Category: Unusual case studies

Researchers have analysed the somniloquies of the world’s most prolific sleep talker

Album artwork for Dion McGregor Dreams Again

The “most extensive sleep talker ever recorded”, according to a new article in Imagination, Cognition and Personality, is the late American songwriter Dion McGregor. McGregor’s unusual sleeping behaviour – one commentator said he “sounds as if he were channeling Truman Capote on acid: flirtatious, slushy, disconnected from reality …” – first became public in the 1960s when McGregor shared a New York apartment with a posse of other artists and creative types. His song-writing partner and flat-mate, Mike Barr, became so fascinated by McGregor’s extensive somniloquies – most were over 100 words long – that he made more than 500 recordings of them, and they were released as a CD and book: The Dream World of Dion McGregor. Now a team of sleep experts led by Deirdre Barrett at Harvard Medical School have analysed 294 of these recordings to see how their content compares with typical dreams.

The researchers coded McGregor’s somniloquies for content using an established scale that is used for analysing dreams, and which includes checklists for characters, aggression, friendliness, sexual interaction, success, misfortune and good fortune. Then they used another scale that’s for coding the bizarreness of dreams, including elements of discontinuity (sudden changes in time and place or identity), incongruity (contradictions, such as saying a building has only one entrance, and then saying the building was entered a different way), and uncertainty and vagueness.

Compared with average dream scores on the scales, McGregor was more active in his somniloquies than most dreamers, while his sleep talk contained less aggression, less friendliness and less sex than usual dreams, fewer negative emotions, good fortune and success, but much more self-negativity and more female characters than is typical for men. His sleep talking was also less bizarre than the average dream, with fewer plot incongruities and contradictions.

The researchers provide this example to show a typical element in McGregor’s somniloquies, which while fantastical is not confused in plot or thought (unlike much typical dream content):

Oh, that doesn’t complete my collection at all! No! Oh no! Well let’s see, I have a dodo, and a rock, and a phoenix . . . oh dear! A pterodactyl, yes, the unicorn, the griffin, dear, oh yes, well a mermaid doesn’t count, she’s out in the pool! No . . . well, if she ever gets out I’m gonna mate her with the centaur! Yes! What do you think?! Certainly! Well, I don’t know. What do you think? Well, if you don’t mate them you know they’ll die off! (Tzadik Records, 1999, “The Collection”)

Album artwork for Dreaming Like Mad
With Dion McGregor

Other examples of content from McGregor’s sleep talking include him going door to door asking women if they have their favourite dress on, a roll call of people entering a hot air balloon for a moon trip (which ends after an encounter with sharp-beaked storks) and playing a game of “food roulette” with “a Lazy Susan of poisoned eclairs”.

The researchers think there are two explanations for the differences between McGregor’s somniloquies and typical dream content. One is that much sleep talking does not occur during dreams, and in fact people’s brain waves during sleep talking are distinct from those usually seen during dreaming, featuring fewer waves in the alpha frequency range, which they explained could be a sign of more frontal brain activity. The researchers further describe this as “an unusual state midway between waking and sleeping” (backing this up, there is a McGregor interview in which he says a sleep researcher recorded his brain activity during sleep talking and found a mix of sleep and waking brain wave patterns).

The other reason for the distinct content of McGregor’s somniloquies, the researchers believe, is simply to do with his personal characteristics: he was they say a quirky character with a self-deprecating sense of humour, he was likely homosexual, and he had an obsession with actresses (this last point could help explain the preponderance of female characters in his dreams). This perspective is consistent with the “continuity hypothesis” of dream content – the idea that “our actions and thoughts in everyday life also determine what we will dream about”.

Surprisingly little is known about the psychology and neuroscience of sleep talking and so this case study provides an intriguing addition to the literature. “Of course Dion McGregor is only one subject, so we can not generalise,” the researchers said, adding: “It would be interesting in future research to gather REM sleep-talking reports from a large sample of subjects to see if these differences from dream reports and continuities with waking traits consistently characterise talking from REM sleep.” For his part, McGregor was much more interested in his waking creative works (he sold songs to Barbara Streisand, among others) than his sleep talking: “it’s like being famous for wetting your bed,” he said.

