Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-20T00:34:56.129Z Has data issue: false hasContentIssue false

Disorders of facial recognition, social behaviour and affect after combined bilateral amygdalotomy and subcaudate tractotomy — a clinical and experimental study

Published online by Cambridge University Press:  09 July 2009

Robin Jacobson*
Affiliation:
Institute of Psychiarty, London
*
1 Address for correspondence: Dr R. R. Jacobson, St George's Hospital, Medical School, Jenner wing, Cranmer Terrace, London SW1 70RE.

Synopsis

Synopsis A case of a 37-year-old patient, 10 years after bilateral amygdalotomy and subcaudate tractotomy for chronic self-mutilation, is described. The clinical picture revealed a complex mental state, including disorders of facial recognition, social behaviour, affect and elements of the Kluver–Bucy syndrome. Mild selective deficits were demonstrated psychometrically in the recognition of familiar and unfamiliar faces. Certain features have been described in rhesus monkeys, but have not previously been reported in humans. Primate studies are discussed, with particular reference to the role of the amygdala in facial recognition.

Type
Case Report
Copyright
Copyright © Cambridge University Press 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acker, W. & Acker, C. F. (1982). Bexley–Maudsley Automated Psychological Screening and Bexley–Maudsley Category Sorting Test: Manual NFER–Nelson: Windsor.Google Scholar
Ackner, B. (1954). Depersonalisation, I. Aetiology and phenomenology: II. Clinical syndrome. Journal of Mental Science 100, 838872.CrossRefGoogle Scholar
Andersen, R. (1978). Cognitive changes after amygdalotomy. Neuropsychologia 16, 439451.CrossRefGoogle ScholarPubMed
Bagshaw, M. H., Mackworth, N. H. & Pribram, K. H. (1972). The effect of resections of the inferotemporal cortex or the amygdala on visual orienting and habituation. Neuropsychologia 10, 153162.CrossRefGoogle ScholarPubMed
Balasubramaniam, V., Kanaka, T. S. & Ramamurthi, B. (1970). Surgical treatment of hyperkinetic and behaviour disorders. International Surgery 54, 1823.Google Scholar
Bauer, R. M. (1982). Visual hypoemotionality as a symptom of visual–limbic disconnection in man. Archives of Neurology 39, 702708.CrossRefGoogle ScholarPubMed
Bauer, R. M. (1984). Autonomic recognition of names and faces in prosopagnosia: a neuropsychological application of the guilty knowledge test. Neuropsychologia 22, 457469.Google Scholar
Bear, D. M. (1983). Hemispheric specialisation and the neurology of emotion. Archives of Neurology 40, 195202.Google Scholar
Benton, A. L., Van Allen, M. W., Hamsher, K. de S. & Levin, H. S. (1978). Test of Facial Recognition, Form SL. University of Iowa: Iowa.Google Scholar
Blumer, D. & Benson, D. F. (1975). Personality changes with frontal and temporal lobe lesions. In Psychiatric Aspects of Neurological Disease (ed. Benson, D. F. and Blumer, D.), pp. 151169. Grune and Stratton: New York.Google Scholar
Bowers, D. & Heilman, K. M. (1984). Dissociation between the processing of affective and nonaffective faces: a case study. Journal of Clinical Neuropsychology 6, 367379.Google Scholar
Bridges, P. K. (1972). Psychosurgery today: psychiatric aspects. Proceedings of the Royal Society of Medicine 65, 11041108.Google Scholar
Butter, C. M. & Snyder, D. R. (1972). Alterations in aversive and agressive behaviours following orbital frontal lesions in rhesus monkeys. Acta Neurobiologica Experimenta 32, 525565.Google Scholar
