Dr. Nolan Williams: Psychedelics & Neurostimulation for Brain Rewiring
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。
Today, my guest is Dr. Nolan Williams.
今天，我的嘉宾是诺兰·威廉姆斯博士。
Dr. Williams is a medical doctor and professor of psychiatry and behavioral sciences at Stanford University School of Medicine.
威廉姆斯博士是斯坦福大学医学院的医学博士兼精神病学和行为科学教授。
His laboratory and clinic focus on depression and other mood disorders.
他的实验室和诊所专注于抑郁症和其他情绪障碍。
They focus specifically on the use of transcranial magnetic stimulation, which is a brain stimulation technique that can either activate or quiet specific brain circuits, as well as circuits within the body, in order to treat depression and other mood disorders.
他们特别关注经颅磁刺激的使用，这是一种大脑刺激技术，可以激活或安静特定的大脑回路以及体内的回路，以治疗抑郁症和其他情绪障碍。
Other laboratories and clinics use TMS.
其他实验室和诊所使用 TMS。
What sets apart the work of Nolan Williams and colleagues is that they combine TMS with other treatments, and some of those treatments are among the more cutting-edge that you've probably heard about these days, including ibogaine, psilocybin, MDMA, cannabis, DMT, and other drugs that, at this point in time, are experimental in terms of clinical trials, but that at least the preliminary data show hold great promise for the treatment of depression and other mood disorders.
Nolan Williams 及其同事的工作与众不同之处在于，他们将 TMS 与其他治疗方法结合起来，其中一些治疗方法是您最近可能听说过的最前沿的治疗方法，包括伊博加因、裸盖菇素、MDMA、大麻、DMT 和其他药物，这些药物目前在临床试验方面处于实验阶段，但至少初步数据显示，这些药物对于治疗抑郁症和其他情绪障碍有很大希望。
In the course of my discussion with Dr. Williams, we covered things such as the history of each of these drugs, how they came to be, and their current status in terms of their clinical use and legality.
在我与威廉姆斯博士讨论的过程中，我们讨论了诸如每种药物的历史、它们是如何形成的以及它们在临床使用和合法性方面的现状等内容。
We also talk about their safety profiles, both in children and in adults, and we talk about what the future of psychedelic research and clinical use really looks like.
我们还讨论了它们对儿童和成人的安全性，并讨论了迷幻剂研究和临床使用的未来到底是什么样子。
For instance, we discuss how a number of laboratories and clinics are modifying psychedelics to remove some of their hallucinogenic properties while maintaining some of their antidepressant or anti-trauma properties.
例如，我们讨论了许多实验室和诊所如何修改致幻剂，以消除其部分致幻特性，同时保留其部分抗抑郁或抗创伤特性。
You'll also learn about some fascinating research in Dr. Williams' laboratory focused on ketamine, which is a drug that is increasingly being used to treat depression.
您还将了解到威廉姆斯博士实验室中一些关于氯胺酮的有趣研究，氯胺酮是一种越来越多地用于治疗抑郁症的药物。
And contrary to common belief, the effects of ketamine in terms of relieving depression may not actually arise from its dissociative effects.
与普遍看法相反，氯胺酮缓解抑郁的作用实际上可能并非源于其解离作用。
One thing that you'll find extraordinary about Dr. Williams is that not only does he have vast knowledge of the various treatments for depression, but that he and his laboratory are really combining these treatments in the most potent way.
您会发现威廉姆斯博士的非凡之处在于，他不仅对抑郁症的各种治疗方法拥有丰富的知识，而且他和他的实验室确实以最有效的方式将这些治疗方法结合起来。
That is, combining psychedelic treatments with brain-machine interface or combining brain-machine interface with particular learning protocols, that is neuroplasticity protocols, which can directly change the brain in specific ways.
也就是说，将迷幻治疗与脑机接口相结合，或者将脑机接口与特定的学习协议相结合，即神经可塑性协议，它可以以特定的方式直接改变大脑。
So today, you're going to learn a tremendous amount about the neural circuitry underlying depression as well as positive moods.
所以今天，您将了解大量有关抑郁症和积极情绪背后的神经回路的知识。
You'll also learn about all the various drugs that I described, and you're really going to learn about the current status and future of the treatment of mood disorders.
您还将了解我描述的所有各种药物，并且您确实将了解情绪障碍治疗的现状和未来。
Today, you'll also learn about a number of ongoing studies in Dr. Williams' laboratory.
今天，您还将了解威廉姆斯博士实验室正在进行的一些研究。
I should mention that they are recruiting subjects for these studies.
我应该提到他们正在招募这些研究的受试者。
If you go to BSL, which stands for Brain Stimulation Laboratory, so that's bsl.stanford.edu, you have the opportunity to apply for one of these clinical trials for the treatment of depression and other mood disorders.
如果您去 BSL（大脑刺激实验室），也就是 bsl.stanford.edu，您就有机会申请其中一项治疗抑郁症和其他情绪障碍的临床试验。
I confess that the conversation with Dr. Williams was, for me, one of the more stimulating and informative conversations I've ever had about psychedelics, which is simply to say that his breadth and depth of knowledge on that topic is incredible, and his breadth and depth of knowledge in terms of the underlying brain science and how it can all be combined with clinical applications is also extraordinary.
我承认，对我来说，与威廉姆斯博士的对话是我所经历过的关于迷幻药的最刺激和信息丰富的对话之一，这只是说他在该主题上的知识广度和深度令人难以置信，而且他在基础脑科学以及如何将其与临床应用相结合方面的知识广度和深度也是非凡的。
I'm sure that by the end of today's episode, you're going to come away with a tremendous amount of knowledge about the clinical and non-clinical uses of those substances, and you're going to understand a lot more about how the healthy and diseased brain work.
我确信，在今天的节目结束时，您将获得有关这些物质的临床和非临床用途的大量知识，并且您将更多地了解健康和患病的大脑如何工作。
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. Nolan Williams.
现在我与诺兰·威廉姆斯博士进行讨论。
Thanks for joining today.
感谢您今天加入。
I'm really excited to have this conversation.
我真的很高兴能进行这次谈话。
It's been a long time coming, and I have a lot of questions about different compounds, psychedelics in particular.
已经很久了，我对不同的化合物，特别是迷幻药有很多疑问。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But before we get into that discussion, I want to ask you about depression, broadly speaking.
但在我们开始讨论之前，我想从广义上问你关于抑郁症的问题。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
Intractable depression.
顽固性抑郁症。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
How common depression is or isn't.
抑郁症有多常见或不常见。
I heard you say in a wonderful talk that you gave that depression is perhaps the most debilitating condition worldwide, and yet in contrast to other medical conditions like cancer, we actually have a fairly limited number of tools to approach depression, and yet the number of tools and the potency of those tools is growing.
我听到你在一次精彩的演讲中说，抑郁症可能是全世界最令人衰弱的疾病，但与癌症等其他疾病相比，我们实际上治疗抑郁症的工具数量相当有限，但工具的数量和这些工具的效力正在不断增长。
So if you could educate us on depression, I would really appreciate it.
因此，如果您能为我们提供有关抑郁症的教育，我将非常感激。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, absolutely.
是的，绝对是。
So depression is a condition that, it has a lot of manifestations.
所以抑郁症是一种有很多表现形式的疾病。
So you can have kind of a depression that's primarily loss of interest.
所以你可能会感到一种抑郁，主要是失去兴趣。
You can have folks who feel very anxious and they're kind of overactive.
有些人可能会感到非常焦虑并且有些过度活跃。
You can have people who don't have any anxiety at all, and they're very underactive, and they have low motivation to do anything.
有些人根本没有任何焦虑，他们非常不活跃，做任何事情的动力都很低。
So you have this huge range of symptoms that are in that umbrella of depression, and some of our work is to actually work with folks like Conor Liston in Cornell and try to actually get biotypes based off of neuroimaging to see if we can kind of parse out the different depression kind of presentations and see that clinically and also see that in the brain.
因此，抑郁症有各种各样的症状，我们的一些工作是与康奈尔大学的康纳·利斯顿(Conor Liston)等人实际合作，尝试根据神经影像学实际获得生物型，看看我们是否可以解析出不同的抑郁症表现形式，并在临床上和大脑中看到这一点。
Depression is the most disabling condition worldwide.
抑郁症是全世界最严重的致残疾病。
What's interesting about depression is it's both a risk factor for other illnesses, and it makes other medical and psychiatric illnesses worse, right?
抑郁症的有趣之处在于，它既是其他疾病的危险因素，又会使其他疾病和精神疾病变得更糟，对吗？
So recently, the American Heart Association added depression as the fourth major risk factor for coronary artery disease, right?
最近，美国心脏协会将抑郁症列为冠状动脉疾病的第四大危险因素，对吗？
So alongside the risk factors that we know, hypertension, high blood pressure, hyperlipidemia, high cholesterol, and diabetes, high blood sugar.
因此，除了我们所知的危险因素外，还有高血压、高血压、高脂血症、高胆固醇、糖尿病、高血糖。
Those three have been on the list for a long time, and depression ended up being added to the list as the fourth one.
这三者已经在名单上很久了，抑郁症最终被列为第四名。
And really interesting, right?
真的很有趣，对吧？
So in addition to Taking medications to address those other three risk factors, we really have to be thinking about how do you treat folks with depression to reduce their risk of having a heart attack in the future.
因此，除了服用药物来解决其他三个风险因素外，我们还必须考虑如何治疗抑郁症患者，以降低他们未来心脏病发作的风险。
And, there's some of that's being worked on now, but we don't have a complete solution to thinking about that at this time.
而且，现在正在研究其中的一些问题，但目前我们还没有完整的解决方案来考虑这个问题。
And then the other thing that's interesting is once you have a heart attack, in the individuals that end up having a heart attack, the risk of having depression after the heart attack is higher than the normal population.
另一件有趣的事情是，一旦心脏病发作，在最终心脏病发作的个体中，心脏病发作后患抑郁症的风险高于正常人群。
Right?
正确的？
And so a lot of what we're doing in the lab actually is measuring brain-heart connections, and we can actually, with transcranial magnetic stimulation, a form of brain stimulation, we can actually decelerate the heart rate, and we can capture that heart rate deceleration over the mood regulatory regions.
因此，我们在实验室所做的很多事情实际上是测量脑-心连接，实际上，通过经颅磁刺激（一种大脑刺激形式），我们实际上可以降低心率，并且可以捕获情绪调节区域的心率减速。
And so actually a direct probe of that connection.
所以实际上是对这种联系的直接探测。
So it's interesting.
所以这很有趣。
And so, as you said a second ago, it's a very disabling condition.
因此，正如您刚才所说，这是一种非常令人丧失能力的情况。
Moderate depression's about as disabling as acutely having a heart attack.
中度抑郁症的致残程度与急性心脏病发作一样严重。
Severe depression's as disabling as having cancer without treatment, and dying from a cancer without treatment.
严重的抑郁症就像患有癌症而不接受治疗，以及死于癌症而不接受治疗一样造成残疾。
And so, it's kind of underappreciated just how disabling depression is in that way.
因此，人们低估了抑郁症的致残程度。
And I think important as stigma is consistently being reduced over the years for mental illnesses, then the idea that we can start really putting more funding and putting more focus at the federal level, private foundation level, whatever it is at a given university to thinking about developing treatments.
我认为重要的是，多年来精神疾病的耻辱感不断减少，然后我们可以开始真正投入更多资金，并更多地关注联邦层面、私人基金会层面，无论是在哪所大学，来考虑开发治疗方法。
We've been very interested in a very particular clinical set of problems around the most severe and the most high acuity settings that folks with depression end up being in.
我们对抑郁症患者最终所处的最严重和最严重的环境中的一系列非常特殊的临床问题非常感兴趣。
And that's in emergency settings where they go into inpatient units.
那是在紧急情况下，他们进入住院病房。
And in the rest of medicine, if it's talking about heart attacks, if I start having chest pain right now and you bring me to a primary care doctor's office, they're going to have a certain number of tests and treatments, right?
在其他医学领域，如果谈论的是心脏病发作，如果我现在开始出现胸痛，你带我去初级保健医生办公室，他们会进行一定数量的检查和治疗，对吗？
But very limited because it's an outpatient facility.
但非常有限，因为它是门诊设施。
If you bring me to the emergency room after that, there are more tests and more treatments.
如果之后你带我去急诊室，就会有更多的检查和更多的治疗。
If you put me in the ICU or in the cath lab where they do invasive procedures to the heart, there are more tests and more treatments.
如果你把我放在重症监护室或导管实验室，在那里他们对心脏进行侵入性手术，就会有更多的检查和更多的治疗。
In psychiatry, as we elevate the acuity of an individual, you go from being just depressed to being depressed and now thinking about ending your life, the number of treatments actually go down on average.
在精神病学中，当我们提高一个人的敏锐度时，你会从单纯的抑郁变成抑郁，现在考虑结束生命，平均治疗次数实际上会下降。
I mean, in some scenarios they go up, but on average they go down and there are no tests.
我的意思是，在某些情况下它们会上升，但平均而言它们会下降并且没有测试。
Right?
正确的？
And so we've been very focused on that particular problem.
因此，我们一直非常关注这个特定问题。
Somebody that maybe was doing fairly okay with a pretty moderate depression, and then their depression gets worse, and then they end up in an emergency setting, and the field really hasn't developed a way of consistently being able to treat that problem, and folks end up getting the same standard oral antidepressants that they've been getting outpatient.
有些人可能在中度抑郁症中表现还不错，然后他们的抑郁症变得更严重，然后他们最终陷入紧急情况，而该领域确实还没有开发出一种能够持续治疗该问题的方法，人们最终会得到与门诊相同的标准口服抗抑郁药。
And I came to this because I've dual trained as a neurologist and psychiatrist, went back and forth between neurology and psychiatry, saw that in neurology we have all of these ways of treating acute brain-based problems, and really wanted to emulate that in psychiatry and find ways to develop and engineer new brain-based solutions.
我之所以从事这一工作，是因为我接受过神经科医生和精神病学家的双重培训，在神经病学和精神病学之间来回穿梭，看到在神经病学中，我们有所有这些治疗急性大脑问题的方法，并且真的想在精神病学中效仿，并找到开发和设计新的基于大脑的解决方案的方法。
Andrew Huberman:
安德鲁·休伯曼：
There's a lot to unpack there.
那里有很多东西需要解压。
One thing that you said is I'd like to focus on a bit more because I think we hear that the brain and the heart are connected.
你说的一件事是我想多关注一点，因为我认为我们听说大脑和心脏是相连的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
But you described, I believe, a direct relationship between areas of the brain associated with emotion and heart rate.
但我相信你描述了与情绪和心率相关的大脑区域之间的直接关系。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And that makes perfect logical sense to me.
这对我来说是完全合乎逻辑的。
But I think at the same time, many people out there probably think of the relationship between the heart and the mind as kind of woo or a soft biology.
但我同时认为，很多人可能认为心灵和思想之间的关系是一种求爱或软生物学。
But here you're talking about an actual physical connection-
但这里你谈论的是实际的物理连接 -
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
between what area of the brain is it roughly?
大致在大脑的哪个区域之间？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
The first place where the stimulation goes is called the dorsolateral prefrontal cortex.
刺激到达的第一个地方称为背外侧前额皮质。
It's the sense of control governor of the brain.
这是大脑的控制感。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And then what we know is that when you use a magnet, use what we call Faraday's law, this idea of using a magnetic pulse to induce an electrical current in electrically conducting substances, so in this case, brain tissue, but not skull or scalp or any of that, or hair, you avoid all that, just the brain tissue, then you have a direct depolarization of cortical neurons, the surface of the brain's neurons in this dorsolateral prefrontal.
然后我们知道的是，当你使用磁铁时，使用我们所说的法拉第定律，这个想法是使用磁脉冲在导电物质中感应出电流，所以在这种情况下，是脑组织，而不是头骨或头皮或任何这些，或头发，你避免了所有这些，只是脑组织，然后你会直接去极化皮质神经元，即背外侧前额叶的大脑神经元表面。
And if you do that in the actual scanner, which we can do, you can see that that distributes down into the anterior cingulate and the insula and the amygdala, and ultimately the tract goes into something called the nucleus tractus solitarius, and ultimately into the vagus nerve into the heart.
如果你在实际的扫描仪中这样做，你可以看到它向下分布到前扣带回、岛叶和杏仁核，最终该束进入称为孤束核的东西，并最终进入迷走神经进入心脏。
So the heart very consistently seems to be the end organ of the dorsolateral prefrontal cortex.
因此，心脏似乎非常一致地是背外侧前额叶皮层的终末器官。
If you measure heart rate in standard ways that cardiologists measure heart rate, and you stimulate over this left dorsolateral, you get a deceleration of the heart rate, and it's very time locked to the stimulation.
如果您以心脏病专家测量心率的标准方法测量心率，并且刺激左背外侧，您的心率就会减慢，并且刺激的时间非常固定。
So it's a two-second train of stimulation.
所以这是一连串两秒钟的刺激。
At one second, you see the deceleration.
下一秒，您会看到减速。
It goes down about 10 beats per minute, and then it'll drift back up, and there's a break for eight seconds on the stimulation.
它每分钟下降约 10 次，然后又上升，刺激时会有 8 秒的休息时间。
It drifts back up, and the stimulation goes back in, and then the heart rate goes back down.
它又回升，刺激又回来，然后心率又回落。
And so you see the heart rate just do this 10 beats per minute every train.
所以你会看到每趟列车的心率为每分钟 10 次。
And so we know if you do that over visual cortex, you don't get that, or motor cortex, you don't get any of those findings.
所以我们知道，如果你在视觉皮层上这样做，你就不会得到这个结果，或者在运动皮层上，你不会得到任何这些发现。
It's really specific to this ...
这确实是具体的...
kind of control region of the brain.
大脑的一种控制区域。
And so, yeah, it seems to, it's our work, other folks' work, Martin Arens in Europe, Netherlands work showing the same connections.
所以，是的，看起来，我们的工作、其他人的工作、马丁·阿伦斯在欧洲、荷兰的工作都显示出同样的联系。
I think it's been replicated like four or five times.
我认为它已经被复制了四五次。
Andrew Huberman:
安德鲁·休伯曼：
So you mentioned left dorsolateral prefrontal cortex.
所以你提到了左背外侧前额皮质。
Anytime I hear about lateralization of function, I get particularly curious.
每当我听到功能偏侧化时，我都会特别好奇。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Because obviously we have two mirror symmetric sides of the brain.
因为显然我们的大脑有两个镜像对称的侧面。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
There are rare exceptions to this, like the pineal and things of that sort, that there's only one pineal.
也有极少数例外，比如松果体之类的，只有一个松果体。
What is special about the left dorsolateral prefrontal cortex?
左背外侧前额叶皮层有什么特别之处？
Does this have anything to do with handedness, right hand or left hand?
这和惯用手、右手还是左手有关系吗？
Because we know right-handed and left-handedness has a lot to do with lateralization of function for language.
因为我们知道右手和左手习惯与语言功能的偏侧化有很大关系。
A topic for another time.
另一个话题。
But why do you think the left dorsolateral prefrontal cortex would be connected to the heart in this way?
但是你为什么认为左背外侧前额叶皮层会以这种方式与心脏相连呢？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
I think so left dorsolateral is thought to be the side that when you excite it, when you kind of do excitatory stimulation, potentiating sort of stimulation, that you can reduce depressive symptoms.
我认为左背外侧被认为是当你兴奋它时，当你进行兴奋性刺激、增强刺激时，你可以减轻抑郁症状。
And a guy by the name of Mike Fox at Harvard has demonstrated that if you have strokes in the brain that cause depression, and you put them on the human connectome 100, 1,000-patient map, and you ask the question what they're all functionally connected to, left dorsolateral.
哈佛大学的一位名叫迈克·福克斯 (Mike Fox) 的人已经证明，如果大脑中风导致抑郁，你将它们放在人类连接组 100、1,000 名患者图上，然后你会问这样的问题：它们在功能上与左背外侧有什么联系。
If you take lesions that cause mania in individuals, and you put those all on the human connectome map and ask what they're all...
如果你采取导致个体躁狂的病变，然后将它们全部放在人类连接组图上并询问它们是什么......
The one common area they're all connected to, it's the right dorsolateral.
它们所连接的一个共同区域是右背外侧。
And so there seems to be a hemispheric balancing of mood between these two brain regions.
因此，这两个大脑区域之间似乎存在半球情绪平衡。
And we know this from an experimental standpoint too, because you can take individuals with depression, and you can excite the left, or you can inhibit the right, and they're both antidepressant.
我们从实验的角度也知道这一点，因为你可以让患有抑郁症的人兴奋，或者抑制右翼，它们都是抗抑郁药。
You can excite the right, and that's anti-manic in some studies.
你可以激发右翼，这在一些研究中是反躁狂的。
And so this idea that there is this hemispheric balancing of mood is quite interesting, right?
因此，这种半球情绪平衡的想法非常有趣，对吧？
Andrew Huberman:
安德鲁·休伯曼：
It's incredibly interesting.
这非常有趣。
And just so people know, if you're curious what the connectome is, a connectome is a term that was built out of this notion of genomes being large collections of sequencing and mapping of genes.
人们知道，如果您好奇连接组是什么，连接组是一个术语，它是根据基因组是基因测序和图谱的大量集合这一概念而构建的。
They're proteomes of proteins, of connectomes as so-called connectomics, of connections between neurons.
它们是蛋白质的蛋白质组，是所谓的连接组学的连接体的蛋白质组，是神经元之间连接的蛋白质组。
So the Human Connectome Project is ongoing, and I find that incredible that within the Connectome Project they can identify these regularities of right versus left dorsolateral prefrontal cortex, especially since I've looked at a fair number of brains from humans, certainly not as many as you have.
因此，人类连接组项目正在进行中，我发现令人难以置信的是，在连接组项目中，他们可以识别左右背外侧前额叶皮层的这些规律，特别是因为我已经观察了相当数量的人类大脑，当然没有你们那么多。
And if you look at the architecture, the layers, the cell types, and even the neurochemicals of which cells are expressing, say, dopamine or serotonin, or receiving input from areas that make dopamine or serotonin, they don't look that different on the right and left side.
如果你观察细胞的结构、层、细胞类型，甚至是表达多巴胺或血清素的细胞的神经化学物质，或者从产生多巴胺或血清素的区域接收输入，它们的右侧和左侧看起来并没有那么不同。
And yet here we're talking about a kind of an accelerator and a brake, if you will-
然而，如果你愿意的话，我们在这里谈论的是一种加速器和制动器——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
on depression and mania using what, at least by my eye, and I think other people's eye, look to be basically the same set of bits.
关于抑郁症和躁狂症使用什么，至少从我的眼睛来看，我认为其他人的眼睛看起来基本上是同一组位。
The same parts list-
相同的零件清单-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
more or less.
或多或少。
So what gives these properties to the right and left dorsolateral prefrontal cortex?
那么，是什么赋予左右背外侧前额叶皮层这些特性呢？
Is it the inputs they receive?
是他们收到的输入吗？
Is this something that we learn during development, or do you think that we come into the world with these hemispheric biases?
这是我们在发育过程中学到的东西，还是你认为我们带着这些半球偏见来到这个世界？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
It's a great question, and it hasn't been worked out, which your original question was around in a left-handed individual, which, as you know, 25% of those folks end up having a right brain dominance, or 1% of right-handed people have a right brain dominance if it's flipped, right?
这是一个很好的问题，而且还没有得到解决，你最初的问题是关于左撇子的，正如你所知，25% 的人最终会右脑占优势，或者如果颠倒过来，1% 的右撇子会右脑占优势，对吗？
And unfortunately, that study still hasn't been done at the level because that would be probably pretty helpful for teasing some of this out.
不幸的是，这项研究还没有达到这个水平，因为这可能对于梳理其中的一些内容非常有帮助。
But it's still being sorted out, right?
但事情还在整理中，对吗？
We know enough to know this phenomenon exists because we can use TMS as a probe and do these sorts of manipulations.
我们足够了解这种现象的存在，因为我们可以使用 TMS 作为探针并进行此类操作。
But to my knowledge, there hasn't been anybody that's gotten so interested in it that they've been able to get a mechanism of why that is.
但据我所知，还没有人对此如此感兴趣，以至于能够找到其中的机制。
But it's kind of empirically true in the sense that you can push and pull on those systems, or in the case of strokes that folks have, and then you kind of get their brains and their brain images and look at where the strokes landed.
但这在经验上是正确的，因为你可以推动和拉动这些系统，或者在人们中风的情况下，然后你可以获取他们的大脑和他们的大脑图像，并查看中风落在哪里。
Those kind of causal bits of information point to this asymmetry.
这些因果信息表明了这种不对称性。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Well, in that case, going with what we do know, that stimulation of dorsolateral prefrontal cortex slows the heart rate down-
好吧，在这种情况下，根据我们所知道的情况，刺激背外侧前额叶皮层会减慢心率——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
transiently-
短暂地——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
but it slows it down, and seems to alleviate at least some symptoms of depression.
但它减慢了速度，并且似乎至少减轻了抑郁症的一些症状。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Leads me to the question of why would that be the case?
这让我想到一个问题：为什么会出现这种情况？
Does it tell us anything fundamental about depression, that anxiety is inherent to depression?
它是否告诉我们有关抑郁症的任何基本信息，即焦虑是抑郁症所固有的？
I think a faster heart rate is part and parcel with-
我认为更快的心率是重要的一部分-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
anxiety.
焦虑。
In my laboratory, we've studied fear a bit in animals-
在我的实验室里，我们研究了一些动物的恐惧——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and in humans, and we often observe bradycardia, where somebody or an animal is afraid of something, and rather than the heart rate speeding up, it actually slows down.
在人类中，我们经常观察到心动过缓，即某人或动物害怕某事，心率不是加快，而是减慢。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Something that most people don't think about or recognize.
大多数人没有想到或认识到的事情。
But given that stimulation of dorsolateral prefrontal cortex slows the heart rate down and can alleviate depressive symptoms, and that there are other ways to slow the heart down, I have two questions.
但鉴于刺激背外侧前额叶皮层可以减慢心率并减轻抑郁症状，并且还有其他方法可以减慢心率，我有两个问题。
What do you think this tells us about the basic architecture of depression and its physiology-
您认为这告诉我们什么有关抑郁症及其生理学的基本结构？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
at the level of the heart?
在心脏的层面上？
And does the circuit run in the opposite direction, too?
电路也朝相反方向运行吗？
If one were to have Or find other ways to slow the heart rate down, say, with a beta blocker.
如果一个人有或找到其他方法来降低心率，例如使用β受体阻滞剂。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Does that help alleviate depression?
这有助于缓解抑郁症吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, no, that's a great question.
是的，不，这是一个很好的问题。
So I'll answer the second question first.
那么我先回答第二个问题。
So we know that, and there are ongoing trials of this, if you stimulate in the vagus nerve, in an implanted vagus nerve stimulator, you can actually have this, the afferent parts of the vagus project ultimately up to the DLPFC through the cingulate, through these anterior insula, so that's obviously the same tract, right?
所以我们知道，并且正在进行这方面的试验，如果你在植入的迷走神经刺激器中刺激迷走神经，你实际上可以得到这个，迷走神经的传入部分最终通过扣带皮，通过这些前岛叶到达 DLPFC，所以这显然是同一个束，对吗？
And you can stimulate there and alleviate depression, which seems very unusual, right?
而且你可以刺激那里并缓解抑郁症，这看起来很不寻常，对吧？
You're stimulating a cranial nerve down in the neck, but if you can get up into the brain, you actually can improve depressive symptoms.
你刺激的是颈部以下的脑神经，但如果你能刺激到大脑，你实际上可以改善抑郁症状。
And so, more evidence that this is a kind of whole track and system.
因此，更多的证据表明这是一种完整的轨道和系统。
And if you stimulate in part of that system, it appears that you can improve mood.
如果刺激该系统的一部分，似乎可以改善情绪。
Andrew Huberman:
安德鲁·休伯曼：
And what if I were somebody who did not have a stimulating electrode in my vagus nerve, and I was dealing with minor depression, and I decided-
如果我的迷走神经中没有刺激电极，而我正在应对轻微的抑郁症，我决定——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
I wanted to take some other approach to slow my heart rate down-
我想采取其他方法来减慢我的心率-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
via the vagus.
通过迷走神经。
For instance, exhale emphasized breathing-
例如，呼气强调呼吸——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
or deliberately slow cadence breathing-
或故意减慢呼吸节奏-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
things of that sort.
诸如此类的事情。
Is there any evidence that behavioral interventions of those kinds can alleviate depression or some symptoms of depression?
是否有任何证据表明此类行为干预可以缓解抑郁症或抑郁症的某些症状？
And is there any evidence that it does indeed feed back to the dorsolateral prefrontal cortex to achieve some of that alleviation?
是否有任何证据表明它确实会反馈到背外侧前额叶皮层以实现部分缓解？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Absolutely.
绝对的。
Yeah.
是的。
So there's a number of studies implicating the dorsolateral in, say, meditation, mindfulness, that sort of thing.
因此，有很多研究表明背外侧与冥想、正念之类的东西有关。
And they're small studies, but pretty well-designed studies suggesting that behavioral interventions in mild depression actually work quite well.
虽然这些研究虽然规模较小，但设计得相当精心，表明行为干预对轻度抑郁症实际上效果很好。
There seems to be a volitional threshold for depression, where at some point you go from being completely in total volition to having kind of semi-volition.
抑郁症似乎有一个意志阈值，在某个时刻，你会从完全意志转变为半意志。
You have thoughts that you really have a hard time controlling and that sort of thing, and when you go through that threshold, at some point it gets harder and harder for those sorts of things to kind of kick in and work.
你认为你真的很难控制诸如此类的事情，当你跨过这个门槛时，在某些时候，这些事情会变得越来越难发挥作用。
And the extreme form of that is catatonia, right?