_________________________________ ResearchBlogging.org

Barrett, D., Grayson, M., Oh, A., & Sogolow, Z. (2015). A Content Analysis of Dion McGregor’s Sleep-Talking Episodes Imagination, Cognition and Personality, 35 (1), 72-83 DOI: 10.1177/0276236615574495

further reading
This guy turned surreal sleep talking into a cult album
Here’s a really simple trick that could help you enjoy more lucid dreams
Does dreaming of exam failure affect your real-life chances of success?
Older people have more black and white dreams

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

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The man who saw a stranger in the mirror

The man was diagnosed with
Capgras syndrome

Mirrors easily call forth the uncanny: the vampire that casts no reflection; the figure who seems to appear in your periphery. Overtired or in an odd mood, I sometimes find myself scrutinising my own reflection, momentarily toying with the idea that it’s something independent, alive in its mirror space. So I was fascinated to read a short account published in the journal Neurocase of a 78-year-old man, referred to as Mr B to protect his privacy, who over the course of ten days, in place of his own reflection had repeatedly encountered a doppelganger in the mirror: a stranger who looked just like him, and knew all about him, but a stranger nonetheless. Eventually this figure “became aggressive” – the article doesn’t share any details – and it was presumably this change in tone that triggered Mr B’s admission to hospital.

Mr B, who had no history of psychiatric illness, was diagnosed with a form of Capgras syndrome. People with Capgras believe that one or more familiar people have been replaced by identical strangers, and it falls within the delusional misidentification syndrome, together with related conditions such as the Fregoli delusion: the belief that many people you encounter are actually a single deceiver in disguise. It’s likely that such delusions involve some degree of impairment in face processing, specifically the ability to process familiarity of other people’s faces: in Cagras the familiar feel somehow not (an experience undergirded by skin conductance response data); in Fregoli the many feel somehow the same. If this hypothesis bears out, these delusions could be seen as the complement – or mirror image – of prosopagnosia (also known as face-blindness), where explicit recognition of faces is impaired, but sufferers still retain their implicit feelings about faces, correctly guessing which belong to people they know.
What’s interesting about Mr B’s mirrored-Capgras, also called mirrored self-misidentification, is that the delusional judgment is applied to one’s own face. Evidence suggests that our brains process own-face information in a special way, suggesting that this particular experience reflects a specific brain impairment, rather than the delusion arbitrarily settling on one target rather than another. The authors of the Neurocase article don’t report too deeply on Mr B’s neurological symptoms, mentioning only some protein indicators consistent with Alzheimer’s Disease, and atrophy in chiefly posterior brain regions. We would expect some damage also within the dorsolateral prefrontal cortex, as this is typical in patients experiencing such delusions. This area is involved in evaluating beliefs, stepping in to question extreme or incoherent ideas.
Mr B was given antidepressant and antipsychotic medication in hospital, and three months later, he had recovered from his delusion: “Mr. B. explained that his double had gone.” It’s nearly Halloween, where we get to play tricks with the uncanny. Maybe spare a thought for the tricks that that the uncanny can play on us.

_________________________________ ResearchBlogging.org

Diard-Detoeuf, C., Desmidt, T., Mondon, K., & Graux, J. (2015). A case of Capgras syndrome with one’s own reflected image in a mirror Neurocase, 1-2 DOI: 10.1080/13554794.2015.1080847

Note: photograph is a stock image and does not portray Mr B. 

further reading
Who replaced all my things?
The stroke patient for whom strangers look normal whilst family look strange
The woman who mistook her daughters for her sisters

Post written by Alex Fradera (@alexfradera) for the BPS Research Digest.

Our free fortnightly email will keep you up-to-date with all the psychology research we digest: Sign up!

What the textbooks don’t tell you about psychology’s most famous case study

Image: Photograph by Jack Wilgus of
a daguerreotype of Phineas Gage
in the collection of Jack and Beverly Wilgus.

It’s a remarkable, mythical tale with lashings of gore – no wonder it’s a favourite of psychology students the world over. I’m talking about Phineas Gage, the nineteenth century railway worker who somehow survived the passing of a three-foot long tamping iron through the front of his brain and out the top of his head. What happened to him next?

If you turn to many of the leading introductory psychology textbooks (American ones, at least), you’ll find the wrong answer, or a misleading account. Richard Griggs, Emeritus Professor of Psychology at the University of Florida, has just analysed the content of 23 contemporary textbooks (either released or updated within the last couple of years), and he finds most of them contain distortions, omissions and inaccuracies.