Cawley, R. H. (1977). The teaching of psychotherapy. Association of University Teachers of Psychiatry Newsletter, 1936.Google Scholar
Cowey, A. (1982). Sensory and non-sensory visual disorders in man and monkey. Philosophical Transactions of the Royal Society of London B298, 313.Google Scholar
Dalby, M. A. (1969). Epilepsy and 3 per second spike and wave rhythms. Acta Neurologica Scandinavica 45, Suppl. 40, 1183.Google Scholar
Damasio, A. R.Damasio, H. & Van Hoesen, G W. (1982). Prosopagnosia: anatomic basis and behavioural mechanisms. Neurology 32, 331342.CrossRefGoogle Scholar
Douglas, R. J. & Pribram, K H. (1969). Distraction and habituation in monkeys with limbic lesions. Journal of Comparative and Physiological Psychology 62, 473480.CrossRefGoogle Scholar
Franzen, E. A. & Myers, R. E. (1972). Neural control of social behaviour: prefrontal and anterior temporal cortex. Neuropsychologia 11, 141157.CrossRefGoogle Scholar
Geschwind, N. (1965). Disconnexion syndromes in animals and man. Part II. Brain 88, 585644.CrossRefGoogle Scholar
Gessler, S. F. (1985). The perception of facial emotion in schizophrenia. Ph.D. Thesis: University of London.Google Scholar
Gloor, P. (1960). Amygdala. In Handbook of Physiology. Section I: Neurophysiology, Vol, II. (ed. Field, J., Magoun, H. W. and Hall, V. E.), pp. 13951420. American Physiological Society: Washington, D.C.Google Scholar
Gollin, E. S. (1960). Development studies of visual recognition of incomplete objects. Perceptual and Motor Skills 11, 289298.Google Scholar
Halgren, E. (1981). The amygdala contribution to emotion and memory: current studies in humans. In The Amygdaloid Complex (ed. Ben-Ari, Y.), pp. 395408. INSERM Symposium No. 20, Elsevier/North-Holland: Amsterdam.Google Scholar
Hay, D. C. & Young, A. W. (1982) The human face. In Normality and Pathology in Cognitive Functions (ed. Ellis, A. W.), pp. 173202. Academic Press: London.Google Scholar
Heimburger, R. F., Small, I. F., Small, J. G., Milstein, V. & Moore, D. (1978). Stereotactic amygdalotomy for convulsive and behavioral disorders. Applied Neurophysiology 41, 4351.Google ScholarPubMed
Hitchcock, E. & Cairns, V. (1973). Amygdalectomy. Postgraduate Medicine 49, 894904.Google Scholar
Hitchcock, E. R., Ashcroft, G. W., Cairns, V. M. & Murray, L. G. (1972). Preoperative and post operative assessment and management of psychosurgical patients. In Psychosurgery (ed. Hitchcock, E., Laitinen, L. V. and Vaernet, K.), pp. 164173. Charles C. Thomas: Springfield, Ill.Google Scholar
Hitchcock, E. R., Ashcroft, G. W., Cairns, V. M. & Murray, L. G. (1973). Observations on the development of an assessment scheme for amygdalectomy. In Surgical Approaches in Psychiatry (ed. Laitinen, L. V. and Livingston, K. E.), pp. 142155. MTP Press: Lancaster.Google Scholar
Horel, J. A., Keating, E. G. & Misantone, L. J. (1975). Partial Kluver–Bucy syndrome produced by destroying temporal neocortex or amygdala. Brain Research 94, 347395.CrossRefGoogle ScholarPubMed
Kaada, B. R. (1972). Stimulation and regional ablation of the amygdaloid complex with reference to functional representations. In The Neurobiology of the Amygdala (ed. Eleftheriou, B. E.), pp. 205281. Plenum: New York.CrossRefGoogle Scholar
Kaada, B. R., Andersen, P. & Jansen, J. (1954). Stimulation of the amygdaloid nuclear complex in anaesthetised cats. Neurology 4, 4864.Google Scholar
