Dr. Karl Deisseroth: Understanding & Healing the Mind
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。
Andrew Huberman:
安德鲁·休伯曼：
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 I have the pleasure of introducing the first guest of the Huberman Lab podcast.
今天我很荣幸地介绍休伯曼实验室播客的第一位嘉宾。
My guest is Dr. Karl Deisseroth.
我的客人是 Karl Deisseroth 博士。
Andrew Huberman:
安德鲁·休伯曼：
Dr. Karl Deisseroth is a medical doctor.
Karl Deisseroth 博士是一名医生。
He's a psychiatrist and a research scientist at Stanford School of Medicine.
他是斯坦福大学医学院的精神病学家和研究科学家。
In his clinical practice, he sees patients dealing with a range of nervous system disorders, including obsessive compulsive disorder, autism, attention deficit disorders, schizophrenia, mania, anxiety disorders and eating disorders.
在他的临床实践中，他看到患者患有一系列神经系统疾病，包括强迫症、自闭症、注意力缺陷障碍、精神分裂症、躁狂症、焦虑症和饮食失调。
Andrew Huberman:
安德鲁·休伯曼：
His laboratory develops and explores tools with which to understand how the nervous system works in the healthy situation, as well as in disorders of the mind.
他的实验室开发并探索了一些工具，用于了解神经系统在健康情况以及精神障碍情况下如何运作。
Andrew Huberman:
安德鲁·休伯曼：
Dr. Deisseroth's laboratory has pioneered the development and use of what are called channelopsins, proteins that come from algae, which can now be introduced to the nervous systems of animals and humans in order to precisely control the activity of neurons in the brain and body with the use of light.
Deisseroth 博士的实验室率先开发和使用了通道蛋白（一种来自藻类的蛋白质），现在可以将其引入动物和人类的神经系统，以便利用光精确控制大脑和身体神经元的活动。
Andrew Huberman:
安德鲁·休伯曼：
This is an absolutely transformative technology because whereas certain drug treatments can often relieve certain symptoms of disorders, they often carry various side effects.
这绝对是一项革命性的技术，因为虽然某些药物治疗通常可以缓解某些疾病的症状，但它们通常会带来各种副作用。
And in some individuals, often many individuals, these drug treatments simply do not work.
对于某些人（通常是许多人）来说，这些药物治疗根本不起作用。
Andrew Huberman:
安德鲁·休伯曼：
The channelopsins and their related technologies stand to transform the way that we treat psychiatric illness, and various disorders of movement and perception.
通道视蛋白及其相关技术将改变我们治疗精神疾病以及各种运动和感知障碍的方式。
In fact, just recently the channelopsins were applied in a human patient to allow an adult, fully blind human being to see light for the very first time.
事实上，就在最近，通道视蛋白被应用于人类患者，使完全失明的成年人第一次看到了光。
Andrew Huberman:
安德鲁·休伯曼：
We also discuss Dr. Deisseroth newly released book, which is entitled "Projections, a Story of Human Emotions." This is an absolutely remarkable book that uses stories about his interactions with his patients to teach you how the brain works in the healthy and disease state and also reveals the motivation for, and discovery of, these channelopsins in other technologies by Karl's laboratory that are being used now to treat various disorders of the nervous system, and that in the future are certain to transform the fields of psychiatry, mental health and health, in general.
我们还讨论了戴瑟罗斯博士新出版的书，书名为《投射，人类情感的故事》。这绝对是一本非凡的书，通过他与患者互动的故事来教你大脑在健康和疾病状态下如何工作，并揭示了卡尔实验室其他技术中这些通道蛋白的动机和发现，这些通道蛋白现在被用于治疗神经系统的各种疾病，并且在未来肯定会改变精神病学、心理健康和健康领域。
Andrew Huberman:
安德鲁·休伯曼：
I found our conversation to be an absolutely fascinating one about how the brain functions in the healthy state, and why and how it breaks down in disorders of the mind.
我发现我们的谈话绝对令人着迷，内容涉及大脑在健康状态下如何运作，以及大脑在精神障碍时为何以及如何崩溃。
Andrew Huberman:
安德鲁·休伯曼：
We also discuss the current status and future of psychedelic treatments for psychiatric illness, as well as for understanding how the brain works more generally.
我们还讨论了精神疾病迷幻治疗的现状和未来，以及了解大脑更普遍的运作方式。
We also discuss issues of consciousness, and we even delve into how somebody like Karl — who's managing a full-time clinical practice, and a 40-plus-person laboratory, and a family of five children and is happily married — how he organizes his internal landscape, his own thinking, in order to manage that immense workload and to progress forward for the sake of medicine and his pursuits in science.
我们还讨论意识问题，我们甚至深入研究像卡尔这样的人——他管理着一个全职临床诊所、一个 40 多人的实验室、一个有五个孩子的家庭，婚姻幸福——他如何组织自己的内部景观和自己的思维，以便管理巨大的工作量，并为了医学和他对科学的追求而进步。
Andrew Huberman:
安德鲁·休伯曼：
I found this to be an incredible conversation.
我发现这是一次令人难以置信的对话。
I learned so much.
我学到了很多。
I also learned through the course of reading Karl's book, "Projections," that not only is he an accomplished psychiatrist, and obviously an accomplished research scientist and a family man, but he's also a phenomenal writer.
通过阅读卡尔的书《预测》，我还了解到，他不仅是一位出色的精神病学家，显然也是一位出色的研究科学家和家庭男人，而且他还是一位杰出的作家。
"Projections" is absolutely masterfully written.
《预测》写得绝对精妙。
It's just beautiful and it's accessible to anybody, even if you don't have a science background.
它非常美丽，而且任何人都可以理解，即使您没有科学背景。
I hope that you'll enjoy my conversation with Karl Deisseroth as much as I did, and thank you for tuning in.
我希望您能像我一样喜欢我与 Karl Deisseroth 的谈话，并感谢您的收听。
Andrew Huberman:
安德鲁·休伯曼：
Before we begin, I want to point out that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想指出这个播客与我在斯坦福大学的教学和研究角色是分开的。
In my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public, I'd like to acknowledge the sponsors of today's podcast, and now my conversation with Dr. Karl Deisseroth.
我希望并努力向公众提供有关科学和科学相关工具的零成本信息，我要感谢今天播客的赞助商，以及我与 Karl Deisseroth 博士的对话。
Well, thanks for being here.
嗯，谢谢你来到这里。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Thanks for having me.
谢谢你有我。
Andrew Huberman:
安德鲁·休伯曼：
It's been a long time coming for me because you may not know this, but one of the reasons I started this podcast was actually so I could have this conversation.
对我来说已经等了很长时间了，因为你可能不知道这一点，但我开始这个播客的原因之一实际上是为了我可以进行这次对话。
There are other reasons, but one of the goals is to be able to hold conversations with colleagues of mine that are doing incredible work in the realm of science.
还有其他原因，但目标之一是能够与在科学领域做出令人难以置信的工作的同事进行对话。
And we also have this really special opportunity because you're also a clinician.
我们也有这个非常特殊的机会，因为您也是一名临床医生。
You see patients and have for a long time.
你看病人并且已经看病人很长时间了。
So for people that might not be so familiar with the fields of neuroscience, etcetera, what is the difference between neurology and psychiatry?
那么，对于那些可能不太熟悉神经科学等领域的人来说，神经病学和精神病学之间有什么区别？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, I'm married to a neurologist, and I am a psychiatrist, and we make fun of each other all the time.
嗯，我嫁给了一位神经科医生，我也是一位精神病医生，我们总是互相取笑。
A lot of neuroscientists and a lot of brain clinicians actually think these two should be the same field at some point in the future.
许多神经科学家和许多脑临床医生实际上认为这两个在未来的某个时候应该是同一领域。
They were in the past; they started together.
他们已经成为过去；他们一起开始。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Psychiatry focuses on disorders where we can't see something that's physically wrong, where we don't have a measurable, where there's no blood test that makes the diagnosis.
精神病学专注于我们看不到身体上的问题、无法测量、无法通过血液测试做出诊断的疾病。
There's no brain scan that tells us this is schizophrenia, this is depression, for an individual patient.
对于个别患者来说，没有任何脑部扫描可以告诉我们这是精神分裂症，这是抑郁症。
Psychiatry is much more mysterious, and the only tools we have are words.
精神病学要神秘得多，我们唯一拥有的工具就是语言。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Neurologists are fantastic physicians: they see the stroke on brain scans, they see the seizure and the pre-seizure activity with an EEG, and they can measure and treat based on those measureables.
神经科医生是出色的医生：他们通过脑部扫描看到中风，通过脑电图看到癫痫发作和癫痫发作前的活动，并且他们可以根据这些可测量的结果进行测量和治疗。
Karl Deisseroth:
卡尔·戴瑟罗斯：
In psychiatry, we have a harder job.
在精神病学领域，我们的工作更加艰巨。
We use words, we have rating scales for symptoms, we can measure depression and autism with rating scales, but those are words still.
我们使用文字，我们有症状评定量表，我们可以用评定量表来衡量抑郁症和自闭症，但这些仍然是文字。
And ultimately that's what psychiatry is built around.
最终，这就是精神病学的基础。
It's an odd situation because we've got the most complex, beautiful, mysterious, incredibly engineered object in the universe, and yet all we have are words to find our way in.
这是一个奇怪的情况，因为我们拥有宇宙中最复杂、最美丽、最神秘、最令人难以置信的工程物体，但我们所拥有的只是找到进入的方式的文字。
Andrew Huberman:
安德鲁·休伯曼：
Do you find that if a patient is very verbal or hyperverbal that you have an easier time diagnosing them, as opposed to somebody who's more quiet and reserved?
您是否发现，如果患者言语非常多或言语过多，您会比那些更安静和保守的患者更容易诊断他们？
Or I could imagine the opposite might be true as well?
或者我可以想象相反的情况也可能是正确的？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, because we only have words, you've put your finger on a key point.
好吧，因为我们只有文字，所以你已经指出了一个关键点。
If they don't speak that much, in principle, it's harder.
如果他们不说那么多，原则上，那就更难了。
The lack of speech can be a symptom.
缺乏言语可能是一种症状。
We can see that in depression.
我们可以在抑郁症中看到这一点。
We can see that in the negative symptoms of schizophrenia.
我们可以在精神分裂症的阴性症状中看到这一点。
We can see that in autism.
我们可以在自闭症中看到这一点。
Sometimes by itself, that is a symptom of reduced speech.
有时，这本身就是言语减少的症状。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But ultimately, you do need something.
但最终，你确实需要一些东西。
You need some words to help guide you, and that in fact, there's challenges that I can tell you about where patients with depression, who are so depressed they can't speak.
你需要一些话来帮助指导你，事实上，我可以告诉你抑郁症患者面临的挑战，他们抑郁得无法说话。
That makes it a bit of a challenge to distinguish depression from some of the other reasons they might not be speaking, and this is a sort of the art and the science of psychiatry.
这使得将抑郁症与他们可能不说话的其他一些原因区分开来有点困难，这是精神病学的一门艺术和一门科学。
Andrew Huberman:
安德鲁·休伯曼：
Do you find that there are patients that have comorbidities or conditions where they would land in both psychiatry and neurology, meaning there's damage to a particular area of the brain and therefore they're depressed?
您是否发现有些患者患有合并症或状况，他们会同时进入精神病学和神经病学，这意味着大脑的特定区域受到损害，因此他们感到抑郁？
And how do you tease that out as a psychiatrist?
作为一名精神科医生，你如何解决这个问题？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, this happens all the time.
是的，这种情况经常发生。
Parkinson's disease is a great example.
帕金森病就是一个很好的例子。
It can be debilitating in so many ways.
它可以在很多方面使人衰弱。
People have trouble moving, they have trouble walking, trouble swallowing, and they can have truly severe depression.
人们行动困难、行走困难、吞咽困难，并且可能患有真正严重的抑郁症。
Karl Deisseroth:
卡尔·戴瑟罗斯：
You might say, Oh, well, they've got a life-threatening illness.
你可能会说，哦，好吧，他们得了危及生命的疾病。
But there are plenty of neurological disorders where depression is not a strongly comorbid symptom, like ALS, Lou Gehrig's disease, for example.
但在许多神经系统疾病中，抑郁症并不是一种强烈的共病症状，例如肌萎缩侧索硬化症、卢伽雷氏病。
Depression is not a strongly comorbid in that disease.
抑郁症并不是该疾病的强烈共病。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But in Parkinson's, it is extremely common.
但在帕金森病中，这种情况极为常见。
And as you know, in Parkinson's disease, we have loss of the dopamine neurons in the midbrain, and this is a very specific population of cells that's dying.
如您所知，在帕金森病中，中脑中的多巴胺神经元缺失，这是一个正在死亡的非常特殊的细胞群。
And probably that leads to both the movement disorder and the depression.
这可能会导致运动障碍和抑郁症。
Karl Deisseroth:
卡尔·戴瑟罗斯：
There are many examples of that where these two fields come together and you really to need work as a team.
有很多例子表明这两个领域结合在一起，你确实需要团队合作。
I've had patients in my clinic that I treat the depression associated with their Parkinson's, and a neurologist treats the movement associated with the Parkinson's, and we work together.
我的诊所里有一些患者，我治疗与帕金森病相关的抑郁症，神经科医生治疗与帕金森病相关的运动，我们一起工作。
Andrew Huberman:
安德鲁·休伯曼：
Do you think we will you ever have a blood test for depression or schizophrenia or autism?
您认为我们会对您进行抑郁症、精神分裂症或自闭症的血液检查吗？
And would that be a good or a bad thing?
这是好事还是坏事？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I think ultimately there will be quantitative tests.
我认为最终会有定量测试。
Already efforts are being made to look at certain rhythms in the brain using external EEGs to look at brain waves effectively, look at the ratios of certain frequencies to other frequencies, and there's some progress being made on that front.
人们已经在努力使用外部脑电图来有效地观察脑电波，观察某些频率与其他频率的比率，以观察大脑中的某些节律，并且在这方面取得了一些进展。
It's not as good as it could be.
它并没有想象的那么好。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It doesn't really give you the confidence for the individual patient that you would like, but ultimately what's going on in the brain in psychiatric disease is physical, and it's due to the circuits and the connections and the projections and the brain that are not working as they would in a typical situation.
它并不能真正给你你想要的对个别患者的信心，但最终精神疾病的大脑中发生的事情是物理的，这是由于电路、连接、投射和大脑没有像在典型情况下那样工作。
And I do think we'll have those measurables at some point.
我确实认为我们会在某个时候拥有这些可衡量的指标。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now, is that good or bad?
现在，这是好是坏？
I think that will be good.
我认为那会很好。
One of the challenges we have with psychiatry is it is an art as well as a science to elicit these symptoms in a precise way.
我们在精神病学方面面临的挑战之一是，以精确的方式引发这些症状既是一门艺术，也是一门科学。
It does take some time, and it would be great if we could just do a quick measurement.
这确实需要一些时间，如果我们能够进行快速测量那就太好了。
Could it be abused or misused?
它会被滥用或误用吗？
Certainly.
当然。
But that's I think true for all of medicine.
但我认为这对所有医学都是如此。
Andrew Huberman:
安德鲁·休伯曼：
I want to know, and I'm sure there are several, but what do you see as the biggest challenge facing psychiatry and the treatment of mental illness today?
我想知道，而且我确信有几个，但您认为当今精神病学和精神疾病治疗面临的最大挑战是什么？
Karl Deisseroth:
卡尔·戴瑟罗斯：
We're making progress on what the biggest challenge is, which I think there's still such a strong stigma for psychiatric disease that patients often don't come to us, and they feel that they should be able to handle this on their own.
我们在最大的挑战上取得了进展，我认为精神疾病仍然存在如此强烈的耻辱，以至于患者经常不来找我们，他们觉得自己应该能够自己处理这个问题。
And that can slow treatment, it can lead to worsening symptoms.
这会减慢治疗速度，并导致症状恶化。
We know, for example, patients who have untreated anxiety issues, if you go for a year or more with a serious untreated anxiety issue, that can convert to depression; you can add another problem on top of the anxiety.
例如，我们知道，患有焦虑问题而未得到治疗的患者，如果患有严重的焦虑问题一年或更长时间而未得到治疗，可能会转化为抑郁症；除了焦虑之外，你还可以添加另一个问题。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Why do people not come for treatment?
为什么人们不来接受治疗？
They feel like this is something they should be able to master on their own, which can be true, but usually some help is a good thing.
他们觉得这是他们应该能够自己掌握的东西，这可能是真的，但通常一些帮助是一件好事。
Andrew Huberman:
安德鲁·休伯曼：
That raises a question related to something I heard you say many years ago at a lecture.
这就提出了一个与我多年前在一次讲座上听你说过的话有关的问题。
This was a scientific lecture, and you said, "We don't know how other people feel.
这是一场科学讲座，你说：“我们不知道其他人的感受。
Most of the time we don't even really know how we feel."
大多数时候我们甚至不知道自己的感受如何。”
Andrew Huberman:
安德鲁·休伯曼：
Maybe you could elaborate on that a little bit and the dearth of ways that we have to talk about feelings.
也许你可以详细说明一下这一点以及我们缺乏谈论感受的方式。
I mean, there's so many words, I don't know how many, but I'm guessing there are more than a dozen words to describe the state that I call sadness.
我的意思是，有很多词，我不知道有多少，但我猜有十多个词来描述我称之为悲伤的状态。
But as far as I understand, we don't have any way of comparing that in a real objective sense.
但据我了解，我们没有任何方法可以真正客观地进行比较。
Andrew Huberman:
安德鲁·休伯曼：
As a psychiatrist, when your job is to use words of the patient to diagnose, do you maneuver around that?
作为一名精神科医生，当你的工作是用病人的言语来诊断时，你会回避这一点吗？
And what is this landscape that we call feelings or emotions?
我们称之为感受或情感的景观是什么？
Karl Deisseroth:
卡尔·戴瑟罗斯：
This is really interesting.
这真的很有趣。
There's a tension between the words that we've built up in the clinic that mean something to the physicians, and then there's the colloquial use of words that may not be the same.
我们在诊所中建立的对医生有意义的词语之间存在着紧张关系，而且口语中使用的词语可能并不相同。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so that's the first level we have to sort out, when someone says, "I'm depressed," what exactly do they mean by that?
所以这是我们必须解决的第一个层面，当有人说“我很沮丧”时，他们到底是什么意思？
That may be different from what we're talking about in terms of depression.
这可能与我们谈论的抑郁症不同。
So part of psychiatry is to get beyond that word and to get into how they're actually feeling, get rid of the jargon and get to real-world examples of how they're feeling.
因此，精神病学的一部分就是超越这个词，了解他们的实际感受，摆脱行话，找到他们感受的真实例子。
How much do you look forward into the future?
您对未来有多少期待？
How much hope do you have?
你还有多少希望？
How much planning are you doing for the future?
你对未来做了多少规划？
So here now you're getting into actual things you can talk about that are unambiguous.
所以现在你正在讨论可以明确谈论的实际事情。
Karl Deisseroth:
卡尔·戴瑟罗斯：
If someone says, "Yeah, I can't even think about tomorrow; I don't see how I'm going to get to tomorrow," that's a nice, precise thing.
如果有人说，“是的，我什至无法考虑明天；我不知道如何到达明天”，这是一件很好的、精确的事情。
It's sad, it's tragic, but also that means something.
这是悲伤的，这是悲剧的，但这也意味着什么。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And we know what that means.
我们知道这意味着什么。
That's the hopelessness symptom of depression.
这就是抑郁症的绝望症状。
And that is what I try to do when I do a psychiatric interview.
这就是我在进行精神病学访谈时尝试做的事情。
I try to get past the jargon and get to what's actually happening in the patient's life and in their mind.
我试图摆脱行话，了解患者生活中和他们的想法中实际发生的事情。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But as you say, ultimately, and this shows up across, I address this issue every day in my life, whether it's in the lab where we're looking at animals, whether fish or mice or rats, and studying their behavior.
但正如你所说，最终，这一点出现了，我在生活中每天都在解决这个问题，无论是在实验室里，我们观察动物，无论是鱼、小鼠还是大鼠，并研究它们的行为。
Or when I'm in a conversation with just a friend or a colleague, or when I'm talking to a patient.
或者当我只与朋友或同事交谈时，或者当我与患者交谈时。
I never really know what's going on inside the mind of the other person.
我永远不知道对方心里在想什么。
I get some feedback, I get words, I get behaviors, I get actions, but I never really know.
我得到一些反馈，我得到言语，我得到行为，我得到行动，但我从来没有真正知道。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And as you said at the very beginning of the question, often we don't even have the words and the insight to even understand what's going on in our own mind.
正如您在问题一开始所说的那样，我们常常甚至没有语言和洞察力来理解我们自己的想法。
I think a lot of psychiatrists are pretty introspective.
我认为很多精神科医生都很内省。
That's part of the reason they end up in that specialty.
这是他们最终选择该专业的部分原因。
And so maybe we spend a little more time than the average person thinking about what's going on within, but it doesn't mean we have answers.
因此，也许我们比一般人花更多的时间思考内心发生的事情，但这并不意味着我们有答案。
Andrew Huberman:
安德鲁·休伯曼：
So in this area of trying to figure out what's going on under the hood through words.
因此，在这个领域，我们试图通过文字来弄清楚幕后发生的事情。
Sounds like certain words would relate to this idea of anticipation and hope.
听起来某些词与这种期待和希望的想法有关。
Is it fair to say that that somehow relates to the dopamine system in the sense that dopamine is involved in motivated behaviors?
可以公平地说，这在某种程度上与多巴胺系统有关，因为多巴胺参与动机行为？
If I say, for instance, and I won't ask you to run a session with me here for free.
如果我说，例如，我不会要求你在这里免费与我进行一次会议。
Karl Deisseroth:
卡尔·戴瑟罗斯：
We'll do that off camera.
我们将在镜头外进行。
Andrew Huberman:
安德鲁·休伯曼：
Okay, right.
好吧，对。
If I were to say, "I just can't imagine the tomorrow, I just can't do it," so that's not action based, that's purely based on my internal narrative.
