Wednesday, January 31, 2024

You Would Never Guess From Her Videos That She Has No Frontal Lobes

In previous posts such as "Preservation of Mind and Memories After Removal of Half a Brain" and "Cases of High Mental Function Despite Large Brain Damage," I have discussed at great length quite a few cases of people whose minds or memories functioned well despite very heavy brain damage.  These included cases such as these:

  • Dandy's patients: The case of Dandy's patients are reported in the American Journal of Psychology, Vol. 46, No. 3 (Jul., 1934), pages 500-503. We read this: "Dandy has completely removed the right cerebral hemisphere from eight patients. He has performed total extirpations of one or more lobes much oftener... There are tabulated below certain generalizations on the effects of removing the right hemisphere.... The operation was the complete extirpation of the right frontal, temporal, parietal, and occipital lobes peripheral to the corpus striatum. The weight of the tissue re moved varies, with the pathological conditions involved, from 250 to 584 grm [grams].Coherent conversation began within twenty-four hours after operation, and in one case on the afternoon of the same day. Later examinations showed no observable mental changes. The patients were perfectly oriented in respect of time, place, and person; their memory was unimpaired for immediate and remote events; conversation was always coherent; ability to read, write, compute, and learn new material was unaltered. Current events were followed with normal interest. There were no personality changes apparent; the patients were emotionally stable, without fears, delusions, hallucinations, expansive ideas or obsessions, and with a good sense of humor; they joked frequently. They showed a natural interest in their condition and future. They cooperated intelligently at all times throughout post-operative care and subsequent testing of function." How could the memory of patients be "unimpaired for immediate and remote events" if memories are stored in brains?
  • Patient P. G. Described in the 1966 paper "Long-term changes in intellect and behaviour after hemispherectomy," Patient   P.G. had an IQ of 128 before the right half of his brain was removed. After the right half of his brain was removed, he scored 142 on the same IQ test, improving his score by 14 points. The paper tells us that this man with half a brain “obtained a university diploma after operation” and “has a responsible administrative position with a local authority.” If your brain makes your mind, how could taking out half of someone's brain cause their IQ to increase by 14 points, with an end result so far above average?
  • Patient D. W. Described in the 1966 paper "Long-term changes in intellect and behaviour after hemispherectomy," Patient D.W.  had an IQ of 97 before the left half of his brain was removed. After the left half of his brain was removed, he scored 100 on the same IQ test, improving his score by 3 points.
  • The French civil servantThe case is discussed here in a Reuters story entitled “Man lives normal life with abnormal brain.” Inside a normal brain are tiny structures called lateral ventricles that hold brain fluid. In this man's case, the ventricles had swollen up like balloons, until they filled almost all of the man's brain. When the 44-year-old man was a child, doctor's had noticed the swelling, and had tried to treat it. Apparently the swelling had progressed since childhood. The man was left with what the Reuters story calls “little more than a sheet of actual brain tissue.”  But this same man, with almost no functioning brain, had been working as a French civil servant, and had his IQ tested to be 75, higher than that of a mentally retarded person. The Reuters story says: “A man with an unusually tiny brain managed to live an entirely normal life despite his condition, caused by a fluid buildup in his skull.” The case was written up in the British medical journal The Lancet in a paper entitled “Brain of a white-collar worker.” It is as if the authors tried to make these facts be noticed by as few as possible, by giving their story the dullest title they could. 
  • Christina Santhouse. In an article in the New Yorker magazine, we are told of a Christina Santhouse who had the right half of her brain surgically removed: “When I met her, she had taken her S.A.T.s and just finished high school, coming in seventy-sixth in a class of two hundred and twenty-five.”
  • Beth Usher. Beth was mentioned in an article in the LA Times, which stated this: "How is it that 8-year-old Beth Usher of Storrs, Conn., can lose her left hemisphere, yet retain her large repertoire of knock-knock jokes? Beth’s memories survived not just the loss of brain tissue, but also the 32 days that she spent in a coma, the result of some brain stem swelling that occurred in response to the trauma of surgery. Shortly after Beth regained consciousness, her father began quizzing her about people and places from her past. Brian Usher didn’t get very far. 'Dad,' Beth interrupted, with a trace of impatience. 'I remember everything.'" Of course, there's a very easy answer to the question asked: the answer that memories are not actually stored in the human brain. 
  • Borgstein and Grootendorst's 7-Year-Old. In 2002 in The Lancet these two published a paper "Half a Brain." They reported this on the child who had the left half of her brain surgically removed: "Though the dominant hemisphere was removed, with its language centres and the motor control for the left side of her body, the child is fully bilingual in Turkish and Dutch, while even her hemiplegia has partially recovered and is only noticeable by a slight spasticity of her left arm and leg. She leads an otherwise normal life."