Kiloh, L. G., Gye, R. S., Rushworth, R. G., Bell, D. S. & White, R. T. (1974). Stereotactic amygdaloidotomy for aggressive behaviour. Journal of Neurology, Neurosurgery and Psychiatry 37, 437444.Google Scholar
Kling, A. (1972). Effects of amygdalectomy on social-affective behaviour in non-human primates. In The Neurobiology of the Amygdala (ed. Eleftheriou, B. E.), pp. 271280. Plenum: New York.Google Scholar
Kling, A. (1986). The anatomy of aggression and affiliation. In Emotion: Theory, Research and Experience, Vol. 3 (ed. Plutchik, R.). Academic Press: New York (in the press).Google Scholar
Kling, A. & Steklis, H. D. (1976). A neural substrate for affiliative behaviour in nonhuman primates. Brain, Behaviour and Evolution 13, 216238.CrossRefGoogle ScholarPubMed
Kling, A., Lancaster, J. & Benitone, J. (1970). Amygdalectomy in the free-ranging vervet. Journal of Psychiatric Research 7, 191.CrossRefGoogle ScholarPubMed
Kluver, H. (1952). Brain mechanisms and behaviour with special reference to the rhiencephalon. Journal – Lancet 72, 567574.Google Scholar
Kluver, H. & Bucy, P. (1939). Preliminary analysis of functions of the temporal lobes in monkeys. Archives of Neurology and Psychiatry 42, 9791000.Google Scholar
Knight, G. (1973). Further observations from an experience of 660 cases of stereotactic tractotomy. Postgraduate Medical Journal 49, 845854.CrossRefGoogle ScholarPubMed
Leonard, C. M., Rolls, E. T., Wilson, F. A. W. & Baylis, G. C. (1985). Neurons in the amygdala of the monkey with responses selective for faces. Behavioural Brain Research 15, 159176.Google Scholar
Lichter, I., Richardson, P. J. & Wyke, M. A. (1984). Differential effects of atenolol and enalapril on tests of memory during treatment for essential hypertension. Journal of Hypertension 2, 560.CrossRefGoogle Scholar
Lilly, R., Cummings, J. L., Benson, F. & Frankel, M. (1983). The human Kluver–Bucy syndrome. Neurology 33, 11411145.Google Scholar
Mark, V. H., Sweet, W. H. & Ervin, F. R. (1972). The effect of amygdalotomy on violent behaviour in patients with temporal lobe epilepsy. In Psychosurgery (ed. Hitchcock, E., Laitinen, L. V. and Vaernet, K.), pp. 139155. Charles C. Thomas: Springfield, Ill.Google Scholar
Marsden, C. D. & Reynolds, E. H. (1982). Neurology. In A Textbook of Epilepsy (ed. Laidlaw, J. and Richens, A.), pp. 91131. Churchill Livingstone: London.Google Scholar
Meadows, J. C. (1974). The anatomical basis of prosopagnosia. Journal of Neurology, Neurosurgery and Psychiatry 37, 489501.Google Scholar
Meyers, R. E. & Swett, C. (1970). Social behaviour deficits of free-ranging monkeys after anterior temporal cortex removals: a preliminary report. Brain Research 19, 39.Google Scholar
Mishkin, M. (1982). A memory system in the monkey. Philosophical Transactions of the Royal Society of London B298, 8595.Google Scholar
Mishkin, M. & Aggleton, J. (1981). Multiple functional contributions of the amygdala in the monkey. In The Amydagloid Complex (ed. Ben-Ari, Y.), pp. 409418. INSERM Symposium No. 20. Elsevier/North-Holland: Amsterdam.Google Scholar
Murray, E. A. & Mishkin, M. (1985). Amygdalectomy impairs crossmodal association in monkeys. Science 228, 604606.CrossRefGoogle ScholarPubMed
Narabayashi, H. (1979). Long-range results of medical amygdalotomy on epileptic traits in adult patients. In Functional Neurosurgery (ed. Rasmussen, T. and Marino, R.), pp. 243252. Raven Press: New York.Google Scholar
