Of the main principles of human neuropsychology, the best known may be cerebral specialization: the left and right hemispheres play different roles in language and other higher-order functions. This chapter discusses whe...Of the main principles of human neuropsychology, the best known may be cerebral specialization: the left and right hemispheres play different roles in language and other higher-order functions. This chapter discusses when and how and by whom the differences were found. It begins with an account of Gall's cortical localization theory, which set the stage. It then describes the discoveries themselves, reviews how the differences were explained, and concludes with a summary of further developments.
Elements of "frontal" syndromes and executive dysfunction have been pondered by humans since ancient times, perhaps because executive dysfunction often threatens the very characteristics that make us human. This chapter...Elements of "frontal" syndromes and executive dysfunction have been pondered by humans since ancient times, perhaps because executive dysfunction often threatens the very characteristics that make us human. This chapter provides a historical account of scientific advancements related to frontal lobe functioning and how the term has transformed over time. From ancient Greek philosophy to early neuroscientific animal studies to the default mode network, knowledge about the neural underpinnings of executive functioning has blossomed, almost so broadly that the behemoth term comprising broad neuropsychological functions may struggle to be provide specificity on its own without further clarification.
The kanji and kana (or kanji vs. kana) problem in the Japanese language denotes the dissociation between kanji (morphograms) and kana (phonograms) in reading/comprehension and writing. Since paragraphia of kana in a pati...The kanji and kana (or kanji vs. kana) problem in the Japanese language denotes the dissociation between kanji (morphograms) and kana (phonograms) in reading/comprehension and writing. Since paragraphia of kana in a patient with amyotrophic lateral sclerosis was first reported in 1893, kanji-kana dissociation has been the central topic in Japanese aphasiology. Recent advancements in lesion-to-symptom analyses and functional imaging studies have identified some areas whose damage causes dissociative disturbances of reading or writing between kanji and kana. That is, (1) angular alexia with agraphia causes kanji agraphia; alexia of kana with an angular gyrus lesion is the result of a damage to the middle occipital gyrus; (2) alexia with agraphia for kanji is caused by a posterior inferior temporal cortex (mid-fusiform/inferior temporal gyri; visual word form area) lesion, whereas pure agraphia for kanji is caused by a posterior middle temporal gyrus lesion; and (3) pure alexia, particularly for kanji, results from a mid-fusiform gyrus lesion (Brodmann's Area [BA] 37), whereas pure alexia for kana results from a posterior fusiform/inferior occipital gyri lesion (BA 18/19).
Studies of alexia and agraphia have played historically important roles in efforts to understand the relation between brain and behavior. In the second half of the 19th century, works by Paul Broca and Carl Wernicke led...Studies of alexia and agraphia have played historically important roles in efforts to understand the relation between brain and behavior. In the second half of the 19th century, works by Paul Broca and Carl Wernicke led to the concept of delimited cortical centers in the left cerebral hemisphere concerned with discrete aspects of spoken and written language. These specialized centers were linked by white matter pathways. Charlton Bastian, Jean-Martin Charcot, Sigmund Exner, and Jules Dejerine championed center-pathway models of reading and writing. Dejerine played a dominant role, rejecting the idea of a left frontal lobe center that mediated writing and proposing a unique, specialized role for the left angular gyrus in both reading and writing. In 1891 and 1892, he detailed the symptoms of alexia and agraphia that resulted from injury to the left angular gyrus and from the isolation of the left angular gyrus from visual input required for reading. During the early 20th century, his work and that of other so-called diagram makers was confronted and largely discredited by Pierre Marie, joined later by Henry Head and Kurt Goldstein. In the 1960s, the center-pathway model was resurrected and refined by Norman Geschwind. He drew upon foundational works of Dejerine, Hugo Liepmann, and others to describe syndromes resulting from cortical disconnections and, in doing so, helped to establish a framework for the modern discipline of behavioral neurology.
We live in a world surrounded by sound. Throughout life, we are exposed to music: from lullabies and songs taught at school to instrumental music both heard and played for pleasure. Every nation, along with its own langu...We live in a world surrounded by sound. Throughout life, we are exposed to music: from lullabies and songs taught at school to instrumental music both heard and played for pleasure. Every nation, along with its own language, has unique forms of music and dance. "Music knows no boundaries," as the saying goes. Just as language impairment is known as "aphasia," impairment of the perception of music is called "amusia." In this article, we will first classify the types of amusia. This will be followed by an introduction to the classical research of Salomon Eberhard Henschen (1847-1930), and to a discussion of higher auditory functions in which we highlight cases of amusia encountered in a person and through the literature.