如果我说，“我无法想象明天，我就是做不到”，那么这不是基于行动的，而是纯粹基于我的内心叙述。
But I could imagine things like, "I have a terrible time sleeping, I'm not hungry, I'm not eating." So statements about physical actions, I'm guessing also have validity.
但我可以想象这样的事情：“我睡得很糟糕，我不饿，我不吃东西。”所以我猜关于身体动作的陈述也是有效的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Absolutely.
绝对的。
Andrew Huberman:
安德鲁·休伯曼：
And there are now ways to measure the accuracy of those statements.
现在有方法可以衡量这些陈述的准确性。
For instance, if I gave you permission, you could know if I slept last night or whether or not I was just saying I had a poor night's sleep.
例如，如果我给了你许可，你就可以知道我昨晚是否睡着了，或者我是否只是说我昨晚睡得不好。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes, that's right.
是的，没错。
Andrew Huberman:
安德鲁·休伯曼：
So in moving forward through 2021 and into the next 10 and a hundred years of psychiatry, do you think that the body reporting some of the actions of a human are going to become useful and mesh with the words in a way that's going to make your job easier?
因此，在 2021 年以及精神病学的下一个 10 年和 100 年中，您认为报告人类某些行为的机构会变得有用并与文字相吻合，从而使您的工作变得更轻松吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I do think that's true.
我确实认为这是真的。
And the two things you've mentioned, eating and sleeping, those are additional criteria that we use to diagnose depression.
你提到的两件事，饮食和睡眠，是我们用来诊断抑郁症的附加标准。
These are the vegetative signs, we call them, of depression: poor sleep and poor eating.
这些就是我们所说的抑郁症的植物人症状：睡眠不佳和饮食不佳。
And if you have a baseline for somebody, that's the real challenge though.
如果你对某人有一个基线，那才是真正的挑战。
Karl Deisseroth:
卡尔·戴瑟罗斯：
What's different in that person?
那个人有什么不同呢？
Some people with depressed, they sleep more.
有些人患有抑郁症，他们睡得更多。
Some people who are depressed, they sleep less.
有些抑郁的人会睡得更少。
Some people who are depressed, they're more physically agitated and they move around more.
有些抑郁症患者的身体会更加烦躁，并且会走动更多。
Some people who are depressed, they move less, even while they're awake.
有些抑郁的人即使在醒着的时候也会减少活动。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Here's the challenge: you can't just look at how they are now.
挑战在于：你不能只看他们现在的情况。
You have to get a baseline and then see how it's changed.
你必须获得一个基线，然后看看它是如何变化的。
And that can be a challenge that raises ethical issues.
这可能是一个引发道德问题的挑战。
How do you collect that baseline information from someone healthy?
如何从健康人那里收集基线信息？
I don't think that's something we have solved.
我不认为这是我们已经解决的问题。
Of course, with phones and accelerometers and phones, you could, in principle, collect a lot of baseline information from people, but that would have to be treated very carefully for privacy reasons.
当然，使用手机、加速度计和手机，原则上你可以从人们那里收集大量基线信息，但出于隐私原因，必须非常小心地对待这些信息。
Andrew Huberman:
安德鲁·休伯曼：
And in terms of measuring one's own behavior, I've heard of work that's going on.
在衡量自己的行为方面，我听说过正在进行的工作。
Sam Golden, up in the University of Washington, who works on aggression and animal models was telling me that there's some effort that he's making.
华盛顿大学研究攻击性和动物模型的萨姆·戈尔登告诉我，他正在做出一些努力。
And perhaps you're involved in this work as well, I don't know, of devices that would allow people to detect, for instance, when they're veering towards a depressive episode for themselves, that they may choose or not choose to report that to their clinician.
也许你也参与了这项工作，我不知道，这些设备可以让人们检测到，例如，当他们自己转向抑郁发作时，他们可以选择或不选择向临床医生报告。
Maybe they don't even have a clinician.
也许他们甚至没有临床医生。
Maybe this person that you referred to at the beginning, this person who doesn't feel comfortable coming to talk to you.
也许是你一开始提到的这个人，这个不愿意来和你说话的人。
Andrew Huberman:
安德鲁·休伯曼：
Maybe something is measuring changes in the inflection of their voice or the speed at which they get up from a chair.
也许有什么东西正在测量他们声音的变化或他们从椅子上站起来的速度。
Do you think that those kind of metrics will eventually inform somebody, "Hey, you're in trouble." This is getting to this question of, back to the statement that I heard you make and rung in my mind now, I think for more than a decade, which is oftentimes we don't even know how we feel.
你认为这些指标最终会告诉某人，“嘿，你有麻烦了。”现在回到这个问题，回到我听到你说的并在我脑海中响起的那句话，我想十多年来，我们常常甚至不知道自己的感受。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That I do like because that gives the patient the agency to detect what's going on.
我确实喜欢这一点，因为这让患者有能力发现正在发生的事情。
Even separate from modern technology, this has been part of ...
即使与现代技术分开，这也已经成为......
the art of psychiatry is to help patients realize that sometimes other people observing them can give them the earliest warning signs of depression.
精神病学的艺术在于帮助患者认识到，有时其他人的观察可以给他们提供抑郁症的最早预警信号。
We see this very often in family.
我们在家庭中经常看到这种情况。
They'll notice when the patient is changing before the patient does.
他们会先于患者注意到患者的变化。
And then there are things the patient may notice but not correctly ascribe to the onset of depression.
患者可能会注意到一些事情，但不能正确地将其归因于抑郁症的发作。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And a classic example of that is what we call early morning awakening.
一个典型的例子就是我们所说的清晨醒来。
And this is something that can happen very early.
这是很早就可能发生的事情。
As people start to slide into depression, they start to wake up earlier and earlier, just inexplicably they're awake at.
当人们开始陷入抑郁时，他们就会开始越来越早地醒来，只是莫名其妙地醒来。
Andrew Huberman:
安德鲁·休伯曼：
This is like 2:00 a.m., 3:00 a.m.
这就像凌晨 2:00、凌晨 3:00。
type of waking.
醒来的类型。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, it could start.
是的，可以开始了。
It could at 5:00 a.m., could go to four
可能在凌晨 5:00，可能会到四点
Andrew Huberman:
安德鲁·休伯曼：
And unable to fall back asleep.
并且无法再入睡。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Unable to fall back asleep, exactly.
确切地说，无法再入睡。
And they may not know what to do with that.
他们可能不知道该怎么办。
It could just be from their perspective is just something that's happening.
从他们的角度来看，这可能只是正在发生的事情。
But if you put enough of that information together, that could be a useful warning sign for the patient, and it could help them seek treatment.
但如果你将足够多的信息放在一起，这可能对患者来说是一个有用的警告信号，并且可以帮助他们寻求治疗。
And I think that is something that could be really valuable.
我认为这可能是非常有价值的。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
So in this framework of needing words to self-report or machines to detect how we feel, and maybe inform a psychiatrist how a patient feels, I want to touch on some of the technologies that you've been involved in building, but as a way to march into that, are there any very good treatments for psychiatric disease?
因此，在需要文字自我报告或机器检测我们的感受，并可能告知精神科医生患者感受的框架下，我想谈谈您参与构建的一些技术，但作为迈向这一目标的一种方式，有没有针对精神疾病的非常好的治疗方法？
Meaning are there currently any pills, potions, forms of communication that reliably work every time?
这意味着目前是否有任何药丸、药水或每次都能可靠地发挥作用的通讯方式？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Or work in most patients?
或者对大多数患者有效？
And could you give a couple examples of great successes of psychiatry if they exist?
您能否举几个精神病学取得巨大成功的例子（如果存在的话）？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
We are fortunate, and this is coming back to the joking between my wife and myself in terms of neurology and psychiatry.
我们很幸运，这又回到了我和妻子在神经病学和精神病学方面的玩笑。
In psychiatry, despite the depths of the mystery we struggle with, many of our treatments may be doing better than some other specialties in terms of actually causing the therapeutic benefit for patients.
在精神病学中，尽管我们面临的谜团很深，但我们的许多治疗方法在实际为患者带来治疗益处方面可能比其他一些专业做得更好。
We do help patients.
我们确实帮助病人。
By the way, both medications and talk therapy have been shown to be extremely effective in many cases.
顺便说一句，药物治疗和谈话疗法在许多情况下都被证明非常有效。
Karl Deisseroth:
卡尔·戴瑟罗斯：
For example people with panic disorder, cognitive behavioral therapy, just working with words, helping people identify the early signs of when they're starting to move toward a panic attack, what are the cognitions that are happening?
例如，患有恐慌症的人，认知行为疗法，只是用语言来帮助人们识别何时开始恐慌发作的早期迹象，正在发生什么认知？
You can train people to derail that and you can very potently treat panic disorder that way.
你可以训练人们摆脱这种情况，这样就可以非常有效地治疗恐慌症。
Andrew Huberman:
安德鲁·休伯曼：
How long does something like that take on average?
这样的事情平均需要多长时间？
Karl Deisseroth:
卡尔·戴瑟罗斯：
For a motivated, insightful patient, you can have a very cookbook series of sessions.
对于积极主动、富有洞察力的患者来说，您可以接受一系列非常实用的治疗。
Six to 12 sessions, or even less for someone who's very insightful and motivated, and can have a very powerful effect that quickly.
对于那些非常有洞察力和积极性的人来说，六到十二次疗程甚至更少，并且可以很快产生非常强大的效果。
And that's just with words.
这只是言语而已。
There are many psychiatric medications that are very effective for the conditions that they're treating.
有许多精神科药物对于所治疗的疾病非常有效。
Antipsychotic medications, they have side effects, but boy do they work; they really can clear up, particularly the positive symptoms of schizophrenia.
抗精神病药物有副作用，但是它们确实有效；它们确实可以清除，特别是精神分裂症的阳性症状。
For example, the auditory hallucinations, the paranoia, people's lives can be turned around by these.
比如幻听，偏执，人的生活都可以被这些扭转。
Andrew Huberman:
安德鲁·休伯曼：
We should clarify positive symptoms.
我们应该澄清阳性症状。
You mean not positive in the qualitative sense, you mean positive meaning that the appearance of something abnormal?
你的意思是在定性意义上不是积极的，你的意思是积极的意思是出现异常的东西？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Exactly, thank you for that clarification.
确实，谢谢您的澄清。
When we say positive symptoms, we do mean the addition of something that wasn't there before, like a hallucination or a paranoia.
当我们说阳性症状时，我们的意思是增加了一些以前不存在的东西，比如幻觉或偏执。
And that stands in contrast to the negative symptoms where something is taken away, and these are patients who are withdrawn.
这与阴性症状形成鲜明对比，即某些东西被拿走，而这些患者就是孤僻的。
They have what we call thought-blocking.
他们有我们所说的思维障碍。
They can't even progress forward in a sequence of thoughts.
他们甚至无法在一系列的想法中前进。
Both of those can be part of schizophrenia.
这两者都可能是精神分裂症的一部分。
The hallucinations and the paranoia are more effectively treated right now, but they are effectively treated.
幻觉和偏执现在得到更有效的治疗，但它们得到了有效的治疗。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And then this is a frustrating and yet heartening aspect of psychiatry.
这是精神病学令人沮丧但又令人振奋的方面。
There are treatments like electroconvulsive therapy, which is where ...
有一些治疗方法，例如电休克疗法，这是......
it's extremely effective for depression.
它对抑郁症非常有效。
We have patients who, nothing else works for them, where they can't tolerate medications, and you can administer under a very safe, controlled condition where the patient's body is not moving; they're put into a very safe situation where the body doesn't move or seize.
我们有一些患者，其他方法对他们都不起作用，他们无法耐受药物，而您可以在非常安全、受控的条件下进行治疗，患者的身体不会移动；他们被置于一个非常安全的环境中，身体不会移动或抓住。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It's just an internal process that's triggered in the brain.
这只是大脑触发的内部过程。
This is an extraordinarily effective treatment for treatment-resistant depression.
这是治疗难治性抑郁症的一种非常有效的治疗方法。
At the same time, I find it, as heartening as it is to see patients respond to this who have severe depression, I'm also frustrated by it.
与此同时，我发现，虽然看到患有严重抑郁症的患者对此做出反应令人振奋，但我也对此感到沮丧。
Why can't we do something more precise than this for these very severe cases?
为什么我们不能对这些非常严重的病例做一些比这更精确的事情呢？
Karl Deisseroth:
卡尔·戴瑟罗斯：
And people have sought for decades to understand how is it that a seizure is leading to the relief of depression?
几十年来，人们一直在寻求了解癫痫发作是如何缓解抑郁症的？
And we don't know the answer yet.
我们还不知道答案。
We would love to do that.
我们很乐意这样做。
People are working hard on that, but that is a treatment that does work too.
人们正在为此努力，但这也是一种确实有效的治疗方法。
In all of these cases though, in psychiatry, the frustrating thing is that we don't have the level of understanding that a cardiologist has in thinking about the heart.
然而，在所有这些情况下，在精神病学中，令人沮丧的是我们对心脏的理解水平不及心脏病专家。
The heart is, we now know it's a pump, it's pumping blood.
心脏是，我们现在知道它是一个泵，它泵送血液。
And so you can look at everything about how it's working, or not working in terms of that frame.
因此，您可以根据该框架查看有关它如何工作或不工作的所有信息。
It's clearly a pump.
很明显这是一个泵。
We don't really have that level of what is the circuit really there for in psychiatry?
我们还没有真正了解该电路在精神病学中的真正用途是什么？
And that's what is missing.
这就是所缺少的。
That's what we need to find so we can design truly effective and specific treatments.
这就是我们需要找到的，这样我们才能设计出真正有效且具体的治疗方法。
Andrew Huberman:
安德鲁·休伯曼：
So what are the pieces that are going to be required to cure autism, cure Parkinson's, cure schizophrenia?
那么，治愈自闭症、帕金森氏症、精神分裂症需要哪些措施呢？
I would imagine there are several elements and bins here.
我想这里有几个元素和垃圾箱。
Understanding that the natural biology, understanding what the activity patterns are, how to modify those.
了解自然生物学，了解活动模式是什么，以及如何修改它们。
Maybe you could just tell us what you think.
也许你可以告诉我们你的想法。
What is the bento box of the perfect cure?
什么是完美治愈的便当盒？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I think the first thing we need is understanding.
我认为我们首先需要的是理解。
Almost every psychiatric treatment has been serendipitously identified, just noting by chance that something that was done for some person also had a side effect.
几乎每一种精神治疗方法都是偶然发现的，只是偶然注意到对某些人所做的某些事情也会产生副作用。
Andrew Huberman:
安德鲁·休伯曼：
Like lithium or something?
比如锂之类的？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Lithium is a good example.
锂就是一个很好的例子。
Andrew Huberman:
安德鲁·休伯曼：
Is it true that it was the urine of guinea pigs given lithium that was given to manic patients that made them not manic?
难道真的是给躁狂症患者服用了锂的豚鼠的尿液才让他们不再躁狂？
Is that true?
这是真的吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I don't have firsthand knowledge of that, but I would defer that, but it's true for essentially every treatment.
我对此没有第一手的了解，但我会推迟这一点，但基本上每种治疗都是如此。
The antidepressants originally arose, antituberculosis drugs, for example.
例如，最初出现的是抗抑郁药、抗结核药。
Andrew Huberman:
安德鲁·休伯曼：
I did not know that.
我不知道。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so it's a classic example, and this is across all of psychiatry, and of course the seizures as well, that was noticed that patients who had epilepsy, or had a seizure there and also had depression, that they became much, at least for a while, they were improved after the seizure.
这是一个典型的例子，这是整个精神病学的一个例子，当然也包括癫痫发作，人们注意到，患有癫痫症或癫痫发作同时患有抑郁症的患者，他们在癫痫发作后，至少在一段时间内，病情得到了改善。
Andrew Huberman:
安德鲁·休伯曼：
That's amazing.
太棒了。
I don't want to take you off course of the question that ...
我不想让你偏离这个问题……
answering the question I asked, but I've heard before that if autistic children get a fever that their symptoms improve.
回答我问的问题，但我以前听说过，如果自闭症儿童发烧，他们的症状就会改善。
Is that true?
这是真的吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I've done a fair bit of work with autism.
我在自闭症方面做了很多工作。
In my clinical practice, I work with adult autism, and I have heard statements like that and descriptions like that from patients and their families.
在我的临床实践中，我与成人自闭症患者一起工作，我从患者及其家人那里听到过类似的陈述和描述。
That is very hard to study quantitatively because often with the children, you have this not as quantitative as you'd like collection of symptom information from home.
定量研究是非常困难的，因为通常对于孩子来说，你所得到的数据并不像你希望从家里收集的症状信息那样定量。
But I have heard that enough that I think there may well be something to that.
但我听得够多了，我认为这很可能是有道理的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And anytime you have a fever, what's going on?
每当你发烧时，这是怎么回事？
Well, we know all the cells in the brain, and I know this as an electrophysiologist, if you just change the temperature by a few degrees, everything changes about how neurons work and that's even just a single neuron.
好吧，我们知道大脑中的所有细胞，作为一名电生理学家，我知道这一点，如果你只是将温度改变几度，神经元工作方式的一切都会改变，甚至只是一个神经元。
It's even more likely to be complex and different with a circuit of neurons that are all affecting each other, just elevate the temperature a little bit, everything's different.
它更有可能是复杂和不同的，神经元回路都互相影响，只要稍微提高温度，一切都会不同。
And so it's plausible for sure that things like that could happen and do happen.
因此，类似的事情可能会发生并且确实会发生，这是合理的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
When you think about autism, to take your example, yes, we see changes, but what is the element in the brain that's analogous to the pumping heart?
当你想到自闭症时，举个例子，是的，我们看到了变化，但是大脑中类似于跳动心脏的元素是什么？
When we think about the symptoms of depression, maybe we think about motivation and dopamine neurons.
当我们想到抑郁症的症状时，也许我们会想到动机和多巴胺神经元。
When we think about autism, it's a little more challenging.
当我们想到自闭症时，它就更具挑战性了。
There's a deficit in social interaction and in communication.
社交互动和沟通方面存在缺陷。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so where is that?
那么那是哪里呢？
Where is that situated?
它位于哪里？
What is the key principle governing the social interaction?
管理社交互动的关键原则是什么？
This is where we need the basic science to bring us a step forward.
这就是我们需要基础科学来推动我们前进的地方。
So we can say, this is the process that's going on, this is what's needed for the incredibly complex task of social interaction where you've got incredibly rich data streams of sound and meaning, eye contact, body movement.
所以我们可以说，这就是正在发生的过程，这就是社交互动这一极其复杂的任务所需要的，在这个任务中，你拥有极其丰富的声音和意义、眼神接触、身体运动的数据流。
And that's just for one person.
而且这只是针对一个人。
Karl Deisseroth:
卡尔·戴瑟罗斯：
What if there's a group of people?
如果有一群人怎么办？
This is overwhelming for people with autism.
这对于自闭症患者来说是难以承受的。
What's the unifying theme there?
那里的统一主题是什么？
It's a lot of information, and that maybe is unmatched in any realm of biology.
这是大量的信息，这可能是任何生物学领域都无法比拟的。
The amount of information coming in through a social interaction, particularly with words and language.
通过社交互动（尤其是文字和语言）传入的信息量。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That turns our attention as neuroscientists; we think, okay, let's think about the parts of the brain that are involved in dealing with merging complex data streams that are very high in bit rate that need to be fused together into a unitary concept.
这引起了我们神经科学家的注意。我们认为，好吧，让我们考虑一下大脑中参与处理合并复杂数据流的部分，这些数据流的比特率非常高，需要融合在一起形成一个统一的概念。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And that starts to guide us, and maybe we can, and we know other animals are social in their own way, and we can study those animals.
这开始指导我们，也许我们可以，而且我们知道其他动物以自己的方式进行社交，我们可以研究这些动物。
So that's how I think about it; there's hope for the future.
这就是我的想法；未来充满希望。
Thinking about the symptoms as an engineer might and trying to identify the circuits that are likely working to make this typical behavior happen, and that will help us understand how it becomes atypical.
像工程师一样思考症状，并尝试识别可能导致这种典型行为发生的电路，这将帮助我们理解它是如何变得非典型的。
Andrew Huberman:
安德鲁·休伯曼：
So that seems like the first to me, the first bin of this, what I call the bento box, for lack of a better analogy, that we need to know the circuits.
所以这对我来说似乎是第一个，第一个箱子，我称之为便当盒，因为缺乏更好的类比，我们需要了解电路。
We need to know the cells in the various brain regions and portions of the body and how they connect to one another and what the patterns of activity are under a normal "healthy interaction."
我们需要了解大脑各个区域和身体各部分的细胞，以及它们如何相互连接，以及在正常的“健康互动”下的活动模式是什么。
Andrew Huberman:
安德鲁·休伯曼：
If we understand that, then it seems that the next step, which of course could be carried out in parallel, that work can be done alongside work where various elements within those circuits are tweaked just right, like the tuning of a piano in the subtle way, or maybe even the replacement of a whole set of keys if the piano is lacking keys, so to speak.
如果我们理解这一点，那么下一步似乎可以并行进行，这项工作可以与对这些电路中的各种元件进行恰到好处的调整的工作一起完成，就像以微妙的方式调整钢琴，或者甚至可以说，如果钢琴缺少琴键，则可以更换整套琴键。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Right, right.
对，对。
Andrew Huberman:
安德鲁·休伯曼：
You've been very involved in trying to generate those tools.
您一直致力于尝试生成这些工具。
Tell us about channelopsins, why you created them and where they're at now in the laboratory and perhaps also in the clinic.
告诉我们有关通道视蛋白的信息，您为什么创建它们以及它们现在在实验室（也许还有诊所）中的位置。
Karl Deisseroth:
卡尔·戴瑟罗斯：
First of all, I give nature the credit for creating channelrhodopsins.
首先，我将视紫红质的创造归功于大自然。
These are beautiful little proteins that are made by algae, single-cell green algae.
