Richard J. Caselli, MD

Creative failure at the level of social context is something we all experience when we have a manuscript rejected for publication or a grant denied funding, or tell a joke at which no one laughs. These are normal occurrences, and with patience and persistence, alternative strategies can help us achieve an approximation of the intended goal, regardless of whether or not it is identical to the original one. Failure to gain acceptance from and resonate with the audience – the prevailing social context – is what distinguishes hit products, such as the Apple iPod, or popular artists from their many rivals whose names are quickly forgotten.

Autism spectrum disorder covers a wide range of abilities and impairments, and may result from many causes. Individuals with Asperger’s syndrome are at the mild end of the autism spectrum (although they face significant challenges that are more than mild for many), and are characterized less by cognitive impairment than by social awkwardness. They possess the necessary motivation, perception, mental imagery, formulation, and execution skills, and the temperament to create products worthy of society’s consideration, and some have succeeded in spectacular ways.

Temple Grandin, Ph.D., is one such remarkable individual. A doctor of animal husbandry, professor at Colorado State University, and self-described techie, she developed the industry standard animal-handling equipment for cattle. She is a noted advocate for those who have autism, and has achieved celebrity status through her speeches, articles, and books.

Her most recent book, "Different Not Less" (Arlington, Tex.: Future Horizons, 2012) contains a series of 14 vignettes of individuals with autism spectrum disorder who tell their own stories of the challenges they faced in their successful struggles to achieve a "normal life." Many share similar tales of social challenges, such as being bullied in school, having difficulty forming intimate relationships, and maintaining steady employment. For example, a member of the special education faculty at Adelphi University described his interactions with classmates in elementary school this way: "Instead of talking with my classmates, I had a repertoire of sounds and actions that I would make at them. I actually hoped I would get them to repeat these sounds and actions back at me. For me, that was a more predictable type of interaction than attempting to enter into a conversation."

Although these are all stories of success, they detail the challenges that these individuals overcame to achieve a stable life for themselves in mainstream society.

However, another individual suspected of being autistic was more famously unsuccessful. Ted Kaczynski, the "Unabomber," did not begin life as a terrorist. Like many of the people in Dr. Grandin’s book, he was an intellectually gifted child who had difficulty socializing with other children – playing beside them rather than with them – and was subject to bullying. He entered Harvard College at age 16, graduated by age 20, and obtained a Ph.D. in mathematics from the University of Michigan where his thesis won the university’s annual prize as the school’s best in mathematics. By age 25, he was hired by the University of California, Berkeley, the youngest professor ever hired by the school. But as a teacher, Kaczynski was uncomfortable with the classroom environment. He resigned less than 2 years later and began his life of isolation that led him to a tiny one-room cabin in rural Montana without electricity or running water. He was offended by the encroachment of technology, roads, and civilization in general.

Kaczynski sent his first bomb in 1978, the first of many over a 17-year period that targeted universities, airlines, and other businesses. His bombs resulted in three deaths and 23 injuries, until he was captured following the New York Times’s and the Washington Post’s publication of his manifesto titled, "Industrial Society and Its Future," in which he essentially explained the rationale for his actions. His was the most expensive manhunt in FBI history, ending only because of his brother’s ability to recognize Ted’s writing style in the published manifesto. Kaczynski is an extremely intelligent man, but he clearly has a problem melding his skill set and goals with those of mainstream society.

Although it may be obvious, it is worth emphasizing that autism does not predispose individuals to sociopathic behavior; rather, Kaczynski’s case illustrates that individuals with socially awkward behavior are still highly capable people with the capacity to give an outlet to whatever other personality traits – good or bad – they possess.

The time line of human creativity is really one of social interaction. Another example of impaired creativity reflecting social context results from social isolation. Human hunter-gatherer groups represent the simplest form of human society. Typically, they are isolate groups, with relatively low numbers of individuals. Biologically, they are no different from us. Their level of cooperation among group members, like ours, far exceeds that of our closest primate relatives, yet technologically, hunter-gatherer groups are very primitive (Evol. Anthropol. 2009; 18:187-200). Assuming that Homo sapiens has existed for roughly 200,000 years, it took 195,000 of those years for us to invent a wheel. Everything else has since followed as a series of incremental advances. However, factors that lead to social isolation exclude the hunter-gatherer group’s members from the slow but steady advance of global knowledge and technology.

