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Antonio R Damasio

Publications and source records attributed to Antonio R Damasio.

9 recordsLinked to original sources

A mechanism for impaired fear recognition after amygdala damage.

Ten years ago, we reported that SM, a patient with rare bilateral amygdala damage, showed an intriguing impairment in her ability to recognize fear from facial expressions. Since then, the importance of the amygdala in processing information about facial emotions has been borne out by a number of lesion and functional imaging studies. Yet the mechanism by which amygdala damage compromises fear recognition has not been identified. Returning to patient SM, we now show that her impairment stems from an inability to make normal use of information from the eye region of faces when judging emotions, a defect we trace to a lack of spontaneous fixations on the eyes during free viewing of faces. Although SM fails to look normally at the eye region in all facial expressions, her selective impairment in recognizing fear is explained by the fact that the eyes are the most important feature for identifying this emotion. Notably, SM's recognition of fearful faces became entirely normal when she was instructed explicitly to look at the eyes. This finding provides a mechanism to explain the amygdala's role in fear recognition, and points to new approaches for the possible rehabilitation of patients with defective emotion perception.

Adult↗

Preferring one taste over another without recognizing either.

Stimuli can be discriminated without being consciously perceived and can be preferred without being remembered. Here we report a subject with a previously unknown dissociation of abilities: a strong behavioral preference for the taste of sugar over saline, despite a complete failure of recognition. The pattern of brain damage responsible for the dissociation suggests that reliable behavioral choice among tastes can occur in the absence of the gustatory cortex necessary for taste recognition.

Aged↗

Investment behavior and the negative side of emotion.

Can dysfunction in neural systems subserving emotion lead, under certain circumstances, to more advantageous decisions? To answer this question, we investigated how normal participants, patients with stable focal lesions in brain regions related to emotion (target patients), and patients with stable focal lesions in brain regions unrelated to emotion (control patients) made 20 rounds of investment decisions. Target patients made more advantageous decisions and ultimately earned more money from their investments than the normal participants and control patients. When normal participants and control patients either won or lost money on an investment round, they adopted a conservative strategy and became more reluctant to invest on the subsequent round; these results suggest that they were more affected than target patients by the outcomes of decisions made in the previous rounds.

Affect↗

A neural basis for collecting behaviour in humans.

Collecting behaviour is commonplace in the normal population, but there has been little investigation of its neural basis in humans. The observation that collecting behaviour can assume pathological proportions in patients with certain patterns of brain damage led us to hypothesize that dysfunction in a system encompassing mesial prefrontal cortices accounts for abnormal collecting and may guide normal collecting. We tested the hypothesis in 86 subjects with focal lesions of the telencephalon, by relating the neuroanatomical placement of the lesions to the presence of repetitive and indiscriminate acquisition behaviour and impaired discard behaviour. The subjects had no history of psychiatric disease or abnormal collecting behaviour prior to lesion onset. Lesions were analysed with high-resolution three-dimensional MRI. Collecting behaviour was evaluated with a standardized questionnaire completed by a close relative of each subject. Thirteen subjects exhibited abnormal collecting, characterized by massive and disruptive accumulation of useless objects. In all cases, the abnormality of collecting behaviour was severe and persisted despite attempted interventions and obvious negative consequences. There were no differences between pathological collectors and non-collectors on tests of executive functions or anterograde memory. All subjects with pathological collecting behaviour had damage to the mesial frontal region (including the right polar sector and the anterior cingulate), but there was no damage to most of the subcortical structures that, in species such as rodents, are known to drive the acquisition and retention of objects. The evidence suggests that damage to the mesial frontal region disrupts a mechanism which normally modulates subcortically driven predispositions to acquire and collect, and adjusts these predispositions to environmental context.

Adult↗

Differential distribution of calbindin D28k and parvalbumin among functionally distinctive sets of structures in the macaque brainstem.

In a study of brainstem in the cynomolgus monkey, we found that the distribution of calbindin D28K (CB) and parvalbumin (PV) is nonoverlapping among functionally distinct sets of brainstem structures. Nuclei involved in representation and regulation of the organism's internal state contain CB, whereas those involved in the representation of the external environment and the representation or execution of externally directed actions contain only PV. Moreover, our findings indicate that different nuclei known as components of the ascending reticular activating system (ARAS) contain either CB or PV or both, suggesting that this system in primates operates with both CB and PV. In line with previously reported findings, we also found that unmyelinated pathways contain only CB, whereas myelinated pathways contain PV. Distribution of CB and PV in the macaque brainstem follows a pattern comparable to, but in some instances significantly different than, the pattern previously reported in the rat. We argue that the nonoverlapping distribution of CB and PV among different structures of the brainstem might reflect underlying differences in the physiological, anatomic, and perhaps phylogenetic properties of these structures. Considering our recent findings of selective vulnerability of brainstem structures to Alzheimer's disease, the present data suggest that the majority of macaque brainstem nuclei that contain CB are vulnerable to neurofibrillary tangles in humans. By contrast, only few nuclei that contain PV exhibit pathologic changes. Some of these nuclei are affected with a high number of neuritic plaques without ever developing neurofibrillary tangles.

Animals↗

Neuroanatomical correlates of brainstem coma.