It needn’t be so. Thanks to painstaking historical analysis of primary sources (by Malcolm Macmillan and Matthew Lena) – much of it published between 2000 and 2010 – and the discovery during the same time period of new photographic evidence of post-accident Gage (see image, right), it is now believed that Gage made a remarkable recovery from his terrible injuries. He ultimately emigrated to Chile where he worked as a horse-coach driver, controlling six horses at once and dealing politely with non-English speaking passengers. The latest simulations of his injury help explain his rehabilitation – it’s thought the iron rod passed through his left frontal lobe only, leaving his right lobe fully intact.

Image: From Van Horn et al 2012

Yet, the textbooks mostly tell a different story. Of the 21 that cover Gage, only 4 mention the years he worked in Chile. Only three detail his mental recovery. Fourteen of the books tell you about the first research that attempted to identify the extent of his brain injuries, but just four of the books give you the results from the most technically advanced effort, published in 2004, that first suggested his brain damage was limited to the left frontal lobe (watch video). Only 9 of the books feature either of the two photos to have emerged of Gage in recent times.

So the textbooks mostly won’t tell you about Gage’s rehabilitation, or provide you with the latest evidence on his injuries. Instead, you might hear how hear never worked again and became a vagrant, or that he became a circus freak for the rest of his life, showing off the holes in his head. “The most egregious error,” says Griggs, “seems to be that Gage survived for 20 years with the tamping iron embedded in his head!”.

Does any of this matter? Griggs argues strongly that it does. There are over one and half million students enrolled in introductory psychology courses in the US alone, and most of them are introduced to the subject via textbooks. We know from past work that psychology textbook coverage of other key cases and studies is also often distorted and inaccurate. Now we learn that psychology’s most famous case study is also misrepresented, potentially giving a misleading, overly simplistic impression about the effects of Gage’s brain damage. “It is important to the psychological teaching community to identify inaccuracies in our textbooks so that they can be corrected, and we as textbook authors and teachers do not continue to ‘give away’ false information about our discipline,” Griggs concludes.

_________________________________ ResearchBlogging.org

Griggs, R. (2015). Coverage of the Phineas Gage Story in Introductory Psychology Textbooks: Was Gage No Longer Gage? Teaching of Psychology, 42 (3), 195-202 DOI: 10.1177/0098628315587614

further reading
Phineas Gage – Unravelling the Myth
Coverage of Phineas Gage in “Great Myths of the Brain”
Glimpsed at last – the life of neuropsychology’s most important patient (Monsieur Leborgne)
Foundations of Sand – the lure of academic myths and their place in classic psychology.
Looking back: Blasts from the past

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Some perfectly healthy people can’t remember their own lives

Psychologists in Canada think they’ve identified an entirely new memory syndrome in healthy people characterised by a specific inability to re-live their past. This may sound like a form of amnesia, but the three individuals currently described have no history of brain damage or illness and have experienced no known recent psychological trauma or disturbance.

In light of the recent discovery that some people have an uncanny ability to recall their lives in extreme detail, known as hyperthymesia or “highly superior autobiographical memory“, Daniela Palombo and her team suggest their syndrome is at the opposite extreme and they propose the label “severely deficient autobiographical memory”.

The researchers describe three individuals with the postulated syndrome: AA is a 52-year-old married woman; BB is a 40-year-old single man; and CC is a 49-year-old man living with his partner. All three are high functioning in their everyday lives, they have jobs, yet they also claim a life-long inability to recollect and relive past events from a first-person perspective (a condition they became fully aware of in their late teens or early adulthood). Their memory for facts and skills is completely normal. Two of the individuals had experienced depression many years earlier, but there was no evidence of this persisting.

Through intense neuropsychological testing for intelligence, memory and mental performance, the three individuals mostly scored normally or higher than normal. One key exception was poor performance on the ability to draw a complex figure from memory. The researchers think this visual memory deficit could be key to understanding their lack of autobiographical memories.

To test their memories of their lives, the researchers interviewed AA, BB and CC about various incidents from their pasts – a mixture of questions about generic life events and also personal incidents the participants proposed themselves after looking at their calendars or consulting loved ones.

