Week 5 Discussion: Biological and Evolutionary and Integrative Personality Theories

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Introduction We present Gall’s views on the faculties in the anterior lobes. Method We discuss the faculties that Gall localized in the anterior lobes. The faculties XI–XIX are common to animals and humans. Among these are faculties for color and music processing, spatial or topographical orientation, language, and facial recognition. Faculties that are unique to humans (XX–XXVII) are those associated with, for instance, compari- son, wit, and poetry. The highest faculties he depicted at the top of the anterior region, two being the faculties for God and religion and perseverance. We also discuss the absence of a fac- ulty for cognitive control or a central executive, and his view on collaboration of faculties in everyday behavior. Conclusion Gall described faculties for basic cognitive pro- cesses and reasoning, localizing the organs for these faculties in the anterior lobes. He wrote about the faculties interac- ting, but other than bringing up proximity, he was at a loss to explain the underlying physiology, having no central coor- dinating faculty and shunning metaphysics. Disclosure of interest The authors declare that they have no competing interest.

https://doi.org/10.1016/j.neurol.2018.09.003

Abstract No. 3

John Hughlings Jackson Michael Trimble Queen Square Hospital, London, United Kingdom E-mail address: [email protected]

The theories of John Hughlings Jackson (1835–1911) on brain structure and function will be discussed in the light of ear- lier theories of the frontal lobes that influenced him. These included the works of Charles Darwin (1809–1882) and Her- bert Spencer (1820–1903). Hughlings Jackson’s Four Principles of Nervous Action were: – evolution of nervous functions; – hierarchy of those functions; – negative and positive symptoms of dissolution; – local and uniform dissolution. Important principles were the hierarchical organisation of the central nervous system, with interactions between levels. The highest level was the prefrontal cortex. His ideas were better applied to the motor than the sensory system. Further he was concerned with movements rather than muscles. Of considerable significance were ideas of inhibition and release, and that clinical signs of neurological injury involved both processes simultaneously. This led to concepts of posi- tive and negative symptoms, which he opined were present in every case; lesions could never localise a function, but only degrade a system, and the clinical effects were a reflection of the continued level of activity of parts of the brain spared by the lesion. His interests in philosophy led him to state there was no physi- ology of the mind any more than there was a psychology of the nervous system; he advocated the Doctrine of Concomitance and parallelism of mental and neural states. Hughlings Jackson disagreed with the cerebral laterality ideas of Pierre Paul Broca (1824–1880). He was impressed by the work of the French anatomist and zoologist Luis Pierre Grati- olet (1815–1865) and advocated an important role for the right hemisphere in language. For Hughlings Jackson mentation was a “dual process, played out between the two hemispheres of the brain”. Finally, in the presentation there will be a brief note on the relationship between Jean-Martin Charcot (1825–1893) and Hughlings Jackson [1–3]. Disclosure of interest The author declares that he has no com- peting interest.

References [1] Dewhurst K. Hughlings Jackson on psychiatry. Oxford:

Sandford; 1982. [2] Taylor J, editor. Selected writings of John Hughlings Jackson.

London: Staples Press; 1958. [3] Trimble MR. The intentional brain. Baltimore: Johns Hop-

kins University Press; 2016.

https://doi.org/10.1016/j.neurol.2018.09.004

Abstract No. 4

Phineas Gage: The brain and the behavior Hanna Damasio (University Professor, Dornsife Professor of Neuroscience, Psychology, Neurology, Director Dornsife Cognitive Neuroscience Imaging Center) Dornsife College of Letters Arts and Sciences, University of Southern California, Los Angeles, USA E-mail address: [email protected]

