and adults have frontal cortices that are learning these rules, and the rule is move your thumbs, stay engaged, emotions, either positive valence emotions or negative emotions.
所以我必须想象孩子和成人的额叶皮质正在学习这些规则，而规则就是移动你的拇指，保持专注，情绪，要么是积极的情绪，要么是消极的情绪。
I mean, it's a fairly limited landscape there when you really think about it.
我的意思是，当你认真思考时，那里的风景相当有限。
But the algorithm that's learned, to me, doesn't seem exportable.
但对我来说，学到的算法似乎无法导出。
It doesn't help me prepare for a podcast at all.
它根本无法帮助我准备播客。
I know that for sure.
我肯定知道这一点。
It doesn't help me go for a run, doesn't help me listen with more focused attention to a family member or a friend or a significant other.
它不能帮助我去跑步，不能帮助我更集中地倾听家人、朋友或重要的其他人。
It may make me more empathic or more angry.
它可能会让我更加同情或更愤怒。
We can speculate, but again, with no intention of demonizing social media, does it seem that the algorithms that are being run in our brain, I mean, are they neutral?
我们可以推测，但同样，无意妖魔化社交媒体，我的意思是，我们大脑中运行的算法似乎是中立的吗？
Are they positive?
他们积极吗？
Are they negative?
他们是消极的吗？
Should we be worried?
我们应该担心吗？
It doesn't seem like they translate to much else.
它们似乎并没有转化为其他东西。
I can't see a way in which they help us be better people in other domains.
我看不出它们可以如何帮助我们在其他领域成为更好的人。
Whereas reading a book line by line and then going back, "Oh, I didn't even remember anything from that page," going back line by line, playing a game of squash or something like that, I can see the real value of the rule sets that generalize.
逐行阅读一本书，然后回过头来看，“哦，我什至不记得那一页上的任何内容”，逐行回看，玩壁球游戏或类似的游戏，我可以看到泛化规则集的真正价值。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, just historically, I grew up in a world when there was no smartphones as a resident, and so one of the most difficult things I do in practice is have to take care of patients in the emergency room, and there's a real emergency.
是的，从历史上看，我是在一个没有智能手机的世界里长大的，所以我在实践中做的最困难的事情之一就是必须在急诊室照顾病人，而且确实有紧急情况。
Someone's having uncontrolled seizures, or they're having a stroke, and doing this back in the '80s or '90s and early 2000s when you went down there and you didn't have any smartphone, you could only rely on what's in your head.
有人癫痫发作不受控制，或者中风了，在 80 年代或 90 年代以及 2000 年代初，当你去那里时，你没有任何智能手机，你只能依靠你脑子里的东西。
And I could say now, having the smartphone, it doesn't help me at all.
我现在可以说，拥有智能手机对我来说根本没有帮助。
It does not help me at all in making the kind of decisions that I have to make in the emergency room.
它对我在急诊室必须做出的决定毫无帮助。
I'm trying to decide what's the problem here, what's the differential diagnosis?
我想确定这里的问题是什么，鉴别诊断是什么？
How should I treat it?
我该如何治疗？
I'm just trying to going through an algorithm, like you said, in a common sense way, and there's nothing on my phone that I can turn to, to help me do that.
我只是想通过一种算法，就像你说的，以常识的方式，而我的手机上没有任何东西可以帮助我做到这一点。
It has helped with giving me knowledge.
它帮助我获得了知识。
Back in the day, I had to remember what the Dilantin dose was and have that in my head or go look for the piece of paper in my pocket and so I can quickly pull up.
以前，我必须记住狄兰汀的剂量是什么，并将其记在脑子里，或者去口袋里寻找那张纸，这样我就可以快速拉起来。
There's information that I can access that I don't have to worry about keeping every single dose in my head or keeping everything in my head, just facts in my head.
我可以获取一些信息，我不必担心将每一剂药物都记在我的脑海中，或者将所有的事情都记在我的脑海中，而只是将事实记在我的脑海中。
But outside of that, there's nothing I can turn to that it's making me make better decisions.
但除此之外，没有什么可以帮助我做出更好的决定。
So I don't even need my cell phone.
所以我什至不需要我的手机。
I don't go searching for my cell phone if I'm going to go to the emergency room or I'm going to take a phone call.
如果我要去急诊室或接电话，我不会去寻找手机。
So I don't see how it's helping sort of make your frontal lo-- It can't be your frontal lobes.
所以我不明白它如何帮助你的额叶——它不可能是你的额叶。
I mean, it's another way of saying it.
我的意思是，这是另一种说法。
But on the flip side, can it help you optimize frontal lobe function technologies?
但另一方面，它可以帮助您优化额叶功能技术吗？
Certainly it can.
当然可以。
We can maybe talk about it later.
我们也许可以稍后再讨论。
That's one way to learn strategies is through a device that's easily accessible to you as opposed to a book or having a therapist in your house.
学习策略的一种方法是通过您可以轻松访问的设备，而不是通过书籍或在家中请治疗师。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I suppose I worry that too much of my time and other people's time, and especially young people's time, is engaging in an algorithm that does not And generalize for adaptive behavior elsewhere.
是的，我想我担心我和其他人的太多时间，尤其是年轻人的时间，都花在了一种算法上，而这种算法不能概括其他地方的适应性行为。
And by comparison, like a game of soccer with friends or something, right?
相比之下，就像和朋友一起踢足球什么的，对吧？
It's social.
这是社交的。
Social media is social.
社交媒体是社交的。
It's physical.
这是身体上的。
Social media is not physical, but we'll rule that portion out.
社交媒体不是实体的，但我们会排除这一部分。
But there's a rule set.
但有一个规则。
There's goal-directed behavior.
有目标导向的行为。
Presumably, some of the things that happen in a game of soccer with friends translate to some other domain of life because it's a single context, game of soccer.
据推测，与朋友一起踢足球时发生的一些事情可能会转化为生活的其他领域，因为这是单一的背景，即足球比赛。
Whereas with social media, I don't know anybody that goes and looks at one account and that's it, and absorbs the information, maybe comments, has an interaction, and goes.
而在社交媒体上，我不知道有谁会查看一个帐户，然后吸收信息，也许是评论，进行互动，然后就离开了。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
It's hundreds or thousands of contexts.
它有数百或数千个上下文。
So is there any risk or perhaps benefit to being able to get this very detailed portal into so many contexts per unit time?
那么，能够在单位时间内将这个非常详细的门户引入如此多的上下文中，是否存在任何风险或可能有好处呢？
I mean, the forebrain's never had done that in the course of human history, as far as I know.
我的意思是，据我所知，在人类历史进程中，前脑从未这样做过。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I think there is a risk, but what pops to mind, having kids, is watching them navigate in their cars to places totally dependent on Google Maps.
是的，我认为存在风险，但我想到的是，有了孩子，看着他们开车前往完全依赖谷歌地图的地方。
I think you're probably old enough to remember real maps where you didn't have-
我想你可能已经足够大了，能够记住你没有的真实地图——
Andrew Huberman:
安德鲁·休伯曼：
I still have one in my car.
我的车里还留着一个。
I love paper maps.
我喜欢纸质地图。
I love maps.
我喜欢地图。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right, where you had to really figure out, you had to go to a certain place, and you had to either look at the map or stop at a gas station and ask the-- These skills were something that you learned, and you developed, and it was problem-solving, and that's all gone now.
是的，你必须真正弄清楚，你必须去某个地方，你必须要么看地图，要么在加油站停下来问——这些技能是你学到的，你发展的，它是解决问题的，但现在一切都消失了。
I wonder even if sometimes if people even know the direction they're going, whether it's west, north, or what town they're in because they're just following the directions.
我想知道有时人们是否知道他们要去的方向，无论是向西，向北，还是他们在哪个城镇，因为他们只是遵循指示。
So, we'll see.
那么，我们拭目以待。
I just can't imagine that that learned skill is not going to be detrimental to us at some point, and generalize in a bad way, right?
我只是无法想象学到的技能在某些时候不会对我们有害，并且会以不好的方式概括，对吧？
As opposed to a good way.
而不是一个好的方法。
So yeah, it does definitely worry me.
所以是的，这确实让我担心。
But like you said, there's nothing on the phone that helps you plan a podcast, nothing that helps me in the emergency room, nothing helps a professor when he's giving a lecture.
但就像你说的，电话上没有任何东西可以帮助你计划播客，没有任何东西可以帮助我在急诊室，没有任何东西可以帮助教授在演讲时。
So, I agree with you that the sort of having your head buried in a cellphone, I don't see it being healthy for your frontal lobes.
所以，我同意你的观点，即把头埋在手机里，我认为这对你的额叶不健康。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Let's talk about working memory.
我们来谈谈工作记忆。
Some years back, but still now, you use working memory tasks and experiments in your laboratory.
几年前，但现在，您仍然在实验室中使用工作记忆任务和实验。
If you would be so kind as to explain what working memory is, and then I'd love to talk about some of the work you've done exploring the role of dopamine in working memory, because this is so critical to everyday life.
如果您愿意解释什么是工作记忆，那么我很乐意谈谈您在探索多巴胺在工作记忆中的作用方面所做的一些工作，因为这对日常生活至关重要。
And I know dopamine's a bit of a buzzword these days, but the listeners of this podcast, anyway, are pretty sophisticated in terms of knowing that dopamine is not just about reward, it's about motivation and goal-directed behavior.
我知道多巴胺现在有点流行，但无论如何，这个播客的听众都相当老练，他们知道多巴胺不仅仅是奖励，它还与动机和目标导向的行为有关。
And I think dopamine intrigues for a good reason, that it does govern a lot of our quality of life.
我认为多巴胺引起人们的兴趣是有充分理由的，因为它确实在很大程度上影响着我们的生活质量。
So, what's working memory?
那么，什么是工作记忆？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, working memory, it's interesting.
是的，工作记忆，很有趣。
I started studying it about 30 years ago, and I don't think I realized how important it was when I started.
我大约 30 年前开始研究它，我认为当我开始时我并没有意识到它有多么重要。
But what we mean by working memory is this ability to hold information in mind when it's no longer accessible to us.
但我们所说的工作记忆是指当我们无法获取信息时将其牢记在心的能力。
So if you tell me your telephone number and I have to put it into my phone, it's no longer there, you just told me, but I'll hold it in my working memory until I can punch it into my phone.
因此，如果你告诉我你的电话号码，而我必须将其放入手机中，那么它就不再存在了，你只是告诉了我，但我会将其保留在我的工作记忆中，直到我可以将其输入手机中。
It doesn't have to be something that comes from the outside world.
它不一定是来自外部世界的东西。
If I'm filling out a form and I want to pull up my Social Security number, I can hold that in mind, too, until I put it down.
如果我在填写表格时想要调出我的社会安全号码，我也可以牢记这一点，直到我把它写下来。
So, when you think about it, it's a very important ability that we have that we do very flawlessly.
所以，当你想一想，这是我们拥有的一项非常重要的能力，我们做得非常完美。
And what I've learned more about working memory is the working part of it.
我对工作记忆的更多了解是它的工作部分。
It's not just this passive holding information in mind, but it's being able to do things with the information.
这不仅仅是被动地记住信息，而是能够利用这些信息做事。
It's being able to, when we do a math problem, which we don't do that much now that we have calculators, but if you do that in your head, you're able to sort of manipulate the information and do the different parts of the problem.
当我们做数学题时，它是能够做到的，现在我们有了计算器，我们就不再做那么多了，但如果你在头脑中这样做，你就能够操纵信息并完成问题的不同部分。
Or even if you're trying to find someone in a crowd and you're holding onto some face, you're able to hold that face in mind and cross-check it and search.
或者，即使您试图在人群中找到某个人，并且您抓住了某张脸，您也可以记住那张脸并进行交叉检查和搜索。
And so there's operations to working memory.
因此，需要对工作记忆进行操作。
It's not just this passive maintenance.
这不仅仅是这种被动维护。
So when we started to think about working memory in that way, we started to realize how important it is for, I think of it as the foundation for cognition.
因此，当我们开始以这种方式思考工作记忆时，我们开始意识到它的重要性，我认为它是认知的基础。
Just think about reading comprehension.
只要考虑一下阅读理解就可以了。
You can't understand this conversation if you can't hold in mind what's going on earlier in the conversation, or when you're reading a book, remembering the sentence before it.
如果你不能记住对话前面发生的事情，或者当你在读书时，记住前面的句子，你就无法理解这次对话。
So it just predicts all these abilities that allows us to read, to plan, to organize, and all the sort of executive functions that we're doing, right?
所以它只是预测了所有这些使我们能够阅读、计划、组织以及我们正在执行的执行功能的能力，对吗？
We have to hold in mind rules, we have to hold in mind goals, we have to hold in mind all of these things in order to just carry out behavior.
我们必须牢记规则，我们必须牢记目标，我们必须牢记所有这些事情，以便执行行为。
So it's really come a long way in terms of how people are thinking about it.
因此，就人们的思考方式而言，它确实取得了很大的进步。
I know that Matt Walker said that sleep is our superpower, but I guess one way to sort of use his term, while we're awake, working memory is really our superpower because it allows us to translate, as we said, sort of our knowledge into action by holding this information in mind as we're thinking about what we want to do.
我知道马特·沃克说睡眠是我们的超能力，但我想用他这个词的一种方式来说，当我们醒着的时候，工作记忆确实是我们的超能力，因为正如我们所说，它使我们能够在思考我们想做的事情时牢记这些信息，从而将我们的知识转化为行动。
Andrew Huberman:
安德鲁·休伯曼：
If we're going to think about dopamine in the context of working memory, is dopamine an accelerator on working memory?
如果我们要在工作记忆的背景下考虑多巴胺，那么多巴胺是工作记忆的加速器吗？
Is it a facilitator?
它是一个促进者吗？
What is dopamine doing for working memory?
多巴胺对工作记忆有什么作用？
And maybe we could talk a little bit about the circuitry.
也许我们可以谈谈电路。
I've talked about dopamine before on this podcast, but there's a good chance that some of the people listening to this haven't heard those episodes, so maybe we could just quickly review the three major circuits for dopamine and the one that's relevant for working memory.
我之前在这个播客上谈到过多巴胺，但是很可能有些听这个的人没有听过这些剧集，所以也许我们可以快速回顾一下多巴胺的三个主要回路以及与工作记忆相关的回路。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
And let me start with the circuitry for working memory because one of the Important things about working memory is the other type of memory is long-term memory.
让我从工作记忆的电路开始，因为关于工作记忆的重要事情之一是另一种类型的记忆是长期记忆。
Working memory is short-lived.
工作记忆是短暂的。
It's only as long as you're able to rehearse it, and then it disappears, whereas what we call long-term memory, remembering what you had for breakfast or your vacation, this is information that gets consolidated and gets put into a more durable form that we call long-term memory.
只要你能够排练它，它就会消失，而我们所说的长期记忆，记住你早餐或假期吃的东西，这些信息会得到巩固并被放入更持久的形式，我们称之为长期记忆。
And the interesting thing about memory is that these are separate systems.
关于内存的有趣之处在于它们是独立的系统。
Everything from working memory just doesn't pass into long-term memory.
工作记忆中的所有内容都不会进入长期记忆。
They're two completely different systems and two completely different parts of the brain that seem to control it.
它们是两个完全不同的系统，也是大脑中控制它的两个完全不同的部分。
So working memory, the frontal cortex seems to be very important for working memory.
所以工作记忆，额叶皮层似乎对工作记忆非常重要。
When we are holding information in line, the neurons, the brain cells in the frontal lobes are active, and they stay kind of active as long as we're holding on to that information.
当我们保持信息一致时，额叶中的神经元和脑细胞就会活跃，并且只要我们保留该信息，它们就会保持活跃状态。
And they're more active when the information is relevant.
当信息相关时，他们会更加活跃。
And if we get distracted, they'll get less active.
如果我们分心，他们就会变得不那么活跃。
So the frontal lobes track the memory that you're holding in mind.
所以额叶会追踪你脑海中的记忆。
Another important thing about the circuitry is that if we're holding in mind, say, digits, the phone number, well, that information's in your back of the brain.
关于电路的另一个重要的事情是，如果我们记住数字、电话号码，那么这些信息就在你的大脑后部。
And so the frontal lobes is sort of keeping information in the back of the brain active because it's connected to the visual areas.
因此，额叶可以使大脑后部的信息保持活跃，因为它与视觉区域相连。
It's able to sort of keep that information active.
它能够使该信息保持活跃。
And so what we've learned is that there's not these buffers in the brain where if you're holding verbal information, it's in this little buffer, and if you're holding visual information, it's in another buffer.
所以我们了解到，大脑中没有这些缓冲区，如果你保存口头信息，它就在这个小缓冲区中，如果你保存视觉信息，它就在另一个缓冲区中。
The whole brain acts as a buffer, and the frontal lobe can call up any part of the brain and keep that part of the brain active as it's trying to hold this information in line.
整个大脑充当缓冲器，额叶可以调用大脑的任何部分，并在试图保持这些信息一致时保持大脑的该部分活跃。
So the mechanism for working memory is just this persistent neural activity within the frontal lobes.
因此，工作记忆的机制就是额叶内这种持续的神经活动。
And so then the question is, what does dopamine do?
那么问题来了，多巴胺有什么作用？
Well, dopamine is one of the neuromodulators that are made in the brain stem, and it projects up to different parts of the brain.
嗯，多巴胺是脑干中产生的神经调节剂之一，它投射到大脑的不同部位。
There's a system that goes up into what we call the basal ganglia, which is important for motor function, and there's another dopaminergic system that goes up to the frontal lobes.
有一个系统上升到我们所说的基底神经节，这对运动功能很重要，还有另一个多巴胺能系统上升到额叶。
And what was discovered was that if you deplete dopamine, working memory drops.
人们发现，如果你耗尽多巴胺，工作记忆就会下降。
You get a significant impairment of working memory if you deplete dopamine, and if you replace it, then your working memory will be improved.
如果你耗尽多巴胺，你的工作记忆就会受到严重损害，如果你补充它，你的工作记忆就会得到改善。
And so dopamine seems to be a modulator to help this persistent activity stay persistent during the time that you need to keep this information in mind.
因此，多巴胺似乎是一种调节剂，可以帮助这种持久的活动在您需要记住这些信息的时间内保持持久。
Andrew Huberman:
安德鲁·休伯曼：
Am I reaching too far to draw an analogy between dopamine's role in working memory, that is, to keep information online, and the other established role of dopamine, which is for movement, for the generation of smooth movement, as evidenced by conditions like Parkinson's, where people lack dopaminergic neurons or have damage to dopaminergic neurons and have challenges in generating smooth movement?
我是否太过分了，无法将多巴胺在工作记忆中的作用（即保持信息在线）与多巴胺的另一个既定作用（即用于运动、产生平滑运动）进行类比，如帕金森氏症等疾病所证明的那样，在帕金森病中，人们缺乏多巴胺能神经元或多巴胺能神经元受损，并且在产生平滑运动方面面临挑战？
What I'm essentially asking is, can we think of dopamine as facilitating physical movement through one circuit, but also kind of mental movement, thought movement, kind of I'm thinking about for those just listening and not watching, I'm kind of rubbing my index and middle finger against my thumb, just keeping something online.
我本质上想问的是，我们是否可以将多巴胺视为通过一个回路促进身体运动，同时也促进一种精神运动、思想运动，我正在为那些只听而不看的人考虑，我有点用食指和中指摩擦拇指，只是让一些东西在线。
It's sort of a movement of thought or information, and then you kind of chuck it away and bring out the next information.
这是一种思想或信息的运动，然后你就把它扔掉并带出下一个信息。
Is that appropriate?
这样合适吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I think that's a good way of thinking about it.
是的，我认为这是一个很好的思考方式。
And one might wonder, "Well, how can dopamine be important for memory but also be important for movement?" And it's really simple.
人们可能会想，“那么，多巴胺怎么可能对记忆很重要，而且对运动也很重要呢？”这真的很简单。
It's just that it's acting on different circuits.
只是作用于不同的电路而已。
The neurons that go to the motor areas that carry dopamine, when dopamine is expressed there and boosted there, then it will be involved in movement.
运动区的神经元携带多巴胺，当多巴胺在那里表达并增强时，它就会参与运动。
And lack of dopamine in the basal ganglia will lead to neurological disorders like Parkinson's disease that has severe movement difficulty.
而基底神经节缺乏多巴胺会导致神经系统疾病，如帕金森病，导致严重的运动困难。
But when it's acting in the frontal cortex, and expressed in the frontal cortex, then it's going to improve working memory.
但当它作用于额叶皮层并在额叶皮层中表达时，它就会改善工作记忆。
So it's just the nature of where the circuits are, where the dopamine is that's allowing it to have different kinds of actions.
因此，正是电路所在位置、多巴胺所在位置的本质使其能够发挥不同类型的作用。
And that's for all transmitters.
这适用于所有发射机。
The reason why acetylcholine seems to be more important for long-term memory is because it's projecting to the hippocampus, which as we know, is another area that's important for memory.
乙酰胆碱似乎对长期记忆更重要的原因是它投射到海马体，正如我们所知，海马体是另一个对记忆很重要的区域。
And that's why acetylcholine doesn't boost your working memory, but dopamine does, and vice versa.
这就是为什么乙酰胆碱不会增强你的工作记忆，但多巴胺可以，反之亦然。
Andrew Huberman:
安德鲁·休伯曼：
So drilling a little bit more deeply into the role of dopamine in working memory, you did some really lovely experiments showing that if people who have low levels of dopamine increase their dopamine pharmacologically, I think the drug that was used was bromocriptine, that working memory improves.