Compared to fifteen comparison participants (matched with the target participants for age and educational background), the impaired participants were able to provide significantly fewer autobiographical, first-person details from their teen and youth years. For more recent events, the impaired participants’ recall appeared more normal, but the researchers think this is due to a combination of conservative scoring (when in doubt the researchers scored reminisces as autobiographical in nature), and the participants having learned compensation strategies such as studying diaries and photos and substituting their lack of autobiographical memory for memory of facts and semantic detail.

From a subjective perspective, the impaired participants described their own memories of past events from both distant and more recent times as almost completely lacking a first-person perspective or involving any sense of “re-experiencing”. They also struggled to imagine future events, consistent with the idea that memory and future imagination involve shared mental processes.

Brain scans of the impaired participants uncovered no evidence of brain damage or illness, but when they attempted to recall autobiographical details from their pasts, there was less activity in key brain regions associated with autobiographical memory, compared with control participants. This included the medial prefrontal cortex and the precuneus and parts of the temporal lobes. The right-sided hippocampus (an important brain area for memory) was slightly smaller in the impaired participants compared with controls. Whether cause or consequence, this might be relevant to their deficits but it also argues against the new syndrome merely being an instance of “developmental amnesia”, which in contrast is characterised by a drastic lack of brain volume in areas involved in memory.

The researchers urge caution given their small sample, and they admit that many questions remain. Yet they state “there is no evidence to support a neurological or psychiatric explanation for our findings”. If this research generates enough interest, I wonder if other healthy people will come forward and describe their own absence of autobiographical memories. This is what’s happened with some other neuropsychological syndromes recently, such as “developmental prosopagnosia“, which is  the term for otherwise healthy people who have a specific difficulty remembering and recognising faces.

Palombo and her team say “our goal was to describe the ‘severely deficient autobiographical memory’ cases’ cognitive syndrome and associated neuroimaging findings in as much detail as possible in order to stimulate further research on the nature of individual differences in episodic autobiographical memory…”. A crucial question they note, is “whether these findings reflect an extreme on a continuum of ability in episodic autobiographical recollection, or, they may be qualitatively set apart from the normal distribution of mnemonic capacities.”

UPDATE: The researchers have a website www.deficientautobiographicalmemory.com providing information on this new syndrome; you can also take part in a survey there and join a forum to share your experiences.

_________________________________ ResearchBlogging.org

Palombo, D., Alain, C., Söderlund, H., Khuu, W., & Levine, B. (2015). Severely deficient autobiographical memory (SDAM) in healthy adults: A new mnemonic syndrome Neuropsychologia, 72, 105-118 DOI: 10.1016/j.neuropsychologia.2015.04.012

further reading
Remembering together – How long-term couples develop interconnected memory systems

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Neurosurgeons find small brain region that turns consciousness on and off, like the key in a car’s ignition

The 54-year-old epilepsy patient – her name remains concealed to protect her privacy – was lying on the operating table while surgeons explored inside her brain with electrodes. They were looking for the source of her epileptic seizures. Suddenly, after they applied electricity to a small region, buried deep, near the front of the brain, the woman froze and her eyes went blank. She was awake, but entirely unresponsive.

The precise area the surgeons had zapped included a sliver of tissue known as the claustrum, which is part of a network that supports awareness. Mohamad Koubeissi and his colleagues state that nobody has ever examined the effects of stimulating this specific brain region before, despite this kind of surgical procedure having been performed for decades. Just as geographers still surprise us with reports of having discovered previously unchartered parts of the earth, it takes one aback to hear of unexplored areas of neural terrain.

Intrigued by the woman’s response to the stimulation of this specific brain region, the surgeons investigated further. Ten further stimulations, and on every occasion zapping the claustrum had the same effect. By contrast, zapping an area just 2.7mm away did not.

Perhaps the woman was simply paralysed by the electrical stimulation? The effects are more intriguing than that. If given an instruction prior to the stimulation, such as words to utter or movements to make, she continued this for a few seconds after the stimulation began, but then descended into still, unresponsive stupor. It was also striking to observe that as soon as the stimulation ended, the woman regained consciousness. However, she had no memory of the preceding moments during the stimulation period.

The researchers also examined the synchronisation of activity across the brain during the stimulation of the claustrum. They found that it increased synchronisation across the brain, possibly to a debilitating level. If so, this would match the situation observed in epileptic seizures that trigger loss of consciousness.

Caution is required – after all, this is a single case study, and the patient in question was missing part of one hippocampus, removed during earlier treatment for epilepsy. Nonetheless this is an intriguing finding. “… [T]he disruption of consciousness that we herein describe has never been precipitated by electrical stimulation of any other site in the human brain,” the researchers said.