其极端形式就是紧张症，对吧？
Where people in a very severe form of depression get kind of stuck motorically, right?
患有非常严重的抑郁症的人会在运动上陷入困境，对吧？
And they obviously have no control or very limited control.
他们显然没有控制权或控制力非常有限。
And so I think there's a threshold in which these sorts of interventions will work.
因此，我认为此类干预措施发挥作用存在一个门槛。
Exercise seems to really be a good treatment for mild depression, and it may work through the mechanism you're describing, right?
运动似乎确实是治疗轻度抑郁症的一种很好的方法，并且它可能通过您描述的机制起作用，对吧？
As we all know, athletes hold a lower resting heart rate-
众所周知，运动员的静息心率较低——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
than folks that aren't...
比那些不...
If you were an athlete, you had a lower resting heart rate, you stopped exercising, and a couple of years later, your resting heart rate, in many cases, goes up, right?
如果您是一名运动员，您的静息心率较低，您停止锻炼，几年后，您的静息心率在许多情况下会上升，对吧？
And so maybe that's part of the process.
所以也许这就是这个过程的一部分。
I'm not aware of any studies specifically looking at dorsolateral prefrontal physiology pre/post-exercise, but it would be a great study.
我不知道有任何专门针对运动前/后背外侧前额叶生理学的研究，但这将是一项很棒的研究。
I think that would be really helpful to understanding this, especially if you had a correlation of changes in kind of lowering of, say, heart rate with mood improvements.
我认为这对于理解这一点非常有帮助，特别是如果你有心率降低等变化与情绪改善之间的相关性。
There's been a lot of work with heart rate variability-
关于心率变异性已经做了很多工作——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
and depression and studies kind of point towards it.
抑郁症和研究都指向这一点。
Not every study is positive for this, but quite a few studies say basically that lower heart rate variability is associated with moderate to severe depression, and that may be part of that mechanism of that heart-brain risk.
并非每一项研究都对此持积极态度，但相当多的研究基本上表明，较低的心率变异性与中度至重度抑郁症相关，这可能是心脑风险机制的一部分。
Andrew Huberman:
安德鲁·休伯曼：
So I'm both intrigued and a little bit perplexed by this relationship between heart rate and depression.
所以我对心率和抑郁之间的关系既感兴趣又有点困惑。
On the face of it, I would think of depression as depressed.
从表面上看，我认为抑郁症就是抑郁症。
A lower heart rate might make somebody more depressed.
较低的心率可能会使人更加抑郁。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
You even mentioned catatonia, or somebody that just doesn't seem motivated or excited to do anything.
你甚至提到了紧张症，或者是一个似乎没有动力或兴奋地做任何事情的人。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I think of mania as elevated heart rate and-
我认为躁狂症是心率加快并且——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
being excited.
很兴奋。
On the other hand, I realize that anxiety, which brings about ideas as elevated heart rate, is also built into depression.
另一方面，我意识到焦虑会带来心率加快等想法，它也与抑郁有关。
Which brings me back to what you said earlier, which is that when we say depression, are we really talking about four or five different-
这让我回到你之前所说的，那就是当我们说抑郁症时，我们真的在谈论四到五种不同的——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
disorders-
疾病-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
for lack of a better word.
因为缺乏更好的词。
And for what percentage of people that have depression does some approach to reducing heart rate work?
对于多少比例的抑郁症患者来说，某些降低心率的方法有效？
Whether or not it's stimulation of the left dorsolateral prefrontal cortex by way of transcranial magnetic stimulation or by taking a beta blocker-
无论是通过经颅磁刺激还是服用β受体阻滞剂来刺激左背外侧前额叶皮层——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
or by stimulating the vagus.
或通过刺激迷走神经。
Can we throw out a number, a rough number?
我们可以给出一个数字，一个粗略的数字吗？
Does that help 30%, 50%?
这对 30%、50% 有帮助吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
How long lasting is that relief?
这种缓解能持续多久？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, and to be clear, the deceleration of the heart rate is in the moment when the stimulation is happening-
是的，需要明确的是，心率减慢是在刺激发生的那一刻——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
but it's not something that's necessarily maintained chronically.
但这并不是必须长期维持的东西。
It's more of an indicator that you're in the right network, more than it appears to be itself central to the mechanism.
它更多的是表明您处于正确的网络中，而不是它本身是该机制的核心。
The heart rate variability piece may be, and there's some studies that link the two, but the actual deceleration seems to be much more of a marker that you're in the right system.
心率变异性可能是这样，并且有一些研究将两者联系起来，但实际的减速度似乎更多地表明您处于正确的系统中。
But it very well could be that the heart rate system and the mood system just sit next to each other, and the stimulation hits both.
但很可能心率系统和情绪系统只是相邻，刺激同时影响两者。
If you look at how much of the variance in the mood is explained by the heart rate deceleration, it's not a huge amount, right?
如果你看看心率减慢可以解释情绪的变化有多少，你会发现这并不是一个很大的数字，对吗？
So it only explains a small percentage.
所以它只能解释一小部分。
And so it's unlikely that simply reducing the heart rate...
因此，简单地降低心率不太可能......
And in fact, for many years, propranolol and these sorts of drugs actually were implicating causing depression- And so that's been kind of debunked, but it's unlikely that simply decelerating the heart rate's going to improve depression.
事实上，多年来，普萘洛尔和这类药物实际上与导致抑郁症有关——所以这已经被揭穿了，但简单地降低心率不太可能改善抑郁症。
But what it does tell you is that if you're in that area that is the mood regulatory area, there's some parasympathetic cortical kind of process that's going on that gets in and causes this to happen.
但它确实告诉你的是，如果你处于情绪调节区域，就会有某种副交感皮层过程进入并导致这种情况发生。
And it's independent of mood.
而且它与心情无关。
You can take a normal healthy individual, and you can do this, and they're going to decelerate their heart rate.
你可以以一个正常健康的人为例，你可以这样做，他们的心率就会减慢。
Andrew Huberman:
安德鲁·休伯曼：
I'm so glad you mentioned the parasympathetic nervous system, which of course most people think of as the rest and digest or the kind of calming side of the autonomic nervous system.
我很高兴你提到副交感神经系统，当然大多数人认为副交感神经系统是自主神经系统的休息和消化或镇静方面。
As I'm hearing you say all of this, and in particular what you just told me, which is that it's not as if having a lower heart rate protects you against depression or a higher heart rate is associated with depression, although at the extremes, that might be true, but rather it's something about the regulatory network, the ability to control your own nervous system to some extent.
正如我听到你所说的所有这些，特别是你刚刚告诉我的，这并不是说较低的心率可以保护你免受抑郁症的侵害，或者较高的心率与抑郁症有关，尽管在极端情况下，这可能是正确的，而是与调节网络有关，即在某种程度上控制自己的神经系统的能力。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And when I think about the autonomic nervous system, I like to think about it as a seesaw-
当我想到自主神经系统时，我喜欢把它想象成一个跷跷板——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
of alertness and calmness, and when you're asleep, it's a lot of calmness, and when you're panicking, it's a lot of alertness to the-- And I don't think this has ever been defined, and when I teach the medical students at Stanford neuroanatomy, my wish is that someday I'll be able to explain what the hinge in that process would be, right?
当你睡着的时候，你会非常平静，当你惊慌失措时，你会非常警惕——我认为这还没有被定义过，当我在斯坦福大学教授医学院的学生神经解剖学时，我的愿望是有一天我能够解释这个过程中的关键是什么，对吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Not the ends of the seesaw.
不是跷跷板的两端。
We know what the sympathetic nervous system is-
我们知道交感神经系统是什么-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and what it's to wake us up and make us panic or make us feel nicely alert and calm.
是什么让我们醒来，让我们恐慌，或者让我们感到警觉和平静。
We know what puts someone into sleep or a coma or makes them feel relaxed.
我们知道是什么使人进入睡眠或昏迷或使他们感到放松。
But what shifts from one side of the seesaw to the other and the tightness of that hinge seems to be what you're describing.
但是从跷跷板的一侧到另一侧的变化以及铰链的紧密程度似乎就是您所描述的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That depression is sort of a lack of control over inner state, so that when I'm stressed, I can't get myself out of it.
抑郁症是一种对内心状态缺乏控制的表现，所以当我有压力时，我无法摆脱它。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
Or when I'm feeling completely collapsed with exhaustion, I can't get out of bed and-
或者当我因精疲力尽而感到彻底崩溃时，我无法起床并且-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
get motivated to do the very things that would help me get out of depression-
有动力去做那些能帮助我摆脱抑郁的事情——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
like a workout or social connection or eat a quality meal, these kinds of things.
比如锻炼、社交或吃一顿优质的饭菜，诸如此类的事情。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So this is perhaps the first time that I've ever heard about a potential circuit for the hinge, as I'm referring to it.
因此，这可能是我第一次听说铰链的潜在电路，正如我所说的那样。
Does that make any sense at all?
这有任何意义吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, absolutely.
是的，绝对是。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
I just want to make sure that I'm framing this correctly in my mind.
我只是想确保我在脑海中正确地构建了这个框架。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, absolutely.
是的，绝对是。
And in some studies, if you do the same identical stimulation on the right dorsolateral, you can get an acceleration.
在一些研究中，如果你对右背外侧进行同样的刺激，你可以获得加速度。
Just kind of further confirming this idea of lateralization, right?
只是进一步证实了这种偏侧化的想法，对吧？
That it appears that even the prefrontal cortical areas seem to be lateralized in this way.
看来甚至前额皮质区域似乎也以这种方式侧化。
The right finding is more variable depending upon the study.
正确的发现因研究而异。
The left's very consistent in this way.
左派在这方面非常一致。
Andrew Huberman:
安德鲁·休伯曼：
So we've talked about transcranial magnetic stimulation for getting into these networks.
我们讨论了进入这些网络的经颅磁刺激。
And I also just want to take a brief tangent because I've heard you say this before, I think it's so vital what you're saying, that it's really not about stimulation of areas, or any specific brain area or vagus nerve being important per se.
我也想简单说一句，因为我以前听过你说过这句话，我认为你所说的非常重要，它实际上与刺激某个区域或任何特定的大脑区域或迷走神经本身并不重要。
It's really about a network, a series of connections.
它实际上是一个网络，一系列的连接。
I think that's really important for people to understand and is a kind of a new emerging theme really.
我认为这对于人们理解非常重要，并且确实是一种新出现的主题。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
The other thing that to me seems extremely important for us to consider is what are these lateral prefrontal cortices doing?
在我看来，我们要考虑的另一件事极其重要，那就是这些外侧前额皮质在做什么？
Are they involved, for instance, in sensation, sensing the heart rate?
例如，它们是否参与感觉、感知心率？
Are they involved in thinking and planning?
他们参与思考和计划吗？
And this gets down to a very simple question that I know a lot of people have, which is can we talk ourselves out of depression if it's mild?
这归结为一个非常简单的问题，我知道很多人都有这个问题，那就是如果抑郁症很轻微，我们可以说服自己摆脱抑郁症吗？
Can we talk ourselves into a manic state or an excited state, a positively excited state that doesn't qualify as mania?
我们能否说服自己进入躁狂状态或兴奋状态，一种不属于躁狂的积极兴奋状态？
Other areas of the brain I think of is responsible for perception or for motor control.
我认为大脑的其他区域负责感知或运动控制。
But here we are in this mysterious frontal cortex area-
但我们现在就在这个神秘的额叶皮层区域——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
which people say executive function, planning, et cetera.
人们所说的执行职能、计划等等。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Are we talking about thoughts?
我们在谈论想法吗？
Are we talking about structured thoughts, or are we talking about dreamlike thoughts?
我们是在谈论结构化的想法，还是在谈论梦幻般的想法？
What in the world is going on in the prefrontal cortex?
前额皮质到底发生了什么？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And here I spend my career in neuroscience, and I still can't really understand what it's doing, and maybe it's doing 50 things.
我在这里度过了我的神经科学职业生涯，但我仍然无法真正理解它在做什么，也许它做了 50 件事。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, no, it's a great question.
是的，不，这是一个很好的问题。
So one of the studies that we've been working on, in addition to the depression work, is actually trying to change trait hypnotizability.
因此，除了抑郁症研究之外，我们一直在进行的研究之一实际上是试图改变特质的催眠性。
So David Spiegel and I have been working on this, and he's found, and published this 10 years ago, that a different part of the left dorsolateral is functionally connected with the dorsal anterior cingulate with a lot of functional connectivity in high hypnotizables and not much in low hypnotizables.
David Spiegel 和我一直在研究这个问题，他发现并在 10 年前发表了这篇文章，左背外侧的另一个部分在功能上与背侧前扣带回相连，在高催眠状态下有很多功能连接，而在低催眠状态下功能连接不多。
And that's a different sub-region within this bigger brain region we call left dorsolateral prefrontal cortex than the part that seems to be important for regulating mood.
这是我们称之为左背外侧前额叶皮层的更大大脑区域中的一个不同的子区域，而不是似乎对调节情绪很重要的部分。
And so the left dorsolateral seems to have connections that are location specific within the overall kind of named brain region that connect to various parts of the cingulate and seem to regulate it.
因此，左背外侧似乎在整个命名大脑区域内具有特定位置的连接，这些连接连接到扣带回的各个部分并似乎对其进行调节。
Right?
正确的？
And so if you knock out the left dorsolateral prefrontal cortex and you have people do the Stroop task, for instance, which is a simple task, you probably know this.
因此，如果你敲除左背外侧前额叶皮层，然后让人做斯特鲁普任务，例如，这是一项简单的任务，你可能知道这一点。
You have people name the color of words.
你让人们命名单词的颜色。
And so if I look at one of the cards that they'll show you, it'll have the word red in red, and that's very easy, and that's called a congruent.
所以如果我看他们给你看的一张卡片，上面会有红色的单词红色，这很简单，这就是所谓的全等。
And then the incongruent is red in the color blue, and you have to say the word.
然后不一致的是蓝色中的红色，你必须说出这个词。
You don't name the color.
你没有说出颜色的名称。
Andrew Huberman:
安德鲁·休伯曼：
So you have to suppress a response.
所以你必须压制回应。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, exactly.
是的，完全正确。
I'm sorry.
对不起。
You name the color, and you see the word written in a different way.
你命名了颜色，你就会看到以不同方式书写的单词。
And so basically If you stimulate in a way that inhibits the left dorsolateral prefrontal cortex or either one, you can actually knock out the ability to do that well, and it'll take longer for people on the incongruent cards to be able to name it.
所以基本上，如果你以一种抑制左背外侧前额叶皮层或其中任何一个的方式进行刺激，你实际上可以消除做好这件事的能力，并且不一致卡片上的人需要更长的时间才能说出它的名字。
And so they have a kind of a time delay that's greater than they had before they got stimulated.
因此，他们的时间延迟比受到刺激之前要长。
So that's a part of the prefrontal cortex that's different than the part of the prefrontal cortex that's involved in mood regulation.
所以这是前额叶皮层的一部分，与参与情绪调节的前额叶皮层的部分不同。
The nice thing about TMS is that you can go through and you can find these areas that are functionally defined through brain imaging, and you can perturb them and answer the question you're talking about.
TMS 的好处在于，你可以浏览并找到这些通过大脑成像在功能上定义的区域，你可以扰乱它们并回答你正在谈论的问题。
How do I understand this part of the prefrontal cortex and its function, this part?
我如何理解前额皮质的这一部分及其功能，这一部分？
And so we were able to stimulate in an inhibitory way within the left dorsolateral prefrontal cortex that's involved with this sort of cognitive control area.
因此，我们能够以抑制方式刺激涉及此类认知控制区域的左背外侧前额叶皮层。
And we were able to knock that area out and increase trait hypnotizability.
我们能够消除该区域并提高特质催眠能力。
So people had greater hypnotizability after they got active stimulation versus when they got sham.
因此，人们在接受主动刺激后比接受假刺激时具有更强的催眠能力。
And so it suggests that that brain circuit is involved in the process of what therapeutic hypnosis ends up being, but it's a very different region within the left dorsolateral than, say, we do when we do these very intensive stimulation approaches to treat severe depression, and we're able to get people out of depression with the part of the dorsolateral that seems to be lower in the kind of more lateral and inferior on the DLPFC and connected with the subgenual anterior cingulate, so the part of the anterior cingulate that processes emotion.
因此，这表明该大脑回路参与了治疗性催眠最终的过程，但它是左背外侧内的一个非常不同的区域，比方说，当我们采用这些非常强烈的刺激方法来治疗严重抑郁症时，我们能够使人们摆脱抑郁，背外侧的部分似乎在 DLPFC 上更外侧和更下方的位置较低，并与膝下前扣带皮层相连，因此前扣带皮层的部分处理情绪的扣带皮层。
Andrew Huberman:
安德鲁·休伯曼：
Based on what you told us about the Stroop task and the role of the prefrontal cortex in the Stroop task, to me, the Stroop task is a rule-switching game.
根据您向我们介绍的斯特鲁普任务以及前额皮质在斯特鲁普任务中的作用，对我来说，斯特鲁普任务是一个规则切换游戏。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
For sure.
一定。
Andrew Huberman:
安德鲁·休伯曼：
You're saying in one moment, the rule is you read whatever the word says, and then you switch and then you say the rule now is you tell me what color the word is written in, and you suppress whatever it is the word says.
你在一瞬间说，规则是你读这个词所说的任何内容，然后你切换，然后你说现在的规则是你告诉我这个词写的是什么颜色，然后你压制这个词所说的任何内容。
Okay?
好的？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, that's right.
是的，没错。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
A rule, in some sense, like that, is a transiently adopted belief system.
从某种意义上说，规则是一种暂时采用的信仰体系。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So I could imagine that in depression, which has all sorts of backstory to it-
所以我可以想象在抑郁症中，它有各种各样的背景故事——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
that of course, the psychiatrist or psychologist or friend can pull on that thread.
当然，精神科医生、心理学家或朋友可以利用这条线索。
Like for instance, somebody might believe that they are bad-
比如说，有人可能认为自己很坏——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
or that they don't deserve love.
或者他们不值得爱。
I'm trying to bring this into the typical language that-
我试图用典型的语言来表达——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
people talk about.
人们谈论。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Absolutely.
绝对地。
Andrew Huberman:
安德鲁·休伯曼：
Or that they will never succeed.
或者他们永远不会成功。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Or that even if they keep succeeding, it's just going to get harder and harder, and it will never feel good.
或者即使他们不断取得成功，也会变得越来越难，而且永远不会感觉良好。
These are sort of rules like the Stroop task-
这些规则就像斯特鲁普任务一样——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
at some level.
在某种程度上。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
They're rules that are more pervasive over time, unfortunately.
不幸的是，随着时间的推移，这些规则变得更加普遍。
But I could imagine that if the PFC also contains some sort of maps or algorithms related to rules of emotionality or self-representation or things that we've heard, I think there must be data out there saying that whatever we heard in middle school when someone made fun of us, we can remember that.
但我可以想象，如果前额皮层还包含某种与情绪规则或自我表达或我们听到的事情相关的地图或算法，我认为一定有数据表明，无论我们在中学时听到有人取笑我们，我们都能记住。
Because I can remember things that people said-
因为我记得人们说过的话——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
about a jacket I wore one day or something-
关于我有一天穿的一件夹克什么的——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
in the fourth grade.
四年级时。
Crazy.
疯狂的。
I didn't even like the jacket.
我什至不喜欢这件夹克。
Now I think it was kind of cool.
现在我觉得这很酷。
But anyway.
但无论如何。
The point being that we have an intense memory for these things.
关键是我们对这些事情有强烈的记忆力。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Totally.
完全。
Andrew Huberman:
安德鲁·休伯曼：
That set up a sort of rule or a question, like maybe I don't really know how to dress, for instance.
这设定了某种规则或问题，例如，也许我真的不知道如何穿着。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Maybe that's why I always wear the same black shirt.
也许这就是为什么我总是穿着同样的黑色衬衫。
But in all seriousness, it seems like the dorsolateral prefrontal cortex is in this amazing position to access rules, which-
但严肃地说，背外侧前额叶皮层似乎处于访问规则的惊人位置，其中——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
are beliefs, and beliefs are rules, and then for moments or longer, to switch those rules.
是信念，而信念是规则，然后在片刻或更长时间内改变这些规则。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And so for somebody who's depressed, to just simply look themselves in the mirror and say, "You are great.
因此，对于抑郁的人来说，只需照照镜子并说：“你很棒。
You are fantastic," it feels like a lie if you feel like garbage to say that.
你太棒了，”如果你觉得自己很垃圾，那么说这句话就感觉像是在撒谎。
It doesn't fit with the rule.
这不符合规则。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It's like saying, "That card is not red.
这就像在说：“那张牌不是红色的。
That card is green," when your eyes tell you that it's red.
那张卡片是绿色的，”当你的眼睛告诉你它是红色的时。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
That's right.
这是正确的。
Andrew Huberman:
安德鲁·休伯曼：
And it seems like there's something about prefrontal cortex that, in principle, gives flexibility to rules based on what we know about-
原则上，前额叶皮层似乎赋予了基于我们所知的灵活性的规则——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
the Stroop task.
斯特鲁普任务
So given its connectivity, can we assume that the talk therapy that occurs in the psychiatrist office or with a friend or through journaling out something, because we do know that reporting things about trauma or difficult circumstances or the rules that we contain and tend to hide inside of us about how we feel miserable about ourselves or anything really, that in rescripting that, that somehow it allows us to do a sort of Stroop task on our beliefs?
因此，考虑到它的连通性，我们是否可以假设，在精神科医生办公室或与朋友一起或通过写日记进行谈话治疗，因为我们确实知道报告有关创伤或困难情况的事情，或者我们所包含的并倾向于隐藏在我们内心的规则，即我们对自己或其他任何事情感到如何痛苦，在重写时，它以某种方式允许我们对我们的信仰做某种斯特鲁普任务？
Is that a tremendous leap?
这是一个巨大的飞跃吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
No.
不。
Andrew Huberman:
安德鲁·休伯曼：
I'm just really trying to frame this in the context of what I and most people think of as depression.
我只是想在我和大多数人所认为的抑郁症的背景下描述这一点。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Totally.
完全。
Andrew Huberman:
安德鲁·休伯曼：
Because the network components are vitally important, but I guess what I'm trying to figure out is what are the algorithms that govern-
因为网络组件至关重要，但我想我想弄清楚的是控制的算法是什么——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
prefrontal cortex?
前额皮质？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Absolutely.
绝对地。
So in a kind of standard cognitive behavioral therapy session, right, what the therapist is trying to do is identify those beliefs and kind of determine how fixed they are, if they're flexible, as you're saying, and then help folks to find another explanation for them and to kind of reintegrate that potential other explanation into their memory system, right?
因此，在一种标准的认知行为治疗过程中，治疗师想要做的就是识别这些信念，并确定它们的固定程度，如果它们灵活，正如你所说，然后帮助人们为它们找到另一种解释，并将潜在的其他解释重新整合到他们的记忆系统中，对吗？
Where I think TMS is really interesting, actually, we had a lot of patients who've told me, "My therapist told me that I wasn't trying hard enough in therapy, and I really am trying hard," but these are moderate or pretty severe depressed patients.
我认为 TMS 真的很有趣，实际上，我们有很多患者告诉我，“我的治疗师告诉我，我在治疗中没有足够努力，但我确实很努力”，但这些都是中度或相当严重的抑郁症患者。
And as soon as we get them well with the TMS approaches, kind of rapid five-day approach, and then the next week we come in and see them, and they'll say, "You know what I did all weekend is I looked at my therapy books, and now I can understand it." And so, I actually see TMS as a way of having kind of exogenous sorts of cognitive functions that in milder forms of depression, we can pull off with psychotherapy.
一旦我们用 TMS 方法（一种快速的五天方法）让他们康复，然后下周我们去看他们，他们会说，“你知道我整个周末都做了什么，我看了我的治疗书籍，现在我能理解它了。”因此，我实际上将 TMS 视为一种具有外源性认知功能的方式，在轻度抑郁症中，我们可以通过心理治疗来实现这种功能。
This idea of being able to kind of turn that prefrontal cortex on and have it govern these deeper regions.
这种想法能够打开前额皮质并让它控制这些更深的区域。
In depression, the deeper regions govern the prefrontal cortex.
在抑郁症中，较深层的区域控制着前额皮质。
They precede the prefrontal cortex timing-wise.
它们在时间上先于前额皮质。
And we've got some data in review now where we're seeing that in depressed individuals that are responsive to our rapid TMS approach, what we call Stanford Accelerated Intelligent Neuromodulation Therapy, or SNT, or SAINT.
我们现在正在审查一些数据，我们发现抑郁症患者对我们的快速 TMS 方法（我们称之为斯坦福加速智能神经调节疗法，或 SNT 或 SAINT）有反应。
If you look at the brain before people get this, they will have a temporal delay where the cingulate is in front of the DLPFC.
如果你在人们意识到这一点之前观察大脑，就会发现扣带皮层位于 DLPFC 前面的时间延迟。
And in people that are normal, healthy controls, no depression, the dorsolateral prefrontal cortex is temporally in front of the anterior cingulate.
在正常、健康、没有抑郁症的人中，背外侧前额叶皮层暂时位于前扣带回前面。
With effective treatment, we can flip the timing of things so the dorsolateral is in front of the anterior cingulate, just like in a normal person.
通过有效的治疗，我们可以扭转事情发生的时间，使背外侧位于前扣带回前面，就像正常人一样。
Andrew Huberman:
安德鲁·休伯曼：
So you're not talking about obviously physically moving these structures.
所以你并不是在谈论明显的物理移动这些结构。
You're talking about in time-
你说的是时间-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
In time
及时
Andrew Huberman:
安德鲁·休伯曼：
...
...
their activation.
他们的激活。
So in one case, it's like the coach telling the player what to do.
所以在一种情况下，就像教练告诉球员该做什么。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Exactly.
正是如此。
Andrew Huberman:
安德鲁·休伯曼：
And in the other case, like the player telling the coach what to do, and you-
在另一种情况下，就像球员告诉教练该做什么，而你-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
you restore order to the game.
你恢复了游戏秩序。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
You restore order to the game.
你恢复了游戏秩序。
And what it looks like is depression, to your point, is a bunch of kind of spontaneous content that's semi-volitional, that's being kind of generated out of this conflict detection system, the cingulate, that seems to sense conflict and kind of feed that information.
在你看来，抑郁症是一堆半自愿的自发内容，是由冲突检测系统（扣带皮层）产生的，它似乎能感觉到冲突并提供该信息。
It gets overactive in depression.
它在抑郁症中变得过度活跃。
And then in depression, it looks like the left dorsolateral does not sufficiently clamp down on it.
然后在抑郁状态下，左背外侧似乎没有充分地对其施加压力。
And what therapy appears to do is to kind of restore that.
治疗似乎要做的就是恢复这种状态。
What we see with TMS over that region is that we just exogenously do the same sort of thing.
我们通过 TMS 在该区域看到的是，我们只是外源性地做同样的事情。
We restore the governance of the left dorsolateral over the cingulate area, and that is correlated with treatment improvement.
我们恢复了扣带回左侧背外侧的控制，这与治疗的改善相关。
So the degree in which you can re-time or re-regulate in time the left dorsolateral over the cingulate, the more of an antidepressant effect you have.
因此，您可以及时重新计时或重新调节扣带回左侧背外侧的程度，您的抗抑郁效果就越大。
Andrew Huberman:
安德鲁·休伯曼：
Can we therefore say in crude terms that the dorsolateral prefrontal cortex really is the governor of how we interpret physiological signals and spontaneous thoughts?
因此，我们是否可以粗略地说，背外侧前额叶皮层确实是我们如何解释生理信号和自发思想的管理者？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It places a lens that the rest of the brain sees things through.
它放置了一个镜头，大脑的其他部分可以通过它来观察事物。
And you can do these experiments where you can put a normal, healthy control person in the scanner, and you can make them feel like they have a loss of control.
你可以做这些实验，你可以把一个正常、健康的控制者放在扫描仪中，你可以让他们感觉自己失去了控制。
And then you can see that region come offline.
然后你就可以看到该区域离线了。
So you can experimentally manipulate the system.
所以你可以通过实验来操纵这个系统。
And so kind of buffing it up, TMS is almost like exercise for the brain, right?
如此加强，TMS 几乎就像大脑的锻炼，对吧？
You're kind of exercising this region over and over again with a physiologically relevant signal and kind of turning that system on.
您可以通过生理相关信号一遍又一遍地锻炼该区域，并打开该系统。
And what's interesting, I think really interesting for this show is we had a couple of folks, probably five or six folks that have actually told me this, where if they remit early enough in the week, we have this very dense stimulation approach where we can stimulate people really rapidly over a five-day block.
有趣的是，我认为这个节目真正有趣的是我们有几个人，可能有五六个人实际上告诉了我这一点，如果他们在一周内足够早地汇款，我们有这种非常密集的刺激方法，我们可以在五天的时间内真正快速地刺激人们。
We don't discriminate when they get better to when they stop.
我们不会歧视他们何时好转或何时停止。
So if they get better on day one, we still give them the other four days because it's in the protocol to do that, and we can't...
因此，如果他们在第一天好转，我们仍然给他们另外四天的时间，因为这是协议中规定的，我们不能……
We're getting to a point where we can tell how long it's going to take, but we're not there yet.
我们已经到了可以知道需要多长时间的地步，但我们还没有到那一步。
And so every time somebody gets better at day one or two, at the beginning when we first started doing this, we'd say, "We're not sure.
因此，每次有人在第一天或第二天变得更好时，在我们第一次开始这样做时，我们都会说：“我们不确定。
We think this is safe to keep going, but what do you want to do?" And everybody was like, "No, I want to keep going." And so, by Wednesday, they're totally zeroed out on the depression scales, even better than most people walking around.
我们认为继续下去是安全的，但你想做什么？”每个人都说：“不，我想继续前进。”因此，到了周三，他们的抑郁量表就完全归零了，甚至比大多数人都好。
Really no anxiety, no depression or anything.