因此，更深入地研究多巴胺在工作记忆中的作用，你做了一些非常可爱的实验，表明如果多巴胺水平低的人在药理学上增加多巴胺，我认为使用的药物是溴隐亭，工作记忆会改善。
Conversely, if one depletes dopamine pharmacologically, working memory gets worse.
相反，如果一个人通过药物消耗多巴胺，工作记忆就会变得更差。
But as I recall, there was an important baseline that is important because it really mattered in terms of the outcome.
但我记得，有一个重要的基线很重要，因为它对结果确实很重要。
Meaning if somebody already had relatively high levels of dopamine in this circuit, increasing dopamine further with bromocriptine didn't impart a benefit and might have even made their working memory worse.
这意味着，如果某人在该回路中已经具有相对较高水平的多巴胺，则用溴隐亭进一步增加多巴胺不会带来任何好处，甚至可能会使他们的工作记忆变得更糟。
So there's a kind of inverted U-shaped function to this.
所以这有一种倒U形函数。
How does one know whether or not their baseline dopamine is low, medium, or high?
一个人如何知道他们的基线多巴胺是低、中还是高？
Ergo, how do they know whether or not they would want to explore going about increasing dopamine through any number of different approaches?
因此，他们如何知道是否愿意通过多种不同的方法来探索增加多巴胺？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Well, most people probably have optimal dopamine, but there's a significant percentage that probably have too little or maybe too much.
嗯，大多数人可能都拥有最佳的多巴胺，但有相当一部分人的多巴胺可能太少或太多。
And unfortunately, we can't measure it in the blood.
不幸的是，我们无法在血液中测量它。
There isn't a blood test that I'm aware of that can measure- dopamine because it's stuck in the brain.
据我所知，没有一种血液测试可以测量多巴胺，因为它滞留在大脑中。
Andrew Huberman:
安德鲁·休伯曼：
Peripheral dopamine in the blood is not a good readout.
血液中的外周多巴胺读数不好。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Is not a good readout, yeah.
不是一个好的读数，是的。
And especially when you're talking about dopamine in areas like prefrontal cortex.
尤其是当你谈论前额皮质等区域的多巴胺时。
And so we don't have a good readout there.
所以我们那里没有很好的读数。
There's invasive procedures like positron emission tomography where we can inject a radioisotope that tags dopamine, and then we can do a scan that actually shows us how much dopamine.
有一些侵入性手术，例如正电子发射断层扫描，我们可以注射标记多巴胺的放射性同位素，然后我们可以进行扫描，实际显示多巴胺的含量。
This scan was originally developed to show Parkinson's disease, that you can diagnose Parkinson's disease by showing that there's less dopamine in patients that have Parkinson's by looking at this scan.
这种扫描最初是为了显示帕金森氏症而开发的，您可以通过查看此扫描显示帕金森氏症患者体内的多巴胺较少来诊断帕金森氏症。
Obviously, it's invasive.
显然，这是侵入性的。
You're injecting a radioisotope.
你正在注射放射性同位素。
It's expensive, and it's not something we could all do.
它很昂贵，而且不是我们所有人都能做到的。
But we had used it to show that it correlates very strongly with your working memory capacity, so how much information you can hold online.
但我们用它来表明它与你的工作记忆容量，即你可以在线保存多少信息密切相关。
If you can hold four or five or six letters when I do a span task, correlated with how much dopamine we can see in the PET scan.
当我做跨度任务时，如果你能握住四个、五个或六个字母，这与我们在 PET 扫描中可以看到多少多巴胺相关。
So that would be a way that we could do it.
所以这将是我们可以做到的一种方式。
Andrew Huberman:
安德鲁·休伯曼：
So if you were to read out a string of a few numbers or letters, and I can remember all of those a few moments later, perhaps my baseline dopamine levels are moderate, in the normal range.
因此，如果你读出一串由几个数字或字母组成的字符串，并且我几分钟后就能记住所有这些，也许我的基线多巴胺水平是中等的，在正常范围内。
Whereas if I couldn't keep that online, that might be reflective of lower baseline dopamine levels.
然而，如果我无法将其保留在网上，这可能反映了基线多巴胺水平较低。
Is that right?
是这样吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
It's a very strong proxy for dopamine.
它是多巴胺的一个非常强大的代理。
So if your working memory capacity is seven letters or numbers when I say four, three, seven, one, five, zero, six, if you get the-
因此，如果你的工作记忆容量是七个字母或数字，当我说四、三、七、一、五、零、六时，如果你得到-
Andrew Huberman:
安德鲁·休伯曼：
Four, three, seven, five, six.
四、三、七、五、六。
Right.
正确的。
Yeah
是啊
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
get them all back very quickly, you probably have more baseline dopamine than someone who has five.
尽快将它们全部恢复，您可能比拥有五个的人拥有更多的基线多巴胺。
So it's a proxy for measuring someone's dopamine.
所以它是测量某人多巴胺的指标。
So that's one way of doing it, and that's actually how we did it in our original studies.
所以这是这样做的一种方法，这实际上就是我们在最初的研究中所做的。
We actually grouped individuals based on whether their capacity, based on this behavioral measure, was high or low.
实际上，我们根据行为测量的能力高低对个人进行分组。
And like you said, those that could only hold five or six letters, if we gave them bromocriptine, which was the dopaminergic agonist, we improved their working memory.
就像你说的，那些只能容纳五六个字母的人，如果我们给他们溴隐亭（多巴胺能激动剂），我们就能改善他们的工作记忆。
We got them into sort of an optimal level.
我们让它们达到了最佳水平。
But those who were already high, we got them worse.
但那些已经很高的人，我们让他们变得更糟。
And the moral of that story was that more is just not better.
这个故事的寓意是，更多并不意味着更好。
We're trying to get people optimal.
我们正在努力让人们达到最佳状态。
And so the real question is if we want to get people optimal, like you were inferring, you have to know what their dopamine is.
所以真正的问题是，如果我们想让人们达到最佳状态，就像你推断的那样，你必须知道他们的多巴胺是什么。
Where are you on this inverted U curve?
你在这个倒U型曲线上的哪个位置？
Another way of doing it is through genetic studies.
另一种方法是通过基因研究。
So dopamine, all neurotransmitters have to be broken down and re-uptaked into the brain cell in order to be used again, and there's different ways of doing it.
因此，多巴胺，所有神经递质都必须被分解并重新吸收到脑细胞中才能再次使用，并且有不同的方法可以做到这一点。
In some cells, it gets transported back into the brain cell.
在某些细胞中，它被运回脑细胞。
In other places, there's an enzyme that breaks it down.
在其他地方，有一种酶可以分解它。
Well, there's an enzyme called COMT, that breaks down dopamine in the prefrontal cortex specifically.
嗯，有一种叫做 COMT 的酶，可以专门分解前额皮质中的多巴胺。
In a large percentage of individuals, that enzyme is either overactive or underactive.
在很大一部分人中，这种酶要么过度活跃，要么活性不足。
Probably about 25% of individuals, it's overactive, and another 25%, it's underactive, so probably half the population.
大概有 25% 的人活动过度，另外 25% 的人活动不足，所以可能是一半人口。
Now, this is going to vary depend on where you live and where you come from and things, but maybe half the population either has an underactive enzyme or overactive enzyme.
现在，这将根据你居住的地方、你来自哪里等因素而有所不同，但也许一半的人要么酶活性不足，要么酶活性过度。
If you have an underactive enzyme, then actually more dopamine sits around, and you actually have more dopamine than others.
如果你的酶活性不足，那么实际上会有更多的多巴胺，而且你实际上比其他人拥有更多的多巴胺。
And if you have an overactive enzyme, it's the opposite.
如果你的酶过度活跃，情况恰恰相反。
So we've actually shown that if you now go and genotype people with a simple saliva test and figure out do they have this genetic, what we call polymorphism, where just one amino acid gets changed, and the enzyme becomes either active or underactive, we can do the same thing as grouping them by their capacity.
因此，我们实际上已经证明，如果你现在通过简单的唾液测试对人们进行基因分型，并弄清楚他们是否具有这种遗传，即我们所说的多态性，其中只有一个氨基酸发生变化，并且酶变得活跃或不活跃，我们可以做同样的事情，根据他们的能力对他们进行分组。
Those that have the low dopamine, we will make them better, and those who have sort of baseline high dopamine, we'll make them worse.
那些多巴胺水平较低的人，我们会让他们变得更好，而那些多巴胺基线水平较高的人，我们会让他们变得更糟。
Andrew Huberman:
安德鲁·休伯曼：
Super interesting.
超级有趣。
Maybe we could talk about bromocriptine a little bit, and I'm not encouraging people to run out and take bromocriptine.
也许我们可以谈谈溴隐亭，我不鼓励人们跑出去服用溴隐亭。
Bromocriptine, as you mentioned, is a dopamine agonist, relatively short acting?
正如您提到的，溴隐亭是一种多巴胺激动剂，作用相对较短？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, four or five hours, six hours.
是的，四五个小时，六个小时。
Andrew Huberman:
安德鲁·休伯曼：
So it kicks in about 90 minutes after-
所以大约90分钟后开始-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
as I recall you saying.
我记得你说过。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
I've never taken it.
我从来没有拿过它。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
How do people feel when they're on bromocriptine?
人们服用溴隐亭时感觉如何？
When I hear dopamine agonist, there are a lot of illicit drugs like cocaine, methamphetamine that increase dopamine, but then again, chocolate, sex, and food increase dopamine.
当我听到多巴胺激动剂时，有很多非法药物，如可卡因、甲基苯丙胺，会增加多巴胺，但话又说回来，巧克力、性和食物会增加多巴胺。
But the kinetics, the time course, and the levels are different for each of those-
但每一个的动力学、时间进程和水平都是不同的——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
things.
的事情。
Dopamine, of course, being a currency of motivation and reward, not directly related to any one compound.
当然，多巴胺是一种动力和奖励的货币，与任何一种化合物没有直接关系。
But I would think that based on the data you just described, and given the fact that there are a number of people out there with challenges in working memory, attention, task switching, et cetera, that there would be a strong interest on the part of the pharmaceutical companies at least, and certainly the general public, in things like bromocriptine to increase dopamine, to increase working memory, given it is our superpower.
但我认为，根据你刚才描述的数据，考虑到有很多人在工作记忆、注意力、任务切换等方面面临挑战，至少制药公司，当然还有公众，会对溴隐亭等增加多巴胺、增加工作记忆的药物产生浓厚的兴趣，因为它是我们的超级大国。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
One of the most disappointing things to me in my career has been that pharmaceutical companies have not picked up on this idea that we could improve cognition and very specifically improve cognitive process with very specific neuromodulators.
在我的职业生涯中，最令我失望的事情之一是制药公司没有意识到我们可以通过非常特定的神经调节剂来改善认知，并且非常具体地改善认知过程。
The discovery that depletion of dopamine and not other transmitters impairs working memory was made in 1979.
1979 年，人们发现多巴胺的消耗而不是其他递质的消耗会损害工作记忆。
When I heard Pat Goldman-Rakic talk about this as a resident, I was just amazed that there could be a single transmitter can change a single behavior.
当我作为一名居民听到帕特·戈德曼-拉基奇（Pat Goldman-Rakic）谈论这个问题时，我很惊讶竟然有一个发射器可以改变一个行为。
I was seeing Very complicated behavioral deficits, and it just seemed impossible to me that there could be such a tight link between a single neuromodulator and a single cognitive process, and just opened the door for me that this really could be an incredibly beneficial therapy for anyone with executive function or frontal lobe function.
我看到了非常复杂的行为缺陷，对我来说，单个神经调节剂和单个认知过程之间不可能存在如此紧密的联系，这为我打开了大门，这对于任何具有执行功能或额叶功能的人来说确实可能是一种非常有益的治疗。
But unfortunately, there's never been a pharmaceutical company that's tried to develop a drug for improving cognition to this-
但不幸的是，从来没有一家制药公司尝试开发一种改善认知的药物——
Andrew Huberman:
安德鲁·休伯曼：
That's crazy
太疯狂了
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
to this day.
直到今天。
Andrew Huberman:
安德鲁·休伯曼：
And it's crazy for several reasons.
这很疯狂有几个原因。
One is that the data are clearly there.
一是数据清晰可见。
Two, these drugs are already established.
第二，这些药物已经成熟。
It's not like they have to go through safety trials again, that's already been done.
他们并不需要再次进行安全试验，这已经完成了。
But mostly because regardless of whether one is a fan of the pharmaceutical industry or hates it, the pharmaceutical industry, in principle, can make a ton of money doing this, so I would think that they'd be heavily incentivized to do it.
但主要是因为无论人们是制药行业的粉丝还是讨厌它，制药行业原则上可以通过这样做赚很多钱，所以我认为他们会受到很大的激励这样做。
So why have they turned a blind eye on this?
那么他们为何对此视而不见呢？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
I'm not sure.
我不确定。
When I realized that I could test these drugs in healthy individuals, that if I gave them in low enough doses, they were safe, and I had so much experience of them in patients that I felt comfortable doing it, then I started asking pharmaceutical companies, "Do you want to get involved here?
当我意识到我可以在健康个体中测试这些药物时，如果我以足够低的剂量给予它们，它们是安全的，而且我在患者中使用它们的经验丰富，所以我觉得这样做很舒服，然后我开始询问制药公司，“你们想参与其中吗？
This should be done.
应该这样做。
I can't do this by myself.
我一个人做不到这件事。
We need to have real trials and real studies of how this will help." And their eyes would always cross and never got any sort of traction.
我们需要进行真正的试验和研究，看看这将如何提供帮助。”他们的目光总是交叉，却从未受到任何牵引。
It always went back to sort of disease, you know, what disease are you curing?
它总是回到某种疾病，你知道，你要治疗什么疾病？
What's the market for it?
它的市场是什么？
Is it a Parkinson's disease thing?
这是帕金森病吗？
Is it an Alzheimer's disease thing?
这是阿尔茨海默病吗？
And this has been a general problem with neurology.
这一直是神经病学的普遍问题。
It's very disease-centric.
它非常以疾病为中心。
It's always focused on how can we develop a treatment for Alzheimer's or traumatic brain injury or stroke, as opposed to how can we develop a treatment for working memory dysfunction, which is a problem across diseases.
它始终关注如何开发治疗阿尔茨海默病、创伤性脑损伤或中风的方法，而不是如何开发治疗工作记忆功能障碍的方法，这是跨疾病的一个问题。
So the answer to your earlier question is these drugs are very safe.
所以你之前的问题的答案是这些药物非常安全。
We give them in such low doses to healthy individuals, they can't even tell the difference between the placebo and the drug.
我们以如此低的剂量给予健康个体，他们甚至无法区分安慰剂和药物之间的区别。
Andrew Huberman:
安德鲁·休伯曼：
Really?
真的吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
They don't even know which one they're on.
他们甚至不知道自己在哪一站。
Andrew Huberman:
安德鲁·休伯曼：
So they're not buzzing, thinking like-
所以他们不会嗡嗡作响，而是这样想——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
No
否
Andrew Huberman:
安德鲁·休伯曼：
...
...
"Oh, this feels good, and my working memory's better."
“哦，这感觉很好，我的工作记忆力也更好了。”
Dr. Mark D'Esposito:
马克·德斯波西托博士：
They have no idea.
他们不知道。
They don't even know their working memory's better until we show them that their working memory is better.
他们甚至不知道自己的工作记忆更好，直到我们向他们展示他们的工作记忆更好。
Andrew Huberman:
安德鲁·休伯曼：
Love it.
喜欢它。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So they're truly blind to what's going on.
所以他们对正在发生的事情真的视而不见。
Bromocriptine is but one of the dopamine agonists.
溴隐亭只是多巴胺激动剂之一。
Can think of a few others, cabergoline, other things like that.
可以想到其他一些，卡麦角林，其他类似的东西。
Do any of these dopamine agonists exert this impact on working memory, or does it vary by drug because different dopamine agonists sort of hit different receptor pathways and things like that?
这些多巴胺激动剂是否会对工作记忆产生这种影响，或者它是否因药物而异，因为不同的多巴胺激动剂会击中不同的受体途径或类似的东西？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, no, it's not specific to the drug.
是的，不，这不是药物特有的。
The reason for bromocriptine is that it's the oldest, and it's the one I was most comfortable with.
溴隐亭的原因是它是最古老的，也是我最舒服的。
I had to be comfortable with it clinically before I'd give it to undergraduates at Penn or Berkeley, so there's nothing special.
在我把它交给宾夕法尼亚大学或伯克利分校的本科生之前，我必须在临床上熟悉它，所以没有什么特别的。
But other agonists work similarly.
但其他激动剂也有类似的作用。
There's a drug that's developed for Parkinson's, which is a COMT inhibitor, which actually inhibits this enzyme that we're talking about, and that also will have the same function.
有一种治疗帕金森病的药物，它是一种 COMT 抑制剂，它实际上抑制了我们正在谈论的这种酶，并且也具有相同的功能。
There's been some future work that norepinephrine also seems to be helpful with working memory.
未来的一些研究表明去甲肾上腺素似乎也有助于工作记忆。
It's maybe not as potent as the dopaminergic.
它可能不如多巴胺能那么有效。
And that's the point I want to make.
这就是我想表达的观点。
Another disappointing thing about this whole field of the pharmacology of cognition.
关于整个认知药理学领域的另一件令人失望的事情。
I wrote a paper as a resident.
我以居民的身份写了一篇论文。
Sometimes your attendings say, "Hey, can you write this review paper for us?" And I wrote one as a resident called "The Pharmacology of Cognition," where I looked at all the animal literature on giving neuromodulators, acetylcholine, dopamine, norepinephrine, and there was a lot of animal literature sort of supporting that this would work in humans.
有时你的主治人员会说：“嘿，你能为我们写这篇评论论文吗？”作为一名住院医师，我写了一篇名为《认知药理学》的文章，其中我查阅了所有有关给予神经调节剂、乙酰胆碱、多巴胺、去甲肾上腺素的动物文献，并且有很多动物文献支持这对人类有效。
But what was more striking to me was that it wasn't always just a single neurotransmitter.
但更令我惊讶的是，它并不总是只有一种神经递质。
There were studies where you'd give dopamine, and it wouldn't do anything.
有研究表明你给予多巴胺，但它没有任何作用。
You'd give acetylcholine, it wouldn't do anything.
你给乙酰胆碱，它没有任何作用。
But if you gave a low dose of both, it would be really effective.
但如果两者都给予低剂量，就会非常有效。
So these neurotransmitter systems don't act in isolation, so we need to also study sort of how the combinations work.
因此，这些神经递质系统并不是孤立起作用的，因此我们还需要研究这些组合是如何发挥作用的。
And that's where the pharmaceutical companies have the infrastructure to do these kind of studies.
这就是制药公司拥有进行此类研究的基础设施的地方。
It's very hard to do in a single lab, to do multiple drugs at one time, and then try and determine all the different interactions.
在一个实验室中很难同时研究多种药物，然后尝试确定所有不同的相互作用。
Andrew Huberman:
安德鲁·休伯曼：
Maybe we could talk about a couple of other drugs that are legal and have FDA approval, are known to be safe in the right context that it seems would fit the bill here for improving working memory.
也许我们可以讨论其他几种合法且获得 FDA 批准的药物，它们在适当的情况下是安全的，似乎适合改善工作记忆。
One is Wellbutrin.
一种是维布特林。
Bupropion?
安非他酮？
I can never pronounce that.
我永远无法发音。
As far as I know, it's a epinephrine or norepinephrine agonist.
据我所知，它是一种肾上腺素或去甲肾上腺素激动剂。
You just mentioned that increasing epinephrine may have a positive impact on working memory, and to some extent, a dopamine agonist.
您刚才提到增加肾上腺素可能对工作记忆产生积极影响，并且在某种程度上是多巴胺激动剂。
Is there any evidence that Wellbutrin can improve working memory?
有证据表明维布特林可以改善工作记忆吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, anything that boosts norepinephrine can do it.
是的，任何能增强去甲肾上腺素的东西都可以。
The one that we've used, that's most used is guanfacine, which is actually a blood pressure medication.
我们使用过的、最常用的是胍法辛，它实际上是一种降血压药物。
So that's starting to gain some traction.
所以这开始获得一些关注。
In fact, I think there was a study with brain fog for COVID showing that it improved symptoms with it.
事实上，我认为一项针对新冠病毒的脑雾研究表明，它可以改善症状。
So there's actually some trials now that are looking at guanfacine.
所以现在实际上有一些试验正在研究胍法辛。
And so I would say anything that boosts norepinephrine would be helpful.
所以我想说任何能增强去甲肾上腺素的东西都会有帮助。
But then again, I don't want to leave out the other transmitters.
但话又说回来，我不想遗漏其他发射机。
Increasing serotonin, increasing acetylcholine boosts other cognitive processes, and then in a way, they can help working memory.
增加血清素和乙酰胆碱会促进其他认知过程，然后在某种程度上，它们可以帮助工作记忆。
We talked about working memory being this foundation.
我们谈到工作记忆是这个基础。
Well, if you give acetylcholine and it kind of boosts memory, well, that can indirectly help your executive function.
好吧，如果你给予乙酰胆碱，它可以增强记忆力，那么，这可以间接帮助你的执行功能。
Or if you give a drug that improves your focus, then that can indirectly help.
或者，如果您服用一种可以提高注意力的药物，那么这可以间接提供帮助。
working memory.
工作记忆。
So what I'm really pushing for is not just a single, it's going to be one drug, it's going to be a cocktail.
所以我真正推动的不仅仅是一种单一药物，而是一种药物，一种鸡尾酒。
And we have to not only figure out what the cocktail is, but also figure out who we're giving it to.
我们不仅要弄清楚鸡尾酒是什么，还要弄清楚我们要把它送给谁。
Link it to the person's own makeup of their own neurochemistry.