这些是由藻类、单细胞绿藻产生的美丽的小蛋白质。
And it's a great story in basic science that our understanding of animal behavior, sensation, cognition, and action in our brains, all the way back to a botanist in the 1850s and 1860s in Russia, is where the story begins.
这是基础科学中的一个伟大故事，我们对动物行为、感觉、认知和大脑活动的理解，一直追溯到 1850 年代和 1860 年代俄罗斯的植物学家，这就是故事的开始。
This was a botanist named Andrei Famintsyn, who worked at St. Petersburg, and he had noticed in the river near his laboratory that there were algae that he could look at in a dish, in a saucer.
这是一位名叫安德烈·法明岑（Andrei Famintsyn）的植物学家，他在圣彼得堡工作，他注意到实验室附近的河里有藻类，他可以在盘子里、碟子里看到藻类。
He could put them there, and when he had light shining from the side, the green tinge in the saucer of water would move to a particular distance from the light that he was shining from the side, which was an amazing thing.
他可以把它们放在那里，当他有光从侧面照射时，水碟中的绿色色调会与他从侧面照射的光移动到特定的距离，这是一件令人惊奇的事情。
If he made the light brighter, the green tinge would back off a little bit to a more optimal location.
如果他把光线调得更亮，绿色色调就会减弱一点，到达更理想的位置。
So just the right light level.
所以光照水平恰到好处。
So this was plant behavior.
这就是植物的行为。
Karl Deisseroth:
卡尔·戴瑟罗斯：
So this was plant behavior.
这就是植物的行为。
It was light-driven plant behavior, and he delves into this a little bit.
这是光驱动的植物行为，他对此进行了一些深入研究。
He identified that with microscopy, he could see that there were little single-cell algae with flagella that were swimming to the right light level.
他发现，通过显微镜，他可以看到很少有带鞭毛的单细胞藻类游到正确的光照水平。
So behaving plant — and this has been the secret that's helped us unlock so many principles of animal behavior.
植物如此行为——这就是帮助我们解开许多动物行为原理的秘密。
So, turns out these algae achieve these amazing results with a single gene that encodes a single protein.
因此，事实证明，这些藻类通过编码单一蛋白质的单一基因实现了这些惊人的结果。
What's a protein?
什么是蛋白质？
It's just a little biomolecule that does a job in a cell.
它只是在细胞中发挥作用的一个小生物分子。
And, these are proteins that sit in the surface of cells, in their surface membrane, and when a photon, a light particle, hits them, they open a little pore, a little hole in the membrane, and charged particles, ions like sodium, rush across the pore.
而且，这些蛋白质位于细胞表面、表面膜中，当光子、光粒子撞击它们时，它们会打开一个小孔，膜上的一个小孔，带电粒子（如钠离子）冲过该孔。
Now, why do they do that?
现在，他们为什么要这样做？
Karl Deisseroth:
卡尔·戴瑟罗斯：
They do that to guide their flagella.
它们这样做是为了引导鞭毛。
That signal coming in, those ions coming in through the pore in response to light guide their flagella motor that guides them to a particular spot in the saucer.
当信号进来时，那些通过孔进入的离子响应光引导它们的鞭毛马达，将它们引导到碟子中的特定位置。
Now, that's plant behavior, but it turns out, as you know, this movement of ions across the membrane, this happens to also be neural code in our brains for on or off.
现在，这就是植物的行为，但事实证明，正如你所知，离子穿过膜的运动，这恰好也是我们大脑中打开或关闭的神经代码。
Sodium ion's rushing into cells turns them on, makes them fire away, fire action potentials communicate to the next cell down the chain.
钠离子冲入细胞，将它们打开，使它们放电，放电动作电位与链上的下一个细胞通讯。
And, this is an amazing opportunity because we can borrow these proteins.
而且，这是一个绝佳的机会，因为我们可以借用这些蛋白质。
Karl Deisseroth:
卡尔·戴瑟罗斯：
In fact, we can take the gene that directs the creation of the protein, and we can use genetic tricks, modern genetic tricks, to put that gene into neurons in the brains of mammals, and then use light to turn those cells, the specific cells that we've put this gene into, turn them on.
事实上，我们可以获取指导蛋白质产生的基因，我们可以使用遗传技巧，现代遗传技巧，将该基因放入哺乳动物大脑的神经元中，然后使用光来打开这些细胞，即我们放入该基因的特定细胞，将它们打开。
There are other options, we call them, that you can use to turn cells off.
还有其他选项（我们称之为它们）可以用来关闭单元格。
It's all fast, real time, you can play in patterns of activity in real time into cells or kinds of cells, just as a conductor elicits the music from the orchestra, the strings and the woodwinds.
这一切都是快速、实时的，你可以在细胞或各种细胞中实时演奏活动模式，就像指挥家从管弦乐队、弦乐和木管乐器中引出音乐一样。
And you can see what matters.
你可以看到什么是重要的。
What matters for sensation, what matters for cognition, what matters for action.
什么对感觉重要，什么对认知重要，什么对行动重要。
And we call this optogenetics.
我们称之为光遗传学。
Andrew Huberman:
安德鲁·休伯曼：
Beautiful, and I must say it was quite an honor and a privilege to watch optogenetics move from idea to discovery to the laboratory.
美丽，我必须说，看到光遗传学从想法到发现再到实验室，我感到非常荣幸。
I think we were postdocs at the same time, which is living proof that people move at different rates, that's a joke at my expense, by the way.
我认为我们同时是博士后，这是人们以不同速度移动的活生生的证据，顺便说一句，这是拿我开玩笑的。
But it's really-
但这确实是——
Karl Deisseroth:
卡尔·戴瑟罗斯：
We end up in the same spot.
我们最终在同一个地方。
Andrew Huberman:
安德鲁·休伯曼：
...
...
More or less.
或多或少。
Physically, if not professionally.
身体上，如果不是职业上的话。
But nonetheless, it's been a marvelous story thus far.
但尽管如此，到目前为止，这仍然是一个精彩的故事。
And I'd like to just touch on a couple examples of where the technology resides in laboratories now.
我只想谈几个目前该技术在实验室中应用的例子。
So, maybe the range of animals that it's being used in and some of the phenomenon that channelrhodopsins and their related genes and proteins are starting to elicit what you've seen.
因此，也许它所使用的动物范围以及视紫红质及其相关基因和蛋白质的一些现象开始引发您所看到的情况。
And then I'd like to talk about their applicability to the clinic, which is I think the bigger mission, if you will.
然后我想谈谈它们对诊所的适用性，如果你愿意的话，我认为这是更大的使命。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
So this is whole thing.
这就是整个事情。
It's been about now going on 17 years that we've been putting channelrhodopsins into neurons.
我们将视紫红质注入神经元已经有大约 17 年的时间了。
It started just like Andre Faminstyn's work in a dish; that was in 2004.
它的开始就像安德烈·法明斯汀（Andre Faminstyn）在盘子里的作品一样；那是在2004年。
In 2007, we were putting these into behaving mice, and we were able to with a flick of a switch, cause them to move one direction or another.
2007 年，我们将它们放入行为小鼠体内，只需轻按一下开关，就能让它们向一个方向或另一个方向移动。
By 2009-
到2009年-
Andrew Huberman:
安德鲁·休伯曼：
So basically, you're controlling the mouse's behavior.
基本上，您正在控制鼠标的行为。
Karl Deisseroth:
卡尔·戴瑟罗斯：
...
...
Yeah, exactly, in real time.
是的，准确地说，是实时的。
So, we could make a mouse that was just sitting there doing nothing to then turn left very consistently, in fact go around in a circle, and as soon as we'd turn off the light, it would stop.
因此，我们可以制作一只老鼠，它只是坐在那里什么都不做，然后非常一致地向左转，实际上是绕了一圈，一旦我们关掉灯，它就会停下来。
That was an eye-opening moment.
那是一个令人大开眼界的时刻。
It took really a few years to make optogenetics work.
光遗传学的发挥确实花了几年的时间。
There were a lot of problems that had to be solved.
有很多问题需要解决。
These channelrhodopsins actually don't move many ions.
这些视紫红质实际上不会移动很多离子。
They have a small current, small conductance, as we say.
正如我们所说，它们的电流小，电导小。
And so, we had to figure out ways to pack a lot of them into cells without damaging cells and still make them targetable.
因此，我们必须找到方法将大量它们装入细胞中而不损坏细胞，并且仍然使它们成为目标。
So we don't want to just be in all the cells, because then it becomes just like an electrode.
所以我们不想只存在于所有细胞中，因为那样它就变得就像一个电极。
You're just stimulating all the cells there nearby.
你只是刺激了附近的所有细胞。
We had to keep that specificity, make them targetable to just one kind of cell or another while still packing in large numbers of them into those cells.
我们必须保持这种特异性，使它们仅针对一种或另一种细胞，同时仍将大量它们装入这些细胞中。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And we had to get in the light in safe and specific ways.
我们必须以安全且具体的方式曝光。
And so, it took probably about four or five years to really create optogenetics, between 2004 and 2009.
因此，从 2004 年到 2009 年，光遗传学的真正诞生大概花了四五年的时间。
By the end of that time though, we had all the basic light delivery, gene delivery, principles worked out, and people started to apply the technology to fish, to rats, to mice, to nonhuman primates like monkeys.
但到那时，我们已经制定了所有基本的光传输、基因传输和原理，人们开始将该技术应用于鱼类、大鼠、小鼠、猴子等非人类灵长类动物。
And just a couple months ago, my colleague Botond Roska in Switzerland succeeded in putting channelrhodopsins into the eyes of human beings and making a blind person see.
就在几个月前，我在瑞士的同事 Botond Roska 成功地将视紫红质通道蛋白放入人类的眼睛中，使盲人能够看见东西。
And so, that's pretty cool.
所以，这很酷。
This was a patient with retinal degeneration, and he provided a channelrhodopsin into the eye of this patient and was able to confer some light sensitivity onto this patient that wasn't there before.
这是一名患有视网膜变性的患者，他向该患者的眼睛中提供了视紫红质通道，并能够赋予该患者一些以前不存在的光敏感性。
Andrew Huberman:
安德鲁·休伯曼：
An amazing paper and discovery.
一篇令人惊叹的论文和发现。
I realize it was one patient, but it's such an important milestone.
我意识到这是一名患者，但这是一个非常重要的里程碑。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, as you say, it's a very important milestone.
嗯，正如你所说，这是一个非常重要的里程碑。
And, the history of that is very deep.
而且，这方面的历史是非常深厚的。
Almost 10 years earlier, Botond Roska and I had published a paper in Science, in human retina, but explanted, taken from cadavers from someone who had died, living retina taken out, opsins put into this retinal tissue and showing that it worked, recording from the cells, showing that in these human neurons, retinal neurons, that you could get light responses.
大约十年前，Botond Roska 和我在《科学》杂志上发表了一篇论文，研究的是人类视网膜，但是是外植的，取自死者的尸体，取出活视网膜，将视蛋白放入视网膜组织中，并显示它起作用，从细胞记录下来，表明在这些人类神经元、视网膜神经元中，你可以获得光反应。
But then from that moment, almost 10 years of — you know how clinical development goes, and this is a gene therapy, so you've got all the regulations and concerns and all that — it took almost 10 years to get to this point now where a living human being has a new functionality that wasn't there before.
但从那一刻起，近10年的时间——你知道临床开发是如何进行的，这是一种基因疗法，所以你有所有的规定和担忧等等——花了近10年的时间才达到现在的程度，一个活着的人类拥有了以前不存在的新功能。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now that's incredibly inspiring and it's a beautiful thing.
现在这真是令人难以置信的鼓舞人心，这是一件美丽的事情。
I would say though, that the broader significance of optogenetics is really still understanding, because once you understand how the circuitry works and which cells actually matter, then any treatment becomes more grounded, and logical, and specific and principled.
但我想说的是，光遗传学的更广泛意义实际上仍然是理解，因为一旦你理解了电路如何工作以及哪些细胞实际上很重要，那么任何治疗都会变得更加基础、合乎逻辑、具体和有原则。
And whether it's medication, or talk therapy or brain stimulation treatment with electrical or magnetic means, if you actually know what matters, that is incredibly powerful.
无论是药物治疗、谈话疗法还是电或磁手段的脑刺激治疗，如果你真正知道什么是重要的，那就是非常强大的。
And I think, not intended to disparage this, the beautiful retinal work and conferring vision on someone who couldn't see, of course that's wonderful.
我认为，无意贬低这一点，美丽的视网膜工作并赋予盲人视力，这当然很棒。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And that's direct, what you might call direct optogenetics and patients.
这是直接的，你可以称之为直接光遗传学和患者。
Indirect is everything that comes from understanding, okay we know these cells matter now for this symptom.
间接是来自理解的一切，好吧，我们知道这些细胞现在对这种症状很重要。
Well how can we target those cells and help them work better in patients by any means?
那么我们如何才能靶向这些细胞并通过任何方式帮助它们在患者体内更好地发挥作用呢？
And I think that's the broader significance of optogenetics clinically.
我认为这就是光遗传学在临床上更广泛的意义。
Andrew Huberman:
安德鲁·休伯曼：
You and I know Botond well, and you and Botond share this incredible big vision that I think only a clinician can really understand, you know, being in close contact with the suffering of patients as a ultimate motivator of developing technologies.
你和我都很了解 Botond，你和 Botond 有着共同的令人难以置信的远大愿景，我认为只有临床医生才能真正理解，你知道，与患者的痛苦密切接触是开发技术的最终动力。
Which makes me have to ask, did you decide to become a scientist to find cures for mental disease?
这让我不得不问，你决定成为一名科学家来寻找精神疾病的治疗方法吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
No, I didn't.
不，我没有。
It's a really important question to actually look back and see the steps that brought you to a particular place.
真正回顾并了解将您带到某个特定位置的步骤是一个非常重要的问题。
And, that was not what brought me initially to science.
而且，这并不是我最初接触科学的原因。
And, it's okay to, I think to embrace the twists and turns that life brings to you.
而且，我认为拥抱生活给你带来的曲折也是可以的。
But I was always interested in the brain.
但我一直对大脑感兴趣。
And so, that was something that for me started from a very early age; we talked about being introspective.
所以，这对我来说是从很小的时候就开始的；我们谈到了内省。
I noticed very early on I had a deep love of poetry, and stories, and I was a voracious reader, and I was amazed by how words could make me feel in particular ways, just even separate from their, of course, dictionary meanings, the rhythm and how they worked together, even separate from meaning.
我很早就注意到我对诗歌和故事有着深深的热爱，我是一个贪婪的读者，我惊讶于文字如何让我以特定的方式感受到，甚至与它们的字典含义、节奏以及它们如何协同工作分开，甚至与意义分开。
And I was stunned by poets that could use words in new ways that were even divorced from their meaning at all, and yet could still trigger specific emotions.
我对诗人能够以新的方式使用词语感到震惊，这些方式甚至完全脱离了它们的含义，但仍然可以引发特定的情感。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And this was always fascinating to me.
这一直让我着迷。
So, I wanted to understand that.
所以，我想了解这一点。
And so I was interested and I became interested in the brain.
所以我很感兴趣，并且对大脑产生了兴趣。
And I thought, well, I'm going to have to study the human brain because only human beings can describe what's going on inside enough.
我想，好吧，我必须研究人脑，因为只有人类才能充分描述大脑内部发生的事情。
So in college I began to steer myself toward medicine and with the idea of becoming a neurosurgeon.
因此，在大学里，我开始转向医学，并想成为一名神经外科医生。
And so, I came here to medical school and did an MD-PhD program, planning neurosurgery all the way through the first rotation.
因此，我来到这里的医学院，完成了医学博士-博士课程，在第一次轮转期间一直规划神经外科。
I did — at the end of medical school, as you know, you do rotations, you go through different specialties, and some of these are required rotations that everybody has to do, some are elective where you can pick what you want to do.
我做到了——在医学院结束时，如你所知，你会进行轮换，你会经历不同的专业，其中一些是每个人都必须做的必修轮换，有些是选修课，你可以选择你想做的事情。
I elected to do neurosurgery first, even before regular surgery.
我选择先进行神经外科手术，甚至在常规手术之前进行。
I was that sure I wanted to do it and I loved it.
我确信我想做这件事并且我喜欢它。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I had a fantastic time.
我度过了一段美好的时光。
There was an amazing patient who had a thalamic damage, and there was a neglect syndrome, where the patient was not able to be aware of something that was right in front of him.
有一位令人惊奇的患者，他的丘脑受损，并且患有忽视综合症，患者无法意识到就在他面前的东西。
Andrew Huberman:
安德鲁·休伯曼：
Even though their vision was perfectly?
即使他们的视力很完美？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Even though their vision was perfectly fine, exactly.
尽管他们的视力确实很好。
I loved the operating room; I loved the rhythm of suturing and the precision of it, and I loved being able to help patients immediately.
我喜欢手术室；我喜欢缝合的节奏和精确度，也喜欢能够立即帮助患者。
But then a required rotation was in psychiatry, which I was not looking forward to at all.
但后来需要轮换的是精神病学，我根本不期待。
And that completely reset my whole life, that experience in psychiatry.
这完全重置了我的整个生活，即精神病学的经历。
And it was at that moment that I saw this is first of all the greatest need, the depth of suffering and the depth of the mystery together.
就在那一刻，我首先看到这是最大的需要，痛苦的深度和奥秘的深度结合在一起。
And also, and I almost feel a little guilty about this, It's so interesting too.
而且，我对此几乎感到有点内疚，这也很有趣。
Yes, we can help, yes there's need, but as a scientist, this is amazing that someone's reality can be different from my own with everything physically, as far as we can tell, the same with the measures we have.
是的，我们可以提供帮助，是的，有需要，但作为一名科学家，令人惊讶的是，据我们所知，某人的现实可能与我自己的现实不同，就我们所知，与我们所采取的措施相同。
And yet we've got a different reality that is an amazing thing.
然而我们却面临着一个不同的现实，这是一件令人惊奇的事情。
And if we couldn't understand that and help these people, that would be just more than anybody could ask for.
如果我们不能理解这一点并帮助这些人，那就超出了任何人的要求。
And so, that's how I ended up taking this path.
所以，这就是我最终走上这条路的原因。
Just a required rotation in psychiatry.
只是精神病学所需的轮换。
Andrew Huberman:
安德鲁·休伯曼：
It all started with poetry.
这一切都始于诗歌。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And it started with poetry.
这一切都是从诗歌开始的。
Andrew Huberman:
安德鲁·休伯曼：
Out of respect for poetry, are there any favorites that you spend time with on a regular basis?
出于对诗歌的尊重，您经常花时间阅读哪些最喜欢的诗歌？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I mean, the ones who got me down this path early on, I remember in childhood and high school, Borges had an immense influence on me.
我的意思是，那些早年让我走上这条道路的人，我记得在童年和高中，博尔赫斯对我产生了巨大的影响。
I studied Spanish all the way through, and reading his work, he was a great writer.
我自始至终都在学习西班牙语，读过他的作品，他是一位伟大的作家。
He wrote both in English and in Spanish, and being able to appreciate his poetry both in English and in Spanish was a pretty amazing thing.
他用英语和西班牙语写作，能够欣赏他的英语和西班牙语诗歌是一件非常了不起的事情。
Not many poets can do that.
没有多少诗人能做到这一点。
Andrew Huberman:
安德鲁·休伯曼：
You're bilingual?
你是双语者吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
At one point I was effectively fluent in Spanish, and I'm pretty good with medical Spanish still because we use Spanish all the time in the clinic here.
有一段时间，我的西班牙语非常流利，而且我仍然很擅长医学西班牙语，因为我们在这里的诊所一直使用西班牙语。
I wouldn't claim full fluency, but it's something I definitely use all the time, and that's been very helpful in the clinic.
我不会声称完全流利，但它绝对是我一直使用的东西，并且这在诊所中非常有帮助。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, Borges is wonderful; as the son of an Argentine, I grew up hearing about it, and I learned that Borges' favorite city was Geneva.
是的，博尔赫斯很棒；作为阿根廷人的儿子，我是听着这件事长大的，我了解到博尔赫斯最喜欢的城市是日内瓦。
So, I spent time in Geneva only for that reason.
所以，我在日内瓦呆了一段时间就是为了这个原因。
It's also turns out to be an interesting city.
事实证明它也是一个有趣的城市。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So, you developed methods to control neurons with these algae proteins using light.
因此，您开发了利用光控制这些藻类蛋白神经元的方法。
Yeah.
是的。
In 2015 there was this, what I thought was a very nice article published in the New Yorker, describing your work and the current state of your work in the laboratory, in the clinic, and an interaction with a patient.
2015 年，《纽约客》发表了一篇我认为非常好的文章，描述了您的工作以及您在实验室、诊所的工作现状以及与患者的互动。
So as I recall, a woman who was severely depressed, and you reported in that article some of the discussion with this patient and then in real time increased the activation of the so-called vagus nerve, this 10th cranial nerve that extends out of the skull and innervates many of the viscera and body.
我记得，有一位患有严重抑郁症的女性，您在那篇文章中报道了与该患者的一些讨论，然后实时增加了所谓迷走神经的激活，迷走神经是从头骨延伸出来并支配许多内脏和身体的第十脑神经。
Andrew Huberman:
安德鲁·休伯曼：
What is the potential for channelrhodopsins or related types of algae engineering to be used to manipulate the vagus?
视紫红质通道蛋白或相关类型的藻类工程用于操纵迷走神经的潜力有多大？
Because I believe in that instance it wasn't channelopsin stimulation, it was electrical stimulation, right?
因为我相信在这种情况下，这不是通道蛋白刺激，而是电刺激，对吗？
Or to manipulate, for instance, a very small localized region of the brain?
或者例如操纵大脑的一个非常小的局部区域？
Let me frame it a little bit differently in light of what we were talking about a couple minutes ago.
让我根据我们几分钟前讨论的内容稍微改变一下。
My understanding is that if somebody has severe depression and they take any number of the available pharmaceutical agents that are out there, SSRI, serotonergic agents, increase dopamine, increase whatever, that sometimes they experience relief, but there're often serious side effects.