真的没有焦虑，没有抑郁什么的。
By Thursday, the first guy that told me this, he came in and he said, "I was driving back to my hotel, and I decided to go to the beach, and I just sat there, and I was totally present in the present moment for an hour." And he's like, "I read about this in my mindfulness books, but I experienced it last night, and I've never experienced anything like this before." And I was like, "Hmm, that's interesting," but kind of wasn't sure.
到周四，第一个告诉我这件事的人进来了，他说：“我正开车回酒店，我决定去海滩，我就坐在那里，整整一个小时我都完全沉浸在当下。”他说，“我在正念书籍中读到过这一点，但我昨晚经历过，我以前从未经历过这样的事情。”我当时想，“嗯，这很有趣，”但有点不确定。
And then I didn't tell obviously any more patients about that.
然后我显然没有告诉更多的病人这件事。
And then about five over the last couple of years, when they remit early in the week, by the end of the week, they're going to the beach, and they're totally having what people describe as a pretty mindful, present moment sort of experience, which is really interesting what that is.
然后，在过去的几年里，大约有五个人，当他们在本周早些时候汇款时，到周末，他们会去海滩，他们完全拥有人们所说的一种非常用心的、当下的体验，这真的很有趣。
I don't have full on scientific data to tell you, but it's an interesting anecdote.
我没有完整的科学数据可以告诉你，但这是一个有趣的轶事。
That folks, when you push them through this point of feeling kind of clinically well, that some people end up reporting this additional set of features.
那些人，当你让他们经历临床上感觉良好的这一点时，有些人最终会报告这组额外的功能。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned the cingulate and the anterior cingulate in particular.
您特别提到了扣带回和前扣带回。
Because now I feel like for the first time in my career, I have some sense of what prefrontal cortex might actually be doing, besides providing a bumper for the rest of the brain.
因为现在我感觉在我的职业生涯中第一次，除了为大脑的其他部分提供缓冲之外，我对前额皮质实际上可能在做什么有了一些了解。
The cingulate, it seems, is a more primitive structure in the sense that ideally it's under the regulation of this top-down control from prefrontal cortex.
扣带皮层似乎是一种更原始的结构，理想情况下它处于前额叶皮层这种自上而下的控制之下。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But what's mapped in the cingulate?
但是扣带回中映射了什么？
And for the non-neuroscientists out there, when I say mapped, if we were to put someone in a scanner and focus in on cingulate or put an electrode in there, what makes the neurons in there fire?
对于非神经科学家来说，当我说映射时，如果我们将某人放在扫描仪中并聚焦于扣带回或在那里放置一个电极，是什么让那里的神经元放电？
What sorts of things in the body and in the mind and out in the world Yeah.
身体里、头脑里、世界上都有什么样的东西 是啊。
Light up, for lack of a better phrase, the cingulate.
点亮，因为没有更好的词来形容，扣带回。
What does the cingulate like?
扣带皮层喜欢什么？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So that Stroop task, those incongruent word-color associations, the dorsal part of that.
所以斯特鲁普任务，那些不一致的单词颜色关联，那个的背面部分。
For obsessive-compulsive disorder patients, certain kind of triggers you'll see.
对于强迫症患者，您会看到某些类型的触发因素。
Some of the neuroimaging studies will point to anterior cingulate.
一些神经影像学研究将指向前扣带回。
In the kind of very crude psychosurgery world 50 years ago, the anterior cingulotomy was a way of treating obsessive-compulsive disorder, right?
在50年前那种非常粗糙的精神外科世界里，前扣带回切开术是治疗强迫症的一种方法，对吗？
Because that area seems to be overactive in people who are experiencing obsessive-compulsive disorder.
因为对于患有强迫症的人来说，该区域似乎过于活跃。
You can kind of walk...
你可以步行...
The cingulate wraps around this white matter tract, like bundles.
扣带回像束一样包裹着白质束。
It wraps around that.
它围绕着这一点。
And so there's a part that's above that, around that, and below that.
因此，有一个部分位于其上方、周围和下方。
And depending upon how much of the conflict task has an emotional component, the more ventral and subgenual that activation is.
取决于冲突任务中有多少是情感成分，激活越是腹侧和膝下。
So the dorsal part of the anterior cingulate seems to be kind of more of a pure cognitive, maybe obsessive-compulsive disorder sort of area.
因此，前扣带回的背侧部分似乎更像是一个纯粹的认知区域，也许是强迫症区域。
Whereas when you start getting into mood sorts of triggers, like facial expression conflicts where you're supposed to...
然而，当你开始情绪化时，就会有各种触发因素，比如面部表情冲突，而你应该……
There's an emotional Stroop task where you show the word happy, and then you have a face of a person that looks mad, then that's another way of having the same sort of Stroop conflict.
有一个情感斯特鲁普任务，你显示“快乐”这个词，然后你的脸看起来很生气，那么这是斯特鲁普冲突的另一种方式。
And that seems to be more perigenual, subgenual areas, right?
这似乎是更多的膝周、膝下区域，对吧？
So you can trigger the cingulate based off of the level of emotional valence from none down to a lot, and that seems to be how it's distributed.
所以你可以根据情绪效价的水平来触发扣带回，从无到很多，这似乎就是它的分布方式。
There are heart rate kind of components to it, and autonomic components in there, too.
它有心率类型的组件，也有自主组件。
There's something called akinetic mutism.
有一种东西叫做运动不能性沉默症。
I'm a board-certified neuropsychiatrist, behavioral neurologist, and I've seen a lot of these, what we call zebra cases in neurology, where people have these unusual neurological presentations, and one of them is akinetic mutism.
我是一名经过委员会认证的神经精神病学家、行为神经学家，我见过很多这样的情况，我们称之为神经病学中的斑马病例，人们有这些不寻常的神经表现，其中之一就是运动不能性沉默症。
And so if you have a glioma sitting in the interhemispheric fissure and kind of having pressure on the cingulate, people can get into an almost catatonic-looking state where they kind of get stuck and they don't speak.
因此，如果大脑半球间裂中存在神经胶质瘤，并对扣带皮层施加压力，人们可能会陷入一种近乎紧张的状态，他们会被卡住并且不说话。
And so that tells you something about how the cingulate works as well, right?
这也告诉了你一些关于扣带回如何工作的信息，对吧？
It's like if it's not functioning, then people have a hard time kind of connecting with reality.
就好像如果它不起作用，那么人们就很难与现实联系起来。
It seems to need to be constantly online to be able to interact with the exterior world.
它似乎需要不断在线才能与外部世界互动。
Andrew Huberman:
安德鲁·休伯曼：
Is it involved in some of the dissociative states that sometimes people who are very stressed or depressed experience?
它是否与压力很大或抑郁的人有时会经历的一些分离状态有关？
You said catatonia being an extreme one, but I know someone, for instance, that when they get really stressed, and it can even be if someone yells at them, or even if someone's angry with them, or they perceive someone's angry with them, there's a developmental backstory to why they likely feel this way.
你说紧张症是一种极端的症状，但我知道有人，例如，当他们感到压力很大时，甚至可能有人对他们大喊大叫，或者即使有人对他们生气，或者他们察觉到有人对他们生气，他们可能会有这种感觉，这是有一个发展背景的。
This is a high functioning individual normally, and they just sort of can't function.
通常这是一个高功能的个体，但他们只是有点无法正常工作。
They can't complete simple things like email or groceries or things for a short while.
他们无法在短时间内完成简单的事情，例如电子邮件或杂货或其他事情。
It's almost like a catatonia, and they refer to it as a dissociative state.
这几乎就像紧张症一样，他们将其称为解离状态。
Do you see that in depression?
你在抑郁症中看到这一点吗？
And we're speculating here as to whether or not that involves a cingulate.
我们在这里猜测这是否涉及扣带回。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But what you're saying, it holds a lot of salience for me in thinking about this example.
但你所说的，对我来说在思考这个例子时具有很大的意义。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So you see catatonia as an extreme outcome of depression and sometimes schizophrenia and other illnesses.
所以你认为紧张症是抑郁症、有时是精神分裂症和其他疾病的极端结果。
Dissociation is an extreme outcome, or even in some cases a less extreme outcome of PTSD and trauma.
解离是一种极端的结果，甚至在某些情况下是创伤后应激障碍和创伤的不太极端的结果。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And it's also a phenomenon that happens naturally in some people that are highly hypnotizable.
这也是一些容易被催眠的人自然发生的现象。
And so if you ask David Spiegel, he'd say that some of the work that he's been working on is around posterior cingulate and the capacity to dissociate.
所以如果你问大卫·斯皮格尔，他会说他一直在做的一些工作是围绕后扣带回和解离能力的。
But yeah, with our stimulation approach to DLPFC, dorsal anterior cingulate, one of the subscales that moved the most was the dissociative subscale for hypnotizability.
但是，是的，通过我们对 DLPFC（背侧前扣带回）的刺激方法，移动最多的分量表之一是催眠性的解离分量表。
So even in a normal individual you see that change in that kind of experience of dissociation.
因此，即使在正常人身上，你也会看到这种分离体验的变化。
Andrew Huberman:
安德鲁·休伯曼：
I am highly hypnotizable.
我很容易被催眠。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, yeah?
哦，是吗？
Andrew Huberman:
安德鲁·休伯曼：
David's hypnotized me a number of times.
大卫催眠了我很多次。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, nice.
哦，不错。
Andrew Huberman:
安德鲁·休伯曼：
In fact, we have a clip of that on our Huberman Lab clips channel.
事实上，我们的 Huberman 实验室剪辑频道上有一个剪辑。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, that's great.
哦，那太好了。
Andrew Huberman:
安德鲁·休伯曼：
In my early teens, I started exploring hypnosis.
在我十几岁的时候，我开始探索催眠。
I am extremely hypnotizable.
我非常容易被催眠。
And self-hypnosis or assisted hypnosis.
还有自我催眠或辅助催眠。
I don't know that I ever go into dissociative states.
我不知道我是否曾经进入过分离状态。
I'll try and avoid forcing you into running a clinical session right now to assess anything like that.
我会尽力避免强迫您现在进行临床会议来评估类似的事情。
But this brings about something really interesting, I think, which is I'm aware that some of the more popular emerging treatments for depression include things like ketamine-
但这带来了一些非常有趣的事情，我认为，我知道一些更流行的新兴抑郁症治疗方法包括氯胺酮等药物——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
which is a dissociative anesthetic.
这是一种解离麻醉剂。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Is that right?
是这样吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And my assumption is that as a dissociative anesthetic, that it leads to dissociative states-
我的假设是，作为一种解离麻醉剂，它会导致解离状态——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
where people can sort of third person themselves-
人们可以自己扮演第三人称——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
and feel somewhat distanced from their emotions.
并感到与他们的情绪有些距离。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I've also been hearing that there are emerging treatments, psilocybin being one of them, but some other treatments, MDMA, et cetera, that we'll parse each of these in detail, that lead to the exact opposite state during the effect of the drug, which is a highly engaged emotionality and heart rate and sense of self.
我还听说有一些新兴的治疗方法，裸盖菇素就是其中之一，但还有其他一些治疗方法，例如摇头丸等，我们将详细解析每一种治疗方法，这些治疗方法在药物作用期间会导致完全相反的状态，即高度参与的情绪、心率和自我意识。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And can also lead to relief of depression.
并且还可以缓解抑郁症。
Now, whether or not this, again, reflects that depression is many conditions as opposed to just one, or whether or not somehow- tickling, or in some cases, pushing really hard on the opposite ends of the scale really matter.
现在，无论这是否再次反映出抑郁症是多种情况而不仅仅是一种情况，或者是否以某种方式令人发痒，或者在某些情况下，在天平的两端施加真正的压力确实很重要。
I am absolutely fascinated and again, also perplexed by this.
我对此非常着迷，但也同样感到困惑。
Why would it be that a drug that induces dissociative states and a drug taken separately that induces hyper-associative states would lead to relief of the same condition?
为什么诱导解离状态的药物和单独服用诱导超联想状态的药物会导致相同病症的缓解？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
No, that's a great question.
不，这是一个很好的问题。
Yeah.
是的。
So for ketamine, the level of dissociation appears to be correlated with the therapeutic effect.
因此对于氯胺酮来说，解离水平似乎与治疗效果相关。
It appears to be necessary but not sufficient to produce an antidepressant effect.
它对于产生抗抑郁作用似乎是必要的，但还不够。
And so, folks that don't have any psychological change from the ketamine or don't experience any dissociation typically tend to have less potent antidepressant effects from ketamine.
因此，那些没有因氯胺酮而产生任何心理变化或没有经历任何解离的人通常往往会因氯胺酮而产生较弱的抗抑郁作用。
We did a study a couple of years ago.
几年前我们做了一项研究。
It was really interesting.
这真的很有趣。
So we gave folks naltrexone, which is an opiate antagonist, a mu and kappa opiate receptor antagonist.
所以我们给人们服用纳曲酮，它是一种阿片拮抗剂，一种 mu 和 kappa 阿片受体拮抗剂。
And we gave the same individuals a pill of that or a pill of placebo, and they had no idea which one they were getting.
我们给同一个人服用一粒安慰剂或一粒安慰剂，他们不知道自己服用的是哪一种。
Andrew Huberman:
安德鲁·休伯曼：
Was this low-dose naltrexone?
这是低剂量纳曲酮吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
50 milligrams, so it's a pretty high dose.
50毫克，所以这是一个相当高的剂量。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
And so we gave a typical ketamine therapeutic dose, and then we gave 50 milligrams of naltrexone or a placebo.
因此，我们给予典型的氯胺酮治疗剂量，然后给予 50 毫克纳曲酮或安慰剂。
And then in the same individuals, we gave two infusions, one with each of those conditions, and if they had an antidepressant effect, we waited until they relapsed, and then we gave them the other condition.
然后，我们对同一个人进行两次输注，每种情况各一次，如果它们具有抗抑郁作用，我们会等到他们复发，然后再给他们另一种情况。
And then we looked to see what effect of blocking the opioid receptor, what effect would you see on the antidepressant effect of blocking the opioid receptor?
然后我们看看阻断阿片受体会产生什么影响，阻断阿片受体对抗抑郁作用会产生什么影响？
With the idea that if ketamine works the way that a lot of researchers at the time thought that it completely worked, and which is the glutamate system, then you would have no effect of naltrexone.
如果氯胺酮以当时许多研究人员认为完全有效的方式发挥作用，即谷氨酸系统，那么纳曲酮就不会产生作用。
Because naltrexone just interacts with the opiate system.
因为纳曲酮只与阿片系统相互作用。
It doesn't do anything with any other systems.
它不会对任何其他系统执行任何操作。
Ketamine has a lot of effects.
氯胺酮有很多作用。
It has clear opiate effects in mice and various ways of looking at that, and NMDA receptor antagonism and glutamate effects.
它对小鼠有明显的阿片类作用，并且有多种观察方式，以及 NMDA 受体拮抗作用和谷氨酸作用。
And so if it's just that the glutamate part is the part driving the antidepressant effect, you shouldn't have any difference in the antidepressant effect between the two conditions.
因此，如果只是谷氨酸部分是驱动抗抑郁作用的部分，那么两种情况之间的抗抑郁作用不应该有任何差异。
If, however, the opioid properties of ketamine are necessary for the antidepressant effect, then you should have a loss of antidepressant effect during the ketamine plus naltrexone condition that you observed in the ketamine plus placebo condition.
然而，如果氯胺酮的阿片类药物特性是抗抑郁作用所必需的，那么在氯胺酮加纳曲酮条件下，您应该会失去抗抑郁作用，就像您在氯胺酮加安慰剂条件下观察到的那样。
And what we saw was that there was a dramatic blockade of the antidepressant effect when naltrexone was present-
我们看到的是，当纳曲酮存在时，抗抑郁作用会受到戏剧性的阻碍——
Andrew Huberman:
安德鲁·休伯曼：
In the-
在-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, in the people that had an antidepressant effect with ketamine plus placebo alone.
是的，对于那些仅使用氯胺酮加安慰剂就具有抗抑郁作用的人来说。
And then some friends of mine did a TMS study with pain, and they stimulated over the left dorsolateral prefrontal cortex, and they gave IV naloxone, which works basically the same way as naltrexone, and they were able to block the anti-pain effects of TMS with an opiate blocker.
然后我的一些朋友做了一项关于疼痛的 TMS 研究，他们刺激了左背外侧前额皮质，然后静脉注射纳洛酮，其作用原理与纳曲酮基本相同，他们能够用阿片类阻滞剂来阻断 TMS 的抗疼痛作用。
Another kind of convergent point, this idea that the opioid receptor may have a role in mood regulation.
另一种趋同点，这种观点认为阿片受体可能具有情绪调节作用。
What's also interesting is if you look at people that are getting a total knee operation, it's a very painful operation, total knee replacement.
同样有趣的是，如果你看看那些接受全膝关节手术的人，这是一个非常痛苦的手术，全膝关节置换术。
And you age, sex, everything match the individuals that are going through that, but you have a group of people that don't have depression and a group of people that do have depression.
你的年龄、性别，一切都与正在经历这些的人相匹配，但你有一群没有抑郁症的人和一群确实患有抑郁症的人。
The presence of depression triples the oral opioid dose by day four.
第四天，抑郁症的存在使口服阿片类药物的剂量增加了三倍。
Andrew Huberman:
安德鲁·休伯曼：
That's required.
这是必需的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's required to cover the pain.
这是掩盖痛苦所必需的。
But what may be happening is it's not just treating physical pain.
但可能发生的情况是，它不仅仅是治疗身体疼痛。
Maybe treating emotional pain as well.
也许也能治疗情感上的痛苦。
At least transiently, it seems to have an antidepressant effect.
至少暂时而言，它似乎具有抗抑郁作用。
Chronically, it seems to have a very pro-depressant effect.
长期来看，它似乎具有非常明显的促抑郁作用。
It can make people treatment resistant.
它可以使人们对治疗产生抵抗力。
But it's an interesting phenomenon.
但这是一个有趣的现象。
But yeah, the opioid system seems to be pretty involved.
但是，是的，阿片类药物系统似乎参与其中。
But what's interesting there with that ketamine trial is that we didn't see any effect on the dissociation.
但氯胺酮试验的有趣之处在于，我们没有看到对解离有任何影响。
And so the dissociation was the same each time.
所以每次的分离都是一样的。
So the psychological effect of what we call the trip or the kind of dissociative effect where people are having a psychological phenomenon from ketamine, that was identical both times.
因此，我们所说的旅行的心理效应，或者人们因氯胺酮而产生心理现象的那种解离效应，两次都是相同的。
And so it also challenged this idea that the psychological experience of the psychedelic effect may be all that's necessary to produce an effect and that the pharmacology doesn't matter as long as you can achieve that state.
因此，它也挑战了这样一种观点，即迷幻效果的心理体验可能是产生效果所必需的全部，只要你能达到那种状态，药理学并不重要。
And so, we think we pretty clearly debunked that idea, that the underlying pharmacology and the state seem to be important.
因此，我们认为我们非常清楚地揭穿了这个想法，即潜在的药理学和状态似乎很重要。
We don't know for sure, and a lot of people are working on this, if you can take out essentially the psychological effect and still have a drug that works to treat the illness that you're trying to target.
我们不确定，很多人正在研究这个问题，如果你能基本上消除心理影响，并且仍然有一种药物可以治疗你想要治疗的疾病。
There was a mouse study out this week where they had an LSD analog, and they were able to see some animal-level data to suggest that could be true.
本周进行了一项小鼠研究，他们使用了 LSD 类似物，并且他们能够看到一些动物水平的数据，表明这可能是真的。
But until we figure that out in humans, it's kind of to be determined.
但在我们弄清楚人类的这一点之前，一切都还有待确定。
But it is curious, being able to kind of use experimental manipulations to try to separate some of these phenomenon apart and really understand what's doing what.
但令人好奇的是，能够使用实验操作来尝试将其中一些现象分开并真正了解正在做什么。
Andrew Huberman:
安德鲁·休伯曼：
It's so critical, and it's so critical to the other conversation that we'll surely get to, which is the progression of psychedelics from illicit illegal drugs to clinically validated and presumably at some point, either decriminalized or legal drugs, which has not yet happened, at least not in the US.
这非常重要，对于我们肯定会谈到的另一个对话也非常重要，即致幻剂从非法药物到临床验证的进展，并且可能在某个时候，要么非刑事化，要么合法化药物，但这还没有发生，至少在美国还没有发生。
But just to make sure that people are getting this and how crucial this is, what we're really talking about here is the fact that if somebody takes a multi-gram dose of psilocybin, or somebody takes MDMA, or they take ketamine and they experience relief from their trauma, their depression, their addiction, or any number of the other things that indeed those compounds have been shown to be useful for in certain contexts, clinically supported, et cetera.
但为了确保人们了解这一点以及这一点的重要性，我们在这里真正讨论的是这样一个事实：如果有人服用了多克剂量的裸盖菇素，或者有人服用了摇头丸，或者他们服用了氯胺酮，他们就会从创伤、抑郁、成瘾或任何其他事情中得到缓解，这些化合物确实已被证明在某些情况下有用，得到临床支持，等等。
There's this gravitational pull to the idea that, oh, it was the hallucinations.
这个想法有一种引力，哦，这是幻觉。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It was the dissociative state.
这是解离状态。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It was the feeling of connectedness.
这是一种联系的感觉。
And what we're really saying is that while that certainly could be true, it may be the case that a major source of the positive shift that occurs after the effect of the drug is some underlying biology, like shifts in the mu-opioid receptor, a la your experiments with naltrexone, or a change in the underlying neuromodulation that had anywhere from nothing to something to do with the real shift.
我们真正想说的是，虽然这当然可能是真的，但药物作用后发生的积极转变的主要来源可能是一些潜在的生物学，比如μ-阿片受体的变化，就像你对纳曲酮的实验一样，或者潜在的神经调节的变化，这些变化与真正的转变无关或有关系。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And I know there's a group up at UC Davis that published a paper in "Nature" about a year ago, also looking at...
我知道加州大学戴维斯分校的一个小组大约一年前在《自然》杂志上发表了一篇论文，也在研究……
This is a chemistry lab essentially modifying psychedelics to remove the hallucinogenic properties-
这是一个化学实验室，主要是修改致幻剂以消除其致幻特性——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
the mood-altering properties, and actually seeing some pretty impressive effects and shifts in mood after the drug wears off.
改变情绪的特性，实际上在药物失效后看到了一些令人印象深刻的效果和情绪变化。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And I know this gets people upset when they hear it.
我知道人们听到这个消息后会感到不安。
This gets a lot of people upset, really.
这确实让很多人感到不安。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Because people think, oh, no, it's the intense experience that matters.
因为人们认为，哦，不，重要的是强烈的体验。
But in fact, that may not be the case at all.
但事实上，情况可能根本不是这样。
In fact, it's so powerful for people that sometimes I liken it in my mind to it's like the birth of a new child, and it's such an incredible experience, and then people feel so much connection, and they sort of connect the experience of the actual birth to the connection, when in fact that's true it turns out, but there are a bunch of other things happening too-
事实上，它对人们来说是如此强大，有时我在脑海中将其比作一个新生儿的诞生，这是一次令人难以置信的经历，然后人们感受到如此多的联系，他们将实际出生的经历与这种联系联系起来，事实证明这是真的，但也有很多其他的事情正在发生——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, totally
是的，完全
Andrew Huberman:
安德鲁·休伯曼：
...
...
that's simply the reflection of the fact that you're holding a child and the pheromonal effects, et cetera.
这只是你抱着一个孩子和信息素效应等事实的反映。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So anyway, I think it's very important that these different variables be figured out.
所以无论如何，我认为弄清楚这些不同的变量非常重要。
Along those lines, I want to make sure that before we dive a bit deeper into ketamine and psilocybin, that we do touch on a really important topic that has been in the press a lot lately, which is SSRIs, selective serotonin-
沿着这些思路，我想确保在我们深入研究氯胺酮和裸盖菇素之前，我们确实触及了最近媒体报道的一个非常重要的话题，那就是 SSRIs，选择性血清素 -
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
reuptake inhibitors, because we can't really have a discussion about depression without talking about SSRIs.
再摄取抑制剂，因为如果不谈论 SSRIs，我们就无法真正讨论抑郁症。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And then I want to circle back to ketamine and psilocybin.
然后我想回到氯胺酮和裸盖菇素。
It seems that there are now data that essentially state that there's no direct link between serotonin levels and depression.
现在似乎有数据基本上表明血清素水平和抑郁症之间没有直接联系。
Although my understanding is that the SSRIs are powerfully effective for certain forms of obsessive-compulsive disorder and may also be effective for treatment of depression, but it may again be through some effect unrelated to serotonin itself.
虽然我的理解是 SSRIs 对某些形式的强迫症非常有效，也可能对抑郁症的治疗有效，但它可能又是通过与血清素本身无关的一些作用实现的。
Is that right?
是这样吗？
And how should we think about SSRIs?
我们应该如何看待 SSRIs？
Are they useful?
它们有用吗？
Are they not useful?
它们没有用吗？
What's going on with SSRIs in your patients-
您的患者服用 SSRIs 后发生了什么情况？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and in other people as well?
其他人也一样吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So that experiment that I described a bit ago around the naltrexone and ketamine is the first time I'm aware of where we were able to essentially eliminate an antidepressant's effect by using a second drug as a kind of a blockade.
因此，我之前描述的关于纳曲酮和氯胺酮的实验是我第一次意识到我们能够通过使用第二种药物作为一种封锁来基本上消除抗抑郁药的作用。
And it highlights a bigger issue, right?
这凸显了一个更大的问题，对吗？
The issue that we haven't had a good way of really understanding how these drugs work.
问题是我们还没有一个好的方法来真正了解这些药物是如何发挥作用的。
And so it's the difference, I think a lot of the controversy there is that it's been difficult, I think, for folks to see that something can, on one hand, work, and on the other hand, we don't know how it works, right?
所以这就是区别，我认为很多争议在于，我认为，人们很难看到某些东西一方面可以发挥作用，另一方面，我们不知道它是如何发挥作用的，对吗？
And so SSRIs clearly work.
因此 SSRI 显然有效。
Many meta-analyses kind of proving that out, right?
许多荟萃分析都证明了这一点，对吧？
That in a subpopulation of individuals, they achieve great benefit for depression, for obsessive-compulsive disorder, for generalized anxiety disorder, panic, all of these things.
在一个亚群中，他们对抑郁症、强迫症、广泛性焦虑症、恐慌等所有这些疾病都有很大的好处。
You can see an improvement in those symptoms with what we call SSRIs or selective serotonin reuptake inhibitors.
使用我们所说的 SSRI 或选择性血清素再摄取抑制剂，您可以看到这些症状得到改善。
The issue there is that these selective serotonin reuptake inhibitors end up blocking the reuptake of serotonin and leaving the serotonin in this kind of in between two neurons for a while and allowing for more serotonin to kind of be there.
问题在于，这些选择性血清素再摄取抑制剂最终会阻止血清素的再摄取，并将血清素留在两个神经元之间一段时间，从而允许更多的血清素存在。
The issue is that they don't work immediately, right?
问题是它们不会立即起作用，对吧？
So they don't work the same day you start taking them, and that suggests that probably it's not exactly the serotonin being in there that's directly driving it, that it's much more likely that it may have some, say, brain plasticity effects, right?
所以它们在你开始服用的当天就不会起作用，这表明可能并不完全是其中的血清素直接驱动它，它更有可能具有一些，比如说，大脑可塑性效应，对吗？
We know that things like brain-derived neurotrophic factor get upregulated with chronic oral antidepressant use.
我们知道，长期使用口服抗抑郁药会导致脑源性神经营养因子等物质上调。
And so that's kind of the idea is that these things work, but what's powerful, and I think what the authors of this paper, it was extremely controversial paper, were in part trying to say was that there's not a deficit of serotonin.
所以，我的想法是，这些东西是有效的，但真正强大的是，我认为这篇论文的作者，这是一篇极具争议性的论文，部分试图说明的是，血清素并不缺乏。
You're not born with what people call a chemical imbalance.
你并不是生来就患有人们所说的化学失衡。
And psychiatry's known this.
精神病学知道这一点。
This is not actually new information.
这实际上并不是新信息。
It's kind of a rehashing of a bunch of information we've known for a while now.
这是对我们已经知道了一段时间的一堆信息的重新整理。
But in the lay press, it's kind of hit in a way that it didn't seem to grab attention before with previous publications.
但在普通媒体中，它受到了某种程度的打击，而之前的出版物似乎没有引起人们的注意。
But this idea that this chemical imbalance idea is wrong, I really think that part's important because I think that for a while, I think psychiatry What I'll call psychiatry 1.0, right?
但这种化学失衡的想法是错误的，我真的认为这部分很重要，因为我认为有一段时间，我认为精神病学我称之为精神病学 1.0，对吗？
This kind of idea of Freud and psychotherapy in its origins.
弗洛伊德的这种思想与心理治疗有其渊源。
It was a lot around your family and those experiences in psychotherapy kind of going in and correcting or helping you to figure out or you being able to see or people hear you so that you can eventually come to the conclusion of certain cognitions that aren't helping you, right?
这在你的家庭和心理治疗中的经历中有很多，这些经历可以帮助你纠正或帮助你弄清楚，或者你能够看到或人们听到你的声音，这样你最终可以得出某些对你没有帮助的认知的结论，对吗？
And there's a huge importance there, but there's a history where things like the schizophrenogenic mother and all of that, that was a concept at some point, right?
这非常重要，但有一段历史，像患有精神分裂症的母亲之类的东西，在某个时候是一个概念，对吗？
And so we've transitioned from that to for a long time, the chemical imbalance, which I'll call psychiatry 2.0, this idea that there's something chemically missing.