将其与人自己的神经化学组成联系起来。
When we get to a point where we'll know we can map out everyone's dopamine, norepinephrine, serotonin levels, then we'll make real progress in helping them.
当我们知道我们可以绘制出每个人的多巴胺、去甲肾上腺素、血清素水平时，我们就会在帮助他们方面取得真正的进展。
Because right now, I sort of say with my students, what we're doing, it's just like cutting open the skull and just sort of pouring it onto the brain.
因为现在，我对我的学生们说，我们正在做的事情，就像切开头骨然后将其倒到大脑上一样。
Andrew Huberman:
安德鲁·休伯曼：
We're not actually doing that, but-
我们实际上并没有这样做，但是-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
We're not actually doing it, but-
我们实际上并没有这样做，但是-
Andrew Huberman:
安德鲁·休伯曼：
Right
右
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
it seems that way.
看起来是这样。
The precision is not there yet.
精度还没有达到。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Well, it's great that you developed this cognitive task that can be a proxy for dopamine levels.
嗯，很高兴您开发了这项可以代表多巴胺水平的认知任务。
The cognitive task again being, how many number or letter strings somebody can remember, basically working memory performance.
认知任务又是，一个人能记住多少数字或字母串，基本上是工作记忆的表现。
There are a lot of tests out there that claim they can assess dopamine and serotonin, acetylcholine levels from a blood draw.
有很多测试声称可以评估抽血中的多巴胺、血清素、乙酰胆碱水平。
I've heard of the Dutch test.
我听说过荷兰语考试。
I've never taken it.
我从来没有拿过它。
But a few minutes ago you said that really one needs to do positron emission tomography imaging, which is fairly labor-intensive.
但几分钟前您说确实需要进行正电子发射断层扫描成像，这是相当劳动密集型的。
Most people don't have access to one of those.
大多数人无法访问其中之一。
It's a clinical tool.
这是一个临床工具。
So there are behavioral proxies, there's neuroimaging, but also, to my knowledge, I don't know that there's any blood draw that will say, "Hey, your serotonin levels are low," or, "Your dopamine levels are moderate, et cetera." There are a lot of companies that market these, but are you aware of any clinical or other tools for getting an accurate read of neurotransmitter levels in a person's brain aside from neuroimaging?
所以有行为指标，有神经影像学，但据我所知，我不知道有任何抽血会说，“嘿，你的血清素水平很低，”或者，“你的多巴胺水平中等，等等。”有很多公司在销售这些产品，但您是否知道除了神经影像学之外，还有任何临床或其他工具可以准确读取人脑中的神经递质水平？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
No, and it's even more complicated than it seems because the dopaminergic system is complicated because it's not only just the prefrontal cortex, as we talked about, it's also the basal ganglia.
不，它比看起来更复杂，因为多巴胺能系统很复杂，因为它不仅是我们谈到的前额叶皮层，而且是基底神经节。
And so not only do we have to measure dopamine, just generally levels, we have to measure the balance of the dopamine in the striatum and the prefrontal cortex.
因此，我们不仅需要测量多巴胺的总体水平，还必须测量纹状体和前额皮质中多巴胺的平衡。
There's a model of dopamine function and its relation to executive function, and it has to do with sort of the balance between these two systems.
有一个多巴胺功能及其与执行功能的关系的模型，它与这两个系统之间的平衡有关。
That dopamine in the prefrontal cortex is promoting sort of stability.
前额皮质中的多巴胺正在促进某种稳定性。
It's keeping information in mind.
它牢记信息。
It's keeping these representations stable.
它使这些表示保持稳定。
Whereas the dopamine in the basal ganglia, what it's doing is allowing you to update and refresh the information that you're holding in mind, this sort of stability versus flexibility.
而基底神经节中的多巴胺，它的作用是让你更新和刷新你所记住的信息，这种稳定性与灵活性。
So if you have too much dopamine in your prefrontal cortex, it can lead to a very rigid state where you don't let anything in.
因此，如果你的前额皮质中多巴胺过多，就会导致一种非常僵化的状态，不允许任何东西进入。
And if you have too much dopamine in the striatum, and then you get too flexible, then you can get very distractible.
如果你的纹状体中有太多的多巴胺，然后你变得太灵活，那么你就会变得非常分心。
So there's this sort of balance of dopamine.
所以多巴胺存在这种平衡。
So it's not just how much dopamine you have in your brain, it's what's the balance of the dopamine?
所以，问题不在于你的大脑中有多少多巴胺，而在于多巴胺的平衡情况如何？
So I don't see a blood test as ever giving us that information, but I do see there being a brain test that can give us this kind of information of the two, or at least a proxy for it.
因此，我认为血液测试不会像以往那样为我们提供这些信息，但我确实看到有一种大脑测试可以为我们提供两者的此类信息，或者至少是它的替代信息。
So what I was thinking about when you were talking about asking this question, for example, if you measure pupil dilation, that's a pretty good proxy for the noradrenergic system.
所以，当你谈论问这个问题时，我在想什么，例如，如果你测量瞳孔扩张，这是去甲肾上腺素能系统的一个很好的代表。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
So at a given, people will wonder how to do it.
因此，在特定情况下，人们会想知道如何做到这一点。
We're not going to go into too much detail here, but at a given brightness in the room, what we call luminance, the pupil tends to be smaller when it's bright and larger when you're in a dim room.
我们不会在这里讨论太多细节，但在房间内给定的亮度（我们称之为亮度）下，瞳孔在明亮时往往会较小，而在昏暗房间时会较大。
That's sort of obvious.
这很明显。
But at a given luminance, the more alert, aroused somebody is, arousal is a general term here, not talking about a particular kind of arousal, then the pupil tends to be more dilated.
但在给定的亮度下，某人越警觉、越兴奋（这里的唤醒是一个通用术语，而不是指某种特定类型的唤醒），那么瞳孔往往会扩张得更多。
It gets bigger the more norepinephrine is-
去甲肾上腺素越多，它就越大-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
in the system.
在系统中。
So if somebody's pupils are really big in bright light, that person's got a lot of epinephrine, adrenaline-
所以如果一个人的瞳孔在强光下真的很大，那么这个人体内就有大量的肾上腺素，肾上腺素——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
in their system.
在他们的系统中。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Do you use this clinically?
临床上用这个吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Like when someone comes in and they have those big old pupils?
就像有人进来时，他们有那些又大又老的瞳孔？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, pupils.
是的，同学们。
Andrew Huberman:
安德鲁·休伯曼：
And then you're like, "Okay, they're probably on a stimulant."
然后你会说，“好吧，他们可能服用了兴奋剂。”
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
A lot of what neurology does is try to look for these windows into the brain.
神经学所做的很多工作就是试图寻找进入大脑的这些窗口。
And so I think there are a number of windows into the brain that we're going to be able to develop that can reflect these neuromodulatory systems.
所以我认为我们将能够开发出许多进入大脑的窗口来反映这些神经调节系统。
So that's why I've been so interested in developing biomarkers, because really what a neural biomarker is, is trying to develop something you can measure easily and simply and cheaply, but gives you information about how the brain is working.
这就是为什么我对开发生物标志物如此感兴趣，因为真正的神经生物标志物就是试图开发一些可以轻松、简单和廉价地测量的东西，但可以为你提供有关大脑如何工作的信息。
And so that's a norepinephrine biomarker, working memory capacity is a dopamine biomarker, and we're getting better at that.
这是去甲肾上腺素生物标志物，工作记忆容量是多巴胺生物标志物，我们在这方面做得越来越好。
But again, we're not putting enough emphasis on it, in my opinion, to really sort of help improve brain health.
但在我看来，我们并没有给予足够的重视，以真正帮助改善大脑健康。
Andrew Huberman:
安德鲁·休伯曼：
Have you ever tried bromocriptine?
您尝试过溴隐亭吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Very early on, but at the dose that my subjects were getting, but like I said, it's so low you don't feel anything.
很早的时候，但在我的受试者接受的剂量下，但就像我说的，它太低了，你感觉不到任何东西。
And I should say, even with patients that take it, they rarely get any side effects.
我应该说，即使患者服用它，他们也很少出现任何副作用。
Sometimes with these drugs, because there's peripheral dopamine, they can get nausea or vomiting, but it's extremely well-tolerated.
有时使用这些药物时，因为存在外周多巴胺，他们可能会感到恶心或呕吐，但耐受性非常好。
You don't get anything feeling from it.
你从中得不到任何感觉。
Andrew Huberman:
安德鲁·休伯曼：
Does it change reaction time?
它会改变反应时间吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
It does, and that's always the question of how much of this is that we're just sort of speeding up, we're just sort of making them faster.
确实如此，这始终是一个问题，即我们只是在加快速度，让它们变得更快。
But for all the work we've done, it's pretty convincing that it's not just how fast you're doing it, you're doing it better.
但对于我们所做的所有工作来说，非常令人信服的是，这不仅仅是你做得有多快，而是你做得更好。
Andrew Huberman:
安德鲁·休伯曼：
You might find this entertaining.
您可能会发现这很有趣。
Some years ago, I learned that athletes were taking bromocriptine pre-Olympics and in the Olympics.
几年前，我了解到运动员在奥运会前和奥运会期间服用溴隐亭。
I think it's a banned substance now.
我认为它现在是违禁物质。
And the athletes that were taking it, don't ask me how I know this, but I could tell you offline.
正在服用它的运动员，不要问我怎么知道这一点，但我可以在线下告诉你。
And I'm not one of these athletes, nor was I supplying the bromocriptine.
我不是这些运动员之一，也没有提供溴隐亭。
We're using it because they were sprinters, and it turns out that a lot of the sprint races are won by being first out the blocks.
我们使用它是因为他们是短跑运动员，事实证明，很多短跑比赛都是通过率先冲出赛区而获胜的。
There are other factors as well, but that reaction time, hundreds of milliseconds are the difference between podium and no podium.
还有其他因素，但反应时间，数百毫秒是登上领奖台和没有登上领奖台的区别。
And bromocriptine was one of the drugs used.
溴隐亭就是使用的药物之一。
It was not on the banned substance list.
它不在禁用物质清单中。
Just a reminder that every Olympics you see, there are lots of things being used that are not on the banned substance list, and I'm not trying to be disparaging.
只是提醒您，您看到的每届奥运会都会使用很多不在禁用物质清单上的东西，我并不是想贬低。
I think there's just a lot of interest in augmenting neuromodulation for nervous system function.
我认为人们对增强神经系统功能的神经调节很感兴趣。
Bromocriptine was top of the list at that time.
溴隐亭是当时的首选。
I think it's on the banned list now.
我想它现在已经在禁止名单上了。
There's a lot of use of pharmacology now on college campuses and in high school and even in elementary schools, and sometimes by parents for their kids to try and improve cognitive function.
现在大学校园、高中甚至小学都大量使用药理学，有时父母也为孩子们尝试改善认知功能。
Most typically, the use of Adderall, Vyvanse, Ritalin, and other stimulants, which are noradrenergic, dopaminergic agonists.
最典型的是使用阿德拉、Vyvanse、利他林和其他兴奋剂，它们是去甲肾上腺素能、多巴胺能激动剂。
Okay, so with the disclaimer, caveat, whatever you want to call it, that those decisions should always be made with a trained psychiatrist monitoring things.
好吧，所以有免责声明，警告，无论你想怎么称呼它，这些决定应该始终由训练有素的精神科医生监控。
What are your thoughts about pharmacology for enhancing cognitive function, given that the landscape of society is challenging and people want to perform well, they need to be able to focus.
鉴于社会形势充满挑战，人们想要表现良好，他们需要能够集中注意力，您对增强认知功能的药理学有何看法。
We've got smartphones distracting us, and to some extent, one could say, "Oh, well, it's cheating to use pharmacology," but a cup of coffee is a bit of a noradrenergic agonist.
智能手机分散了我们的注意力，在某种程度上，人们可能会说，“哦，好吧，使用药理学是作弊”，但一杯咖啡有点去甲肾上腺素激动剂的作用。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Absolutely.
绝对的。
Andrew Huberman:
安德鲁·休伯曼：
And certainly improves my focus-
当然也提高了我的注意力-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
as long as I don't drink too much of it.
只要我不喝太多。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
What are your thoughts?
你有什么想法？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
I think it kind of gets back to what we talked about there being an optimal level of dopamine in your brain.
我认为这有点回到我们所说的大脑中多巴胺的最佳水平。
I think if you think about it as just more and more and more is better, and that more is better, then how do you know how much you should be taking?
我想如果你认为越多越好，越多越好，那么你怎么知道你应该服用多少？
There's sort of no end to it.
好像没有尽头。
Andrew Huberman:
安德鲁·休伯曼：
That experiment was run in the '80s.
该实验是在 80 年代进行的。
It's called the cocaine-
它的名字叫可卡因——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
culture of Wall Street in the '80s.
八十年代的华尔街文化。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
There was movies about it.
有关于它的电影。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And it doesn't lead to good places.
而且它不会通向好地方。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
So I'm all for optimizing function, because I want to optimize brain health, and if you have an underactive enzyme that makes your dopamine levels, then I'm all for trying to optimize that along with everything else we need to optimize in the brain.
所以我完全支持优化功能，因为我想优化大脑健康，如果你有一种酶活性不足，可以提高多巴胺水平，那么我完全支持尝试优化它以及我们需要在大脑中优化的其他一切。
So if we could figure out who is sort of on the lower end and boost them up, I'm all for that.
因此，如果我们能够找出谁处于低端并提高他们的水平，我完全赞成。
The problem is we don't know if they're on the high end, and some of these athletes were actually making themselves worse.
问题是我们不知道他们是否处于高端，而其中一些运动员实际上让自己变得更糟。
We know for sure.
我们肯定知道。
These are healthy Penn and Berkeley undergraduates that we made them worse on working memory tests-
这些是健康的宾夕法尼亚大学和伯克利分校的本科生，我们让他们在工作记忆测试中变得更糟-
Andrew Huberman:
安德鲁·休伯曼：
By increasing their dopamine
通过增加多巴胺
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
by increasing their dopamine.
通过增加他们的多巴胺。
Just a little amount, just tipped them over, just a little amount.
只需一点点，只需将它们翻倒即可，只需一点点。
And so without the knowing, then it seems like it's not well-informed to be taking it.
因此，在不知情的情况下，服用它似乎并不明智。
The other thing is if we're going to do this, we should do it right.
另一件事是，如果我们要做这件事，我们就应该做得正确。
I think drugs like Adderall and Ritalin, they were developed because they helped patients, but they weren't necessarily developed with knowing how exactly they worked.
我认为像阿得拉和利他林这样的药物，它们的开发是因为它们可以帮助患者，但它们不一定是在了解它们到底如何起作用的情况下开发的。
That's how the pharmaceutical company works sometimes.
制药公司有时就是这样运作的。
Andrew Huberman:
安德鲁·休伯曼：
necessaries too.
必需品也。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
It works, so let's do it.
它有效，所以让我们开始吧。
I'm all for that as a physician.
作为一名医生，我完全赞成这一点。
But if I had my choice, drugs that boost up multiple systems, all the catecholamines, the ones that boost up dopamine, epinephrine, and norepinephrine, I would steer away from those because you have no control over how you're modulating the system.
但如果我有选择的话，那些能增强多个系统的药物，所有的儿茶酚胺，那些能增强多巴胺、肾上腺素和去甲肾上腺素的药物，我会避开这些，因为你无法控制如何调节系统。
Again, I was sort of talking about a cocktail.
再说一次，我在谈论鸡尾酒。
It may be a little bit of dopamine and a little more norepinephrine, but if you take something like Ritalin and Adderall, you're just getting the same amount.
它可能含有一点多巴胺和更多的去甲肾上腺素，但如果您服用利他林和阿得拉之类的药物，您只会得到相同的量。
If I was to start to experiment, then I wouldn't use Adderall or Ritalin as the drug that I think would helpful, even though they're clinically sort of useful.
如果我要开始实验，那么我不会使用阿得拉或利他林作为我认为有用的药物，即使它们在临床上有点用。
I use things like bromocriptine and guanfacine, where they can modulate a very specific drug.
我使用溴隐亭和胍法辛等药物，它们可以调节非常特定的药物。
And then, yeah, then the goal is to optimize.
然后，是的，目标就是优化。
And that's what we're trying to do with cognitive therapy and everything, sleeping better and better nutrition.
这就是我们试图通过认知疗法和其他一切来实现的目标，包括更好的睡眠和更好的营养。
All of these are aiming to optimize, not reach some superhuman potential.
所有这些都是为了优化，而不是达到某种超人的潜力。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Just bring out the best in people's abilities.
只是发挥人们最好的能力。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
And I'm so glad you mentioned sleep.
我很高兴你提到睡眠。
I would say, sleep is the bedrock, it's the foundation of mental health, physical health, and performance.
我想说，睡眠是基石，是心理健康、身体健康和表现的基础。
Without that, pharmacology might bridge you for an afternoon, but you're going to pay the piper somehow.
如果没有这个，药理学可能会帮你度过一个下午的时间，但你会以某种方式付出代价。
Our friend and colleague, Matt Walker, obviously has been beating that drum-
我们的朋友兼同事马特·沃克显然一直在鼓吹——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
for a while.
有一段时间了。
What about drugs like modafinil, which are thought to be true cognitive enhancers, as opposed to drugs that just kind of are designed to ramp up levels of alertness, as many of the drugs we're discussing do?
像莫达非尼这样的药物怎么样，它被认为是真正的认知增强剂，而不是像我们正在讨论的许多药物那样只是旨在提高警觉水平的药物？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, it's hard to know.
是的，这很难知道。
I think certain drugs just improve general abilities.
我认为某些药物只能提高一般能力。
Either they speed how fast you can process it, or how efficient you can process or narrow the focus of your attention, and that just helps all abilities.
它们要么提高你处理事情的速度，要么提高你处理事情的效率，或者缩小你的注意力焦点，这对所有能力都有帮助。
So it's hard to say.
所以很难说。
I think just has to be more work on really understanding what specifically these drugs are doing.
我认为需要做更多的工作来真正了解这些药物的具体作用。
That's why the dopaminergic story's been so interesting, because it's a very specific effect or the very specific mechanism.
这就是为什么多巴胺能的故事如此有趣，因为它是一种非常具体的效应或非常具体的机制。
I'd like to see that be done with other neuromodulators.
我希望看到其他神经调节剂也能做到这一点。
Andrew Huberman:
安德鲁·休伯曼：
Maybe we could talk a bit about some of the disease conditions that you treat and the role of working memory and dopamine in those conditions, as well as other transmitter systems.
也许我们可以谈谈您治疗的一些疾病以及工作记忆和多巴胺在这些疾病中的作用，以及其他发射系统。
One subject that we haven't talked about on this podcast previously, but is of tremendous interest to people, is traumatic brain injury or concussion, even mild concussion.
我们之前没有在这个播客上讨论过但人们非常感兴趣的一个主题是创伤性脑损伤或脑震荡，甚至是轻度脑震荡。
And before we were recording today, we were talking about football, but just want to remind people that football is just one instance of an opportunity to get a concussion or traumatic brain injury.
在我们今天录制之前，我们谈论的是足球，但只是想提醒人们，足球只是导致脑震荡或创伤性脑损伤的一个例子。
Most traumatic brain injury and concussion is not due to football.
大多数创伤性脑损伤和脑震荡不是由足球引起的。
It just gets a lot of the attention.
它只是引起了很多关注。
But you've got bicycle accidents, car accidents, playground accidents.
但你也会遇到自行车事故、汽车事故、游乐场事故。
Maybe you could list off a few more.
也许你可以再列出一些。
But how common is TBI and concussion?
但 TBI 和脑震荡有多常见？
And maybe you could just perhaps list out some of the other situations where you see a lot of this, that it's a bit more cryptic that people wouldn't necessarily think that sport or that population gets TBI, but they do.
也许你可以列出一些你看到很多这样的其他情况，这有点神秘，人们不一定会认为运动或人群会患上 TBI，但他们确实会患上 TBI。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
I think concussion is much more prevalent than we realize.
我认为脑震荡比我们意识到的要普遍得多。
And the numbers have gone up and up, not because it's becoming more common, it's just it's becoming more recognized.
而且这个数字一直在上升，并不是因为它变得越来越普遍，而是因为它变得越来越被认可。
And I think we underestimated and trivialize sort of what a concussion is.
我认为我们低估并轻视了脑震荡的含义。
It's just something that you're going to recover from it.
这只是你要从中恢复的东西。
Still the old school thinking by a lot of neurologists is that everyone gets better within a couple of months.
许多神经科医生仍然持守旧的想法，认为每个人都会在几个月内变得更好。
Just wait it out and you'll get better.
等一下，你就会好起来的。
That's just sort of the normal time course of concussion.
这只是脑震荡的正常时间过程。
But as we've studied it more, we've realized that there's actually quite a large percentage of people who, a year out, they're still suffering problems.
但随着我们进行更多研究，我们意识到实际上有相当大比例的人一年后仍然面临问题。
They still feel like they're not mentally clear, and they still are sensitive to light, and they still feel a little dizzy, and just a host of symptoms that just one year later after a concussion where they didn't even lose consciousness.
他们仍然感觉精神不清醒，仍然对光敏感，仍然感觉有点头晕，只是脑震荡一年后出现的一系列症状，甚至没有失去知觉。
That's something that they may not have even talked to their doctor about is lingering.
这是他们可能甚至没有与医生谈论过的事情一直挥之不去。
And so it's a real, we call this persistent post-concussion syndrome, and that's the most worrisome to me.
所以这是一个真实的，我们称之为持续性脑震荡后综合症，这对我来说是最令人担忧的。
Because it is true that most concussions will recover.
因为确实大多数脑震荡都会康复。
Luckily, the brain is incredibly resilient, incredibly plastic, and it will heal itself.