Even if Babinski (1914) is usually considered as the discoverer of anosognosia, other authors before him contributed to the development of this construct. Von Monakow (1885) and Dejerine and Vialet (1893) gave the first...Even if Babinski (1914) is usually considered as the discoverer of anosognosia, other authors before him contributed to the development of this construct. Von Monakow (1885) and Dejerine and Vialet (1893) gave the first descriptions of patients with cortical blindness who were unaware of their disability, but did not distinguish this unawareness from the rest of the clinical description. Anton (1999) described patients with cortical deafness and cortical blindness, considering these defects of awareness as a symptom independent from the neurological dysfunction. He conceptualized them as a phenomenon in its own right and tried to link this unawareness of a disability with specific neuro-anatomical changes. Finally, Babinski (1914) coined the term "anosognosia" to designate the clinical entity conceptualized by Anton (1899) and extended this concept from the unawareness of cortical deafness and blindness to the unawareness of hemiplegia. The choice of the term "anosognosia" to denote the observed phenomenon was important, because referring to "lack of knowledge of the disease" (anosognosia), he not only emphasized the separation between "lack of knowledge" and "disease, " but also suggested a general use of this term, because disease can refer to many other disabilities besides hemiplegia. Further investigations have shown that: (a) brain-damaged patients may be unaware of different kinds of disabilities; (b) anosognosia can be selective, in that an affected person with multiple impairments may be unaware of only one handicap, while appearing fully aware of any others; and (c) lack of acknowledgment of a disease may not necessarily be due to a defective awareness, but must sometimes be considered as an extreme but understable pattern of adaptation to stress. For this condition, the term "Denial of Illness" seems preferable to that of anosognosia. Anosognosia must perhaps be viewed as a multifaceted phenomenon, resulting from both cognitive and motivational factors.
In this chapter, I will present an overview of early case descriptions of specific isolated cognitive deficits in children for which no clear brain impairment could be demonstrated and which were therefore considered to...In this chapter, I will present an overview of early case descriptions of specific isolated cognitive deficits in children for which no clear brain impairment could be demonstrated and which were therefore considered to be congenital or developmental in nature. Three kinds of syndromes will be discussed. First, more general deficits like the attention and hyperactivity disorder and congenital aphasia will be presented. The second category relates to the more specific cognitive deficits, like developmental prosopagnosia, that have been reported, especially from the early 1980s onwards. In particular, early reports of specific congenital deficits in the areas of attention, language, perception, and memory will be presented. And finally, I will briefly discuss early case descriptions of individuals with autism and savant syndrome. Instead of suffering from a specific cognitive deficit, the latter show a special talent.
The representation of cognitive function in the cerebral cortex has a long and cherished history, but much evidence also supports a critical role of subcortical structures in the operations of cognition. The idea of subc...The representation of cognitive function in the cerebral cortex has a long and cherished history, but much evidence also supports a critical role of subcortical structures in the operations of cognition. The idea of subcortical dementia, first proposed in 1932 and substantially expanded in the 1970s, is the most prominent formulation intended to capture the phenomenology of cognitive impairment attributable to subcortical involvement. Despite criticism highlighting its imprecision, subcortical dementia has endured as a useful general concept assisting the classification of dementia syndromes based on the primary site(s) of neuropathology. As neuroscientific knowledge expanded with the advent of modern structural and functional neuroimaging, a more detailed understanding of the contributions of specific subcortical regions emerged, such that the cognitive affiliations of the basal ganglia, thalamus, cerebellum, brainstem, and white matter are all better defined. Important advances have been made by the study of both neurodegenerative diseases and focal lesions. Today, the complex admixture of cortical and subcortical foundations of cognition is increasingly well appreciated, and has been conceptually organized within the broadly inclusive notion of distributed neural networks. These networks are thought to integrate cortical and subcortical gray and white matter structures throughout the brain into functional neuronal ensembles subserving various domains of cognition. In this light, specific disorders of subcortical regions produce cognitive sequelae that can be usefully analyzed within the context of networks that involve key cortical regions as well. The study of subcortical contributions to cognition has been highly informative in expanding neurobehavioral thinking to include regions beyond the cerebral cortex, adding nuance and sophistication to the conceptualization of brain-behavior relationships.