  • The Johns Hopkins 58 hemispherectomy patientsIn a scientific paper ("Why Would You Remove Half a Brain? The Outcome of 58 Children After Hemispherectomy −−The Johns Hopkins Experience: 1968 to 1996") we read about surgeons at Johns Hopkins Medical School who performed fifty-eight hemispherectomy operations on children over a thirty-year period. At least eleven had the left half of the brain removed; and more had the right half removed. The paper states this: 
    "Despite removal of one hemisphere [i.e. one half of the brain], the intellect of all but one of the children seems either unchanged or improved....It is tempting to speculate, that the continuous electrical activity of these severely dysfunctional hemispheres interferes with the function of the other, more normal hemisphere. This might explain why motor function improves after hemispherectomy and why language recovers after removal of the dysfunctional left hemisphere, but does not seem to fully transfer before surgery. Perhaps it also partially explains intellectual improvement in these children after removal of half of the cortex. We are awed by the apparent retention of memory after removal of half of the brain, either half, and by the retention of the child’s personality and sense of humor."  An appropriate response to such observations would be not mere awe, but the questioning or discarding of belief dogmas such as the dogma that brains store memories (which cannot be found by microscopically inspecting brain tissue). 
  • Kim Peek.  Kim Peek suffered from a lack of a corpus callosum, the bundle of fibers that connect the two hemispheres of the brain. Instead of this resulting in two minds in a single body (as we would expect from the "brains make minds" dogma), the result was a single mind and personality with an exceptional memory and astonishing calculation abilities. A newspaper report said Peek could accurately tell the contents of 12,000 books he had read, and the wikipedia article on him says he could "remember almost everything he had read." He could quickly tell strangers which day of the week they were born when they merely told him their birthdays. 
  • Martel's boy. In a scientific paper ("Discrepancy Between Cerebral Structure and Cognitive Functioning") we read of a case of a boy who was "mentally unimpaired" until death (despite progressive loss of the senses), and who was found in an autopsy to have almost no brain. We read this: "Martel (1823) described a boy who died at the age of 10. During the first years of his life, he seemed healthy, but eventually, his health deteriorated considerably. He had severe headaches, gradually lost all his senses except hearing, developed fits, and became confined to his bed, but he nevertheless seemed mentally unimpaired until his death. His head appeared enlarged, and upon autopsy, apart from 'residues of meninges,' 'no trace of a brain' was found inside the skull (Martel, 1823, p. 20)." 
  • John Lorber's patients. Lorber was a physician who had patients who lost the great majority of their brain due to a disease that replaces brain tissue with a watery fluid. Lorber was astounded to find that many of the patients had above-average intelligence, including a patient that had almost no brain but still had an IQ of 144. His patients are discussed here
  • Masdeu's 44-year old. In the paper "Ventricular Wall Granulations and Draining of Cerebrospinal Fluid in Chronic Giant Hydrocephalus," Joseph C. Masdeu MD and others report a case of a 44-year-old woman with a huge fluid-filled hole in her brain, one that seemed to have replaced most of the tissue in her brain (judging from the photos in the paper). The paper reports the woman had an IQ of 98, worked as an administrator for a government agency, and could speak seven languages. 
  • Egnor's Katie. In an article Michael Egnor MD tells of a patient he had named Katie who only "had a third of the brain that her sister had," her fraternal twin. Egnor tells us that Katie "sat and talked and walked earlier than her sister," "made the honor roll," and "will soon graduate high school."
  • The Birjand Cyst patient:  This patient's case is reported in the paper "Giant Brain Hydatid Cyst in an Adult: A New Case Report." We are shown a photo of a giant hole in the patient's brain. We are told "The patient only complained of headache in the last two weeks and had no symptoms of visual or speech impairment." We are told the patient had no psychological problems. Surgery removed a fist-sized brain cyst that was 90 millimeters long and 40 millimeters wide. No mention is made of any mental or memory problem. 
  • The 500 gram cyst girl. This patient's case is reported in the paper "Primary Giant Cerebral Hydatid Cyst in an 8-year-old Girl." Doctor's discovered a giant brain cyst of 500 grams measuring 20 cm × 15 cm × 12 cm, and they said "in our search this is the largest brain hydrated cyst in the literature." This was probably more than half the size of her brain, since the average adult female brain is about 1200 grams, and since an 8-year-old female would have a brain of less than 1000 grams. Despite having so large a brain cyst there was "no history of neurological deficits" and "no changes in behavior." A month after the removal of the cyst, the patient is described as "vitally stable, thriving well, no complaints, no neurological deficits, and with the normal neurological examination." No mention is made of any mental or memory problem. 
