From phineas gage and monsieur leborgne to H.M. Revisiting disconnection syndromes

M. Thiebaut De Schotten, F. Dell'Acqua, P. Ratiu, A. Leslie, H. Howells, E. Cabanis, M. T. Iba-Zizen, O. Plaisant, A. Simmons, Nina Dronkers, S. Corkin, M. Catani

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

On the 50th anniversary of Norman Geschwind's seminal paper entitled 'Disconnexion syndrome in animal and man', we pay tribute to his ideas by applying contemporary tractographymethods to understand whitematter disconnection in 3 classic cases that made history in behavioral neurology.We first documented the locus and extent of the brain lesion from the computerized tomography of Phineas Gage's skull and themagnetic resonance images of Louis Victor Leborgne's brain, Broca's first patient, and Henry Gustave Molaison. We then applied the reconstructed lesions to an atlas of white matter connections obtained from diffusion tractography of 129 healthy adults. Our results showed that in all 3 patients, disruption extended to connections projecting to areas distant from the lesion.We confirmed that the damaged tracts link areas that in contemporary neuroscience are considered functionally engaged for tasks related to emotion and decision-making (Gage), language production (Leborgne), and declarative memory (Molaison). Our findings suggest that even historic cases should be reappraised within a disconnection framework whose principles were plainly established by the associationist schools in the last 2 centuries.

Original languageEnglish (US)
Pages (from-to)4812-4827
Number of pages16
JournalCerebral Cortex
Volume25
Issue number12
DOIs
StatePublished - 2015

Keywords

  • Behavioral neurology
  • Brain lesion
  • Diaschisis
  • Disconnection syndromes
  • White matter

ASJC Scopus subject areas

  • Cellular and Molecular Neuroscience
  • Cognitive Neuroscience

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    Thiebaut De Schotten, M., Dell'Acqua, F., Ratiu, P., Leslie, A., Howells, H., Cabanis, E., Iba-Zizen, M. T., Plaisant, O., Simmons, A., Dronkers, N., Corkin, S., & Catani, M. (2015). From phineas gage and monsieur leborgne to H.M. Revisiting disconnection syndromes. Cerebral Cortex, 25(12), 4812-4827. https://doi.org/10.1093/cercor/bhv173