Spared and impaired cognitive abilities after bilateral frontal damage

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

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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
Issue number1
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Experimental and Cognitive Psychology
  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)


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