That's the suggestion of a new study that posed the question: Is it better to give food to some hungry children while others go hungry? Or is it better that every child get a share, albeit a smaller one?

"People prefer equity, when all things are equal, to efficiency," said study lead researcher Ming Hsu, a fellow at the University of Illinois Beckman Institute for Advanced Science and Technology.

And different regions of the brain are involved when making decisions involving fairness or efficiency, he said.

"In terms of the brain, we find areas of the insular cortex are activated when people were choosing the equitable allocation of food," Hsu said. "Given the involvement of the insular cortex in emotions and fairness judgments, we conclude that emotions are underlying equity judgments."

Other areas of the brain are activated when people are making judgments about efficiency, he said.

But, not everyone is sensitive to equity, Hsu noted. "Some people care less about equity, and that's associated with a lower sensitivity in their insula," he said. "When these people are confronted with inequitable situations, their insula is activated less."

The study, by researchers at the University of Illinois and the California Institute of Technology, was published in the May 8 issue of Science.

For the study, the volunteers were hypothetically asked to distribute food to children in an orphanage in Uganda. The children would be given the cash equivalent of 24 meals, a "gift" from the research team to the orphanage.

But, a number of meals would have to be cut for some of the children. So, the volunteers were given two options to deal with the problem.

In one option, 15 meals could be taken from one child, or 13 from another child, or five from yet another child, for instance. Choosing this option, the total number of meals lost would be less, but one child would suffer from all cuts. Efficiency would be maintained at the expense of equity.

The second option reduced efficiency, but promoted equity. In this option, all the children would be fed, but they'd share fewer meals.

The researchers found that the study participants overwhelmingly chose the second option. This finding echoed other studies that showed that most people are intolerant of inequity, Hsu said.

During the experiment, the volunteers underwent functional magnetic resonance imaging. This allowed the researchers to determine which parts of the brain were most affected during decision-making.

The researchers found that regions of the brain called the insula, putamen and caudate were activated differently, and at different times, during the experiment. The insula responded to changes in equity, while the putamen responded to changes in efficiency. The caudate appeared to blend both equity and efficiency, Hsu said.

The insights involving the insula, which plays a key role in emotions, supports the idea that emotion rather than reason is at the base of people's attitudes about inequality, Hsu said. Also, studies had found that the insula is involved in deciding fairness. But, the putamen and the caudate are activated during reward-related learning, the researchers noted.

"These results support the idea that people care about equity at a very deep level," Hsu said.

Brian Knutson, an assistant professor of psychology and neuroscience at Stanford University, said the findings illustrate just how much emotion is involved in decision-making.

"We are finding that similar brain regions seem to be involved in individual economic well-being and also the well-being of others," he said.

Because the areas of the brain involved in such decisions are located deep inside the brain, it suggests they have a role in evolutionary survival function, Knutson said. "They are serving some sort of survival and emotional function," he said.

Knutson noted that many economic theories assume that people use reason to make decisions, but the areas of the brain involved in equity and efficiency are really areas activated by emotion.

"When people see an unfair offer, they actually have a negative emotional reaction to it," Knutson said. "They have a visceral reaction to unfairness."

More information

To learn more about the human brain, visit the National Institute of Neurological Disorders and Stroke.

WEDNESDAY, May 7 (HealthDay News) -- New treatments for a type of depression in the elderly related to blood vessels -- called vascular depression -- are under development, and researchers have discovered why some patients with this condition fail to respond to current medications.

Details of the findings were to be presented Wednesday during a news conference by researchers taking part in U.S. National Institute of Mental Health symposiums at the annual meeting of the American Psychiatric Association, in Washington, D.C.

Vascular depression is a recently recognized type of depression that usually develops in patients older than age 60. The condition is associated with loss of blood supply to the brain.

"Mental health practitioners and patients should be aware of the relationship between vascular problems and depression, and should understand the value of preventing vascular changes that might lead to difficult-to-treat depressions, for example, through early recognition and treatment of high blood pressure," Dr. John Newcomer, of Washington University in St. Louis, said in a prepared statement.

Several research teams are reporting progress in understanding and treating vascular depression.

Dr. George Alexopoulos of Weill Cornell Medical College in White Plains, N.Y., and colleagues are investigating the specific brain abnormalities associated with blood vessel problems. Using a new MRI technique called diffusion tensor imaging, the researchers found that, in late life depression, higher blood pressure readings are linked to tiny white matter abnormalities, mainly in the brain's frontal lobes and in subcortical areas. Some of these abnormalities are associated with impairment in specific frontal lobe functions.

The same team also found that patients with major depression treated with the antidepressant citalopram were less likely to recover if they had cardiovascular disease or did poorly on a test of cognition requiring frontal lobe function.