幸运的是，大脑具有令人难以置信的弹性和可塑性，并且它会自我修复。
But there are a lot of patients where it just persists, and those are the most worrisome to me because we don't have very good interventions to try and help that.
但有很多患者的症状持续存在，这对我来说是最令人担忧的，因为我们没有很好的干预措施来尝试帮助解决这个问题。
And I don't think we take these patients very seriously when they're complaining of something that seems very vague and not very specific to most doctors.
我认为，当这些患者抱怨的事情对大多数医生来说似乎非常模糊且不具体时，我们不会非常认真地对待他们。
Andrew Huberman:
安德鲁·休伯曼：
What do you tell a patient who comes in and has clearly had a concussion, mild or severe concussion.
对于明显患有脑震荡（轻度或重度脑震荡）的患者，您会说什么？
Maybe a car accident, maybe a sports injury.
也许是车祸，也许是运动损伤。
Maybe they were knocked out cold, maybe not.
也许他们被冷落了，也许没有。
But they're having some headaches, some photophobia, sensitivity to light, just feeling not right.
但他们有些头痛，有些畏光，对光敏感，只是感觉不对劲。
I've had a couple of these, unfortunately, and you just feel off.
不幸的是，我已经经历过几次这样的事情，而你只是感觉不舒服。
You don't feel quite right.
你感觉不太对劲。
And some of that manifests as focus issues.
其中一些表现为焦点问题。
This was some years ago.
这是几年前的事了。
I like to think I'm through it.
我喜欢认为我已经度过了难关。
I've had scans and I'm good, so thank goodness.
我已经做了扫描，一切都很好，所以谢天谢地。
But what do you tell them besides, "Don't get another one?"
但除了“不要再买一个”之外，你还能告诉他们什么呢？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Well, first of all, I explain what a concussion is.
好吧，首先我解释一下什么是脑震荡。
What I've found in neurology, a lot of what patients want to know is just, they just want to understand their problem.
我在神经病学中发现，很多患者想知道的只是，他们只是想了解他们的问题。
They're not walking in expecting a cure.
他们进来并不是期待治愈。
It's just understanding what it is, having someone understand what happened to them is very helpful and comforting.
只是了解它是什么，让某人了解发生在他们身上的事情是非常有帮助和安慰的。
So what we mean by concussion, and in the clinical world, we use mild traumatic brain injury kind of synonymously with concussion.
那么我们所说的脑震荡是什么意思，在临床领域，我们将轻度创伤性脑损伤视为脑震荡的同义词。
It basically is a tearing of axons.
它基本上是轴突的撕裂。
The brain cells have these long fibers that communicate with each other, and they're called axons.
脑细胞具有相互沟通的长纤维，它们被称为轴突。
And when the brain violently moves forward and backwards, if you're in a car accident and you have your seatbelt on and you suddenly hit, you go from 50 to 0, your head violently goes forward and violently goes backwards, and that angular force actually tears and stretches axons in the brain.
当大脑猛烈地向前和向后移动时，如果你出了车祸，你系着安全带，然后突然受到撞击，你就会从 50 变成 0，你的头猛烈地向前和猛烈地向后移动，这种角力实际上会撕裂并拉伸大脑中的轴突。
So if you've had a concussion, you have torn some axons.
因此，如果您遭受了脑震荡，那么您就会撕裂一些轴突。
Luckily, we have billions of them, and so if you tear a couple of thousand, you will recover, but you have torn axons.
幸运的是，我们有数十亿个轴突，所以如果你撕裂几千个，你会恢复，但你撕裂了轴突。
It's a real brain injury, even if you haven't lost consciousness and you've only had symptoms for a couple of days.
这是真正的脑损伤，即使您没有失去意识并且症状只出现了几天。
And there's a correlation.
并且存在相关性。
The longer you've lost consciousness and the longer your symptoms last, the more axons you've torn.
您失去意识的时间越长，症状持续的时间越长，撕裂的轴突就越多。
There's kind of a direct relationship between the two.
两者之间有某种直接的关系。
So the mechanism is these torn axons, so now nerve cells don't communicate with each other, and different brain regions are not communicating with each other.
所以机制就是这些撕裂的轴突，所以现在神经细胞不能互相交流，不同的大脑区域也不能互相交流。
And it turns out the most common place for axons to tear is in the frontal lobes.
事实证明，轴突撕裂最常见的地方是额叶。
And so now we've talked about all these things that the frontal lobes do to orchestrate the rest of the brain.
现在我们已经讨论了额叶协调大脑其他部分所做的所有事情。
Well, it has some injured pathways, and that's why a lot of the symptoms that patients have are these kind of mild executive symptoms.
嗯，它有一些受损的通路，这就是为什么患者的很多症状都是这些轻微的执行症状。
This mental fogginess that they're describing is just this inability to get things done.
他们所描述的这种精神上的迷茫就是无法完成事情。
They don't lose knowledge of who they, they don't forget their name or forget where they live or lose memories from the past or anything like that, but they don't officially get things done as well as they used to.
他们不会忘记自己是谁，不会忘记自己的名字，也不会忘记自己住在哪里，也不会失去过去的记忆或类似的事情，但他们不会像以前那样正式完成事情。
And it only takes a little bit of a drop, right?
而且只需要一点点，对吧？
People think you have to have a big drop in performance to have a real life impact.
人们认为你的表现必须大幅下降才能对现实生活产生影响。
Just a 1% drop and you're having a hard time doing your podcast or teaching a lecture or whatever you might do.
只要下降 1%，你就会很难做播客、讲课或做任何你可能做的事情。
Andrew Huberman:
安德鲁·休伯曼：
A 1% drop sounds like a frighteningly small change required to negatively impact life.
1% 的下降听起来像是一个可怕的小变化，却会对生活产生负面影响。
So how about a poor night's sleep?
那么晚上睡眠不好怎么办？
What kind of drop in prefrontal cortical function are we looking at from a, let's say, I normally get seven or eight hours, or six to eight hours, and I suddenly only get three or four.
我们看到前额皮质功能有什么样的下降，比方说，我通常可以工作七到八个小时，或者六到八个小时，但我突然只得到三四个小时。
Are we talking a significant detriment?
我们正在谈论重大损害吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
I do think so.
我确实这么认为。
I do think that, yeah, that it is significant, a poor night's sleep.
我确实认为，是的，这很重要，一夜睡眠不好。
And we all notice that.
我们都注意到了这一点。
It's very obvious.
这是非常明显的。
It's hard to sort of quantify.
很难量化。
I'm a baseball fan, so I can quantify it like if you think about it in a pitcher and how fast they throw A small drop for them, someone who's throwing 100 miles an hour, just a small drop turns them from really elite to someone mediocre.
我是一个棒球迷，所以我可以量化它，就像你在投手中思考它以及他们投掷的速度有多快一样，对于他们来说，一个每小时投掷100英里的人，只要一个小小的下降，就可以将他们从真正的精英变成平庸的人。
Maybe it's more of a 10% drop, but a still relatively small drop can have a huge impact.
也许下降了 10% 以上，但相对较小的下降也会产生巨大的影响。
I think people think that just because you're a little bit off, that's not a big deal.
我认为人们认为仅仅因为你有点偏离，那没什么大不了的。
You work through it.
你努力克服它。
And that's what most doctors say.
这就是大多数医生所说的。
"Just plow through it.
“只要犁过它就可以了。
Just work your way through it.
只要按照自己的方式解决即可。
You're going to get better." And as opposed to saying, "Yeah, you really had a brain injury.
你会好起来的。”而不是说：“是的，你确实脑部受伤了。
This is what happened.
这就是发生的事情。
We need to rehabilitate you, just like we would do if you tore your anterior cruciate ligament." I don't know why tearing your cruciate ligament or your Achilles tendon gets more interest than tearing axons in your brain.
我们需要让你康复，就像你前十字韧带撕裂时我们会做的那样。”我不知道为什么撕裂你的十字韧带或你的跟腱比撕裂你大脑中的轴突更有趣。
It's amazing to me that there's more emphasis on orthopedic injuries than brain injuries.
令我惊讶的是，人们对骨科损伤的重视程度超过了脑损伤。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I don't know why that is either.
是的，我也不知道为什么会这样。
I think the brain is mysterious enough that most people and many clinicians just back away with hands raised.
我认为大脑非常神秘，以至于大多数人和许多临床医生都举起手来后退。
But if you are in the field of neurology or psychiatry, I suppose that then one has officially signed on to try and resolve these matters.
但如果你从事神经病学或精神病学领域，我想有人已经正式签约尝试解决这些问题。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
So for somebody that has a traumatic brain injury or low level concussion, would part of the primary advice be to try and get one's sleep as good as possible?
那么，对于患有脑外伤或轻度脑震荡的人来说，主要建议的一部分是尝试让自己的睡眠尽可能好吗？
Given that sleep deprivation can compound traumatic brain injury induced deficits in working memory.
鉴于睡眠不足可能会加剧创伤性脑损伤引起的工作记忆缺陷。
And who knows?
谁知道呢？
Maybe a good portion of the deficits in working memory due to traumatic brain injury and concussion is because of the sleep deprivation that it can cause.
也许由创伤性脑损伤和脑震荡导致的工作记忆缺陷很大一部分是因为它可能导致睡眠不足。
So it can get circular.
所以它可以变成圆形。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Not only that, but one of the most common symptoms that my patients with concussion have is their sleep is disruptive.
不仅如此，我的脑震荡患者最常见的症状之一就是他们的睡眠受到干扰。
And that's true in neurology.
在神经学领域也是如此。
It's fascinating.
这很有趣。
Almost every neurological disorder, my patients complain of their sleep.
几乎每一种神经系统疾病，我的病人都会抱怨他们的睡眠问题。
And I start asking, not a lot of neurologists ask you how you sleep.
我开始问，没有多少神经科医生问你睡眠如何。
But I remember back from my residency, one of the first things my attending would do when we got to the ward, he said, "How'd you sleep last night?" And it's just across the board.
但我记得从我的住院医师实习回来，当我们到达病房时，我的主治医生要做的第一件事就是，他说，“你昨晚睡得怎么样？”这只是全面的。
Patients are not falling asleep, they're not staying asleep, and we still don't understand why just brain injury does that.
患者无法入睡，无法保持睡眠状态，我们仍然不明白为什么脑损伤会导致这种情况。
So almost every concussion patient says, "I'm not sleeping well," which then compounds the problem.
因此，几乎每个脑震荡患者都会说：“我睡得不好”，这使得问题变得更加复杂。
So optimizing sleep, obviously optimizing nutrition.
因此，优化睡眠，显然就是优化营养。
There's a question about activity.
有一个关于活动的问题。
It used to be that we used to recommend you had a concussion, you should don't go to work, just take it easy for a while.
以前我们建议你有脑震荡，不要去上班，放松一段时间。
Don't exercise.
不要运动。
Andrew Huberman:
安德鲁·休伯曼：
Keep the blinds drawn.
保持百叶窗拉上。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
But now, it's the idea is that you should really get up and moving as best.
但现在，我们的想法是你应该真正站起来并尽可能地活动。
You got to do what you can tolerate, so you don't want to give yourself more of a headache or more light sensitivity.
你必须做你能忍受的事情，这样你就不想让自己更加头痛或对光更加敏感。
But as much as you can tolerate is the thought these days about sort of promoting recovery, and then really getting your brain back working.
但你能忍受的就是这些天关于促进康复，然后真正让你的大脑恢复工作的想法。
I think a lot of my patients, they're off from work for a couple of weeks, and they feel fine, and they think they're pretty much normal, and then the first day of work is a complete disaster because until you actually test it in real life, you don't know what kind of troubles you have.
我想我的很多病人，他们休息了几个星期，感觉很好，他们认为自己很正常，然后第一天工作就完全是一场灾难，因为直到你在现实生活中真正测试它，你才知道自己有什么样的麻烦。
So I don't recommend going back full steam, but I do recommend going back trying to build up these skills again.
因此，我不建议全力以赴，但我确实建议回去尝试再次建立这些技能。
And then I think we need to develop therapies that people will use.
然后我认为我们需要开发人们会使用的疗法。
Things like goal management training, which involves a therapist, and health insurance doesn't pay for this.
像目标管理培训这样的事情，需要治疗师的参与，而健康保险不支付这些费用。
So 99% of my patients don't get any help by any kind of intervention, unfortunately.
不幸的是，我的 99% 的患者没有通过任何干预措施得到任何帮助。
But now, we talked about technology, things like BrainHQ.
但现在，我们谈论技术，比如 BrainHQ。
Do you know about BrainHQ?
你知道BrainHQ吗？
Andrew Huberman:
安德鲁·休伯曼：
No.
不。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
So Mike Merzenich, which I know you've talked about with Eddie, developed a company called Posit Science, where developed these brain training games that can help improve specific cognitive functions, and they're very easy to do because they're online, and there's science behind them, and you can do them.
所以迈克·梅泽尼奇（Mike Merzenich），我知道你和埃迪谈论过，他开发了一家名为 Posit Science 的公司，该公司开发了这些大脑训练游戏，可以帮助改善特定的认知功能，而且它们很容易做到，因为它们是在线的，而且背后有科学依据，你可以做。
So in that way, you don't have a therapist in your room, but you can online do these sort of things that are targeting specific mechanisms, just trying to improve the kind of things that we think are impaired by a concussion.
这样一来，你的房间里就没有治疗师了，但你可以在网上做这些针对特定机制的事情，只是试图改善我们认为因脑震荡而受损的事情。
And I'd like to see more patients get started on some of those things.
我希望看到更多的患者开始做其中的一些事情。
Unfortunately, if you go on the web and just say, "I want to do brain training," you'll be overwhelmed with things, and you don't know what works and what doesn't work.
不幸的是，如果你在网上只是说：“我想做大脑训练”，你就会被各种事情压垮，而且你不知道什么有效，什么无效。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I think the work that Merzenich and colleagues have done, we'll provide a link to that.
我认为 Merzenich 和同事所做的工作，我们将提供一个链接。
I don't have any financial stake in his work or products, trainings that is.
我在他的工作或产品（即培训）中没有任何经济利益。
But I will say, I think Mike's work has been tremendous.
但我要说的是，我认为迈克的工作非常出色。
He is so far ahead of the curve.
他遥遥领先。
Twenty years ago, everyone was talking about neuroplasticity in critical periods.
二十年前，每个人都在谈论关键时期的神经可塑性。
They gave a Nobel Prize to it, to my scientific great-grandparents, David Hubel and Torsten Wiesel, and they deserved that Nobel Prize.
他们将诺贝尔奖授予了我的科学曾祖父母大卫·休贝尔和托斯顿·威塞尔，他们理应获得诺贝尔奖。
But there was a kind of a central tenet of neuroscience at that time was that critical period plasticity ends around adolescence or one's early 20s, and that is simply not true.
但当时神经科学有一个核心原则，即关键时期的可塑性在青春期或 20 岁出头时结束，但这根本不是事实。
And Merzenich really, I think, is one of the people who deserves credit for making it clear that plasticity is ongoing.
我认为，梅泽尼奇确实是最值得赞扬的人之一，因为他清楚地表明了可塑性正在持续存在。
It takes some focus and work to access it in adulthood, but that we can all access neuroplasticity, but it's there.
在成年后需要一些关注和努力才能获得它，但我们都可以获得神经可塑性，但它就在那里。
So I don't know.
所以我不知道。
They should give Merzenich a Nobel too, but I'm not on the committee.
他们也应该授予梅泽尼奇诺贝尔奖，但我不是委员会成员。
So just a little editorial there.
所以这里只是一点社论。
The description of specific cognitive trainings that can improve working memory in people that have had traumatic brain injury or concussion, as well as our earlier discussion about the development of frontal lobe function and plasticity of frontal lobe function, makes me wonder Is the working memory circuitry and frontal lobe function a use it or lose it kind of circuit?
对可以改善患有创伤性脑损伤或脑震荡的人的工作记忆的特定认知训练的描述，以及我们之前关于额叶功能的发展和额叶功能可塑性的讨论，让我想知道工作记忆回路和额叶功能是一种使用它还是失去它的回路？
Meaning, if somebody goes to high school, graduates high school, and then gets into a lifestyle or college, and then graduates college as well, and then gets into a lifestyle where they're not reading very many books.
意思是，如果有人上高中，高中毕业，然后进入一种生活方式或大学，然后大学毕业，然后进入一种他们不读很多书的生活方式。
They're definitely scrolling social media.
他们肯定在浏览社交媒体。
They're carrying out their daily tasks with apparently a high degree of functionality.
他们正在以显然高度的功能来执行日常任务。
But they're not really pushing these forebrain circuits.
但他们并没有真正推动这些前脑回路。
Do we imagine that some of those forebrain circuits regress, AKA use it or lose it?
我们是否想象其中一些前脑回路会退化，也就是使用它或失去它？
It seems to me that a few years back, maybe 10, 15 years back, there was a lot of interest in how to maintain cognitive function.
在我看来，几年前，也许是 10、15 年前，人们对如何维持认知功能很感兴趣。
In fact, one of the most common questions I would get, even as a neuroscientist primarily focused on the visual and autonomic nervous system, was, how do I keep my memory as I age?
事实上，即使作为一名主要研究视觉和自主神经系统的神经科学家，我最常见的问题之一是，随着年龄的增长，我如何保持记忆力？
It seems to me that training it up and then continuing to use those circuits would be a really good way.
在我看来，训练它然后继续使用这些电路将是一个非常好的方法。
Reading books without forcing oneself to finish the chapter, even though distractions jump into one's head, things like that.
读书时不要强迫自己读完这一章，即使分心的事情突然出现在你的脑海中，诸如此类。
For me, it's when I go to the gym, I try not to bring my phone, and if I do, I'll listen to one album of music, but I won't allow myself to play on my phone.
对我来说，就是当我去健身房的时候，我尽量不带手机，如果带的话，我会听一张音乐专辑，但我不会允许自己玩手机。
I try.
我尝试一下。
I mean, not interrupting a conversation with text messaging.
我的意思是，不要用短信打断对话。
Basically, the landscape I'm trying to draw here is it seems like the world is designed to disrupt, the modern world is designed to disrupt working memory and cognition of the frontal lobes.
基本上，我想在这里描绘的景观是，世界似乎是为了破坏而设计的，现代世界的设计就是为了破坏额叶的工作记忆和认知。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
And we need to do some real training, just like muscles and atrophy and cardiac fitness atrophies if we're not doing resistance and cardiovascular training.
我们需要做一些真正的训练，就像如果我们不进行阻力和心血管训练，肌肉就会萎缩，心脏健康也会萎缩。
Does that set?
就这么定了？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I think that's fair.
是的，我认为这是公平的。
I think of all the systems that decline with aging, not every brain system declines, but certainly the frontal executive system we're talking about is one that takes more of a decline than others.
我想到所有随着衰老而衰退的系统，并不是每个大脑系统都会衰退，但我们谈论的额叶执行系统肯定比其他系统衰退得更多。
That's just how it is with healthy aging.
健康老龄化就是如此。
Not surprising, it's the most complicated system, and it's probably the most biologically costly.
毫不奇怪，它是最复杂的系统，而且可能是生物学上成本最高的。
And so, the more complicated system is going to take more of a hit than other systems.
因此，更复杂的系统将比其他系统受到更大的打击。
And so certainly, I don't know about regressing, but certainly we're maybe accelerating this decline that we know exists.
当然，我不知道什么是倒退，但我们肯定可能正在加速这种我们知道存在的衰退。
But a way I would think about it, though, is that not just trying to prevent a decline, but what we talked about before, there's no reason not to optimize.
但我思考的一个方式是，不仅仅是试图防止下降，而且正如我们之前讨论的那样，没有理由不进行优化。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
If everything is couched in, "I don't want to get dementia, and don't want to get Alzheimer's disease, and I don't want to get this and that," I think that's not the way we should be looking about it.
如果一切都表达为“我不想得痴呆症，不想得阿尔茨海默病，我不想得这个那个”，我认为这不是我们应该考虑的方式。
We want to look about optimizing health and brain health and getting up to our optimal levels, because otherwise we're always playing defense instead of playing-
我们想要考虑优化健康和大脑健康并达到最佳水平，因为否则我们总是在防守而不是比赛-
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
offense.
冒犯。
And that's really hard for neurologists.
这对神经科医生来说真的很难。
We have a hard time thinking about brain health, even though we're the brain specialists.
尽管我们是大脑专家，但我们很难思考大脑健康。
We think about brain disease.
我们想到脑部疾病。
And we're just now as a field start thinking about preventative neurology, and thinking about it not just like stopping Alzheimer's disease, but promoting health and a healthy brain.
作为一个领域，我们现在才刚刚开始思考预防性神经病学，不仅要思考如何阻止阿尔茨海默病，还要促进健康和大脑健康。
Neurologists don't talk to healthy patients about being healthier.
神经科医生不会与健康的患者谈论如何变得更健康。
Andrew Huberman:
安德鲁·休伯曼：
I love how candid you are about the medical profession.
我喜欢你对医学界的坦诚。
And I like to think it's changing.
我喜欢认为它正在改变。
I don't know.
我不知道。
Something happened in the 2020, 2021 era, I feel, this is just my bias, but I feel that the general public started becoming more aware of the things they might do to support their mental and physical health.
2020、2021 年发生了一些事情，我觉得这只是我的偏见，但我觉得公众开始更加意识到他们可能会做些什么来支持他们的身心健康。
Maybe they had more time on their hands, but I think there was just more foraging for information.
也许他们有更多的时间，但我认为只是更多地寻找信息。
I love the idea that through simple practices like forcing oneself to read a book chapter start to finish without looking at one's phone, even if it takes twice as long as one would like, redirecting one's focus when focus moves away is a way of keeping working memory and cognitive function online, maybe even strengthening it, as you said, optimizing it.