This chapter pays homage to the masters who made neuropsychology an esteemed and legitimate field in the 19th and 20th centuries. Here we offer a brief biography for each of them and an analysis of their discoveries: Thé...This chapter pays homage to the masters who made neuropsychology an esteemed and legitimate field in the 19th and 20th centuries. Here we offer a brief biography for each of them and an analysis of their discoveries: Théophile Alajouanine (1890-1980), Henry Charlton Bastian (1837-1915), Arthur L. Benton (1909-2006), Julian de Ajuriaguerra (1911-1993), Ennio De Renzi (1924-2016), Norman Geschwind (1926-1984), Kurt Goldstein (1878-1965), Henry Head (1861-1940), Henry Hécaen (1912-1983), Pierre Janet (1859-1947), François Lhermitte (1921-1998), Jean Lhermitte (1877-1959), Hugo Karl Liepmann (1863-1925), Heinrich Lissauer (1861-1891), Alexander Romanovich Luria (1902-1977), Brenda Milner (1918-), Théodule Ribot (1839-1916), Charles Richet (1850-1935), Paul Sollier (1861-1933), and Carl Wernicke (1848-1905).
In 1943, Tsuneo Imura, a neuropsychiatrist at Tokyo University, proposed a new aphasic syndrome and designated it as Gogi (word meaning) aphasia. According to Imura, it is characterized by (1) difficulty in comprehending...In 1943, Tsuneo Imura, a neuropsychiatrist at Tokyo University, proposed a new aphasic syndrome and designated it as Gogi (word meaning) aphasia. According to Imura, it is characterized by (1) difficulty in comprehending spoken words despite good perception of sound, (2) disorders of expression due to loss of vocabulary and verbal paraphasia, (3) preserved ability of repetition, and (4) selective difficulty in reading and writing kanji (Japanese logographic character) with preserved ability of reading and writing kana (Japanese syllabic character). To be more specific, the difficulty in comprehending spoken words in Gogi aphasia is limited to substantive words as the name of the syndrome indicates, while comprehension of syntax remains unimpaired. Preserved repetition ability cannot be simply regarded as an automatic response, that is, echolalia, because the patient's attitude in repeating was quizzical, picking up the particular word he did not comprehend. Imura vaguely attributed the responsible lesion to the second and third temporal gyri on the left side. Although the general pattern of the syndrome can be placed in the category of transcortical sensory aphasia, its uniqueness as the syndrome still stands out. Another uniqueness of the syndrome is its characteristic pattern of dissociated kanji-kana difficulty in reading and writing. This linguistic symptomatology observed in Gogi aphasia was first introduced to the western academic world on a German neuropsychiatric journal by Panse and Shimoyama in 1955. Ever since, the existence of Gogi aphasia as an independent syndrome among disorders of spoken language has gradually gained international recognition. But whether the pattern of the kanji-kana dissociation described by Imura is an integral part of the syndrome remains unsettled. A recently proposed concept of semantic dementia suggests symptomatic continuation of word meaning loss with non-linguistic semantic memory loss.
In a series of papers which appeared in 1906, Pierre Marie advanced a new concept of aphasiology against the classical view based on functional localization of cerebral cortex. He denied the role of Broca's area in langu...In a series of papers which appeared in 1906, Pierre Marie advanced a new concept of aphasiology against the classical view based on functional localization of cerebral cortex. He denied the role of Broca's area in language function and proposed as the center for articulation "zone lenticulaire," the lesion of which causes anarthria. But his illustration of "zone lenticulaire" which appears repeatedly in his papers dealing with aphasia, is anatomically incorrect since the most important portions of Broca's area, opercular part and triangular part of the inferior frontal gyrus are missing in his illustration. The detailed anatomical investigation of Marie's illustrations reveals that he repeated the same errors in identifying rolandic and frontal opercula. But the similar mistake of identifying these opercula is also seen in Dejerine's "Anatomie des Centres Nerveux."