Speaking to New Scientist magazine, lead author Koubeissi likened the claustrum to a car’s ignition. While both the brain and the car are made up of many functioning parts, “…there’s only one spot where you turn the key and it all switches on and works together,” he told them. “So while consciousness is a complicated process created by many structures and networks – we may have found the key.” If these results can be replicated, the hope is that stimulation of the claustrum may offer a way to treat disorders of consciousness associated with epileptic seizures.

_________________________________ ResearchBlogging.org

Mohamad Z. Koubeissia, Fabrice Bartolomei, Abdelrahman Beltagy, Fabienne Picard. (2014). Electrical stimulation of a small brain area reversibly disrupts consciousness.  Epilepsy & Behavior Volume 37, August 2014, Pages 32–35

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Mirror writing: What does it reflect about how we all write?

Our story starts with a wheeze: a schoolboy punished with lines saves time by wielding two pens at once. Exploring the ease with which he can play with writing, what began as a diversion eventually becomes an artistic practice that incorporates mirrored and inverted script into paintings. What can investigation of this skill offer to science?

Mirror writing in Western script flows from right to left, writing first A, then l, e, x to produce xɘlA. It’s reported both in neurologically impaired patients and healthy practitioners such as Lewis Carroll, Leonardo da Vinci, and our own case participant, 65-year old “KB”.

This phenomenon is no mere curiosity. It challenges popular theory that says we have a mental programme for writing that represents the act step by step, from start to finish; a programme most practised with our dominant hand, but abstract enough to be available by other means. This account has empirical support: when we write from our shoulder to mark a large canvas, some handwriting flourishes are still preserved, and this is true even when we grip a pen with our teeth! The standard theory predicts that writing with our non-dominant hand would be somewhat awkward, and non-dominant mirror writing extremely so: the work of using an unpractised hand compounded by the additional need to remap this high-level recipe.

But the mirror-writing evidence simply doesn’t agree. Comparisons of static script produced by right-handed individuals with mirror-writing competence (such as KB, although his handedness is not clear-cut), shows that the closest thing to their normal handwriting (with their dominant hand) isn’t normal left-hand, or even mirrored-right, but mirrored left-hand script.

Now a team led by Robert McIntosh have gone further (pdf), using an electronic tablet to record the order, timing and nature of individual strokes of KB’s stylus. In terms of accuracy, speed, and similarity of stylus-strokes, they found that KB’s mirrored-left writing is the best match to his natural writing, confirming and strengthening the data to date.

Perhaps KB’s mirrored left-hand writing is so assured simply because it’s the most practised. To address this, the researchers looked at upside-down writing, a much more recent addition to his repertoire. Left-mirrored was again the best match to right-forward – even though neither look that similar to upright right-forward.

This new investigation with KB supports the idea that writing is not stored as universal coordinates, but instead as movements relative to body position: a capital “A” beginning with an “up and away from the body” pen-stroke. This is why writing with our non-dominant hand is awkward, as every stroke violates these principles, even though its output is “the right way around” perceptually. Indeed, mirror-writers including KB show little fluency or appetite for reading mirrored text, suggesting that motor and perceptual representations of writing are rather different.

KB is part of a small breed – the deliberate mirror-writer – and McIntosh’s team are interested in taking this methodology to other populations, both healthy and neurologically impaired, to see whether this vision of mirror-writing is reflected elsewhere.

 _________________________________

  ResearchBlogging.orgMcIntosh RD, De Lucia N, Della Sala S. (2014) Mirror man: a case of skilled deliberate mirror writing. Cognitive Neuropsychology.

-further reading-
Mirror-writing: Robert D. McIntosh and Sergio Della Sala explore some intriguing phenomena (in The Psychologist magazine).
Your brain unscrambles words in the mirror but then switches them back again.

Post written by Alex Fradera (@alexfradera) for the BPS Research Digest.
Image: Christian Jarrett

Targeted brain stimulation provokes feelings of bliss

It’s hard to fathom how our subjective lives can be rooted in the spongy flesh of brain matter. Yet the reality of the brain-mind link was made stark half way through the last century by the Canadian neurosurgeon Wilder Penfield. Before conducting neurosurgery on epilepsy patients he stimulated parts of their brains directly with an electrode, triggering in them subjective sensations that varied according to the source of stimulation.

