The Significance of the Frontal Brain With Respect to the Higher Psychic Functions

Psychological changes in organic brain lesions and ablations.

“…These changes appear capable of occurring either in the form of euphoria with hyperactivity and irritability or in the form of depression with general psychomotor retardation and dullness. Alterations in both directions have been observed by Feuchtwanger (26), Donath (22), Holmes (63), Khoroshko (75), Kleist (76), and Ruffin (113). Goldstein (41) and Marcus (85) observe the dominant picture to be one of euphoria or "Witzelsucht" with little mention of depression or retardation.…”

“…"General intellectual deterioration" was the predominant change noted in the cases studied by Isserlin (67), Donath (22), and Foerster (27). This general defect is also reported by Fritsch and Hitzig (35), Bolton (9), Franz (29), Poppelreuter (106), Grunthal (48) and Ruffin (113).…”

“…Other mental symptoms have been reported with lesions of the frontal region, but they have been reported with far less frequency than those mentioned above. Donath (22), Sachs (115), Wimmer (137), and Marcus (85) have all observed an impairment in recent memory functioning. On the other hand, Goldstein (41) and Grunthal (48) have failed to note the existence of any memory defect whatever.…”

“…Loss of initiative, lack of spontaneity, or apathy were first emphasized by Foerster (27) in 1918 when he had an opportunity to study numerous cases of war injury to the frontal region. Donath (22), Sachs (116), and Khoroshko (75) report these to be predominant mental changes and Goldstein (43), Ruffin (113), and Griinthal (48) observed these with marked frequency.…”

“…On the other hand, Goldstein (41) and Grunthal (48) have failed to note the existence of any memory defect whatever. Bolton (9), Donath (22), and Poppelreuter (106) believe the memory defect to be a generalized one affecting both recent and remote memory functions, Sachs (115), however, finds that memory for remote events remains intact, but that recent memory function is markedly impaired. The confusion and disagreement with reference to the existence and nature of the memory loss can probably be attributed to the absence of any test techniques for its more objective evaluation.…”