What led to the perpetuated isolation that has limited the advance of these groups? There are various theories, but most evidence supports that it resulted from fear based upon previous encounters with "civilized" explorers who killed or subjugated the indigenous people and took control of their land. Tribes that survived have remained less welcoming to outside contact attempts.

We can argue about whether Ted Kaczynski was psychiatrically ill; he himself disavowed such a notion, even to the point of his sentencing. Social isolation can be a symptom of many psychiatric diseases that affect the individual, or – in the case of isolated tribes – an adaptive (or maladaptive) group behavior. Nonetheless, the question of psychiatric illness and creativity has captured the imagination of the general public. Next month, we shall consider it more directly.

Dr. Richard J. Caselli is the medical editor of Clinical Neurology News and is professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

Creative failure at the level of social context is something we all experience when we have a manuscript rejected for publication or a grant denied funding, or tell a joke at which no one laughs. These are normal occurrences, and with patience and persistence, alternative strategies can help us achieve an approximation of the intended goal, regardless of whether or not it is identical to the original one. Failure to gain acceptance from and resonate with the audience – the prevailing social context – is what distinguishes hit products, such as the Apple iPod, or popular artists from their many rivals whose names are quickly forgotten.

Autism spectrum disorder covers a wide range of abilities and impairments, and may result from many causes. Individuals with Asperger’s syndrome are at the mild end of the autism spectrum (although they face significant challenges that are more than mild for many), and are characterized less by cognitive impairment than by social awkwardness. They possess the necessary motivation, perception, mental imagery, formulation, and execution skills, and the temperament to create products worthy of society’s consideration, and some have succeeded in spectacular ways.

Temple Grandin, Ph.D., is one such remarkable individual. A doctor of animal husbandry, professor at Colorado State University, and self-described techie, she developed the industry standard animal-handling equipment for cattle. She is a noted advocate for those who have autism, and has achieved celebrity status through her speeches, articles, and books.

Her most recent book, "Different Not Less" (Arlington, Tex.: Future Horizons, 2012) contains a series of 14 vignettes of individuals with autism spectrum disorder who tell their own stories of the challenges they faced in their successful struggles to achieve a "normal life." Many share similar tales of social challenges, such as being bullied in school, having difficulty forming intimate relationships, and maintaining steady employment. For example, a member of the special education faculty at Adelphi University described his interactions with classmates in elementary school this way: "Instead of talking with my classmates, I had a repertoire of sounds and actions that I would make at them. I actually hoped I would get them to repeat these sounds and actions back at me. For me, that was a more predictable type of interaction than attempting to enter into a conversation."

Although these are all stories of success, they detail the challenges that these individuals overcame to achieve a stable life for themselves in mainstream society.

However, another individual suspected of being autistic was more famously unsuccessful. Ted Kaczynski, the "Unabomber," did not begin life as a terrorist. Like many of the people in Dr. Grandin’s book, he was an intellectually gifted child who had difficulty socializing with other children – playing beside them rather than with them – and was subject to bullying. He entered Harvard College at age 16, graduated by age 20, and obtained a Ph.D. in mathematics from the University of Michigan where his thesis won the university’s annual prize as the school’s best in mathematics. By age 25, he was hired by the University of California, Berkeley, the youngest professor ever hired by the school. But as a teacher, Kaczynski was uncomfortable with the classroom environment. He resigned less than 2 years later and began his life of isolation that led him to a tiny one-room cabin in rural Montana without electricity or running water. He was offended by the encroachment of technology, roads, and civilization in general.

Kaczynski sent his first bomb in 1978, the first of many over a 17-year period that targeted universities, airlines, and other businesses. His bombs resulted in three deaths and 23 injuries, until he was captured following the New York Times’s and the Washington Post’s publication of his manifesto titled, "Industrial Society and Its Future," in which he essentially explained the rationale for his actions. His was the most expensive manhunt in FBI history, ending only because of his brother’s ability to recognize Ted’s writing style in the published manifesto. Kaczynski is an extremely intelligent man, but he clearly has a problem melding his skill set and goals with those of mainstream society.

Although it may be obvious, it is worth emphasizing that autism does not predispose individuals to sociopathic behavior; rather, Kaczynski’s case illustrates that individuals with socially awkward behavior are still highly capable people with the capacity to give an outlet to whatever other personality traits – good or bad – they possess.