我的理解是，如果有人患有严重的抑郁症，他们服用任何数量的可用药物，SSRI，血清素能药物，增加多巴胺，增加任何东西，有时他们会感到缓解，但通常会出现严重的副作用。
Sometimes they don't experience relief, but as I understand it, channelopsins and their related technology, in principle, would allow you to turn on or off the specific regions of the brain that lead to the depressive symptoms, or maybe you turn up a happiness circuit, or a positive anticipation circuit.
有时他们不会感到缓解，但据我了解，通道视蛋白及其相关技术原则上可以让你打开或关闭导致抑郁症状的大脑特定区域，或者你可以打开幸福回路或积极预期回路。
Where are we at now, in terms of bringing this technology to the nervous system?
在将这项技术引入神经系统方面，我们现在处于什么阶段？
And let's start with body and then move into the skull.
让我们从身体开始，然后进入头骨。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yup, so starting with the body is a good example because it highlights the opportunity and how far we have to go.
是的，所以从身体开始是一个很好的例子，因为它强调了机会以及我们必须走多远。
So let's take this example of vagus nerve stimulation.
让我们以迷走神经刺激为例。
So the vagus nerve, it's the 10th cranial nerve.
迷走神经，它是第十脑神经。
It comes from the brain, it goes down, it innervates the heart, and innervates the gut.
它来自大脑，下行，支配心脏，支配肠道。
And by innervate, I mean it sends little connections down to help guide what happens in these organs in the abdomen and chest.
我所说的神经支配，是指它向下发送很少的连接，以帮助指导腹部和胸部这些器官发生的情况。
It also collects information back, and there's information coming back from all those organs that also go through this vagus nerve, the 10th cranial nerve, back to the brain.
它还收集返回的信息，并且信息从所有也通过迷走神经（第十脑神经）返回大脑的器官返回。
And so this is somewhat of a superhighway to the brain then was the idea.
所以这有点像一条通往大脑的高速公路，当时的想法就是这样。
And maybe the idea is maybe we could put a little cuff, a little electrical device around the vagus nerve itself, and maybe have just like a pacemaker battery, have a little power source here under the clavicle, everything under the skin, and have a little cuff and drive signals, and maybe they'll get back to the brain.
也许我们的想法是，我们可以在迷走神经周围放一个小袖带，一个小电子装置，也许就像起搏器电池一样，在锁骨下面有一个小电源，所有东西都在皮肤下面，有一个小袖带和驱动信号，也许它们会回到大脑。
So a way of getting into the brain without putting something physical into the brain.
这是一种无需将物理物质放入大脑即可进入大脑的方法。
Andrew Huberman:
安德鲁·休伯曼：
And why the vagus, I mean it's there and it's accessible.
为什么是迷走神经，我的意思是它就在那里并且可以触及。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's the reason.
这就是原因。
Andrew Huberman:
安德鲁·休伯曼：
That's the reason?
是这个原因吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's the reason, yes.
这就是原因，是的。
Andrew Huberman:
安德鲁·休伯曼：
Really?
真的吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
You're not kidding?
你没开玩笑吧？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I'm not kidding.
我不是在开玩笑。
Andrew Huberman:
安德鲁·休伯曼：
So stimulating the vagus to treat depression, simply because it's accessible.
所以刺激迷走神经来治疗抑郁症，只是因为它容易实现。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It started as actually as an epilepsy treatment, and it can help with epilepsy, but yes, it's simply because it's accessible.
它实际上是作为一种癫痫治疗开始的，它可以帮助治疗癫痫，但是，是的，这只是因为它容易获得。
Andrew Huberman:
安德鲁·休伯曼：
God, you got to love medicine.
天啊，你一定要热爱医学。
As a scientist, this is where I get to chuckle and just say, I'm in the field of medicine.
作为一名科学家，这是我可以笑着说，我在医学领域的地方。
From that perspective.
从这个角度来看。
From the perspective of a scientist and outsider, the field of medicine as a field that goes in and tickles pathways because they're there.
从科学家和局外人的角度来看，医学领域是一个进入并刺激路径的领域，因为它们就在那里。
It's ...
这是...
I don't know what to say.
我不知道该说什么。
It's a little shocking.
有点令人震惊。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And, at least in my laboratory, I always say, "You never do an experiment because you can, you do an experiment to test a specific hypothesis."
而且，至少在我的实验室里，我总是说，“你永远不会做实验，因为你可以做实验，你做实验是为了检验一个特定的假设。”
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, yeah.
是啊，是啊。
I mean there are stories people tell.
我的意思是人们会讲故事。
So the vagus nerve lands on a particular spot on the brain called the solitary tract nucleus, which is just one synapse away from the serotonin and dopamine and the norepinephrine.
因此，迷走神经落在大脑上一个称为孤束核的特定位置，该位置距离血清素、多巴胺和去甲肾上腺素仅一个突触。
Andrew Huberman:
安德鲁·休伯曼：
So there's a link to chemical systems in the brain that make it a rational choice.
因此，这与大脑中的化学系统存在联系，使其成为理性的选择。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
It's not irrational, but I can tell you that even if that were not true, the same thing would've been tried.
这并非不合理，但我可以告诉你，即使事实并非如此，同样的事情也会被尝试过。
Andrew Huberman:
安德鲁·休伯曼：
You guys would've done it anyway.
无论如何你们都会这么做的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Because it's accessible.
因为它触手可及。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
Okay.
好的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And why?
为什么？
Well, it's again, not to disparage what's been happening in this branch of medicine.
好吧，我再说一遍，不是为了贬低这个医学领域正在发生的事情。
There's immense suffering, treatments.
有巨大的痛苦和治疗。
Many treatments don't work and we try things.
许多治疗方法都不起作用，我们尝试一些方法。
And this is how so many advances in medicine happen.
医学上的许多进步就是这样发生的。
When you think about a kidney dialysis, which has kept many people alive, that was just started by someone saying, "Hey, let's try this.
当你想到让很多人活下来的肾透析时，你会发现有人说：“嘿，让我们试试这个。
Maybe there's something building up in the blood and maybe we can dialyze something and help them." Yeah, it worked.
也许血液中有些东西在积聚，也许我们可以透析一些东西来帮助他们。”是的，它起作用了。
And it was just a test pilot mentality.
这只是试飞员的心态。
We can access the blood — let's run it across a dialysis membrane, put it back in the body.
我们可以获取血液——让它穿过透析膜，然后将其放回体内。
Oh my God, that actually works.
天哪，这确实有效。
And sometimes you do need that test pilot mentality, of course, to do it in a rigorous, safe, controlled way, which is what we do.
当然，有时你确实需要试飞员心态，以严格、安全、受控的方式进行测试，这就是我们所做的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Anyway, that's how we ended up, but still with the vagus nerve stimulation, okay, so what is it?
不管怎样，我们就是这样结束的，但仍然有迷走神经刺激，好吧，那是什么呢？
Does it work?
有效吗？
It's FDA approved for depression, this vagus nerve stimulation, but on the population level, if you average across all people, the effect sizes are pretty small.
FDA 批准它用于治疗抑郁症，这种迷走神经刺激，但在人群水平上，如果对所有人进行平均，效果相当小。
Some patients, it has an amazing effect, but some patients it doesn't work at all, and average across everybody, the effect size is pretty small.
有些患者，它有惊人的效果，但有些患者根本不起作用，而且对于每个人来说，平均而言，效果很小。
Andrew Huberman:
安德鲁·休伯曼：
How do you think it's working when it does work?
当它起作用时，你认为它的效果如何？
Is it triggering the activation of neurons that release more serotonin or dopamine?
它是否会触发神经元的激活，释放更多的血清素或多巴胺？
Karl Deisseroth:
卡尔·戴瑟罗斯：
It could be, but I would say we don't have evidence for that, and so I just don't know.
有可能，但我想说我们没有证据证明这一点，所以我不知道。
But what is clear is that it's dose limited in how high and strongly we can stimulate, and why?
但显而易见的是，我们可以刺激的高度和强度受到剂量的限制，为什么呢？
It's because it's an electrode and it's stimulating everything nearby.
这是因为它是一个电极，它会刺激附近的一切。
And, when you turn on the vagus nerve stimulator, the patient's voice becomes strangulated and hoarse; they can have trouble swallowing; they can have trouble speaking, for sure, even some trouble breathing, because everything in the neck, every electrically responsive cell and projection in the neck is being affected by this electrode.
而且，当你打开迷走神经刺激器时，病人的声音会变得压抑、沙哑；他们可能有吞咽困难；当然，他们可能会说话有困难，甚至呼吸困难，因为脖子上的所有东西，每个电反应细胞和脖子上的突起都受到这个电极的影响。
And so you can go up just so far with the intensity, and then you have to stop.
所以你的强度可以上升到一定程度，然后你就必须停下来。
So, to your initial question, could a more precise stimulation method like optogenetics help in the setting?
那么，对于你最初的问题，像光遗传学这样更精确的刺激方法可以帮助解决这个问题吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
In principle, it could, because if you would target the light sensitivity to just the right cell, let's say cell X that goes from point A to point B, that you know causes symptom relief of a particular kind, then you're in business.
原则上是可以的，因为如果你将光敏感性瞄准正确的细胞，比如说从 A 点到 B 点的 X 细胞，你知道它会导致某种特定症状的缓解，那么你就成功了。
You can have that be the only cell that's light sensitive.
你可以让它成为唯一对光敏感的细胞。
You're not going to affect any of the other cells, the larynx and the pharynx and the projections passing through.
你不会影响任何其他细胞、喉部和咽部以及穿过的突出物。
So that's the hope, that's the opportunity.
所以这就是希望，这就是机会。
The problem is that we don't yet have that level of specific knowledge.
问题是我们还没有达到那种程度的具体知识。
We don't know, okay, it's the cell starting in point A going to point B that relieves this particular symptom.
我们不知道，好吧，是细胞从 A 点开始到 B 点缓解了这种特殊的症状。
Andrew Huberman:
安德鲁·休伯曼：
We want to fix this key on the piano.
我们想把这个键固定在钢琴上。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And then I see two other steps that are required.
然后我看到还需要两个步骤。
One is to get the channelopsin gene into the cell.
一是将通道视蛋白基因引入细胞。
In the case of Botond Roska and colleagues rescuing vision in this patient, they did that by an injection of a virus that doesn't damage the neurons.
在 Botond Roska 及其同事挽救这名患者视力的案例中，他们通过注射一种不会损害神经元的病毒来做到这一点。
The virus itself is fairly innocuous, but carries a cargo, and it's a one-time injection, the cells express, and then they used light to stimulate.
病毒本身相当无害，但携带货物，而且是一次性注射，细胞表达，然后用光刺激。
So, let's say I'm depressed, which I don't think I am, although now sitting in front of a psychiatrist, you probably can see signs that maybe I am or maybe I'm not, but let's say we put channelopsin into a specific branch of the vagus that we understand is responsible for mood; how are we going to get it in there?
所以，假设我很抑郁，但我认为我并不抑郁，尽管现在坐在精神科医生面前，你可能可以看到我可能抑郁或不抑郁的迹象，但假设我们将通道视蛋白放入迷走神经的一个特定分支中，我们知道它负责情绪；我们怎样才能把它放进去呢？
And, then how are we going to deliver the light?
那么我们如何传递光呢？
Because we're not talking about sunlight or standing in front of a light bulb, necessarily.
因为我们不一定谈论阳光或站在灯泡前。
What are the mechanisms for the body?
身体有哪些机制？
Karl Deisseroth:
卡尔·戴瑟罗斯：
So we had to solve exactly these questions you're saying.
所以我们必须准确解决你所说的这些问题。
How do you get the light in?
怎么让光进来？
How do you get the gene in in a potent and robust and safe way?
如何以有效、稳健且安全的方式获取基因？
And that's now solved, and that's not a challenge.
现在这个问题已经解决了，这不是一个挑战。
So there are very safe, well-tolerated gene-delivery mechanisms that are called adeno-associated viruses, AAVs, and these are things that are associated with the common cold.
因此，存在非常安全、耐受性良好的基因传递机制，称为腺相关病毒 (AAV)，这些病毒与普通感冒有关。
They themselves don't cause any symptoms.
它们本身不会引起任何症状。
They've been engineered, and there's been a broad community of viral engineering that's been going on for decades, making these safer, well-tolerated and so on.
它们已经被工程化，并且已经有一个广泛的病毒工程社区已经持续了几十年，使它们更安全、耐受性良好等等。
We can put the channelrhodopsin gene into these viral vectors that deliver the gene, and we can have little bits of additional DNA that govern expression only in one cell, but not another.
我们可以将视紫红质通道蛋白基因放入这些传递该基因的病毒载体中，并且我们可以有少量额外的 DNA 只在一个细胞中控制表达，而不能在另一个细胞中控制表达。
These are called promoters and enhancers, all genetic tricks built up by a very broad community of great scientists over the decades.
这些被称为启动子和增强子，所有遗传技巧都是由广大伟大科学家在几十年来建立的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
We can put these different bits of DNA, package them into this AAV, this little virus, and that can be then injected into a particular part of the body, and sticking with this vagus nerve example, we know that there are particular clumps of neurons.
我们可以将这些不同的 DNA 片段，将它们包装到这个 AAV，这个小病毒中，然后可以将其注射到身体的特定部位，并坚持这个迷走神经的例子，我们知道有特定的神经元团。
There's one called the nodose ganglion that has a clump of cells related to the vagus nerve, and you could, for example, target a little injection into that ganglion.
有一种叫做结状神经节，它有一群与迷走神经相关的细胞，例如，你可以向该神经节注射少量药物。
Andrew Huberman:
安德鲁·休伯曼：
Would that be an outpatient procedure?
这是门诊手术吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yup.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So you come in the morning, get your injection, maybe walk out a few hours later?
所以你早上来，接受注射，也许几个小时后就出去？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, that's right.
是的，没错。
And so that's the gene.
这就是基因。
Then the light delivery, this is also something that we've worked out.
然后是光的传递，这个也是我们已经研究出来的。
We've worked on making very, very light-sensitive opsins.
我们一直致力于制造对光非常非常敏感的视蛋白。
One challenge, and Botond would be the first to state this in fact, in solving this problem for the patient, he had to build goggles that created much brighter light than the normal ambient light delivery, because as I mentioned earlier, you have to pack a lot of these channelrhodopsins in; they don't have much current.
事实上，Botond 是第一个提出这一挑战的人，在为患者解决这个问题时，他必须制造能够产生比正常环境光传输更亮的光的护目镜，因为正如我之前提到的，你必须装入大量视紫红质通道；他们没有太多电流。
You have to really make sure that you've got a tense enough light to activate enough of them to cause a stimulation.
你必须真正确保你有足够强的光来激活足够多的它们以引起刺激。
Andrew Huberman:
安德鲁·休伯曼：
And it has to be the right wavelength, right?
而且它必须是正确的波长，对吧？
Karl Deisseroth:
卡尔·戴瑟罗斯：
It has to be the right wave.
它必须是正确的波浪。
Andrew Huberman:
安德鲁·休伯曼：
And going back to your example of the algae moving toward or away ...
回到你的藻类移动或远离的例子......
the light, it has to be tuned just right.
灯光，必须调得恰到好处。
So, I'm imagining in my mind as a nonengineer, I know you're also a bioengineer; I'm imagining a little, tiny blue light-emitting object that's a little bigger than a clump of cells, or maybe about the size of a clump of cells.
所以，我在脑海中想象自己是一名非工程师，我知道你也是一名生物工程师；我正在想象一个微小的蓝色发光物体，它比细胞团大一点，或者大约是细胞团的大小。
And for those that don't know, your credit card is about 200 microns thick on the side, and micron is a thousandths of a millimeter, and so we're talking about a little, tiny stamp that's basically half a millimeter in size all around.
对于那些不知道的人来说，您的信用卡侧面大约有 200 微米厚，而微米是千分之一毫米，所以我们谈论的是一个很小的、很小的邮票，它的周围尺寸基本上是半毫米。
Each edge, half a millimeter in size.
每个边缘的大小为半毫米。
I could imagine that being put under my skin, and then I would what, I'd hit an app on my phone and I'd say, "Dr. Deisseroth, I'm not feeling great today.
我可以想象这是在我的皮肤下，然后我会做什么，我会点击手机上的应用程序，然后我会说，“戴瑟罗斯博士，我今天感觉不太好。
Can I increase the stimulation?" And you'd say, "Go for it." And then I'd ramp it up.
我可以增加刺激吗？”你会说：“去做吧。”然后我会加大力度。
Is that how it would go?
事情就这样发展吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I mean that's effectively what we already do with the vagus nerve stimulation.
我的意思是，这实际上就是我们已经对迷走神经刺激所做的事情。
The doctor in this case, and I have this in some of my patients in the clinic; I do vagus nerve stimulation.
这个案例中的医生，以及我在诊所的一些病人身上都遇到过这种情况；我做迷走神经刺激。
I talk to them, I say, "How are you?" I go through the symptoms, I use the psychiatric interview to elicit their internal states, and then I have a radio frequency controller that I can dial in-
我和他们说话，我说，“你好吗？”我检查症状，通过精神病学访谈来了解他们的内部状态，然后我有一个可以拨入的射频控制器——
Andrew Huberman:
安德鲁·休伯曼：
Right there in real time?
实时就在那里？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Right there in real time.
实时就在那里。
Andrew Huberman:
安德鲁·休伯曼：
You're holding the remote control essentially to their brain, although it's remote controlled?
尽管它是远程控制的，但你实际上是把遥控器放在他们的大脑上？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, through a couple steps, but yeah.
是的，通过几个步骤，但是是的。
And I can turn up the frequency, I can turn up the intensity, all with the radio frequency and control, and then it's reprogrammed or re-dosed, and then the patient can then leave at this altered dose.
我可以调高频率，调高强度，所有这些都通过射频和控制进行，然后重新编程或重新剂量，然后患者可以按照改变的剂量离开。
Andrew Huberman:
安德鲁·休伯曼：
So this is happening now?
那么现在这种情况正在发生吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
This is happening right now electrically.
这现在正在以电力方式发生。
Andrew Huberman:
安德鲁·休伯曼：
You do this routinely?
你经常这样做吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I do it routinely in my clinic electrically, yeah.
是的，我在诊所里经常用电的方式做这件事。
Andrew Huberman:
安德鲁·休伯曼：
And you're getting the verbal content, which as you described earlier, is the indication of how well something is working in real time.
正如您之前所描述的，您将获得口头内容，这表明某些内容实时运行得有多好。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So, maybe you could just describe a little bit of the interaction with that particular patient or another patient.
因此，也许您可以描述一下与该特定患者或另一位患者的互动。
What's a typical arc of narrative as you go from no stimulation to increase stimulation?
从无刺激到增加刺激的典型叙述弧是怎样的？
Karl Deisseroth:
卡尔·戴瑟罗斯：
In most patients, the actual therapeutic effects, the benefits actually take many days, two weeks.
对于大多数患者来说，真正的治疗效果、益处实际上需要很多天、两周的时间。
And so what I'm mostly focusing on in the office in real time is making sure I'm in a safe low side-effect regime.
因此，我在办公室实时关注的重点是确保我处于安全的低副作用状态。
And so, first I talk to the patient who has been on a particular dose of the stimulation for weeks or longer, and I talk about symptoms — how were things over the past month?
因此，首先我会与接受特定剂量刺激数周或更长时间的患者交谈，并谈论症状 - 过去一个月情况如何？
How was your hope?
你的希望如何？
How was your energy level?
你的精力水平如何？
Sleep?
睡觉？
What is your mood?
你的心情如何？
And then we talk with the patient; we decide, well, this is not yet where we'd like to be.
然后我们与病人交谈；我们决定，好吧，这还不是我们想要的地方。
And so then, I can turn up the intensity of the stimulation real time in the office.
这样我就可以在办公室实时调高刺激的强度。
In most patients, I don't expect an immediate mood change.
对于大多数患者，我预计情绪不会立即改变。
What I do is I increase the dose until a next level up, while asking the patient for side effects.
我所做的就是增加剂量直到下一个级别，同时询问患者副作用。
Can you still breathe okay?
你还能呼吸吗？
Can you still swallow okay?
还能吞咽吗？
And I can hear their voice as well, and I can get a sense.
我也能听到他们的声音，我能感觉到。
Andrew Huberman:
安德鲁·休伯曼：
And you're looking at their face?
你在看他们的脸吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I'm looking at their face.
我看着他们的脸。
And so I can get a sense, am I still in a safe side-effect regime?
这样我就能感觉到，我是否仍然处于安全的副作用状态中？
And then I stop at a particular point that looks safe, and then patient goes home, comes back a month later, and I get the report on how things were over that month.
然后我在一个看起来安全的特定点停下来，然后病人回家，一个月后回来，我得到有关该月情况的报告。
Andrew Huberman:
安德鲁·休伯曼：
I asked if you're looking at their face, because in your book, you described the incredible complexity of social interactions.
我问你是否在看他们的脸，因为在你的书中，你描述了社交互动的难以置信的复杂性。
And at one point, you described the incredible amount of information that the eyes inform about the brain and the context of somebody's inner experience, whether depressed or happy or otherwise.
在某一时刻，你描述了眼睛传达的关于大脑的大量信息以及某人内心体验的背景，无论是抑郁还是快乐还是其他。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I want to make sure that we get back to how to maneuver and manipulate the nervous system for sake of mental health.
我想确保我们回到如何为了心理健康而操纵和操纵神经系统。
But, what are you looking for?
但是，你在寻找什么？
So as a vision scientist, I think pupils dilating is a sign of arousal, but that could be a positive arousal, positive valence, like excitement, or it could be terror.
因此，作为一名视觉科学家，我认为瞳孔扩张是觉醒的标志，但这可能是一种积极的觉醒，正价，比如兴奋，也可能是恐惧。
You're going to get the same dilation of the pupils.
你会得到同样的瞳孔放大。
Andrew Huberman:
安德鲁·休伯曼：
And I'm always reminding people that these two little goodies are two pieces of brain basically, they're just outside the cranial vault.