They also found that patients with major depression who took the antidepressant escitalopram (which is more potent than citalopram) were less likely to recover if they had more of the tiny structural abnormalities in several areas of the frontal lobes and in subcortical structures.

"With further refinement, the findings may improve physicians' ability to predict who will fail to respond to antidepressants. Such patients may need close follow-up and different treatments such as psychotherapy or novel medications. Second, our findings can be used in the development of new treatments for those who do not respond to classical antidepressants," Alexopoulos said in a prepared statement.

He and his team are currently studying how parts of the frontal lobes are activated when depressed patients do cognitive tasks that activate this area.

Preliminary findings show that depressed older patients cannot activate these frontal lobe parts as efficiently as non-depressed older adults," Alexopoulos said.

In other research, a team at the University of Iowa found that vascular depression can be treated with an experimental technique called repetitive transcranial magnetic stimulation (rTMS). They found that rTMS led to better remission rates than standard medication treatment, and that increasing the number of magnetic pulses significantly improved remission rates.

"These findings suggest that this new method of treatment may be particularly useful for these late life onset depressions and that even greater response rates might be achieved by utilizing more pulses of magnetic stimulation," Dr. Robert Robinson, a professor of psychiatry, said in a prepared statement.

In other reports presented at the conference, scientists urged caution in the use of antipsychotic drugs in elderly people and other patients in order to minimize metabolic, heart and stroke risks.

More information

The American Academy of Family Physicians has more about older adults and depression.

The study findings are preliminary. But, early results with Iraq war veterans point to a potent way to help PSTD patients through the use of drugs along with exposure to interactive reenactments of the sights, sounds, smells, and movements related to a highly traumatic experience.

"I am very optimistic," said study lead author Barbara O. Rothbaum, a professor of psychiatry, and director of the Trauma and Anxiety Recovery Program at Emory University School of Medicine in Atlanta. "We think that, aided by medications, virtual reality is going to be a useful way to help people haunted by an experience confront their fears in a more complete and therapeutic way."

Rothbaum and her team were expected to present their findings Wednesday at the American Psychiatric Association annual meeting, in Washington, D.C.

Post-traumatic stress disorder affects about 7.7 million American adults, although it can strike at any age and is more common among women, according to the U.S. National Institute of Mental Health, sponsor of the new study.

The risk for developing PTSD is highest following exposure to physical harm or the threat of physical harm. Soldiers at war are particularly vulnerable, but victims of rape, violent assault, and even traumatic accidents may also develop the disorder.

A range of anti-depressant and anti-anxiety medications can help manage, but not cure, PTSD. The medications are often prescribed along with cognitive-behavioral therapy.

Rothbaum and her colleagues decided to explore the potential of one form of exposure therapy -- virtual reality treatment -- among 24 war veterans. All the participants were men in their 20s or 30s, and all had recently been involved in the war in Iraq.

The veterans suffered from a particular aspect of PSTD known as "acoustic startle" -- a form of hyper arousal that causes an uncontrollable reflexive response provoked by sudden loud sounds.

Two-minute video clips were specifically tailored for each veteran to re-enact, as closely as possible, the traumatic event that led to their PSTD. Besides providing imagery and sounds, the computer-generated 360-degree virtual experience also involved mimicked vibrations and smells, such as burning fires and smoke.

Clips, for example, depicted the Iraq war, and included scenes of Humvee vehicles driving alone or in convoys on a desert highway, as well as a soldier on foot patrol in an urban setting.

During treatment, the patients watched the videos through helmets outfitted with tiny TV screens placed in front of each eye, and headphones. Position trackers enabled each veteran to maintain realistic views of his visual environment, the researchers said.

The patients were also divided into three prescription medication groups: the first taking the antibiotic d-cycloserine, the second taking the anti-anxiety drug Xanax, and the third taking a placebo. D-cycloserine has been shown to help boost the learning of safety memories, potentially enhancing the benefits of exposure therapy.

The researchers measured the severity of each veteran's acoustic startle response before treatment, during treatment, and immediately after treatment, as well as three and six months later. By the six-month mark, all the men appeared to benefit from the virtual reality therapy, with startle severity reduced, on average, by 75 percent.

Although the researchers haven't been able yet to analyze the comparative benefits of the three complementary medications, they said the first patient placed on a d-cycloserine regimen experienced a 56 percent drop in PSTD measurements after just four virtual reality sessions.

Dr. Randall Marshall, director of Trauma Studies and Service at the New York State Psychiatric Institute, and an associate professor of clinical psychiatry at Columbia University College of Physicians & Surgeons, called the finding "exciting."