The time line of human creativity is really one of social interaction. Another example of impaired creativity reflecting social context results from social isolation. Human hunter-gatherer groups represent the simplest form of human society. Typically, they are isolate groups, with relatively low numbers of individuals. Biologically, they are no different from us. Their level of cooperation among group members, like ours, far exceeds that of our closest primate relatives, yet technologically, hunter-gatherer groups are very primitive (Evol. Anthropol. 2009; 18:187-200). Assuming that Homo sapiens has existed for roughly 200,000 years, it took 195,000 of those years for us to invent a wheel. Everything else has since followed as a series of incremental advances. However, factors that lead to social isolation exclude the hunter-gatherer group’s members from the slow but steady advance of global knowledge and technology.

What led to the perpetuated isolation that has limited the advance of these groups? There are various theories, but most evidence supports that it resulted from fear based upon previous encounters with "civilized" explorers who killed or subjugated the indigenous people and took control of their land. Tribes that survived have remained less welcoming to outside contact attempts.

We can argue about whether Ted Kaczynski was psychiatrically ill; he himself disavowed such a notion, even to the point of his sentencing. Social isolation can be a symptom of many psychiatric diseases that affect the individual, or – in the case of isolated tribes – an adaptive (or maladaptive) group behavior. Nonetheless, the question of psychiatric illness and creativity has captured the imagination of the general public. Next month, we shall consider it more directly.

Dr. Richard J. Caselli is the medical editor of Clinical Neurology News and is professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

Creative failure at the level of social context is something we all experience when we have a manuscript rejected for publication or a grant denied funding, or tell a joke at which no one laughs. These are normal occurrences, and with patience and persistence, alternative strategies can help us achieve an approximation of the intended goal, regardless of whether or not it is identical to the original one. Failure to gain acceptance from and resonate with the audience – the prevailing social context – is what distinguishes hit products, such as the Apple iPod, or popular artists from their many rivals whose names are quickly forgotten.

Autism spectrum disorder covers a wide range of abilities and impairments, and may result from many causes. Individuals with Asperger’s syndrome are at the mild end of the autism spectrum (although they face significant challenges that are more than mild for many), and are characterized less by cognitive impairment than by social awkwardness. They possess the necessary motivation, perception, mental imagery, formulation, and execution skills, and the temperament to create products worthy of society’s consideration, and some have succeeded in spectacular ways.

Temple Grandin, Ph.D., is one such remarkable individual. A doctor of animal husbandry, professor at Colorado State University, and self-described techie, she developed the industry standard animal-handling equipment for cattle. She is a noted advocate for those who have autism, and has achieved celebrity status through her speeches, articles, and books.

Her most recent book, "Different Not Less" (Arlington, Tex.: Future Horizons, 2012) contains a series of 14 vignettes of individuals with autism spectrum disorder who tell their own stories of the challenges they faced in their successful struggles to achieve a "normal life." Many share similar tales of social challenges, such as being bullied in school, having difficulty forming intimate relationships, and maintaining steady employment. For example, a member of the special education faculty at Adelphi University described his interactions with classmates in elementary school this way: "Instead of talking with my classmates, I had a repertoire of sounds and actions that I would make at them. I actually hoped I would get them to repeat these sounds and actions back at me. For me, that was a more predictable type of interaction than attempting to enter into a conversation."

Although these are all stories of success, they detail the challenges that these individuals overcame to achieve a stable life for themselves in mainstream society.

However, another individual suspected of being autistic was more famously unsuccessful. Ted Kaczynski, the "Unabomber," did not begin life as a terrorist. Like many of the people in Dr. Grandin’s book, he was an intellectually gifted child who had difficulty socializing with other children – playing beside them rather than with them – and was subject to bullying. He entered Harvard College at age 16, graduated by age 20, and obtained a Ph.D. in mathematics from the University of Michigan where his thesis won the university’s annual prize as the school’s best in mathematics. By age 25, he was hired by the University of California, Berkeley, the youngest professor ever hired by the school. But as a teacher, Kaczynski was uncomfortable with the classroom environment. He resigned less than 2 years later and began his life of isolation that led him to a tiny one-room cabin in rural Montana without electricity or running water. He was offended by the encroachment of technology, roads, and civilization in general.

