James Throt MBBS, MD, PhD, FRCPath Profile picture
Feb 27 15 tweets 3 min read Read on X
We are being gaslit into believing that the impulsivity, cruelty & polarisation we are seeing is purely cultural & political.

That explanation is psychologically comforting, but inaccurate.

It means we don't have to examine biology.

But we must.

COVID has entered the chat 🧵
The pretrontal cortex, particularly dorsolateral & orbitofrontal regions, is the regulatory governor of human behaviour.

It exerts top-down control over limbic threat circuitry.

It suppresses impulses before they become actions.

It filters speech before it leaves your mouth.
This is the system that allows you to

Pause.
Reconsider.
Anticipate consequences.
Inhibit bias.
Tolerate ambiguity.
De-escalate when provoked.

Remove or weaken that system and behaviour changes reliably.
In clinical neurology, frontal lobe dysfunction produces a recognisable profile:

Disinhibition.
Reduced empathy.
Impaired risk evaluation.
Rigid thinking.
Poor social judgement.
Diminished insight into one's own deficits.

This is not controversial.
Now introduce a pathogen with well documented evidence of neuroinflammation, microvascular injury, blood-brain barrier disruption, white matter disruption, microglial activation, measurable executive dysfunction post-infection.

Including in mild & asymptomatic cases.

SARS-CoV-2
Executive function is defined within neurology.

It is the operational capacity of the frontal lobes.

If you inflame or disrupt those circuits repeatedly, you are not dealing with a purely respiratory event.

You are applying repeated stress to the brain's regulatory system.
One infection does not "turn someone into a fascist", before the usual lot chime in. That caricature exists to avoid real discussion.

Neurobiology alters thresholds, not identities.

Inhibition ⬇️.
Cognitive flexibility ⬇️.
Reactivity ⬆️.

Small shifts, but on a global scale.
What does reduced inhibition look like socially?

More people saying what used to remain internal.

More inability to read context.

More absolutist rhetoric.

More Al-generated shock content posted without proportion.

More "I'm just being honest" as a substitute for restraint.
Prejudice does not need to be invented.

It needs to be suppressed.

Frontal control is heavily involved in inhibiting automatic bias responses.

Weaken the control system, and expression increases.

Hence the probability of doing and/or saying inappropriate things rises.
Now consider power structures.

Politics requires long-term risk modelling & perspective taking.

Diplomacy requires cognitive flexibility under provocation.

Law enforcement requires calibrated threat assessment under stress.

These are frontal lobe tasks.
If executive control is even modestly degraded in high power roles, escalation becomes easier & more likely.

Overconfidence increases.

Impulse overrides foresight.

Seconds of reduced inhibition change outcomes.

And we know that history often hinges on a single moment.
The most disturbing part?

Frontal dysfunction commonly impairs insight.

You do not feel your inhibitory control eroding.

You feel "normal". You'd refuse to believe otherwise.

If impairment is widespread, social feedback loops collapse.

The baseline quietly shifts.
The crux of the matter is that, yes, social media algorithms amplity outrage.

And, yes, economic stress polarises populations.

But biology and environment interact. This is simply undeniable.

If the neural brakes are worn down then the entire system becomes more combustible.
We are living through a mass infection event involving a virus with documented neurological effects.

Refusing to even interrogate the behavioural implications is not prudence.

It is avoidance, verging on denialism.
The question isn't whether people are evil or immoral. Even if it seems that way.

It is whether we are ignoring cumulative neurological insult while pretending the erosion of restraint, empathy & foresight is purely cultural & political.

That assumption may age very badly.

END

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More from @JamesThrot

Mar 18
Because COVID has caused so many health problems for so many people, they’re inundated with patients demanding help for their new ailments.

And because nobody, including doctors, wants to acknowledge COVID, it’s more convenient to label the myriad of health problems as “anxiety”
“My new issue that just so happened to appear post-2020 is nothing to do with COVID”

Maybe not.

But repeated infections w/a virus that is vasculotropic, neurotropic, cardiotropic, thromboembolic, oncogenic & damages the immune system certainly won’t be beneficial to your health
I increasingly suspect a feedback loop is emerging in medicine.