The brainstem tegmentum, including the reticular formation, contains distinct nuclei, each of which has a set of chemical, physiological and anatomical features. Damage to the brainstem tegmentum is known to cause coma, the most radical disturbance of consciousness. However, it has remained unclear which nuclei within the tegmentum are crucial for the maintenance of consciousness in humans. Accordingly, we initiated a retrospective study of MRIs obtained from 47 patients with brainstem stroke. The lesion boundaries were charted on patient MRIs and transferred onto a corresponding series of 4.7 T MRIs obtained from a control brainstem specimen that later was cut on a freezing microtome and analysed histologically. In addition, medical charts and available post-mortem materials were used to obtain relevant clinical and anatomical data to verify the MRI readings in each case. We found that in the 38 patients who did not have coma, brainstem damage either was located outside the tegmentum (n = 29) or produced a very small and unilateral compromise of the tegmentum (n = 9). In contrast, in patients who had coma (n = 9), the lesions in the tegmentum were mostly bilateral (n = 7) and were located either in the pons alone (n = 4) or in the upper pons and the midbrain (n = 5). The maximum overlap territory of the lesions coincided with the location of the rostral raphe complex, locus coeruleus, laterodorsal tegmental nucleus, nucleus pontis oralis, parabrachial nucleus and the white matter in between these nuclei. We also found that four coma subjects developed hyperthermia and died in the absence of any infections. In these cases, the maximum lesion overlap was centred in the core of pontine tegmentum. Our findings suggest that lesions confined to the upper pons can cause coma in humans even in the absence of damage to the midbrain. The findings also point to the brainstem nuclei whose lesions are likely to be associated with loss of consciousness and fatal hyperthermia in humans.

Adult↗

Dissociable neural systems for recognizing emotions.

This study tested the hypothesis that the recognition of emotions would draw upon anatomically separable brain regions, depending on whether the stimuli were static or explicitly conveyed information regarding actions. We investigated the hypothesis in a rare subject with extensive bilateral brain lesions, patient B., by administering tasks that assessed recognition and naming of emotions from visual and verbal stimuli, some of which depicted actions and some of which did not. B. could not recognize any primary emotion other than happiness, when emotions were shown as static images or given as single verbal labels. By contrast, with the notable exception of disgust, he correctly recognized primary emotions from dynamic displays of facial expressions as well as from stories that described actions. Our findings are consistent with the idea that information about actions is processed in occipitoparietal and dorsal frontal cortices, all of which are intact in B.'s brain. Such information subsequently would be linked to knowledge about emotions that depends on structures mapping somatic states, many of which are also intact in B.'s brain. However, one of these somatosensory structures, the insula, is bilaterally damaged, perhaps accounting for B.'s uniformly impaired recognition of disgust (from both static and action stimuli). Other structures that are damaged in B.'s brain, including bilateral inferior and anterior temporal lobe and medial frontal cortices, appear to be critical for linking perception of static stimuli to recognition of emotions. Thus the retrieval of knowledge regarding emotions draws upon widely distributed and partly distinct sets of neural structures, depending on the attributes of the stimulus.

Affect↗

Role of the amygdala in decision-making.

The somatic marker hypothesis proposes that both the amygdala and the orbitofrontal cortex are parts of a neural circuit critical for judgment and decision-making. Although both structures couple exteroceptive sensory information with interoceptive information concerning somatic/emotional states, they do so at different levels, thus making different contributions to the process. We define "primary inducers" as stimuli that unconditionally, or through learning (e.g., conditioning and semantic knowledge), can (perceptually or subliminally) produce states that are pleasurable or aversive. Encountering a fear object (e.g., a snake), a stimulus predictive of a snake, or semantic information such as winning or losing a large sum of money are all examples of primary inducers. "Secondary inducers" are entities generated by the recall of a personal or hypothetical emotional event or perceiving a primary inducer that generates "thoughts" and "memories" about the inducer, all of which, when they are brought to memory, elicit a somatic state. The episodic memory of encountering a snake, losing a large sum of money, imagining the gain of a large sum of money, or hearing or looking at primary inducers that bring to memory "thoughts" pertaining to an emotional event are all examples of secondary inducers. We present evidence in support of the hypothesis that the amygdala is a critical substrate in the neural system necessary for triggering somatic states from primary inducers. The ventromedial cortex is a critical substrate in the neural system necessary for the triggering of somatic states from secondary inducers. The amygdala system is a priori a necessary step for the normal development of the orbitofrontal system for triggering somatic states from secondary inducers. However, once this orbitofrontal system is developed, the induction of somatic states by secondary inducers via the orbitofrontal system is less dependent on the amygdala system. Perhaps the amygdala is equivalent to the hippocampus with regard to emotions, that is, necessary for acquiring new emotional attributes (anterograde emotions), but not for retrieving old emotional attributes (retrograde emotions). Given the numerous lesion and functional neuroimaging studies illustrating the involvement of the amygdala in complex cognitive and behavioral functions, including "social cognition," we suggest that this involvement is a manifestation of a more fundamental function mediated by the amygdala, which is to couple stimuli/entities with their emotional attributes, that is, the processing of somatic states from primary inducers.

Amygdala↗