  • The asymptomatic man with a giant brain cyst. This patient's case is reported in the paper "Asymptomatic giant arachnoidal cyst." We read of "a 39-year-old right-handed man, with a high-school education, good social and job functioning, and good command of three foreign languages (English, Spanish, and, in part, Arabic), had a 3-year history of mild migraine without aura." We are told that "neurologic examination and standardized cognitive assessment revealed normal findings." The man was found to have a giant cyst "occupying the anterior two thirds of the left hemisphere." We see a photo showing a huge hole in the person's brain, so big that it took about one third of the person's brain mass. How could you lose one third of your brain and have no symptoms, if a person's brain makes his mind? 
  • Alex, who did not start speaking until the left half of his brain was removed. A scientific paper describing the case says that Alex “failed to develop speech throughout early boyhood.” He could apparently say only one word (“mumma”) before his operation to cure epilepsy seizures. But then following a hemispherectomy (also called a hemidecortication) in which half of his brain was removed at age 8.5, “and withdrawal of anticonvulsants when he was more than 9 years old, Alex suddenly began to acquire speech.” We are told, “His most recent scores on tests of receptive and expressive language place him at an age equivalent of 8–10 years,” and that by age 10 he could “converse with copious and appropriate speech, involving some fairly long words.” Astonishingly, the boy who could not speak with a full brain could speak well after half of his brain was removed. The half of the brain removed was the left half – the very half that scientists tell us is the half that has more to do with language than the right half. 
  • The honors student (IQ=126) with only 3% to 10% of a brain. In the scientific paper "Long-Term Memory: Scaling of Information to Brain Size" by Donald R. Forsdyke of Queens University in Canada, he quotes the physician John Lorber on an honors student with an IQ of 126: "Instead of the normal 4.5 centimetre thickness of brain tissue between the ventricles and the cortical surface, there was just a thin layer of mantle measuring a millimeter or so. The cranium is filled mainly with cerebrospinal fluid. … I can’t say whether the mathematics student has a brain weighing 50 grams or 150 grams, but it’s clear that it is nowhere near the normal 1.5 kilograms." Forsdyke notes two similar cases in more recent years, one from France and another from Brazil.  Forsdyke says, "Three independent studies agree that there are, among us, people leading normal lives with approximately 5 % of the quantity of brain tissue found in others."
  • The patient of Smith and Sugar. In their paper "Development of above normal language and intelligence 21 years after left hemispherectomy," Smith and Sugar state that "Neuropsychologic follow-up studies of a 5-year-old boy who had left hemispherectomy for seizures showed that he had developed superior language and intellectual abilities." This was a boy who had the left half of his brain removed, but who ended up with "superior language and intellectual abilities."
  • Patient B.M. Patient B.M. had the right half of her brain removed, in an operation called a right hemispherectomy. She  had difficulty recognizing faces, a problem called prosopagnosia. But according to a paper on her, her "intellectual and cognitive functions were otherwise normal or only slightly impaired," despite the loss of half of her brain. 
  • Brown and Vahidassr's Case: The case was reported by these two in a paper with the misleading title "The Man Who Lost (Part) of His Mind." The paper discusses an 84-year-old without  mentioning any mental problems at all, conflicting with their title. The abnormality they report is that man had lost almost half of his brain, with an air cavity replacing the lost tissue. Despite this loss, no cognitive difficulty is reported, and we hear that except for some muscle weakness "there was no confusion, facial weakness, visual or speech disturbance, and he was feeling otherwise well," and that he was "independent with physical activities of daily living."
  • Patient HS4. This patient is discussed in the paper "Intrinsic Functional Connectivity of the Brain in Adults with a Single Cerebral Hemisphere.'" The paper discusses attempts to measure brain connectivity in patients who had half of their brain removed to treat very frequent seizures. The half-brain patient with the highest intelligence was patient HS4, with an IQ of 99 (according to the Supplemental Information of the paper). But this very patient had the smallest brain of the six half-brain patients. This patient HS4 had an average brain connectivity score of only .30, which is the same as one of the group of controls with normal brains, and less than the brain connectivity of the other group of controls with normal brains.   So the smartest person with half a brain (who had an IQ of 99) did not at all have any greater brain connectivity that can explain his normal intelligence with only half a brain. How can this subject HS4 have had a normal intelligence with only half a brain?  In this case, favorable brain rewiring or greater brain connectivity cannot explain the result.  
half brain
The half brain of subject HS4, IQ of 99, average brain wiring