People develop health problems after SARS-CoV-2 infection, but neither the patient nor the doctor wants to raise COVID as a possible factor.

So it quietly disappears from the diagnostic conversation.
Read 11 tweets
Mar 15
Two students at the University of Kent in the UK have died following an outbreak of "invasive" meningitis.

A further 11 students are currently in hospital and reported to be seriously ill.

All normal on plague island during a never-ending SARS-CoV-2 pandemic. Image
Image
It’s worth knowing that COVID has been associated with T-cell exhaustion, lymphopenia, impaired interferon responses & persistent immune dysregulation.

When host immune regulation is altered, susceptibility/vulnerability to other infections, like meningitis, can increase.
Pathogens responsible for meningitis, like Neisseria meningitidis & Streptococcus pneumoniae, often take hold when immune defenses are impaired.

If SARS-CoV-2 can dysregulate immune function, the downstream effects on vulnerability to infections need acknowledging.
Read 7 tweets
Mar 8
Spreading a brain damaging virus on repeat for >6 years won’t be helping

And since nobody has an appetite for avoiding brain damage, there’s no end in sight

Pretending your 8th COVID infection is just another cold won’t protect you either

Actions & inactions have consequences
Frontal lobes refine behaviour. COVID damages them.

They regulate impulse control, empathy, moral reasoning & judgment.

Damaged lobes mean someone can remain articulate & knowledgeable while becoming reckless, cruel, suggestible & catastrophically bad at evaluating consequences
Executive function is also degraded.

Intelligence without executive function is dangerous. You can be sharp, knowledgeable, eloquent… and still impulsively destroy lives, misjudge catastrophes, or follow urges with zero moral compass.

The brain’s brakes & filters are gone.
Read 6 tweets
Mar 7
MAGA has gone full throttle at attempting to smear me and claim I am unequivocally incorrect in my suggestion Trump may have FTD

Exhibit A below ⬇️

These are not the words of a world leader with fully functioning frontal lobes

His internal filter is progressively diminishing Image
MAGA has been hanging off every word of a dementia patient. No matter how ridiculous or how unhinged it became. They followed. They regurgitated. They worshipped.

The baseline for what constitutes normal behaviour has continually shifted into increasingly preposterous territory.
Imagine having to reckon with the fact you were hoodwinked, beguiled & cajoled by a cognitively compromised senior citizen w/progressive brain atrophy. This won’t sit well.

Under normal circumstances this individual would be in a memory care facility.

But instead, they’re POTUS
Read 5 tweets
Mar 5
As a neurologist, I’ve dealt with Frontotemporal Dementia (FTD) patients for years

I often pondered how diabolical it would be if a world leader suffered the same fate

Now I’m seeing it play out in real time

Without impeachment, this will get darker than you could ever imagine
Frontotemporal dementia attacks the frontal lobes. The brain’s command center for judgment, empathy, impulse control, moral reasoning and long-term planning.

Imagine a world leader whose frontal lobes progressively fail, but no one intervenes.

Or worse, they cheer it on.
As FTD progresses, disinhibition dominates.

The leader may issue impulsive orders, make erratic public statements or flout norms & laws.

Even in those who were previously unmalicious, there would be a genuine neurological inability to foresee consequences.
Read 17 tweets
Mar 3
When you realise that frontal lobe dysfunction lowers resistance to manipulation & propaganda

And that aging leads to frontal decline, affecting how seniors vote

You’ll understand why the uncontrolled spread of a virus, well documented to damage the frontal lobes, is encouraged
Why?

Reduced prefrontal cortical function, whether from injury, aging or temp impairment, is associated with decreased critical evaluation, increased impulsivity & greater reliance on emotionally salient narratives, which can increase vulnerability to manipulation & propaganda.
A society’s resistance to propaganda depends on the cognitive health of its population.

If executive function declines at scale, you end up with worse decisions on an individual basis, and weaker collective judgment.

And SARS-CoV-2 is the virus that corrodes executive function.
Read 6 tweets

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