Affiliated member of the WPA – World Psychiatric Association

Abstract Makris, Nikos; Westin, Carl-Fredrik; van der Kouwe, Andre; Pallanti, Stefano

Neuroscience of Anger and Disgust in a Perspective of Current Precision Psychiatry and Applied Neuroimaging

Recent developments in neural systems conceptualization and characterization using current neuroimaging technology has advanced considerably our understanding of brain structure and function in humans. The integration of structure and function is a critical goal in basic and clinical neuroscience and multimodal neuroimaging offers a unique possibility to achieve this objective. A fundamental aspect of scientific knowledge in this regard is the brain’s structural connectivity to define the neural systems responsible as biomarkers of such cognitive and affective behaviors as anger and anger-management. Importantly, recent neuro-modulatory therapeutic interventions have been applied in psychiatry, neurology and neurosurgery. The role of neuroimaging in the utilization of current neuromodulation interventions in clinical psychiatry using transcranial magnetic stimulation and deep brain stimulation will be discussed. Neuropsychiatrists, behavioral neurologists and psychotherapists are increasingly engaged in the assessment and management of emotional dysregulation. One of the major challenges identified by clinicians across neurology and psychiatry is the lack of an updated neurobiological model through which through to conceptualize these patients. An improved neurobiological understanding of psychiatric disorder also offers the opportunity to develop biologically-informed diagnostic and prognostic biomarkers.
Advances in system-level neuroscience have aided our understanding of emotion regulation. In this symposium, we aim to provide the WADP audience with a cutting-edge neurobiologicallyfocused series of lectures on brain-emotion processing and current brain imaging tools. Following a brief introduction, this symposium will begin with a “deep-dive” into the neural networks implicated in emotion regulation, disgust and anger control.

This lecture will be led by Dr. Nikos Makris, a world leader in neuroanatomy and neuroimaging pioneer. Our 2nd and 3rd lectures, will be led by Dr. Carl-Fredrik Westin and Dr. Andre van der Kouwe respectively, two world experts in brain imaging of structural and functional connectivity. Our final lecture led by Dr. Stefano Pallanti a world leader in clinical Psychiatry, will provide a perspective on the phenomenology, psychopathology and clinical features of Disgust and its biosocial meaning. Biomarker research will also be highlighted, including a discussion on current transcranial magnetic stimulation (TMS) interventions.

Goals and Objectives:

  • To advance understanding of the biological basis in emotion regulation and anger.
  • To gain knowledge on the clinical aspects of disgust and anger behavior.
  • To familiarize with brain imaging literature and realize its relevance in applying current Transcranial Magnetic Stimulation (TMS) in precision psychiatry therapeutic interventions.


Nikolaos Makris M.D., Ph.D. is a systems neuroanatomist, an Associate Professor in the Departments of Psychiatry and Neurology at Harvard Medical School and the Director of the Center for Morphometric Analysis (CMA) at Massachusetts General Hospital (MGH). Dr. Makris is an internationally regarded pioneer in lesion mapping, brain morphometric analyses, and diffusion tensor imaging. Importantly, Dr. Makris is also a highly regarded educator, including directing the Computational Imaging Anatomy course at the Psychiatric Neuroimaging Lab (PNL) at Brigham and Women’s Hospital (BWH) for the past 7 years. As PI or co-investigator on several NIH-funded grants, Dr. Makris laid the groundwork for multimodal MRI and diffusion imaging tractography analyses. He has published over 200 scientific articles. Dr. Makris’ research was highlighted in the 2014 list of The World’s Most Influential Scientific Minds by the Thompson Reuters Agency. The list includes 3,200 individuals around the globe who published the top 1% of highly cited papers in one of 21 broad fields during the decade of 2002-2012 and Dr. Makris is listed among 128 neuroscientists in the field of Neuroscience & Behavior worldwide.