因此，很长一段时间以来，我们已经从化学失衡过渡到化学失衡，我将其称为精神病学 2.0，即化学物质缺失的想法。
And I think that the trouble there for a patient who's not a physician, who's not someone who's steeped in these sorts of ideas, who's more of kind of a average American out there, right, is that it's sending a message of there's something missing with me, whether it be my experiences I had no control over when I was a child or a chemical in my brain.
我认为，对于一个不是医生、不是沉浸在这些想法中的人、更像是普通美国人的病人来说，问题在于它传递出一个信息：我缺少某些东西，无论是我小时候无法控制的经历，还是我大脑中的化学物质。
What I think is really powerful with TMS, and a level even powerful with the psychedelic story, is it's saying something different.
我认为 TMS 真正强大的地方，甚至迷幻故事的强大之处在于它表达了不同的东西。
TMS works, and there's no serotonin coming in or out of the brain, right?
TMS 起作用了，而且大脑中没有血清素进出，对吗？
And we're doing a rapid form of TMS that works in one to five days.
我们正在开发一种快速 TMS，只需一到五天就可以发挥作用。
It's very unlikely that there's some long-term kind of upregulation of serotonin that's driving that.
不太可能是某种长期的血清素上调导致了这种情况。
So our work actually kind of pushes back on this serotonin hypothesis as being kind of the center of depression because it says, "Look, we're not giving anybody any serotonin.
因此，我们的工作实际上有点反驳了血清素假说，认为它是抑郁症的中心，因为它说：“看，我们不会给任何人任何血清素。
We're simply turning these brain regions on, and we're focused on the circuitry." And that's psychiatry 3.0.
我们只是打开这些大脑区域，然后专注于电路。”这就是精神病学3.0。
It's not just like neuromodulation.
这不仅仅是神经调节。
Neuromodulations are a really nice use case for psychiatry 3.0 because it's a way to focally and directly perturb brain regions in whatever modality you're using.
神经调节是精神病学 3.0 的一个非常好的用例，因为它是一种以任何方式集中、直接扰乱大脑区域的方法。
But there are a lot of groups that are actually doing neuroimaging before and after, and they're able to see circuit-level changes for something like psilocybin or ketamine long after the drug is gone, right?
但实际上有很多小组在用药前后进行神经影像学检查，他们能够在药物消失后很久看到裸盖菇素或氯胺酮等药物的回路水平变化，对吗？
Suggesting in those same brain regions converge, so the subgenual default mode network connection that we see is changing with our Stanford neuromodulation therapy technique.
这表明这些相同的大脑区域会聚合，因此我们看到的膝下默认模式网络连接正在随着我们的斯坦福神经调节治疗技术而改变。
It's that same set of brain regions that ketamine and psilocybin seem to act on these connections between brain networks that seem to shift.
氯胺酮和裸盖菇素似乎作用于大脑网络之间的这些连接的同一组大脑区域似乎发生了变化。
And so it refocuses the story on something that's highly correctable, and it's basically electrophysiology, and it's basically kind of recalibrating a circuit that is recalibratable instead of I have something missing, or I have some set of experiences early in life that are going to forever trap me in these psychiatric diagnoses.
所以它把故事的焦点重新集中在一些高度可纠正的东西上，它基本上是电生理学，它基本上是一种重新校准一个可重新校准的电路，而不是我丢失了一些东西，或者我在生命早期有一些经历，这些经历将永远让我陷入这些精神病诊断。
And so it kind of challenges that idea, and I think that's what's so powerful about psychiatry 3.0, this idea of focusing on the circuit because it gets us into thinking about psychiatry and psychiatric illnesses as something that are recoverable.
所以它在某种程度上挑战了这个想法，我认为这就是精神病学 3.0 的强大之处，这种专注于回路的想法因为它让我们开始思考精神病学和精神疾病是可以康复的。
People can get better.
人们可以变得更好。
We've seen with our TMS techniques, we've seen it with some of the psychedelic work that we've done, where people are actually in normal levels of mood for sustained periods of time or-
我们已经通过 TMS 技术看到了这一点，我们已经通过我们所做的一些迷幻工作看到了这一点，人们实际上在持续一段时间内处于正常的情绪水平，或者-
Andrew Huberman:
安德鲁·休伯曼：
Within five days
五天内
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
within five or less days.
五天内或更短的时间内。
And in the case of the psychedelics, within a few days, right?
至于迷幻药，几天之内，对吗？
So we can get people out of these states.
这样我们就可以让人们离开这些州。
They're totally well.
他们很好。
There's no drug in their system at that point.
那时他们的系统中没有药物。
In the case of the psychedelics, there was never a drug in their system in the case of TMS.
就迷幻药而言，在 TMS 的情况下，他们的系统中从来没有药物。
And it just tells us that it's fixable.
它只是告诉我们它是可以修复的。
It's just like the heart.
就像心脏一样。
It's just like an arrhythmia in the heart.
就像心脏出现心律失常一样。
It's just like these other illnesses that it's like a broken leg.
就像其他疾病一样，它就像断了腿一样。
We can go in and do something, and we can get somebody better.
我们可以进去做点什么，我们可以让某人变得更好。
Then I think what's empowering and what a lot of patients have told me is they say, some people will relapse and need more stimulation or need more psychedelics or whatever it is, but they'll tell me, "I've relapsed, and I'm depressed again, but I'll never think about killing myself again because I know that if I go get stimulated again, it improves.
然后我认为什么是赋权，很多病人告诉我的是他们说，有些人会旧病复发，需要更多刺激或需要更多迷幻药或其他什么，但他们会告诉我，“我旧病复发了，我又抑郁了，但我永远不会再考虑自杀，因为我知道如果我再次受到刺激，情况就会好转。
It gets better.
情况会变得更好。
I will be able to reachieve it.
我一定能够实现它。
And I don't fear that I'm chronically broken.
我并不担心我会长期崩溃。
I don't fear that the chemical imbalance is still imbalanced.
我不担心化学不平衡仍然不平衡。
I don't fear that these things that I couldn't control in my childhood are going to be there and drive this problem forever." And I think that's what's so powerful about this.
我不担心我童年时无法控制的这些事情会继续存在并永远导致这个问题。”我认为这就是它的强大之处。
Andrew Huberman:
安德鲁·休伯曼：
The sense of control.
控制感。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
The sense of control.
控制感。
They're not doing the stimulation themselves.
他们自己并没有进行刺激。
They're not administering the drug in these trials themselves.
他们自己并没有在这些试验中使用该药物。
They probably never will.
他们可能永远不会。
These will probably be medical treatments.
这些可能是医学治疗。
But they are choosing to do it.
但他们选择这样做。
And in that sense, they are in control.
从这个意义上说，他们处于控制之中。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I have a good friend, I won't out him for reasons that'll become clear in a moment, who was quite obese and lost a lot of weight and was really proud of himself.
是的，我有一个好朋友，我不会因为很快就会明白的原因而抛弃他，他非常肥胖，体重减轻了很多，而且非常为自己感到骄傲。
And then I guess we could say he sort of relapsed in a sense.
然后我想我们可以说他在某种意义上又旧病复发了。
Not all the way, but far along.
不是一路走来，而是走得很远。
But his tone around it was very different.
但他的语气却截然不同。
He knew he had accomplished what his goal once before.
他知道他之前的目标已经完成了。
He was disappointed in himself, but he knew exactly why he had relapsed.
他对自己很失望，但他很清楚自己为何旧病复发。
It was very clear.
情况非常清楚。
He had essentially relapsed to the previous set of eating behaviors and lack of exercise behaviors and has now brought himself back again.
他基本上又恢复了之前的饮食习惯和缺乏运动习惯，现在又恢复了。
And it It just resonates with your story that once somebody understands they can do it because they've been there before, this idea again of considering new rules.
这与你的故事产生了共鸣，一旦有人明白他们可以做到这一点，因为他们以前曾经经历过这种情况，这又是考虑新规则的想法。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And that brings me to this question about psychedelics and frankly, the altered thinking and perception that occurs in high-dose psilocybin-
这让我想到了关于迷幻药的问题，坦率地说，高剂量裸盖菇素会改变思维和感知——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
clinical sessions.
临床会议。
It seems that the disordered thinking, even though it could be random, right?
看起来思维混乱，虽然可能是随机的，对吧？
Hearing colors and seeing sounds is always the kind of cliche statement of the Timothy Leary era.
听到颜色和看到声音一直是蒂莫西·利里时代的陈词滥调。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Also, right there, that's a Stroop task of sorts.
而且，就在那里，这也是斯特鲁普的任务。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It's a synesthesia.
这是一种联觉。
It's a combining-
这是一个组合——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
of perceptions, but it's sort of Stroop task-ish in that it's a new set of rules for the same stuff.
的看法，但这有点像斯特鲁普任务，因为它是针对相同事物的一套新规则。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Right?
对吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And many people do report improvements in trauma-related symptomology and depression, as I understand it-
据我了解，许多人确实报告了与创伤相关的症状和抑郁症的改善——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
from my read of the clinical trials, after taking psilocybin, because during those sessions, something comes to mind spontaneously.
根据我对临床试验的阅读，在服用裸盖菇素后，因为在这些疗程中，一些事情会自发地浮现在脑海中。
As you and I were talking about earlier, they will report, for instance, a new way of seeing the old problem.
正如你和我之前谈到的，他们会报告，例如，一种看待老问题的新方法。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
And the old problem could be the voice that they're no good, nothing will ever work out, or could be even more subtle than that.
老问题可能是他们的声音说他们不好，什么都不会解决，或者可能比这更微妙。
So that raises two questions.
这就提出了两个问题。
One is about the basic functioning of the human brain, which is, why do you think the brain would ever hold on to rules that don't serve us well?
一是关于人类大脑的基本功能，也就是说，为什么你认为大脑会坚持不利于我们的规则？
That's one question.
这是一个问题。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yes.
是的。
Okay.
好的。
Andrew Huberman:
安德鲁·休伯曼：
And then the second question is, what is it about psilocybin and related molecules, in terms of their neurochemistry, in terms of the ways they disrupt thinking and feeling, et cetera, during the session, that allow this novel rule consideration phenomenon?
第二个问题是，裸盖菇素和相关分子在神经化学方面、在会议期间扰乱思维和感觉的方式等方面是什么，导致了这种新颖的规则考虑现象？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So the first question, I think it's an evolutionary neurobiology answer, right?
所以第一个问题，我认为这是进化神经生物学的答案，对吗？
I think that at the individual person level, it doesn't make a whole lot of sense that when we're really stressed out, some of us want to eat more, right, at the individual person level, because it's like that's not particularly that good for my health in the long term.
我认为，在个人层面上，当我们真的感到压力很大时，我们中的一些人想要吃得更多，对吧，在个人层面上，这没有多大意义，因为从长远来看，这对我的健康并不是特别有好处。
But if you think about it, like in some 500 years ago, 1,000 years ago, if I'm highly stressed out, it's most likely that I'm about to not have food at some point, and I should eat a bunch of food that is high fat, high sugar, high carb food to put on weight for that next phase where in this stress, I may be in battle and I don't have food, and I have enough fuel on board, right?
但如果你想一想，就像在大约500年前，1000年前，如果我压力很大，很可能在某个时候我将没有食物，我应该吃一堆高脂肪、高糖、高碳水化合物的食物来增加体重，以便在下一个阶段在这种压力下，我可能在战斗，但我没有食物，而且我船上有足够的燃料，对吗？
And so we end up being a result of probably a lot of biology that's not that useful in the modern era.
因此，我们最终可能成为许多生物学的结果，而这些生物学在现代并不那么有用。
And I think in the brain, for let's say PTSD, right?
我认为在大脑中，比如说创伤后应激障碍（PTSD），对吧？
A lot of veterans come back, and they experience these PTSD symptoms, and they're not at all useful back home, right?
很多退伍军人回来后，他们都会经历这些创伤后应激障碍症状，但这些症状回到家后根本没有用处，对吗？
They hear some loud noise, and all of a sudden, they're behind a car, or they're behind a...
他们听到一些巨响，突然之间，他们就在一辆车后面，或者在...
I've heard of folks jump and run behind a trash can or whatever in the middle of San Francisco when they hear a loud noise.
我听说在旧金山市中心，人们听到巨响时会跳到垃圾桶或其他什么地方后面。
But if you put them back in the battlefield-
但如果你把他们放回战场——
Andrew Huberman:
安德鲁·休伯曼：
Highly adaptive
适应性强
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
that's highly adaptive, right?
这是高度适应性的，对吧？
And so I think what's interesting is that we, in the absence of using substances like psychedelics, end up having these very persistent memories that are attached to negatively valenced emotion predominantly.
所以我认为有趣的是，在没有使用迷幻药等物质的情况下，我们最终会拥有这些非常持久的记忆，这些记忆主要与负价情绪相关。
As you were saying earlier, the jacket in elementary school.
正如你之前所说，小学时的夹克。
I had various things like that for me, too, right?
我也有很多这样的事情，对吧？
You remember these things.
这些事情你都记得。
And we hold onto those things from, I think, an evolutionary neurobiology standpoint.
我认为，我们从进化神经生物学的角度坚持这些东西。
But what seems to, for whatever reason, kind of alleviate that are these substances, some new, like MDMA, some that have been around for thousands of years, like psilocybin, and used as a sacrament in traditions, seem to have a therapeutic effect that seems to be pretty long-lasting for these phenomenon.
但无论出于什么原因，这些物质似乎能缓解这种情况，有些是新的，如摇头丸，有些已经存在了数千年，如裸盖菇素，并在传统中用作圣礼，似乎对这些现象具有相当持久的治疗作用。
And so it's just curious, right?
所以这只是好奇，对吧？
It's curious that in the absence of that, these things will keep going on and on.
奇怪的是，如果没有这一点，这些事情就会继续发生。
But in the presence of that exposure, then all of a sudden, you see a resolution of the problem.
但在这种曝光的存在下，突然之间，你看到了问题的解决。
And we have some work now.
我们现在有一些工作。
We're treating folks with Navy SEALs, and the data's still being analyzed, but the anecdotes that we're getting are folks are coming back, and they're saying, "It's finally gone," right?
我们正在用海豹突击队治疗人们，数据仍在分析中，但我们得到的轶事是人们回来了，他们说，“它终于消失了，”对吗？
"These set of PTSD symptoms are finally gone." And so this idea that, for whatever reason, going into what's probably a highly plastic state, like we were talking about earlier, upregulation of brain-derived neurotrophic factor, in the case of ibogaine, glial-derived neurotrophic factor.
“这些创伤后应激障碍症状终于消失了。”因此，无论出于何种原因，这种想法都会进入可能高度可塑的状态，就像我们之前讨论的那样，脑源性神经营养因子的上调，就伊博加因而言，神经胶质源性神经营养因子。
This highly plastic state and the ability to re-experience memories.
这种高度可塑的状态和重新体验记忆的能力。
And then, as you know, we always reconsolidate a memory.
然后，如你所知，我们总是会重新巩固记忆。
When we bring it back up, we always reconsolidate.
当我们把它重新提起时，我们总是会重新整合。
But reconsolidating it in that state, for whatever reason, may drive a therapeutic effect.
但无论出于何种原因，将其重新巩固在这种状态下都可能会产生治疗效果。
And the jury's still out.
陪审团还没有定论。
I would say that I'm an agnostic to what tool I'm using kind of guy.
我想说的是，我对自己使用的工具一无所知。
My business is to find treatments that help people, and so I'm much more pragmatic about it.
我的工作是寻找对人们有帮助的治疗方法，所以我对此更加务实。
If this sort of thing, which has a lot of cultural ...
如果这种事情，里面有很多文化...
baggage.
行李。
But if this sort of thing ultimately ends up being therapeutic, if we can design trials that convince me and others that it is, then we should absolutely use it.
但如果这种事情最终具有治疗作用，如果我们能够设计试验让我和其他人相信它确实有效，那么我们绝对应该使用它。
And if it doesn't, then we clearly shouldn't use it, right?
如果没有，那么我们显然不应该使用它，对吧？
And I think that's a big question the field's going to have to work out.
我认为这是该领域必须解决的一个大问题。
We have a hard time blinding these trials because the placebo condition is not easy to pull off, obviously.
我们很难对这些试验进行盲法，因为安慰剂条件显然不容易实现。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
A placebo for a psilocybin journey is hard to imagine.
裸盖菇素之旅的安慰剂是很难想象的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
We've been thinking about this, and maybe that ketamine study that I was talking about earlier, if we could give people naltrexone and ketamine, maybe that's a good sort of placebo condition, right?
我们一直在考虑这个问题，也许我之前谈到的氯胺酮研究，如果我们可以给人们提供纳曲酮和氯胺酮，也许这是一种很好的安慰剂条件，对吗？
Because we know that we can block any of the actual antidepressant effects of ketamine.
因为我们知道我们可以阻止氯胺酮的任何实际抗抑郁作用。
They still have an experience.
他们还是有经验的。
And so that's one way of doing it, but thinking about ways to do that and really kind of proving this out, and that's been central to the way I've been thinking about this.
所以这是这样做的一种方法，但是思考如何做到这一点并真正证明这一点，这是我一直在思考这个问题的方式的核心。
But yeah, I think the work that's been done so far, the first psilocybin trial, the first MDMA trial was published in "Nature Medicine" recently.
但是，是的，我认为迄今为止所做的工作，第一个裸盖菇素试验，第一个 MDMA 试验最近发表在《自然医学》上。
Andrew Huberman:
安德鲁·休伯曼：
And what do those generally say?
这些通常怎么说？
I mean, that they are effective for a number of people after one session, two sessions?
我的意思是，一次或两次疗程后，它们对很多人都有效？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What's sort of the general contour?
总体轮廓是什么样的？
Let's start with psilocybin and MDMA.
让我们从裸盖菇素和摇头丸开始。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So MDMA appears to, in one to a few MDMA sessions, have an anti-PTSD effect that seems to be outside of the standard assumed levels of PTSD improvement that you can observe in individuals with this level of PTSD, right?
因此，在一到几次 MDMA 疗程中，MDMA 似乎具有抗 PTSD 效果，该效果似乎超出了您可以在具有这种 PTSD 水平的个体中观察到的 PTSD 改善的标准假设水平，对吧？
So what we call the effect size, which is essentially a Cohen's d effect size is a measure that allows for you to compare different treatments to each other for different conditions that are agnostic to what the actual illness is.
因此，我们所说的效应大小，本质上是 Cohen's d 效应大小，是一种衡量标准，可让您针对不同的情况，对不同的治疗方法进行比较，而这些情况与实际疾病无关。
The effect size is their approach effect sizes of things that are pretty effective, like antacids for heartburn, right?
效果大小是指非常有效的药物的接近效果大小，例如治疗胃灼热的抗酸剂，对吗？
And you see that with MDMA treatment.
你可以通过 MDMA 治疗看到这一点。
Andrew Huberman:
安德鲁·休伯曼：
So does that mean that for people that have trauma who do a...
那么这是否意味着对于遭受创伤的人来说......
And again, we're talking about in a clinical setting.
再说一次，我们谈论的是临床环境。
They take one or two doses of MDMA.
他们服用一剂或两剂 MDMA。
I think the standard MAPS dose is 150 to 175 milligrams.
我认为标准 MAPS 剂量是 150 至 175 毫克。
Again, doing this with a physician, et cetera, controlled clinical trial, legal.
再次强调，与医生等一起进行对照临床试验是合法的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep, exactly.
是的，完全正确。
Andrew Huberman:
安德鲁·休伯曼：
They do it once or twice.
他们这样做一次或两次。
And broadly speaking, what percentage of people who had trauma report feeling significant relief from their trauma afterward?
一般来说，有多少比例的遭受过创伤的人表示在创伤后感觉创伤得到了显着缓解？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It's about two-thirds of people had a clinically significant change in their PTSD symptoms.
大约三分之二的人的创伤后应激障碍症状出现了临床上的显着变化。
Andrew Huberman:
安德鲁·休伯曼：
That's impressive.
这令人印象深刻。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Which is impressive, right?
哪个令人印象深刻，对吧？
Andrew Huberman:
安德鲁·休伯曼：
And how long-lasting was that?
那持续多久了？
These trials were ended pretty recently.
这些试验最近刚刚结束。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
It appears to last for a while.
看来还要持续一段时间。
In the earlier trials where they followed people out, it seemed to last for kind of in the years range for some people.
在他们跟踪人们的早期试验中，对于某些人来说，这种情况似乎持续了几年。
And so it's pretty compelling.
所以它非常引人注目。
Psilocybin, and contrast that with ketamine, which only on average lasts about a week and a half for a single infusion, so it's a much shorter-
裸盖菇素，与氯胺酮形成鲜明对比，氯胺酮一次输注平均只能持续大约一周半，所以它的时间要短得多——
Andrew Huberman:
安德鲁·休伯曼：
So they have to get repeated infusions of ketamine every 10 days or so?
那么他们必须每 10 天左右重复输注氯胺酮吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Or you get-
或者你得到-
Andrew Huberman:
安德鲁·休伯曼：
Forever?
永远？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
For some people, or they end up getting a bunch of doses for a couple of weeks, and then for some people, that seems to last a while.
对于某些人来说，或者他们最终会在几周内接受大量剂量，然后对于某些人来说，这似乎会持续一段时间。
That's where I think the psilocybin story for depression and the MDMA story for PTSD seem more interesting to me.
这就是我认为裸盖菇素治疗抑郁症的故事和摇头丸治疗创伤后应激障碍的故事对我来说更有趣的地方。
Andrew Huberman:
安德鲁·休伯曼：
So for psilocybin, what is the rough percentages on...
那么对于裸盖菇素来说，粗略的百分比是多少......
And this would be relief not from trauma, but from depression, correct?
这不是缓解创伤，而是缓解抑郁，对吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, exactly.
是的，完全正确。
So in open label studies, it's closer to half to two-thirds of people end up getting better, depending upon their level of treatment resistance.
因此，在开放标签研究中，接近一半到三分之二的人最终会好转，具体取决于他们的治疗抵抗程度。
In the blinded trials, it was more like a third or so of people experienced relief.
在盲法试验中，大约三分之一的人感到缓解了。
And this is a press release of the data.
这是数据的新闻稿。
Andrew Huberman:
安德鲁·休伯曼：
Sure.
当然。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And so it hasn't, to my knowledge, it hasn't been published yet.
据我所知，它还没有出版。
And so I'm looking forward to seeing the full paper on that one.
因此，我期待看到有关该论文的全文。
But it separated from placebo and looks pretty good as well.
但它与安慰剂不同，看起来也不错。
It looks like it's the first of two trials that need to be done to get this thing approved for treatment-resistant depression.
看起来这是两项试验中的第一项，需要进行两项试验才能使该药物获得批准用于治疗难治性抑郁症。
And so that stuff looks good.
所以这些东西看起来不错。
Andrew Huberman:
安德鲁·休伯曼：
In terms of MDMA, for many years it was reported in the popular press, and there was a paper published in "Science" that MDMA was neurotoxic, that it would kill serotonin neurons.
就MDMA而言，大众媒体多年来一直对其进行报道，《科学》杂志上曾发表论文称MDMA具有神经毒性，会杀死血清素神经元。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
This was what was always said.
这是人们常说的。
Then I saw another paper published in "Science" that wasn't a retraction of the previous paper, but rather was a second paper in the same group that essentially admitted that the first time around they had injected these monkeys with not MDMA, but with methamphetamine-
然后我看到《科学》杂志上发表的另一篇论文，并不是撤回前一篇论文，而是同一组的第二篇论文，基本上承认他们第一次给这些猴子注射的不是摇头丸，而是甲基苯丙胺——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
which is known to be neurotoxic.
已知它具有神经毒性。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
So it was kind of a public admittance of oops, or big, really big screw up, so oops.
所以这有点像公开承认哎呀，或者是大、非常大的搞砸了，所以哎呀。
But never a retraction, and then never really a publicly acknowledged correction in the popular press.
但从来没有撤回，也从来没有在大众媒体上真正公开承认过纠正。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So it seems that in the appropriate dosage range and with these one or two sessions, my assumption, and this again is an assumption, tell me if I'm right or wrong here, is that MDMA is not neurotoxic for serotonergic neurons at appropriate doses and with appropriate sourcing, et cetera.
因此，在适当的剂量范围内，通过一两次疗程，我的假设（这又是一个假设，请告诉我我是对还是错）是，在适当的剂量和适当的来源等情况下，MDMA 对血清素能神经元不会产生神经毒性。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So, it was an interesting study that, I think the guy's name is Halpern.
所以，这是一项有趣的研究，我认为这个人的名字是 Halpern。
Last name's Halpern.
姓哈尔彭。
It-
它——
Andrew Huberman:
安德鲁·休伯曼：
Not Casey Halpern
不是凯西·哈尔彭
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Not Casey.
不是凯西。
A different-
一个不同的——
Andrew Huberman:
安德鲁·休伯曼：
A former
前任
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
Halpern.
哈尔彭。
I think Joshua Halpern.
我认为是约书亚·哈尔彭。
I'm blanking on his first name.
我对他的名字一片空白。
But-
但是——
Andrew Huberman:
安德鲁·休伯曼：
Casey Halpern was a guest on this podcast, and is a former colleague of ours at Stanford, who unfortunately we lost to University of Pennsylvania, and maybe someday we'll bring him back.
凯西·哈尔彭 (Casey Halpern) 是这个播客的嘉宾，也是我们在斯坦福大学的前同事，不幸的是我们输给了宾夕法尼亚大学，也许有一天我们会让他回来。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, that's right.
是的，没错。
So this individual received some NIH funding to actually, NIDA, National Institute for Drug Abuse funding, to explore individuals of the Mormon faith In Utah who've partaken only MDMA.
因此，这个人获得了 NIH 的一些资助，实际上是 NIDA（国家药物滥用研究所）的资助，以探索犹他州只服用 MDMA 的摩门教徒。
So, the way this works is that MDMA happened kind of after a lot of the religious documents were developed, and so MDMA isn't on the prohibited drug list.
因此，这种情况的运作方式是，摇头丸是在许多宗教文件制定之后发生的，因此摇头丸不在违禁药物清单上。
Andrew Huberman:
安德鲁·休伯曼：
The banned substance list for-
禁用物质清单为：
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
The banned substance list for-
禁用物质清单为：
Andrew Huberman:
安德鲁·休伯曼：
I have some good friends who are LDS, very interesting
我有一些好朋友是摩门教徒，非常有趣
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Great people.
伟大的人们。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, great people.
是啊，伟大的人们。
Yeah.
是的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
I do as well.
我也一样。
Just a kind of set of facts.
只是一组事实。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And so these folks only use MDMA, but the problem with some people using drugs is they're poly substance users, right?
所以这些人只使用摇头丸，但一些吸毒者的问题是他们是多物质使用者，对吗？
So you can't say it's the MDMA if they've also taken other psychedelics-
所以如果他们还服用了其他迷幻药，你就不能说这是 MDMA——
Andrew Huberman:
安德鲁·休伯曼：
Mm
毫米
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
and they've taken opiates and they've taken cocaine, and you have this picture where you can't really tease out that problem.
他们服用了阿片类药物和可卡因，在这张照片中你无法真正弄清楚这个问题。
But with this, right, it was just individuals that were part of the Mormon faith, and so they were kind of purists in the sense they only used MDMA, and he confirmed all of that.
但这样一来，对了，只有个人是摩门教信仰的一部分，所以他们是纯粹主义者，因为他们只使用摇头丸，他证实了这一切。
And it was a brilliant study, right?
这是一项出色的研究，对吧？
Because then he was able to go in and look at their cognitive profiles versus individuals of the same geography or the same faith, all of that, that happened to not take MDMA, and found there were no neurocognitive differences.
因为随后他能够进入并观察他们的认知概况与相同地理位置或相同信仰的个体的认知情况，所有这些，碰巧没有服用摇头丸，并发现没有神经认知差异。
Andrew Huberman:
安德鲁·休伯曼：
So does that mean that it was not damaging?
那么这是否意味着它没有造成损害呢？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It was not damaging.
它没有损坏。
It's hard to know because to really do this study well, you'd have to track these folks down before they ever took MDMA-
这很难知道，因为要真正做好这项研究，你必须在这些人服用摇头丸之前找到他们——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
and do a pre-post and compare it to people that didn't.
并做一个预发布并将其与没有发布的人进行比较。
But this is about as good of a study as you can do given the situation to be able to check this out.
但考虑到能够检查这一点的情况，这已经是一项很好的研究了。
Additionally, when I was back in Charleston and working in the Medical University of South Carolina, one of my mentors there, Dr. Wagner, was a neuropsychologist at MUSC, and he was also the neuropsychologist for the early MDMA trials.
此外，当我回到查尔斯顿并在南卡罗来纳医科大学工作时，我在那里的一位导师瓦格纳博士是 MUSC 的神经心理学家，他也是早期 MDMA 试验的神经心理学家。
And so he did all the neurocognitive batteries for individuals pre, post, and similarly did not see any changes in neurocognitive profiles in a negative way.
因此，他在前后对个体进行了所有神经认知电池测试，同样没有看到神经认知特征有任何负面变化。
And so, there's data from experimental patients receiving this, there's data from people that are chronic users who only take MDMA.
因此，有来自接受这种药物的实验患者的数据，有来自只服用 MDMA 的长期使用者的数据。
And that combination of data suggests that there's certainly no apparent risk in the kind of one to two to three dose range.
这些数据组合表明，一到二到三个剂量范围肯定不存在明显的风险。
It's probably unlikely that at least modest dose exposure over a lifetime doesn't appear to have a profound neurocognitive damaging effect.
一生中至少适度的剂量暴露似乎不太可能不会产生深远的神经认知损害作用。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Yeah, I know that sourcing is key, and here we're talking about clinical trials where purity is assured.
是的，我知道采购是关键，这里我们谈论的是保证纯度的临床试验。
And years ago when so-called raves were really popular, maybe they're still popular.
几年前，当所谓的狂欢真正流行时，也许它们仍然很流行。
Never been to one, so-
从来没有去过，所以——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, neither have I
是的，我也没有
Andrew Huberman:
安德鲁·休伯曼：
...