Franz Kafka's Letter to His Father is one of the greatest examples in world literature of memory of a traumatic childhood. In it, the author takes a retrospective journey through his life, recollecting and analyzing the...Franz Kafka's Letter to His Father is one of the greatest examples in world literature of memory of a traumatic childhood. In it, the author takes a retrospective journey through his life, recollecting and analyzing the reasons for the estrangement and hostility between a father and a son. This essay considers Letter to His Father in the light of current knowledge about autobiographical memory. The essay first sets forth basic aspects of Kafka's life in order to place Letter to His Father in the context of Kafka's biography, and then presents Kafka's relevance to the literature and thought of the twentieth and twenty-first centuries. The essay then considers the different forms of childhood abuse and their consequences in light of evidence from neurodevelopmental psychology. We present evidence about the relationship between trauma and the construction of self-image. Furthermore, we discuss the subjectivity of Kafka's recollections from the perspective of recent advances in neurobiology. Memory is shown to be dynamic, selective, inherently malleable and dependent on perception, which is a subjective construction, in which the brain interprets and gives coherence to experienced stimuli. We consider the inaccuracy of memory, which is related to neuroplastic changes in the brain that take place over time: consolidation, reconsolidation and transformation. Finally, the relationship between literature and autobiography in the Kafkaesque universe is considered.
Machado de Assis (1839-1908) suffered from temporal lobe epilepsy, probably with origin in the non-dominant hemisphere. The evidence for this is provided by the detailed reports of the characteristics of his seizures by...Machado de Assis (1839-1908) suffered from temporal lobe epilepsy, probably with origin in the non-dominant hemisphere. The evidence for this is provided by the detailed reports of the characteristics of his seizures by his contemporaries and by his correspondence with other writers. He was treated with bromides and homeopathy. It is unclear whether his neurological disorder influenced his artistic performance. What is evident is that he was deeply ashamed of the disease - he avoided the word "epilepsy" and just wrote about it in his personal correspondence with friends in the last years of his life. Though controversial, he had no clear traces of personality disorders linked to his temporal lobe epilepsy. Despite all his adversities, including being "mulatto," having a stutter, being of humble origins, and epileptic in a period when there was no efficacious therapy and a profound stigma associated with the disease, Machado de Assis became one of the most important Brazilian writers of all times.
Raymond Roussel (1877-1933) was an eccentric writer whose strange novelistic and theatrical work was launched by the surrealists and is still worshipped by the French intelligentia. While writing his first text at the ag...Raymond Roussel (1877-1933) was an eccentric writer whose strange novelistic and theatrical work was launched by the surrealists and is still worshipped by the French intelligentia. While writing his first text at the age of 19 years, he presented a delusional episode marked by the conviction that he was shining like a sun and that he had acquired universal glory. He "fell back to earth" when the book was published and he realized that no one was stopping to gaze at him. He later led a ritualized life, continuing to write and eventually achieving success - glory even - with the champions of the surrealist revolution, who saw the genius in him. His eccentricities, permitted by his immense fortune, contributed to the legend and helped him to exist socially. He was also able to conceal his homosexuality, which appears to be closely dependent on an emotional infantilism. His pathology is recognized thanks to Pierre Janet's account (1859-1947) of his case in De l'Angoisse à l'Extase. Janet's accompanying psychotherapy, which supported him for many years, was effective in moving him towards a form of obsessive consolidation. Janet's therapeutic approach, however, is currently strongly criticized by dogmatic psychoanalysts. Roussel must have been aware of the artificial nature of his theatrical successes and he succumbed to a depressive state, taking refuge in barbiturate addiction. He died in a Palermo hotel room of a barbiturate overdose, considered to be suicidal.
Visual art is one of the means of non-verbal communication that bypasses cultural, societal, language and, more importantly, time differences. It allows for establishing a multilevel connection between the artist and art...Visual art is one of the means of non-verbal communication that bypasses cultural, societal, language and, more importantly, time differences. It allows for establishing a multilevel connection between the artist and art receiver. Production of visual art is a form of expression of emotions. Art reception involves the initiation of a cascade of emotions and thoughts based on visual input. One of the ways to express artistic content is through abstraction. Abstract visual art is based on portraying elements that do not represent any real, objective shapes, with the means of lines, colours, tones and texture. Abstract expressionism is a form of abstract art infused with strong emotional and expressive content. The combination of expression of emotions in abstraction requires almost direct translation between neuronal function and artistic output without using formal shapes or references as means of communication. That is why it is very interesting to look at the artistic output in abstract expressionists with neurological disorders affecting the brain. Here, we review several key abstract expressionists, including James Brooks, Agnes Martin and Willem de Kooning, and their artistic production in the context of brain disease.
