Spared and impaired cognitive abilities after bilateral frontal damage

M Brazzelli, N Colombo, S Della Sala, H Spinnler

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.

Original languageEnglish
Pages (from-to)27-51
Number of pages25
JournalCortex
Volume30
Issue number1
Publication statusPublished - Mar 1994

Fingerprint

Aptitude
Social Alienation
Anomia
Cold Climate
Herpes Simplex Encephalitis
Psychomotor Agitation
Amnesia
Impulsive Behavior
Aphasia
Psychological Adaptation
Temporal Lobe
Intelligence

Keywords

  • Adolescent
  • Adult
  • Attention
  • Brain Damage, Chronic
  • Brain Mapping
  • Cognition Disorders
  • Dominance, Cerebral
  • Emotions
  • Encephalitis
  • Follow-Up Studies
  • Frontal Lobe
  • Herpes Simplex
  • Humans
  • Imitative Behavior
  • Magnetic Resonance Imaging
  • Mental Recall
  • Motivation
  • Neuropsychological Tests
  • Social Behavior
  • Stereotyped Behavior
  • Verbal Behavior
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Brazzelli, M., Colombo, N., Della Sala, S., & Spinnler, H. (1994). Spared and impaired cognitive abilities after bilateral frontal damage. Cortex, 30(1), 27-51.

Spared and impaired cognitive abilities after bilateral frontal damage. / Brazzelli, M; Colombo, N; Della Sala, S; Spinnler, H.

In: Cortex, Vol. 30, No. 1, 03.1994, p. 27-51.

Research output: Contribution to journalArticle

Brazzelli, M, Colombo, N, Della Sala, S & Spinnler, H 1994, 'Spared and impaired cognitive abilities after bilateral frontal damage', Cortex, vol. 30, no. 1, pp. 27-51.
Brazzelli M, Colombo N, Della Sala S, Spinnler H. Spared and impaired cognitive abilities after bilateral frontal damage. Cortex. 1994 Mar;30(1):27-51.
Brazzelli, M ; Colombo, N ; Della Sala, S ; Spinnler, H. / Spared and impaired cognitive abilities after bilateral frontal damage. In: Cortex. 1994 ; Vol. 30, No. 1. pp. 27-51.
@article{d6770e55ed3b4d9a9efc15e450b2fb83,
title = "Spared and impaired cognitive abilities after bilateral frontal damage",
abstract = "We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented {"}adynamic aphasia{"} associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent {"}utilization behaviour{"}. Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, {"}frontal{"}, and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.",
keywords = "Adolescent, Adult, Attention, Brain Damage, Chronic, Brain Mapping, Cognition Disorders, Dominance, Cerebral, Emotions, Encephalitis, Follow-Up Studies, Frontal Lobe, Herpes Simplex, Humans, Imitative Behavior, Magnetic Resonance Imaging, Mental Recall, Motivation, Neuropsychological Tests, Social Behavior, Stereotyped Behavior, Verbal Behavior, Journal Article, Research Support, Non-U.S. Gov't",
author = "M Brazzelli and N Colombo and {Della Sala}, S and H Spinnler",
year = "1994",
month = "3",
language = "English",
volume = "30",
pages = "27--51",
journal = "Cortex",
issn = "0010-9452",
publisher = "Masson SpA",
number = "1",

}

TY - JOUR

T1 - Spared and impaired cognitive abilities after bilateral frontal damage

AU - Brazzelli, M

AU - Colombo, N

AU - Della Sala, S

AU - Spinnler, H

PY - 1994/3

Y1 - 1994/3

N2 - We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.

AB - We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.

KW - Adolescent

KW - Adult

KW - Attention

KW - Brain Damage, Chronic

KW - Brain Mapping

KW - Cognition Disorders

KW - Dominance, Cerebral

KW - Emotions

KW - Encephalitis

KW - Follow-Up Studies

KW - Frontal Lobe

KW - Herpes Simplex

KW - Humans

KW - Imitative Behavior

KW - Magnetic Resonance Imaging

KW - Mental Recall

KW - Motivation

KW - Neuropsychological Tests

KW - Social Behavior

KW - Stereotyped Behavior

KW - Verbal Behavior

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Article

VL - 30

SP - 27

EP - 51

JO - Cortex

JF - Cortex

SN - 0010-9452

IS - 1

ER -