...
I wouldn't know-
我不知道-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
if they're happening or not.
无论它们是否发生。
That's how in the know I am.
这就是我所知道的。
But it was clear that testing for purity was important because sometimes the drugs are made such that there are contaminants like methamphetamine, which we know is highly neurotoxic.
但很明显，纯度测试很重要，因为有时制造的药物含有甲基苯丙胺等污染物，我们知道它具有高度神经毒性。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I think that one reason why people think that MDMA might be neurotoxic is the reported drop in energy or sort of feeling fatigued for a few days afterward.
我认为人们认为 MDMA 可能具有神经毒性的原因之一是据报道，服用 MDMA 之后几天会出现精力下降或感觉疲劳的情况。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I spoke to a physician colleague of ours who said that very likely has something to do with the surge in prolactin that arrives subsequent to the big dopamine surge that occurs in MDMA.
我和我们的一位医生同事交谈过，他说这很可能与 MDMA 中多巴胺大量激增后催乳素激增有关。
And I mention that because I know a number of people talk about serotonin depletion after taking MDMA.
我之所以提到这一点，是因为我知道很多人都在谈论服用 MDMA 后血清素消耗的问题。
He has it in mind that while that could be true, it's likely that any time somebody takes something or does something where there's a huge lift in dopamine, that there's very likely a huge compensatory increase in prolactin that follows.
他认为，虽然这可能是真的，但每当有人服用某物或做某事时，多巴胺会大幅增加，催乳素很可能会随之出现巨大的代偿性增加。
And prolactin has a kind of sedative effect-
而催乳素有一种镇静作用——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
numbing effect on mood and libido, et cetera, that eventually also wears off.
对情绪和性欲等的麻木作用最终也会消失。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Does that make sense to you as a physician?
作为一名医生，这对您有意义吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Yeah, it makes sense.
是的，这是有道理的。
The difference between, say, MDMA and psilocybin is that MDMA is kind of an amphetamine of sorts, right?
例如，MDMA 和裸盖菇素之间的区别在于，MDMA 是一种安非他明，对吗？
So it has effects in dopamine, and psilocybin's pretty neutral, and maybe a little bit of dopamine effects, but kind of much more of a serotonergic-focused drug.
所以它对多巴胺有影响，裸盖菇素相当中性，也许有一点多巴胺影响，但更像是一种以血清素为重点的药物。
And so yeah, I think you're going to see kind of a different profile after.
是的，我想您之后会看到不同的个人资料。
I haven't heard that story, but that makes sense to me, too.
我没听过这个故事，但这对我来说也很有意义。
Andrew Huberman:
安德鲁·休伯曼：
Since you mentioned psilocybin, let's talk a little bit about the neurochemistry of psilocybin.
既然你提到了裸盖菇素，我们就来谈谈裸盖菇素的神经化学。
As a serotonergic agent, my understanding is it operates on these, is it the 5HT serotonin, 2C receptor?
作为一种血清素能药物，我的理解是它作用于这些，是5HT血清素、2C受体吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
2A.
2A。
Andrew Huberman:
安德鲁·休伯曼：
2A, excuse me.
2A，对不起。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
2A receptors.
2A受体。
And that I've seen a bunch of different reports in terms of what it's actually doing to the brain while people are under the effects of the drug.
我看过很多不同的报告，关于人们在药物作用下它对大脑的实际影响。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And this is important for us to segment out because there are the effects that happen while people are under the influence, and then the more long-lasting effects.
这对我们来说很重要，因为人们受到影响时会产生一些影响，然后会产生更持久的影响。
But some of the effects that I've heard about are, for instance, and tell me again if these are right or wrong, that there is increased activation of lateral connections, sort of broader areas of the brain being co-active than would normally occur.
但我听说过的一些影响是，例如，再次告诉我这些是对还是错，横向连接的激活增加，大脑中比正常情况更广泛的区域共同活跃。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Maybe that explains some of the synesthesias.
也许这可以解释一些联觉。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
Seeing sounds and hearing colors as the trivial example, but rule breaking-
看到声音和听到颜色只是一个微不足道的例子，但打破了规则——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
within the mind.
心中。
But then I've also heard that perhaps it's lack of gating of sensory input.
但后来我也听说，也许是缺乏感官输入门控。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So normally if I'm looking at something, I'm not thinking about the sensation in my right toe unless it's relevant.
所以通常情况下，如果我在看某样东西，我不会考虑右脚趾的感觉，除非它是相关的。
But if I'm thinking about the sensation in my right toe, I'm generally not thinking about the truck around the corner.
但如果我考虑右脚趾的感觉，我通常不会考虑拐角处的卡车。
So we have these attentional spotlights, but that somehow it creates a more, it adds spotlights.
所以我们有这些引人注目的聚光灯，但不知何故它创造了更多，它增加了聚光灯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
De-gates the thalamus.
关闭丘脑。
Andrew Huberman:
安德鲁·休伯曼：
De-gates the thalamus.
关闭丘脑。
Right.
正确的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Through the reticular thalamic structure.
通过网状丘脑结构。
So- What is the evidence that any of that is true?
那么——有什么证据证明这些都是真的呢？
And are there other phenomena?
还有其他现象吗？
Is there involvement of dorsolateral prefrontal cortex that we are aware of?
我们知道是否存在背外侧前额叶皮层的参与？
And where I'm really headed here in a few minutes is, is there a place for combining directed stimulation of the brain with psychedelics so that the effects of serotonin could be primarily within the structures that you know from your work to be relevant to depression?
几分钟后我真正要讨论的是，是否有一个地方可以将大脑的定向刺激与致幻剂结合起来，以便血清素的作用主要集中在你从工作中知道的与抑郁症相关的结构中？
But to simplify it first, what's going on when one takes psilocybin and why is it interesting in light of depression?
但首先要简化一下，当一个人服用裸盖菇素时会发生什么？鉴于抑郁症，它为什么有趣？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, definitely.
是的，绝对是。
So David Nutt and Robin Carhart-Harris's work around neuroimaging psychedelics are some of the first folks to do that work.
因此，大卫·纳特（David Nutt）和罗宾·卡哈特-哈里斯（Robin Carhart-Harris）围绕神经影像迷幻药的研究是最早从事这项工作的人之一。
And to their great surprise, they thought there was going to be an increase in activity on psychedelics, and what they found is the opposite, right?
令他们大吃一惊的是，他们认为迷幻药的活动将会增加，但他们发现事实恰恰相反，对吗？
There's an overall decrease in the level of activity in the brain with psychedelics.
迷幻药导致大脑活动水平总体下降。
But they've also looked at connectivity, and there's this small world, large world connectivity that you think about.
但他们也研究了连通性，你会想到这个小世界、大世界的连通性。
And so small world meaning there's a much more focused cortical function or subcortical function or whatever it is.
如此小的世界意味着有更集中的皮质功能或皮质下功能或其他任何东西。
And what you see is a difference in that level of engagement and of brain regions.
你看到的是参与程度和大脑区域的差异。
So the connectivity, global connectivity, to your point, increases.
因此，按照你的观点，连通性、全球连通性增加了。
And so it's interesting.
这很有趣。
I think to have a convergent theory on this, it's still to be determined.
我认为对此有一个趋同的理论，还有待确定。
There's still a lot of work, I think, that needs to be done.
我认为还有很多工作需要完成。
But it's certainly suggestive that there's pretty profound changes in brain activity and brain connectivity after.
但这肯定表明，之后大脑活动和大脑连接发生了相当深刻的变化。
And what we've found to be really interesting is the antidepressant effects of psilocybin have a particular connectivity change that we also see with our TMS approaches, right?
我们发现真正有趣的是裸盖菇素的抗抑郁作用具有特定的连接性变化，我们在 TMS 方法中也看到了这一点，对吗？
And it's this connectivity between the subgenual anterior cingulate and the default mode network.
这就是膝下前扣带回和默认模式网络之间的连接。
And so when we do this effective Stanford neuromodulation therapy stimulation, we see a downregulation, the connectivity between the negatively valenced mood state in the case of depressed individuals and the self-representation of the brain.
因此，当我们进行这种有效的斯坦福神经调节疗法刺激时，我们会看到下调，即抑郁症患者的负价情绪状态与大脑的自我表征之间的联系。
And you see that same connectivity change occur post psilocybin, suggesting there's a convergent mechanism.
您会看到裸盖菇素后发生了相同的连接变化，表明存在收敛机制。
And it makes sense, right?
这是有道理的，对吧？
You've got an over-connected, negatively valenced system, conflict system, that's attached onto the self-representation and people feel stuck, right?
你有一个过度连接的、负价的系统、冲突系统，它依附于自我表征，人们感到陷入困境，对吗？
And then when you do whatever you do that's effective, it unpairs those two systems.
然后，当你做任何有效的事情时，它就会取消这两个系统的配对。
Andrew Huberman:
安德鲁·休伯曼：
I want to ask you about this phenomenon I've heard about during psilocybin journeys.
我想问你关于我在裸盖菇素之旅中听说过的这种现象。
I heard about this from Dr. Matthew Johnson, who's running a lot of the clinical trials at Johns Hopkins and has been a guest on this podcast.
我从马修·约翰逊博士那里听说了这个消息，他在约翰·霍普金斯大学进行了大量的临床试验，并且是这个播客的嘉宾。
He said that something seems to be important about the patient who's depressed or who's under the influence of psilocybin, or the patient who's trying to get over smoking or an eating disorder, who's taking psilocybin and is in the clinic, that there's something important to this notion of letting go.
他说，对于抑郁症患者或受到裸盖菇素影响的患者，或者正在诊所服用裸盖菇素并试图戒烟或饮食失调的患者来说，放手的概念似乎很重要。
That people will feel as if their thoughts and their feelings and maybe even their body aren't under their control, and that the clinician's job under those circumstances is, of course, to make sure that they're physically safe, that they don't jump out a window or try to...
人们会觉得他们的思想、感觉，甚至身体都不受他们的控制，而在这种情况下，临床医生的工作当然是确保他们的身体安全，确保他们不会跳出窗外或试图……
He actually gave an example of a patient who thought that, I think it was a she, could move into the painting in the wall, and obviously that wasn't true in the real world, although it was true in her mind.
他实际上举了一个病人的例子，她认为，我认为这是一个她，可以进入墙上的画，显然这在现实世界中不是真的，尽管在她的心里这是真的。
So they prevented her from doing that.
所以他们阻止她这样做。
But that letting go, that somehow untethering from the autonomic arousal that's occurring is important.
但放手，以某种方式摆脱正在发生的自主唤醒的束缚是很重要的。
Which brings us back to this idea, or me back to this idea of a seesaw where you're sort of letting go of the hinge.
这让我们回到了这个想法，或者让我回到了跷跷板的想法，你可以在其中松开铰链。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And just your heart rate's going up, just go with it and trust.
只是你的心率在上升，跟着它并相信。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Your heart rate's going down, just go with it and trust.
你的心率正在下降，顺其自然并相信。
You're thinking about something very powerful and depressing related to your childhood, you're just supposed to go there without fear.
你正在思考一些与你的童年有关的非常强大和令人沮丧的事情，你应该毫无恐惧地去那里。
You're thinking about what's possible in terms of what could happen.
你正在考虑可能发生的事情。
So anyway, you get the picture.
所以无论如何，你明白了。
Can we think of that as just the willingness to do a million different variations on the emotional Stroop task?
我们是否可以将其视为对情感斯特鲁普任务进行一百万种不同变化的意愿？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
You will entertain the full array of rules within your head and consider them.
您将在脑海中考虑并考虑所有规则。
Or is there something more to it?
或者还有更多的事情吗？
And again, we're in the outer margins of understanding here.
再说一次，我们处于理解的边缘。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But what are your thoughts on this notion of letting go as such a key variable for relief from depression during the psychedelic journey?
但是，对于在迷幻之旅中将放手作为缓解抑郁的关键变量这一概念，您有何看法？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So I'll talk a little bit about something called exposure and response prevention therapy that's a typical kind of gold standard treatment for OCD, and it'll help this a little bit conceptually.
所以我会谈谈所谓的暴露和反应预防疗法，这是一种典型的强迫症金标准治疗方法，它会在概念上有所帮助。
And so what that really is, it's a letting go therapy.
所以这实际上是一种放手疗法。
And so exposure and response prevention, the idea is that you have to expose the individual to something that triggers an obsession that they then want to do whatever the compulsion is, right?
因此，暴露和反应预防的想法是，你必须让个人接触一些会引发强迫症的东西，然后他们就会想做任何强迫性的事情，对吗？
And so I'll give you my first exposure and response prevention patient when I was a resident.
因此，我将向您介绍我作为住院医师时的第一个接触和反应预防患者。
He was very concerned about leaving the lights on in his car.
他非常担心车内的灯是否开着。
And so what we did is we went out and we turned the lights on in his car and locked his door so his lights were on, and he was super worried that it's going to kill his battery.
所以我们所做的就是出去，打开他车里的灯，锁上车门，这样他的灯就亮了，他非常担心这会耗尽他的电池。
And we went and we spent an hour talking about things, and we went back out to his car and his battery was fine, and his lights were on.
我们去了，我们花了一个小时讨论事情，然后我们回到他的车旁，他的电池很好，他的灯也亮着。
And he cranked the car, and we did it maybe one other time, and then all of a sudden that was gone Right.
他发动了汽车，我们可能又做了一次，然后突然间一切就都好了。
And that's the idea, is that you're essentially exposing, and you want to do it at levels that are, from an anxiety standpoint, tolerable, but exposing the person to something and then letting them see that that exposure ends up being fine.
这就是你的想法，你本质上是在暴露，并且你想要在从焦虑的角度来看可以忍受的水平上进行，但是让人们暴露于某些东西，然后让他们看到这种暴露最终是好的。
Right?
正确的？
It ends up not causing the thing that they end up being worried about.
它最终并没有引起他们最终担心的事情。
And so, in some sense, being in the psychedelic state, and we're all taught at a level to retain some level of control.
因此，从某种意义上说，处于迷幻状态，我们都被教导要在一定程度上保持一定程度的控制。
People have more or less of that, but we're all effectively retaining some level of control.
人们或多或少都拥有这样的能力，但我们都有效地保留了一定程度的控制权。
We all wake up in the morning and put clothes on to go into society.
我们早上醒来，穿上衣服，走向社会。
Most people try to say the right things.
大多数人都试图说正确的话。
They don't try to do things that are outside of cultural norms when they're in conversation.
他们在谈话时不会尝试做超出文化规范的事情。
And so we're constantly, at some level, controlling the situation that we're in.
因此，我们在某种程度上不断地控制着我们所处的情况。
And so it makes a lot of sense that in that state, part of the therapeutic effect that may be linked to the neural circuitry is this idea of letting go and essentially letting the system, the network configuration maybe, whatever it is, assume a state that you've essentially been fighting the whole time, the same way that my OCD patient was fighting this need to click the off button on the lights of his car 50 times before he would go and do whatever he needed to do, and at some level letting go there, meaning letting us just turn the lights on and him not do anything, or letting go meaning in the psychedelic state, you're just letting go of whatever it is you're holding on to.
因此，在这种状态下，可能与神经回路相关的部分治疗效果是放手的想法，本质上让系统、网络配置可能，无论是什么，假设你基本上一直在与这种状态作斗争，就像我的强迫症患者在做任何他需要做的事情之前需要点击车灯上的关闭按钮 50 次一样，在某种程度上放手，这意味着让我们打开灯，他什么都不做，或者在迷幻状态下放手，你只是放开了你所坚持的一切。
Negatively valenced thoughts about yourself in the setting of having depression or re-experiencing a trauma, memory and allowing that to just happen and re-seeing it again through a different light.
在患有抑郁症或重新经历创伤、记忆的情况下对自己产生消极的想法，并允许这种情况发生并通过不同的角度重新审视它。
It feels the same in the sense that that's allowing for whatever's going on with these psychedelic states to do whatever they do.
从某种意义上来说，感觉是一样的，那就是允许这些迷幻状态发生的任何事情都可以做他们所做的任何事情。
Andrew Huberman:
安德鲁·休伯曼：
It's fascinating.
这很有趣。
You said exposure response therapy is the traditional name?
你说的暴露反应疗法是传统名称？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Exposure response prevention therapy.
暴露反应预防治疗。
Andrew Huberman:
安德鲁·休伯曼：
Prevention therapy.
预防治疗。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Done outside of the psychedelic journey.
在迷幻之旅之外完成。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It's done outside the psychedelic journey, but that idea of letting go is present in both of those.
这是在迷幻之旅之外完成的，但放手的想法在这两者中都存在。
Psychotherapy, kind of straight up, totally sober, non-psychedelic, non-anything, manualized psychotherapy that we know works really well for OCD, and then in that psychedelic state.
心理治疗，一种直接的、完全清醒的、非迷幻的、非任何东西的、我们知道的手动心理治疗对于强迫症非常有效，然后在那种迷幻状态下。
And so people have done studies with psilocybin, and now there's some studies with MDMA trying to look at treating OCD with the same sort of idea of letting go, right?
人们已经对裸盖菇素进行了研究，现在有一些关于 MDMA 的研究试图以同样的放手理念来治疗强迫症，对吗？
And how do you have an OCD patient let go?
如何让强迫症患者放下心来？
Maybe even letting go of not washing their hands anymore, accepting the idea they're not going to get germs on their hands or whatever it is.
也许甚至放弃不再洗手的想法，接受他们的手上不会沾染细菌或其他什么的想法。
And so it's part of that part and parcel, that same sort of thinking.
所以这是同样的想法的一部分。
Andrew Huberman:
安德鲁·休伯曼：
When I was in college, I developed a compulsive superstition.
当我上大学时，我产生了一种强迫性的迷信。
I'm not afraid to admit this.
我并不害怕承认这一点。
I somehow developed a knock-on-wood superstition, and I was actually ashamed of it because it rationally made no sense.
我不知何故产生了一种彻头彻尾的迷信，我实际上为它感到羞耻，因为它在理性上毫无意义。
I don't consider myself a superstitious person, never was a superstitious kid.
我不认为自己是一个迷信的人，从来都不是一个迷信的孩子。
I'd step on the sidewalk cracks.
我会踩在人行道的裂缝上。
I'd walk under ladders.
我会在梯子下行走。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I'd even try to walk under a ladder, even though I don't suggest it.
我什至尝试从梯子下走，尽管我不建议这样做。
But somehow I picked this thing up, and I used to sneak it at times.
但不知怎的，我捡起了这个东西，并且有时我会偷偷地拿它。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I told my girlfriend at the time that I had it in hopes that that would prevent me from doing it.
我当时告诉我的女朋友我有它，希望这能阻止我这样做。
And it's tricky.
这很棘手。
Sometimes it actually comes back where I think, "Gosh, I didn't say knock on wood.
有时它实际上会回到我想的地方，“天哪，我没有说敲木头。
I didn't knock on wood.
我没有敲木头。
I hope that doesn't actually happen."
我希望这实际上不会发生。”
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And it's "crazy," right?
这很“疯狂”，对吧？
Crazy in the sense that it makes no sense rationally why the events would be linked, and yet I think a lot of people out there do have internal superstitions.
疯狂是因为从理性上讲，为什么这些事件会联系在一起是没有意义的，但我认为很多人内心确实有迷信。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Maybe by talking about it now, it'll go away.
也许现在谈论它，它就会消失。
Clearly I just need to challenge it.
显然我只需要挑战它。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Anyway, I mention it because I consider myself a generally rational person.
不管怎样，我提到它是因为我认为自己是一个总体上理性的人。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
But it's interesting how these motor patterns get activated and this notion of letting go, because I don't actually know what consequence I fear.
但有趣的是，这些运动模式是如何被激活的，以及这种放手的想法，因为我实际上不知道我担心什么后果。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And as I was hearing the example you gave, the fear of the car battery running down, I was about to say, "Well, what if the battery actually did run out?"
当我听到你举的例子时，担心汽车电池耗尽，我正想说，“好吧，如果电池真的耗尽了怎么办？”
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Right.
对。
Andrew Huberman:
安德鲁·休伯曼：
Then the therapy would be undermined.
那么治疗就会受到破坏。
And yet that could also be interesting, too, because it's not that big of a deal.
但这也可能很有趣，因为这没什么大不了的。
You jump the car and-
你跳下车然后——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
but in my case, I need to think about what the ultimate fear is.
但就我而言，我需要思考最终的恐惧是什么。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
And I think a lot of people...
而且我认为很多人...
So it's interesting if you look at, say, the OCD scale or the depression scale or whatever, we don't define normal as zero.
所以有趣的是，如果你看看强迫症量表或抑郁量表或其他什么，我们不会将正常定义为零。
We define normal as some number range above, so zero to, in the case of the Montgomery-Åsberg Depression Rating Scale, one of the depression scales we use, 10, right?
我们将正常定义为上面的某个数字范围，所以在蒙哥马利-阿斯伯格抑郁量表（我们使用的抑郁量表之一）的情况下，从 0 到 10，对吧？
That's the normal range.
这是正常范围。
And so people could have some sadness and still be considered normal.
因此，人们可能会感到一些悲伤，但仍然被认为是正常的。
In the case of the OCD scale, it's about the same, 10, right?
就强迫症量表而言，它大约是相同的，10，对吧？
Where we say it starts to be mildly abnormal or something.
我们说它开始出现轻微异常或其他什么情况。
And I'd always tell the medical students, "Look, my friends that are surf instructors, they're more like a zero on the YBOC.
我总是告诉医学院的学生，“看，我的冲浪教练朋友们，他们更像是 YBOC 上的零。
People that are professionals, they're non-zero." But it's still within the normal range, and especially in the case that you're talking about, it doesn't sound like it got in your way.
专业人士，他们不是零。”但它仍然在正常范围内，尤其是在你所说的情况下，听起来并没有妨碍你。
You're obviously highly successful tenured professor at Stanford and do all the great things that you do.
您显然是斯坦福大学非常成功的终身教授，并且做了您所做的所有伟大的事情。
And so it's very much within the normal range, and I think totally assume that a lot of people have these sorts of things.
所以这在正常范围内，我认为完全可以假设很多人都有这种情况。
And I think a psychiatric diagnosis When it severely impairs your ability to function, and that's when we kind of cross that threshold.
我认为，当精神科诊断严重损害你的运作能力时，那就是我们跨过这个阈值的时候。
But, I think that a lot of people, and it's great that you're bringing this up, it's very anti-stigmatizing that you're bringing it up, right?
但是，我认为很多人，你提出这个问题很好，你提出这个问题非常反污名化，对吗？
Because I think a lot of people hold that stuff in and they don't want to talk about it because they're worried that somebody else may think something.
因为我认为很多人都把这些东西藏在心里，他们不想谈论它，因为他们担心别人可能会想到什么。
But the reality is, as a psychiatrist, I talk to a lot of patients, a lot of people that are family members, folks that are just going through a death in the family, whatever it is, and what you figure out is everybody's got a little something here and there.
但现实是，作为一名精神科医生，我和很多病人交谈过，很多是家庭成员，刚刚经历家庭成员死亡的人，无论是什么，你会发现每个人都有一些东西。
Everybody has the knock in some way, if that makes sense.
每个人都会以某种方式受到打击，如果这有意义的话。
And we're all just kind of more predisposed not to talk about it, but I think it's important to talk about it because I think that when we start all talking about it, then we realize that we're all in this together in a way.
我们都更倾向于不谈论它，但我认为谈论它很重要，因为我认为当我们开始谈论它时，我们就会意识到我们在某种程度上是在一起的。
And then some folks that have to knock 100 times, we call that OCD, and they're worried about germs and all these other things, we call that OCD.
然后有些人必须敲门 100 次，我们称之为强迫症，他们担心细菌和所有其他事情，我们称之为强迫症。
And then in that circumstance, they need treatment, right?
那么在这种情况下，他们就需要治疗，对吧？
But it is really, just like blood sugar, just like blood pressure, it's on a range, and it's not just these discrete diagnoses, you have them or you don't.
但它实际上就像血糖、血压一样，都有一个范围，而且不仅仅是这些离散的诊断，你有或没有。
Andrew Huberman:
安德鲁·休伯曼：
It's good to know.
很高兴知道。
I actually feel some relief just hearing this because I am slightly, I wouldn't say ashamed or sort of embarrassed by it, but I offer it as a, it is what it is, as they say.
实际上，听到这个消息我感到有些宽慰，因为我有点，我不会说对此感到羞愧或尴尬，但我把它作为一个，正如他们所说的那样。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And it certainly doesn't seem to hinder my life much.
而且它似乎并没有对我的生活造成太大阻碍。
Knock on wood.
敲木头。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Nice.
不错。
Andrew Huberman:
安德鲁·休伯曼：
So if we could talk a bit about ibogaine.
那么我们可以谈谈伊博加因吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I don't know much about ibogaine, although anytime I hear the A I N E, lidocaine, ibogaine, I think of an anesthetic.
我对伊博加因了解不多，尽管每当我听到 A I N E、利多卡因、伊博加因时，我都会想到麻醉剂。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And going to the dentist, which is an unpleasant experience for me-
去看牙医，这对我来说是一次不愉快的经历-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Fair
公平
Andrew Huberman:
安德鲁·休伯曼：
...
...
generally.
一般来说。
What is ibogaine?
什么是伊博加因？
Does this have anything to do with the so-called toad?
这和所谓的蟾蜍有什么关系吗？
People talk about smoking frog skin, toad skin.
人们谈论熏青蛙皮、蟾蜍皮。
What is it used for clinically?
临床上有什么用途？
Is it legal in the US as a clinical tool?
作为临床工具在美国合法吗？
Who's using it and for what purposes?
谁在使用它以及用于什么目的？
If you could educate me on ibogaine, I truly know nothing about it, except I think I know how to spell it correctly.
如果你能教我有关伊博加因的知识，我真的对此一无所知，除了我认为我知道如何正确拼写它。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, that's fair, yeah.
是的，这很公平，是的。
So ibogaine is one of the alkaloids that you can extract from a iboga tree root bark that's typically growing in the country of Gabon, Africa.
因此，伊博加因是一种生物碱，可以从通常生长在非洲加蓬的伊博加树根皮中提取。
So Gabon is one of the West African countries, kind of middle of Africa on the west coast.
加蓬是西非国家之一，位于非洲中部的西海岸。
And Gabon has a group of folks called the Bwiti.
加蓬有一群叫做 Bwiti 的人。
It's a religious kind of sacramental group that sacramentally uses iboga root bark as part of the sacrament.
这是一种宗教圣礼团体，在圣礼上使用伊博加根皮作为圣礼的一部分。
And they've been using iboga root bark for a very long time.
他们使用伊博加根皮已经很长时间了。
And it's part of the tradition.
这是传统的一部分。
There's a whole set of ceremony around it.
围绕它有一整套仪式。
If you're interested in this, there's a book called "Breaking Open the Head" by Daniel Pinchbeck that goes through and talks about this whole process.
如果您对此感兴趣，丹尼尔·平奇贝克（Daniel Pinchbeck）写的一本名为《Breaking Open the Head》的书详细介绍并讨论了整个过程。
But essentially, the Gabonese have been using this for a long time.
但本质上，加蓬人已经使用它很长时间了。
And it's a kind of an atypical psychedelic.
这是一种非典型的迷幻剂。
It's not a psychedelic that we normally think about with psilocybin and LSD, where there are visual perceptual changes, right?
它不是我们通常认为的裸盖菇素和LSD那样的迷幻药，会带来视觉感知的变化，对吧？
So if you take psilocybin or LSD, what you experience is you experience these kind of visual perceptual differences in the external world, right?
因此，如果您服用裸盖菇素或LSD，您所经历的就是在外部世界中经历这种视觉感知差异，对吧？
And on enough LSD or psilocybin, an individual can actually perceive something visually in the external world that isn't there, as we talked about earlier.
正如我们之前谈到的，只要服用足够的LSD或裸盖菇素，一个人实际上可以在视觉上感知到外部世界中不存在的东西。
Ibogaine doesn't do that.
伊博加因不这样做。
Ibogaine does something different.
伊博加因做了一些不同的事情。
It's kind of like, have you ever seen "Minority Report," the movie with Tom Cruise, I think 15 or 20 years ago or something, so it dates us a little bit.
这有点像，你看过汤姆·克鲁斯主演的电影《少数派报告》吗？我想是 15 或 20 年前的事了，所以它对我们来说有点过时了。
But it was this movie where he would be able to go and see these kind of pre-crimes, and he had this big screen where he could look at scenes from time and go through that scene and see it.
但正是在这部电影中，他能够去观看这些犯罪前的场景，并且他有一个大屏幕，他可以在其中观看过去的场景并浏览该场景并看到它。
And so what individuals taking ibogaine will say is that open eyes, they don't see anything, but closed eyes, they'll go back through and re-experience earlier life memories, and they will be able to experience it from a place of empathy, not only for themselves, but from others, and kind of a detached empathy and being able to see this as almost a third party, even though they were there.
因此，服用伊博加因的人会说，睁开眼睛，他们看不到任何东西，但闭上眼睛，他们会回顾并重新体验早年的生活记忆，他们将能够从同理心的地方体验它，不仅是对自己，而且是对他人，一种超然的同理心，能够将其视为几乎第三方，即使他们在那里。
But they're able to see it as a third party.
但他们能够将其视为第三方。
So Claudio Naranjo, a psychiatrist from Argentina, described this for a lot of books that he wrote, I think in the '80s and '90s around this.
来自阿根廷的精神病学家克劳迪奥·纳兰霍（Claudio Naranjo）在他写的很多书中描述了这一点，我想是在 80 年代和 90 年代。
And so ibogaine's been around for a long time.
所以伊博加因已经存在很长时间了。
Howard Lotsof, American guy that brought it over from Africa, he was a polysubstance user, used every drug that he had his hands on.
