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The frontal lobe is the anterior most lobe of the brain and is responsible for many brain functions: reasoning, personality and moderating behavior, planning, and problem-solving. When damage occurs to the frontal lobe, such as from a head injury, the symptoms can dramatically change a person's personality and intellect.
One of the most well-known cases of frontal lobe damage is that of Phineas Gage, who suffered frontal lobe damage in 1848 when a tamping iron pierced his skull and brain:
“He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference to his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate yet capricious and vacillating, devising many plans for future operation which no sooner are arranged than they are abandoned in turn for others appearing more feasible. His mind was radically changed so that his friends and acquaintances said he was no longer Gage.” —J.M. Harlow, Gage's physician (1868)
The symptoms Gage displayed would now be considered frontal lobe syndrome. As Jenni A. Ogden, PhD, author of the book “Fractured Minds: A Case-Study Approach to Clinical Neuropsychology” notes, “the frontal lobe syndrome is a syndrome in the sense that it comprises a range of cognitive and emotional deficits commonly associated with damage to the prefrontal lobes (the area of frontal cortex from the frontal poles extended back to, but not including, the motor association cortex, plus the basomedial portions of the frontal lobes).”
According to Ogden, frontal lobe syndrome is common in patients with:
—Alcoholism
—Wernicke-Korsakoff's syndrome
—Dementia (Alzheimer's disease, Parkinson's disease, Huntington's disease)
The damage resulting in the frontal lobe syndrome can sometimes be seen with a CT scan (computed tomography scan) when it is severe, but the syndrome is usually diagnosed with neuropsychological symptoms from the prefrontal lobes working abnormally. Symptoms of frontal lobe syndrome include:
—Frontal amnesia: the memory problems are not due to the patient being unable to recall information, but are due to “an inability to form plans that enable them to regulate the procedures and verify the outcomes of the various mental steps in the memory process.” (Ogden)
—Disinhibition: the patient cannot stop inappropriate behaviors, one of the symptoms Gage was noted having.
—Confabulation: the patient creates stories and believes them to be true; the confabulation is done to fill in the gaps from memory loss, which is often seen in Wernicke-Korsakoff's syndrome.
—Preservation: the patient repeats behaviors or sentences, even if told her actions are inappropriate.
The outlook for rehabilitation is depended on the extensiveness of the frontal lobe damage. Some patients may exhibit aggressiveness, while others may become more passive. Psychological treatment is recommended for both the patient and the patient's family, as the changes from the frontal lobe syndrome can be hard for the family to handle.
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Elizabeth Stannard Gromisch received her bachelor’s of science degree in neuroscience from Trinity College in Hartford, CT in May 2009. She is the Hartford Women's Health Examiner and she writes about abuse on Suite 101.
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