What have we learned about the brain

from cases of brain damaged people?

Despite his horrific injury, within minutes

Gage was sitting up in a cart, conscious
and recounting what had happened. He
Phineas Gage (18231860)
was the victim of a terrible was taken back to his lodgings, where he
was attended by Dr John Harlow. The
accident in 1848
doctor cleaned and dressed his wound,
His injuries helped
replacing fragments of the skull around
scientists understand
the exit wound and making sure there
more about the brain
were no fragments lodged in the brain by
and human behaviour.
feeling inside Gages head with his finger.
In 1848 Gage was working as a Despite Harlows efforts, the wound
foreman on the construction of became infected and Gage fell into a
semi-comatose state. His family did not
the Rutland and Burlington
expect him to survive: they even prepared
Railroad in Vermont, USA.
his coffin. But Gage revived and later that
Workers often used dynamite
It seems that physically, Gage made a good recovery, but his
year was well enough to return to his
to
blast
away
rock
and
clear
a
On 13 September, Gage was using a tamping
injury may have had a permanent impact on his mental
parents home in New Hampshire.
for the
railway.
iron (a long hollowpath
cylinder
of iron
weighing
condition. Although accounts from the time are sometimes
more than 6 kilos) to compact explosive powder conflicting and often unreliable, numerous sources report that
into the rock ready for a blast. The iron rod hit
Gages character altered dramatically after his accident.
The damage to Gages frontal cortex caused by the iron rod
the rock, creating a spark that ignited the
seems to have resulted in a loss of social inhibitions. The role
explosives. The rod was propelled through
of the frontal cortex in social cognition and decision making is
Gages skull, entering through his left cheekbone
now well-recognised; in the 19th century, however,
and exiting through the top of his head. It was
neurologists were only just beginning to realise these
later found some 30 yards away from Gage,
connections. Gages injuries provided some of the first
smeared with blood and brain.
evidence that the frontal cortex was involved in personality
and behaviour.

An MRI was used to identify the specific structures in Clive's brain that
were damaged.
He was interviewed and observed to gain insight into the extent of his
amnesia.

His MRI scans showed damage to his hippocampus and some frontal
regions of the brain.
He suffers from anterograde amnesia (failure to store memories after
trauma) and retrograde amnesia (failure to recall memories before
trauma).
Clive Wearing is a 70 year old
Clive has a memory span of only seconds, making every moment new
English musician and musicologist Significance
to him with of
theFindings
blink of an eye, literally.
who contracted herpes simplex
His
journal
containing
entries
of how
he feels and
he is and
thinking
Gives
us insight
into how
memory
is distributed
inwhat
the brain
not
encephalitis in 1985.
helps
givetoathe
heart
breaking insight into what it is like to lose one's
localized
hippocampus.
The virus destroyed his
memory.
Clive
is still able to play the piano, which suggests that the areas of the
hippocampus bilaterally (as well as
brain related to procedural memory (the cerebellum) is intact.
surrounding areas).
Also Clive has a strong emotional response every time he sees his wife
He retained the ability to play the
suggesting that emotional memory (related to the amygdala) is also not
piano and conduct a choir (which
impaired.
he did previously to his illness).

Criticisms

This can't be replicated to generalize results since no two cases

of amnesia are the same (Larry Squire)
Doesn't answer questions like how his memory of basic things like
showering, eating, grooming, etc remain intact, is it procedural or
episodic memory?