我喜欢这样的想法：通过简单的练习，比如强迫自己从头到尾读一本书的章节，而不看手机，即使它需要花费两倍的时间，当焦点移开时重新调整注意力，是保持工作记忆和认知功能在线的一种方式，甚至可能加强它，正如你所说，优化它。
I think that there's so much emphasis now on physical health, which I think is great.
我认为现在人们非常重视身体健康，我认为这很好。
Sleep-
睡眠-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
thanks to Matt Walker.
感谢马特·沃克。
He really brought that torch in on sleep.
他确实在睡觉时带了火把。
And now others like myself are really trying to amplify the message of the critical role of sleep.
现在，像我这样的人正在努力宣传睡眠的关键作用。
But also, most people realize they should probably at least walk.
而且，大多数人意识到他们至少应该步行。
The 10,000 steps thing is not a bad idea.
10,000 步并不是一个坏主意。
Getting some heart rate up a few times a week or more, maybe doing some resistance training a few times a week or more.
每周或多次提高心率，也许每周进行几次或多次阻力训练。
And not just for athletes, but for elderly folks, men and women.
不仅适用于运动员，也适用于老年人、男性和女性。
I feel like we need the same for cognition, for brain function, and there just isn't a structure to that.
我觉得我们的认知和大脑功能也需要同样的东西，但只是没有一个结构。
No one can say right now, "You need to do three chapters of reading fiction per week," or, "You got to learn a few new vocabulary words and then write sentences with them." They do it in school, but then we're just set into the general population and-
现在没有人可以说，“你需要每周阅读三章小说”，或者“你必须学习一些新的词汇，然后用它们写句子”。他们在学校里这样做，但随后我们就进入了普通人群，然后——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
and most people, I think, regress, right?
我认为大多数人都会倒退，对吧？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
I think the big problem with brain health is trying to have a measure of what brain health is.
我认为大脑健康的一个大问题是试图衡量大脑健康是什么。
And it's interesting to me, again, as a physician, thinking about it from a neurologist standpoint, when you go to your family doctor, your primary care physician every year for your yearly physical, they examine every organ in your body except your brain.
对我来说很有趣的是，作为一名医生，从神经科医生的角度思考，当你每年去看你的家庭医生、你的初级保健医生进行年度体检时，他们会检查你身体中除大脑之外的每个器官。
Your lungs, your heart, your skeletal system, your skin.
你的肺、你的心脏、你的骨骼系统、你的皮肤。
But what do they do for your brain, outside of having a conversation with you?
但除了与你交谈之外，它们对你的大脑还有什么作用呢？
Andrew Huberman:
安德鲁·休伯曼：
Yeah, no cognitive tasks.
是的，没有认知任务。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
There's nothing.
什么都没有。
Andrew Huberman:
安德鲁·休伯曼：
No working memory tasks.
没有工作记忆任务。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
They don't measure your brain at all.
他们根本不测量你的大脑。
And it's not their fault.
这不是他们的错。
The field has not provided them with a test of brain health.
该领域尚未为他们提供大脑健康测试。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
And so part of the problem is we don't have a measurement of brain health.
因此，部分问题在于我们无法测量大脑健康状况。
I'm involved And it's something called the Brain Health Project, which is at UT Dallas.
我参与了这个名为“大脑健康项目”的项目，该项目位于德克萨斯大学达拉斯分校。
Their goal is a study to enroll 100,000 people, and they've been developing a brain health index.
他们的目标是开展一项招募 10 万人的研究，并且他们一直在开发大脑健康指数。
And that's a complicated thing to do, but I really believe they're onto something because it's not just cognition.
这是一件复杂的事情，但我真的相信他们正在做某事，因为这不仅仅是认知。
It's social, it's lifestyle, like sleep, and it's well-being.
它是社交的，它是生活方式，就像睡眠一样，它是幸福的。
A brain health index is going to cover all of these aspects.
大脑健康指数将涵盖所有这些方面。
So they've developed quite an interesting, important index which does try to capture all aspects of brain health and then can be used to track your brain health over time with interventions that they've developed.
因此，他们开发了一个非常有趣且重要的指数，该指数确实试图捕获大脑健康的各个方面，然后可以通过他们开发的干预措施来跟踪您的大脑健康状况。
Once we develop a brain health index, then we have something to follow and to be able to measure if we are optimizing our brain health.
一旦我们制定了大脑健康指数，我们就可以遵循并能够衡量我们是否正在优化大脑健康。
Otherwise, how do you know if you're optimizing your brain health?
否则，你怎么知道你是否正在优化你的大脑健康？
Your doctor's not telling you.
你的医生没有告诉你。
You don't know.
你不知道。
All these games you get on, on the web don't really tell you.
您在网络上玩的所有这些游戏并不能真正告诉您。
So when we develop that, then all of the things that can promote brain health will be measurable, and I think it will take off the way physical fitness did.
因此，当我们开发出这一点时，所有可以促进大脑健康的事情都将是可测量的，我认为它将像身体健康那样起飞。
Andrew Huberman:
安德鲁·休伯曼：
Perhaps you get enough of it from your work, but given what you know about brain health and approaches to brain health, what are some of the things that you do besides sleep, exercise, nutrition, in terms of trying to optimize brain function?
也许你从工作中得到了足够的信息，但考虑到你对大脑健康和大脑健康方法的了解，除了睡眠、锻炼、营养之外，你还做了哪些事情来试图优化大脑功能？
Do you make it a point to read fiction?
你重视阅读小说吗？
Do you make it a point to learn new skills like instruments, things like that?
你是否重视学习新技能，例如乐器之类的东西？
Again, maybe your profession and your personal life keeps you busy enough that you don't have to do those things.
再说一遍，也许你的职业和个人生活让你足够忙碌，以至于你不必做这些事情。
For me, gathering, organizing, and disseminating the information for the podcast feels like the heavy lifting mental work for me, but I'm keenly aware of the fact that were I to read more fiction or learn an instrument, everyone else around me would suffer if I learned an instrument.
对我来说，收集、组织和传播播客的信息对我来说就像是一项繁重的脑力劳动，但我敏锐地意识到，如果我读更多小说或学习一种乐器，如果我学习一种乐器，我周围的其他人都会受苦。
But that it would probably benefit me in some real way.
但这可能会给我带来某种真正的好处。
What are the things that you do, and that you think are access points that hopefully people also enjoy?
你做了哪些事情，以及你认为哪些事情是希望人们也喜欢的切入点？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, no, I agree with that.
是的，不，我同意这一点。
I think when you have a busy career and you're doing many different things like teaching and research and seeing patients, I've always felt that I'm maxing out.
我认为，当你的职业生涯很忙碌，要做很多不同的事情，比如教学、研究和看病人时，我总是觉得自己已经精疲力尽了。
Andrew Huberman:
安德鲁·休伯曼：
You're full.
你吃饱了。
Yeah.
是的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
I'm full.
我吃饱了。
My executive function is being tested to the limit, but-
我的执行能力正经受着极限的考验，但是——
Andrew Huberman:
安德鲁·休伯曼：
You're like a professional athlete of the mind.
你就像一位专业的心灵运动员。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
In a way, but then you realize that's not everything.
在某种程度上，但后来你意识到这并不是全部。
There's so many other aspects.
还有很多其他方面。
Everything emanates from the brain, so you start to think about what should I be doing in my life as a father and a husband?
一切都源于大脑，所以你开始思考作为一个父亲和丈夫我的生活应该做什么？
What should I be doing in terms of promoting social interactions with friends, and what should I be doing for sleep and health, sleep and nutrition?
在促进与朋友的社交互动方面我应该做什么？为了睡眠和健康、睡眠和营养我应该做什么？
And it's funny you bring up books.
有趣的是你提到了书。
I think I went probably 20 years where I never read any fictional book and said, "This can't be good for my brain," and then just consciously started reading books and reading more non-fiction books and just-
我想我大概有 20 年没有读过任何虚构类书籍，并说，“这对我的大脑没有好处”，然后就有意识地开始读书，阅读更多非虚构类书籍，然后——
Andrew Huberman:
安德鲁·休伯曼：
Listening to books or reading hard books?
听书还是看硬书？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Reading.
阅读。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
I still like to read the hard-
我还是喜欢读硬文
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
covers, you know?
封面，你知道吗？
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Likewise.
同样地。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Unfortunately, when I was an undergraduate, with pre-med, they don't let you take any courses that are interesting, so I never learned any history or all the books that I never read, I started reading my kids' English literature books that I never got a chance to and started reading history, and so, yeah, I always felt just increasing knowledge was enough.
不幸的是，当我还是一名医学预科本科生时，他们不让你选修任何有趣的课程，所以我从来没有学过任何历史或所有我从未读过的书，我开始阅读我孩子们从未有机会读过的英国文学书籍，并开始阅读历史，所以，是的，我总是觉得只要增加知识就足够了。
Like I said, our brain just stores information.
就像我说的，我们的大脑只是存储信息。
That's one of its jobs.
这是它的工作之一。
So that's got to be useful.
所以这一定是有用的。
But, again, all of these things that I do believe help brain health, we need some way to measure it, I think.
但是，我认为所有这些我确实相信有助于大脑健康的事情，我们需要某种方法来衡量它。
Certainly, if you feel healthy, that's an important thing.
当然，如果你感觉健康，那是一件很重要的事情。
If you feel like you're healthy physically or mentally, that's a good start.
如果您感觉自己的身体或精神都很健康，那么这是一个好的开始。
But if we actually had a way to sort of track it the way we can track heart disease and lung disease and skin and things like that, I think that would really boost everyone's confidence that this is really making a difference.
但如果我们真的有一种方法来追踪它，就像追踪心脏病、肺病、皮肤病和类似疾病一样，我认为这将真正增强每个人的信心，相信这确实会带来改变。
Andrew Huberman:
安德鲁·休伯曼：
Well, on the basis of today's conversation, I'm going to read some fiction.
嗯，在今天谈话的基础上，我要读一些小说。
I read a lot of non-fiction, and I enjoy it.
我读了很多非小说类书籍，而且很喜欢。
I listen to some audiobooks, but it's crazy to me because I'm a neuroscientist by training, and I understand neuroplasticity, and I do know a bit about fitness and the key role of remaining active, kind of use it or lose it, and maybe improve it, right?
我听一些有声读物，但这对我来说很疯狂，因为我是一名训练有素的神经科学家，我了解神经可塑性，而且我确实了解一些关于健身和保持活跃的关键作用，使用它或失去它，也许会改善它，对吗？
That wasn't intended to rhyme, folks.
伙计们，这并不是为了押韵。
Kind of behaviors, but clearly, based on everything you've told us, that if we don't exercise these working memory and other circuits for cognition, why should they stick around?
某种行为，但显然，根据你告诉我们的一切，如果我们不锻炼这些工作记忆和其他认知回路，它们为什么要留下来？
And I'm beginning to think that social media, as entertaining as it is, and I learn there, and I teach there, but that it's not a cohesive plot.
我开始认为社交媒体虽然很有趣，但我在那里学习，在那里教书，但这不是一个有凝聚力的情节。
Right?
正确的？
It's like those baby otters, that really cool-looking dog that I'd love to own, I'm thinking about getting another dog, this interesting conference.
就像那些小水獭，我很想拥有那只看起来很酷的狗，我正在考虑再养一只狗，这次有趣的会议。
It's random, pseudo-random, tailored to me, of course, because that's what their algorithms do, but that's not following a plot, character development, antagonist, protagonist, any of the things that provide cognitive richness.
当然，它是随机的、伪随机的，是为我量身定制的，因为这就是他们的算法所做的，但这并不遵循情节、角色发展、对手、主角，或任何提供认知丰富性的东西。
This is kind of obvious as I say this-
正如我所说，这是显而易见的——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
but I feel like we're divorced from these things that really helped evolve culture and evolved individuals.
但我觉得我们已经脱离了那些真正有助于发展文化和发展个人的东西。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And it takes some discipline But like a run or going to the gym, you do it a few times for a shorter amount of time with less intensity, and pretty soon you're up to speed, and there's an upper threshold unless you're going to be a pro.
这需要一些纪律，但就像跑步或去健身房一样，你在较短的时间内以较低的强度进行几次，很快你就可以达到速度，除非你想成为专业人士，否则有一个上限。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I'm certainly not going to be an English lit professor.
我当然不会成为一名英语文学教授。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
So I don't think-- Obviously, boosting executive function is incredibly important, but I don't think it's going to happen just with technology.
所以我不认为——显然，增强执行功能非常重要，但我不认为仅靠技术就能实现这一点。
I think it needs human interaction.
我认为这需要人际互动。
I believe executive function should be taught in school as a course.
我认为执行功能应该作为一门课程在学校教授。
This goal management theory that I talk about could be taught in school.
我所说的目标管理理论可以在学校教授。
It's what you do with your students.
这就是你对学生所做的事情。
For example, when you have a graduate student and they have to learn how to read the literature and design an experiment and carry out the experiment, there's no technology that's going to just be able to teach them how to do that.
例如，当你有一名研究生，他们必须学习如何阅读文献、设计实验并进行实验时，没有任何技术能够教他们如何做到这一点。
You've got to intervene sometimes and say, "Stop reading all those papers that are not relevant," okay?
有时你必须介入并说：“停止阅读所有那些不相关的论文，”好吗？
Or, "You've piloted this enough, get going." It's that kind of wisdom that you get when you get older that has to be on top of the technology.
或者，“你已经试验够了，开始吧。”当你变老时，你就会获得这种智慧，而这种智慧必须掌握在技术之上。
So that's why I think it needs to be directed.
所以这就是为什么我认为它需要被引导。
So whether it's in school or whether it's in a patient, I think there still needs to be someone coaching us.
所以无论是在学校还是在病人身上，我认为仍然需要有人指导我们。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
And I know that's why some people have really benefited from life coaches, because someone just-- It sounds obvious when you tell your kids, "Just do it this way, break it up into little pieces." It seems so obvious, but to them, it's not always obvious, and they just need to be told something simple for it to make a big difference.
我知道这就是为什么有些人确实从生活教练中受益，因为有人——当你告诉你的孩子时，这听起来很明显，“就这样做，把它分成小部分。”这看起来很明显，但对他们来说，这并不总是显而易见的，他们只需要告诉他们一些简单的事情就可以产生很大的影响。
Andrew Huberman:
安德鲁·休伯曼：
And in school, we were brought along step by step, and there was context, so why wouldn't it be the same in adulthood?
而且在学校里，我们是被一步一步带过来的，有背景，那成年后为什么不一样呢？
I'm realizing I should probably learn how to play chess.
我意识到我应该学习如何下国际象棋。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Seems like a good game, right?
看起来是个好游戏，对吧？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Chess, yeah.
国际象棋，是的。
Any one of these.
其中任何一项。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, it's working memory.
是的，这就是工作记忆。
You've got to keep information online.
你必须将信息保存在网上。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
For sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
There's a bunch else there.
那里还有其他一堆。
I think, but as a tool to improve cognition.
我想，不过是作为提高认知的工具。
I was also thinking, some people orient more towards the arts.
我也在想，有些人更偏向于艺术。
My sister is really great about-- She's a therapist in San Francisco, but also takes theater classes, and she said improv forces you to keep on your toes, keep the context there.
我姐姐真的很棒——她是旧金山的一名治疗师，但也参加了戏剧课程，她说即兴表演迫使你保持警惕，保持背景。
You're up on your feet.
你站起来了。
And I wasn't a theater kid.
而且我不是一个戏剧小孩。
I did the crew.
我做了船员。
I did the pulling the curtains and stuff till I went and did other things.
我负责拉窗帘之类的事情，直到我去做其他事情。
But that whole biz is about learning the novel rule set in the moment.
但整个业务就是学习当下的新规则。
It's improv by definition.
根据定义，它是即兴的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Absolutely.
绝对的。
Anything that requires you to have that, where there's a goal and you've got to break it down into sub-goals, and you've got to do it simultaneously, and you've got to filter out distractions and...
任何需要你做到这一点的事情，有一个目标，你必须将其分解为子目标，你必须同时完成它，你必须过滤掉干扰，然后......
For example, my kids got me one of these pizza ovens for Christmas.
例如，我的孩子们给我买了一个这样的披萨烤箱作为圣诞节礼物。
And you know how hard-- You think it's easy.
你知道这有多难——你认为这很容易。
You just sort of make some pizza and throw it in the oven and done.
你只需制作一些披萨，然后将其放入烤箱即可完成。
I'm on my third time, and it's still not even round.
我已经第三次了，但它仍然不圆。
Andrew Huberman:
安德鲁·休伯曼：
Oh, yeah.
哦，是的。
I'll come over and test.
我过来测试一下。
That sounds good.
听起来很好。
That sounds good.
听起来很好。
And you're in a city with great food, so the standard is really high.
而且你所在的城市有很多美食，所以标准非常高。
I'm tempted to make a reference to the cheeseboard pizza, but I want to keep the lines as short as possible because they're already too long.
我很想参考奶酪板披萨，但我想保持线路尽可能短，因为它们已经太长了。
Maybe we could talk a little bit about some other unfortunately common disease states.
也许我们可以谈谈其他一些不幸的常见疾病状态。
Parkinson's and Alzheimer's.
帕金森氏症和阿尔茨海默氏症。
Let's start with Alzheimer's.
让我们从阿尔茨海默氏症开始。
I think few things scare people more than the idea of getting Alzheimer's, especially if they have Alzheimer's in their family.
我认为没有什么比得上阿尔茨海默氏症更让人们害怕的了，尤其是如果他们的家人患有阿尔茨海默氏症。
First of all, what is the genetic link with Alzheimer's?
首先，阿尔茨海默病与遗传有何联系？
If one has a parent or grandparent that got Alzheimer's, is there a known increase in one's risk for getting Alzheimer's?
如果一个人的父母或祖父母患有阿尔茨海默病，那么患阿尔茨海默病的风险是否会增加？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
It's not that straightforward as other diseases.
它并不像其他疾病那么简单。
There's diseases like Huntington's disease, where it's a very strong link that if you have a parent, you have a very high chance of getting it.
亨廷顿氏舞蹈症等疾病与您有很强的联系，如果您有父母，那么您患上这种疾病的机会就很高。
But there's so many factors that it's not necessarily the case that you increased your risk of getting it.
但因素太多，并不一定会增加感染的风险。
There are families where there is something special about the family, where it just runs in families.
有些家庭有一些特别的东西，它只是在家庭中传承。
But I try to not scare my patients' children into worrying that they're necessarily going to get Alzheimer's because it's not that straightforward.
但我尽量不吓唬病人的孩子，让他们担心他们一定会患上阿尔茨海默病，因为事情没那么简单。
Andrew Huberman:
安德鲁·休伯曼：
As I understand, Alzheimer's is a neurodegenerative disorder.
据我了解，阿尔茨海默氏症是一种神经退行性疾病。
Impacts the hippocampus, among other structures.
影响海马体和其他结构。
There's been some debate in recent years as to whether or not the whole amyloid hypothesis is real or not.
近年来，关于整个淀粉样蛋白假说是否真实存在一些争论。
There's a bunch of, unfortunately, false data accusations and that whole thing.
不幸的是，存在大量虚假数据指控以及整个事情。
But my understanding is that if you look at a slice of human brain from a patient that died with Alzheimer's, maybe even from Alzheimer's, that you see plaques and tangles.
但我的理解是，如果你观察死于阿尔茨海默氏症（甚至可能是阿尔茨海默氏症）的患者的人类大脑切片，你会看到斑块和缠结。
You see these sub-cellular structures and build-up, and that our basic understanding of Alzheimer's that's in the textbook and that most people have heard of is still correct, right?
你看到这些亚细胞结构和堆积，我们在教科书中以及大多数人都听说过的对阿尔茨海默氏症的基本理解仍然是正确的，对吧？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay, because I think a couple of years ago, unfortunately the way social media sometimes can work is that the idea was that it was all wrong.
好吧，因为我认为几年前，不幸的是，社交媒体有时的运作方式是，这个想法是完全错误的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
All wrong.
都错了。
And indeed, somebody fudged data.
事实上，有人捏造了数据。
They made up data.
他们编造了数据。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
And that's terrible.
那太可怕了。
But Alzheimer's is a neurodegenerative disorder, includes the hippocampus.
但阿尔茨海默病是一种神经退行性疾病，包括海马体。
Plaques and tangles are present in the neurons.
神经元中存在斑块和缠结。
Those are not good for neurons, as I understand.
据我了解，这些对神经元不利。
So what's the controversy?
那么有什么争议呢？
And why don't we have a treatment for Alzheimer's yet?
为什么我们还没有治疗阿尔茨海默病的方法呢？
I feel like almost every other psychiatric disease, including Parkinson's, there are certain things you can do to at least push the system in the right way.
我觉得几乎所有其他精神疾病，包括帕金森病，您都可以采取某些措施来至少以正确的方式推动系统。
Why is Alzheimer's and other dementias so tricky?
为什么阿尔茨海默氏症和其他痴呆症如此棘手？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, it's very frustrating because the neurodegenerative source, it's so com- so many factors that are probably involved in the pathology that there's not one single transmitter.
是的，这非常令人沮丧，因为神经退行性疾病的根源非常复杂，可能涉及病理学的因素太多，以至于没有一个单一的递质。
In Parkinson's disease, it's a decreased dopamine, and so one transmitter can make a very big difference.
在帕金森病中，多巴胺减少，因此一个递质可以产生很大的影响。
Early on in Alzheimer's, it was discovered that there was low acetylcholine in the brains, and the only approved treatment for Alzheimer's disease is a drug that boosts acetylcholine.
在阿尔茨海默病早期，人们发现大脑中的乙酰胆碱含量较低，而唯一批准的阿尔茨海默病治疗方法是提高乙酰胆碱的药物。
Andrew Huberman:
安德鲁·休伯曼：
What's the drug?