I recently learned of another case of this type. The case is particularly interesting because it helps to discredit the claim that the frontal lobes of the brain are necessary for language and thinking.  The case is reported in the paper "Early bilateral and massive compromise of the frontal lobes."  We read about an amazing case of an 8-year-old girl with good mental skills despite having basically no frontal lobes of the brain. We see an MRI scan showing a gigantic black empty region in the brain corresponding to missing frontal lobes.

We read that a brain scan at age three revealed this:

"GC's first report of frontal compromise at age three. MRI scans revealed no structures in the frontal lobe, covered with cerebrospinal fluid. Weighed-T1 MRI scans showed no recognizable frontal structures, expect for a small portion of the ventral frontal cortex. The mesencephalon, pons, and medulla oblongata were present, and so were all other lobes and the cerebellum."  

We read that a brain scan of the girl at age 8 showed basically the same results, with at most only a tiny of the frontal lobes existing. 

Under a heading of "Neurological and neuropsychological assessment" we read that "she could describe sensory and affective experiences, and reacted to environmental events with apparent emotional and cognitive congruency (e.g., pleasure, tiredness, playfulness, anger, and basic symbolization  Supplementary Video 1, Supplementary Video 2)." The links take us to a page of videos of the young girl. We see her seeming to act pretty much like a normal girl of her age. I recommend watching all of the short videos on the page. The girl with basically no frontal lobes stands, dances, seems to speak normally, and responds to requests to touch parts of her body, and show how she brushes her teeth. The person asking the questions to the girl speaks very rapidly, but the girl seems to have no difficulty understanding the questions, and the girl makes appropriate verbal and manual responses.  Asked to point to the questioner's thumb, the girl points to the right spot. Asked to point to the girl's eyes, the girl points to the right spot. Asked where she would wear a pair of glasses, the girl points to her eyes. Asked where she would wear a pair of shoes, she points to her feet. The girl is able to distinguish between herself and a fantasy character (Minnie Mouse), and says that she is not Minnie (Video 9). 

We hear in the text of the paper vague mentions about various types of "deficits," but we seem to get very little in the way of  specifics. None of the nine videos of the girl seem to show any signs of cognitive deficits. 

We see below a visual of the girl's brain, from Supplementary Video 11:


A much better title for the paper would have been "Good cognitive performance despite loss of the frontal lobes."  Why is that when neuroscientists discover cases that contradict their dogmas, that they report such cases using titles that fail to alert us of the important finding in conflict with their dogmas? It's as if they were trying as hard as possible to make such "inconvenient truths" as hard to discover as possible. Also, the authors have used language in their abstract that fails to alert any readers of this important case. Rather than referring to an absence of the frontal lobes (as they do in the body of the paper), they merely refer in the abstract to "nearly complete affectation of bilateral frontal structures," as if they were trying to prevent people from discovering this case that should shock a neuroscientist to the core. 

Our neuroscientists keep telling us that higher cognitive capabilities such as abstract thought and self-consciousness come from the frontal lobes of the brain. The case reported above shows that such a claim is untrue.  For many other reasons for rejecting such a claim, read my post here.  Referring to removal of brain tissue (resection), the paper here states that " intellectual or memory decrements are seldom found after frontal resections."

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