Biomedical subjects

D Tranel

Publications and source records attributed to D Tranel.

At least 37 records · Page 2Linked to original sources

PubMed2000

Effects of early onset brain injury on the development of cognition and behavior: introduction to the special issue.

The effects of brain injury acquired early in life on the development of cognition and behavior are not well understood. Deciphering these effects and modeling their neurodevelopmental trajectories are major concerns for clinicians and scientists. Historically, a prevailing notion has been that early-onset brain damage has a more favorable prognosis than does brain damage acquired in adulthood. However, there is growing evidence suggesting that early-onset damage to prefrontal brain structures may have devastating consequences on the emergence of adaptive behavior throughout development. Particularly prominent are disorders of personality, social behavior, and executive functions such as planning and decision making. This special issue presents a series of new empirical studies that address these issues in depth, from several different perspectives, and in both human and animal participants. The findings promise to shed further light on both the neurobiology of development, and diverse neurodevelopmental disorders. Such advances may also enhance clinical diagnosis and facilitate the design of more effective interventions to help reduce the tremendous burden that neurodevelopmental disorders place on personal well-being, family structure, educational systems, and social resources.

Adolescent↗

PubMed2000

Long-term sequelae of prefrontal cortex damage acquired in early childhood.

Frontal lobe dysfunction is often invoked as a contributing factor in developmental disorders characterized by chronic maladaptive behavior, but interpretation of relevant neuropsychological findings has been hampered by the limited information available regarding the consequences of focal prefrontal damage early in life. We describe here the long-term behavioral and cognitive sequelae of damage to prefrontal cortex in two young adult patients who had sustained their brain damage prior to 16 months of age. In the context of normal neurological examinations, both cases had remarkable histories of impaired decision making, behavioral dyscontrol, social defects, and abnormal emotion. Performances were primarily normal on a broad range of neuropsychological measures (intellect, memory, language, academic achievement, visual perception, and visuoconstruction), but selective impairments of executive function were evident. Early dysfunction in the prefrontal region may result in severe and chronic social maladjustment despite largely normal cognitive abilities. These findings can help inform neuropsychological evaluation of patients with possible prefrontal dysfunction in the setting of developmental disabilities or early brain trauma.

Adult↗

PubMed2000

Acquired personality disturbances associated with bilateral damage to the ventromedial prefrontal region.

Personality changes in 7 participants with bilateral ventromedial prefrontal lesions (PF-BVM), 14 participants with prefrontal lesions but not bilateral ventromedial involvement (PF-NBVM), and 36 with nonprefrontal lesions (NPF) were investigated with the Iowa Rating Scales of Personality Change. Informants rated 30 specific characteristics for degree of disturbance and change from premorbid personality. PF-BVM participants showed a higher rate of acquired disturbances than NPF participants in blunted emotional experience, apathy, low emotional expressiveness, inappropriate affect, poor frustration tolerance, irritability, lability, indecisiveness, poor judgment, social inappropriateness, lack of planning, lack of initiation and persistence, and lack of insight. Differences between the PF-BVM and PF-NBVM groups were significant for several of these characteristics. All 7 PF-BVM participants developed a syndrome, including general dampening of emotional experience; poorly modulated emotional reactions; defective decision making, especially in the social realm; impaired goal-directed behavior; and striking lack of insight. Similarities between this syndrome of "acquired sociopathy" and developmental psychopathy in characteristic personality disturbances and psychophysiological abnormalities suggest that diminished emotionality, impaired decision making, and psychosocial dysfunction may be related to ventromedial prefrontal dysfunction in both groups.

Aged↗

PubMed1999

Frontal lobe lesions and electrodermal activity: effects of significance.

Several studies have shown that cortical damage, especially to the right hemisphere and to frontal lobes, may attenuate skin conductance responses selectively to psychologically significant stimuli. We tested this hypothesis in 32 patients with frontal lesions, verified by computer assisted tomography and magnetic resonance imaging, and 45 healthy controls. Patients and controls were given a protocol which included a rest period, a series of innocuous tones, and a reaction time task. Patients were given a second protocol in which they viewed slides with positive and negative emotional content and neutral slides. Results showed attenuated electrodermal activity (EDA) during task instructions and smaller skin conductance responses to reaction-time stimuli in patients compared to controls but few differences under passive conditions or in orienting responses to simple tones. Patients with lateral prefrontal and paraventricular lesions were especially low in EDA in the reaction time task, and those with right and bilateral lesions in the cingulate gyrus and/or frontal operculum had attenuated EDA in both protocols. We conclude that the effects of certain frontal lesions are on the psychological response to significance which is indexed by EDA rather than directly on EDA per se.

Adult↗

PubMed1999

Intact recognition of emotional prosody following amygdala damage.