Phineas Gage has long occupied a privileged position in the history of science. Few isolated cases have been as influential, in the neurological and neuroscientific thinking, and yet the documentation on which conclusions and interpretations rest are remarkably incomplete [1,2]. We do have a number of sure facts: – Gage did suffer a well-described accident, which resulted in major damage to his skull and brain; – we do know that after the accident his personality under- went a major change and that his reliability was compromised; – we do have his actual, damaged, skull as well as the weapon that traversed it, both preserved as museum artifacts. By undertaking a direct analysis of the skull and taking direct advantage of novel neuroimaging techniques, we took a new look at the Gage case [3]. After analyzing, measuring and pho- tographing the skull at the museum of the Harvard Medical School, we modeled a restricted number of trajectories for the weapon and for the respective sites of brain injury. We were then able to interpret aspects of Gage’s behavior that were credibly compromised in the setting of Gage’s presumed lesions. The confidence we were able to place on these interpreta- tions depended on the fact that we had extensive experience with the systematic study of brain lesions and their con- sequences — namely with frontal lobe lesions — in cases that were well documented neuroanatomically and neuropsy- chologically and were even included in neuropsychological experiments. Our goal, nearly a quarter of a century ago, was to add a chapter to the Gage history and enrich this historical case with the benefits of modern techniques and theoretical advances. We did not intend to use Phineas Gage to advance knowledge in neuroscience, rather we used advances in neu- roscience to complete the study that Harlow had obviously intended to author about Phineas Gage. Interest in the Gage case has not waned, and two additional studies are worth mentioning. Of interest, in 2004, Ratiu et al. [4] replicated our findings and suggested that the Gage lesion was probably confined to the left hemisphere, something entirely compatible with our views but that, on the basis of our own data, we could not conclude with confidence. In 2012, yet another research group addressed the likely disruption of white matter tracks in relation to cortical networks [5]. I plan to discuss these results in light of current knowledge of frontal lobe dysfunction. Disclosure of interest The author declares that she has no competing interest. References [1] Harlow JM. Passage of an iron bar through the head. Boston

Med Surg 1848;13:389.

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[2] Harlow JM. Recovery from the passage of an iron rod bar through the head. Pub Mass Med Soc 1868;2:327.

[3] Damasio H, et al. The return of Phineas Gage: clues from the skull of a famous patient. Science 1994;264:1102.

[4] Ratiu P, et al. The tale of Phineas Gage, digitally remastered. J Neurotrauma 2004;21:637.

[5] Van Horn JD, et al. Mapping connectivity damage in the case of Phineas Gage. PLoS One 2012;7(5):e37454.

https://doi.org/10.1016/j.neurol.2018.09.005

Abstract No. 5

History of the frontal lobes: Language and language disorders François Boller (MD, Ph.D.) (Clinical Professor of Neurology) ∗, Nicoletta Caputi George Washington University, Washington DC 20037, USA ∗ Corresponding author. E-mail address: [email protected] (F. Boller)

The topic “Language and language disorders” fits well into a meeting dedicated to the history of the frontal lobes because that is where it all began. The ability to communicate is cer- tainly not restricted to humans but language is. Specifically the ability to learn, articulate and use symbolic language, the use of accompanying facial and body gestures, the abil- ity to teach and correct are all unique to humans. They are related to the development of frontal lobe structures, with mirror neurons the likely neuronal basis of these abilities [1–3]. The birth of neuropsychology in its current meaning occurred in the second part of the 19th century when studies of lan- guage and its disorders were linked to lesions of structures located in the frontal lobes. There were several contributors. Broca of course comes to mind but others played a role, some even preceded him. Jean-Baptiste Boullaud had gone as far as offering 500 francs to “anyone who could produce the brain of one who had during life lost speech, and which did not show any frontal lesion”. On April 4th 1861, his son-in-law Ernest Aubertin made a presentation on “the seat of articulated lan- guage”. That date is considered “the most important one in the history of aphasiology” by McDonald Critchley (1970, p. 61) [4]. As for Broca, his contribution first formally presented on May 2nd 1861 was crucial, but it must be remembered that this was only a relatively short parenthesis in a life dedicated to surgery and above all to anthropology. We will conclude with the cri de douleur of Pierre Marie who proclaimed that the third frontal convolution plays no role on language function. This iconoclastic position was later dis- cretely retracted, but we will summarize the fierce debates, particularly those of 1908 when a duel of swords was for- tunately cancelled to become a duel of words [5]. We will present the taped voice of two very reduced patients from Henry Hécaen’s Unit [6]. In his signature book “Introduction à la Neuropsychologie” (1972), he refers to these two patients as examples of “Aphasie de réalisation phonématique”. To this day the precise definition of Broca’s aphasia and aphemia is not entirely agreed upon except mostly for one thing: the lesion is in the frontal lobes [1–6]. Disclosure of interest The authors declare that they have no competing interest. References [1] Premack D. Is language the key to human intelligence? Sci-