Kaczynski sent his first bomb in 1978, the first of many over a 17-year period that targeted universities, airlines, and other businesses. His bombs resulted in three deaths and 23 injuries, until he was captured following the New York Times’s and the Washington Post’s publication of his manifesto titled, "Industrial Society and Its Future," in which he essentially explained the rationale for his actions. His was the most expensive manhunt in FBI history, ending only because of his brother’s ability to recognize Ted’s writing style in the published manifesto. Kaczynski is an extremely intelligent man, but he clearly has a problem melding his skill set and goals with those of mainstream society.

Although it may be obvious, it is worth emphasizing that autism does not predispose individuals to sociopathic behavior; rather, Kaczynski’s case illustrates that individuals with socially awkward behavior are still highly capable people with the capacity to give an outlet to whatever other personality traits – good or bad – they possess.

The time line of human creativity is really one of social interaction. Another example of impaired creativity reflecting social context results from social isolation. Human hunter-gatherer groups represent the simplest form of human society. Typically, they are isolate groups, with relatively low numbers of individuals. Biologically, they are no different from us. Their level of cooperation among group members, like ours, far exceeds that of our closest primate relatives, yet technologically, hunter-gatherer groups are very primitive (Evol. Anthropol. 2009; 18:187-200). Assuming that Homo sapiens has existed for roughly 200,000 years, it took 195,000 of those years for us to invent a wheel. Everything else has since followed as a series of incremental advances. However, factors that lead to social isolation exclude the hunter-gatherer group’s members from the slow but steady advance of global knowledge and technology.

What led to the perpetuated isolation that has limited the advance of these groups? There are various theories, but most evidence supports that it resulted from fear based upon previous encounters with "civilized" explorers who killed or subjugated the indigenous people and took control of their land. Tribes that survived have remained less welcoming to outside contact attempts.

We can argue about whether Ted Kaczynski was psychiatrically ill; he himself disavowed such a notion, even to the point of his sentencing. Social isolation can be a symptom of many psychiatric diseases that affect the individual, or – in the case of isolated tribes – an adaptive (or maladaptive) group behavior. Nonetheless, the question of psychiatric illness and creativity has captured the imagination of the general public. Next month, we shall consider it more directly.

Dr. Richard J. Caselli is the medical editor of Clinical Neurology News and is professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

The success of a creation should, in theory, be determined by its creator, who is in the best position to determine how closely the creation matches the original vision. But in science, as in other creative endeavors, this is not the case. Success in science requires funding and publication, which does not arise from scientists’ opinions of their own work, but rather from the judgment rendered by a peer group comprising reviewers and editors.

This socially determined valuation of a creative effort helps to determine what society (or any social grouping) deems to be important. How much value we place on a new creation influences its creator’s drive to bridge the perceived gap between what is and what should be. The satiation of that creative drive is a biologically and psychologically relevant measure of creative success because it influences the likelihood that the creator will react again in the future to such perceived gaps, thus perpetuating creative behavior. Other factors may influence the degree of such satisfaction, including the reward received; the value that the creator’s culture places on individual attainment (Annu. Rev. Psychol. 2003;54:403-25); the creator’s enjoyment of the creative effort itself, as expressed in Mihály Csíkszentmihályi’s "Finding Flow: The Psychology of Engagement with Everyday Life" (New York: Basic Books, 1997); and the nature of the creation, in that creators who serve the greater good may derive a greater sense of happiness from their work, as discussed in Jonathan Haidt’s "The Happiness Hypothesis" (New York: Basic Books, 2006).

Although the creator’s opinion is important, Dr. Csíkszentmihályi’s "systems model" of creativity highlights the role of society in which a gatekeeper determines what creative work will be admitted to the existing intended domain ("The Nature of Creativity: Current Psychological Perspectives" [Cambridge: Cambridge University Press, 1988, p. 325-39]). Because society cannot know the creator’s vision and so cannot match the creation to the vision, an external set of aesthetic rules is needed to judge creative achievement.

Aesthetics are the cooperatively determined hierarchical categorization and quantification of quality, expressed as rules or principles. Aesthetics reflect the opinions and values of the social grouping in which creativity arises. For example, the aesthetic value of a painting lies in the artist’s choice of color and form, and the aesthetic value of a scientific experiment lies in its methodological rigor, but the general principle of judging excellence is similar for both art and science.