Bilateral damage to the amygdala in a variety of animal species can impair emotional reactions to stimuli in several sensory modalities. Such damage in humans impairs visual recognition of emotion in facial expressions, but possible impairments in modalities other than vision have not been sufficiently explored. We examined two subjects with complete bilateral amygdala damage, and seven with unilateral amygdala damage, on a standardized task of emotional prosody recognition. The data were compared to those from 15 brain-damaged and from 14 normal control subjects. One of the bilateral amygdala subjects, whose lesions were restricted to the amygdala, was entirely normal in recognizing emotion in prosody on all tasks, the other, whose damage included substantial lesions also in extra-amygdalar structures, especially in right hemisphere, was normal on most, albeit not all, measures of emotional prosody recognition. We suggest that the human amygdala's role in recognizing emotion in prosody may not be as critical as it is for facial expressions, and that extra-amygdalar structures in right hemisphere may be more important for recognizing emotional prosody. It remains possible that recognition of emotion in classes of auditory stimuli other than prosody will require the amygdala.

Adult↗

PubMed1999

Recognition of facial emotion in nine individuals with bilateral amygdala damage.

Findings from several case studies have shown that bilateral amygdala damage impairs recognition of emotions in facial expressions, especially fear. However, one study did not find such an impairment, and, in general, comparison across studies has been made difficult because of the different stimuli and tasks employed. In a collaborative study to facilitate such comparisons, we report here the recognition of emotional facial expressions in nine subjects with bilateral amygdala damage, using a sensitive and quantitative assessment. Compared to controls, the subjects as a group were significantly impaired in recognizing fear, although individual performances ranged from severely impaired to essentially normal. Most subjects were impaired on several negative emotions in addition to fear, but no subject was impaired in recognizing happy expressions. An analysis of response consistency showed that impaired recognition of fear could not be attributed simply to mistaking fear for another emotion. While it remains unclear why some subjects with amygdala damage included here are not impaired on our task, the results overall are consistent with the idea that the amygdala plays an important role in triggering knowledge related to threat and danger signaled by facial expressions.

Adult↗

PubMed1999

Impairment of social and moral behavior related to early damage in human prefrontal cortex.

The long-term consequences of early prefrontal cortex lesions occurring before 16 months were investigated in two adults. As is the case when such damage occurs in adulthood, the two early-onset patients had severely impaired social behavior despite normal basic cognitive abilities, and showed insensitivity to future consequences of decisions, defective autonomic responses to punishment contingencies and failure to respond to behavioral interventions. Unlike adult-onset patients, however, the two patients had defective social and moral reasoning, suggesting that the acquisition of complex social conventions and moral rules had been impaired. Thus early-onset prefrontal damage resulted in a syndrome resembling psychopathy.

Adult↗

PubMed1999

Preferences for visual stimuli following amygdala damage.

Bilateral damage to the human amygdala impairs retrieval of emotional and social information from faces. An important unanswered question concerns the specificity of the impairment for faces. To address this question, we examined preferences for a broad class of visual stimuli in two subjects with complete bilateral amygdala damage, both of whom were impaired in judgments of faces. Relative to controls, the subjects showed a positive bias for simple nonsense figures, color patterns, three-dimensional-looking objects and landscapes. The impairment was most pronounced in regard to those stimuli that are normally liked the least. The human amygdala thus appears to play a general role in guiding preferences for visual stimuli that are normally judged to be aversive.

Adult↗

PubMed1998

The human amygdala in social judgment.

Studies in animals have implicated the amygdala in emotional and social behaviours, especially those related to fear and aggression. Although lesion and functional imaging studies in humans have demonstrated the amygdala's participation in recognizing emotional facial expressions, its role in human social behaviour has remained unclear. We report here our investigation into the hypothesis that the human amygdala is required for accurate social judgments of other individuals on the basis of their facial appearance. We asked three subjects with complete bilateral amygdala damage to judge faces of unfamiliar people with respect to two attributes important in real-life social encounters: approachability and trustworthiness. All three subjects judged unfamiliar individuals to be more approachable and more trustworthy than did control subjects. The impairment was most striking for faces to which normal subjects assign the most negative ratings: unapproachable and untrustworthy looking individuals. Additional investigations revealed that the impairment does not extend to judging verbal descriptions of people. The amygdala appears to be an important component of the neural systems that help retrieve socially relevant knowledge on the basis of facial appearance.

Adult↗

PubMed1998

Dissociation Of working memory from decision making within the human prefrontal cortex.