我总是提醒人们，这两个小东西基本上是大脑的两块，它们就在颅顶外面。
So they're not unlike the vagus in that sense, but they're more of a report than a control knob, although I'd like to think they could be used as control knobs too.
因此，从这个意义上说，它们与迷走神经没有什么不同，但它们更像是一种报告，而不是一个控制旋钮，尽管我想认为它们也可以用作控制旋钮。
So, without putting you on the spot again to diagnose me, something I would never ask you to do with the camera's rolling, but what are you looking for that the patient might not be aware of?
所以，不用再让你在现场诊断我，我永远不会要求你在相机滚动时做这些事情，但你在寻找病人可能不知道的什么？
In other words, can you see depression in somebody's eyes?
换句话说，你能从某人的眼中看到抑郁吗？
And if you know a patient, or if you don't, can you see it in their body posture when they walk in?
如果你认识或不认识某个病人，当他们走进来时，你能从他们的身体姿势中看出这一点吗？
Realizing, of course, that a trained psychiatrist like yourself develops an intuitive sense that's aggregating lots of different features of a patient, but what about the eyes?
当然，像您这样受过训练的精神科医生会发展出一种直觉，这种直觉会聚集患者的许多不同特征，但是眼睛呢？
What's going on there?
那里发生了什么事？
Karl Deisseroth:
卡尔·戴瑟罗斯：
The eyes are incredibly rich in information.
眼睛里蕴藏着极其丰富的信息。
And as you allude to though, it's not as if any one measurable conveys all the information you need.
正如您所提到的，并不是任何一个可衡量的指标都能传达您需要的所有信息。
It's what an engineer would say, joint statistics.
这就是工程师所说的联合统计。
It's many things all at once, whether they're in synchrony, or out of synchrony, that actually turns out to matter.
很多事情同时发生，无论它们是同步的还是不同步的，这实际上都很重要。
And the eye contact question, we all know eye contact is incredibly important.
至于眼神接触问题，我们都知道眼神接触非常重要。
You don't feel you've connected with somebody unless there's eye contact, but eye contact can go awry too.
除非有眼神交流，否则你不会觉得自己与某人建立了联系，但眼神交流也可能出错。
It can be too intense, or it can be mistimed, or if there's someone with autism, it can be barely there at all.
它可能太强烈，或者可能不合时宜，或者如果有人患有自闭症，它可能根本不存在。
And this is one of the most striking symptoms of autism is the avoidance of eye contact, almost as if it's a harmful quantity.
自闭症最显着的症状之一就是避免目光接触，几乎就好像这是有害的量一样。
And so, there's an immense amount of information you get from the eyes, but it's the pairing of what's going on in the eyes, with everything else going on, the body language, the verbal content of what's coming out.
因此，你从眼睛中获得了大量的信息，但这些信息是眼睛中发生的事情与其他事情、肢体语言、所流露出的言语内容的配对。
All that together is the art of psychiatry and social interaction.
所有这些加在一起就是精神病学和社会互动的艺术。
Karl Deisseroth:
卡尔·戴瑟罗斯：
...
...
of psychiatry and social interaction.
精神病学和社会互动。
But sometimes you don't have the eye contact.
但有时你们没有目光接触。
And this is an amazing thing, and I do talk about this in the book as well.
这是一件了不起的事情，我也在书中谈到了这一点。
In many cases in psychiatry, sometimes it's over the phone that you have to make key decisions.
在精神病学的许多情况下，有时您必须通过电话做出关键决定。
And as I recall vividly being as a resident, very often you have to take these phone calls from people who are not in the hospital, people, you can't see their eye, you can't see their body, anything about them, just the sound of their voice.
我清楚地记得，作为一名住院医生，很多时候你必须接听不在医院的人打来的电话，人们，你看不到他们的眼睛，你看不到他们的身体，看不到他们的任何东西，只能听到他们的声音。
And you can ask them questions, and you have to make, in some cases, life or death decisions.
你可以问他们问题，在某些情况下，你必须做出生死攸关的决定。
Is this person truly suicidal?
这个人真的有自杀倾向吗？
Something like that comes up all the time.
类似的事情总是会出现。
And so I developed over the course of training, and I think all psychiatrists do this, is you develop a way that whatever data stream you have, whether it's the eyes or whether it's just the sound of a voice coming over the phone, you learn to hone in on that data stream you have and focus on it and identify changes.
所以我在培训过程中发展了，我认为所有精神病学家都会这样做，你开发一种方法，无论你拥有什么数据流，无论是眼睛还是只是电话中传来的声音，你都要学会磨练你拥有的数据流并专注于它并识别变化。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And it's quite amazing.
这真是太神奇了。
I found that you can actually, if you know a patient, you can detect very precise changes in mood just from the sound of the voice.
我发现，如果你认识一个病人，你实际上可以从声音中察觉到非常精确的情绪变化。
And you can have a realization that, oh, this patient's depression has improved by about half, just by the tone of their voice.
你可以意识到，哦，这个病人的抑郁症已经改善了大约一半，仅从他们的语气来看。
And same with eyes, with enough practice you can get enough information from a single data stream to give you some information.
与眼睛一样，通过足够的练习，您可以从单个数据流中获取足够的信息，从而为您提供一些信息。
But when you do have the whole picture, that of course is best.
但当你确实了解了整个情况时，那当然是最好的。
Andrew Huberman:
安德鲁·休伯曼：
So many theories out there about excessive blinking and lying, lack of blinking and sociopathy.
关于过度眨眼和说谎、缺乏眨眼和反社会的理论有很多。
I like to remind people that people have varying degrees of lubrication of the eyes, which also influence the frequency of blinking and presumably have nothing to do with whether or not what they're saying is true or not.
我想提醒人们，人们的眼睛有不同程度的润滑，这也会影响眨眼的频率，并且可能与他们所说的是否真实无关。
But incredible, nonetheless, that the eyes are a portal to overall arousal state.
但令人难以置信的是，眼睛是整体唤醒状态的门户。
I'm fascinated by the effects of light on circadian biology and just overall desire to be awake or asleep, et cetera.
我对光对昼夜节律生物学的影响以及清醒或睡眠的整体欲望等着迷。
So the eyes are on the outside of the cranial vault.
所以眼睛位于颅顶的外侧。
The vagus is outside the cranial vault, obviously.
显然，迷走神经位于颅顶之外。
What about the goodies in here?
这里的好东西怎么样？
Andrew Huberman:
安德鲁·休伯曼：
Parkinson's, we know at least one of the major sites of degeneration and failure that lead to those symptoms.
对于帕金森氏症，我们至少知道导致这些症状的退化和衰竭的主要部位之一。
I can name off any number of other things.
我可以列举许多其他事情。
In your book, you talk about the beautiful work done with optogenetics of active versus passive coping, that there are areas of the brain like the habenula that, when active, make animals and presumably people passive and unwilling or uninterested in fighting back against pressures of life.
在你的书中，你谈到了光遗传学在主动应对和被动应对方面所做的出色工作，大脑中的某些区域，如缰核，当活跃时，会使动物和可能的人变得被动，不愿意或不感兴趣对抗生活压力。
Whereas another region, the raphe, you stimulate that and they actively cope, they get their grit going, and they're able to lean into life.
而另一个区域，即中缝，你刺激它，他们就会积极应对，他们就会有勇气，并且能够融入生活。
So how does one get to those structures in a focused way?
那么如何才能集中地了解这些结构呢？
And what does the next two to five to 10 years look like?
未来两到五到十年会是什么样子？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, this is the promise on that, and it is on that time scale that I think things may start to play out.
嗯，这就是对此的承诺，我认为事情可能会在这个时间范围内开始发挥作用。
The specificity of optogenetics is really only useful if you have some idea of how to use that specificity.
仅当您了解如何使用光遗传学的特异性时，光遗传学的特异性才真正有用。
And actually, it's a frustrating aspect of psychiatry that, in many cases, the most effective treatments we have have the least specificity, electroconvulsive therapy being a great example, where you're causing a brain-wide-
事实上，精神病学的一个令人沮丧的方面是，在许多情况下，我们拥有的最有效的治疗方法的特异性最低，电休克疗法就是一个很好的例子，你会引起全脑 -
Andrew Huberman:
安德鲁·休伯曼：
Which looks barbaric, but as you mentioned is effective.
这看起来很野蛮，但正如你提到的，它是有效的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I mean, these days it's much more clinically-
我的意思是，现在它更加临床化了——
Andrew Huberman:
安德鲁·休伯曼：
Doesn't look like the last scene in "One Flew Over the Cuckoo's Nest."
看起来不像《飞越疯人院》的最后一幕。
Karl Deisseroth:
卡尔·戴瑟罗斯：
No, it doesn't.
不，事实并非如此。
Now it's a very clinically safe and stable procedure.
现在，这是一种临床上非常安全且稳定的手术。
But where I would say yeah, it's got this almost medieval lack of specificity even if the procedure's well-controlled and clinically safe and stable.
但我想说的是，即使手术控制良好且临床安全稳定，它仍然缺乏特异性。
It's not very specific.
这不是很具体。
You're causing a brain-wide seizure.
你正在引起全脑癫痫发作。
How could you be less specific than that?
你怎么能比这更不具体呢？
Andrew Huberman:
安德鲁·休伯曼：
And we don't know the source of the relief.
我们不知道救济的来源。
Presumably it's a dump of neuromodulators like dopamine and serotonin, but we don't-
大概是多巴胺和血清素等神经调节剂的垃圾场，但我们不-
Karl Deisseroth:
卡尔·戴瑟罗斯：
There certainly is a dump of neuromodulators.
肯定有大量的神经调节剂。
We don't know that that's the cause for the relief.
我们不知道这就是缓解的原因。
And likewise with medications, this is also an interesting thing.
与药物一样，这也是一件有趣的事情。
Some of the most effective antidepressants, some of the most effective antipsychotics, are the ones that have the most side effects.
一些最有效的抗抑郁药和一些最有效的抗精神病药的副作用也最多。
And many examples of this.
这方面的例子还有很多。
For example, the most effective antipsychotic is something called clozapine, which has ...
例如，最有效的抗精神病药是氯氮平，它具有...
It unquestionably has the most side effects.
毫无疑问，它的副作用最多。
It has terrible, terrible side effects.
它有非常非常可怕的副作用。
Andrew Huberman:
安德鲁·休伯曼：
It's a D4 antagonist?
这是D4的反派吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
It has basically every receptor.
它基本上具有所有受体。
Andrew Huberman:
安德鲁·休伯曼：
Does it really?
真的吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, it has prominent serotonin, prominent muscarinic, certainly acts on dopamine receptors.
是的，它含有显着的血清素，显着的毒蕈碱，肯定会作用于多巴胺受体。
But it causes ...
但它会导致...
Blood cell counts change.
血细胞计数发生变化。
Andrew Huberman:
安德鲁·休伯曼：
How do people feel?
人们感觉如何？
So if I were schizophrenic and I was getting auditory hallucinations, et cetera, and I took clozapine, what could I expect to feel?
因此，如果我患有精神分裂症并且出现幻听等症状，并且服用了氯氮平，我会感觉到什么？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, so you would notice side effects and you would notice resolution of symptoms both.
嗯，所以你会注意到副作用，也会注意到症状的解决。
Andrew Huberman:
安德鲁·休伯曼：
So the voices would go away in a good situation.
因此，在良好的情况下，声音会消失。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
The voices would go away, but I would feel not good in my body?
声音消失了，但我的身体却感觉不舒服？
Karl Deisseroth:
卡尔·戴瑟罗斯：
You might have dizziness, you might have drooling, you might have any number of physical sensations that would be due to these off-target effects, the medication acting on these other receptors.
您可能会头晕，您可能会流口水，您可能会有许多身体感觉，这些都是由于药物作用于这些其他受体的脱靶效应造成的。
Andrew Huberman:
安德鲁·休伯曼：
And I'm certainly not suggesting this, but what if somebody without schizophrenia took clozapine?
我当然不是建议这样做，但如果没有精神分裂症的人服用氯氮平怎么办？
Karl Deisseroth:
卡尔·戴瑟罗斯：
You'd have the same side effects, presumably.
想必你也会有同样的副作用。
And so it would not be something that I would recommend.
所以我不会推荐它。
Andrew Huberman:
安德鲁·休伯曼：
Do psychiatrists take the drugs that they prescribe?
精神科医生会服用他们开的药物吗？
I just finished, for the third time, Oliver Sacks' autobiography, which is marvelous and I highly recommend to people.
我刚刚第三次读完奥利弗·萨克斯的自传，这本书非常棒，我强烈推荐给人们。
He certainly took a lot of drugs, not as part of his professional role.
他确实服用了大量药物，这并不是他职业角色的一部分。
But just out of curiosity, what is the interest or role of drugs in the field of psychiatry?
但出于好奇，药物在精神病学领域的兴趣或作用是什么？
Because I would imagine for a group of very curious, introspective people who are making recommendations about what to take, there could actually be some benefit for understanding what the experience of those drugs was like for their patients.
因为我想象对于一群非常好奇、内省的人来说，他们正在就服用什么药物提出建议，了解这些药物对患者的体验实际上可能会有一些好处。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I think that's true.
我认为这是真的。
And I will say that probably many or most psychiatrists have sampled a number of these for exactly the reason that you're saying, is to understand better and to help treat their patients better.
我想说的是，可能许多或大多数精神科医生已经对其中的一些进行了采样，正是出于你所说的原因，为了更好地理解并帮助更好地治疗他们的患者。
And I've spoken to people who have really found this very helpful to know, okay, this sleep disruption caused by this medication or the libido disruption caused by this other medication, wow, that is a big effect.
我和那些确实发现这非常有帮助的人交谈过，他们知道，好吧，这种药物引起的睡眠中断或其他药物引起的性欲中断，哇，这是一个很大的影响。
And it really helps with empathy for the patients to understand.
这确实有助于患者理解的同理心。
Andrew Huberman:
安德鲁·休伯曼：
I'm not suggesting that physicians or anybody experiment with drugs, but I am relieved to hear that because I think that when you're talking about accessing somebody's mind and their basic physiology, as you mentioned related to appetite, libido and sleep, really one is acting as a mechanic of the person's whole experience.
我并不是建议医生或任何人尝试药物，但听到这个消息我感到很欣慰，因为我认为当你谈论进入某人的思想和他们的基本生理学时，正如你提到的与食欲、性欲和睡眠有关的那样，实际上一个人正在充当一个人整个体验的机制。
They walk out of the office and they have a life experience that extends beyond the script.
他们走出办公室，获得了超出剧本的生活体验。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
And so at the same time though, you can't let that completely guide your clinical decisions because, as I mentioned, some of these medications that have the most side effects, they are also the most effective.
但与此同时，您不能让它完全指导您的临床决策，因为正如我所提到的，其中一些副作用最大的药物也是最有效的。
And clozapine is a great example.
氯氮平就是一个很好的例子。
That will work in patients where nothing else works.
这对于其他方法都不起作用的患者来说是有效的。
And believe me, we don't take the step of clozapine prescription lightly, because of all these side effects.
相信我，由于所有这些副作用，我们不会轻易采取氯氮平处方的步骤。
You have to come in for a weekly blood cell ...
你必须每周去检查一次血细胞...
or every few weeks a blood cell check to make sure that the blood counts are not off, for example.
例如，或者每隔几周检查一次血细胞，以确保血细胞计数没有异常。
But there are patients where no other medication works for the schizophrenia, and clozapine works amazingly well.
但有些患者的精神分裂症没有其他药物有效，而氯氮平的效果却出奇的好。
And so we do it even though there are the side effects.
因此，尽管有副作用，我们还是这样做。
And so then this comes back to your question, what if we had better and better specificity?
那么这又回到了你的问题，如果我们有越来越好的特异性怎么办？
Well, only if we know exactly what we're doing is the point.
好吧，只有我们确切地知道我们在做什么才是重点。
And so because as we become more refined, we better be right about where we're refining to.
因为当我们变得更加精致时，我们最好正确地了解我们要精炼的目标。
Andrew Huberman:
安德鲁·休伯曼：
And you imagine a day where it will be a single, maybe even outpatient neurosurgery — would go in through the skull or the back of the ear, deliver a small viral injection of one of these adenoviruses, a little sticker of light-emitting diode deep in the brain?
你想象有一天，这将是一次单一的、甚至是门诊神经外科手术——穿过头骨或耳后，注射一种腺病毒的小量病毒注射，在大脑深处贴上一张发光二极管的小贴纸？
Is that how you envision this someday?
这就是你所设想的有一天吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
That certainly could happen.
这当然有可能发生。
What I actually prefer as a vision is still medications, because those are minimally invasive.
我实际上更喜欢的视力仍然是药物治疗，因为它们是微创的。
If we knew what we were doing, we could make them more specific, have fewer side effects.
如果我们知道我们在做什么，我们就可以使它们更加具体，并减少副作用。
But optogenetics, that'll arm us with true causal understanding.
但光遗传学将帮助我们真正理解因果关系。
And so we'll know, and we're already moving rapidly toward this point, we'll know, okay, this symptom, the loss of pleasure in life that we call anhedonia, or the loss of motivation or energy to overcome challenges, active coping, these are largely subserved, largely controlled by this circuit, or that circuit or the cell that inhabits this other circuit.
所以我们会知道，我们已经在迅速朝这一点迈进，我们会知道，好吧，这种症状，我们称之为快感缺失的生活乐趣的丧失，或者克服挑战的动力或能量的丧失，积极应对，这些在很大程度上受到这个回路、那个回路或居住在另一个回路中的细胞的影响和控制。
Andrew Huberman:
安德鲁·休伯曼：
And we will know that because of the work done with channelopsins?
我们会因为通道视蛋白所做的工作而知道这一点？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Exactly.
正是如此。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I agree.
是的，我同意。
Karl Deisseroth:
卡尔·戴瑟罗斯：
In ways that we never could have the confidence otherwise.
以其他方式我们永远不可能有信心。
And so we'll know that this is the circuit that underlies the symptom or its resolution.
这样我们就会知道这是症状或其解决方案的基础电路。
And then we'll get to understand these cells very deeply.
然后我们将非常深入地了解这些细胞。
Okay, these cells that are causal, that do matter, who are they?
好吧，这些具有因果关系的细胞确实很重要，它们是谁？
What's their wiring?
他们的接线是怎样的？
What are the proteins that they make?
它们产生什么蛋白质？
What are the little things that are on the surface of the cell that could be receptors for specific medications, or combinations of receptors that would give us the specificity we need?
细胞表面的哪些小东西可能是特定药物的受体，或者是能给我们带来所需特异性的受体组合？
And then armed with that causal and precise and rigorous knowledge, then you can imagine medication development becoming totally different.
然后，有了因果性、精确性和严谨性的知识，你就可以想象药物开发会变得完全不同。
No longer serendipitous but truly grounded in causality.
不再是偶然的，而是真正扎根于因果关系。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
So using channelopsins as a way to probe the circuitry and figure out the sites that are disrupted, what patterns of activity are required, and then by understanding the constituents of those cells, like what they express and what they make, then developing drugs that could target those cells.
因此，使用通道视蛋白作为探测电路并找出被破坏的位点、需要什么活动模式的方法，然后通过了解这些细胞的成分，例如它们表达的内容和它们制造的内容，然后开发可以针对这些细胞的药物。
Not necessarily putting light-inducing diodes into the brain or walking around with wire packs attached to our skull or something.
不一定要把发光二极管放入大脑中，或者带着连接到我们头骨或其他东西上的线包走来走去。
That's fantastic, and I realize no one has a crystal ball, but what do you think the arc of that is?
这太棒了，我知道没有人有水晶球，但你认为它的弧线是什么？
Meaning are we going to see that in a year, in two years, three years?
这意味着我们会在一年、两年、三年内看到这一点吗？
Let me reframe that.
让我重新定义一下。
How soon will a pill-based treatment for a psychiatric disease be available that targets a specific set of cells that we know are important because of the work done with channel opsins?
基于通道视蛋白的工作，我们知道这些细胞很重要，针对精神疾病的基于药物的治疗需要多长时间才能上市？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I think that is, in some ways it's already happening at the level of individual patients.
我认为，在某些方面，这种情况已经在个体患者的层面上发生了。
Andrew Huberman:
安德鲁·休伯曼：
Here at Stanford?
在斯坦福吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yep.
是的。
And more broadly in terms of new drugs, new multicenter clinical trials, that'll play out over the next few years.
更广泛地说，新药、新的多中心临床试验将在未来几年内展开。
And these could be drugs that are already safe and approved for other purposes, but we might say, okay, now we know that this medication, based on what we know from causal optogenetics, this could be useful for this other purpose, this psychiatric symptom.
这些可能是已经安全并被批准用于其他目的的药物，但我们可能会说，好吧，现在我们知道这种药物，根据我们从因果光遗传学中了解到的信息，这可能对其他目的、这种精神症状有用。
And so the path to helping patients could be relatively swift.
因此，帮助患者的道路可能相对较快。
Andrew Huberman:
安德鲁·休伯曼：
That's very exciting.
这非常令人兴奋。
What are your thoughts about brain-machine interface?
您对脑机接口有何看法？
And Neuralink always comes up, although I do want to point out I have tremendous respect for the folks at Neuralink, including someone who came up through my lab, is now there as a neurosurgeon.
Neuralink 总是会出现，尽管我确实想指出，我非常尊重 Neuralink 的人员，包括从我的实验室出来的人，现在是一名神经外科医生。
But brain-machine interface is something that's been happening for a long time now.
但脑机接口已经出现很长时间了。
Some of the best work, among the best work being done here at Stanford, and elsewhere too, of course.
一些最好的工作，其中最好的工作是在斯坦福大学完成的，当然，其他地方也是如此。
How is what you just described compatible with or different than brain-machine interface, meaning devices, little probes that are going to stimulate different patterns of activity in ensembles of neurons, and what are your general thoughts about brain-machine interface as going forward?
您刚才描述的内容与脑机接口、意味着设备、将刺激神经元集合中不同活动模式的小探针兼容或不同，以及您对脑机接口未来的总体看法是什么？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
I mean, this is, first of all, it's an amazing scientific discovery approach.