Narabayashi, H., Nago, T., Saito, Y., Yoshida, M. & Nagahata, M. (1963). Stereotaxic amygdalotomy for behaviour disorders. Archives of Neurology 9, 1126.CrossRefGoogle Scholar
Newcombe, F. (1969). Missile Wounds of the Brain. Oxford University Press: Oxford.Google Scholar
Perrett, D. I. & Rolls, E. T. (1983). Neural mechanisms underlying the visual analysis of faces. In Advances in Vertebrate Neuroethology (ed. Ewert, J. P., Capranica, R. R. and Ingle, D. J.), pp. 543569. Plenum Press: New York.CrossRefGoogle Scholar
Perrett, D. I., Smith, P. A. J., Potter, D. D., Mistlin, A. J., Head, A. S., Milner, A. D. & Jeeves, M. A. (1985). Visual cells in the temporal cortex sensitive to face view and gaze direction. Proceedings of the Royal Society of London B223, 293317.Google Scholar
Pribram, K. H. (1981). Emotions. In Handbook of Clinical Neuropsychology (ed. Filskov, S. B. and Boll, T. J.), pp. 102134. John Wiley: New York.Google Scholar
Pribram, K. H. & McGuinness, D. (1975). Arousal, activation and effort in the control of attention. Psychological Review 82, 116149.CrossRefGoogle ScholarPubMed
Rolls, E. T. (1984). Neurons in the cortex of the temporal lobe and in the amygdala of the monkey with responses selective for faces. Human Neurobiology 3, 209222.Google Scholar
Sanghera, M. K., Rolls, E. T. & Roper, Hall A. (1979). Visual responses of neurons in the dorsolateral amygdala of the alert monkey. Experimental Neurology 63, 610626.CrossRefGoogle ScholarPubMed
Sawa, M., Ueki, Y., Arita, M. & Harada, T. (1954). Preliminary report on amygdaloidectomy on psychotic patients, with interpretation of oral–emotional manifestation in schizophrenics. Folia Psychiatrica et Neurologica Japonica 7, 309329.Google ScholarPubMed
Schurr, P. H. (1973). Psychosurgery. British Journal of Hospital Medicine 10, 5360.Google Scholar
Scoville, W. B., Dunsmore, R. H., Liberson, W. T., Henry, C. E. & Pepe, A. (1953). Observations on medial temporal lobotomy uncotomy in the treatment of psychotic states. Proceedings of the Association on Research in Nervous and Mental Disease 31, 347.Google Scholar
Strom-Olsen, R. & Carlisle, S. (1971). Bi-frontal stereotactic tractotomy: a follow-up study of its effects on 210 patients. British Journal of Psychiatry 118, 141154.Google Scholar
Stuss, D. T. & Benson, F. (1983). Emotional concomitants of psychosurgery. In Neuropsychology of Human Emotion (ed. Heilman, K. M. and Satz, P.), pp. 111140. Guilford Press: New York.Google Scholar
Terzian, H. & Dalle Ore, G. (1955). Syndrome of Kluver and Bucy reproduced in man by bilateral removal of the temporal lobes. Neurology 5, 373.Google Scholar
Vaernet, K. (1972). Stereotaxic amygdalotomy in temporal lobe epilepsy. Confinia Neurologica 34, 176180.CrossRefGoogle ScholarPubMed
Warrington, E. K. (1984). Recognition Memory Test. NFER-Nelson: Windsor.Google Scholar
Weiskrantz, L. (1977). Trying to bridge some neuropsychological gaps between monkey and man. British Journal of Psychology 68, 431445.Google Scholar
Weiskrantz, L. (1982). Comparative aspects of studies of amnesia. Philosophical Transactions of the Royal Society of London B298, 97109.Google Scholar
Whiteley, A. M. & Warrington, E. K. (1977). Prosopagnosia: a clinical, psychological, and anatomical study of three patients. Journal of Neurology, Neurosurgery and Psychiatry 40, 395403.Google Scholar
Young, A. W. (1985). The Familiar Faces Test (personal communication).Google Scholar