We tested the hypothesis that cognitive functions related to working memory (assessed with delay tasks) are distinct from those related to decision making (assessed with a gambling task), and that working memory and decision making depend in part on separate anatomical substrates. Normal controls (n = 21), subjects with lesions in the ventromedial (VM) (n = 9) or dorsolateral/high mesial (DL/M) prefrontal cortices (n = 10), performed on (1) modified delay tasks that assess working memory and (2) a gambling task designed to measure decision making. VM subjects with more anterior lesions (n = 4) performed defectively on the gambling but not the delay task. VM subjects with more posterior lesions (n = 5) were impaired on both tasks. Right DL/M subjects were impaired on the delay task but not the gambling task. Left DL/M subjects were not impaired on either task. The findings reveal a cognitive and anatomic double dissociation between deficits in decision making (anterior VM) and working memory (right DL/M). This presents the first direct evidence of such effects in humans using the lesion method and underscores the special importance of the VM prefrontal region in decision making, independent of a direct role in working memory.

Adult↗

PubMed1998

Intact recognition of facial emotion in Parkinson's disease.

Although the basal ganglia have been shown to be critical for the expression of emotion in prosody and facial expressions, it is unclear whether they are also critical for recognition of emotions. Selective pathology of parts of the basal ganglia is a hallmark of individuals with Parkinson's disease, and such patients have been examined in several studies of emotion. We examined 18 patients with Parkinson's disease (11 men, 7 women) and 13 age-, education-, gender ratio-, and IQ-matched normal controls on their ability to recognize emotions signaled by facial expressions. Parkinson's patients performed entirely normally on a quantitative task of recognizing emotional facial expressions. The findings do not support the notion that the sectors of basal ganglia that are dysfunctional in Parkinson's disease are essential for recognizing emotion in facial expressions.

Adult↗

PubMed1997

Deciding advantageously before knowing the advantageous strategy.

Deciding advantageously in a complex situation is thought to require overt reasoning on declarative knowledge, namely, on facts pertaining to premises, options for action, and outcomes of actions that embody the pertinent previous experience. An alternative possibility was investigated: that overt reasoning is preceded by a nonconscious biasing step that uses neural systems other than those that support declarative knowledge. Normal participants and patients with prefrontal damage and decision-making defects performed a gambling task in which behavioral, psychophysiological, and self-account measures were obtained in parallel. Normals began to choose advantageously before they realized which strategy worked best, whereas prefrontal patients continued to choose disadvantageously even after they knew the correct strategy. Moreover, normals began to generate anticipatory skin conductance responses (SCRs) whenever they pondered a choice that turned out to be risky, before they knew explicitly that it was a risky choice, whereas patients never developed anticipatory SCRs, although some eventually realized which choices were risky. The results suggest that, in normal individuals, nonconscious biases guide behavior before conscious knowledge does. Without the help of such biases, overt knowledge may be insufficient to ensure advantageous behavior.

Aged↗

PubMed1997

A neural basis for the retrieval of conceptual knowledge.

Both clinical reports and systematic neuropsychological studies have shown that patients with damage to selected brain sites develop defects in the retrieval of conceptual knowledge for various concrete entities, leading to the hypothesis that the retrieval of knowledge for entities from different conceptual categories depends on partially segregated large-scale neural systems. To test this hypothesis, 116 subjects with focal, unilateral lesions to various sectors of the telencephalon, and 55 matched controls, were studied with a procedure which required the visual recognition of entities from three categories--unique persons, non-unique animals and non-unique tools. Defective recognition of persons was associated with maximal lesion overlap in right temporal polar region; defective recognition of animals was associated with maximal lesion overlap in right mesial occipital/ventral temporal region and also in left mesial occipital region; and defective recognition of tools was associated with maximal lesion overlap in the occipital-temporal-parietal junction of the left hemisphere. The findings support the hypothesis that the normal retrieval of knowledge for concrete entities from different conceptual domains depends on partially segregated neural systems. These sites may operate as catalysts for the retrieval of the multidimensional aspects of knowledge which are necessary and sufficient for the mental representation of a concept of a given entity.

Agnosia↗

PubMed1997

Explaining category-related effects in the retrieval of conceptual and lexical knowledge for concrete entities: operationalization and analysis of factors.