是什么药？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
It's called Donepezil.
它的名字叫多奈哌齐。
There's a few of them.
其中有几个。
They're acetylcholinesterase inhibitors that boost acetylcholine.
它们是乙酰胆碱酯酶抑制剂，可以增强乙酰胆碱。
They've been around for 20 years or more, and the reality is when you give it to your patients, they don't see much of a difference because it's not the primary deficit.
它们已经存在了 20 年或更长时间，而现实是，当您将其提供给患者时，他们并没有看到太大的差异，因为这不是主要的缺陷。
So the real problem has been trying to find out what is the primary mechanism that's leading to this, the wide range of cognitive behavioral issues, and there doesn't seem to be at least one neurotransmitter that can make the difference.
因此，真正的问题是试图找出导致这种情况的主要机制是什么，即广泛的认知行为问题，但似乎至少没有一种神经递质可以发挥作用。
And so now the push has been, is there something else that we can do?
所以现在的推动是，我们还能做些什么吗？
Can we block amyloid?
我们可以阻断淀粉样蛋白吗？
Can we block something in the pathology?
我们可以阻止病理学中的某些东西吗？
And again, it just has not been successful.
再说一次，它只是没有成功。
It's very frustrating because I think it was over probably 35 years ago, I saw my first Alzheimer's patients, and I don't believe I say that much different to them now, except that we have a lot more things we can do just on the social side of things.
这非常令人沮丧，因为我认为这一切可能已经在 35 年前结束了，我看到了我的第一批阿尔茨海默氏症患者，我不相信我现在所说的对他们来说有什么不同，除了我们在社交方面还有很多事情可以做。
But unfortunately for drugs, we don't have anything that's been really transformative.
但不幸的是，对于药物来说，我们没有任何真正具有变革性的东西。
But again, being a neurologist, it sounds very depressing, but I think part of what the family isn't always looking for a cure.
但同样，作为一名神经科医生，这听起来非常令人沮丧，但我认为部分原因是这个家庭并不总是在寻找治疗方法。
Of course, they'd like to have a cure, but I think them understanding what's going on, what to expect, how to handle the behaviors is what they're really after, at least until we find a cure.
当然，他们希望找到治疗方法，但我认为他们真正想要的是了解正在发生什么、会发生什么、如何处理这些行为，至少在我们找到治疗方法之前是这样。
Andrew Huberman:
安德鲁·休伯曼：
Parkinson's, you mentioned, is a deficit in dopaminergic function due largely to degeneration of dopaminergic neurons.
您提到，帕金森病是多巴胺能功能缺陷，很大程度上是由于多巴胺能神经元退化所致。
There, there's some effective treatments, right?
那里有一些有效的治疗方法，对吗？
L-DOPA.
左旋多巴。
Did you know there's this over-the-counter stuff that's sold that a lot of people take who don't have Parkinson's?
您是否知道有一种非处方药可供许多没有帕金森病的人服用？
I'm not suggesting they take it, called mucuna pruriens.
我并不是建议他们服用这种叫做黧豆的东西。
It's the velvety bean.
这是天鹅绒般的豆子。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I've heard of it.
是的，我听说过。
Andrew Huberman:
安德鲁·休伯曼：
It's 99% L-DOPA.
99% 是左旋多巴。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
I've heard of it, yeah.
我听说过，是的。
Andrew Huberman:
安德鲁·休伯曼：
It's present in some energy drinks and supplements, and people can go buy it.
它存在于一些能量饮料和补充剂中，人们可以去购买。
I'm not suggesting they do that.
我并不是建议他们这样做。
I actually tried it.
我实际上尝试过。
Boy, being really dopamined out, to me, doesn't feel that good.
男孩，对我来说，多巴胺真的耗尽了，感觉不太好。
Yeah, I felt kind of agitated.
是的，我感到有点激动。
My vision got a little twinkly.
我的视线变得有点闪烁。
It did not feel like a high of any kind, and then I felt lousy for a couple of hours after it wore off.
这种感觉并不像任何一种兴奋，在这种感觉消失后的几个小时里我感觉很糟糕。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, I don't think you can really get in enough L-DOPA to get enough into your brain.
是的，我认为你无法真正摄入足够的左旋多巴来进入你的大脑。
That happened early in neurology when it was discovered we couldn't give our patients enough L-DOPA without them feeling bad because it's also metabolized in the periphery.
这种情况在神经病学早期就发生过，当时我们发现我们无法给患者提供足够的左旋多巴而不会让他们感觉不舒服，因为它也在外周代谢。
And so it wasn't until Sinemet came along, which has this decarboxylase inhibitor that blocks sort of the breakdown of dopamine, that we were able to sort of get enough dopamine into the brain.
因此，直到 Sinemet 出现，它含有这种脱羧酶抑制剂，可以阻止多巴胺的分解，我们才能够让足够的多巴胺进入大脑。
So I'm not sure.
所以我不确定。
Yeah, so that's why I think it's not going to probably get the levels up high enough in the brain.
是的，所以这就是为什么我认为它可能不会让大脑中的水平达到足够高的水平。
Andrew Huberman:
安德鲁·休伯曼：
So Parkinson's patients are given L-DOPA or bromocriptine or drugs like that.
因此，帕金森病患者会服用左旋多巴或溴隐亭或类似药物。
Going back to Alzheimer's for a moment, what do you tell somebody who has early-stage Alzheimer's?
回到阿尔茨海默氏症，您会告诉患有早期阿尔茨海默氏症的人什么？
You just say, "Listen, try and get good sleep.
你只需说：“听着，努力睡个好觉。
Try and keep people around you.
尝试让人们留在你身边。
Stay cognitively engaged.
保持认知投入。
Try and keep those circuits going through behavioral-induced neuroplasticity, but we're just going to watch the steepness of the decline."
尝试让这些回路经历行为引起的神经可塑性，但我们只会看到下降的幅度。”
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Is that really all we've got?
这真的是我们所拥有的一切吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
All we've got is to help them with everything that comes up on a day-to-day basis.
我们所能做的就是帮助他们解决日常遇到的一切问题。
A lot of the problems, the memory problems tend to be something that families can help compensate for, but you do get to a point where you can't be with someone for 24/7.
很多问题，记忆问题往往是家庭可以帮助弥补的，但你确实会到了无法与某人全天候 (24/7) 在一起的地步。
It's a real burnout for caregivers.
对于护理人员来说，这确实是一种倦怠。
A lot of the behaviors that come up, patients get kind of delusions and agitated, and some of the medications that we use for other conditions are helpful for treating that, but it's really just a purely symptomatic therapy.
出现的很多行为，患者会产生某种妄想和烦躁，我们用于其他病症的一些药物有助于治疗这种情况，但这实际上只是一种纯粹的对症治疗。
And the more socialization that patients get, they tend to do better.
患者接受的社会化越多，他们往往会做得更好。
There was a study back at Penn way back that if you showed patients family movies or family albums, it was better than any drug you could give them to sort of help their behavior.
宾夕法尼亚大学很久以前就有一项研究表明，如果你给病人看家庭电影或家庭相册，这比你给他们服用的任何药物都更好，可以帮助他们的行为。
So those memories are in there, and they were making some type of contact that was helping them emotionally that you couldn't turn off with a drug.
所以那些记忆就在那里，他们正在进行某种类型的接触，这些接触在情感上帮助他们，而你无法用药物来关闭它们。
So I think the more we do things like that, the more we'll be helpful for them, at least symptomatically.
所以我认为我们做的事情越多，我们对他们的帮助就越多，至少在症状上是这样。
Andrew Huberman:
安德鲁·休伯曼：
I've seen a number of videos on social media of people with Alzheimer's who listen to a piece of music, or people with Parkinson's that hear a piece of music, and that seems to resurrect some at least contextually appropriate emotional state where it kind of brings the person to the surface again.
我在社交媒体上看过很多视频，内容是阿尔茨海默氏症患者听一段音乐，或者帕金森氏症患者听一段音乐，这似乎会复活一些至少与情境相符的情绪状态，从而使人再次浮出水面。
Yeah, it's a kind of tragic situation for Alzheimer's right now.
是的，目前对于阿尔茨海默病来说这是一种悲惨的情况。
It seems like if ever there was a call to arms for the neurology community and biotech and behavioral tech, it would be for Alzheimer's, for the treatment of Alzheimer's.
看起来，如果神经病学界、生物技术和行为技术有战斗的号召，那一定是为了阿尔茨海默氏症，为了治疗阿尔茨海默氏症。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, absolutely.
是的，绝对是。
Andrew Huberman:
安德鲁·休伯曼：
I will never ask a guest to comment on the good or bad behaviors of other people except my own.
我绝不会要求客人评论除我自己以外的其他人的好或坏行为。
But there's a Nobel Prize-winning neuroscientist, and I visited him, he's at a big East Coast school, back in 2010, and during the course of our one-hour meeting, he consumed no fewer than four pieces of Nicorette gum.
但是有一位获得诺贝尔奖的神经科学家，我拜访了他，他在东海岸的一所大型学校，早在 2010 年，在我们一小时的会面过程中，他吃了不少于四块尼古丁口香糖。
And I said, "I got to ask, what's this about?" By the way, he's extremely sharp still.
我说：“我得问，这是怎么回事？”顺便说一句，他仍然非常敏锐。
And he said, "Oh, yeah.
他说：“哦，是的。
I used to be a smoker, but smoking's really bad for you because you can get lung cancer." "Dipping's bad for you because you can get mouth cancer, but nicotine," these are his words, by the way, "is protective against Parkinson's and Alzheimer's, and it keeps my brain sharp, so I chew Nicorette all day long." And I thought, "Okay, well, he is an MD, actually." And I thought, "Oh, that's interesting." And I did an episode of this podcast on nicotine.
我曾经是一名吸烟者，但吸烟对你来说真的很糟糕，因为你可能会患上肺癌。” “吸食对你不好，因为你可能会得口腔癌，但尼古丁，”顺便说一下，这是他的话，“可以预防帕金森氏症和阿尔茨海默氏症，它可以让我的大脑保持敏锐，所以我整天咀嚼尼古丁。”我想，“好吧，他实际上是一名医学博士。”我想，“哦，这很有趣。”我制作了一集关于尼古丁的播客。
By the way, it can raise blood pressure.
顺便说一句，它可以升高血压。
Certainly, smoking, vaping, dipping, or snuffing, not good.
当然，吸烟、吸电子烟、吸食或吸鼻烟都是不好的。
Bad.
坏的。
Don't do it.
不要这样做。
But there is some interest in the use of nicotine as a cognitive enhancer, so I'd love to know your thoughts on that.
但有人对使用尼古丁作为认知增强剂感兴趣，所以我很想知道你对此的想法。
And I'd love to know your thoughts on his statement about nicotine being a potential way to stave off Parkinson's and Alzheimer's, with the caveat that he just kind of threw that out there, and this guy's sort of known for just kind of throwing stuff out there every once in a while.
我很想知道你对他关于尼古丁是预防帕金森氏症和阿尔茨海默氏症的潜在方法的说法的看法，但需要注意的是，他只是把它扔在那里，而这个人以偶尔扔东西而闻名。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I have a feeling you know who this person is.
我有一种感觉，你知道这个人是谁。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But in any event, what gives?
但无论如何，有什么好处呢？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Well, I don't know anything about nicotine staving off any neurodegenerative disorder.
嗯，我对尼古丁预防神经退行性疾病一无所知。
But nicotine was used in a number of early Alzheimer's studies just because of its effect on the cholinergic system.
但尼古丁被用于许多早期阿尔茨海默病研究只是因为它对胆碱能系统的影响。
So there is some truth to that.
所以这是有一定道理的。
The cholinergic system is dysfunctional in Alzheimer's disease, and boosting the cholinergic system probably is beneficial.
阿尔茨海默病的胆碱能系统功能失调，增强胆碱能系统可能是有益的。
The patients that we give the anticholinesterase inhibitors, there are some families that say, "Yeah, he's remembering more, and he's just doing better." I've seen positive things to it.
对于我们给予抗胆碱酯酶抑制剂的患者，有些家属会说：“是的，他记得更多了，而且他做得更好了。”我看到了积极的一面。
It doesn't really slow the course of the disease.
它并不能真正减缓疾病的进程。
That's the problem.
这就是问题所在。
The disease just carries on even though we're symptomatically improving the symptoms.
即使我们在症状上有所改善，这种疾病仍然会继续存在。
But again, I think it's going to take both acetylcholine and something else.
但我再次认为，这需要乙酰胆碱和其他东西。
I think we don't know should we give dopamine with the nicotine or the acetylcholine, or should we give norepinephrine?
我想我们不知道我们应该给予多巴胺和尼古丁或乙酰胆碱，还是应该给予去甲肾上腺素？
I think it's going to be a cocktail.
我想这将是一杯鸡尾酒。
Which, again, pharmaceutical companies have not tried a cocktail of neuromodulators for Alzheimer's disease.
制药公司还没有尝试过神经调节剂混合物来治疗阿尔茨海默病。
They've just tried acetylcholine.
他们刚刚尝试过乙酰胆碱。
Andrew Huberman:
安德鲁·休伯曼：
Sounds like you should be running the FDA.
听起来你应该管理 FDA。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
No disrespect to the current people in charge, by the way.
顺便说一句，这并不是对现任负责人的不尊重。
Actually, I'm a big believer that there shouldn't be individuals in charge of large organizations.
事实上，我坚信不应该由个人来负责大型组织。
There should be panels.
应该有面板。
There's so much talk about diversity, but they appoint individuals.
关于多样性的讨论太多了，但他们任命的是个人。
You can't get it right when there's only one person, by definition.
根据定义，当只有一个人时，你就无法把事情做好。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Committees, folks.
各位委员会。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Exactly.
正是如此。
Andrew Huberman:
安德鲁·休伯曼：
Committees.
委员会。
Anyway, another editorial.
无论如何，另一篇社论。
Are there any sex differences, male-female differences, in sort of these dopamine levels, working memory, injuries, concussion, things that would direct people toward different routes of treatment?
在多巴胺水平、工作记忆、受伤、脑震荡等方面是否存在性别差异、男女差异，这些差异会引导人们采取不同的治疗途径？
Given that maybe there's more susceptibility in one case, maybe less susceptibility, maybe certain neurotransmitters are more effective in improving symptoms in men versus women.
考虑到在一种情况下可能有更高的敏感性，也可能有更低的敏感性，也许某些神经递质在改善男性症状方面比女性更有效。
Do you see that in the clinic?
你在诊所看到过吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, that's a great question.
是的，这是一个很好的问题。
Emily Jacobs, who's a professor at UC Santa Barbara now in the psychology department, when she was a graduate student in my lab, studied the role of estrogen on working memory and dopaminergic function.
艾米莉·雅各布斯（Emily Jacobs）是加州大学圣巴巴拉分校心理学系的教授，当她还是我实验室的研究生时，她研究了雌激素对工作记忆和多巴胺能功能的作用。
And what she brought to my attention at the time, and it was embarrassing that I didn't know, was that the frontal lobes are full of estrogen receptors.
她当时引起我注意的是，额叶充满了雌激素受体，令我尴尬的是我不知道。
There's probably more estrogen receptors in the frontal lobes than any other part of the brain.
额叶中的雌激素受体可能比大脑的任何其他部分都多。
Andrew Huberman:
安德鲁·休伯曼：
In men and women.
在男性和女性中。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Estrogen boosts dopamine.
雌激素会增强多巴胺。
So higher estrogen levels correlates with increased dopamine levels.
因此，雌激素水平升高与多巴胺水平升高相关。
And there was some anecdotal evidence that in post-menopausal women who were put on estrogen, that their working memory improved, and there was a kind of evolving link between estrogen and frontal lobe function.
有一些轶事证据表明，在服用雌激素的绝经后女性中，她们的工作记忆得到改善，并且雌激素和额叶功能之间存在着一种不断发展的联系。
And she did this amazing study where she studied healthy Berkeley undergraduates at two points in time during their menstrual cycle, when estrogen was at its lowest and when it was its highest.
她做了这项令人惊奇的研究，她研究了健康的伯克利本科生在月经周期的两个时间点，即雌激素最低和最高的时间。
And she also genotyped them for this enzyme they were talking about to know if they were sort of lower or higher on the dopamine level, and then put them in the scanner and measured frontal lobe function and showed that frontal lobe function was modulated by where they were in their estrogen cycle.
她还对他们正在谈论的这种酶进行了基因分型，以了解他们的多巴胺水平是否较低或较高，然后将他们放入扫描仪中并测量额叶功能，结果表明额叶功能是由他们处于雌激素周期的位置调节的。
When they were low estrogen, they were low dopamine, and if they were low estrogen and low dopamine to start, they really had decreased frontal lobe function and decreased working memory ability.
当她们的雌激素水平较低时，多巴胺水平也较低，如果她们一开始就处于低雌激素和低多巴胺水平，那么她们的额叶功能确实会下降，工作记忆能力也会下降。
So it fluctuated based on this interaction between estrogen and dopamine, suggesting that not only is dopamine is important, but hormones are clearly important, and they work synergistically.
因此，它的波动是基于雌激素和多巴胺之间的相互作用，这表明不仅多巴胺很重要，而且激素显然也很重要，并且它们具有协同作用。
So as we're developing this cocktail, we certainly have to bring hormones into the equation and learn more about it.
因此，当我们开发这种鸡尾酒时，我们当然必须将激素纳入考虑范围并对其进行更多了解。
There's just so little information about hormones and cognition.
关于激素和认知的信息很少。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
One of the themes that's come out of some of the episodes we've done with MDs who specialize in endocrine health is that for both men and for women, optimizing estrogen levels is really important for cognition and vascular function.
我们与专门从事内分泌健康的医学博士一起进行的一些节目中出现的主题之一是，对于男性和女性来说，优化雌激素水平对于认知和血管功能都非常重要。
I think people mistakenly hear, "Okay, testosterone, men, estrogen, women." Obviously, both hormones are present in men and women.
我认为人们错误地听到了“好吧，睾丸激素，男性，雌激素，女性。”显然，这两种激素都存在于男性和女性中。
In fact, I know that testosterone levels in women are actually higher than their estrogen levels when you sort of use the same units of measure.
事实上，我知道当你使用相同的测量单位时，女性的睾酮水平实际上高于雌激素水平。
It just so happens that they still have lower testosterone on average than the typical male, but that men whose estrogen levels are too low suffer cognitive defects and vascular defects.
碰巧的是，他们的平均睾酮水平仍然低于典型男性，但雌激素水平过低的男性会出现认知缺陷和血管缺陷。
So this idea that more testosterone, lower estrogen in men is the ideal-
因此，男性体内睾酮水平较高、雌激素水平较低的观点是理想的——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
it just doesn't hold.
它就是不成立。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
It doesn't hold.
它不成立。
Unless you want to be dumb and have a heart attack, it just doesn't hold.
除非你想装傻并心脏病发作，否则它就站不住脚。
Very interesting.
非常有趣。
Do we know what estrogen's doing there?
我们知道雌激素在那里做什么吗？
It's specifically raising dopamine?
它专门提高多巴胺吗？
We don't have to get into the synaptic biology-
我们不必深入研究突触生物学——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
but it's so interesting.
但这很有趣。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
It's actually boosting dopamine activity
它实际上促进了多巴胺活动
Andrew Huberman:
安德鲁·休伯曼：
So it's making more dopamine available.
所以它会产生更多的多巴胺。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
It's really amazing.
真是太神奇了。
And to think about it sort of fluctuating, certainly during the menstrual cycle, we can think about how much it fluctuates in an individual woman over 30 days, but then you can think across individuals, you can think about how much it can account for individual differences.
考虑到它的波动，当然是在月经周期期间，我们可以考虑单个女性在 30 天内的波动程度，但是你可以考虑不同个体，你可以考虑它可以在多大程度上解释个体差异。
So not only sort of knowing your dopamine level, but just knowing sort of estrogen and serotonin is really going to be important.
因此，不仅了解您的多巴胺水平，而且了解雌激素和血清素的含量也非常重要。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Is there any evidence that physical exercise can improve working memory and cognition separate from the known improvements in cardiovascular function and blood flow to the brain that occur with exercise?
除了已知的运动对心血管功能和大脑血流量的改善之外，是否有任何证据表明体育锻炼可以改善工作记忆和认知能力？
Is there anything about going for a 45-minute bout of exercise, pick your favorite exercise, and then doing cognitive work immediately afterward when presumably the catecholamines, dopamine, norepinephrine, and epinephrine are going to be circulating, at least in the blood, at higher levels?
进行 45 分钟的运动，选择你最喜欢的运动，然后立即进行认知工作，此时儿茶酚胺、多巴胺、去甲肾上腺素和肾上腺素可能会以更高的水平循环（至少在血液中），这有什么好处吗？
Has that stuff ever been explored?
这些东西曾经被探索过吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
In all of the groups around the country that are trying to develop cognitive therapies, they often use aerobic exercise as another type of therapy.
在全国各地试图开发认知疗法的团体中，他们经常使用有氧运动作为另一种疗法。
And so for example, the group at University of Illinois Urbana-Champaign, our Cramer's group, has done aerobic exercise quite a bit, and they can find it just as effective as cognitive therapy in improving executive function.
例如，伊利诺伊大学厄巴纳-香槟分校的研究小组（我们的克莱默研究小组）已经进行了大量的有氧运动，他们发现它在改善执行功能方面与认知疗法一样有效。
Just straight up-
直接说吧——
Andrew Huberman:
安德鲁·休伯曼：
Wow
哇
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
aerobic exercise.
有氧运动。
Andrew Huberman:
安德鲁·休伯曼：
Wow.