In a new case study, a team of Swiss and French neurologists followed a similar strategy during brain surgery with a 23-year-old female patient. She has temporal lobe epilepsy and experiences “ecstatic auras” before seizure onset. During these periods she has “intense feelings of bliss and well-being”, a floating sensation in her stomach, enhanced senses and time appears to contract.

Fabienne Picard and his colleagues stimulated different parts of the woman’s temporal lobes with electrodes to try to find the precise source of her epileptic seizures. In fact none of their stimulations caused her to have a seizure. However they did observe some intriguing subjective experiences in the woman. When they stimulated her anterior-dorsal insula – a brain region implicated in many functions, including representing the internal state of the body – she experienced the same feelings of bliss and ecstasy that she reports prior to a seizure. “I feel really well with a very pleasant funny sensation of floating and a sweet shiver in my arms,” she said. Such sensations were not triggered by stimulation in any other part of her temporal lobe.

Prior research has shown that stimulation of other brain regions, including the amygdala and other parts of the insula, can evoke pleasant memories and pleasant sensory experiences, but the researchers said theirs is the first ever account of neurostimulation leading to feelings of bliss or ecstasy. It complements brain imaging research that has found correlations between anterior insula activity and feelings of intense love and joy, and also oneness with God.

It’s important not to be lulled into thinking this case study has helped identify the brain’s “pleasure centre”. Many parts of the brain are involved in motivation and hedonic experience. Stimulation of the nucleus accumbens, part of the brain’s so-called “reward pathway”, is being explored as a treatment for depression (although it has not been linked with the sensations of bliss reported here). Research also shows that rats will press a lever for hundreds of hours so as to receive stimulation of the nucleus accumbens, but it’s thought this stimulation may trigger wanting and craving rather than pleasure per se. Activity in orbitofrontal cortex (at the front and bottom of the brain) has been associated with enjoyment of food and other sensory pleasures.

With that caveat aside, this case study makes a useful contribution. “Our findings, if reproduced in future studies, should aid in the understanding of the brain mechanisms causing feelings of happiness/bliss, whether they are elicited externally (for example, by highly positive emotional stimuli) or internally (for example, by religious or deep meditative states, or by seizures),” the researchers said.

_________________________________ ResearchBlogging.org

Fabienne Picard, Didier Scavarda, and Fabrice Bartolomei (2013). Induction of a sense of bliss by electrical stimulation of the anterior insula. Cortex DOI: 10.1016/j.cortex.2013.08.013

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

The man who says his smelly hallucinations predict the weather

A 64-year-old man with Parkinson’s Disease has been putting on weight these last five years. It’s hard not to because he’s found that eating brings him relief from unpleasant phantom odours.

Things are normal when he wakes up each day, but as time progresses he comes to experience an increasingly intense smell of skunk excrement mixed with onion. Stranger still, he’s found that on a 0-10 scale the stench intensifies from 0 to 7-10 in the few hours preceding a storm. Writing in the International Journal of Biometeorology, S.R. Aiello at the University of Michigan-Ann Arbor and Alan Hirsch at the Smell and Taste Treatment and Research Foundation state that this is the “first reported case of weather-induced exacerbation of phantosmia.”

Apart from a pending storm, other factors that intensify the man’s odour hallucinations include “coughing, nasal congestion, and tiredness”. Relief comes not just from eating but also “watching TV, nasal irrigation … occluding the nostrils … snorting salt water, blowing of the nose, laughing … humming and talking.”

Aiello and Hirsch conducted extensive tests of the patient’s smelling abilities and found him to be significantly impaired. This is consistent with a diagnosis of Parkinson’s Disease and makes sense in terms of his hallucinations, the researchers explained, because “impaired ability to smell allows disinhibition of spontaneous olfactory discharge.”

The researchers present several possible explanations for why the man’s phantom smells intensify prior to a storm: a drop in atmospheric pressure could further impair his sense of smell, thus disinhibiting his phantosmia; if his olfactory nerves (involved in smell) are damaged in some way, a lower atmospheric pressure may cause contractions of the scar tissue, exacerbating the hallucination that way; or the weather changes prior to a storm could lower the man’s mood, perhaps intensifying his focus on his unpleasant hallucinations.

