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The strange case of Phineous Gage
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Phineous Gage
Railroad foreman
Well-respected, hard-working
1848: tamping iron accident
He never lost consciousness, and had no
obvious neurological symptoms
But he was no longer Gage
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Phineas Gage
the powder exploded, carrying an iron instrument
through his head an inch and a fourth in
circumference, and three feet and eight inches in
length, which he was using at the time. The iron
entered on the side of his face, shattering the upperjaw, and passing back of the left eye, and out at the
top of the head.
The most singular circumstances connected
with this melancholy affair is, that he was alive attwo oclock this afternoon, and in full possession of
his reason, and free from pain.
from Free Soil Union, September 1948
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The equilibrium or balance between his
intellectual faculties and animal
propensities, seems to have beendestroyed.(Former R.R. Employer)
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Qui ckTime and aTIFF (Uncompres sed) deco mpres s
are needed to see this pi cture.
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Brain Anatomy - Phineas Gage
Personality changedGage became crude,uncaring, impulsive, irrational, anti-social
Damasio H., Grabowski T,. Frank R., Galaburda AM., Damasio AR. (1994). The return ofPhineas Gage: clues about the brain from the skull of a famous patient. Science.264(5162):1102-5,.
Ventromedial region of the frontal lobes on
both sides - causing a defect in rationaldecision making and the processing ofemotion
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Phineous Gage
Gages Doctor described Gages post accident
personality as
Fitful, irreverent, indulging at times in the greatest profanity which wasnot previously his custom, manifesting but little deference for his fellows,
impatient of restraint and advice when it conflicts with his desires, at
times pertinaciously obstinate, yet capricious and vacillating, devising
many plans of future operation, which are no sooner arranged than they
are abandoned a child in his intellectual capacity and manifestations, he
has the animal passions of a strong man.
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He was no longer Gage
Several different
angles of where the
rod passed through hisskull
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Phineous gage
QuickTime and aTIFF (Uncompressed) decompressor
are needed to see this picture.
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Some symptoms associated with
frontal lobe damageWorking memory deficits
Temporal memory / Source memory
PerseverationLoss of spontaneous behavior
Apathy
Planning deficits/impaired goal-directed behavior
Disinhibition/impulsive behavior
Impaired attention
Depression
Elevated mood
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Mood/Affect/Emotion Symptoms
Depression
Mood elevation
Apathy
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Frontal Lobotomies 1935: chimps who were neurotic before surgery became
more relaxed after it
1930s: Egaz Moniz begins frontal lobotomies in humans(and eventually wins Nobel Prize)
1950s: psychosurgery in vogue; 40,000 frontallobotomies in North America
The story of Agnes (Kolb & Whishaw) no outward signs of emotion
no facial expression
no feelings toward other people (but still liked her dog)
felt empty, zombie-like
Other patients lose prosody = emotional component ofspeech
orbitofrontal cortex Patients with damage can remember info but dont have
emotions associated with it
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Frontal Lobe
Lobotomy: Early Critisicms
Hoffman (1949)
"these patients are not only no longer distressed by
their mental conflicts but also seem to have little
capacity for any emotional experiences - pleasurable orotherwise. They are described by the nurses and the
doctors, over and over, as dull, apathetic, listless,
without drive or initiative, flat, lethargic, placid and
unconcerned, childlike, docile, needing pushing,
passive, lacking in spontaneity, without aim or purpose,
preoccupied and dependent."
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Frontal LobeFrontal Lobe Damage
May have normal IQ on standard tests
Poor control: reasoning, planning & emotions
Disinhibition: poor control of emotions
Poor mental flexibilityPerseveration: e.g. trouble stopping action once
initiated, e.g. dialing 999.
Frontal lobe modulates functions of other regions