哇。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
And so the hard part in the real world is how do you get a seven or eight-year-old to do the kind of aerobics that you're...
所以现实世界中最困难的部分是如何让一个七八岁的孩子做你正在做的有氧运动......
But now with recumbent bicycles and now there has been studies with seven-year-olds with just putting them in, mostly with recumbent bicycles, is sort of designing.
但现在有了卧式自行车，现在已经有一项针对七岁儿童的研究，只是把它们放进去，大部分都是卧式自行车，算是一种设计。
We have to think about ways to design exercise that can get aerobics up.
我们必须考虑如何设计可以提高有氧运动水平的运动。
I think my field is starting to realize that we got to tackle this every way we can.
我认为我的领域开始意识到我们必须尽一切努力来解决这个问题。
And so now you hear more neurologists talk about that.
所以现在你会听到更多的神经科医生谈论这个问题。
Thirty years ago, no neurologist would say, "You got to exercise more." Now they're talking about exercise and nutrition and sleep, and it's all becoming sort of part of our package of how we're going to help our patients.
三十年前，没有哪个神经科医生会说：“你必须多锻炼。”现在他们正在谈论锻炼、营养和睡眠，这一切都成为我们帮助患者的一揽子计划的一部分。
But the aerobic exercise is super interesting, and I think it's going to be.
但有氧运动超级有趣，我想它会的。
That kind of made me think that what we didn't talk about was mindfulness.
这让我觉得我们没有谈论的是正念。
And so a lot of these studies also, if they add mindfulness training to the hardcore goal management training, it's better than just the executive training alone.
因此，很多这些研究也表明，如果将正念训练添加到核心目标管理培训中，那么它比单独的高管培训要好。
Just learning skills to stop, relax, refocus, kind of gives this sort of boost to executive function as well.
仅仅学习停止、放松、重新集中注意力的技巧，也能增强执行功能。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I think of mindfulness like sort of, well, there's no such thing as traditional meditation, I have to be careful here, but the sort of stereotypical meditation of closing one's eyes, excuse me, sitting down, lying down, and just focusing on one's breath, and then redirecting one's focus to maybe third eye center, area between the forehead, just redirecting focus.
是的，我认为正念就像是，嗯，没有传统冥想之类的东西，我在这里必须小心，但是那种典型的冥想，闭上眼睛，对不起，坐下来，躺下，只专注于呼吸，然后将注意力转移到第三眼中心，额头之间的区域，只是重新转移焦点。
I think of meditation of that sort as a focus exercise.
我认为这种冥想是一种集中注意力的练习。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
It's not so much a perceptual exercise because thoughts are kind of doing what they're doing.
这与其说是一种感性练习，不如说是思想在做它们正在做的事情。
It's like focus exercise.
这就像集中注意力练习。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
And that's half of the problem with not achieving our goals, right?
这就是未实现目标的一半问题，对吧？
Is we lose our focus.
我们是否失去了焦点。
And so building into sort of strategies to main focus, to stop and relax and refocus is an important strategy for boosting executive function.
因此，建立集中注意力、停下来、放松和重新集中注意力的策略是增强执行功能的重要策略。
And it doesn't seem to matter what, I know there's all different flavors of mindfulness, so we just happened to use one when we were studying it.
这似乎并不重要，我知道正念有各种不同的风格，所以我们在研究它时碰巧使用了其中一种。
I don't think we know enough about how we should tailor the mindfulness, but most forms of mindfulness will work of the type you're talking about.
我认为我们对如何调整正念了解得还不够，但大多数形式的正念都适合您所说的类型。
Andrew Huberman:
安德鲁·休伯曼：
What I described is similar to what you guys explored.
我所描述的与你们探索的类似。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Exactly.
正是如此。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It's amazing to me, 20 years ago, if somebody wanted to talk about neuroscience and mindfulness-
20 年前，如果有人想谈论神经科学和正念，这对我来说是很惊讶的——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
on a major university campus, let's say Stanford or Berkeley was probably a little bit more tolerant of these ideas at that time, just given the-
在一所主要的大学校园里，假设斯坦福大学或伯克利大学当时可能对这些想法更宽容一些，只是考虑到——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
the kind of culture.
那种文化。
They wouldn't have been laughed out of the room, but there was a lot of skepticism.
他们不会被嘲笑出房间，但存在很多怀疑。
And I feel like now, mindfulness meditation, breathwork, the idea that-
我现在感觉，正念冥想，呼吸，这个想法——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
oh my goodness, breathing can impact your emotional state.
天哪，呼吸会影响你的情绪状态。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I mean, that should've been obvious.
我的意思是，这应该是显而易见的。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
But now that people are on board then, and now, of course, there's a lot of interest in psychedelics-
但现在人们都加入了，当然，现在人们对迷幻药很感兴趣——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
as kind of a new emerging therapy, carrying more potential risk.
作为一种新兴疗法，具有更多潜在风险。
But it looks like it's very likely that some of those are going to make it through the FDA filters at some point.
但看起来其中一些很可能会在某个时候通过 FDA 的过滤。
But the conversation we're having now-
但我们现在正在进行的对话——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
a neurologist and a neurobiologist talking about mindfulness, nutrition, we're talking freely about nicotine.
一位神经学家和一位神经生物学家谈论正念、营养，我们自由地谈论尼古丁。
We're not suggesting people do that.
我们并不是建议人们这样做。
Bromocriptine to optimize cognitive function.
溴隐亭优化认知功能。
This conversation would have never happened seven years ago.
七年前根本不会发生这样的谈话。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
No.
不。
Andrew Huberman:
安德鲁·休伯曼：
The field has changed.
领域已经改变。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
I hear neurologists talk about it all the time.
我经常听到神经科医生谈论这个问题。
So do you try mindfulness?
那么你尝试正念吗？
And if you do, do you feel like you perform better that day?
如果你这样做了，你觉得你那天表现得更好吗？
Andrew Huberman:
安德鲁·休伯曼：
Yeah, thanks for asking.
是的，谢谢你的询问。
There are two forms of yes.
是有两种形式。
The short answer is yes.
简短的回答是肯定的。
There's a very specific practice that I've used since 2017 that's really benefited me so much, which is, I call it non-sleep deep rest, but it's based on a practice called Yoga Nidra, where you just lie down and these are free audio scripts online.
自 2017 年以来，我一直在使用一种非常具体的练习，这确实让我受益匪浅，我称之为非睡眠深度休息，但它是基于一种名为 Yoga Nidra 的练习，你只需躺下，这些都是在线免费的音频脚本。
We can provide links to these.
我们可以提供这些的链接。
And you go through a body scan, and you do some long exhale breathing, which emphasizes the parasympathetic, AKA relaxing aspect of the autonomic nervous system.
你会进行身体扫描，然后做一些长时间的呼气呼吸，这会强调副交感神经，也就是自主神经系统的放松方面。
I know you know this, so I'm saying that for the audience.
我知道你知道这一点，所以我是对观众说的。
And it does involve some intentions and things like that, but it can also just be self-directed relaxation.
它确实涉及一些意图和类似的事情，但它也可以只是自我导向的放松。
And I emerge from that with much more mental and physical vigor than I did prior.
从那以后，我的精神和身体活力都比以前更强了。
And this only takes maybe 10 minutes.
而这可能只需要 10 分钟。
There's also a 30-minute script.
还有一个30分钟的剧本。
I do those, and then I do ...
我做这些，然后我做...
mindfulness meditation.
正念冥想。
The thing about mindfulness meditation that the biggest impact for me has been the problems of my life, I get a different perspective.
关于正念冥想，对我影响最大的是我生活中的问题，我有不同的观点。
I start thinking about things in different domains of time.
我开始思考不同时间领域的事物。
Like this thing that is like a problem that I've been dealing with, for instance.
例如，就像我一直在处理的一个问题一样。
I start thinking, in the course of my lifetime, this is a relatively small, not small thing, but in relatively small time bin.
我开始想，在我的一生中，这是一个相对较小、不小的事情，但在相对较小的时间段内。
And I sort of think about, best course of action given its real role in my life and what I want, et cetera.
我会考虑，考虑到它在我生活中的真正作用以及我想要什么，等等，最好的行动方案。
So I feel like it sort of orients me in time.
所以我觉得它在某种程度上为我指明了时间方向。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
So that's been a major effect.
所以这是一个重大影响。
For focus, the best tool I know is to put the phone in another room.
为了集中注意力，我所知道的最好的工具是将手机放在另一个房间。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
But that's kind of a don't.
但这是一种不该做的事情。
And I know our friend Eddie Chang, neurosurgeon, Chair of Neurosurgery at UCSF, he's big on mindfulness meditation.
我认识我们的朋友艾迪·张（Eddie Chang），神经外科医生，加州大学旧金山分校神经外科主任，他热衷于正念冥想。
So do you meditate?
那么你冥想吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
No, I think that's one of the things when we were talking about what should we do besides reading fiction, I think that should be on my list because-
不，我认为这是当我们谈论除了阅读小说之外我们应该做什么时的事情之一，我认为这应该在我的清单上，因为-
Andrew Huberman:
安德鲁·休伯曼：
Five seconds a day
每天五秒
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
yeah, because it's just amazing that the patients tell me about it, and what we've seen from our studies.
是的，因为患者告诉我这件事以及我们从研究中看到的情况真是太神奇了。
A lot of this, again, I was saying before, is if we had some measure of brain health that we could see the impact of it, would sort of push us towards probably doing it more.
我之前说过，很多事情是，如果我们对大脑健康有某种衡量标准，我们可以看到它的影响，会推动我们做更多的事情。
I think another thing that we didn't sort of talk about, we talked a little about with dopamine is, are there other kind of brain states that sort of predict how you're going to respond to these therapies and if you're going to benefit from them.
我认为我们没有谈论的另一件事是，我们与多巴胺进行了一些讨论，是否有其他类型的大脑状态可以预测你将如何对这些疗法做出反应以及你是否会从中受益。
And we've done a lot of work with sort of measuring the large scale organization of the brain and brain networks, and that's sort of very popular idea in neuroscience today, sort of moving away from what is this?
我们已经做了很多工作来测量大脑和大脑网络的大规模组织，这是当今神经科学中非常流行的想法，有点偏离了这是什么？
We've talked a lot about what the frontal lobes do, but the frontal lobes are part of these networks in the brain, and really sort of the state of your networks is really important factor as well, in addition to your sort of neurochemical profile.
我们已经讨论了很多关于额叶的作用，但额叶是大脑中这些网络的一部分，除了你的神经化学特征之外，你的网络的状态也是非常重要的因素。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Tell me more about this.
请告诉我更多有关此的信息。
You actually preempted my next question, which was going to be, and this is my favorite question to ask.
你实际上抢先了我的下一个问题，这是我最喜欢问的问题。
Carl Diaz-Serraf taught me to ask this way back when.
卡尔·迪亚兹·塞拉夫 (Carl Diaz-Serraf) 曾教过我用这种方式提问。
What are you most excited about now?
你现在最兴奋的是什么？
Because I know the work you've published-
因为我知道你发表的作品-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and you've done a magnificent job of sharing the details of that and work of others, in a really informative and in some cases, actionable way.
您在分享相关细节和其他人的工作方面做得非常出色，以一种信息丰富、在某些情况下甚至是可行的方式。
But what are you really excited about?
但你真正兴奋的是什么呢？
If there were no financial barriers to your grants, et cetera, you had 1,000 people working, what's the thing that's hitting your dopamine circuits these days?
如果你的资助不存在经济障碍，等等，你有 1,000 名员工在工作，那么这些天是什么东西在影响你的多巴胺回路？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
Well, in the grand scale, I'm excited that things that we've learned over the last 30 years, not just in my lab or your lab or anyone's lab, is actually now being translated to actually helping people.
嗯，从宏观上看，我很高兴我们在过去 30 年里学到的东西，不仅仅是在我的实验室、你的实验室或任何人的实验室中学到的东西，现在实际上正在转化为实际帮助人们。
When people ask me what I do, I say I'm a neurologist because that's at my core what I feel I am, and I feel I got into this business to help people.
当人们问我做什么时，我说我是一名神经科医生，因为这就是我的核心感受，我觉得我进入这个行业是为了帮助人们。
And so when you work for years and years and years and it doesn't translate, it can be frustrating.
因此，当你工作了很多年，但结果却没有转化时，你可能会感到沮丧。
But now I'm excited that it seems that the things we've learned, that all of us have learned in neuroscience is starting to now translate into something.
但现在我很兴奋，我们所有人在神经科学中学到的东西似乎现在开始转化为某种东西。
In neuroscience, what's happened in the last 10 years is we're thinking of the brain and in a kind of grander scale, its sort of overall organization and not so focused on just this area or that area.
在神经科学领域，过去十年发生的事情是，我们正在以一种更大的规模来思考大脑，它的整体组织，而不是仅仅关注这个或那个区域。
When I talk about the frontal lobes as being the most important part, the conductor, yes, I am talking about one brain region, but it's a brain region, like I said, that's connected to everywhere, and it's because it's connected to everywhere is what's really the essence of why it's so important.
当我谈到额叶是最重要的部分时，是的，我说的是一个大脑区域，但它是一个大脑区域，就像我说的，它与任何地方都有联系，正因为它与任何地方都有联系，这才是它如此重要的真正本质。
So, some of the research I'm excited most about is sort of taking away the names of areas and just thinking about the brain as a big network, like an airline network or electrical network, and how different areas communicate with each other.
因此，我最兴奋的一些研究是去掉区域的名称，只将大脑视为一个大网络，例如航空网络或电力网络，以及不同区域如何相互通信。
And when you think of it that way, so for example, an airline network, you've got all these hubs all over the country.
当你这样想时，例如，一个航空公司网络，你在全国各地都有所有这些枢纽。
In the United States, for example, you've got Chicago as a hub and there's other hub, Milwaukee or Cincinnati, but they have very different functions in the network as a whole, right?
例如，在美国，芝加哥作为枢纽，还有其他枢纽，密尔沃基或辛辛那提，但它们在整个网络中具有非常不同的功能，对吧？
If you're trying to get from New York to San Francisco, which happened to me many times, even though you're not going through Chicago, if Chicago's shut down, you're probably going to get delayed because it just has this huge impact on the whole system.
如果你想从纽约飞往旧金山，这种情况在我身上发生过很多次，即使你不经过芝加哥，如果芝加哥关闭，你可能会被延误，因为它对整个系统产生了巨大的影响。
And if Milwaukee goes down, you don't even know it, you just fly right over that.
如果密尔沃基倒下，你甚至不知道，你只是飞过它。
I'm sorry if anyone's listening from Milwaukee.
如果有人在密尔沃基收听，我很抱歉。
Andrew Huberman:
安德鲁·休伯曼：
There are probably a few.
大概有几个。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
You got to go through.
你必须经历。
But so thinking about the brain, the brain is the same way.
但想想大脑，大脑也是一样的。
The brain has these hubs as well, and the prefrontal cortex is a hub like Chicago.
大脑也有这些枢纽，前额叶皮层就是像芝加哥一样的枢纽。
It's just an important hub that keeps the whole system going, and that's why it has much more of an impact when you damage it or you stress it, as opposed to some other part of the brain.
它只是保持整个系统运转的重要枢纽，这就是为什么当你损坏它或给它施加压力时，它比大脑的其他部分会产生更大的影响。
And so what's exciting to me is not only is that make us thinking about disease differently because now we're starting to think about how is diseases affecting these hubs, that the pathology seems to be, like when you look at Alzheimer's disease and you look at schizophrenia and you look at a lot of diseases, it's not just that there's some microscopic change in some neuron.
因此，令我兴奋的不仅是这让我们以不同的方式思考疾病，因为现在我们开始思考疾病如何影响这些中枢，病理学似乎是，就像当你观察阿尔茨海默病、精神分裂症和许多疾病时，这不仅仅是某些神经元中存在一些微观变化。
It seems to be affecting hubs in the brain that are affecting the whole network.
它似乎正在影响大脑中影响整个网络的中枢。
And so we have a different target to go after for treatments.
因此，我们有不同的治疗目标。
What can we do to sort of boost a hub that's been damaged, as opposed to thinking about it in a less specific way?
我们可以做些什么来增强已经受损的枢纽，而不是以不太具体的方式来思考它？
And then also, as we've really start to learn about how the brain is organized in these networks, we've also learned that in measuring Your network structure is very predictive of your well-being and how you respond to interventions.
而且，随着我们真正开始了解大脑在这些网络中是如何组织的，我们还了解到，测量您的网络结构可以很好地预测您的健康状况以及您对干预措施的反应。
So there's a metric called modularity, which measures how organized your brain networks are.
因此，有一个称为模块化的指标，它可以衡量大脑网络的组织程度。
And the brain is made up of different modules, different networks, and these networks can either be very communicating with each other or not so communicating with each other.
大脑是由不同的模块、不同的网络组成的，这些网络可以彼此非常沟通，也可以彼此不那么沟通。
And the more segregated they are, we call that more modularity.
它们越隔离，我们称之为越模块化。
They're kind of separate entities.
它们是一些独立的实体。
They're modular.
它们是模块化的。
And it turns out we can measure that with fMRI.
事实证明我们可以用功能磁共振成像来测量这一点。
We can put someone in the scanner, we can do this resting fMRI scanning, and then we can measure how modular your brain is versus my brain, and all of us are very different levels of modularity.
我们可以把某人放在扫描仪中，我们可以进行静息功能磁共振成像扫描，然后我们可以测量你的大脑与我的大脑的模块化程度，而我们所有人的模块化程度都非常不同。
Andrew Huberman:
安德鲁·休伯曼：
Is it more advantageous to have more modularity as opposed to less?
拥有更多的模块化比更少的模块化更有利吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, it turns out that it seems to be more advantageous to have more.
是啊，事实证明，拥有的越多似乎更有利。
So we can predict-
所以我们可以预测——
Andrew Huberman:
安德鲁·休伯曼：
More separateness of brain-
大脑更加独立-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
of function between areas.
区域之间的功能。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah, that the networks are sort of more independent.
是的，网络更加独立。
That doesn't mean they don't talk to each other, but at sort of baseline, they're more independent.
这并不意味着他们不互相交谈，但在某种程度上，他们更加独立。
Andrew Huberman:
安德鲁·休伯曼：
Resting state connectivity.
静息状态连接。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
They're more independent as opposed to less independent with each other.
他们彼此之间更加独立，而不是不太独立。
Andrew Huberman:
安德鲁·休伯曼：
Not unlike neuromuscular junctions-
与神经肌肉接头不同——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
during development are what we call polyinnervated.
在发育过程中，我们称之为多神经支配。
That's why babies can move their limbs, but not with a lot of coordination.
这就是为什么婴儿可以移动四肢，但不太协调。
Look at a one-year-old trying to eat spaghetti, for instance.
例如，看看一个一岁的孩子试图吃意大利面。
It's hilarious.
太搞笑了。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Look at that same kid seven months later, there's a lot more precision to movement, largely due to removal-
七个月后看看同一个孩子，动作更加精确，很大程度上是由于移除了——
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
more modularity of connections.
连接更加模块化。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
So we did a study where we took 12 traumatic brain injury patients and measured their modularity.
因此我们做了一项研究，对 12 名脑外伤患者进行了测量，并测量了他们的模块化程度。
So you get a number, you just get a modularity index for each of the 12 people.
所以你得到一个数字，你就得到了 12 个人中每人的模块化指数。
And then they underwent this goal management training, and we were able to predict who was going to improve on the training.
然后他们接受了目标管理培训，我们能够预测谁将在培训中取得进步。
Those who had started off more modular benefited more from the training.
那些一开始就更加模块化的人从培训中受益更多。
And it's turned out that this has been a very robust finding across studies now, across different training, different young/old patient populations.
事实证明，这是一个非常有力的发现，涵盖了现在的研究、不同的培训、不同的年轻/老年患者群体。
It's also predicted things like whether someone in a coma is more likely to do well, or if someone who's older is going to have a certain amount of cognitive decline, or someone's going to respond to behavioral therapy if they're obsessive-compulsive.
它还预测了一些事情，比如昏迷中的人是否更有可能表现良好，或者年纪较大的人是否会出现一定程度的认知能力下降，或者如果有人有强迫症，他们会对行为治疗产生反应。
So there's something about this brain state that not only we can measure, but actually is giving us insight into the interventions that we're doing, which again, is going to be much more helpful in determining what helps and what doesn't help if we know sort of what the state is before we start the intervention.
因此，关于这种大脑状态的一些东西，我们不仅可以测量，而且实际上可以让我们深入了解我们正在做的干预措施，如果我们在开始干预之前知道大脑状态是什么，那么这将更有利于确定什么有帮助，什么没有帮助。
Andrew Huberman:
安德鲁·休伯曼：
So interesting, and makes me think many things, but I'll just focus on two of them.
很有趣，让我思考很多事情，但我只关注其中的两件事。
One is, I love this idea that you and others are starting to look at brain network activity as opposed to over-emphasizing the role of, say, prefrontal cortex or hippocampus, understanding more that those are hubs in a larger theme of activation.
一是，我喜欢这个想法，即你和其他人开始关注大脑网络活动，而不是过分强调前额皮质或海马体的作用，更多地了解这些是更大的激活主题的枢纽。
Because if I had one wish for science communication, it's that people would, yes, learn some terms like dopamine and frontal lobes, it is important to know the nomenclature, but to understand that if you really want to be able to work with the information in a way that's beneficial, you need to think about verbs, not nouns.
因为如果我对科学传播有一个愿望，那就是人们会，是的，学习一些术语，如多巴胺和额叶，了解术语很重要，但要理解，如果你真的希望能够以一种有益的方式处理信息，你需要考虑动词，而不是名词。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
It's about the action states of these areas, and those action states are always involving multiple areas.
