Spared and impaired cognitive abilities after bilateral frontal damage

M Brazzelli, N Colombo, S Della Sala, H Spinnler

Research output: Contribution to journalArticlepeer-review

97 Citations (Scopus)


We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.

Original languageEnglish
Pages (from-to)27-51
Number of pages25
Issue number1
Publication statusPublished - Mar 1994


  • Adolescent
  • Adult
  • Attention
  • Brain Damage, Chronic
  • Brain Mapping
  • Cognition Disorders
  • Dominance, Cerebral
  • Emotions
  • Encephalitis
  • Follow-Up Studies
  • Frontal Lobe
  • Herpes Simplex
  • Humans
  • Imitative Behavior
  • Magnetic Resonance Imaging
  • Mental Recall
  • Motivation
  • Neuropsychological Tests
  • Social Behavior
  • Stereotyped Behavior
  • Verbal Behavior
  • Journal Article
  • Research Support, Non-U.S. Gov't


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