霍华德·洛索夫（Howard Lotsof），一个从非洲带来这种药物的美国人，他是一名多物质使用者，使用了他手上的每一种药物。
Took ibogaine, and including a lot of other psychedelics, by the way, took ibogaine and then never did another drug again, supposedly, because he had such a profound ibogaine experience.
服用了伊博加因，包括许多其他致幻剂，顺便说一句，服用了伊博加因，然后再也没有吸过其他药物，据说是因为他有如此深刻的伊博加因体验。
Ibogaine is in no way a recreational substance.
伊博加因绝不是一种娱乐物质。
It's not a recreational substance if you want it to be a recreational substance, because you're essentially having this, what they call a life review.
如果你想让它成为一种娱乐物质，它就不是一种娱乐物质，因为你本质上是在拥有这个，他们称之为生活回顾。
They also call it 10 years of psychotherapy in a night.
他们也称之为一夜心理治疗十年。
So these are the terminology that people talk about.
这些就是人们谈论的术语。
Andrew Huberman:
安德鲁·休伯曼：
How long does it last?
持续多久？
Is it truly one night?
真的是一晚吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It can go, depending upon if you get redosed or anything, depending upon how fast you metabolize it, sometimes 24, sometimes 36 hours.
它可以消失，取决于你是否重新服药或其他什么，取决于你代谢它的速度，有时是 24 小时，有时是 36 小时。
Sometimes it can be shorter, but it is a long time.
有时可以更短，但时间却很长。
Andrew Huberman:
安德鲁·休伯曼：
Wow.
哇。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It's a very long time.
这是很长一段时间了。
So it's definitely the longest acting psychedelic substance I know of.
所以它绝对是我所知道的作用时间最长的迷幻物质。
And so people will take this and they'll have this reevaluation of a given memory, and then, as we were talking about earlier, reconsolidate that memory again, and then it seems to have an effect of that reconsolidation process.
所以人们会接受这个，他们会对给定的记忆进行重新评估，然后，正如我们之前讨论的那样，再次重新巩固该记忆，然后它似乎会产生重新巩固过程的效果。
And so, about four or five years ago, I was tapped by Robert Malenka, one of the senior neuroscientists we both know in the university, and he says, "Well, there's an unnamed donor that's very interested in funding a scientific kind of open label study of these Navy SEALs that have been going down to Mexico and taking ibogaine," and also on 5-MeO-DMT, which I'll talk about in a second, to treat PTSD.
因此，大约四五年前，罗伯特·马伦卡（Robert Malenka）找到了我，他是我们在大学认识的一位资深神经科学家，他说：“嗯，有一位不知名的捐助者非常有兴趣资助对这些前往墨西哥服用伊博加因的海豹突击队进行科学的开放标签研究”，以及 5-MeO-DMT（我稍后会谈到）治疗创伤后应激障碍（PTSD）的研究。
They claim to have traumatic brain injury, depression, that whole constellation of symptoms.
他们声称自己患有脑外伤、抑郁症等一系列症状。
And as it was described to me by various people that had done this, by their spouses and whatnot, we'll just say John.
正如许多做过这件事的人，他们的配偶等等向我描述的那样，我们就说约翰。
John couldn't screw a light bulb into a light fixture.
约翰无法将灯泡拧入灯具中。
They were just so debilitated they couldn't do simple tasks, what we call activities of daily living.
他们非常虚弱，无法完成简单的任务，即我们所说的日常生活活动。
And they were coming back and having these really dramatic improvements in all aspects of life.
他们回来后，生活的各个方面都取得了巨大的进步。
And so, we have, over the last couple of years, been able to do this first in-human, kind of full neurobiological, clinical neurocognitive evaluation of what ibogaine is doing, in this case, in special operations, special forces individuals, former Navy SEALs, former Army Rangers, that kind of crew of folks, and look at the pre/post changes that their experience to be able to totally quantitate all of that.
因此，在过去的几年里，我们已经能够对伊博加因在特种作战、特种部队、前海豹突击队、前陆军游骑兵等人员中所做的事情进行首次人体、全面的神经生物学、临床神经认知评估，并观察他们经历的前后变化，以便能够完全量化所有这些。
And so we've been able to capture all the clinical scales, depression scales, PTSD scales, all that standard stuff.
因此，我们已经能够捕获所有临床量表、抑郁量表、创伤后应激障碍量表以及所有标准内容。
Neurocognitive batteries, so how does your executive function work specifically?
神经认知电池，那么你的执行功能具体是如何运作的呢？
How does your verbal memory, all of that.
你的言语记忆如何，所有这些。
And then neuroimaging and EEG.
然后是神经影像学和脑电图。
So this will be the first human study of ibogaine for those.
因此，这将是针对伊博加因的首次人体研究。
And the reason why is because ibogaine's both seemingly the most potent and seemingly, to me at least, most powerful psychedelic, but the one that has the most risk too, because it has a cardiac effect.
原因是伊博加因看起来既是最有效的，至少对我来说也是最强大的迷幻剂，但也是风险最大的一种，因为它具有心脏作用。
It seems to be that you can screen people out that have risk off of their electrocardiogram and reduce the risk quite a bit, and that's what we all did.
似乎你可以通过心电图筛选出有风险的人，并大大降低风险，这就是我们所有人所做的。
But that's why people haven't really studied it as much.
但这就是为什么人们还没有真正研究过它。
In addition, nobody goes to a rave on ibogaine.
此外，没有人去参加伊博加因狂欢派对。
There's no recreation at all with this.
这根本没有任何娱乐可言。
Andrew Huberman:
安德鲁·休伯曼：
It's not fun.
这并不好玩。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
People say that it's relieving, but it's hard work.
人们说这很轻松，但其实很辛苦。
Because yeah, you're re-examining things.
因为是的，你正在重新审视事情。
And so then we see these folks after, and I'll tell you, we haven't fully analyzed the data yet, but I'll tell you that from what my folks are telling me, it's pretty dramatic.
然后我们会看到这些人，我会告诉你，我们还没有完全分析数据，但我会告诉你，从我的家人告诉我的情况来看，这是相当戏剧性的。
People come back and they're doing a lot better.
人们回来后，他们的表现好多了。
And knock on wood, nobody's had any sort of cardiac issue at all in the cohort that we've studied.
老实说，在我们研究的队列中，没有人患有任何类型的心脏问题。
And they look a lot better, and they feel a lot better too.
他们看起来好多了，感觉也好多了。
And they describe these experiences of being able to go back through.
他们描述了这些能够回顾的经历。
And soldiers experience something called moral injury, where maybe they accidentally blew something up and it had a kid in it or something like that.
士兵们会经历一种叫做精神伤害的事情，也许他们不小心炸毁了某个东西，而里面有一个孩子或类似的东西。
If they're in Afghanistan or Iraq, maybe a child died on accident or maybe a civilian died or whatever it was.
如果他们在阿富汗或伊拉克，可能有一个孩子死于意外，或者可能有一个平民死亡，或者其他什么原因。
And they suffer these moral injuries as part of the job, and it's almost one of the kind of vocational risks.
作为工作的一部分，他们遭受这些道德伤害，这几乎是一种职业风险。
They come back and say that they've forgiven themselves, which is huge.
他们回来后说他们已经原谅了自己，这是巨大的。
And part of that is being able to see themself in a different light and having empathy finally for themself, and being able to have that experience of forgiving.
其中一部分是能够以不同的眼光看待自己，最终对自己产生同理心，并能够获得宽恕的体验。
And so very cool.
非常酷。
The study, what was happening was they were taking ibogaine and then taking something called 5-MeO-DMT.
研究中，他们服用伊博加因，然后服用一种叫做 5-MeO-DMT 的药物。
People call the toad.
人们称之为蟾蜍。
It's the Sonoran River toad, I think.
我想这是索诺兰河蟾蜍。
You can find these in Mexico, find them in Arizona.
你可以在墨西哥找到它们，在亚利桑那州找到它们。
In the back of the toad produces something called 5-MeO-DMT, which is a flavor of DMT that produces a particular psychedelic effect, also used as a sacrament.
蟾蜍的背部会产生一种叫做 5-MeO-DMT 的物质，这是 DMT 的一种味道，能产生特殊的迷幻效果，也用作圣礼。
Andrew Huberman:
安德鲁·休伯曼：
Is it a dimethyltryptamine?
它是二甲基色胺吗？
Is that-
难道是——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It is a 5-MeO dimethyltryptamine.
它是一种 5-MeO 二甲基色胺。
So it's a kind of dimethyltryptamine with a kind of addition to it.
所以它是一种二甲基色胺，其中添加了某种添加剂。
The deal there is that it lasts longer than traditional DMT.
其优点是它比传统的 DMT 持续时间更长。
It's like 20 minutes to five, three or whatever kind of thing.
大概还有 20 分钟到五点、三点或其他什么时间。
And so these guys were taking ibogaine, and then they would take the 5-MeO-DMT after.
所以这些人服用伊博加因，然后他们会服用 5-MeO-DMT。
We had to kind of divorce those two things to be able to do the study and just understand what the ibogaine was doing.
我们必须将这两件事分开才能进行研究并了解伊博加因在做什么。
And they'd go back down a month later, and they'll do the 5-MeO-DMT.
一个月后他们会回去进行 5-MeO-DMT。
Andrew Huberman:
安德鲁·休伯曼：
So two completely separate sessions.
所以两个完全独立的会议。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Two completely separate sessions.
两个完全独立的会议。
Andrew Huberman:
安德鲁·休伯曼：
And then one quick question about ibogaine before a bit more on 5-MeO-DMT.
然后是一个关于伊博加因的快速问题，然后再详细介绍一下 5-MeO-DMT。
Is the ibogaine journey guided, or the person just closes their eyes and they just start falling into the back catalog of memories?
伊博加因旅程是被引导的，还是人们只是闭上眼睛，他们就开始陷入记忆的深处？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
They have a bunch of preparatory sessions, and then they have a bunch of sessions after that they're able to rehash things.
他们有很多准备会议，然后他们有很多会议，之后他们能够重新讨论事情。
During, there's a sitter that sits there and sits with them, and helps them out.
期间，有一个保姆坐在那里和他们坐在一起，帮助他们。
But the phenomenon of the drug seems to drive a lot of this.
但药物现象似乎在很大程度上推动了这一现象。
Right?
正确的？
And so a lot of it ends up being what we call supportive psychotherapy, just being there and maybe you're holding the person's hand, maybe you're just saying, "I'm here." Maybe whatever it is, but you're making sure they know you're around, but there's not really an interaction per se.
所以很多最终都是我们所说的支持性心理治疗，只是在那里，也许你握着那个人的手，也许你只是说，“我在这里。”也许无论是什么，但你要确保他们知道你在附近，但本质上并没有真正的互动。
And then the whole goal there is just to get folks to go back through and re-examine these memories, and then ultimately look like they reconsolidate them.
整个目标就是让人们回顾并重新审视这些记忆，然后最终看起来像是他们重新巩固了它们。
And it's very interesting.
这很有趣。
There's this, as you said earlier, Timothy Leary sociocultural construct that ends up being overlaid over psychedelics.
正如你之前所说，蒂莫西·利里的社会文化结构最终被迷幻剂所覆盖。
And what I think is that if you rid yourself of all of those preconceived notions of what it is and isn't, and the counterculture movement, all that stuff that neither of us were ever involved in, neither of us ever partake in, as straight scientists looking at this.
我的想法是，如果你摆脱所有那些关于它是什么和不是什么的先入为主的观念，以及反文化运动，所有这些我们俩都没有参与过的东西，我们俩都没有参与过，作为正直的科学家来看待这个问题。
If you can rid yourself of all those sociocultural constructions and then re-examine this, if we just discovered these today, we would say that these sorts of drugs are a huge breakthrough in psychiatry because they allow for us to do a lot of the sorts of things we've been thinking about with SSRIs, with psychotherapy, but combined.
如果你能摆脱所有这些社会文化建构，然后重新审视这一点，如果我们今天才发现这些，我们会说这类药物是精神病学的巨大突破，因为它们使我们能够做很多我们一直在考虑的 SSRIs 和心理治疗的事情，但将它们结合起来。
Psychotherapy plus drugs in a substance that allows you to re-examine these things.
心理治疗加上药物中的一种物质，可以让你重新审视这些东西。
And so it's interesting.
这很有趣。
There's a lot to do to try to figure out if that's true.
要弄清楚这是否属实，还有很多工作要做。
And I can say that as it stands right now, we don't know if that statement is true.
我可以说，就目前情况而言，我们不知道这种说法是否属实。
Right?
正确的？
There's a lot more work that needs to happen for that statement to be proven to be true.
要证明该声明的真实性，还需要做更多的工作。
But the hypothesis is, if it is true, then it's very likely that this will be seen as a breakthrough because it allows you to do these sorts of things that you can't do with normal waking consciousness.
但假设是，如果这是真的，那么这很可能会被视为一个突破，因为它允许你做这些在正常清醒意识下无法做的事情。
But also why we have to really think about this and these drugs can't be recreational drugs.
但也是为什么我们必须真正考虑这一点，这些药物不能是娱乐性药物。
They really shouldn't be recreational drugs.
它们确实不应该是消遣性药物。
Right?
正确的？
They're really too powerful to be used in the context of recreation because they can put you into these states.
它们确实太强大了，无法在娱乐环境中使用，因为它们可以让你进入这些状态。
And this generation of psychedelic researchers are really clear about that.
这一代迷幻研究人员对此非常清楚。
I think the '60s folks were not clear about that, and they felt like there was this whole cultural thing that was going on there.
我认为 60 年代的人们对此并不清楚，他们觉得那里正在发生整个文化事件。
But I think this cohort of individuals really understands that in order to really make this happen, we have to understand that if you need a prescription for an SSRI, which doesn't change your consciousness a whole lot, and we're very worried about that, and the doctor has to evaluate you for that every week.
但我认为这群人真正明白，为了真正实现这一目标，我们必须明白，如果你需要 SSRI 处方，这不会完全改变你的意识，我们对此非常担心，医生必须每周对你进行评估。
That the idea that some of these substances would go outside of very strict medical supervision is kind of preposterous, actually.
事实上，认为其中一些物质会不受非常严格的医疗监督的想法有点荒谬。
It's a dumb moment, I think, for all of medicine to say, "Look, if we're going to do this right, we've got to do it in such a way that's so protected, that's so safe that we make sure people know these things are not recreational, and they're really for the pure purposes of really powerfully changing cognition for a while and letting people have these," what seem to be relatively therapeutic states.
我认为，对于所有医学界来说，这是一个愚蠢的时刻，“看，如果我们要做正确的事情，我们就必须以一种如此受保护、如此安全的方式来做这件事，以至于我们确保人们知道这些东西不是娱乐性的，它们实际上是为了在一段时间内真正有效地改变认知并让人们拥有这些东西，”这似乎是相对治疗的状态。
Andrew Huberman:
安德鲁·休伯曼：
I think it's great that you're doing this study.
我认为你正在进行这项研究非常棒。
And along the lines of the early iterations of psychedelics and the counterculture of the '60s and '70s, some of which took place, like "One Flew Over the Cuckoo's Nest," I think is actually-
沿着迷幻剂的早期迭代和 60 年代和 70 年代的反主流文化，其中一些发生过，比如《飞越疯人院》，我认为实际上是——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
based on the Menlo Park VA, which is-
基于门洛帕克弗吉尼亚州，它是-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
in our neighborhood of Stanford.
在我们斯坦福大学附近。
And things are quite a bit different now.
现在情况已经有点不同了。
I know you and I have spent some time with the operators and former operators at an event on last Veterans Day, in fact, the so-called Veteran Solutions Group that's pioneering a lot of these psychedelic treatments for former special operators and current special operators.
我知道你和我在去年退伍军人节的一次活动中与操作员和前操作员一起度过了一些时间，事实上，所谓的退伍军人解决方案小组正在为前特种操作员和现任特种操作员开创许多此类迷幻疗法。
And what's interesting to me about that is in contrast to the counterculture movement of the '60s and '70s, that room was filled with people that are very much of a structure, the military.
对我来说有趣的是，与 60 年代和 70 年代的反主流文化运动形成鲜明对比的是，那个房间里挤满了非常有结构的人，即军人。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Right?
对吗？
So it's no longer considered left wing, right wing, anti-military, pro-military.
所以它不再被认为是左翼、右翼、反军事、亲军事。
Here, this is just but one group of people who's exploring psychedelics as a treatment for trauma and PTSD and other things.
在这里，这只是一群人正在探索迷幻药作为创伤、创伤后应激障碍和其他疾病的治疗方法。
And of course, you also have other domains of society looking at this.
当然，社会的其他领域也在关注这个问题。
And in fact, it was really interesting because there were both far left and far right politicians at that event-
事实上，这真的很有趣，因为那次活动中既有极左翼政治家，也有极右翼政治家——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
up on stage together-
一起上台——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
talking about, in lighter terms, heart medicine, but also talking about neurobiology.
通俗地说，我们谈论心脏医学，也谈论神经生物学。
It was just fascinating from the perspective of somebody who's trying to learn about this stuff, that psychedelic therapies no longer sit within the anti-establishment realm.
从试图了解这些东西的人的角度来看，迷幻疗法不再属于反体制领域，这真是令人着迷。
It's independent of all that, certainly when people in the military are adopting it as a potential treatment.
它独立于所有这些，当然当军队中的人们将其作为一种潜在的治疗方法时。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Absolutely.
绝对的。
Andrew Huberman:
安德鲁·休伯曼：
Again, still under exploration, but also under exploration at universities like Stanford and Johns Hopkins and UCSF-
同样，仍在探索中，而且斯坦福大学、约翰霍普金斯大学和加州大学旧金山分校等大学也在探索中——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
and University College London, and on and on.
和伦敦大学学院等等。
Along the lines of tree barks and toad skins, tell me about ayahuasca.
沿着树皮和蟾蜍皮的线条，告诉我关于死藤水的事。
And as a plant, it's intriguing.
作为一种植物，它很有趣。
And is it a pro-serotonergic drug like psilocybin?
它是像裸盖菇素一样的促血清素药物吗？
And is it useful for the same sorts of conditions that we've talked about thus far?
它对于我们迄今为止讨论过的同类情况有用吗？
And if you could perhaps tell me a little bit also about the Brazilian prisoner study.
如果您能告诉我一些关于巴西囚犯研究的信息吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Definitely.
确实。
Ayahuasca is another psychedelic.
死藤水是另一种迷幻剂。
It's used as a sacrament in Brazil and in Peru and Ecuador and Colombia, so a lot of the South American countries.
它在巴西、秘鲁、厄瓜多尔和哥伦比亚以及许多南美国家被用作圣礼。
And what they do is they combine Two plants together where one plant of the two-plant combination would effectively do nothing, but the two-plant combination together is capable of producing this very profound psychedelic effect.
他们所做的是将两种植物结合在一起，两种植物组合中的一种植物实际上什么也不做，但两种植物组合在一起能够产生这种非常深刻的迷幻效果。
And what's really kind of curious is that there are, as I understand it, 10,000 to 20,000 plant species in the Amazon.
真正令人好奇的是，据我了解，亚马逊地区有 10,000 到 20,000 种植物。
And somehow somebody-
不知怎的，有人——
Andrew Huberman:
安德鲁·休伯曼：
Someone tried them all.
有人尝试了所有这些。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
combined these two plants together in certain proportionality and cooked this for five, 10 hours to the point where you cook out the dimethyltryptamine out of one of the plants and cook out the reversible monoamine oxidase inhibitor out of the other plant in such a way that the reversible monoamine oxidase inhibitor prevents the GI breakdown of the dimethyltryptamine in such a way that it's then allowed to cross the blood-brain barrier and get into the brain.
将这两种植物按一定比例混合在一起，煮五到十个小时，直到从其中一种植物中煮出二甲基色胺，并从另一种植物中煮出可逆单胺氧化酶抑制剂，这样可逆单胺氧化酶抑制剂可以防止二甲基色胺在胃肠道中分解，从而使其穿过血脑屏障并进入大脑。
And if you didn't add the reversible monoamine oxidase inhibitor plant-derived into this combination, then it would never cross the brain.
如果你没有将植物来源的可逆单胺氧化酶抑制剂添加到这种组合中，那么它永远不会穿过大脑。
If you put people on a standard psychiatry-prescribed monoamine oxidase inhibitor that wasn't reversible, you'd throw them into serotonin syndrome, right?
如果你让人们服用标准的精神病学规定的不可逆的单胺氧化酶抑制剂，你就会让他们陷入血清素综合症，对吗？
So this kind of sweet spot that somehow ayahuasca practitioners have found of being able to get DMT into the brain from an oral source with this combination of a monoamine oxidase inhibitor is curious.
因此，死藤水练习者以某种方式发现能够将 DMT 与单胺氧化酶抑制剂的组合从口服来源进入大脑的这种最佳点令人好奇。
And so that substance has been explored as an antidepressant agent, and some studies have looked at that.
因此，这种物质已被探索作为抗抑郁剂，一些研究也对此进行了研究。
It also seems to be very safe.
看起来也很安全。
There's a psychiatrist down at UCLA Harbor who's done a lot of work with this, where he's looked at children even that have been exposed to small doses of ayahuasca as a kind of a sacrament within Amazonian tribes, and found no neurocognitive effects, no neurocognitive effects in adults.
加州大学洛杉矶分校港口分校的一位精神科医生在这方面做了很多工作，他观察了那些接触过小剂量死藤水作为亚马逊部落圣礼的儿童，结果发现没有神经认知效应，成年人也没有神经认知效应。
And so it appears to be safe.
所以它看起来是安全的。
It's kind of part and brought into various religions, including kind of merged with Catholicism in South America, which is very interesting.
它是不同宗教的一部分，包括与南美天主教的融合，这非常有趣。
And so, in some sects of Catholicism in Brazil, it's used as sacrament during religious ceremonies.
因此，在巴西天主教的一些教派中，它在宗教仪式中被用作圣礼。
And so it became interesting to Brazilian researchers as to whether or not they could affect recidivism rates for prisoners in Brazilian prisons, right?
因此，巴西研究人员对它们是否会影响巴西监狱中囚犯的累犯率变得很感兴趣，对吗？
And so they gave half of the prisoners some sort of inert substance and half of the prisoners an ayahuasca session.
因此，他们给一半的囚犯注射了某种惰性物质，给一半的囚犯注射了死藤水。
And the recidivism rate or the return to prison rate in the ayahuasca-exposed individuals was statistically significantly lower than the recidivism rate in the control group, suggesting that whatever is going on there seems to have an effect on whatever drives criminal behavior, whatever criminal behavior that happened to be.
而且，接触死藤水的人的累犯率或重返监狱率在统计上显着低于对照组的累犯率，这表明那里发生的任何事情似乎都会对驱动犯罪行为的因素产生影响，无论发生的犯罪行为是什么。
And I don't have the details on the exact nature of the crime.
我不知道犯罪的具体性质的细节。
I am also in no way saying that we should just be giving psychedelics to folks in prison and all of that.
我也绝不是说我们应该给监狱里的人服用迷幻药等等。
I think that is a very edgy thing to do and probably not something that anybody should try.
我认为这是一件非常前卫的事情，可能不适合任何人尝试。
But it does kind of bring up this curious question of what is it about that that would drive people to change those behaviors and why do people make those behavioral decisions?
但这确实提出了一个奇怪的问题：是什么促使人们改变这些行为以及人们为什么做出这些行为决定？
And a lot of times, if you look at prisons in the United States, people say this, what's the biggest mental health facility in the United States?
很多时候，如果你看看美国的监狱，人们会说，美国最大的精神卫生设施是什么？
It's a prison.
这是一座监狱。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, there's a lot to unpack there, for sure.
是的，当然有很多东西需要解压。
The homeless issue, the prison issue, it does lead to something that I heard recently, which is related to all this, which is cannabis.
无家可归的问题，监狱的问题，确实导致了我最近听到的一个事情，它与这一切有关，那就是大麻。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
We hear a lot nowadays about people will say, "Well, it's safer than alcohol." And we did an episode on alcohol that, at least by my read of the literature, indeed, alcohol does seem to be quite bad for our health beyond-
如今，我们经常听到人们说：“嗯，它比酒精更安全。”我们做了一集关于酒精的节目，至少从我读到的文献来看，确实，酒精似乎对我们的健康非常有害，除了——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, yeah
哦，是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
I think and it's pretty clear that not drinking is better for your health than drinking at all.
我认为，很明显，不喝酒比完全喝酒更有利于健康。
And here I'm not trying to tell people what to do, but those are what the data say, and forget the studies on red wine.
在这里，我并不是想告诉人们该怎么做，但这些都是数据所说的，忘记对红酒的研究吧。
You'd have to drink so much red wine to get enough resveratrol.
你必须喝很多红酒才能获得足够的白藜芦醇。
It's not even clear resveratrol does anything useful anyway-
甚至还不清楚白藜芦醇有什么用处-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
et cetera, et cetera.
等等，等等。
Nonetheless, cannabis is now available in a lot of very high potency forms.
尽管如此，大麻现在有许多非常高效的形式。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
People are vaping cannabis.
人们正在吸食大麻。
People are smoking cannabis.
人们正在吸食大麻。
I certainly am not saying that cannabis is bad for people necessarily, although I think children, I would hope that their brain development would be completed first.
我当然不是说大麻一定对人不好，虽然我认为孩子们，我希望他们的大脑发育首先完成。
Get to age 25.
到了25岁。
I know that sounds late-
我知道这听起来很晚-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
for a lot of people, but the THC obviously taps into some endogenous systems of endocannabinoid systems and is powerful.
对于很多人来说，但 THC 显然利用了内源性大麻素系统的一些内源性系统，并且功能强大。
And I've seen this report that was in Lancet Psychiatry this last year that said that early use of potent cannabis, meaning age 14 to 20 or so, can potentially lead to an exacerbation of psychosis-
我去年在《柳叶刀精神病学》上看到过一份报告，其中指出，过早使用强效大麻（即 14 岁至 20 岁左右）可能会导致精神病恶化——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
later in life.
在以后的生活中。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And I actually put this out on social media, and it sort of exploded.
我实际上把这个发布到了社交媒体上，然后就爆炸了。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I didn't expect it to.
我没想到会这样。
And people were saying, "Well, that's not causal," and obviously it's not causal, because people say, "Well, maybe people with psychotic tendencies are seeking out cannabis." Although that's sort of a weak argument in the sense that there's at least a 4x increase in these psychotic episodes-
人们说，“好吧，这不是因果关系”，显然这不是因果关系，因为人们说，“好吧，也许有精神病倾向的人正在寻找大麻。”尽管从某种意义上来说，这是一个站不住脚的论据，因为这些精神病发作至少增加了 4 倍——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
for people later in life.
对于以后的生活的人。
But what are your thoughts about cannabis?
但您对大麻有何看法？
Because I do want to acknowledge that it does have medical benefits for certain things.
因为我确实想承认它确实对某些事情有医疗益处。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Pain, chemotherapy.
疼痛，化疗。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So by no means trying to knock on cannabis in its appropriate medicinal use.
因此，绝不要试图阻止大麻的适当药用用途。
But what should we Think about cannabis in terms of this finding that it can exacerbate a psychosis in certain individuals.
但是，鉴于大麻会加剧某些人的精神病这一发现，我们应该如何看待大麻呢？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So there's a couple of things, right?
所以有几件事，对吧？
So cannabis is multiple cannabinoids, right?
那么大麻是多种大麻素，对吗？
As you-
正如你——
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
THC, CBD, CBN-
THC、CBD、CBN-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
sativas and indicas.
苜蓿和籼稻。
Yeah, there's a lot there to unpack.
是的，有很多东西需要解压。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
There are two main kind of chemicals you think about and how things are essentially bred, right?
您会想到两种主要的化学物质以及它们本质上是如何培育的，对吗？
And so, there's a lot of cannabis that's really bred to be very high, very potent THC, and there's cannabis where the THC is bred completely out.
因此，有很多大麻确实被培育成含有非常高、非常有效的 THC，而有些大麻则完全不含 THC。
So there's stories from Colorado, right, this strain of cannabis that's THC-free.
所以有来自科罗拉多州的故事，对吧，这种大麻品种不含四氢大麻酚。
There's no THC at all, and it's all CBD.
根本没有 THC，全是 CBD。
It's called Charlotte's Web.
它的名字叫夏洛特的网。
And a bunch of kids' parents, one kid, and then kind of a string of parents after that, moved to Colorado when cannabis was legalized because CBD is anti-epileptic.
当大麻合法化时，一群孩子的父母，一个孩子，然后是一系列父母搬到了科罗拉多州，因为 CBD 具有抗癫痫作用。
So CBD is also anti-psychotic, and so there have been a number of studies that if you give CBD at high doses, it's anti-psychotic in established schizophrenic patients.
因此 CBD 也具有抗精神病作用，因此有许多研究表明，如果给予高剂量的 CBD，它对既定的精神分裂症患者具有抗精神病作用。
The issue is that we've bred CBD out of marijuana selectively over time.
问题是，随着时间的推移，我们有选择地从大麻中培育出 CBD。
We've gotten very good at figuring out how to do that, right?
我们已经非常擅长弄清楚如何做到这一点，对吗？
Conversely, THC is pro-psychotic and pro-epileptic.
相反，THC 具有促精神病和促癫痫的作用。
Right?
正确的？
And so when you talk about does cannabis cause psychosis or does cannabis treat psychosis, it appears to be more related to the proportions of CBD to THC than it does to the idea of cannabis.
因此，当您谈论大麻是否会导致精神病或大麻是否可以治疗精神病时，它似乎与 CBD 与 THC 的比例关系更大，而不是与大麻的概念相关。
So for me, and I have no stock in this or anything like that, but there's a company called GW Pharmaceuticals, and I haven't looked into them in a while, but they have a lot of clinical trials for something called Dravet syndrome, which is a seizure disorder where kids seize a whole lot, Lennox-Gastaut syndrome, which is a seizure disorder where kids are seizing 300 times a day.
