phineous gage

7/29/2019 phineous gage

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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

phineous gage

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