这是关于这些区域的动作状态，而这些动作状态总是涉及多个区域。
Just like you can't talk about running as just quadricep and hamstring flexion and extension, and contraction.
就像你不能只谈论股四头肌和腿筋的屈伸和收缩一样。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
You can, you can break it down that way, and it's useful to know that, but ultimately you're talking about gait and stride and things that have a real verb action to them.
你可以，你可以这样分解它，知道这一点很有用，但最终你谈论的是步态和步幅以及对它们有真正动词动作的东西。
And we haven't had so much of that for the nervous system-
而我们的神经系统还没有那么多这样的东西-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
at a circuit level.
在电路层面。
We've been able to do that for individual neurons.
我们已经能够对单个神经元做到这一点。
That's the first piece.
这是第一块。
And then the second piece is that it occurs to me that there's so much rich understanding of the different states of sleep.
第二件事是，我突然想到，对不同的睡眠状态有如此丰富的理解。
Matt Walker was just here recording this series on sleep that we'll release later this year, and stages one, two, three, four, deep sleep, slow-wave sleep, rapid eye movement sleep.
马特·沃克刚刚在这里录制了我们将于今年晚些时候发布的睡眠系列节目，其中包括第一、二、三、四阶段：深度睡眠、慢波睡眠、快速眼动睡眠。
But we don't even really have a naming system for waking states.
但我们甚至没有真正的清醒状态命名系统。
We say focus, we say task switching, but those are just names we made up.
我们说专注，我们说任务切换，但这些只是我们编造的名字。
Just as stage one, two, three, and REM sleep are names that we made up.
正如第一阶段、第二阶段、第三阶段和快速眼动睡眠的名称都是我们编造的。
But there seems to be a much richer understanding of what rapid eye movement sleep is good for, and what deficits in rapid eye movement sleep lead to, than there is, for instance, how given our network G, I'm going to make this up, calling a certain network activation state like State A.
但是，对于快速眼动睡眠的好处以及快速眼动睡眠的缺陷会导致什么，人们似乎有了更丰富的理解，例如，给定我们的网络 G，我将弥补这一点，将某种网络激活状态称为状态 A。
I feel like the field of neuroscience now is tasked with giving us an understanding of the verb states, and-
我觉得神经科学领域现在的任务是让我们理解动词状态，并且-
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Right
右
Andrew Huberman:
安德鲁·休伯曼：
...
...
these waking states of mind are very mysterious.
这些清醒的心境是非常神秘的。
And for the general public, this is important because people wonder, like, "Is my focus poor, or is it good?
对于公众来说，这很重要，因为人们会想，“我的注意力是差还是好？
Is my task-switching ability good?" We only tend to look at are they functional enough to do their job and manage their family, manage their lives, but we don't really have metrics.
我的任务切换能力好吗？”我们只倾向于关注他们是否有足够的能力来完成他们的工作、管理他们的家庭、管理他们的生活，但我们并没有真正的衡量标准。
But for sleep, we have metrics, and commercial products can measure that.
但对于睡眠，我们有指标，商业产品可以衡量它。
Sleep tracker rings, wristbands, mattress covers, this sort of thing.
睡眠追踪环、腕带、床垫套之类的东西。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Well, yeah.
嗯，是的。
I think modularity can actually be that metric, some metric of your large-scale organization of your brain can be that metric.
我认为模块化实际上可以是这个指标，你大脑的大规模组织的某些指标可以是这个指标。
There's a number of labs that have done this, have measured modularity in real time.
有许多实验室已经做到了这一点，并实时测量了模块化程度。
So what I was talking about was just getting a snapshot of this is what your baseline modularity is.
所以我所说的只是获得一个快照，这就是你的基线模块化是什么。
But we can also look at modularity, how it changes on a second-to-second, to minute-to-minute basis.
但我们也可以看看模块化，它如何在每一秒、每分钟的基础上发生变化。
And one of my former postdocs, Sepideh Sadeghzadeh, she just did a very simple experiment where there were sounds and the functional MRI scanner is very loud, so you can't hear very well.
我以前的一位博士后 Sepideh Sadeghzadeh，她刚刚做了一个非常简单的实验，其中有声音，功能性 MRI 扫描仪声音很大，所以你听不清楚。
But every once in a while, there'd be a sound that was just above the level of the noise of the scanner, and all you had to do was sort of press a button if you heard that sound.
但每隔一段时间，就会发出略高于扫描仪噪音水平的声音，如果听到这种声音，您所要做的就是按一下按钮。
And you didn't pick it up all the time.
而且你并不是一直都把它捡起来。
Maybe 80% of the time you heard, and sometimes 20% of the times you didn't hear it.
也许80%的时间你听到了，有时20%的时间你没有听到。
Well, she measured their modularity on a moment-to-moment basis, and she could predict if they were going to be correct or not, and break the sound before they got the sound.
好吧，她时时刻刻地测量它们的模块化程度，她可以预测它们是否正确，并在它们发出声音之前打破声音。
If they were highly modular, boom, they got it.
如果他们是高度模块化的，那么他们就明白了。
If their brain had gone into this kind of diffuse, less modular state, they missed it.
如果他们的大脑进入了这种分散的、模块化程度较低的状态，他们就会错过它。
And so I could definitely see, as you're talking about, where if we could develop a modularity metric in real time on a device, this would be game-changer.
因此，正如您所说，我绝对可以看到，如果我们可以在设备上实时开发模块化指标，这将改变游戏规则。
And that's sort of what I've been interested in doing.
这就是我一直感兴趣的事情。
What excites me is that we're not going to do with a scan, obviously, you can't walk around with a scanner in your head, right?
令我兴奋的是，我们不会进行扫描，显然，你不能带着扫描仪到处走动，对吧？
And I don't think you could even do it with EEG.
我认为你甚至不能用脑电图来做到这一点。
I think, can we develop a proxy for modularity with some more simple way of doing it?
我想，我们可以用一些更简单的方法来开发模块化代理吗？
Can we extract this maybe out of heart rate variability or for oxygen?
我们可以从心率变异性或氧气中提取这一点吗？
I've been working with some colleagues, a former student, Brian Miller, and a post-doc of Adam Gazzaley's, Wes Clapp, who have a company called NeuroScouting where they are able to-- We've been sort of doing scanning and also collecting physiological data to try and determine if there's some pro-- We can measure the modularity in the scanner, but can we pick that up in the physiology data?
我一直在和一些同事一起工作，包括前学生布莱恩·米勒（Brian Miller）和亚当·加扎利（Adam Gazzaley）的博士后韦斯·克拉普（Wes Clapp），他们拥有一家名为 NeuroScouting 的公司，他们能够——我们一直在进行扫描并收集生理数据，以尝试确定是否有一些专业——我们可以测量扫描仪中的模块化，但我们可以在生理学数据中找到它吗？
Because they can collect oxygen and heart rate variability and other metrics that may be kind of a readout of that.
因为他们可以收集氧气和心率变异性以及其他可能作为读数的指标。
And then we'd have a brain state, which is what you were looking for some brain state.
然后我们就有了一个大脑状态，这就是你正在寻找的大脑状态。
I think people are thinking we need a helmet or something like that.
我认为人们认为我们需要头盔或类似的东西。
We need just something simple, right?
我们只需要一些简单的东西，对吧？
That reads out brain state just the way we read out other physiological information from our watch or something like that.
这就像我们从手表或类似设备上读取其他生理信息一样读取大脑状态。
Andrew Huberman:
安德鲁·休伯曼：
Well, the sleep trackers of various kinds have certainly been able to pull out information about rapid eye movement and other stages of sleep.
嗯，各种睡眠追踪器确实能够提取有关快速眼球运动和其他睡眠阶段的信息。
Key metrics, not every metric, not what you would get with a person wearing an EEG probe or something, a set of probes, but certainly information that can be used.
关键指标，不是每个指标，也不是佩戴脑电图探头或其他东西、一组探头得到的结果，但肯定是可以使用的信息。
One thing that has me a little bit perplexed, and I'm almost reluctant to bring it up, but I'm going to do it, is that I did a couple episodes about psilocybin and the use of psilocybin for the treatment of depression.
有一件事让我有点困惑，我几乎不愿意提起，但我会这么做，那就是我做了几集关于裸盖菇素和裸盖菇素治疗抑郁症的用途。
This is Robin Carhart-Harris from UCSF, and I also did a solo episode emphasizing, of course, this isn't recreational use we're talking about.
我是加州大学旧金山分校的罗宾·卡哈特-哈里斯，我也做了一个单独的节目，强调，当然，这不是我们谈论的娱乐用途。
We're talking about for treatment of depression.
我们正在谈论治疗抑郁症。
But there's a lot of neuroimaging of patients before and after macro-dose psilocybin, and this isn't microdosing.
但是，在大剂量裸盖菇素治疗前后对患者进行了大量的神经影像学检查，而这并不是微剂量治疗。
And one of the major takeaways is increased resting state connectivity, which by virtue of what you just described, might not be ideal for cognitive function.
主要收获之一是增加静息状态连接，根据您刚才的描述，这对于认知功能来说可能并不理想。
It might be good for social emotional function, and I certainly don't want to disparage the beautiful work that's being done there.
这可能对社交情感功能有好处，我当然不想贬低那里所做的美丽工作。
But you said that increased modularity predicted improved function, especially with cognitive interventions.
但你说模块化的增加预示着功能的改善，尤其是在认知干预方面。
Psilocybin seems to induce fairly significant increases in cross-modal talk between brain networks.
裸盖菇素似乎会显着增加大脑网络之间的跨模式对话。
In other words, less modularity.
换句话说，模块化程度较低。
So, should we be concerned?
那么，我们应该担心吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
No, it has to do with how we make these measurements, and connectivity doesn't mean the same.
不，这与我们如何进行这些测量有关，而连接性并不意味着相同。
There's different types of connectivity.
有不同类型的连接。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
And so when I think about connectivity, we talked about this connectivity of a brain state versus a brain trait.
因此，当我想到连通性时，我们讨论了大脑状态与大脑特征的连通性。
So when we're talking about you being highly modular as a trait, that's very different than what your modularity is like in different states.
因此，当我们谈论高度模块化的特征时，这与不同状态下的模块化非常不同。
It actually turns out when you do these highly executive demanding tasks, you get less modular because your networks are communicating-
事实上，当你执行这些高度执行要求的任务时，你的模块化程度会降低，因为你的网络正在通信-
Andrew Huberman:
安德鲁·休伯曼：
I see
我明白了
Dr. Mark D'Esposito:
马克·德斯波西托博士：
...
...
with each other.
与彼此。
So it's important for networks to get less modular when it's a more demanding task.
因此，当任务要求更高时，降低网络的模块化程度非常重要。
But that's very different than what's your baseline modularity.
但这与您的基线模块化有很大不同。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Because you got to get from where your baseline is to this other state.
因为你必须从你的基线所在的位置到达另一个状态。
And a lot of it has to do with going from one state to another, not so much sort of the absolute sort of differences.
其中很大一部分与从一种状态到另一种状态有关，而不是绝对的差异。
So that's interesting.
这很有趣。
I didn't know about those results, but it's interesting that it does affect sort of connectivity in that way.
我不知道这些结果，但有趣的是它确实以这种方式影响某种连接。
I think the drugs that are going to be helpful are going to promote sort of networks talking to each other as opposed to networks not communicating with each other.
我认为有用的药物将促进某种类型的网络相互通信，而不是网络相互不通信。
Andrew Huberman:
安德鲁·休伯曼：
In your clinic, do you ever combine drug therapies, cognitive training, and things like transcranial magnetic stimulation?
在您的诊所中，您是否曾经将药物治疗、认知训练和经颅磁刺激等结合起来？
Do you use stimulators?
你使用刺激器吗？
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Yeah.
是的。
So I think I have a lot of patients that I've referred for its approved use, which is depression.
所以我认为我已经推荐了很多患者来批准其用途，即抑郁症。
So I'm very excited about sort of the work that's being done for depression.
因此，我对针对抑郁症所做的工作感到非常兴奋。
But we haven't really had any approved anything that's been for cognition.
但我们还没有真正批准任何与认知有关的东西。
So there are a bunch of studies, anecdotal small studies, where you can give transcranial magnetic stimulation to the frontal cortex and working memory improve.
因此，有很多研究，轶事性的小研究，你可以对额叶皮层进行经颅磁刺激，从而改善工作记忆。
But they really haven't been done in ways that we don't know if it generalizes, if it's going to be the way it's been done in depression in a way that can really be.
但它们确实还没有以我们不知道是否具有普遍性的方式进行，是否会像在抑郁症中那样以真正可行的方式进行。
But again, it's just a matter of doing it.
但话又说回来，这只是做事的问题。
I think it will be part of the things we do, drugs, TMS, and all the other things we've talked about.
我认为这将成为我们所做的事情的一部分，药物、经颅磁刺激以及我们讨论过的所有其他事情。
It's not just going to be one thing.
这不仅仅是一件事。
And it gets back to networks, right?
它又回到了网络，对吧？
What this is doing is really changing how nodes, the interaction of regions.
这确实改变了节点和区域的交互方式。
It's not about sort of just increasing or decreasing activity in some mysterious part of the brain.
这不仅仅是增加或减少大脑某些神秘部分的活动。
It's just sort of restoring the balance of a network.
这只是恢复网络平衡。
Andrew Huberman:
安德鲁·休伯曼：
Well, Mark, I just really want to thank you.
嗯，马克，我真的很想感谢你。
You've given us an amazing tour of basically five fields.
您让我们对五个领域进行了一次精彩的游览。
I threw a lot at you as a neurologist.
作为一名神经科医生，我向你扔了很多东西。
By the way, I'm slightly reluctant to do this, but I'm going to tell you a joke that was told to me.
顺便说一句，我有点不愿意这样做，但我要告诉你一个别人告诉我的笑话。
So there are these people stranded on an island, and they're really stuck, and they're running out of resources.
所以这些人被困在一个岛上，他们真的被困住了，他们的资源即将耗尽。
And by the way, this joke was told to me by a physician.
顺便说一句，这个笑话是一位医生告诉我的。
And all of a sudden, this hot air balloon comes over, and they're like, "Oh, my goodness." So they write help in the sand, and the hot air balloon goes directly over them, kind of descends almost to them.
突然，这个热气球飞过来了，他们就像是，“哦，天哪。”所以他们在沙子上写下帮助，热气球直接从他们上方飞过，几乎降落到他们身边。
And then someone in the hot air balloon says, "I'm doing the measurement, and it's exactly 76 feet down to those people." And then the hot air balloon takes off and goes away.
然后热气球里的一个人说：“我正在测量，那些人的高度正好是 76 英尺。”然后热气球起飞并消失。
And the people on the beach, one of them is a physician, and he goes, "Those were neurologists." I tell that joke because that was the old school view of neurology, that neurologists were great at describing things, talking about the terrible conditions they could observe in great detail, but that they did not do anything about it.
海滩上的人，其中一个是医生，他说，“那些人是神经科医生。”我讲这个笑话是因为这是神经病学的老派观点，神经科医生很擅长描述事物，谈论他们可以详细观察到的可怕情况，但他们对此没有采取任何行动。
You, on the other hand, and I'm guessing others in the field, but certainly you have proven today that that joke needs to be revised, whereby there's at least one neurologist who casts a line down and shimmies down and assists them and pulls those stranded people on the island up to the balloon.
另一方面，你，我猜是这个领域的其他人，但你今天肯定已经证明了那个笑话需要修改，至少有一个神经科医生放下一根绳子，摇晃下来，帮助他们，把岛上那些被困的人拉上气球。
Because today you've described the underlying nature of some of these things, like working memory deficits, traumatic brain injury, concussion, Alzheimer's, Parkinson's.
因为今天您描述了其中一些事情的根本性质，例如工作记忆缺陷、创伤性脑损伤、脑震荡、阿尔茨海默氏症、帕金森氏症。
Again, I threw a lot at you, and you've responded in thorough, clear detail, but also a number of things that clearly can assist in these situations, such as bromocriptine, mindfulness, exercise, and really as an exploration of what can be done, interventions.
再说一次，我向你提出了很多问题，你的回应非常彻底、清晰，而且也提出了一些显然可以在这些情况下提供帮助的东西，例如溴隐亭、正念、锻炼，以及真正对可以做什么的探索、干预措施。
And so, for all those reasons, and for tolerating this terrible joke that I just told, I want to say thank you because I've learned a ton, and I know the audience has learned a ton, and much of what we've learned has us looking in the directions of possibility to alleviate these situations.
因此，出于所有这些原因，并且为了容忍我刚才讲的这个可怕的笑话，我想说谢谢，因为我学到了很多东西，我知道观众也学到了很多东西，而我们学到的很多东西让我们寻找缓解这些情况的可能性。
And as you point out, for the already healthy even to optimize brain function and health.
正如您所指出的，对于已经健康的人来说，甚至可以优化大脑功能和健康。
So, for all of that, thanks for sliding down the rope to the island.
因此，尽管如此，还是感谢您顺着绳索滑到了岛上。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
Well, I'd say on behalf of all the neurologists in the world, thank you.
好吧，我代表世界上所有的神经科医生说，谢谢。
We're appreciating what we do.
我们很感激我们所做的事情。
It's just so important to try and get this message apart.
尝试区分此消息非常重要。
Like I said, with patients, we just try to have them understand what it is that they're going through.
就像我说的，对于病人，我们只是试图让他们了解他们正在经历什么。
And I think today, patients have to really be advocates for themselves.
我认为今天，患者必须真正成为自己的倡导者。
And so I think the more they learn about all of these possibilities, the more they can go back to their doctors or whoever and ask for, "What about this?
所以我认为他们对所有这些可能性了解得越多，他们就越能回到医生或任何人那里询问，“这个怎么样？
What about that?
那又怎样呢？
Do you think this would help me?" Because we have to be advocates for our own health, and the only way we're going to do that is just make people understand what the possibilities are.
你认为这对我有帮助吗？”因为我们必须成为自己健康的倡导者，而我们要做到这一点的唯一方法就是让人们了解可能性是什么。
So, thank you.
所以，谢谢你。
It was a lot of fun.
这很有趣。
It was a great time.
那是一段美好的时光。
Andrew Huberman:
安德鲁·休伯曼：
Well, amen to all of that.
好吧，阿们。
And hope to have you back again.
并希望您能再次回来。
Thanks so much.
非常感谢。
Dr. Mark D'Esposito:
马克·德斯波西托博士：
You're welcome.
不客气。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for joining me for today's discussion about the brain mechanisms of cognition and memory and how to optimize cognition and memory with Dr. Mark D'Esposito.
感谢您今天与 Mark D'Esposito 博士一起讨论认知和记忆的大脑机制以及如何优化认知和记忆。
To learn more about Dr. D'Esposito's work, please see the links in the show note captions.
要了解有关 D'Esposito 博士工作的更多信息，请参阅节目注释标题中的链接。
If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.
如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。
That's a terrific zero-cost way to support us.
这是支持我们的绝佳零成本方式。
In addition, please subscribe to the podcast on both Spotify and Apple.
此外，请在 Spotify 和 Apple 上订阅该播客。
And on both Spotify and Apple, you can leave us up to a five-star review.
在 Spotify 和 Apple 上，您都可以给我们五星级的评价。
Please check out the sponsors mentioned at the beginning and throughout today's episode.
请查看今天节目开头和整个节目中提到的赞助商。
That's the best way to support this podcast.
这是支持这个播客的最佳方式。
If you have questions or comments about the podcast or topics or guests that you'd like to suggest for the Huberman Lab Podcast, please put those in the comments section on YouTube.
如果您对播客有任何疑问或意见，或者您想向 Huberman 实验室播客推荐的主题或嘉宾，请将这些问题或意见放入 YouTube 的评论部分。
I do read all the comments.
我确实阅读了所有评论。
If you're not already following me on social media, I am Huberman Lab on all social media platforms.
如果您还没有在社交媒体上关注我，我是所有社交媒体平台上的 Huberman Lab。
So that's Instagram, Twitter, now called X, LinkedIn, Facebook, and Threads.
这就是 Instagram、Twitter（现在称为 X）、LinkedIn、Facebook 和 Threads。
And on all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the content covered on the Huberman Lab podcast.
在所有这些平台上，我讨论科学和科学相关工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客涵盖的内容不同。
Again, that's Huberman Lab on all social media platforms.
再说一次，这就是所有社交媒体平台上的 Huberman Lab。
If you haven't already subscribed to our monthly Neural Network Newsletter, our Neural Network Newsletter is a zero-cost newsletter that includes podcast summaries and protocols as short one- to three-page PDFs.
如果您尚未订阅我们的每月神经网络新闻通讯，我们的神经网络新闻通讯是一份零成本新闻通讯，其中包括一到三页 PDF 格式的播客摘要和协议。
For instance, we have zero-cost protocols for improving sleep, for improving dopamine function, for deliberate cold exposure, for fitness, for learning and neuroplasticity, and much more.
例如，我们有零成本方案来改善睡眠、改善多巴胺功能、刻意冷暴露、健身、学习和神经可塑性等等。
To sign up for the newsletter, simply go to hubermanlab.com, go to the Menu tab, scroll down to Newsletter, and supply your email.
要注册新闻通讯，只需访问 hubermanlab.com，转到“菜单”选项卡，向下滚动到新闻通讯，然后提供您的电子邮件。
Again, the newsletter is completely zero cost, and I want to emphasize that we do not share your email with anybody.
再次强调，时事通讯完全是零成本，我想强调的是，我们不会与任何人分享您的电子邮件。
Thank you once again for joining me for today's discussion with doctor and professor Mark D'Esposito.
再次感谢您参加今天与 Mark D'Esposito 博士兼教授的讨论。
And last but certainly not least, thank you for your interest in science.
最后但并非最不重要的一点是，感谢您对科学的兴趣。