我的意思是，首先，这是一种令人惊叹的科学发现方法。
As you mentioned, we and others here at Stanford are using electrodes, collecting information from tens of thousands of neurons.
正如您提到的，我们和斯坦福大学的其他人正在使用电极，从数以万计的神经元收集信息。
Andrew Huberman:
安德鲁·休伯曼：
In humans, I should add.
对于人类，我应该补充一点。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And even, yes, it is quite, even separate from the Neuralink work; as you point out, many people have been doing this in humans as well as in nonhuman primates.
甚至，是的，它与 Neuralink 的工作完全、甚至是分开的；正如你所指出的，许多人已经在人类和非人类灵长类动物身上进行了这种研究。
And this is pretty powerful.
这非常强大。
It's important.
这很重要。
This will let us understand what's going on in the brain in psychiatric disease and neurological disease and will give us ideas for treatment.
这将使我们了解精神疾病和神经系统疾病的大脑中发生了什么，并为我们提供治疗思路。
It is, of course, it's still invasive.
当然，它仍然是侵入性的。
You still are talking about putting a device into the brain, and that has to be treated as a situation that has some risks and a step that has to be taken carefully.
您仍然在谈论将设备放入大脑中，这必须被视为具有一定风险的情况，并且必须谨慎采取步骤。
I see that as something that will be part of psychiatry in the long run.
我认为从长远来看这将成为精神病学的一部分。
Already with deep brain stimulation approaches, we can help people with psychiatric disorders.
通过深部脑刺激方法，我们可以帮助患有精神疾病的人。
And that's putting just a single electrode, not even a complex closed loop system where you're both playing in and getting information back.
这只是放置一个电极，甚至不是一个复杂的闭环系统，您可以在其中进行操作并获取信息。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Even just a single stimulation electrode in the brain can help people with OCD, for example, quite powerfully.
例如，即使大脑中只有一个刺激电极也可以非常有效地帮助患有强迫症的人。
And that would become much more powerful when we get to a true brain-machine interface collecting information back, stimulating only when you need to.
当我们建立一个真正的脑机接口来收集信息并仅在需要时进行刺激时，这将变得更加强大。
If we could identify a pathological activity pattern, a particular, almost like the prodrome or the early stage of a seizure, maybe there are events that happen leading up to on some time scale a psychiatric symptom, we could intervene in a closed loop way, detect what's happening, what's starting to go wrong, feed that back to the brain stimulation electrode, have it be in that way more efficient and more principled.
如果我们能够识别出一种病理活动模式，一种特殊的，几乎像前驱症状或癫痫发作的早期阶段，也许在某个时间范围内发生了导致精神症状的事件，我们可以以闭环方式进行干预，检测正在发生的事情，开始出错的地方，将其反馈到大脑刺激电极，让它以这种方式更有效，更有原则性。
This is, I think, it's great.
我认为这很棒。
It's something that, of course, will be grounded again in causal understanding.
当然，这将再次建立在因果理解的基础上。
Karl Deisseroth:
卡尔·戴瑟罗斯：
We'll need to know what is that pathological pattern that we're detecting and we need to know that it matters.
我们需要知道我们检测到的病理模式是什么，我们需要知道它很重要。
And so again, that's where optogenetics is helping us know, okay, this pattern of activity in these cells, in these circuits, this does mean that there's a particular kind of symptom that's happening.
再说一次，这就是光遗传学帮助我们知道这些细胞、这些回路中的这种活动模式，这确实意味着正在发生一种特殊的症状。
But armed with that knowledge, absolutely.
但绝对具备这些知识。
Even a simple closed loop device detect and stimulate is going to be part of psychiatry in the future.
即使是简单的闭环设备检测和刺激也将成为未来精神病学的一部分。
And then of course, as you get to more cells, more connections, the ability that we have to help people will become more powerful.
当然，当你获得更多的细胞、更多的联系时，我们帮助人们的能力将会变得更加强大。
Andrew Huberman:
安德鲁·休伯曼：
One of the questions I get asked a lot is about ADHD and attention deficit of various kinds.
我经常被问到的问题之一是关于注意力缺陷多动症和各种注意力缺陷。
I have the hunch that one reason I get asked so often is that people are feeling really distracted and challenged in funneling their attention and their behavior.
我有预感，我经常被问到的原因之一是人们在集中注意力和行为方面感到非常心烦意乱和受到挑战。
And there are a number of reasons for that, of course.
当然，这有很多原因。
But what is true ADHD and what does it look like?
但什么是真正的多动症？它是什么样子的？
What can be done for it?
可以为此做些什么呢？
And what, if any, role for channelopsins or these downstream technologies that you're developing, what do they offer for people that suffer from ADHD or have a family member that suffers from ADHD?
如果有的话，通道视蛋白或您正在开发的这些下游技术的作用是什么？它们为患有多动症的人或有患有多动症的家庭成员提供什么？
Karl Deisseroth:
卡尔·戴瑟罗斯：
This is a pretty interesting branch of psychiatry.
这是精神病学的一个非常有趣的分支。
There's no question that people have been helped by the treatments.
毫无疑问，人们已经从这些治疗中得到了帮助。
There's active debate over what fraction of people who have these symptoms can or should be treated.
关于有这些症状的人中哪一部分可以或应该接受治疗，存在着激烈的争论。
Andrew Huberman:
安德鲁·休伯曼：
This is typically Adderall or stimulants of some kind.
这通常是阿得拉或某种兴奋剂。
Karl Deisseroth:
卡尔·戴瑟罗斯：
For example, the stimulants.
例如，兴奋剂。
That's right.
这是正确的。
So ADHD, as its name suggests, it can have either a hyperactive state or an inattentive state.
因此，多动症，顾名思义，它可以处于过度活跃状态或注意力不集中状态。
And those can be completely separate from each other.
这些可以彼此完全分开。
You could have a patient who effectively is not hyperactive at all but can't remain focused on the, what's going on around them.
您可能会遇到一位患者，他实际上根本没有过度活跃，但无法保持专注于周围发生的事情。
Andrew Huberman:
安德鲁·休伯曼：
So their body can be still, but their mind is darting around.
所以他们的身体可以静止，但他们的思想却在飞驰。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
Or they can be very hyperactive with their body.
或者他们的身体可能非常活跃。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It happens both ways.
它是双向发生的。
Andrew Huberman:
安德鲁·休伯曼：
Probably rarely is somebody hyperactive with their body but their mind is still, Although I have to say, and this is a benevolent shout out to Botond Roska.
可能很少有人身体过度活跃，但他们的思想仍然静止，尽管我不得不说，这是对波通德·罗斯卡的善意呼喊。
Botond has an incredibly sharp and focused mind, and his hand movements are extremely exact also.
波通德的头脑极其敏锐和专注，他的手部动作也极其精确。
So I do sometimes wonder whether or not our body movements and our head movements, whether or not they're coordinated or not is a readout of how directed our attention is.
所以我有时确实想知道我们的身体运动和头部运动是否协调，是否可以表明我们的注意力是如何定向的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I notice I have ...
我注意到我有...
to think complex, abstract thoughts, I notice I have to be very still, so my body has to be almost completely unmoving for me to think very abstractly and deeply.
为了思考复杂、抽象的想法，我注意到我必须非常安静，所以我的身体必须几乎完全不动，这样我才能进行非常抽象和深入的思考。
Other people are different.
其他人则不同。
Some people, when they're running, they get their best thoughts.
有些人，当他们跑步时，他们会想到最好的想法。
I can't even imagine that.
我什至无法想象。
My brain does not work that way at all.
我的大脑根本不是这样运作的。
I have to be totally motionless, which is kind of interesting.
我必须完全一动不动，这很有趣。
Andrew Huberman:
安德鲁·休伯曼：
How do you go about that?
你怎么办？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I sit, much like this.
我坐着，就像这样。
I try to have time in each day where I'm literally sitting almost in this position, but without distraction, and thinking.
我试着每天都有时间几乎坐在这个位置上，但没有分心和思考。
It's almost meditative in some ways, except it's not true meditation.
在某些方面它几乎是冥想，但它不是真正的冥想。
But I am thinking while not moving.
但我一边思考一边一动不动。
Andrew Huberman:
安德鲁·休伯曼：
You're trying to structure your thoughts in that time.
那时你正在尝试构建你的想法。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, that's right.
是的，没错。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But everybody, as you say, is very different.
但正如你所说，每个人都是非常不同的。
And so with ADHD, you have, the key thing is we want to make sure that this is present across different domains of life, school and home, to show that it really is a pervasive pattern and not something specific to the teacher or the home situation or something.
因此，对于多动症，关键是我们要确保这种情况存在于生活、学校和家庭的不同领域，以表明它确实是一种普遍的模式，而不是特定于老师或家庭情况或其他什么的东西。
And then you can help patients.
然后你就可以帮助病人。
It's interesting that ADHD is one of those disorders where people are trying to work on quantitative EEG-based diagnoses.
有趣的是，多动症是人们试图进行基于脑电图的定量诊断的疾病之一。
And so there's some progress toward making a diagnosis with looking at particular externally detectable brainwave rhythms.
因此，通过观察特定的外部可检测脑电波节律来进行诊断已经取得了一些进展。
Andrew Huberman:
安德鲁·休伯曼：
So skull cap with some electrodes that don't penetrate the skull.
所以头盖骨上有一些不穿透头骨的电极。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
And this can be done in an hour or two-hour session.
这可以在一小时或两小时内完成。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, that's right.
是的，没错。
Andrew Huberman:
安德鲁·休伯曼：
Has to be done in a clinic, right?
一定要在诊所做吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, in a clinic, right.
是的，在诊所，对吧。
You have to have the right recording apparatus and so on.
你必须有合适的录音设备等等。
But that's, in principle, as increase in confidence comes in exactly which measurements, one could even imagine moving toward home tests.
但原则上，随着测量结果的可信度增加，人们甚至可以想象进行家庭测试。
But we're not there yet.
但我们还没有到那一步。
Andrew Huberman:
安德鲁·休伯曼：
Amazing.
太棒了。
I think one of the reasons I get asked about it so much is a lot of people wonder if they have ADHD.
我认为我被问到这么多的原因之一是很多人想知道他们是否患有多动症。
Do you think that some of the lifestyle factors that inhabit us all these days could induce a subclinical or a clinical-like ADHD?
您认为我们这些天生活中的一些生活方式因素是否会诱发亚临床或类似临床的多动症？
Meaning if ...
意思是如果...
I look at people's phone use, including my own, and I don't think of it like addiction.
我观察人们的手机使用情况，包括我自己，我不认为这是上瘾。
It looks to me and feels to me more like OCD.
在我看来，它更像是强迫症。
And I'll come clean here by saying, when I was younger, when I was a kid, I had a grunting tic.
我要坦白说，当我年轻的时候，当我还是个孩子的时候，我有过一阵咕噜抽动的症状。
I used to hide it.
我曾经把它隐藏起来。
I actually used to hide in the closet because my dad would make me stop.
事实上，我曾经躲在壁橱里，因为我爸爸会让我停下来。
I couldn't feel any relief of my mind until I'd, nhhh, do this.
在我，嗯，这样做之前，我的心情无法得到任何缓解。
And actually now if I get very tired, if I've been pushing long hours, it'll come back.
事实上，现在如果我感到很累，如果我长时间工作，它就会回来。
Andrew Huberman:
安德鲁·休伯曼：
I was not treated for it.
我没有因此受到治疗。
But I will confess that I've had the experience of ...
但我承认我有过这样的经历...
I always liked sports where involve a lot of impact, fortunately not football because I went to a high school where the football team was terrible.
我一直喜欢有很大影响力的运动，幸运的是不是足球，因为我上的高中的橄榄球队很糟糕。
Maybe that would've avoided more impact.
也许这样可以避免更多的影响。
But things like skateboarding, boxing, they bring relief.
但像滑板、拳击这样的事情，它们可以带来缓解。
I feel clarity after a head hit, which I avoid.
头部受到撞击后，我感觉很清醒，但我避免了这种情况。
But I used to say that's the only time I feel truly clear for a while.
但我曾经说过，这是一段时间内我唯一感到真正清醒的时候。
And then eventually it dissipated.
然后最终它消散了。
By about age 16 and 17 it just disappeared.
到了大约 16 岁和 17 岁的时候，它就消失了。
Andrew Huberman:
安德鲁·休伯曼：
So I have great empathy for those that feel like there's something contained in them that won't allow them to focus on what they want to focus on.
因此，我对那些感觉自己身上有某种东西不允许他们专注于自己想要专注的事情的人深表同情。
And these days, with the phone and all these email, et cetera, I wonder, and I empathize a bit when I hear people saying, "I think I might have ADHD or ADD." Do you think it's possible that our behaviors and our interaction with the sensory world, which is really what phones and email really are, could induce ADD or reactivate it?
如今，有了电话和所有这些电子邮件等等，我想知道，当我听到人们说“我想我可能患有多动症或ADD”时，我有点同情。你认为我们的行为以及我们与感官世界的互动（实际上就是电话和电子邮件）可能会诱发或重新激活ADD吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
This is a great question.
这是一个很好的问题。
I think about it a lot.
我想了很多。
And you mentioned this tic-like behavior in yourself.
你也提到过你自己有这种类似抽动的行为。
It's very common that people who have tics have this building up of something that can only be relieved by executing the tic, which can be a motor movement or vocalization or even a thought.
抽动症患者体内积聚的东西很常见，只有通过抽动才能缓解，这种抽动可以是运动、发声甚至是想法。
And people do, I think, these days, do have this, if they haven't checked their phone in a while, they do have a buildup, a buildup, a buildup until they can check it and relieve it.
我认为，现在人们确实有这种情况，如果他们有一段时间没有检查手机，他们确实会积聚、积聚、积聚，直到他们可以检查并缓解它。
And there's some similarities.
并且有一些相似之处。
There is a little reward that comes with the checking.
检查后会有一点奖励。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But the key question in all of psychiatry, what we do is we don't diagnose something unless it's disrupting what we call social or occupational functioning.
但在所有精神病学中，我们所做的关键问题是，我们不会诊断某些东西，除非它扰乱了我们所谓的社会或职业功能。
You could have any number of symptoms, but literally every psychiatric diagnosis requires that it has to be disrupting someone's social or occupational functioning.
你可能有多种症状，但实际上每一个精神病学诊断都要求它必须扰乱某人的社交或职业功能。
And these days, checking your phone is pretty adaptive.
如今，检查手机已成为一种非常适应性的行为。
That pretty much helps your social and occupational functioning.
这对你的社交和职业功能很有帮助。
And so we can't make it a psychiatric diagnosis, at least in the world of today.
因此，我们不能将其视为精神病学诊断，至少在当今世界是这样。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, opting out of communication now makes you in some ways less adaptive.
是的，现在选择退出沟通会在某些方面降低你的适应能力。
Though I would point to you as an example of somebody who is quite good at managing his interactions, at least from an outsider perspective.
不过我会以你为例，说明他非常善于管理自己的互动，至少从局外人的角度来看是这样。
I do want to ask you a little bit about you.
我确实想问一些关于你的事情。
And first of all, and I realize this is only a partial list, but you're a clinician, you see patients, you run a big laboratory.
首先，我意识到这只是部分清单，但你是一名临床医生，你看病人，你经营一个大实验室。
How many people are in your laboratory now?
你们实验室现在有多少人？
Karl Deisseroth:
卡尔·戴瑟罗斯：
.
。
Andrew Huberman:
安德鲁·休伯曼：
That's a huge laboratory.
那是一个巨大的实验室。
From experience, I can say that's an enormous laboratory.
根据经验，我可以说这是一个巨大的实验室。
You have a family of five children, and you're happily married to a wonderful colleague of ours as well, who does incredible work.
您有一个有五个孩子的家庭，并且您与我们的一位出色的同事婚姻幸福，他的工作非常出色。
How do you organize, at a kind of conceptual level, the day and the week?
在某种概念层面上，你如何组织一天和一周？
And I should say, what stress-mitigation practices, if any, do you incorporate?
我应该说，你采取了哪些缓解压力的做法（如果有的话）？
I've received emails from you at three in the morning.
凌晨三点我收到了你发来的电子邮件。
I sometimes send emails at three in the morning, but that's when I wake up.
我有时会在凌晨三点发送电子邮件，但那是我醒来的时间。
Maybe I'm depressed, but I go back to sleep.
也许我很沮丧，但我还是回去睡觉了。
So maybe you just describe the arc of the blocks of the day, not hour by hour necessarily, or the details of what are in those blocks.
因此，也许您只是描述一天中各个区块的弧线，不一定是每小时，或者这些区块中的内容的详细信息。
But how do you conceptualize the day?
但你如何概念化这一天呢？
How do you conceptualize the week?
您如何概念化这一周？
And how do you feel about how that's lined up with your larger goals of making sure these five young people flourish, which I hear they are, but how do you go about this, what for most people would just be an overwhelming set of items?
你觉得这与确保这五个年轻人蓬勃发展的更大目标相一致，我听说他们是这样，但你如何去做呢？对于大多数人来说，这只是一组压倒性的项目？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, of course sometimes it's just a take it day by day.
好吧，当然有时只是日复一日地接受。
And so I don't claim-
所以我不主张-
Andrew Huberman:
安德鲁·休伯曼：
So you bring the horizon into the unit of the day.
所以你把地平线带入天的单位。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I do.
我愿意。
The unit is the day, that's right.
单位是天，没错。
I try to have in each day, as I mentioned earlier, some, at least an hour of time where I can think.
正如我之前提到的，我尝试每天至少留出一个小时的时间来思考。
And it can be when the kids are napping.
也可能是在孩子们午睡的时候。
Actually, because while driving I can do that too because I'm sitting still.
事实上，因为在开车时我也可以这样做，因为我坐着不动。
But that's the one thing I try to preserve.
但这是我试图保留的一件事。
When I was writing the book, I adapted that time to be my writing time.
当我写这本书时，我把那个时间调整为我的写作时间。
But it wasn't enough, so I had to add in a new block of time, which was sort of midnight to 2:00 a.m.
但这还不够，所以我必须添加一个新的时间段，即午夜到凌晨 2:00。
writing time.
写作时间。
And so that, carving out these, even small protected times are very important.
因此，留出这些时间，即使是很小的保护时间也非常重要。
Of course, obligations will expand to fill the time available, and you have to be disciplined, at least I found I had to be disciplined in truly protecting those times where one can think.
当然，义务会扩大以填补可用的时间，并且你必须遵守纪律，至少我发现我必须遵守纪律才能真正保护那些人们可以思考的时间。
Andrew Huberman:
安德鲁·休伯曼：
So that means no phone.
所以这意味着没有电话。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That means no phone, no checking of the phone.
这意味着没有电话，没有检查电话。
When I was writing the book, there's a focus mode on the MacBook, which kind of removes the border, and you just have your document, and it's very pure and you don't have the temptation of distraction.
当我写这本书的时候，MacBook 上有一个焦点模式，它消除了边框，你只需要你的文档，它非常纯粹，你不会受到分心的诱惑。
Andrew Huberman:
安德鲁·休伯曼：
I'm a big believer in ...
我非常相信...
Because the vision and the eyes play such a prominent role in directing our cognition, something you talk about in the book really beautifully and with a lot of depth and rigor, using visual tools to harness one's complete mental attention.
因为视觉和眼睛在指导我们的认知方面发挥着如此重要的作用，所以你在书中谈论的东西非常漂亮，并且具有很大的深度和严谨性，使用视觉工具来充分利用一个人的精神注意力。
When you do this practice of sitting and just thinking, sitting still and thinking, you said your eyes are open.
当你练习坐下来思考、静静地坐着思考时，你说你的眼睛是睁开的。
Are you hearing your own verbal voice, although in your head?
你是否听到自己的声音，尽管是在你的脑海里？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So you're actually in conversation with yourself.
所以你实际上是在和自己对话。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yes.
是的。
And hearing, literally; I mean, not quite literally.
从字面上看，还有听力；我的意思是，不完全是字面意义上的。
I don't actually hear a phonation, but I'm hearing words.
我实际上并没有听到声音，但我听到了文字。
So I discovered this about myself.
所以我发现了我自己的这一点。
Other people I think may operate differently, but I'm extremely verbal in how I think.
我认为其他人的做法可能会有所不同，但我的想法非常口头表达。
That's how all my reasoning is done.
我所有的推理都是这样完成的。
It's with sentences and construction of almost equations with words.
它是用句子和用单词构建几乎方程式的方式。
Andrew Huberman:
安德鲁·休伯曼：
Complete sentences?
完整的句子？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Complete sentences, or complete-ish, anyway, mostly complete.
完整的句子，或者说是完整的，无论如何，大部分都是完整的。
And when writing the book, everything about the writing, I would always ...
当写这本书时，关于写作的一切，我总是......
Every sentence was always played out in my mind, listening for rhythm and timing.
每句话都在我的脑海里播放，聆听节奏和时机。
And I would obsess over exact placement of words to get the right rhythm of the spoken sentence in my mind.
我会着迷于单词的准确位置，以便在我的脑海中获得正确的句子节奏。
Andrew Huberman:
安德鲁·休伯曼：
I don't mean to interrupt your flow, but when you do that, and having experienced this process a bit, although differently, do you experience any kind of welling up of anxiety when you're hitting the friction points?
我并不是有意打断你的流程，但是当你这样做时，并且稍微经历了这个过程，尽管有所不同，当你遇到摩擦点时，你是否会经历任何形式的焦虑？
And if so, do you have tools or ways that you quell that anxiety in real time?
如果是这样，您是否有工具或方法可以实时平息这种焦虑？
Because what we're really talking about here is your mind, but what we're really talking about is this process of converting the activity of neurons into something physically concrete in the world.
因为我们在这里真正谈论的是你的思想，但我们真正谈论的是把神经元的活动转化为世界上物理上具体的东西的过程。
And these intermediate steps are so mysterious to everybody.
而这些中间步骤对每个人来说都是那么神秘。
We hear, "Just write the book, just do it," whatever that means.