How do we arrive at a set of aesthetic rules? Arguably, neurophysiology might lend some degree of objectivity. For example, neuronal receptive fields and firing patterns reflecting tonal quality, timbre, pitch, temporal structure, complexity, and familiarity of music can be measured (Nat. Neurosci. 2005;8:1241-7), but even so, there must be some determination of which responses or qualities are best. As a society, therefore, we must agree to a set of principles that define a work as being good or bad. Just as social norms define what conduct is expected and tolerated within a given society, aesthetics define what is desirable and undesirable within artistic, scientific, and other creative communities.

Leaders influence such norms, and within the social or professional grouping promote cooperation among its members to conform to the set standards (Nature 2003;422:137-40). Within large social groupings, cooperation can be and usually is enforced by the membership, either through designated experts or simply in the form of peer pressure.

Social norms are necessary because one person’s actions affect other members of the group. Evolutionary psychologists have provided evidence that our minds have evolved a social contract algorithm specialized for detecting liars, cheaters, and rule-breakers – those individuals who violate social law. Neuroeconomists suggest that social norms are based on "conditional cooperation," in which the level of cooperation of each group member is based on the level of mutual cooperation of all the members. If mutual cooperation is high, then individual cooperation is high. On the other hand, if I see many people breaking the law, benefiting as a result, and getting away with it, then I will be more likely to take a chance by breaking the law, too. Looting during times of social upheaval is a familiar manifestation of this principle.

For a paradigm, law, or any social norm to prevail, it must be enforced. And for the aesthetic principle to endure, social (aesthetic) norms must be enforced, and noncooperators (those who fail to comply with accepted aesthetic principles) punished, leaving their papers unpublished or grant applications unfunded.

As I mentioned in the February issue’s discussion about motivation, we like justice and we dislike injustice. Exacting social justice activates striatal and orbitofrontal reward substrates (Science 2004;305:1254-8), so we have powerful neurobiological drivers that serve to maintain social order.

However, social norms, aesthetic principles, and scientific paradigms can change. When the cost of cooperation with such a principle rises, due perhaps to mounting evidence that the scientific paradigm is wrong, the level of mutual cooperation will drop. Recall that if the reward value of an ongoing action drops, the reduced reward is the signal that drives the formation of a new action plan. When mutual cooperation with a social norm drops and defection rates rise, the social norm is destined to break down. In science, this is termed a "paradigm shift," as described by Thomas S. Kuhn in "The Structure of Scientific Revolutions" (Chicago: University of Chicago Press, 1970).

Aesthetic laws, as practiced at the peer-to-peer and leadership levels, define and validate the merit of a creation. Aesthetic rules, when they are enforced by credible authorities, become accepted fact. We may even extend this principle to another human creation – morality – and we shall do so next month.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

The success of a creation should, in theory, be determined by its creator, who is in the best position to determine how closely the creation matches the original vision. But in science, as in other creative endeavors, this is not the case. Success in science requires funding and publication, which does not arise from scientists’ opinions of their own work, but rather from the judgment rendered by a peer group comprising reviewers and editors.

This socially determined valuation of a creative effort helps to determine what society (or any social grouping) deems to be important. How much value we place on a new creation influences its creator’s drive to bridge the perceived gap between what is and what should be. The satiation of that creative drive is a biologically and psychologically relevant measure of creative success because it influences the likelihood that the creator will react again in the future to such perceived gaps, thus perpetuating creative behavior. Other factors may influence the degree of such satisfaction, including the reward received; the value that the creator’s culture places on individual attainment (Annu. Rev. Psychol. 2003;54:403-25); the creator’s enjoyment of the creative effort itself, as expressed in Mihály Csíkszentmihályi’s "Finding Flow: The Psychology of Engagement with Everyday Life" (New York: Basic Books, 1997); and the nature of the creation, in that creators who serve the greater good may derive a greater sense of happiness from their work, as discussed in Jonathan Haidt’s "The Happiness Hypothesis" (New York: Basic Books, 2006).