Category-related effects in the retrieval of conceptual and lexical knowledge for concrete entities have been well documented in lesion studies, and also with functional imaging and electrophysiological approaches. For example, brain-damaged subjects may be impaired in the ability to recognize or to name animals but not tools, or the opposite pattern may obtain. One reason for these dissociations is that different patterns of defects tend to be caused by distinct lesion profiles, suggesting a relative tendency for certain neural systems to be involved in category-related knowledge. But we and others have also hypothesized that a variety of traits of concrete entities co-determine category-related dissociations. Such traits ('factors') include homomorphy (similarity of form), familiarity, value to perceiver, manipulability, characteristic motion, characteristic sensory modality of transaction (vision, touch, hearing), and typical age of acquisition. It is our view that the mix of factors relative to different conceptual categories plays a key role in the neuroanatomical distribution of records for those different categories, and is thus behind the systematic correlations between certain retrieval defects and damage to certain neural systems [12, 52]. In this study, we operationalized these factors and analyzed their intercorrelations. Stimuli were slides of 215 items from the conceptual categories of animals, fruits/vegetables, tools/utensils, vehicles, and musical instruments. The factors were operationalized on the basis of ratings obtained from 227 normal control subjects and on the basis of computer analyses of the digitized outlines of the stimuli. Principal components analysis revealed that 81% of the variability across items could be accounted for by three components: Component 1 (practically useful, common items): high value to perceiver, tactile mode of transaction, high familiarity, low age of acquisition; Component 2 (homomorphic, non-manipulable items): high homomorphy, low characteristic motion and manipulability; Component 3 (items with characteristic sound): hearing mode of transaction, highly distinctive sounds. In another analysis, we found that the categories of animals versus tools/utensils differed significantly on the factors of homomorphy, familiarity, value, manipulability, characteristic motion, and touch. The factor structure we identified in this study may help explain category-related performance defects in brain-damaged subjects. The results lend support to our proposal that systematic differences in physical characteristics and contextual specification of concrete entities constitute a driving force behind the regionalization of neural systems related to the acquisition and retrieval of conceptual and lexical knowledge.

Adolescent↗

PubMed1997

Memory performance after head injury: contributions of malingering, litigation status, psychological factors, and medication use.

Impaired memory test performance can reflect a host of factors, such as head injury/postconcussive syndrome, involvement in litigation, malingering behavior, psychological distress, and medication use. Such factors are important in interpreting memory test performances in patients referred in the context of litigation. We examined memory test performance in mild head-injured patients in litigation, mild to moderate head-injured patients not in litigation, severely head-injured patients not in litigation, depressed patients, and patients with somatization disorders. Findings showed that several memory tests were useful in distinguishing probable malingerers from the other groups. There was a complex interaction among malingering status, psychological status, and medication use in the prediction of memory test results. Although nonneurological factors were related to memory impairment, litigation status alone was not predictive of memory performance. The results emphasize the need to consider nonneurological factors in the interpretation of poor memory performance in patients seen for forensic evaluation.

Adult↗

PubMed1997

Standardized stimuli and procedures for investigating the retrieval of lexical and conceptual knowledge for actions.

We have developed a set of naming and recognition tests for evaluating the retrieval of lexical and conceptual knowledge for actions. As a first step, normative information about 280 items was collected for the following variables: (1) the naming responses elicited by each item, (2) the degree to which the image of each item agreed with a target name, (3) the familiarity to each depicted action, and (4) the visual complexity of each item. This information was used to develop administration and scoring procedures for a standardized test of action naming. The effectiveness and reliability of these procedures were evaluated in a second experiment. In a third experiment, five tests were developed to probe the retrieval of conceptual knowledge: (1) independently of the production of a naming response, (2) in response to pictorial and nonpictorial stimuli, (3) in terms of the attributes associated with specific actions, and (4) in terms of similarities and differences between various actions.

Humans↗

PubMed1996

Cortical systems for the recognition of emotion in facial expressions.

This study is part of an effort to map neural systems involved in the processing of emotion, and it focuses on the possible cortical components of the process of recognizing facial expressions. We hypothesized that the cortical systems most responsible for the recognition of emotional facial expressions would draw on discrete regions of right higher-order sensory cortices and that the recognition of specific emotions would depend on partially distinct system subsets of such cortical regions. We tested these hypotheses using lesion analysis in 37 subjects with focal brain damage. Subjects were asked to recognize facial expressions of six basic emotions: happiness, surprise, fear, anger, disgust, and sadness. Data were analyzed with a novel technique, based on three-dimensional reconstruction of brain images, in which anatomical description of surface lesions and task performance scores were jointly mapped onto a standard brain-space. We found that all subjects recognized happy expressions normally but that some subjects were impaired in recognizing negative emotions, especially fear and sadness. The cortical surface regions that best correlated with impaired recognition of emotion were in the right inferior parietal cortex and in the right mesial anterior infracalcarine cortex. We did not find impairments in recognizing any emotion in subjects with lesions restricted to the left hemisphere. These data provide evidence for a neural system important to processing facial expressions of some emotions, involving discrete visual and somatosensory cortical sectors in right hemisphere.

Adult↗

PubMed1996

A neural basis for lexical retrieval.

Two parallel studies using positron emission tomography, one conducted in neurological patients with brain lesions, the other in normal individuals, indicate that the normal process of retrieving words that denote concrete entities depends in part on multiple regions of the left cerebral hemisphere, located outside the classic language areas. Moreover, anatomically separable regions tends to process words for distinct kinds of items.

Adult↗