我们听到“只要写书，就去做”，无论这意味着什么。
In fact, statements like that to me are kind of empty and meaningless.
事实上，这样的言论对我来说有点空洞且毫无意义。
But when you hear your voice, and you're trying to find the correct word and you keep hitting, it doesn't sound quite right, what is the experience in your body?
但是当你听到自己的声音，并且试图找到正确的词并且不断敲击时，听起来不太正确，你的身体有什么体验？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
When it's not right, it's definitely ...
当它不正确时，它肯定是...
it's aversive.
这是令人厌恶的。
It doesn't feel good.
感觉不太好。
But there's also a hope because I know I can solve it too.
但还有希望，因为我知道我也能解决它。
It's almost like you're almost there.
就好像你快到了。
There's a path that you know is there.
有一条路你知道就在那里。
You don't quite see it, but it's there.
你看不到它，但它就在那里。
And I keep that in mind.
我牢记这一点。
And so there's this propulsive force forward because I know that the solution is there.
所以就有了前进的推动力，因为我知道解决方案就在那里。
And that said, there were single words that I would spend days on because I was just not happy until I got it right.
也就是说，有些词我会花上好几天的时间，因为直到我把它做对之前我才感到高兴。
And there were some things that I never quite got perfect and so I left out of the book entirely because it was so close, but not quite there.
有些事情我从来没有完全做到完美，所以我完全从这本书中省略了，因为它是如此接近，但又不那么完美。
And so at the end, I was like, no, I can't put that in.
所以最后，我想，不，我不能把它放进去。
Andrew Huberman:
安德鲁·休伯曼：
Everything you just said is entirely consistent with my experience of you and the way you go about everything.
你刚才所说的一切与我对你的经历以及你做事的方式完全一致。
I have to ask, are your kids writers, do they like books and words and poetry?
我想问，你的孩子是作家吗？他们喜欢书籍、文字和诗歌吗？
I know one of your children is going on to a career in medicine and science.
我知道您的一个孩子即将从事医学和科学事业。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, they're each different, which is amazing.
是的，他们每个人都不同，这真是太神奇了。
Yet they all, I think, do have some appreciation, or a lot of appreciation, for reading.
然而，我认为他们都对阅读有一定的欣赏，或者说非常欣赏。
But some are very musical.
但有些非常有音乐性。
Two of the five are extremely musical, very, very talented with guitar and singing and vocal impressions.
五人中的两人非常有音乐天赋，在吉他、歌唱和声乐方面非常非常有才华。
It's just astonishing.
真是令人惊讶。
And some of them are great with drawing and artistry.
其中一些人擅长绘画和艺术。
And some are very physical and vigorous and are never happy except when leaping about.
有些人体力充沛，精力充沛，除了跳跃时从不快乐。
And so it's just amazing how different they are, honestly.
老实说，它们的不同之处真是令人惊讶。
But I think there is a shared appreciation for language.
但我认为人们对语言有着共同的欣赏。
Andrew Huberman:
安德鲁·休伯曼：
Do you think that one can train their mind in using these practices?
你认为人们可以通过这些练习来训练他们的思想吗？
I really-
我真的——
Andrew Huberman:
安德鲁·休伯曼：
In using these practices.
在使用这些做法时。
I really like your description of the sitting, staying physically still and learning to grapple with those challenges.
我真的很喜欢你对坐着、保持身体静止并学习应对这些挑战的描述。
It's something that, especially in laboratory science, we aren't really trained to do.
这是我们没有真正接受过的训练，尤其是在实验室科学领域。
Like many professions, we're taught to come in and just get into motion, and I found that very relaxing, as someone who probably has an underlying tick, or something like that.
像许多职业一样，我们被教导要进来并开始行动，我发现这非常放松，就像一个可能患有潜在蜱虫或类似疾病的人一样。
It felt great to be in motion.
运动的感觉真好。
One of the hardest things about becoming a university professor and running a lab was that I was no longer working with my hands, and it felt like some big, important part of my life had been amputated.
成为一名大学教授和管理一个实验室最困难的事情之一是我不再用手工作，感觉就像我生命中某个重要的部分被截肢了。
Andrew Huberman:
安德鲁·休伯曼：
But what sorts of practices do you incorporate there, and do you think people can learn to get better at focusing through a dedicated practice of the sort that you described?
但是你在那里融入了什么样的实践，你认为人们可以通过你所描述的那种专门的实践来学会更好地集中注意力吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I think I also ...
我想我也...
I remember the rhythms of physical work in the laboratory very well.
我清楚地记得实验室里体力劳动的节奏。
My work these days as the laboratory leader, my job has returned mostly to words now again, and so it's kind of coming full circle.
这些天我作为实验室负责人的工作，我的工作现在又回到了语言上，所以一切又回到了原点。
So it's a different mode.
所以这是一种不同的模式。
I think you just have to embrace that different stages of life come with different modes, but you can definitely train yourself for each mode.
我认为你只需要接受生命的不同阶段有不同的模式，但你绝对可以针对每种模式训练自己。
I loved, as I mentioned, the rhythm of sewing and suturing and surgery, and I worked really hard on that and became good at it, and now I never do it, but it's what's the next challenge.
正如我提到的，我喜欢缝纫、缝合和手术的节奏，我非常努力地工作并变得擅长，现在我从不这样做，但这就是下一个挑战。
There's all the various experimental techniques, the dissections of the brain.
有各种各样的实验技术，大脑的解剖。
I can't tell you how many thousands of brain dissections I've done in my life, and now I don't do them at all.
我无法告诉你我一生中做过多少次大脑解剖，但现在我根本不做。
Andrew Huberman:
安德鲁·休伯曼：
And then you developed a method so that we don't have to dissect brains.
然后你开发了一种方法，这样我们就不必解剖大脑了。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
I should mention, maybe tell us for a moment about clarity, and for people who will probably never set foot into a laboratory, what yet another incredible discovery and development clarity is and why it helps us understand how the brain is structured.
我应该提一下，或许可以告诉我们一下关于清晰度的问题，对于那些可能永远不会踏入实验室的人来说，另一个令人难以置信的发现和发展清晰度是什么，以及为什么它可以帮助我们理解大脑的结构。
Karl Deisseroth:
卡尔·戴瑟罗斯：
So this is a different technology, also developed in my lab here, and it's part of a broader approach that we call hydrogel tissue chemistry.
所以这是一种不同的技术，也是在我的实验室开发的，它是我们称之为水凝胶组织化学的更广泛方法的一部分。
And what this is is it's building a gel, like a clear Jell-O-like substance, from within all the cells of a tissue, or even an animal, all at once.
这就是从组织甚至动物的所有细胞中一次性构建出一种凝胶，就像一种透明的果冻状物质。
So you're effectively building a gel inside all the cells at once.
因此，您可以同时在所有细胞内有效地构建凝胶。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now that's an odd thing to do.
现在这是一件奇怪的事情。
Why do we do it?
我们为什么这样做？
Well, we do it to transform the tissue into a more tractable, accessible object.
好吧，我们这样做是为了将组织转变为更容易处理、更容易接近的物体。
And the reason that works is we, having built this gel, this new infrastructure inside the tissue, we can then use chemical tricks, and we can link the molecules we care about like proteins or RNAs, which are the things, as you know, right before they become proteins.
起作用的原因是我们在组织内构建了这种凝胶，这种新的基础设施，然后我们可以使用化学技巧，我们可以连接我们关心的分子，如蛋白质或RNA，正如你所知，这些分子在它们变成蛋白质之前。
We can link them, physically anchor them to this gel, which is a scaffold basically.
我们可以将它们连接起来，将它们物理锚定到这种凝胶上，这基本上是一个支架。
It's an interlocking network of polymers.
它是聚合物的联锁网络。
Karl Deisseroth:
卡尔·戴瑟罗斯：
We can link all these interesting molecules in place, lock them in where they were initially in the tissue, in the cell, in all the cells.
我们可以将所有这些有趣的分子连接到位，将它们锁定在它们最初在组织、细胞和所有细胞中的位置。
And then we can remove very vigorously everything we don't care about that's blocking our light, that's blocking our molecules coming in to exchange information with the tissue.
然后我们可以非常有力地去除所有我们不关心的东西，它们会阻挡我们的光线，阻挡我们的分子进入与组织交换信息。
We can get rid of everything else, like the lipids, the fats.
我们可以摆脱其他一切，比如脂质、脂肪。
We can effectively use detergents to get them all out.
我们可以有效地使用清洁剂将它们全部清除。
And then we can see in all the things that were absorbing or scattering light are gone.
然后我们可以看到所有吸收或散射光的东西都消失了。
You can have a brain that's completely transparent, and yet all the interesting molecules are still locked into place there at the cellular and subcellular level.
你可以拥有一个完全透明的大脑，但所有有趣的分子仍然被锁定在细胞和亚细胞水平上。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so this is hydrogel tissue chemistry.
这就是水凝胶组织化学。
The first form we described was called clarity.
我们描述的第一种形式称为清晰度。
We use that quite a bit still, but there are many variants now that we and others have developed on this basic concept of building this gel within the tissue and anchoring molecules into place.
我们仍然经常使用它，但是现在我们和其他人已经根据在组织内构建这种凝胶并将分子锚定到位的基本概念开发了许多变体。
Andrew Huberman:
安德鲁·休伯曼：
Literally glass-clear brains.
简直就是玻璃般透明的大脑。
I've done this; I've taken a brain cleared with this method and looked at somebody through it.
我已经这样做了；我用这种方法清理了大脑，并通过它来观察某人。
And although you don't want to get it too close to your eye, you don't want to touch it to your own eye.
虽然你不想让它离你的眼睛太近，但你也不想让它碰到你自己的眼睛。
And you can see direct all the way through it.
而且你可以直接看到整个过程。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That's incredible.
这太不可思议了。
It raises an important question, which is, again, about the human brain.
它提出了一个重要的问题，这又是关于人脑的。
And as somebody who essentially started out in neuroanatomy and then got into other things, I always am bothered by the fact that we actually know very little about the microstructure of the human brain compared to the brains of other organisms.
作为一个基本上从神经解剖学开始，然后进入其他领域的人，我总是对这样一个事实感到困扰：与其他生物体的大脑相比，我们实际上对人类大脑的微观结构知之甚少。
Andrew Huberman:
安德鲁·休伯曼：
And in thinking about understanding the circuitry, and the piano, so to speak, and how to manipulate it in order to relieve suffering, one wonders are the structures in these animal brains and how they behave in active coping, passive coping, ADD, et cetera, those models, how well they translate to the human condition.
在思考理解电路和钢琴，以及如何操纵它来减轻痛苦时，人们想知道这些动物大脑的结构，以及它们在主动应对、被动应对、ADD等方面的表现，这些模型，以及它们如何很好地转化为人类的状况。
Andrew Huberman:
安德鲁·休伯曼：
Do you think it's fair to say that there are entire regions of the human brain that aren't just bigger but that exist only in the brains of humans, especially given that we have this speech?
你认为可以公平地说，人类大脑的整个区域不仅更大，而且只存在于人类的大脑中，特别是考虑到我们有这个演讲？
Although I do wonder sometimes if animals are reporting to each other; maybe they have little psychiatric sessions with one another.
尽管我有时确实想知道动物是否会互相报告；但事实并非如此。也许他们彼此之间很少进行心理治疗。
Karl Deisseroth:
卡尔·戴瑟罗斯：
I'm always careful to not assume we do things better.
我总是小心翼翼地不假设我们做得更好。
We certainly understand what we're doing better than we understand what animals are doing, and they certainly do things better than we do.
我们当然比动物更了解我们在做什么，而且它们也确实比我们做得更好。
That said, we do have amazing, wonderful brains and many structures that are very highly developed in our brains that are not nearly so developed in mice and fish, for example.
也就是说，我们确实拥有令人惊叹的、美妙的大脑和许多在我们的大脑中非常发达的结构，而在小鼠和鱼类中却远没有那么发达。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now, that said, when I look at the big picture, what is the mammalian brain really doing?
现在，话虽如此，当我纵观全局时，哺乳动物的大脑到底在做什么？
There are things that you would never have thought we could study in animals, in laboratory mammals like mice, that it turns out you can actually.
有些事情你永远不会想到我们可以在动物身上研究，在像老鼠这样的实验室哺乳动物身上研究，事实证明你确实可以。
And so I would never draw the line and say, "Here's something you can't study in mice," or, "Here's something that has no parallel in mice." I would be very careful before making any statement like that.
因此，我绝不会划清界限并说：“这是你无法在老鼠身上研究的东西”，或者“这是在老鼠身上无法相比的东西”。在发表类似声明之前我会非常小心。
A good example of that is we've been able to study, just in the past year, come to an understanding of dissociation, and we had a paper that came out in late 2020, both mouse and human work, in which we got to the circuit basis for dissociation.
一个很好的例子是，就在过去的一年里，我们已经能够研究了解解离，我们在 2020 年底发表了一篇论文，包括小鼠和人类的工作，其中我们了解了解离的电路基础。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now, what is dissociation?
现在，什么是解离？
A lot of people might not have experienced it, but it's actually very common.
很多人可能没有经历过，但实际上这是很常见的。
More than 70% of people who've been through trauma experience dissociation.
超过 70% 经历过创伤的人都会经历分离。
It shows up in borderline personality.
它表现在边缘人格中。
It shows up in PTSD.
它出现在创伤后应激障碍中。
What it is is a separation of the sense of self from the body.
它是自我意识与身体的分离。
And so you can have someone who's ...
所以你可以拥有一个...
It's not as if you're numb.
这并不是说你已经麻木了。
You're not anesthetized.
你没有被麻醉。
You can still, you know that something's happening to the body, but you just don't care because you don't ascribe it to yourself, which is very interesting.
你仍然可以，你知道身体发生了一些事情，但你只是不在乎，因为你不把它归咎于你自己，这很有趣。
How interesting is that?
那有多有趣？
Andrew Huberman:
安德鲁·休伯曼：
The self-report narrative.
自我报告叙述。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Almost ...
几乎...
In your book you touch on this, and I will say it is the most precise and meaningful and eloquent description of what might be consciousness, this narrative toward the self or of the self and where it might reside.
在你的书中你谈到了这一点，我会说这是对意识的最精确、最有意义、最雄辩的描述，这种对自我或自我的叙述以及它可能存在的地方。
So in dissociative conditions, people are feeling this kind of an absence of a merge between mind and body.
因此，在分离的情况下，人们会感觉到身心之间缺乏融合。
Is that one way you describe it?
这是你描述它的一种方式吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
And as I recall, this paper involved an exploration of ketamine.
我记得，这篇论文涉及对氯胺酮的探索。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Ketamine was a big part of it.
氯胺酮是其中的重要组成部分。
Yeah, that's right.
是的，没错。
And so ketamine is another one of those cases where people can experience dissociation — ketamine or PCP.
因此，氯胺酮是另一种让人可能经历解离的情况——氯胺酮或 PCP。
We call these the dissociative drugs; they cause it, just like these other psychiatric conditions can cause it.
我们称这些为解离药物；它们会导致这种情况，就像其他精神疾病也会导致这种情况一样。
But we were able to manifest this in mice, administering these dissociative agents in mice.
但我们通过给小鼠注射这些解离剂，能够在小鼠身上证明这一点。
We could make them still able to detect stimulus but not care that it was happening.
我们可以让他们仍然能够检测到刺激，但不关心它正在发生。
All the while, we were recording the activity of individual cells in the brain to see what was going on, what was happening along with this dissociation, and then used optogenetics to see that it mattered, to actually provide that pattern of activity and see, "Oh, that actually causes the dissociation."
一直以来，我们都在记录大脑中单个细胞的活动，以了解发生了什么，随着这种解离而发生了什么，然后使用光遗传学来发现它的重要性，以实际提供这种活动模式并看到，“哦，这实际上导致了解离。”
Karl Deisseroth:
卡尔·戴瑟罗斯：
So we could do all that in mice, which was just ...
所以我们可以在老鼠身上完成所有这些，这只是......
who would've thought that you could study something like this in mice?
谁会想到可以在老鼠身上研究这样的事情？
And we were able to go back and forth with human work because here in our Stanford Comprehensive Epilepsy Center, there's a lot of what we call stereo EEG recording, patients who come in and in the course of normal clinical care, they have electrodes recording in their brain to identify where the seizure is, so they can be candidates for removing a little patch of the brain that's causing the seizure.
我们能够反复进行人类工作，因为在我们的斯坦福综合癫痫中心，有很多我们所说的立体脑电图记录，进来的患者在正常的临床护理过程中，他们的大脑中记录了电极，以识别癫痫发作的位置，因此他们可以成为切除引起癫痫发作的大脑一小块的候选者。
Karl Deisseroth:
卡尔·戴瑟罗斯：
This is done for patients who medications are not helping their seizure disorder.
这是针对药物无法帮助癫痫发作的患者进行的。
And there was a patient who had a dissociative state before every seizure.
还有一位患者在每次癫痫发作前都处于解离状态。
So this was a human being who was really dissociating, who could tell us literally as it was happening, and we could see this pattern, the same pattern that was happening in the mice in the same patch of the brain.
所以这是一个真正处于分离状态的人，他可以逐字地告诉我们事情正在发生，我们可以看到这种模式，与小鼠大脑同一区域中发生的模式相同。
We could see that happening in the human being at exactly the right time in the same patch of the brain that's homologous across these immense evolutionary distances.
我们可以看到，这种情况在人类大脑的同一块区域中恰好发生，在这些巨大的进化距离上是同源的。
And we knew that it mattered too, both in mouse and human, because in the human we could cause it to happen.
我们知道这对于小鼠和人类也很重要，因为在人类中我们可以导致它发生。
Andrew Huberman:
安德鲁·休伯曼：
I want to underscore the power of optogenetics and the ability to not just remove a particular experience or behavior by lesioning or destroying, but then to go back and actually activate the same structure or group of structures and see the emergence.
我想强调光遗传学的力量，以及不仅能够通过损伤或破坏来消除特定的经历或行为，而且还能返回并实际激活相同的结构或结构组并看到其出现的能力。
So it's essentially, these days you hear a lot about gain of function research in the context of viral manipulation, but gain-of-function is something that we do in the laboratory and you do in patients to both take away something and put it back, and which gives you causality.
所以本质上，这些天你听到了很多关于病毒操作背景下的功能获得研究，但功能获得是我们在实验室里做的事情，你在病人身上做的事情，既拿走了一些东西又把它放回去，这给了你因果关系。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Yeah, and exactly, and so with optogenetics, we were able to provide in animals, without being on any ketamine or any drug, and we could cause the dissociative state by playing in a precise pattern of activity.
是的，正是如此，通过光遗传学，我们能够在不服用任何氯胺酮或任何药物的情况下为动物提供服务，并且我们可以通过以精确的活动模式进行游戏来引起解离状态。
And who would've thought you could do that?
谁会想到你能做到这一点？
But there was a combined mouse and human paper.
但有一张老鼠纸和人类纸的组合。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Likewise, we've been able to play in visual sensations into the brains of mice.
同样，我们已经能够影响小鼠大脑的视觉感觉。
And by observing which cells in the visual part of the brain, visual cortex, are naturally responsive to, for example, vertical bars instead of horizontal bars in the visual world, we could see which cells were normally reporting on vertical bars, and then we could use optogenetics to come and play in activity just to those cells.
通过观察大脑视觉部分（即视觉皮层）中的哪些细胞对视觉世界中的垂直条而不是水平条自然做出反应，我们可以看到哪些细胞通常报告垂直条，然后我们可以使用光遗传学来仅对这些细胞进行活动。
Andrew Huberman:
安德鲁·休伯曼：
So these animals are not viewing anything.
所以这些动物没有看到任何东西。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Not viewing anything at all.
根本不看任何东西。
And we could activate just the vertical bar cells.
我们可以只激活竖条单元。
And not only did the animal act as if it was seeing a vertical bar behaviorally; it was trained to do a particular thing if it saw a vertical bar, and it did that just as if it was seeing something visually.
动物不仅在行为上表现得好像看到了一根竖条；而且它被训练为在看到垂直条时执行特定操作，并且它会这样做，就像它在视觉上看到某些东西一样。
Karl Deisseroth:
卡尔·戴瑟罗斯：
But everything in the brain that we were recording too, the internal representation of this external world was naturalistic too.
但我们大脑中记录的一切，外部世界的内部表征也是自然主义的。
It looked like the brain was seeing something visual, so that's gain-of-function too, playing in, providing a complex sensation or percept that wasn't there before.
看起来大脑正在看到一些视觉东西，所以这也是功能获得，发挥作用，提供以前不存在的复杂感觉或知觉。
And we can do that across species.
我们可以跨物种做到这一点。
So we haven't ...
所以我们还没有...
And, of course, mice are social, and they do amazing acts of information processing, so I try not to disparage our cousins too much.
当然，老鼠是群居动物，它们的信息处理能力令人惊叹，所以我尽量不要过分贬低我们的表兄弟。
Andrew Huberman:
安德鲁·休伯曼：
They certainly have helped the field of neuroscience and medicine, I should mention.
我应该提一下，他们确实对神经科学和医学领域有所帮助。
And I know that people have various sensitivities about animal research, but the work that's been carried out in mice has been absolutely vital and instructional for treatment of human disease.
我知道人们对动物研究有不同的敏感性，但在小鼠身上进行的工作对于治疗人类疾病绝对至关重要且具有指导意义。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
Since we talked about dissociation and dissociative states rather, and ketamine, I'd love your thoughts on psychedelic medicine.
既然我们谈论的是解离和解离状态，以及氯胺酮，我很想听听你对迷幻医学的看法。
I sort of half joke, having grown up in this area in Northern California, when it was much more counterculture than it is now, that many of the things that we're hearing about now, at least from my read of the history books, happened before.
我半开玩笑地说，我在北加州的这个地区长大，当时的反主流文化比现在要多得多，我们现在听到的许多事情，至少从我读到的历史书来看，都是以前发生过的。
There was a movement aimed at taking the very same compounds, essentially, putting them into patients or ...