"We already have very effective cognitive behavioral therapies," he said. "But there are a lot of patients who are avoidant about talking about their trauma. Doing so scares them. Many just hope that the nightmares go away.

"In contrast," Marshall added, "it does seem that people are much more interested in virtual reality -- especially young patients who have the idea that it might be much more fun and interesting and unthreatening. So you'll have a much lower rate of therapy refusal in relation to being offered the opportunity to talk about their issues. So even if it's only just as good as what we have now, it expands the options."

More information

To learn more about PSTD, visit the U.S. National Institute of Mental Health.

In research with mice, they found this class of drugs also suppresses the adaptive rewiring of the brain necessary for neural development in young animals. The findings are in the May 8 issue of Neuron.

One such drug is rimonabant (Acomplia), which was developed by Sanofi-Aventis and is awaiting approval by the U.S. Food and Drug Administration. Other pharmaceutical companies are developing similar drugs.

In this study, researchers concluded that a cannabinoid receptor-blocking drug called AM 251 affected experience-dependent cortical plasticity in the brains of juvenile mice. This plasticity is the experience-prompted adaptive rewiring of the brain that plays an critical role in the neural development of young animals.

"Our finding of a profound disruption of cortical plasticity in juvenile mice treated with AM 251 suggests caution is advised in the use of such compounds in children," wrote Mark F. Bear and his colleagues, of the Howard Hughes Medical Institute, The Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, in Cambridge, Mass.

More information

The Nemours Foundation has more about childhood obesity.

Information about these techniques was expected to be presented Tuesday during a news conference by researchers taking part in U.S. National Institute of Mental Health symposiums at the American Psychiatric Association annual meeting, in Washington, D.C.

"These studies contribute new information about how the brain malfunctions in depression and bipolar disorder, what goes wrong with brain chemicals, and where in the brain the problems arise," Dr. Ellen Leibenluft, of the NIMH, said in a prepared statement. "We find that the brain systems involved and the exact nature of the difficulties differs among patients, even when those patients have similar symptoms. Eventually, data like these will allow us to develop more individualized and targeted treatments for depression."

In one study, University of Michigan researchers using molecular imaging with positron emission tomography (PET) found that patients with untreated major depression had an overall reduction in the concentration of serotonin 1A receptors in the hippocampus, a brain region that helps regulate stress.

"The reductions in these receptors were correlated with the functional impairment of the patients in work and with their families, with greater impairment being associated with lower receptor concentrations in this region," study author Dr. Jon-Kar Zubieta said in a prepared statement.

The patients responded to treatment with citalopram.

In another study, Zubieta and colleagues found that people with untreated major depression had reduced concentrations of "mu" opioid receptors in the thalamus, an area of the brain involved in the regulation of emotions. The mu receptors play a key role in regulating mood and triggering brain reward systems. A reduction in the receptors was associated with greater concentrations of stress hormones.

The researchers also found that depressed patients who didn't respond to the antidepressant fluoxetine (Prozac) had lower concentrations of mu receptors in the anterior cingulate, an area of the brain involved in the processing of emotional states.

In other studies, NIMH researchers used PET and functional MRI to identify abnormal patterns of neural activity and chemical function in the brain's reward pathway that underlie depressed patients' inability to experience pleasure.

"The identification of brain systems and circuits whose activity can be correlated with specific symptoms is a first step toward the development of more targeted and effective treatments for depression and other disorders of the brain," Dr. Wayne Drevets, of the NIMH, said in a prepared statement.

In another study, Yale School of Medicine researchers using specialized applications of MRI found that people with bipolar disorder have reduced volume of the brain's prefrontal cortex and its subcortical connections sites, including the amygdala.

Previous research found that patients with bipolar disorder have abnormal functioning of these brain structures, especially during the processing of emotional stimuli and during tasks that require inhibition of impulsive responses.

In other studies, scientists found that fMRI can help determine whether children have biploar disorder or severe irritability with attention-deficit hyperactivity disorder (ADHD). This suggests that brain imaging may prove useful in making a correct diagnosis.

"We're finding that these very irritable children with ADHD share some characteristics with children with bipolar disorder but also have significant differences," said Leibenluft.

Children with these conditions are easily frustrated, have difficulty reading facial emotional cues, and have social cognition deficits.

"Yet what's happening in the brain during frustration differed between the two groups. So these data indicate that, even when two groups of patients exhibit the same symptoms, the brain mechanisms underlying that symptom can differ. Data like these indicate how, eventually, psychiatric diagnosis will be based on brain mechanisms, in addition to symptoms," Leibenluft said.

More information

The U.S. Center for Mental Health Services has more about mood disorders.