ence 2004;303:318–20. [2] Corballis MC. Mirror neurons and the evolution of

language. 2010;112:25–35. https://www.ncbi.nlm.nih.gov/ pubmed/19342089.

[3] Arbib MA. Toward the language-ready brain: biological evolution and primate comparisons. Psychon Bull Rev 2017;24:142–50.

[4] Critchley M. Aphasiology. London: E. Arnold; 1970. p. 61. [5] Roch Lecours A. Aphasie : les débats. Rev Neurol (Paris)

1999;155:833–47. [6] Hécaen H. Introduction à la neuropsychologie. Paris:

Larousse; 1972. p. 13.

https://doi.org/10.1016/j.neurol.2018.09.006

Abstract No. 6

AR Luria and the role of frontal lobes in the regulation of higher mental activities and behavior Christian Derouesné (Honorary Professor of Neurology) Université Pierre et Marie-Curie (Paris VI), France E-mail address: [email protected]

Aleksandr Romanovich Luria (1902–1977), doctor of psychol- ogy and of medicine was one of the prominent scientists in neuropsychology in the XXth century, and gave the first sys- tematic description of the frontal lobe functions. His very personal approach was based on: – the historical and cultural theory of psychology developed in close collaboration with LS Vygotski (1896–1934) from 1924 to 1934, emphasizing the crucial role of speech in the devel- opment of the higher (i.d. conscious and voluntary) mental activities [1,2] and, in the 1950s, the regulation of behavior by inner speech [1]; – his experimental work inspired by the physiology of IP Pavlov (1849–1936), but also by the theory of functional sys- tems of PK Anokhin (1898–1974), and the intentional character of human activities outlined by NA Bernstein (1896–1966) [3,4]; – his research in patients with brain lesions at the Neurosurgi- cal Institute in Moscow from 1936 to his death and as director of the Rehabilitation hospital of neurosurgery in Urals during the war [5]. According to Luria, human mental processes are complex functional systems requiring the participation of three main units working in close association: a unit for regulating tone and waking and mental states, a unit for receiving, analyzing and storing information, and a unit for programming, regula- tion and verification of activity [6]. Frontal lobes play a crucial role in the first and the third unit, specifically for the conscious and voluntary activity. In the 1960s, Luria gave an extensive description of the frontal lobe syndromes with original meth- ods for their clinical assessment [7]. Disclosure of interest The author declares that he has no com- peting interest. References [1] Luria AR. Language and cognition (1979), Translation by

Wertsch JV. New York: John Wiley; 1982. [2] Vygotski LS. Histoire du développement des fonctions psy-

chiques supérieures (1928–1931 ?). Trad Sève F. Paris: La dispute; 2014.

[3] Luria AR. In: Lindsey GE, editor. A history of psychology in autobiography, volume VI. Englewood Cliffs (NY): Prentice Hall; 1974. p. 251–92.

[4] Luria AR. The making of mind (1979). In: Cole M, Levitin K, Luria A, editors. The autobiography of Alexander Luria. A dialogue with the making of mind. New York: Psychology Press; 2006. p. 1–188.

[5] Homskaya ED. Alexander Romanovitch Luria. A scientific biography. Translation by Krotova D. Foreword by Tupper DE. New York: Kluwer Academic; 2001.