有一场运动旨在服用完全相同的化合物，本质上是将它们放入患者体内或......
People were obviously using them recreationally, but putting them into patients and seeing tremendous positive effects, but also tremendous examples of induced psychiatric illness.
人们显然只是为了娱乐而使用它们，但将它们放入患者体内并看到了巨大的积极效果，但也看到了诱发精神疾病的巨大例子。
In other words, many people lost their minds as a consequence of overuse of psychedelics.
换句话说，许多人因过度使用致幻剂而失去了理智。
Andrew Huberman:
安德鲁·休伯曼：
I'll probably lose a few people out there, but I do want to talk about, what is the state of these compounds?
我可能会失去一些人，但我确实想谈谈，这些化合物的状态如何？
And I realize it's a huge category of compounds, but LSD and psilocybin, as I understand, trigger activation of particular serotonin receptor mechanisms, may or may not lead to more widespread activation of the brain that one wouldn't see otherwise.
我意识到这是一大类化合物，但据我所知，LSD 和裸盖菇素会触发特定血清素受体机制的激活，可能会也可能不会导致大脑更广泛的激活，否则人们不会看到这种情况。
But when you look at the clinical and experimental literature, what is your sort of top contour sense of how effective these tools are going to be for treating depression?
但是，当您查看临床和实验文献时，您对这些工具治疗抑郁症的效果有何总体感觉？
And then if we have the time, we could talk about trauma and MDMA and some of that work.
然后，如果我们有时间，我们可以谈论创伤和摇头丸以及其中的一些工作。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, you're right to highlight both the opportunity and the peril that is there.
嗯，你强调了其中的机遇和危险是正确的。
And of course, we want to help patients, and of course we want to explore anything that might be helpful, but we want to do it in a safe and rigorous way.
当然，我们想帮助患者，当然我们想探索任何可能有帮助的事情，但我们希望以安全和严格的方式做到这一点。
But I do think we should explore these avenues.
但我确实认为我们应该探索这些途径。
These are agents that alter reality, and alter the experience of reality, I should say, in relatively precise ways.
我应该说，这些是改变现实、改变现实体验的媒介，以相对精确的方式。
They do have problems.
他们确实有问题。
They can be addictive, they can cause lasting change, that is not desirable.
它们可能会让人上瘾，它们可能会导致持久的改变，这是不可取的。
But we have to see these as opportunities.
但我们必须将这些视为机遇。
We have to first of all study in the laboratory, and I'm doing this here.
我们首先必须在实验室里进行研究，而我就是在这里做的。
We have safes with many interesting psychedelics that are all very carefully regulated.
我们的保险箱里装有许多有趣的迷幻药，而且都受到非常仔细的监管。
We get inspections from the DEA and so on.
我们接受 DEA 等机构的检查。
Andrew Huberman:
安德鲁·休伯曼：
If anyone's hoping to find these labs, they exist in outer space.
如果有人希望找到这些实验室，它们就存在于外太空。
So you need to be on board one of the SpaceX missions in order to access them, so don't try and come find them.
因此，您需要登上 SpaceX 的一项任务才能访问它们，所以不要尝试来寻找它们。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, no, that's exactly true.
是的，不，那是千真万确的。
Yes.
是的。
And we're doing exactly this.
我们正在做这件事。
We're saying this is an incredible opportunity.
我们说这是一个难以置信的机会。
If we could understand how the perception of reality is altered, we could create new kinds of intervention that don't have the risks and the problems of causing lasting change or addiction.
如果我们能够理解对现实的感知是如何改变的，我们就可以创造出新的干预措施，而不会带来造成持久改变或成瘾的风险和问题。
Now that said, even as these medications exist now, as you know, there's an impulse to use them in very small doses and to use them as adjunctive treatments for therapy of various kinds.
话虽如此，正如您所知，即使这些药物现在已经存在，人们仍然有一种冲动以非常小的剂量使用它们，并将它们用作各种治疗的辅助治疗。
And I'm also supportive of that, if done carefully and rigorously.
我也支持这一点，但前提是要认真、严格地进行。
Of course there's risk, but there's risk with many other kinds of treatment, and I'm not sure that the risks for these medications vastly outweigh the risks that we normally tolerate in other branches of medicine.
当然存在风险，但是许多其他类型的治疗也存在风险，而且我不确定这些药物的风险是否远远超过我们通常在其他医学分支中容忍的风险。
Andrew Huberman:
安德鲁·休伯曼：
Why would they work?
他们为什么要工作？
I mean, let's say that, indeed, their main effect is to create more connectivity, at least in the moment, between brain areas.
我的意思是，事实上，它们的主要作用是在大脑区域之间创建更多的连接，至少在目前是这样。
So the way I think about the two extremes, of my experience anyway, is a high degree of stress and focus for whatever reason, is going to create changes in my visual field and changes in the way that I perceive time, so that I'm going to microslice time.
因此，我对我的经历的两个极端的看法是，无论出于何种原因，高度的压力和注意力都会改变我的视野和我感知时间的方式，这样我就会对时间进行微切片。
I might, in a very contracted view of whatever my experience is.
我可能会以一种非常狭隘的方式看待我的经历。
Whereas on the opposite extreme, in a dream or in sleep, space and time are very fluid, and I'm essentially relaxed, although it might be a very interesting dream, it might not be.
而在另一个极端，在梦中或睡眠中，空间和时间非常流动，我基本上很放松，尽管这可能是一个非常有趣的梦，但也可能不是。
Psychedelics seem to be a trajectory not too far off from the dream state, where space and time are essentially not as rigid.
迷幻剂似乎是一条离梦境不太远的轨迹，其中空间和时间本质上并不那么严格。
And there is this element of synesthesia, of blending of the senses, feeling colors and hearing light and things of that sort.
还有联觉的元素，感官的混合，感觉颜色和听到光以及诸如此类的东西。
You hear these reports anyway.
无论如何，你都会听到这些报道。
Why would having that dreamlike experience somehow relieve depression long term?
为什么那种梦幻般的经历会以某种方式长期缓解抑郁症呢？
Do we have any idea why that might be?
我们知道为什么会这样吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
We have some ideas and no deep understanding.
我们有一些想法，但没有深入的理解。
One way I think about the psychedelics is they increase the willingness of our brain to accept unlikely ways of constructing the world, unlikely hypotheses, as it were, as to what's going on.
我对迷幻剂的一种看法是，它们增加了我们大脑的意愿，让我们接受不太可能的构建世界的方式，以及对正在发生的事情的不太可能的假设。
The brain, and in particular our cortex, I think, is a hypothesis generation and testing machine.
我认为，大脑，特别是我们的皮层，是一个假设生成和测试机器。
It's coming up with models about everything.
它正在提出关于一切的模型。
It's got a lot of bits of data coming in, and it's making models and updating the models and changing them — theories, hypotheses for what's going on.
它收到了大量的数据，它正在制作模型、更新模型并改变它们——关于正在发生的事情的理论和假设。
And some of those never reach our conscious mind.
其中一些永远不会到达我们的意识中。
And this is something I talk about in "Projections," in the book quite a bit, is many of these are filtered out before they get to our conscious mind.
这是我在书中多次谈到的“投射”，其中许多在进入我们的意识之前就被过滤掉了。
And that's good.
这很好。
Think how distracted we'd be if we were constantly having to evaluate all these hypotheses about what kinds of shapes or objects or processes were out there.
想象一下，如果我们不断地评估所有这些关于那里有哪些形状、物体或过程的假设，我们会多么心烦意乱。
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so a lot of this is handled before it gets to consciousness.
因此，很多事情都是在人们意识到之前就已经处理好的。
What the psychedelics seem to do is they change the threshold for us to become aware of these incomplete hypotheses or wrong hypotheses or concepts that might be noise, but are just wrong, and so are never allowed to get into our conscious mind.
迷幻药似乎所做的是，它们改变了我们意识到这些不完整的假设或错误的假设或概念的门槛，这些假设或概念可能是噪音，但实际上是错误的，因此永远不会被允许进入我们的意识。
Now, that's pretty interesting, and it goes wrong in psychiatric disorders; I think in schizophrenia, that sometimes the paranoid delusions that people have are examples of these poor models that escape into the conscious mind and become accepted as reality, and they never should have gotten out there.
现在，这非常有趣，但在精神疾病中却出了问题。我认为在精神分裂症中，有时人们的偏执妄想就是这些可怜的模型的例子，这些模型逃进了意识头脑并被接受为现实，而他们根本不应该走出去。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Now, how could something like this in the right way help with something like depression?
那么，这样的事情如何以正确的方式帮助治疗抑郁症呢？
Patients with depression often are stuck.
抑郁症患者常常陷入困境。
They can't look into the future world of possibilities as effectively.
他们无法有效地审视未来世界的可能性。
Everything seems hopeless.
一切似乎都毫无希望。
And what does that really mean?
这到底意味着什么？
They discount the value of their own action.
他们低估了自己行动的价值。
They discount the value of the world and giving rise to a future that matters.
他们低估了世界的价值，并创造了一个重要的未来。
Everything seems to run out like a river just running out into a desert and drying up.
一切似乎都在耗尽，就像河流流进沙漠并干涸一样。
And what these agents may do that increase the flow through circuitry, if you will, the percolation of activity through circuitry may end up doing for depression is increasing the escape of some tendrils of process, of forward progression through the world.
这些药物可能会增加通过回路的流动，如果你愿意的话，通过回路的活动渗透最终可能会导致抑郁症，那就是增加一些过程卷须的逃脱，以及世界前进的进展。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's a concept.
这是一个概念。
It's how I think about it.
我就是这么想的。
There are ways we can make that rigorous.
我们可以通过多种方法使其变得严格。
We can, indeed, identify in the brain by recording.
事实上，我们可以通过记录在大脑中进行识别。
We can see cells that represent steps along a path and look into the future.
我们可以看到代表沿着路径前进的步骤的单元格并展望未来。
And we can rigorously define these cells and we can see if these are altered on psychedelics.
我们可以严格定义这些细胞，并观察这些细胞是否会因迷幻药而发生改变。
And so that's one of the reasons that we're working with these agents in the laboratory to say, "Is this really the case?
这就是我们在实验室与这些药物合作的原因之一：“情况真的是这样吗？
Are these opening up new paths or representations of paths into the future?"
这些是否开辟了新的道路或代表了通向未来的道路？”
Andrew Huberman:
安德鲁·休伯曼：
MDMA, ecstasy, is a unique compound in that it leads to big increases in brain levels of dopamine and serotonin simultaneously.
MDMA（摇头丸）是一种独特的化合物，它会同时导致大脑中多巴胺和血清素水平大幅增加。
And I realize that the neuromodulators like dopamine, serotonin, often work in concert, not alone, the way they're commonly described in the more general popular discussions.
我意识到，像多巴胺、血清素这样的神经调节剂经常协同作用，而不是单独作用，就像更普遍的流行讨论中通常描述的那样。
However, it is a unique compound, and it's different than these serotonergic compounds like LSD and psilocybin.
然而，它是一种独特的化合物，与LSD和裸盖菇素等血清素能化合物不同。
And there are now data still emerging that it might be, and in some cases can be, useful for the treatment of trauma, PTSD and similar things.
现在仍有数据表明，它可能（在某些情况下）对于治疗创伤、创伤后应激障碍（PTSD）和类似疾病有用。
Andrew Huberman:
安德鲁·休伯曼：
Why would that work?
为什么那会起作用？
And a larger question, perhaps the more important question is: psychedelics, MDMA, LSD, all those compounds, in my mind, there are two components.
一个更大的问题，也许更重要的问题是：致幻剂、MDMA、LSD，所有这些化合物，在我看来，有两个组成部分。
There's the experience you have while you're on them, and then there's the effect they have after.
这是你使用它们时的体验，然后是它们之后产生的效果。
People are generating variations of these compounds that are nonhallucinatory variations.
人们正在产生这些化合物的变体，这些变体是非幻觉的变体。
But how crucial do you think it is to have, let's stay with MDMA, the experience of huge levels of dopamine, huge levels of serotonin, atypical levels of dopamine and serotonin released, having this highly abnormal experience in order to be normal again?
但你认为拥有大量的多巴胺、大量的血清素、非典型水平的多巴胺和血清素释放的体验，让我们继续使用摇头丸，拥有这种高度异常的体验，以便再次恢复正常有多重要？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah.
是的。
I think the brain learns from those experiences.
我认为大脑会从这些经历中学习。
That's the way I see it.
我就是这么看的。
And so for example, people who've taken MDMA, they will, as you say, they'll be the acute phase of being on the drug and experiencing this extreme connectedness with other people, for example.
举个例子，服用摇头丸的人，正如你所说，他们将处于吸毒的急性期，并经历与其他人的这种极端联系。
And then the drug wears off, but the brain learned from that experience.
然后药效就会消失，但大脑会从这次经历中吸取教训。
And so what people will report is, "Yeah, I'm not in that state, but I saw what was possible.
所以人们会报告说，“是的，我没有处于那种状态，但我看到了可能性。
I saw ...
我看到...
There don't need to be barriers, or at least not as many barriers as I thought.
不需要有障碍，或者至少没有我想象的那么多障碍。
I can connect with more people in a way that is helpful." And so I think it's the learning that happens in that state that actually matters.
我可以通过一种有益的方式与更多的人建立联系。”所以我认为真正重要的是在这种状态下发生的学习。
Andrew Huberman:
安德鲁·休伯曼：
And this, as you described, that sounds a lot like what I understand to be the hallmark feature of really good psychoanalysis, that the relationship between patient and therapist hopefully evolves to the point where these kinds of tests can be run within the context of that relationship and then exported to other relations.
正如您所描述的，这听起来很像我所理解的真正优秀的精神分析的标志特征，即患者和治疗师之间的关系有望发展到可以在该关系的背景下进行此类测试，然后导出到其他关系的程度。
Is that...?
那是……？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Exactly, right.
完全正确。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And that probably, I'm assuming, is still the goal of really good psychiatry also.
我认为这可能仍然是真正优秀的精神病学的目标。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It's a part of...
它是...的一部分
Andrew Huberman:
安德鲁·休伯曼：
It's intimacy, really.
确实是亲密关系。
Karl Deisseroth:
卡尔·戴瑟罗斯：
It should be.
应该是的。
When we have time, I think all good psychiatrists try to achieve that level of connection and learning, try to help patients create a new model that is stable, that is learned, and that can help instruct future behavior.
当我们有时间时，我认为所有优秀的精神科医生都会尝试达到这种联系和学习的水平，尝试帮助患者创建一个稳定的、可学习的、可以帮助指导未来行为的新模型。
Andrew Huberman:
安德鲁·休伯曼：
One of the things that I took from reading your book, in addition to learning so much science and the future of psychiatry and brain science, was amidst these, in many cases, very tragic cases and sadness and a lot of the weight that that puts on the clinician, on you also, that there's a central cord of optimism that where we're headed is not just possible, but very likely and better.
我从读你的书中学到的东西之一，除了学习了如此多的科学以及精神病学和脑科学的未来之外，在许多情况下，非常悲惨的案例和悲伤以及这给临床医生和你带来了很大的压力，有一种乐观的中心思想，我们前进的方向不仅是可能的，而且很有可能而且更好。
And are you an optimist?
你是一个乐观主义者吗？
Karl Deisseroth:
卡尔·戴瑟罗斯：
I am.
我是。
And by the way, this was a really interesting experience in writing "Projections" because I had a dual goal.
顺便说一句，这是写“预测”的一次非常有趣的经历，因为我有双重目标。
I wanted it to be for everybody, literally everybody in the world who wants to read it.
我希望它适合每个人，实际上是世界上每个想阅读它的人。
And yet, at the same time, I wanted to stay absolutely, rigorously close to the science, what was actually known, when I was speaking about science, when I was speaking about the neurobiology of the brain or psychiatry.
然而，与此同时，当我谈论科学、当我谈论大脑的神经生物学或精神病学时，我想绝对、严格地接近科学，即实际已知的东西。
I wanted to not have any of my scientific colleagues think, "Oh, he's going too far.
我不想让我的任何科学同事认为，“哦，他太过分了。
He's saying too much."
他说得太多了。”
Karl Deisseroth:
卡尔·戴瑟罗斯：
And so I had these two goals, which I kept in my mind the entire time.
所以我就有了这两个目标，我一直牢记在心。
And a lot of this trying to find exactly the right word we talked about was on this path of staying excruciatingly rigorous in the science, and yet letting people see the hope, where things were, have everybody see that we've come a long way.
很多尝试找到我们所讨论的正确词语的努力都是在科学上保持极其严格的态度，同时让人们看到希望，让每个人看到我们已经取得了长足的进步。
We have a long way to go, but the trajectory and the path is beautiful.
我们的路还很长，但轨迹和道路是美好的。
And so that was the goal.
这就是我们的目标。
I think, of course that sounds almost impossible, to jointly satisfy those two goals, but I kept that in my mind the whole way through.
我认为，当然，这听起来几乎不可能，共同实现这两个目标，但我自始至终都牢记这一点。
And yes, I am optimistic, and I hope that came through in the book.
是的，我很乐观，我希望这在书中得到体现。
Andrew Huberman:
安德鲁·休伯曼：
Well, it certainly did.
嗯，确实如此。
And at least from this colleague, you did achieve both.
至少从这位同事身上，你确实实现了这两点。
And it's a wonderful, a masterful book really, and one that, as a scientist and somebody who is a fellow brain explorer, hits all the marks of rigor and is incredibly interesting.
这确实是一本精彩的、大师级的书，作为一名科学家和一名大脑探索者，它达到了所有严谨的标准，而且非常有趣。
And there's a ton of storytelling.
还有大量的故事。
I don't want to give away too much about it, but people should definitely check out the book.
我不想透露太多，但人们绝对应该看看这本书。
Are you active on social media if people want to follow you and connect with what you're doing now and going forward?
如果人们想关注您并了解您现在正在做的事情以及未来的发展，您是否在社交媒体上很活跃？
Karl Deisseroth:
卡尔·戴瑟罗斯：
Yeah, I have a Twitter.
是的，我有一个推特。
That's where I mainly do exchange, tell people about things that are happening.
这就是我主要进行交流的地方，告诉人们正在发生的事情。
Andrew Huberman:
安德鲁·休伯曼：
We'll provide a link to it.
我们将提供它的链接。
But that's Karl Deisseroth, as I recall, with a "K"?
但我记得那是卡尔·戴瑟罗斯（Karl Deisseroth），带有“K”？
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Karl Deisseroth:
卡尔·戴瑟罗斯：
That's right.
没错。
Andrew Huberman:
安德鲁·休伯曼：
And so you're on Twitter, and people will hear this.
所以你在 Twitter 上，人们就会听到这个消息。
Definitely check out the book.
一定要看看书。
There are other people in our community that, of course, are going to be reaching out on your behalf, but it's incredible that you juggle this enormous number of things.
当然，我们社区中还有其他人会代表您伸出援手，但您同时处理如此多的事情真是令人难以置信。
Perhaps even more important, however, is that it's all in service to this larger thing of relieving suffering.
然而，也许更重要的是，这一切都是为了减轻痛苦这个更大的事情。
So thank you so much for your time today, for the book, and the work that went into the book— I can't even imagine — for the laboratory work and the development of channelopsins, clarity, and all the related technologies, and for the clinical work you're doing, and for sharing with us.
非常感谢您今天抽出宝贵的时间，感谢这本书，感谢您为这本书所做的工作——我什至无法想象——感谢您的实验室工作和通道视蛋白的开发、清晰度和所有相关技术，感谢您正在进行的临床工作，感谢您与我们分享。
Karl Deisseroth:
卡尔·戴瑟罗斯：
Well, thank you for all you're doing and reaching out.
好吧，感谢您所做的一切和伸出援手。
I'm very impressed by it.
我对此印象非常深刻。
It's important, and it's so valuable.
这很重要，而且非常有价值。
And thank you for taking the time and for all your gracious words about the book.
感谢您抽出时间并感谢您对这本书的所有溢美之辞。
Thank you.
谢谢。
Andrew Huberman:
安德鲁·休伯曼：
I hope you enjoyed today's discussion with Dr. Deisseroth as much as I did.
我希望您和我一样喜欢今天与 Deisseroth 博士的讨论。
Be sure to check out his new book, "Projections: A Story of Human Emotions." It's available on Amazon, Audible, and all the other standard places where books are found.
一定要看看他的新书《预测：人类情感的故事》。它可以在亚马逊、Audible 和所有其他可以找到书籍的标准地方找到。
If you'd like to support this podcast, please subscribe to us on YouTube as well.
如果您想支持此播客，也请在 YouTube 上订阅我们。
You can subscribe to us on Apple or Spotify.
您可以在 Apple 或 Spotify 上订阅我们。
At Apple, you also have the opportunity to leave us a five-star review and to give us feedback.
在 Apple，您还有机会给我们留下五星级评价并向我们提供反馈。
Andrew Huberman:
安德鲁·休伯曼：
Please put any questions you have in the comment section below the YouTube video if you'd like us to address certain things in future episodes, or if you have questions about this particular episode.
如果您希望我们在以后的剧集中解决某些问题，或者您对此特定剧集有疑问，请在 YouTube 视频下方的评论部分提出您的任何问题。
Andrew Huberman:
安德鲁·休伯曼：
In addition, please check out our sponsors.
此外，请查看我们的赞助商。
That's a terrific way to support us.
这是支持我们的好方法。
Andrew Huberman:
安德鲁·休伯曼：
Last but not least, if you're interested in understanding more about how the brain works and how it functions, and how it breaks down in various conditions, check out the first episode of the Huberman Lab podcast.
最后但并非最不重要的一点是，如果您有兴趣更多地了解大脑如何工作、如何发挥作用，以及它在各种条件下如何分解，请查看 Huberman 实验室播客的第一集。
The title of that episode is "How Your Nervous System Works and Changes." If you're watching this right now on YouTube, you can simply click on the title card for that episode.
该集的标题是“你的神经系统如何工作和变化”。如果您现在正在 YouTube 上观看此节目，只需单击该集的标题卡即可。
And last but 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。