Dr. Carl-Fredrik Westin, Ph.D. is the founding Director of the Laboratory of Mathematics in Imaging (LMI,, and Professor of Radiology at Harvard Medical School, Boston, MA, USA. He also has joint appointments with the MIT Computer Science and Artificial Intelligence Laboratory, Cambridge, MA. The Laboratory of Mathematics in Imaging is focused on the application of mathematical theory, analysis, modeling, and signal processing to medical imaging. Dr. Westin’s research covers both novel theoretical contributions and translational clinical efforts and he combines strengths in computer science and mathematics with radiology and neuroscience in his research. He has been involved in imaging studies, including structural, functional and diffusion-weighted magnetic resonance imaging (dMRI) investigations since 1996, when he joined Brigham and Women’s Hospital and Harvard Medical School. A main focus of his research during the past two decades has been diffusion MRI to investigating brain circuitries for cognitive and emotional processing. His laboratory is internationally known for developing innovative and pioneering methods within this field. Dr. Westin has co/authored over 250 publications, in the fields of computer vision, medical image analysis, and image guided surgery. He is also the recipient of the Distinguished Investigator Award from Academy of Radiology Research, and a Fellow of the ISMRM Society.

Andre van der Kouwe, Ph.D. Dr. van der Kouwe’s major activity is research in the field of magnetic resonance (MR) physics, specifically pulse sequence design and image analysis. He supports neuroscience research at the MGH and collaborating institutions by improving acquisition methods, such as high-reliability imaging methods for quantitative brain morphometry, automatic slice prescription and motion correction. These methods are shared with collaborators at various sites around the world. He has twelve awarded and six pending patents on MR methods. One patent relates to automatic slice prescription. The method was adopted by Siemens as their “AutoAlign” product. “AutoAlign” has shipped with Siemens MRI scanners purchased with the license, all over the world. The technology improves clinical workflow and reliability in brain imaging. Another patent relates to band-width matched morphometry. We have distributed the software worldwide. Students and post-doctoral fellows have worked on motion correction under his supervision. He has two current NIH grants as PI and joint-PI. In the first, he is developing high resolution imaging for identifying abnormalities in the hippocampus for understanding Alzheimer’s Disease. In the second, he works with physicists at the University of Cape Town on techniques for imaging HIV infected children. Dr. van der Kouwe is also joint-PI on a grant awarded by the Bertarelli Foundation to develop real-time motion correction methods for slice-by-slice correction of fMRI acquisitions to study resting state connectivity in autism. He is also the PI on an SBIR phase II subcontract with Robin Medical Inc. integrating the Endoscout motion tracking system with the Siemens scanner. He supports investigators at the Martinos Center and elsewhere with specific imaging needs on an ad hoc basis. In 2007, he was elected to senior membership of the IEEE in recognition of contributions to the field of biomedical engineering. In 2014, he was elected to the position of “Chair” of the Motion Correction Study Group of the ISMRM. Also in 2014, Dr. van der Kouwe was recognized by Thomson Reuters to be amongst the top 1% most cited researchers in neuroscience. In 2016, he was given the honorary title of “Associate Professor” in the Department of Human Biology at the University of Cape Town for contributions to student mentorship and research there. He has collaborated with the Universities of Cape Town and Stellenbosch for more than a decade on topics of particular public health relevance in the region, including HIV, fetal alcohol spectrum disorder and methamphetamine use.

Stefano Pallanti M.D. has a broad background in Psychiatry, with specific training and expertise in the clinical, pharmacological and neurofunctional aspects of psychiatric disorders. Since 2000 he is a researcher in Impulsive Compulsive Autism Spectrum at the Mount Sinai School of Medicine (New York, U.S.), where in 2007/2008 he has been Director of the Strategic Center of Excellence of Psychiatry. In 2005/2006 Dr. Pallanti has been member of the APA International Advisory Board for DSM 5 (Chair J. Kupfer) and of the OCD spectrum workgroup of APA for DSM V Impulse Control Disorders Taskforce (Chair E. Hollander and Y. Zohar). In these years, he has collaborated with other researchers in the development of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS). Dr. Pallanti has previously been PI and co-Investigator of over ten studies, most of which were multicenter or international, producing peer-reviewed publications
from each project. Moreover, his expertise in the field of neuromodulation techniques has developed from 2005 with the beginning of an extensive clinical practice and a research fund from the Italian Ministry of Health. In 2013, he received the certificate of Deep TMS Operator by Brainsway and in the same year he joined UC Davis School of Medicine Department of Psychiatry as Full Professor of Psychiatry and Behavioral Sciences and continued his research on TMS. Dr.
Pallanti is currently member of the Board of Directors of Clinical TMS Society and author/coauthorof over a dozen of papers regarding neuromodulation. Since 2018, Dr. Pallanti is Full Professor of Psychiatry and Behavioral Sciences in the Department of Psychiatry and Behavioral Sciences at Stanford University, Palo Alto, USA. He is also the Director of the Institute of Neuroscience in Florence, Italy.


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