Although the creator’s opinion is important, Dr. Csíkszentmihályi’s "systems model" of creativity highlights the role of society in which a gatekeeper determines what creative work will be admitted to the existing intended domain ("The Nature of Creativity: Current Psychological Perspectives" [Cambridge: Cambridge University Press, 1988, p. 325-39]). Because society cannot know the creator’s vision and so cannot match the creation to the vision, an external set of aesthetic rules is needed to judge creative achievement.

Aesthetics are the cooperatively determined hierarchical categorization and quantification of quality, expressed as rules or principles. Aesthetics reflect the opinions and values of the social grouping in which creativity arises. For example, the aesthetic value of a painting lies in the artist’s choice of color and form, and the aesthetic value of a scientific experiment lies in its methodological rigor, but the general principle of judging excellence is similar for both art and science.

How do we arrive at a set of aesthetic rules? Arguably, neurophysiology might lend some degree of objectivity. For example, neuronal receptive fields and firing patterns reflecting tonal quality, timbre, pitch, temporal structure, complexity, and familiarity of music can be measured (Nat. Neurosci. 2005;8:1241-7), but even so, there must be some determination of which responses or qualities are best. As a society, therefore, we must agree to a set of principles that define a work as being good or bad. Just as social norms define what conduct is expected and tolerated within a given society, aesthetics define what is desirable and undesirable within artistic, scientific, and other creative communities.

Leaders influence such norms, and within the social or professional grouping promote cooperation among its members to conform to the set standards (Nature 2003;422:137-40). Within large social groupings, cooperation can be and usually is enforced by the membership, either through designated experts or simply in the form of peer pressure.

Social norms are necessary because one person’s actions affect other members of the group. Evolutionary psychologists have provided evidence that our minds have evolved a social contract algorithm specialized for detecting liars, cheaters, and rule-breakers – those individuals who violate social law. Neuroeconomists suggest that social norms are based on "conditional cooperation," in which the level of cooperation of each group member is based on the level of mutual cooperation of all the members. If mutual cooperation is high, then individual cooperation is high. On the other hand, if I see many people breaking the law, benefiting as a result, and getting away with it, then I will be more likely to take a chance by breaking the law, too. Looting during times of social upheaval is a familiar manifestation of this principle.

For a paradigm, law, or any social norm to prevail, it must be enforced. And for the aesthetic principle to endure, social (aesthetic) norms must be enforced, and noncooperators (those who fail to comply with accepted aesthetic principles) punished, leaving their papers unpublished or grant applications unfunded.

As I mentioned in the February issue’s discussion about motivation, we like justice and we dislike injustice. Exacting social justice activates striatal and orbitofrontal reward substrates (Science 2004;305:1254-8), so we have powerful neurobiological drivers that serve to maintain social order.

However, social norms, aesthetic principles, and scientific paradigms can change. When the cost of cooperation with such a principle rises, due perhaps to mounting evidence that the scientific paradigm is wrong, the level of mutual cooperation will drop. Recall that if the reward value of an ongoing action drops, the reduced reward is the signal that drives the formation of a new action plan. When mutual cooperation with a social norm drops and defection rates rise, the social norm is destined to break down. In science, this is termed a "paradigm shift," as described by Thomas S. Kuhn in "The Structure of Scientific Revolutions" (Chicago: University of Chicago Press, 1970).

Aesthetic laws, as practiced at the peer-to-peer and leadership levels, define and validate the merit of a creation. Aesthetic rules, when they are enforced by credible authorities, become accepted fact. We may even extend this principle to another human creation – morality – and we shall do so next month.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

The success of a creation should, in theory, be determined by its creator, who is in the best position to determine how closely the creation matches the original vision. But in science, as in other creative endeavors, this is not the case. Success in science requires funding and publication, which does not arise from scientists’ opinions of their own work, but rather from the judgment rendered by a peer group comprising reviewers and editors.

This socially determined valuation of a creative effort helps to determine what society (or any social grouping) deems to be important. How much value we place on a new creation influences its creator’s drive to bridge the perceived gap between what is and what should be. The satiation of that creative drive is a biologically and psychologically relevant measure of creative success because it influences the likelihood that the creator will react again in the future to such perceived gaps, thus perpetuating creative behavior. Other factors may influence the degree of such satisfaction, including the reward received; the value that the creator’s culture places on individual attainment (Annu. Rev. Psychol. 2003;54:403-25); the creator’s enjoyment of the creative effort itself, as expressed in Mihály Csíkszentmihályi’s "Finding Flow: The Psychology of Engagement with Everyday Life" (New York: Basic Books, 1997); and the nature of the creation, in that creators who serve the greater good may derive a greater sense of happiness from their work, as discussed in Jonathan Haidt’s "The Happiness Hypothesis" (New York: Basic Books, 2006).