Unfortunately, Aiello and Hirsch didn’t actually test the veracity of the man’s claims about his storm predicting abilities. This leads them to admit: “the weather dependent phantosmia may not truly exist, but rather may be a misattribution error.”

Just as we tend to remember all those times that we received a phone call from a friend or relative just when we were thinking of them – but none of the more numerous times when we weren’t – perhaps this patient’s purported forecasting ability is a trick of memory. This explanation is supported by the fact that twenty years earlier the patient claimed to predict the weather based on worsening of pain in a torn cartilage. This history may have led him to expect other sensory experiences to be weather-related and to seek out meteorological associations with his phantom smells that may not be real.

_________________________________ ResearchBlogging.org

Aiello SR, and Hirsch AR (2013). Phantosmia as a meteorological forecaster. International journal of biometeorology, 57 (5), 813-5 PMID: 23456373

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Glimpsed at last – the life of neuropsychology’s most important patient

Leborgne’s brain

Monsieur Leborgne, nicknamed Tan Tan, for that was the only syllable he could utter (save for a swear word or two), died in the care of the neurologist Paul Broca in Paris on April 17, 1861. Arguably the most important case in the history of neuropsychology, Leborgne’s death coincided with a debate raging in scholarly circles about the location of language function in the brain. When Broca autopsied Leborgne’s brain, he observed a malformation on the left frontal lobe – “Broca’s area” – and concluded this was the site of speech production, a moment that the historian Stanley Finger has described as a “key turning point in the history of the brain sciences”.

Broca was far from being the first person to propose that speech function is located in the frontal lobes, but crucially, the evidence from Leborgne helped him persuade the academic community. For centuries experts had believed mental functions were located in the brain’s hollows; that the cortex (“husk” in Latin) was little more than a rind of tissue and blood vessels. Today, problems producing language are still termed Broca’s aphasia in recognition of Broca’s landmark contribution, although Broca in fact named Leborgne’s problems aphémie (meaning “without speech”). The Greek term “aphasia” (also meaning “speechlessness”), adopted by medicine, was coined in Broca’s day by the physician Armand Trousseau.

Far more is known about Gage’s life

In terms of the historical record, Leborgne is like a mirror opposite of Phineas Gage – another of neuropsychology’s legendary cases. The story of Gage’s life and infamous accident, in which a tamping iron shot through his brain, has been researched in-depth, inspiring books, poems, YouTube skits and snowmen makers along the way. Yet relatively little is known about the brain damage Gage suffered because no autopsy was performed when he died and his brain was never preserved (that hasn’t stopped scientists from attempting to simulate the likely damage).

In contrast, Broca was careful to save Leborgne’s brain for posterity. He decided against a full dissection, performing a surface examination only. Today the preserved organ is housed at the Musée Dupuytren museum in Paris, where Broca placed it. The brain has been scanned numerous times using modern methods (e.g. PDF), allowing detailed analysis of the location and nature of any lesions. We now know that the frontal lobe damage to Leborgne’s brain was more extensive and deeper than Broca had realised based on his superficial examinations. But, contra the situation with Gage, while we are well-informed about Leborgne’s brain, before now his identity and life story have remained largely mysterious. Broca’s medical notes revealed little.

Thankfully, in a new paper, Cezary Domanski at Maria Curie-Sklodowska University in Poland has used archive registers in France to uncover hitherto unknown detailed biographical information about Monsieur Leborgne. Born in Moret-sur-Loing – the picturesque town that inspired Monet and other impressionists – “Tan’s” full name was Louis Victor Leborgne. He was the son of Pierre Christophe Leborgne, a school teacher, and Margueritte Savard. He had three older siblings, Lucille, Pierre and Anne, and two younger siblings, Arsene and Louise.

An epileptic since his youth, it was Leborgne’s loss of speech that led to him being hospitalised at age 30. Unmarried, he ended up spending the remaining 21 years of his life in hospital. Before this incapacitation through illness, Domanski tells us Leborgne was a “formier” in Paris, a kind of skilled craftsman who made the wooden forms used by shoemakers in their work.  Together with the information on Leborgne’s family, this news corrects at least one historical myth. The oft-told idea that Leborgne “was an uneducated illiterate from the lower social class should once and for all be deemed erroneous,” writes Domanski.

Based on his inquiries, the Polish historian offers an intriguing speculation – given that Leborgne’s birthplace of Moret was home to several tanneries, Domanski wonders if his repeated utterance of Tan was somehow connected to childhood memories of the pretty town.

