Frontal Lobotomy

Frontal Lobotomy means incision of the white matter of the frontal lobe with a leukotome passed via a cannula through holes drilled in the skull. The “refined” version of Moniz' procedure came to be known as frontal lobotomy. The procedure basically involves severing the frontal lobes from the rest of the brain … sometimes simply by sticking a spatela up there and swishing it around (nice thought eh?). This procedure was very popular for a while (see “One Flew Over the Cuckoo's Nest”) as it most definitely does stop any strong emotional reactions. However, it was eventually discovered that it was not the cure that was claimed … patients have huge problems with planning and with performing socially appropriate behaviors despite seeming to know what those behaviours would be.

The frontal lobes have been shown to have a role in cognitive functions as well as social behaviour, personality, memories and self-awareness. Stuss et al (2001) mention one previous study that directly implicates the frontal lobes in the theory of mind. This study by Stone et al (1998) used lesioned patients. Past research has shown how damage to the left or right orbitofrontal/ ventro medial areas consistently caused personality changes. The authors also mention functional imaging data that has found the left medial frontal lobe to be active in theory of mind tasks. (Hawkins, p147). They point out that while imaging data shows what areas are involved, they do not show which areas are necessary for the theory of mind. The paper used two main tasks. Both required patients to make inferences about the location of an object they couldn't see based on the direction the experimenter was pointing to. The First involved verbal perspective taking.

In this experiment patients had two people pointing to the location of a hidden object, only one of which could actually see the location of this object. Therefore they had to infer position from this person. It was found that frontal patients produced a much higher error rate on this task. It was also suggested that the right frontal lobe was the most critical region. The second task involved deception. For this the hidden object had two possible positions. This time, the one experimenter always pointed to the wrong position. This time there was a striking right medial prefrontal difference between impaired and unimpaired patients (Duncan, p475). Bifrontal lesions involving medial regions impaired performance on ...