所以对我来说，我没有这个或类似的股票，但是有一家叫做 GW Pharmaceuticals 的公司，我已经有一段时间没有研究过他们了，但是他们有很多关于 Dravet 综合征的临床试验，这是一种孩子们会癫痫发作很多次的癫痫症，Lennox-Gastaut 综合征是一种孩子们每天癫痫发作 300 次的癫痫症。
Both of these are like kids are seizing so much, they're basically in a seizure or in the postictal phase constantly.
这两种情况都像是孩子癫痫发作太多，他们基本上处于癫痫发作或持续处于发作后阶段。
Andrew Huberman:
安德鲁·休伯曼：
Mm.
嗯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And they've failed everything.
他们一切都失败了。
They've failed barbiturates, they've failed bromides, which we just don't use anymore except in these cases because of the side effects, and they'll give kids CBD, and I think CBD is a pretty safe drug compared to bromide, right?
他们已经失败了巴比妥类药物，他们已经失败了溴化物，除了在这些情况下，我们只是因为副作用而不再使用它们，他们会给孩子们 CBD，我认为 CBD 与溴化物相比是一种非常安全的药物，对吗？
And so this idea that CBD in a kid is actually safe, it's a cannabinoid, but it's CBD and it's safe, right?
因此，认为儿童中的 CBD 实际上是安全的，它是一种大麻素，但它是 CBD 并且是安全的，对吗？
And so that to me is totally fine.
所以这对我来说完全没问题。
Also, giving CBD as an adjunctive treatment for schizophrenia, there have been some positive trials and negative trials in that, but there seems to be no negative side effects.
此外，将 CBD 作为精神分裂症的辅助治疗，已经有一些积极的试验和消极的试验，但似乎没有负面副作用。
It seems to reduce some of the metabolic syndrome issues in folks with schizophrenia who are having side effects from the primary antipsychotic.
它似乎可以减少患有主要抗精神病药物副作用的精神分裂症患者的一些代谢综合征问题。
The converse is there's clearly cases where people that are taking very high doses of THC become psychotic.
相反，在某些情况下，服用高剂量 THC 的人显然会变得精神病。
They get put into the psychiatric unit.
他们被送进精神病院。
Nothing happens other than they get the THC out of their system, and then they resolve their psychosis, right?
除了他们将 THC 从他们的系统中清除，然后他们解决了他们的精神病之外，什么也没有发生，对吗？
And a handful of people have had seizures related to high doses of THC, and syncope, and all sorts of things.
少数人曾因高剂量四氢大麻酚而出现癫痫发作、晕厥等症状。
And so this idea that high doses of THC can be pro-psychotic is also not taking a shot at people that think that cannabis overall is a good thing.
因此，高剂量的四氢大麻酚可能会导致精神病的想法也并没有对那些认为大麻总体上是件好事的人产生影响。
It just is what it is.
它就是这样。
I think if you zoom back and you say you're a true naturalist, you're thinking about natural medicines in the world, you should think, well, probably marijuana was balanced THC, CBD at some point, and then we humans messed with it.
我认为，如果你回过头来，你说你是一个真正的博物学家，你在思考世界上的天然药物，你应该想，好吧，大麻可能在某个时候是平衡的 THC、CBD，然后我们人类就把它搞乱了。
Right?
正确的？
And that most likely that was probably okay at some level, and then we pushed it one way or another.
这很可能在某种程度上是可以接受的，然后我们以某种方式推动它。
And what I mean by okay is in a 45-year-old, it's okay kind of thing.
我所说的“还好”是指对于 45 岁的人来说，“还好”之类的事情。
Now, what I think is going on with the kids, with the teenagers, is you've got prefrontal maturation, right?
现在，我认为孩子们、青少年们的前额叶已经成熟了，对吗？
And then you're exposing them to a whole lot of high THC load.
然后你将它们暴露在大量高 THC 负荷下。
And while it's unclear if it's cause or effect, it's certainly in the picture.
虽然尚不清楚这是因果关系，但它肯定在图片中。
And if I were a parent, I wouldn't want my 16-year-old smoking marijuana.
如果我是一名家长，我不会希望我 16 岁的孩子吸食大麻。
If I were a parent and my 30-year-old, otherwise healthy, totally fine, whatever, banker, lawyer kid decided to try marijuana for the first time, I wouldn't scold them about it, right?
如果我是一名家长，我 30 岁，其他方面都很健康，完全没问题，不管怎样，银行家、律师孩子决定第一次尝试大麻，我不会为此责骂他们，对吧？
So I think it's a different thing, right?
所以我认为这是另一回事，对吧？
I would never want my up to 25-year-old, just like you're saying, before prefrontal maturation, I would never want my kid to be exposed at all.
我永远不希望我的孩子在25岁之前，就像你说的，在前额叶成熟之前，我永远不希望我的孩子暴露在外。
But it looks like except in susceptible individuals that are susceptible to drug-induced psychosis, it looks like it's a relatively safe thing past prefrontal maturation.
但看起来，除了易受药物引起的精神病的易感人群之外，在前额叶成熟之后，这似乎是相对安全的事情。
Again, I'm not going to comment of cause and effect-
再说一次，我不会评论因果关系-
Andrew Huberman:
安德鲁·休伯曼：
Sure
当然可以
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
but I would say that if you're a parent, it doesn't make much sense, right?
但我想说，如果你是父母，那就没有多大意义了，对吧？
You never know what's ultimately going to hurt your kid.
你永远不知道什么最终会伤害你的孩子。
We were talking about this earlier.
我们之前讨论过这个。
My wife's pregnant now.
我妻子现在怀孕了。
She kind of avoids everything, right?
她有点回避一切，对吧？
And rightfully so, right?
这是理所当然的，对吧？
This idea that we want to be careful when our children's brains are developing, and I think that's really what you were saying, and I think actually important.
当我们孩子的大脑发育时，我们要小心，我认为这确实是你所说的，我认为这非常重要。
The bigger question that you asked, which is relative risks of drugs, is an interesting one.
您问的更大问题是药物的相对风险，这是一个有趣的问题。
So David Nutt published in, I think it was in "The Lancet." I'll have to look it up, but I think in "The Lancet" An article about relative drug risks for the person and for society, and he was on the UK's British drug policy group, where essentially what he showed was if you look at societal risk plus personal risk, and you combine those two, you know what drug is the most dangerous drug in the world?
大卫·纳特（David Nutt）发表在《柳叶刀》上。我得查一下，但我认为《柳叶刀》中有一篇关于个人和社会相对药物风险的文章，他是英国药物政策小组的成员，他所展示的基本上是，如果你看看社会风险加上个人风险，然后将这两者结合起来，你知道哪种药物是世界上最危险的药物吗？
Andrew Huberman:
安德鲁·休伯曼：
I'm going to guess it's alcohol.
我猜是酒精。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It's alcohol.
这是酒精。
Right behind heroin and cocaine, and da, da, da, and somewhere in the middle is marijuana, and right on the tail end, on the exact other end of this, psilocybin.
就在海洛因和可卡因之后，还有 da，da，da，中间的某个地方是大麻，而在尾端，在它的另一端，是裸盖菇素。
Andrew Huberman:
安德鲁·休伯曼：
Is caffeine...
咖啡因吗...
It usually doesn't make the list.
它通常不会出现在列表中。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It may have been on the list.
它可能已经在名单上了。
If it was, it was probably pretty close to psilocybin, but somewhere in the middle was ketamine, somewhere in the middle was amphetamine.
如果是的话，它可能非常接近裸盖菇素，但中间的某个地方是氯胺酮，中间的某个地方是安非他明。
A little closer to psilocybin, I think it was MDMA.
有点接近裸盖菇素，我认为它是摇头丸。
But it's this combined personal world risk of these things.
但这是这些事情的综合个人世界风险。
And so alcohol makes it because there's a huge amount of personal risk and there's a huge amount of societal risk.
所以酒精之所以会出现，是因为存在巨大的个人风险和巨大的社会风险。
Drunk drivers kill X amount of people in the world.
醉酒司机杀死了世界上X数量的人。
Andrew Huberman:
安德鲁·休伯曼：
Fights, sexual assaults.
打架、性侵犯。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
All that.
所有这些。
Andrew Huberman:
安德鲁·休伯曼：
All that.
所有这些。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
And then all the cancer and all that stuff.
然后是所有的癌症和所有这些东西。
And so it beats out cocaine, it beats out heroin, it beats out all of these things.
所以它打败了可卡因，它打败了海洛因，它打败了所有这些东西。
And yet, for whatever reason, we don't as a culture see it as a drug.
然而，无论出于何种原因，我们作为一种文化并不将其视为药物。
And that's the part that really baffles me.
这才是真正让我困惑的部分。
And I'm going to-
我要-
Andrew Huberman:
安德鲁·休伯曼：
They serve it.
他们服务它。
This is no knock on Stanford at all, of course I wouldn't do that.
这根本不是对斯坦福大学的攻击，我当然不会这样做。
At every institution I've been to, they serve alcohol at the graduate student events.
在我去过的每一个机构，他们都会在研究生活动中提供酒精饮料。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
They serve alcohol.
他们提供酒精饮料。
They do a happy hour.
他们度过了欢乐时光。
I've never been a drinker.
我从来不喝酒。
I can take it or leave it.
我可以接受也可以离开。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, same.
是的，一样。
Andrew Huberman:
安德鲁·休伯曼：
And I realize that some people, they really enjoy alcohol.
我意识到有些人真的很喜欢喝酒。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
My former partner, she just was in that 10% or so of people who have a glass of wine and just feel great.
我以前的伴侣，她就是那 10% 左右的人，喝了一杯酒就感觉很棒。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And the second one, feel great.
第二个，感觉很棒。
I just want to take a nap after I have a bit of alcohol.
我只是想喝点酒后小睡一会儿。
So it never does much for me.
所以它对我来说从来没有多大作用。
I always feel poisoned.
我总感觉中毒了。
I feel lucky in that sense.
从这个意义上说，我感到很幸运。
But it's unbelievable that it is so prevalent, and it's baked into even medical institutions.
但令人难以置信的是，它如此普遍，甚至被纳入医疗机构。
They'll pop a bottle of champagne to celebrate the opening of a hospital.
他们会开一瓶香槟庆祝医院开业。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
It's pretty crazy.
这太疯狂了。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
No, you're absolutely right.
不，你说得完全正确。
I think what's going to happen, but this is me looking at a crystal ball a little bit, but I think what's going to happen is what happened with doctors and smoking.
我认为将会发生什么，但这只是我在看一个水晶球，但我认为将会发生的是医生和吸烟所发生的事情。
So if you look at the '50s and '60s, there are all these pictures of doctors smoking cigarettes-
所以如果你看看 50 年代和 60 年代，就会发现所有这些医生抽烟的照片——
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
with patients, or psychiatrists doing psychotherapy and smoking a cigarette with the patient sitting on the couch.
与病人在一起，或者精神科医生在病人坐在沙发上进行心理治疗并抽烟。
Surgeons smoking a cigarette in between cases.
外科医生在手术间隙抽烟。
There are all these pictures of that.
有所有这些照片。
And now all of a sudden, smoking's totally banned.
现在突然之间，吸烟完全被禁止了。
I think it's totally banned from most of Stanford campus.
我认为斯坦福大学校园的大部分地区都完全禁止这样做。
My suspicion is, as you're suggesting, this is everywhere and it's all ubiquitous.
我的怀疑是，正如你所暗示的，这种情况无处不在，而且无处不在。
At some critical point, some tipping point, everybody's going to realize that just like with smoking, we've got to rid hospital systems and universities of alcohol.
在某个关键时刻，某个转折点，每个人都会意识到，就像吸烟一样，我们必须消除医院系统和大学中的酒精。
And at some point in 50 years, it's my view that we'll look back at these scenarios that you're talking about and be like, "You know what?
在 50 年后的某个时刻，我认为我们会回顾你所谈论的这些场景，然后说：“你知道吗？
We were foolish about this.
我们在这件事上很愚蠢。
I can't believe that we gave people alcohol when they graduated from whatever." And I think we'll have a different take on it, but it's going to take a longer time.
我不敢相信当人们从任何学校毕业时我们都会给他们喝酒。”我认为我们对此会有不同的看法，但这需要更长的时间。
I think people did a really good job tying smoking to lung cancer, and it's a very simplistic story.
我认为人们在将吸烟与肺癌联系起来方面做得非常好，而且这是一个非常简单的故事。
Smoking, lung cancer.
吸烟，肺癌。
Now, as you know, alcohol increases the risk of a lot of different cancers.
现在，如您所知，酒精会增加许多不同癌症的风险。
Not so clear which one.
不太清楚是哪一个。
There's the throat, tongue cancer, that's one.
有喉咙癌、舌癌，就是其中之一。
Andrew Huberman:
安德鲁·休伯曼：
Breast cancer.
乳腺癌。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Breast cancer.
乳腺癌。
And so it's a harder story to tell, and I think that's why...
所以这是一个更难讲的故事，我想这就是为什么......
And then there's this whole, my mom says this.
然后就是整个过程，我妈妈是这么说的。
It's like, "I drink my glass of wine because my doctor told me it was heart healthy." And we were talking about this.
就像，“我喝了一杯酒，因为我的医生告诉我，它有益于心脏健康。”我们正在谈论这个。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And I try to, "No, no, no, but Dr. So-and-so said it's heart healthy." And so it ends up being this thing where she's drinking alcohol because she thinks that it's good for her heart.
我试着说，“不，不，不，但是某某医生说这对心脏健康有益。”所以最终她喝酒是因为她认为这对她的心脏有好处。
And it's hard.
这很难。
I've had those conversations with her.
我和她有过这样的谈话。
It's hard to untie that, and I think that at some point, we're going to hit some threshold moment, and it'll be interesting if we really look at the data and we really look at what's safe and not safe purely from this analysis, it points to the right direction.
很难解开这一点，我认为在某些时候，我们将达到某个阈值时刻，如果我们真正查看数据，并且纯粹从这种分析中真正了解什么是安全的，什么是不安全的，那将会很有趣，它指出了正确的方向。
Andrew Huberman:
安德鲁·休伯曼：
It's really interesting.
这真的很有趣。
And also, to say nothing of poor judgment under the influence of alcohol.
而且，更不用说在酒精的影响下判断力差了。
I would venture that if we were to remove alcohol from university campuses, watch, the students are going to lobby against me if I say this, but-
我敢说，如果我们要在大学校园里禁止饮酒，注意，如果我这么说，学生们就会游说反对我，但是——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, that's fair
是的，这很公平
Andrew Huberman:
安德鲁·休伯曼：
...
...
if you were to remove alcohol from campuses, just think about what I suspect would be the improvement in good decision-making-
如果你要从校园中消除酒精，想想我怀疑会改善良好的决策-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, yeah
哦，是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
that would occur.
那将会发生。
Or I've got stories from graduate school, and it was very different 10 years ago.
或者我有研究生院的故事，十年前情况非常不同。
There was a lot more alcohol consumption.
饮酒量增加了很多。
Again, that was never my thing, but I know people who made really bad decisions.
再说一遍，这从来都不是我的事，但我知道有人做出了非常错误的决定。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
In any case, there's a whole landscape there emerging.
无论如何，那里已经出现了整个景观。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I think you got your finger right on the pulse of it.
我想你已经掌握了它的脉搏。
I want to touch on something slightly different than what we've been talking about, but definitely related to depression.
我想谈一些与我们一直在谈论的内容略有不同的事情，但肯定与抑郁症有关。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And this, again, is one of these intriguing but perplexing things, which is that sleep deprivation-
这又是这些有趣但令人困惑的事情之一，那就是睡眠剥夺——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
can improve symptoms of depression.
可以改善抑郁症状。
And yet, I'm personally very familiar with the fact that if I don't sleep well for one night, or don't sleep at all, in fact, I do have an ability to function pretty well the next day.
然而，我个人非常熟悉这样一个事实：如果我一晚睡不好，或者根本不睡，事实上，我第二天确实有能力很好地工作。
I'll do this non-sleep deep rest practice that I blab a lot about on the Huberman Lab podcast, which for me is tremendously restorative.
我将进行这种非睡眠深度休息练习，我在 Huberman 实验室播客上对此进行了很多讨论，这对我来说具有极大的恢复作用。
But I like a good night's sleep.
但我喜欢睡个好觉。
I think everybody understands now, thanks to the great work of Matthew Walker and others that have really gotten out into the world saying, "Look, the foundation of mental health, physical health, and high performance," if that's your thing, being a functional human being, is to try and get enough quality deep sleep at least 80% of the nights of your life, if you can.
我想现在每个人都明白了，感谢马修·沃克和其他真正走向世界的人所做的伟大工作，他们说：“看，心理健康、身体健康和高绩效的基础”，如果这就是你的职责，作为一个正常的人类，那就是尝试并在你生命中至少 80% 的夜晚获得足够的高质量深度睡眠（如果可以的话）。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That's something to focus on, just like good nutrition-
这是需要关注的事情，就像良好的营养一样——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
just like exercise and social connection, et cetera.
就像锻炼和社交联系等等。
So sleep deprivation, we know can, in particular, I think rapid eye movement components of sleep deprivation can improve the symptoms of depression, and yet, being sleep-deprived can also really dysregulate our control of the autonomic system.
因此，我们知道睡眠剥夺可以，特别是我认为睡眠剥夺的快速眼动成分可以改善抑郁症的症状，然而，睡眠剥夺也确实会扰乱我们对自主系统的控制。
I notice on night two or night three of poor sleep, if I'm going through a stressful phase and that's happening, all of a sudden my heart rate is chronically elevated.
我注意到在睡眠质量不佳的第二晚或第三晚，如果我正在经历一个压力很大的阶段并且这种情况正在发生，我的心率会突然长期升高。
My thought patterns become really disrupted.
我的思维模式真的被打乱了。
I can't then exercise.
那我就不能运动了。
My decision-making is thrown off.
我的决策被打乱了。
My emotionality is more labile.
我的情绪比较不稳定。
The hinge, as we were referring to it earlier, feels less under my control, and maybe I wonder sometimes if I enter that state that you referred to earlier where the dorsolateral prefrontal cortex is no longer leading the cingulate, but the cingulate is now in charge.
正如我们之前提到的，铰链感觉不太受我的控制，也许我有时想知道我是否进入了你之前提到的那种状态，即背外侧前额叶皮层不再领导扣带皮层，但扣带皮层现在负责。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
The players are in charge of the coach.
球员对教练负责。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Oh, yeah.
哦，是的。
Andrew Huberman:
安德鲁·休伯曼：
Not a good situation.
情况不太好。
So I know you've done some work on sleep deprivation and light and effects.
所以我知道你在睡眠剥夺、光线和影响方面做了一些工作。
Please tell us about that and please tell us about this triple therapy.
请告诉我们这一点，并请告诉我们有关这种三联疗法的信息。
Is that-
难道是——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
So a friend of mine, Greg Salem, one of the professors at Stanford, is very interested in sleep.
我的一位朋友、斯坦福大学教授格雷格·塞勒姆（Greg Salem）对睡眠非常感兴趣。
He did a bunch of training in sleep before he went to medical school and got very interested in this idea that, as you're saying, if you sleep deprive somebody one night, in just kind of an isolated single night, at the end of that sleep deprivation, they will have an antidepressant effect, but as soon as they fall asleep, they lose it.
在去医学院之前，他做了很多睡眠方面的训练，并对这个想法非常感兴趣，正如你所说，如果你在一个晚上剥夺某人的睡眠，在一个孤立的单一晚上，在睡眠剥夺结束时，他们会产生抗抑郁作用，但一旦他们入睡，他们就会失去这种作用。
So if it's a depressed individual, you can get them to be less depressed acutely.
因此，如果这是一个抑郁的人，你可以让他们的抑郁程度减轻。
As soon as they fall asleep, they wake up eight hours later, then they come back into the same level of depression.
他们一入睡，八小时后就会醒来，然后又回到同样程度的抑郁状态。
And so the idea was that you needed to do some sort of circadian reset, and that part of what depression is, is that it's a dysregulated circadian system.
所以我们的想法是你需要进行某种昼夜节律重置，而抑郁症的部分原因是它是一个失调的昼夜节律系统。
And so mentors of mine say if you can just get the sleep better, that's half the battle of dealing with depression because so many people have insomnia around depression and have a whole host of types of insomnia.
所以我的导师说，如果你能睡得更好，那就是应对抑郁症的成功的一半，因为很多人都因抑郁症而失眠，并且有各种各样的失眠类型。
Having a hard time falling asleep, waking up in the middle of the night, and waking up early are all symptoms of depression.
入睡困难、半夜醒来、早醒等都是抑郁症的症状。
And so what this does is it sleep deprives the individual, and then there's a certain calculation of shifting their phase and simultaneously exposing them to bright light.
所以这样做的作用是剥夺个体的睡眠，然后进行一定的计算来改变他们的相位并同时将他们暴露在强光下。
So that's the triple, the phase shift, the sleep deprivation, and the bright light to try to get their circadian rhythm.
这就是三重因素：相移、睡眠剥夺和强光，以试图控制他们的昼夜节律。
Essentially, the theory is reentrained.
本质上，该理论被重新引入。
And so in the trials that we've done and other trials prior to ours and after, it looked like there was a pretty profound antidepressant effect from this triple therapy that seemed to be durable, meaning durability is this term we use to say that not only can you get point relief, but that the relief ends up lasting.
因此，在我们所做的试验以及之前和之后的其他试验中，这种三重疗法似乎具有相当深远的抗抑郁作用，而且似乎是持久的，这意味着持久性是我们用来说的术语，不仅可以得到点缓解，而且这种缓解最终会持续。
What's important to know about this is you shouldn't do this at home, for sure.
重要的是要知道你不应该在家里这样做，这是肯定的。
You would need to do this with a professional because it's complicated.
您需要由专业人士来完成此操作，因为它很复杂。
It's not just one thing.
这不仅仅是一件事。
And in sleep deprivation, while it seems to be antidepressant, it's pro-anxiety.
在睡眠不足方面，虽然它似乎具有抗抑郁作用，但它却会加剧焦虑。
So if you take a highly anxious person that's not depressed and you sleep deprive them, they get profoundly anxious.
因此，如果你带一个高度焦虑但并不抑郁的人，而你剥夺了他们的睡眠，他们就会变得非常焦虑。
And so that's the other thing that you have to really realize is that this is like everything else that I've talked about today, all things that you have to do under medical supervision, but curious, right?
所以，你必须真正意识到的另一件事是，这就像我今天谈论的其他所有事情一样，所有你必须在医疗监督下做的事情，但很好奇，对吧？
And I think the question that always comes up is why isn't this used more?
我认为经常出现的问题是为什么它没有被更多地使用？
And I think the reason is that there's not really a mechanism for...
我认为原因是没有真正的机制......
Ultimately, in medicine, as sad as it is, you have to have a code to do a thing.
最终，在医学上，尽管令人悲伤，你必须有一个代码才能做一件事。
There has to be a code associated with a treatment, and it's hard to figure out how to make a code for this.
必须有一个与治疗相关的代码，但很难弄清楚如何为此编写代码。
And so I think that's part of it.
所以我认为这是其中的一部分。
And so if there's a way, and somebody's got to take that baton on that, but if there's a way to make a code for this, I think you could actually turn it into something that was more widely utilized, and probably dream up ways of how to integrate AI, passive sensing, all that stuff to really make that work.
因此，如果有办法，并且必须有人接过接力棒，但如果有办法为此编写代码，我认为您实际上可以将其变成更广泛使用的东西，并且可能会想出如何集成人工智能、被动传感等所有东西的方法，以真正使其发挥作用。
But I think that would be the idea.
但我认为这就是想法。
That would be the trajectory I'd see.
这就是我所看到的轨迹。
So yeah.
所以是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Having a billable to insurance code is fundamental.
拥有可计费的保险代码是基础。
And a lot of listeners of this podcast, I think, have a background in engineering science, and we will put a link to that manuscript-
我认为这个播客的很多听众都有工程科学背景，我们将放置一个指向该手稿的链接 -
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
that talks about the triple therapy, because here we're talking about one night sleep deprivation, some timed light exposure to the eyes, and then shifting the circadian clock, things central to the themes of the podcast that come up often.
那谈到了三重疗法，因为在这里我们谈论的是一晚睡眠不足，对眼睛进行定时光照，然后改变生物钟，这些都是经常出现的播客主题的核心。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I think for the typical person, can we say that trying to get a regular light-dark cycle and sleep rhythm would be beneficial for overall mood regulation?
我认为对于典型的人来说，我们是否可以说尝试获得规律的明暗周期和睡眠节奏对整体情绪调节有益？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
I think for the typical person, really reregulating your sleep and trying to get a good night's sleep in which you fall asleep, stay asleep, wake up at a set time every morning is going to be pretty crucial.
我认为对于一般人来说，真正重新调节你的睡眠并努力获得良好的睡眠，让你入睡、保持睡眠、每天早上在设定的时间醒来将是非常重要的。
In mild depression, I think that one has a lot of control over that, as we were talking about earlier.
在轻度抑郁症中，我认为人们对此有很大的控制力，正如我们之前讨论的那样。
I think when you hit some threshold in depression where things become semi-volitional, it's harder to will yourself into that.
我认为，当你达到抑郁症的某个阈值时，事情就会变得半自愿，你就很难让自己陷入困境。
There are therapies.
有治疗方法。
There's a CBT for insomnia, for instance, where you can do cognitive behavioral therapy to help with insomnia.
例如，有针对失眠的认知行为疗法，您可以进行认知行为疗法来帮助治疗失眠。
Sometimes people...
有时人们...
And I'm no sleep expert.
我不是睡眠专家。
I pass this to Greg to fully talk about this.
我将其传递给格雷格以充分讨论这一点。
But some of what goes on that people with milder insomnia ...
但失眠程度较轻的人会发生一些事情......
experiences like blue light out of their computer and things like that.
诸如电脑发出蓝光之类的体验。
So you can use blue light blockers.
所以你可以使用蓝光阻滞剂。
As you know better than me, it tricks your brain to think that it's still light outside.
正如你比我更了解的那样，它会欺骗你的大脑，让你认为外面仍然很亮。
And so people will still have insomnia because their brain still thinks that it's light outside.
所以人们仍然会失眠，因为他们的大脑仍然认为外面是光的。
And then people will, the kind of strict CBT for sleep, therapists will say there are only two things that you should do in your bed, and if you're under a certain age and whatnot, it's really one thing that you should do in your bed, which is to sleep and and be with your partner.
然后人们会，对睡眠进行严格的CBT，治疗师会说你只应该在床上做两件事，如果你低于一定年龄等等，那么你实际上应该在床上做一件事，那就是睡觉和与你的伴侣在一起。
And so those are the two things that you should do in a bedroom, and that's really the only things that you should do in a bedroom if you're having sleep problems.
因此，这是您应该在卧室里做的两件事，如果您有睡眠问题，这确实是您应该在卧室里做的唯一事情。
You shouldn't watch TV in a bedroom, you shouldn't eat in a bedroom, you shouldn't hang out.
你不应该在卧室里看电视，你不应该在卧室里吃饭，你不应该出去玩。
Andrew Huberman:
安德鲁·休伯曼：
Keep the phone out of the bedroom.
将手机放在卧室外面。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Keep the phone out of the bedroom, yeah.
把手机放在卧室外面，是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
We should get Greg Salem on the podcast.
我们应该让格雷格·塞勒姆加入播客。
I'll just mention for people that want to regulate their sleep, we have a sleep toolkit that's available as a downloadable PDF at hubermanlab.com.
我只想向那些想要调节睡眠的人提一下，我们有一个睡眠工具包，可以在 hubermanlab.com 上下载 PDF 版本。
Just go to the menu.
只需进入菜单即可。
And a lot of the things in that toolkit are based on work from Stanford Sleep Laboratories, including Jamie Zeitzer's and others' lab.
该工具包中的很多内容都基于斯坦福睡眠实验室的工作，包括 Jamie Zeitzer 和其他人的实验室。
Not aimed at depression specifically.
并非专门针对抑郁症。
Listen, Nolan, Dr. Williams, this has been an amazing voyage through the circuitry of autonomic control.
听着，诺兰，威廉姆斯博士，这是一次穿越自主控制电路的奇妙旅程。
This landscape of the prefrontal cortex is I find incredibly fascinating, and I just want to start off by saying please do come back again-
我发现前额叶皮层的景观非常迷人，我只想说，请再次回来-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, I'll do
哦，我会做
Andrew Huberman:
安德鲁·休伯曼：
...
...
and teach us more about that and your TMS work.
并告诉我们更多有关此内容以及您的 TMS 工作的信息。
Before we wrap, however, I do want to give you the opportunity to talk about the SAINT study.
然而，在结束之前，我确实想给您一个机会来谈谈 SAINT 研究。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, definitely.
是的，绝对是。
Andrew Huberman:
安德鲁·休伯曼：
Is it SAINT or SAINTS plural?
SAINT 或 SAINTS 是复数吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah, it's SAINT.
是的，这是圣人。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So, SAINT, or what we're calling it SNT now.
所以，SAINT，或者我们现在所说的 SNT。
SAINT, the intent was not to connect it to religion, but we may have accidentally done so, and so we abbreviated it to SNT for the subsequent trials, which was initially Stanford Accelerated Intelligent Neuromodulation Therapy, or now what we're calling Stanford Neuromodulation Therapy.
SAINT，本意不是要把它和宗教联系起来，但我们可能不小心这么做了，所以我们把它缩写为SNT，用于后续的试验，最初是斯坦福加速智能神经调节疗法，或者现在我们所说的斯坦福神经调节疗法。
But the idea there, which is a cool idea, is that TMS is a device that delivers a treatment, and the treatment is the protocol, and the protocol is the stimulation parameter set in a specific brain region for a specific condition.