“One thing remains certain,” Domanski concludes, “The memory of the disease and cause of death of ‘Monsieur Leborgne’ proved far more enduring than the story of his life, which was deemed irrelevant even when the patient was still alive. It is time for Louis Victor Leborgne to regain his identity …”.

In 2009, out of the blue, a photograph was discovered of Phineas Gage. I wonder if we will ever look upon an image of Leborgne?

_________________________________ ResearchBlogging.org

Domanski CW (2013). Mysterious “Monsieur Leborgne”: The Mystery of the Famous Patient in the History of Neuropsychology is Explained. Journal of the history of the neurosciences, 22 (1), 47-52 PMID: 23323531

–Further reading– 
500 Francs Says Language Is Housed in the Frontal Lobes!
Speaking without Broca’s area
Broca’s area: Nomenclature, anatomy, typology and asymmetry

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

What’s it like to be face-blind?

Most of us take the ability to recognise each other for granted. What must it be like to go through life unable to identify and distinguish people based on their facial appearance?

Some idea comes from a new, candid first-person account written for the journal Cognitive Neuropsychology by a doctor about his life-long face-blindness (known formally as prosopagnosia). It’s a problem he didn’t even realise he had for 30 years, and which he only discovered was a neuropsychological condition in 2006, when he was diagnosed for the first time. “It now seems remarkable that I lived at least half my life with a socially disabling condition of which not only myself, but also those around me, seemed unaware,” writes Dr David Roger Fine, a gastroenterologist at the University of Southampton.

Looking back at his childhood, Fine realises that he can remember school buildings with detail, the clothes worn by his male friends, the hairstyles of the girls – but no faces. He got into difficulties in the playground confusing “high- and low- status boys”, and was admonished for not raising his cap to his form teacher when he encountered her out of context and so failed to recognise her.

At senior school he made friends with a close-knit group, all of whom were physically distinctive and so easy to distinguish. In his professional life, Fine describes how there are some situations where his condition doesn’t matter – such as committee meetings, where everyone keeps the same seat, and when he’s giving a conference presentation. His job as a hospital doctor also involves distinct spatial areas of work and he uses these environmental contexts to help him judge who he is likely to encounter at any given time. Nonetheless, he often walks right past colleagues, earning him a reputation as capricious and aloof. More than once he’s been mislabeled as having Asperger’s.

In his personal life, before marriage, romantic liaisons were especially problematic. Although women often dress in more distinctive ways than men, they also vary their appearance more often, for example changing their hair style and make-up after work. “It seemed to me that girls popped out of the Ether in one place then disappeared perhaps for months or even years before reappearing in another place, often disgruntled,” he says.

Before his wife became his companion and minder, parties were particularly awkward and stressful. “I once met and had a long conversation with a man at a Christmas party,” Fine recalls. “We circulated until we met again at the other side of the room and I introduced myself [again]. He looked puzzled until my wife came to my rescue.” Making friends is nigh on impossible. “Recognising” strangers is a constant embarrassing risk.

Fine has had a successful career in spite of his prosopagnosia, but he feels his success was “blunted” by the condition. Now aged 60 he has highly developed strategies for coping – he has a better sense of people’s age, which is one of the criteria he uses to distinguish people. The ethnic mix of modern Britain also helps. And he tries to focus on distinct items of jewellery, such as people’s rings, that tend to be worn at all times. The increased popularity of tattoos is another help, although it can cause problems too – one female colleague with a tattoo low on her chest visible in summer clothes “caused consternation in the corridor [one winter] as she unbuttoned her blouse by way of identification.”

Looking to the future, Fine is worried that his confusion about people’s identity could lead to him being misdiagnosed with dementia. “During a recent hospital stay I asked the nurses to introduce themselves every time, as I was concerned that I might be misdiagnosed as confused if I muddled them up.”

Experts used to think that the inability to recognise faces was a problem that nearly always arose after brain injury. In recent years, however, it’s become apparent that many people are born with face-blindness (or develop it early in life), with the prevalence estimated at two per cent of the population. Do you have the condition or know anyone who has? How do you/they cope?

_________________________________ ResearchBlogging.org

Fine, D. (2012). A life with prosopagnosia. Cognitive Neuropsychology, 1-6 DOI: 10.1080/02643294.2012.736377

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.