Although the creator’s opinion is important, Dr. Csíkszentmihályi’s "systems model" of creativity highlights the role of society in which a gatekeeper determines what creative work will be admitted to the existing intended domain ("The Nature of Creativity: Current Psychological Perspectives" [Cambridge: Cambridge University Press, 1988, p. 325-39]). Because society cannot know the creator’s vision and so cannot match the creation to the vision, an external set of aesthetic rules is needed to judge creative achievement.

Aesthetics are the cooperatively determined hierarchical categorization and quantification of quality, expressed as rules or principles. Aesthetics reflect the opinions and values of the social grouping in which creativity arises. For example, the aesthetic value of a painting lies in the artist’s choice of color and form, and the aesthetic value of a scientific experiment lies in its methodological rigor, but the general principle of judging excellence is similar for both art and science.

How do we arrive at a set of aesthetic rules? Arguably, neurophysiology might lend some degree of objectivity. For example, neuronal receptive fields and firing patterns reflecting tonal quality, timbre, pitch, temporal structure, complexity, and familiarity of music can be measured (Nat. Neurosci. 2005;8:1241-7), but even so, there must be some determination of which responses or qualities are best. As a society, therefore, we must agree to a set of principles that define a work as being good or bad. Just as social norms define what conduct is expected and tolerated within a given society, aesthetics define what is desirable and undesirable within artistic, scientific, and other creative communities.

Leaders influence such norms, and within the social or professional grouping promote cooperation among its members to conform to the set standards (Nature 2003;422:137-40). Within large social groupings, cooperation can be and usually is enforced by the membership, either through designated experts or simply in the form of peer pressure.

Social norms are necessary because one person’s actions affect other members of the group. Evolutionary psychologists have provided evidence that our minds have evolved a social contract algorithm specialized for detecting liars, cheaters, and rule-breakers – those individuals who violate social law. Neuroeconomists suggest that social norms are based on "conditional cooperation," in which the level of cooperation of each group member is based on the level of mutual cooperation of all the members. If mutual cooperation is high, then individual cooperation is high. On the other hand, if I see many people breaking the law, benefiting as a result, and getting away with it, then I will be more likely to take a chance by breaking the law, too. Looting during times of social upheaval is a familiar manifestation of this principle.

For a paradigm, law, or any social norm to prevail, it must be enforced. And for the aesthetic principle to endure, social (aesthetic) norms must be enforced, and noncooperators (those who fail to comply with accepted aesthetic principles) punished, leaving their papers unpublished or grant applications unfunded.

As I mentioned in the February issue’s discussion about motivation, we like justice and we dislike injustice. Exacting social justice activates striatal and orbitofrontal reward substrates (Science 2004;305:1254-8), so we have powerful neurobiological drivers that serve to maintain social order.

However, social norms, aesthetic principles, and scientific paradigms can change. When the cost of cooperation with such a principle rises, due perhaps to mounting evidence that the scientific paradigm is wrong, the level of mutual cooperation will drop. Recall that if the reward value of an ongoing action drops, the reduced reward is the signal that drives the formation of a new action plan. When mutual cooperation with a social norm drops and defection rates rise, the social norm is destined to break down. In science, this is termed a "paradigm shift," as described by Thomas S. Kuhn in "The Structure of Scientific Revolutions" (Chicago: University of Chicago Press, 1970).

Aesthetic laws, as practiced at the peer-to-peer and leadership levels, define and validate the merit of a creation. Aesthetic rules, when they are enforced by credible authorities, become accepted fact. We may even extend this principle to another human creation – morality – and we shall do so next month.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.

Creativity requires motivation; it does not happen passively. Our lives begin with biologic appetitive and aversive drives, such as the need to feed or avoid the cold. They are the roots of motivation.

