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Nihilism and pessimism are concerned with the conditions under which we make normative claims in a world that is inherently meaningless. Friedrich Nietzsche aptly summarized this problem in TheGay Science (1882, second edition 1887): “The total character of the world … is for all eternity chaos, not in the sense of a lack of necessity but of a lack of order, organization, form, beauty, wisdom, and whatever else our aesthetic anthropomorphisms are called … Let us beware of saying that there are laws in nature. There are only necessities: … Once you know that there are no purposes, you also know that there is no accident; for only against a world of purposes does the word ‘accident’ have a meaning.” Nihilism offers a glimpse into the fundamental paradox of normativity that is central to modern European thought at least since the later eighteenth century: There are no external authorities that safeguard the binding force of the normative commitments we make, both epistemically and morally, and yet we cannot escape, or deny, normative claims. We can live in a world without meaning, but we cannot live in a world without normativity.
Electroconvulsive therapy (ECT) is a fast-acting intervention for major depressive disorder. Previous studies indicated neurotrophic effects following ECT that might contribute to changes in white matter brain structure. We investigated the influence of ECT in a non-randomized prospective study focusing on white matter changes over time.
Twenty-nine severely depressed patients receiving ECT in addition to inpatient treatment, 69 severely depressed patients with inpatient treatment (NON-ECT) and 52 healthy controls (HC) took part in a non-randomized prospective study. Participants were scanned twice, approximately 6 weeks apart, using diffusion tensor imaging, applying tract-based spatial statistics. Additional correlational analyses were conducted in the ECT subsample to investigate the effects of seizure duration and therapeutic response.
Mean diffusivity (MD) increased after ECT in the right hemisphere, which was an ECT-group-specific effect. Seizure duration was associated with decreased fractional anisotropy (FA) following ECT. Longitudinal changes in ECT were not associated with therapy response. However, within the ECT group only, baseline FA was positively and MD negatively associated with post-ECT symptomatology.
Our data suggest that ECT changes white matter integrity, possibly reflecting increased permeability of the blood–brain barrier, resulting in disturbed communication of fibers. Further, baseline diffusion metrics were associated with therapy response. Coherent fiber structure could be a prerequisite for a generalized seizure and inhibitory brain signaling necessary to successfully inhibit increased seizure activity.
This book explores Nietzsche's philosophical naturalism in its historical context, showing that his position is best understood against the background of encounters between neo-Kantianism and the life sciences in the nineteenth century. Analyzing most of Nietzsche's writings from the late 1860s onwards, Christian J. Emden reconstructs Nietzsche's naturalism and argues for a new understanding of his account of nature and normativity. Emden proposes historical reasons why Nietzsche came to adopt the position he did; his genealogy of values and his account of a will to power are as much influenced by Kantian thought as they are by nineteenth-century debates on teleology, biological functions, and theories of evolution. This rich and wide-ranging study will be of interest to scholars and students of Nietzsche, the history of modern philosophy, intellectual history, and history of science.