Frontoparietal cortex: The immune system of the mind

The frontoparietal control system is to the mind what the immune system is to the body. It may oversimplify the situation, but we’re finding it’s a useful metaphor nonetheless. Indeed, we’ve just published a new theory paper explaining that there is already an avalanche of evidence supporting this metaphor. Even though much work is left to fully establish the theory, we’re very excited about it as it appears it can explain much that is mysterious about mental illnesses. Most exciting is that the theory may unify understanding and treatment of all mental illnesses simultaneously.

Of course mental illnesses are very complex and problems in most parts of the brain can contribute. However, recent findings suggest a particular brain network may be especially important for predicting and curing mental disease: the frontoparietal control network (see yellow areas in figure). We and others have found that this network is not only highly connected to many other parts of the brain (i.e. its regions are hubs), but it also shifts that connectivity dynamically to specify the current task at hand. This means that any particular goal you are focusing on – such as solving a puzzle or finding food or cheering yourself up when you feel sad – will involve dynamic network interactions with this network (to maintain and implement that goal).

Applying this basic understanding of goal-directed thoughts and actions to mental illness, we realized deficits in this brain network may be critical for explaining many of the cognitive symptoms – such as the inability to concentrate on the task at hand – experienced across a wide variety of mental diseases. Further, we realized that many of the emotional symptoms of mental disease are indirectly affected by this network, since emotional regulation (e.g., reducing phobia-related anxiety) involves brain interactions with this network. This suggests this network may regulate symptoms and promote mental health generally, much like the body’s immune system regulates pathogens to promote physical health.

Another way to think of this is in terms of an interaction between a regulator like a thermostat and a thing to be regulated like the temperature in a room. Similar to the regulation of temperature, the frontoparietal system sets a goal to a range of distributed brain activity patterns (like setting the goal temperature on the thermostat), and the system searches for activity patterns that will make the dysfunctional brain activity patterns shift toward that goal.

As covered in our theory paper, it is well established that the frontoparietal system has all the key properties of a regulator: it maintains goal information, it has access to many other parts of the brain, and it affects distal parts of the brain according to the maintained goal. Further, there is evidence that things like emotional regulation during cognitive behavioral therapy increase activity in the frontoparietal system, suggesting this brain system is working harder when cognitive strategies are used to facilitate mental health.

Perhaps the most exciting prediction of this theory is that enhancing the frontoparietal system may reduce all symptoms of all mental diseases using a single treatment. This is because the frontoparietal system is domain general, meaning it directs goal-directed processes across all aspects of the mind and therefore all possible mental symptoms. In practice there will certainly be exceptions to this, yet simultaneous progress on reducing even just 50% of symptoms would be a tremendous advance.

How might we enhance the frontoparietal system? Perhaps using drugs that differentially influence this system (e.g., dopamine agonists) or direct stimulation of the system (e.g., using transcranial magnetic or current stimulation). Since the frontoparietal system can be reconfigured using verbal instructions, however, building on carefully structured talk therapies may be an especially specific and effective way. In particular, the frontoparietal system is known to implement rapid instructed task learning (RITL) – a way for the brain to implement novel behaviors based on instructions. Ultimately, this theory suggests the proper combination of frontoparietal system enhancement through direct influence (drugs and/or stimulation), talk therapy, and symptom-specific interventions will allow us to make major progress toward curing a wide variety of mental diseases.