In the 1950s, James Olds, Ph.D., showed that appetitive and aversive behaviors were controlled by distinct brain regions (J. Comp. Physiol. Psychol. 1954;47:419-27). He implanted electrodes into rat brains and placed the rats in a cage containing a foot switch that, when pressed, delivered an electrical shock to the brain region in which the electrode was implanted. By varying the location of the electrodes and the conditions under which rats were tested, Dr. Olds found that some regions and situations led to self-stimulation rates as high as 7,000 shocks per hour, and others led the rats to avoid self-stimulation. The size of the shock, fatigue, hunger, pain, hormonal levels, and drugs all influenced response rates.

Three brain regions, or systems, involved in motivation are the hypothalamus; the mesolimbic dopaminergic system (comprised of the ventral tegmental area [VTA], the nucleus accumbens/ventral striatum, and the orbitofrontal cortex [OFC], all linked together by the median forebrain bundle); and the amygdala. The hypothalamus maintains set points for different aspects of the "internal milieu," such as body weight and fluid balance. As our body strays from a set point, we are driven by hunger or thirst to alter our behavior and restore the set point. Returning our body to an established set point is powerfully rewarding. Within the mesolimbic system, VTA neurons generate a reward signal by comparing what occurs with what was expected (J. Neurophysiol. 1998;80:1-27). VTA dopaminergic reward neurons are most strongly activated by rewarding events that are better than expected.

The basolateral amygdala forms associations between sensory cues and rewarding or aversive stimuli, and acts as a "fear center" (J. Neurosci. 1995;15:5879-91). It is interconnected with sensory cortices and the hippocampus, forming associations with emotionally salient aspects of a stimulus that influence our perception and memory encoding of the stimulus (Curr. Opin. Neurobiol. 2004;14:198-202). Reward centers also modulate activity of the hypothalamus and locus ceruleus, thereby influencing endocrine and noradrenergic feedback to cortical regions.

The interplay of appetitive and aversive signals define a predicted, most rewarding (or least punishing) goal. Neurologists typically awaken early and perform a variety of duties over a long day (plus hospital call). Some appetitive signals include helping patients, research discoveries, educating students, pay, and benefits. Some aversive signals are the stresses of sick or otherwise difficult patients, research failures, underperforming students, and long hours. On balance, however, the net result is a greater feeling of reward than punishment so we keep doing it. But our behavior will change if discrepancies arise between the predicted and realized reward. If my health coverage were discontinued or my pay cut in half, I would seek a different position. The activity of anterior cingulate neurons – the earliest anatomical stage of action planning and movement – is influenced by reward signals from the orbitofrontal cortex. If a goal is made less rewarding, OFC neuronal activity declines as then does OFC stimulation of anterior cingulate neurons. The less rewarding activity stops and is replaced by a more rewarding one. Immediately preceding the change in behavior, specific neurons in the anterior cingulate fire, marking the first step that results in the altered response to the reduced reward (Science 1998;282:1335-8; Proc. Natl. Acad. Sci. U.S.A. 2002;99:523-8).

Our reward system has many targets defining our wants. These include biologic stimuli such as food when we are hungry; aesthetic stimuli such as humor, paintings, music, and sports cars; and money (Neuron 2001;30:619-39). Reward centers also are activated by socially relevant behaviors, such as the decision to enact justice-related punishment and social comparisons in which we may perceive ourselves as better off than our neighbor. The developing relationship between two people learning the degree to which they can trust one another also causes changes in reward center activity (detected by fMRI) in an interpersonally synchronized fashion (Science 2005;308:78-83).

Aversive stimuli, such as pain or the loss of money, activate similar brain regions, although specific areas differ from those activated by reward (Nat. Neurosci. 2001;4:95-102). Motivation is also attenuated by diminished reward, and by nonescalating, static reward. We quickly accommodate to any improvement in our life circumstances (for example a higher income) so that initially heightened satisfaction rapidly recalibrates to baseline (the hedonic treadmill).

These examples illustrate that there is a final common reward pathway. All appetitive and aversive stimuli are translated into a common biologically relevant motivational signal that tells us whether something will enhance or diminish our survival or quality of life. The perceived difference in reward value between what is and what should be generates the motivational voltage that drives creativity.

This column, "Evoked Potentials," regularly appears in Clinical Neurology News, an Elsevier publication. Dr. Caselli is the medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic Arizona in Scottsdale. E-mail Dr. Caselli.