但那里的想法很酷，TMS 是一种提供治疗的设备，而治疗就是协议，而协议就是针对特定条件在特定大脑区域设置的刺激参数。
And so what's cool about neuromodulation, whether it be transcranial magnetic stimulation or transcranial direct current stimulation or deep brain stimulation, like what Casey Halpern talked about on another podcast, is this idea that in all of those cases, the device itself is a physical layer conduit of a stimulation protocol that's therapeutic for a given condition in a given brain region.
因此，神经调节的最酷之处在于，无论是经颅磁刺激、经颅直流电刺激还是深部脑刺激，就像 Casey Halpern 在另一个播客中谈到的那样，在所有这些情况下，设备本身都是刺激方案的物理层管道，可以治疗特定大脑区域的特定条件。
And so in the case of depression, which we know the most about with TMS, we've been doing TMS studies for depression since 1995.
因此，就抑郁症而言，我们对 TMS 最了解，自 1995 年以来，我们一直在进行抑郁症的 TMS 研究。
And a clearance in 2008, 2009.
并于2008年、2009年清关。
And in that timeframe, we were able to go from really knowing very little at all about how to do something like this to getting an FDA clearance.
在那个时间范围内，我们能够从对如何做这样的事情一无所知到获得 FDA 的许可。
And the way that it went down was that there were two groups studying different components at NIH.
结果是，美国国立卫生研究院有两个小组研究不同的成分。
The first group was studying mood neuroanatomy on functional imaging.
第一组正在研究功能成像的情绪神经解剖学。
That was kind of the first generation of functional imaging back then, so PET scans, which are metabolic scans, and then SPECT scans.
这就是当时的第一代功能成像，即 PET 扫描，即代谢扫描，然后是 SPECT 扫描。
And the idea there was looking at activity and metabolism in prefrontal cortex.
这个想法是研究前额皮质的活动和新陈代谢。
And what they found in these more crude scans is a just general hypoactivity, hypometabolism.
他们在这些更粗略的扫描中发现的是普遍的活动减退和代谢减退。
The other group, right upstairs at the National Institute for Neurological Diseases and Stroke, NINDS, they were looking at using TMS, which had been around for 10 years, and repetitively stimulating in motor cortex.
另一组就在国家神经疾病和中风研究所 (NINDS) 的楼上，他们正在研究使用已经存在 10 年的 TMS，并重复刺激运动皮层。
And what they found was, gosh, we can get a readout in thumb muscle movement amplitude that's really reproducible across people.
他们发现，天哪，我们可以获得拇指肌肉运动幅度的读数，这在人与人之间确实可以重现。
It's universally reproducible.
它是普遍可复制的。
And if we do certain stimulation approaches, they are biologically active to either increase excitability, i.e., the thumb motion on a set intensity goes up, the amount of amplitude goes up, or inhibitory or depotentiating, it goes down with other biological stimulation approaches.
如果我们采用某些刺激方法，它们具有生物活性，可以增加兴奋性，即设定强度下的拇指运动增加，振幅量增加，或者抑制或减弱，它会随着其他生物刺激方法而下降。
And then a third outcome, which is important, that it's inert.
然后是第三个结果，这很重要，它是惰性的。
It doesn't do either.
这也不起作用。
So you can have stimulation approaches that do one, increase activity, decrease activity, or are inert.
因此，你可以采取刺激方法来实现这一目的，增加活动、减少活动或惰性。
And so what they found was, oh, we can excite certain brain regions.
所以他们发现，哦，我们可以兴奋某些大脑区域。
And then my mentor, Mark George, had this kind of aha moment where he said, "Wow, there's underactivity in prefrontal cortex in depression, and we can increase activity using this thing that we know we can increase activity in motor cortex.
然后我的导师马克·乔治突然恍然大悟，他说：“哇，抑郁症患者的前额叶皮层活动不足，我们可以使用我们知道可以增加运动皮层活动的东西来增加活动。
We just need to put it in the left dorsolateral prefrontal cortex." And then they combined the two and started stimulating once a day in this very abbreviated fashion.
我们只需要把它放在左背外侧前额皮质中。”然后他们将两者结合起来，开始以这种非常简短的方式每天进行一次刺激。
And lo and behold, some of those depression patients resolved their depression.
你瞧，有些抑郁症患者的抑郁症得到了缓解。
And back then, and still today, you can go in as a psychiatric patient, stay at the National Institute of Mental Health, and go through clinical trials to try to get treated.
无论是在当时还是今天，你都可以作为一名精神病患者进入国家心理健康研究所，并通过临床试验来尝试接受治疗。
And there were patients who'd been there for months, and they were able to be discharged-
还有一些病人已经在那里呆了几个月了，他们能够出院了——
Andrew Huberman:
安德鲁·休伯曼：
Incredible
难以置信
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
because their mood was better.
因为他们的心情更好了。
Yeah.
是的。
And so it was just this very crude approach where they were using ruler measurements where DLPFC was, and they were stimulating with devices that you needed to physically dunk the coil in an ice bath.
因此，这只是一种非常粗略的方法，他们使用尺子测量 DLPFC 所在的位置，并且使用将线圈物理浸入冰浴中所需的设备进行刺激。
And with that, they still were able to, the kind of genius of this, and Mark and others, still be able to create a purely engineered stimulation approach What's cool about that is that they kind of found two things.
有了这个，他们仍然能够，这种天才，以及马克和其他人，仍然能够创造出一种纯粹工程化的刺激方法，最酷的是他们发现了两件事。
They found this one stimulation protocol.
他们发现了这一刺激方案。
It does have some antidepressant effect.
它确实有一定的抗抑郁作用。
It's limited.
这是有限的。
It doesn't treat everybody.
它并不对待所有人。
It does have some antidepressant effect, and this bigger concept that a neuromodulation device is like a pharmaceutical company for you.
它确实有一定的抗抑郁作用，而这个更大的概念是神经调节装置对你来说就像一家制药公司。
That in a given individual, a TMS device or whatever neuromodulation device is able to generate, you can create a stimulation approach that is specific to a given condition and specific to an individual.
对于给定的个体，TMS 设备或任何神经调节设备能够生成，您可以创建针对给定条件和个体的刺激方法。
And so the physical layer is just how you exert that, similarly to how we make pharmaceutical drugs in a pharmaceutical company, but the actual therapy itself is what you do, where you do it.
因此，物理层就是您发挥作用的方式，类似于我们在制药公司生产药品的方式，但实际的治疗本身就是您所做的事情、在哪里做。
And so what we learned from another 20, 30 years of this is that you can modify the stimulation protocol in such a way where you can create a whole new treatment and put it through the same TMS device.
因此，我们从另外 20、30 年中学到的是，您可以修改刺激方案，从而创建全新的治疗方法并将其通过相同的 TMS 设备。
Or, thank God, an evolved version of it where you don't have to dunk it in ice baths, and it can actually really handle much more aggressive stimulation approaches.
或者，感谢上帝，它是它的进化版本，你不必将它浸入冰浴中，而且它实际上可以处理更具攻击性的刺激方法。
And so in 2005, a group published in "Neuron" a paper demonstrating that if you stimulate with the hippocampal rhythms through a TMS coil, you can excite the brain with memory rhythms, and it'll last an hour.
因此，2005年，一个小组在《神经元》上发表了一篇论文，证明如果通过TMS线圈刺激海马节律，就可以用记忆节律激发大脑，而且会持续一个小时。
So you can change cortical excitability in this thumb twitch for an hour, sending three minutes of excitatory or 40 seconds in the case of inhibitory stimulation that mimics the hippocampal rhythms.
因此，您可以通过拇指抽动一小时来改变皮质的兴奋性，发送三分钟的兴奋性或 40 秒的模拟海马节律的抑制性刺激。
So much more efficient than the original TMS approaches.
比原来的 TMS 方法高效得多。
And so after that group tried to do it in this kind of six-week schedule.
因此，在那之后，该小组尝试按照这种六周的时间表进行这项工作。
And after that, and while they were doing that, we decided, gosh, this problem I talked about at the beginning of the show where you have this problem that we don't have a treatment for people who are in these high acuity psychiatric emergency states.
之后，当他们这样做时，我们决定，天哪，我在节目开始时谈到的这个问题，你有这个问题，我们没有为处于这些高度严重的精神紧急状态的人提供治疗。
This idea that we're going to engineer a treatment where we can reorganize the stimulation approach in time to be much more efficient by utilizing something called space learning theory.
这个想法是，我们将设计一种治疗方法，通过利用空间学习理论，我们可以及时重组刺激方法，使其更加有效。
And so you probably know about the space learning theory.
所以你可能知道空间学习理论。
The idea for the viewers is it's a simple psychological thing, but we've also seen it in hippocampal slice sort of physiology too, where if I'm cramming for a test, what I do is I write out 60 note cards, and I read each one for a minute until I get to the first note card again, and that's about an hour later.
观众的想法是，这是一个简单的心理问题，但我们也在海马切片的生理学中看到了它，如果我为了考试而死记硬背，我所做的就是写下 60 张记事卡，然后我读每张记事卡一分钟，直到我再次读到第一张记事卡，大约一个小时后。
And we just intuitively do this.
我们只是凭直觉这样做。
We all automatically do that.
我们都会自动这样做。
And we intuit that because we know that what doesn't work is writing out one note card and looking at it over and over again.
我们凭直觉知道这一点，因为我们知道写一张便条卡并一遍又一遍地查看是行不通的。
Nobody ever does that.
从来没有人这样做过。
We've all been in graduate school, medical school, and we have these big stacks of note cards.
我们都读过研究生院、医学院，我们都有一大堆记事卡。
That's space learning theory.
这就是空间学习理论。
It's this idea that you need to see it about every hour to an hour and a half, and that optimizes learning.
正是这个想法，你需要大约每小时到一个半小时看一次，这可以优化学习。
If you take the same stimulation approach that I'm talking about, this theta burst stimulation approach, and you take a hippocampal slice of a mouse and you stimulate, you enlarge some dendritic spines and you prime some.
如果你采用与我所说的相同的刺激方法，即θ爆发刺激方法，你取出小鼠的海马切片并进行刺激，你会扩大一些树突棘并启动一些。
And then if you stimulate right after that, you don't get any change.
如果你在那之后立即刺激，你不会得到任何变化。
It's called en masse stimulation.
这就是所谓的集体刺激。
But if you wait about an hour to an hour and a half, you get more dendritic spines enlarged and more primed.
但如果你等待大约一个小时到一个半小时，你就会看到更多的树突棘变大，并且更加活跃。
Which by the way, also is what ketamine does.
顺便说一句，这也是氯胺酮的作用。
It causes this dendritic spine enlargement.
它导致树突棘增大。
And so what we found was is that the old way of doing TMS, this idea of just doing it once a day, every day, five days a week for six weeks, didn't utilize the space learning theory.
所以我们发现，做 TMS 的旧方法，这种每天做一次、每天做一次、每周做五天、持续六周的想法，并没有利用空间学习理论。
It's like studying for a month or two just a little bit once a day.
这就像学习一两个月，每天学习一点点。
You remember some of that stuff, but it's not as potent as that week where you're kind of cramming.
你记得其中一些东西，但它不如你临时抱佛脚那一周那么有效。
And what we realized is that if we could reorganize the stimulation in times, that we took the whole six-week course, we actually figured out a way to do it in a day.
我们意识到，如果我们能够及时重新组织刺激，我们完成了整个六周的课程，我们实际上就找到了一种在一天内完成的方法。
And then what we also figured out is that people were underdosing TMS because if you just keep going after six weeks out to month three, four, five, more and more people got better.
然后我们还发现，人们服用 TMS 的剂量不足，因为如果你在六周后继续坚持到第三、四、五个月，越来越多的人会好起来。
So we figured out it's not just one day.
所以我们发现这不仅仅是一天。
We're going to give five times the normal dose.
我们将给予正常剂量的五倍。
We're going to give seven and a half months worth in five days using space learning theory.
我们将利用空间学习理论在五天内提供七个半月的时间。
Andrew Huberman:
安德鲁·休伯曼：
So every hour?
那么每小时？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Every hour for 10 hours.
每小时一次，持续10小时。
Andrew Huberman:
安德鲁·休伯曼：
For five days.
为期五天。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
For five days.
为期五天。
So it's a 50-hour block.
所以这是一个 50 小时的区块。
It's 90 minutes of actual stimulation, but spread out through the day in the same way of learning, which is perfect for an inpatient psychiatric unit, right?
这是 90 分钟的实际刺激，但以同样的学习方式分散在一天中，这对于住院精神病科来说是完美的，对吗？
Andrew Huberman:
安德鲁·休伯曼：
Five days is manageable.
五天是可以应付的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
Then you can get stimulation.
然后你就能得到刺激。
Nobody's ever dropped out by the schedule.
从来没有人按计划退学过。
Folks that want to do this want to do it.
想要这样做的人都想这样做。
So they'll do their nine minutes.
所以他们会完成九分钟的比赛。
They'll go get breakfast.
他们去吃早餐。
They'll do their nine minutes.
他们会完成九分钟的比赛。
They'll go see their therapist or whatever it is.
他们会去看治疗师或其他什么人。
And so what we found with this reorganization in time of the stimulation dose, and then the third component is we do resting state functional connectivity scans on everybody, and we have ways now in the last five, 10 years of picking out that specific subgenual DLPFC subcircuit that I was talking about earlier, that cingulate DLPFC.
因此，我们通过刺激剂量时的重组发现，第三个组成部分是我们对每个人进行静息态功能连接扫描，在过去的五年、十年中，我们现在有办法找出我之前谈到的特定膝下 DLPFC 子电路，即扣带回 DLPFC。
We can pick that out in every single one.
我们可以在每一件作品中挑出这一点。
If you want to come to the lab, we can find your DLPFC subgenual.
如果您想来实验室，我们可以找到您的 DLPFC 膝下区域。
It's even more robust than non-depressed-
它比非抑郁症还要坚强——
Andrew Huberman:
安德鲁·休伯曼：
Maybe we can stimulate too, just while we're in there.
也许我们也可以刺激一下，就在我们在那里的时候。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Yeah.
是的。
If you want to, we can move around your hypnotizability.
如果你愿意，我们可以改变你的催眠能力。
And we can find that spot in each person.
我们可以在每个人身上找到这个位置。
Instead of finding the same spot on the skull, we find the same spot on the brain, and we can stimulate, and we do that every hour on the hour.
我们不是在头骨上寻找相同的点，而是在大脑上找到相同的点，然后我们可以进行刺激，而且我们每小时都这样做。
And what we have found is that folks will within one to five days, in more cases than not, and depending upon if you're looking at this open label or in trials, somewhere between 60 and 90% of the time, they will go into full-on remission in the sense they're totally normal from a mood standpoint at the end of this.
我们发现，人们会在一到五天内，在更多的情况下，取决于你是否正在考虑这个开放标签或试验，在 60% 到 90% 的时间里，他们会进入完全缓解，从某种意义上说，从情绪的角度来看，他们在结束时是完全正常的。
And like I said, with variable durability.
就像我说的，具有可变的耐用性。
So that's the part we have to figure out now about dosing and how to keep people well.
这就是我们现在必须弄清楚的有关剂量以及如何保持人们健康的部分。
But for some people, we've had four years of remission, a year of remission, and it's really that cramming of the test.
但对于某些人来说，我们已经缓解了四年，缓解了一年，这确实是临时抱佛脚的测试。
It's really that idea that you're laying in that information in the exact right spot, and the signal is a simple signal, but it's a profound one, which is turn on, stay on, remember to stay on.
这确实是这样的想法，即您将信息放置在正确的位置，并且该信号是一个简单的信号，但它是一个深刻的信号，即打开，保持打开，记住保持打开。
That idea that you're sending this memory signal into the brain, and you're doing it in such a way that you're telling the system, you're taking it out of your own hippocampus' hand, and you're sending the same signal the hippocampus normally signals out.
这个想法是，你将这个记忆信号发送到大脑中，你的方式是告诉系统，你将它从你自己的海马体手中取出，并且你发送的信号与海马体通常发出的信号相同。
Now you're sending that signal into the prefrontal cortex and kind of utilizing the brain's own communication style to get it to get out of the state.
现在，您将该信号发送到前额皮质，并利用大脑自身的通信方式使其摆脱该状态。
And what's very cool about this is that people, when they exit out of that, they end up saying they don't have any side effects from it, and they feel back to normal.
最酷的是，当人们摆脱这种状态时，他们最终会说他们没有任何副作用，并且感觉恢复了正常。
Some people, not everybody, but there's a subsection of people with SSRIs where they'll say, "I kind of feel numb," or, "I have GI side effects," or, "I don't have the sexual interest that I used to have," and that sort of thing.
有些人，不是所有人，但有一小部分服用 SSRI 的人会说，“我有点麻木”，或者“我有胃肠道副作用”，或者“我没有以前的性兴趣”，诸如此类的话。
Not anything against SSRIs, as I said earlier, life-saving.
正如我之前所说，SSRIs 可以挽救生命，这并不是什么反对的事情。
For a subsection of people, these things really work.
对于一小部分人来说，这些东西确实有效。
But with this, what you see is that people don't talk about any of that stuff.
但通过这个，你会看到人们不会谈论任何这些东西。
And I think it's likely because you're tapping into that core circuitry and you're reversing it, and you're doing it with a magnet that because it's a very profound electromagnet, it's the same field strength as an MRI scanner, it's able to induce a current in the brain in this focal targeted way without getting into the rest of the brain, without getting into the rest of the body at all, and just really kind of acting only on that circuitry that's involved.
我认为这可能是因为你正在利用核心电路并反转它，并且你正在使用磁铁来做到这一点，因为它是一个非常深的电磁体，它的场强与 MRI 扫描仪相同，它能够以这种焦点目标方式在大脑中感应出电流，而不会进入大脑的其他部分，根本不会进入身体的其他部分，并且只是真正只作用于所涉及的电路。
Andrew Huberman:
安德鲁·休伯曼：
Incredible.
难以置信。
Is the SAINT study still ongoing?
SAINT 研究仍在进行中吗？
And if people are interested in potentially being patients or subjects in the study, can we provide them a portal link?
如果人们有兴趣成为研究中的患者或受试者，我们可以为他们提供门户链接吗？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Absolutely, yeah.
绝对是的。
So we have now the treatment.
所以我们现在有了治疗方法。
Some of my students went over to a company called Magnus Medical, and they've been working on this.
我的一些学生去了一家名为 Magnus Medical 的公司，他们一直在从事这方面的工作。
They've got an FDA clearance now, and now folks can get it through trials over the next couple of years because it's going to take some time for that company to get up and running and get a device and get the whole thing set up nationally.
他们现在已经获得了 FDA 的许可，现在人们可以在未来几年内通过试验，因为该公司需要一些时间才能启动和运行、获得设备并在全国范围内建立整个系统。
But while that's all going on, there's still about 1,000 patients that need to be recruited across a bunch of different trials all over the country.
但尽管这一切都在进行，全国各地仍有大约 1,000 名患者需要在一系列不同的试验中招募。
We'll take people from anywhere in the country.
我们将从全国任何地方带走人们。
We also have partners in New York and San Diego and soon to be South Carolina and other places where my lab can help to let people know where to go based off of where they're at in the US and get them access to being able to be in a trial.
我们在纽约和圣地亚哥也有合作伙伴，很快就会在南卡罗来纳州和其他地方有合作伙伴，我的实验室可以帮助人们根据他们在美国的位置知道该去哪里，并让他们能够参加试验。
And what we've tried to do is make it so that even if you get the 50/50 chance you're going to get the real deal or you're going to get the non-real deal, but what we have figured out is a way to let everyone have access.
我们试图做的是，即使你有 50/50 的机会，你也会得到真正的交易，或者你会得到非真实的交易，但我们已经找到了一种让每个人都有机会获得的方法。
If they got the not real deal version, the kind of sham version or the fake version for the first part of the trial, there are other trials where they can have access to the real version.
如果他们在试用的第一部分获得了非真实版本、假版本或假版本，那么他们还可以在其他试用中获得真实版本。
So essentially everybody eventually gets access to having the real version, and so that's been a big thing for me is I want everybody that comes through one of our trials to be able to have access.
所以基本上每个人最终都能获得真正的版本，所以这对我来说是一件大事，我希望每个经历过我们试验的人都能够获得。
I think it's important while the company's doing what they're doing and what the lab's doing and nationally what other partner labs are doing.
我认为，当公司正在做他们正在做的事情、实验室正在做的事情以及全国范围内其他合作伙伴实验室正在做的事情时，这一点很重要。
Andrew Huberman:
安德鲁·休伯曼：
Well, I can assure you, you're going to get some interest.
好吧，我可以向你保证，你会得到一些兴趣。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Happy to have it, yeah.
很高兴拥有它，是的。
Andrew Huberman:
安德鲁·休伯曼：
Thank you.
谢谢你。
And listen, thank you so much for taking us on this incredible voyage through the neurocircuitry underlying certain aspects of depression, the coverage of the different types of depression, the various therapeutic compounds, how they work.
听着，非常感谢您带我们踏上这段令人难以置信的旅程，了解抑郁症某些方面背后的神经回路、不同类型抑郁症的覆盖范围、各种治疗化合物及其作用原理。
We've talked about a lot of things today, and you've shared so much knowledge.
今天我们讨论了很多事情，你也分享了很多知识。
And even as I say that, I very much want to have you back to talk about-
即使我这么说，我也非常想让你回来谈谈——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, cool
哦，酷
Andrew Huberman:
安德鲁·休伯曼：
...
...
many other things as well that we didn't have time to cover.
还有许多其他我们没有时间讨论的事情。
But also just really want to thank you for the work that you do.
但我也真的想感谢你所做的工作。
I know we are colleagues, but you run an enormous laboratory.
我知道我们是同事，但你经营着一个巨大的实验室。
Enormous in my book.
在我的书中是巨大的。
40 people is a big group, a very big group.
40个人是一个大团体，非常大的团体。
Plus, you're in the clinic.
另外，你在诊所。
You also have a life of your own outside of work.
工作之余，你也有自己的生活。
And to take the time to sit down with us and share all this knowledge that really is in service to mental health and humans feeling better and, in fact, avoiding often suicidal depression.
花时间与我们坐下来分享所有这些真正有助于心理健康和人类感觉更好的知识，事实上，避免经常自杀的抑郁症。
It's just incredible work and incredible generosity, and just thank you so much.
这是令人难以置信的工作和令人难以置信的慷慨，非常感谢你们。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Oh, thank you, man.
哦，谢谢你，伙计。
Similarly, I want to thank you for what you're doing.
同样，我要感谢你所做的事情。
I've got a lot of friends, folks that are not in the medical profession, friends of mine.
我有很多朋友，他们不是医学界的，也是我的朋友。
One of my buddies who's a real estate agent who works with us, who's a big fan of your show, and I told a couple people like that I was coming on, and they were super stoked.
我的一个朋友是一位与我们合作的房地产经纪人，他是你们节目的忠实粉丝，我告诉了几个这样的人我即将上场，他们非常兴奋。
They're like, "We watch every show," and super excited to watch mine.
他们就像是，“我们观看每场演出”，并且非常兴奋地观看我的节目。
And they said something very important to me that you make this complicated neuroscience and brain-body science accessible in a way that few have a gift to do, and I think that that's so important.
他们说了一些对我来说非常重要的话，那就是你以一种很少有人有天赋的方式使这种复杂的神经科学和脑体科学变得容易理解，我认为这非常重要。
And this show is doing so much to help with science literacy and, yeah, appreciate you, so.
这个节目在帮助提高科学素养方面做了很多工作，是的，非常感谢你。
Andrew Huberman:
安德鲁·休伯曼：
Well, thank you.
嗯，谢谢。
I'm gratified and honored by your statement, and I look forward to more.
我对您的发言感到高兴和荣幸，并期待更多。
Thank you.
谢谢。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Absolutely.
绝对的。
Thank you.
谢谢。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for joining me today for my discussion with Dr. Nolan Williams.
感谢您今天加入我与诺兰·威廉姆斯博士的讨论。
I hope you found our discussion about psychedelics and other compounds, about transcranial magnetic stimulation, and about the treatments for depression in general, to be as stimulating as I did.
我希望您发现我们关于致幻剂和其他化合物、经颅磁刺激以及一般抑郁症治疗的讨论和我一样令人兴奋。
If you'd like to learn more about the work being done in Dr. Williams' laboratory, you can go to the Brain Stimulation Laboratory website, which is bsl.stanford.edu, and there you have the opportunity to apply to be in one of the clinical trials for depression or other studies.
如果您想了解有关威廉姆斯博士实验室正在进行的工作的更多信息，您可以访问脑刺激实验室网站，即 bsl.stanford.edu，在那里您有机会申请参加一项抑郁症临床试验或其他研究。
As well, if you'd like to support the work being done in Dr. Williams' laboratory for the treatment of depression and other psychiatric disorders.
另外，如果您想支持威廉姆斯博士实验室正在开展的治疗抑郁症和其他精神疾病的工作。
If you're learning from and are enjoying the Huberman Lab podcast, please subscribe to our YouTube channel.
如果您正在学习并喜欢 Huberman Lab 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 Huberman Lab podcast on Spotify and Apple.
此外，请订阅 Spotify 和 Apple 上的 Huberman Lab 播客。
And on both Spotify and Apple, you also have the opportunity to leave us up to a five-star review.
在 Spotify 和 Apple 上，您还有机会给我们留下五星级的评价。
If you have questions for us or comments about the information we've covered or suggestions about future guests, please put those in the comments section on YouTube.
如果您对我们有任何疑问或对我们所报道的信息有意见或对未来嘉宾有建议，请在 YouTube 的评论部分中提出。
We do read all the comments.
我们确实阅读了所有评论。
Please also check out the sponsors mentioned at the beginning of today's episode.
另请查看今天节目开头提到的赞助商。
That's the best way to support the Huberman Lab podcast.
这是支持 Huberman 实验室播客的最佳方式。
Not so much today, but in many previous episodes of the Huberman Lab podcast, we talk about supplements.
今天不多，但在 Huberman Lab 播客的许多之前的剧集中，我们谈论了补充剂。
While supplements aren't necessary for everybody, many people derive tremendous benefit from them, for things like enhancing sleep and focus and hormone optimization.
虽然补充剂并不是每个人都需要的，但许多人从它们中获得了巨大的好处，例如增强睡眠和注意力以及优化荷尔蒙。
The Huberman Lab podcast has partnered with Momentous Supplements.
Huberman Lab 播客与 Momentous Supplements 合作。
If you'd like to see the supplements that the Huberman Lab podcast has partnered with Momentous on, you can go to livemomentous, spelled O-U-S, so livemomentous.com/huberman, and there you'll see a number of the supplements that we talk about regularly on the podcast.
如果您想查看 Huberman Lab 播客与 Momentous 合作的补充剂，您可以访问 livemomentous，拼写为 O-U-S，即 livemomentous.com/huberman，在那里您会看到我们在播客上经常讨论的一些补充剂。
I should just mention that that catalog of supplements is constantly being updated.
我只想提一下，补充剂目录正在不断更新。
As mentioned at the beginning of today's episode, the Huberman Lab podcast has now launched a premium channel.
正如今天节目开头提到的，胡伯曼实验室播客现已推出高级频道。
That premium channel will feature monthly AMAs or Ask Me Anythings, where I answer your questions in depth, as well as other premium resources.
该付费频道将提供每月 AMA 或“问我任何问题”，我将在其中深入回答您的问题，以及其他优质资源。
If you'd like to subscribe to the premium channel, you can simply go to hubermanlab.com/premium.
如果您想订阅高级频道，只需访问 hubermanlab.com/premium。
I should mention that the proceeds from the premium channel go to support the standard Huberman Lab podcast, which will continue to be released every Monday per usual, as well as supporting various research projects done on humans to create the sorts of tools for mental health, physical health, and performance that you hear about on the Huberman Lab podcast.
我应该提到的是，高级频道的收益将用于支持标准的 Huberman Lab 播客，该播客将继续每周一照常发布，并支持针对人类进行的各种研究项目，以创建您在 Huberman Lab 播客上听到的各种针对心理健康、身体健康和表现的工具。
Again, it's hubermanlab.com/premium to subscribe.
再次强调，可以通过 hubermanlab.com/premium 进行订阅。
It's $10 a month or $100 per year.
每月 10 美元或每年 100 美元。
If you haven't already subscribed to our zero-cost newsletter, we have what is called the Neural Network Newsletter.
如果您还没有订阅我们的零成本时事通讯，我们有所谓的神经网络时事通讯。
You can subscribe by going to hubermanlab.com, go to the menu, and click on Newsletter.
您可以通过访问 hubermanlab.com 进行订阅，进入菜单，然后单击新闻通讯。
Those newsletters include summaries of podcast episodes, lists of tools from the Huberman Lab podcast, and if you'd like to see previous newsletters we've released, you can also just go to hubermanlab.com, click on Newsletter in the menu, and you'll see various downloadable PDFs.
这些时事通讯包括播客剧集摘要、Huberman Lab 播客中的工具列表，如果您想查看我们之前发布的时事通讯，您也可以访问 hubermanlab.com，单击菜单中的时事通讯，您将看到各种可下载的 PDF。
If you want to sign up for the newsletter, we just ask for your email.
如果您想订阅时事通讯，我们只需提供您的电子邮件即可。
We do not share your email with anybody, and again, it's completely zero cost.
我们不会与任何人分享您的电子邮件，而且这完全是零成本。
If you're not already following me on social media, it's hubermanlab on Twitter, on Facebook, and on Instagram, and at all three of those places, I cover topics and subject matter that are sometimes overlapping with the information covered on the Huberman Lab podcast, but that's often distinct from information on the Huberman Lab podcast.
如果您还没有在社交媒体上关注我，请关注 Twitter、Facebook 和 Instagram 上的 hubermanlab，在所有这三个地方，我介绍的主题和主题有时与 Huberman Lab 播客中涵盖的信息重叠，但这通常与 Huberman Lab 播客上的信息不同。
Again, it's hubermanlab on all social media channels.
再说一遍，所有社交媒体渠道上都是 hubermanlab。
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。