The famous poet Arthur Rimbaud (1854-1891) stopped writing poetry at 21 years and subsequently had a rather adventurous life mainly in the Arabic peninsula and Ethiopia. He died at 37 years, only a few months after the a...The famous poet Arthur Rimbaud (1854-1891) stopped writing poetry at 21 years and subsequently had a rather adventurous life mainly in the Arabic peninsula and Ethiopia. He died at 37 years, only a few months after the amputation of his right lower limb due to a developing tumor in the knee, which probably was an osteosarcoma in the lower third of the femur. His letters to his sister Isabelle suggest that he suffered from severe stump pain rather than phantom limb, but since he lived only shortly after surgery (he developed extensive carcinomatosis), one does not know whether a full phantom would have developed and how this would have affected his subsequent life.
The issue of First World War shell shock has been documented mainly from a medical perspective. Many medical texts dealing with war psychoneuroses and their aggressive treatments, such as electrotherapy, were published d...The issue of First World War shell shock has been documented mainly from a medical perspective. Many medical texts dealing with war psychoneuroses and their aggressive treatments, such as electrotherapy, were published during the war. Accounts from shell-shocked soldiers are rare. Nevertheless, shell shock was described from a non-medical point of view by a few writers who had undergone or witnessed this pathology. Their texts deal mainly with the psychiatric forms, the most striking ones, but also with the more common concepts of commotion, emotion and pathological fear. The French philosopher Émile Chartier (1868-1951), alias Alain, described the commotional syndrome from which he suffered. The German writer Ernst Jünger (1895-1998), a brave officer and an example for his men, reported his emotional shock. Some psychiatric forms of shell shock are present in the work of the pacifist writer Jean Giono (1895-1970), the naturalist Maurice Genevoix (1890-1980), who suffered himself from a section of the left median and ulnar nerves, or the British poet Siegfried Sassoon (1886-1967). War hysteria and pathological fear have been described, on several occasions, by Blaise Cendrars (1887-1961) or the German writer Erich Maria Remarque (1898-1970). Electrotherapy has been scarcely reported except by Louis-Ferdinand Céline (1894-1961).
The writer Louis Ferdinand Céline (1894-1961) developed a personal style which changed twentieth century French literature. As an enlisted soldier in 1912, he was involved in the Great War and his right arm was severely...The writer Louis Ferdinand Céline (1894-1961) developed a personal style which changed twentieth century French literature. As an enlisted soldier in 1912, he was involved in the Great War and his right arm was severely wounded. After the war, he became a medical doctor and a writer who published his first novel, Voyage au bout de la nuit (Journey to the End of the Night), in 1932. In the middle of the 1930s, he began to write anti-Semitic and racist pamphlets and turned to a collaborationist stance with Nazi Germany. After the Second World War, he was declared a national disgrace in France and fled to Denmark. In 1951, he was granted amnesty and went back to France, where he regained fame with his last three novels. Céline was a First World War neurologically wounded soldier who received a severe injury in the right arm leading to a radial nerve paralysis. Furthermore, in his texts and letters, he complained of many symptoms that he considered to be related to the First World War. In reality, to build a heroic image of himself, Céline rewrote his personal First World War history, in particular his war wounds. The aim of this reconstruction was to help him achieve literary fame. At the end of the Second World War, he also used this rewriting to organise his defence when he was accused and tried for collaborationism. Using medical and military archives, Céline's First World War medical mythology is reviewed to distinguish facts from fiction concerning his wound and other war neurological disturbances. We present the history of his radial nerve lesion and surgery, and confirm that Céline was never trepanned. Two other controversial neurological points, his left ear disease and his possible shell shock, are also discussed.
Many artists were involved in the First World War. Some of them were mobilized, like millions of soldiers, others enlisted to fight on the battlefield. The stories of writers who returned neurologically wounded from the...Many artists were involved in the First World War. Some of them were mobilized, like millions of soldiers, others enlisted to fight on the battlefield. The stories of writers who returned neurologically wounded from the war, such as Guillaume Apollinaire (1880-1918) or Blaise Cendrars (1887-1961), are well-known. The cases of painters and sculptors who suffered from First World War neurological wounds are scarce. Nevertheless, their injuries led to intense modifications of artistic practice. We detail four examples of artists whose creative mind was impacted by their First World War neurological wounds or diseases. The painter Jean-Julien Lemordant (1878-1968), who suffered from blindness after his injury, stopped his artistic work and became an icon of Franco-American friendship. The sculptor Maurice Prost (1894-1967), suffering from a neuroma due to the loss of his arm, built a special device to continue his work as a wildlife artist. The painter Georges Braque (1882-1963) was trepanned but carried on with his cubist work without ever mentioning the conflict. Conversely, the painter Fernand Léger (1881-1955), who suffered from a war neurosis, produced a significant war testimony through drawings and letters.