Month: January 2013

A patient who could only say the word ‘tan’ after suffering brain damage became one of the most important cases in the history of neuroscience. But the identity of the famously monosyllabic man has only just been revealed.

Broca’s area was one of the first brain areas identified with a specific function after 19th Century neurologist Paul Broca autopsied a man who had lost the ability to speak.

When examining the man’s brain (you can see it on the right), Broca found selective damage to the third convolution of the left frontal lobe and linked this with the fact that the person could understand speech but not produce it.

This type of speech problem after brain injury is now known as Broca’s aphasia but his innovation was not simply naming a new type of neurological problem.

Broca was one of the first people to think of the brain in terms of separate areas supporting specialised functions and studying patterns of difficulty after brain damage as a way of working this out – a science now known as cognitive neuropsychology.

The patient Broca described was nicknamed ‘Tan’ because this was the only syllable he could produce. The scientific report named his as Monsieur Leborgne but no further details existed.

Oddly, personal details were not even recorded in Broca’s unpublished medical notes for the patient.

Because of the mystery, people have speculated for years about the identity of Monsieur Leborgne with theories ranging from the idea that he was a French peasant to a philandering man struck down by syphilis.

But now, historian Cezary Domanski has tracked down the identity of Broca’s famous patient through detective work in record offices in France and published the results in the Journal of the History of the Neurosciences.

According to the Broca’s report, the health problems of Louis Victor Leborgne became apparent during his youth, when he suffered the first fits of epilepsy. Although epileptic, Louis Victor Leborgne was a working person. He lived in Paris, in the third district. His profession is given as “formier” (a common description in the nineteenth century used for craftsmen who produced forms for shoemakers).

Leborgne worked until the age of 30 when the loss of speech occurred. It is not known if the damage to the left side of Leborgne’s brain had anything to do with traumas sustained during fits of epilepsy nor, as reported in some recent publications, does it appear to have been caused by syphilis, as that was not indicated in Broca’s reports. The immediate cause for his hospitalization was his problem with communicating.

Leborgne was admitted to the Bicêtre hospital two or three months after losing his ability to speak. Perhaps at first this might have been perceived as a temporary loss, but the defect proved incurable. Because Leborgne was unmarried, he could not be released to be cared for by close relatives; he therefore spent the rest of his life (21 years total) in the hospital.

Domanski’s article finishes on a poignant note, highlighting that Leborgne became famous through his disease and death and his life history was seemingly thought irrelevant even when he was alive.

“It is time” says Domanski, “for Louis Victor Leborgne to regain his identity”.
 

Link to locked article on the identity of Broca’s patient (via @Neuro_Skeptic)

Phrenology was the practice of reading someone’s personality from the bumps on their head based on the idea that the shape of the brain affected the shape of the skull.

Contemporary neuroscience lectures often have a part where the professor puts up an image of a phrenology head and says “although this was a rediculous concept, it sparked the idea that the brain could have parts that were specialised for particular functions”.

Phrenologists are usually considered to be quacks and that serious neuroscientists ‘took over’ from where they left off, but I’ve found lots of old copies of The Phrenological Magazine in the Institute of Psychiatry library and it turns out they had a keen interest in serious neuroscience.

The images on the right are from the June 1890 edition (the brain) and October 1895 edition (the neuron) and both show some of the then cutting-edge neuroscience that the magazine regularly featured.

The brain is from the work of legendary neurologist David Ferrier showing his map of cortical functions transposed from his work on open-brain stimulation on animals.

The second image shows the structure of the neuron. The text describes how “molecular movements generated within any individual cell can probably be transmitted to other cells in the same striatum in the cortex” and the feature article goes on to highlight the latest discoveries in neuronal function.

It’s worth saying that this detailed discussion of neuroscience with accurate neuroanatomical images is far more common in the magazine than phrenological brain maps. It seems serious medical men wrote some of the articles and neuroscience debates are common in the pages.

The magazine is not without a bit of kookiness, however, although it’s hard to judge how much of this was considered kooky at the time.

My favourite part is where every issue has a portrait of a famous person with an interpretation of their character underneath. This is the interpretation from the portrait of Lord Wolseley, new head of the British Army, from October 1985.

The head of the new Commander-in-Chief indicates a fair balance of all the powers of his mind. He has no superabundance in any particular to give bias, no special deficiency to cause eccentricity. His head is well formed and appears to be well-developed in all parts.

Inside one issue I found an insert that just said “WANTED TO PURCHASE: a Tatoo’ed New Zealander’s Head. – Apply to Major-General H. ROBLEY, 7 St Alban’s Place, Haymarket”. It turns out that Robley was a renowned collector of such things and it seems phrenologists were one of his sources.

In fact, the magazines are full of wonderful adverts. This list of ‘penny lectures’ isn’t that different from pop psychology and neuroscience today.

There’s some good names for a band lurking in there.

The Atlantic has a sublime article on identity, memory and amnesia – written as a reflection on meeting a friend who has lost much of his memory due to an advancing brain tumour.

The author is neuropsychologist Daniel Levitin who is better known for his work on the cognitive science of music, but here he writes beautifully about how theories of memory can blend uncomfortably with individual experience.

Once Tom and I were sitting next to each other when Pribram told the class about a colleague of his who had just died a few days earlier. Pribram paused to look out over the classroom and told us that his colleague had been one of the greatest neuropsychologists of all time. Pribram then lowered his head and stared at the floor for such a long time I thought he might have discovered something there. Without lifting his head, he told us that his colleague had been a close friend, and had telephoned a month earlier to say he had just been diagnosed with a brain tumor growing in his temporal lobe. The doctors said that he would gradually lose his memory — not his ability to form new memories, but his ability to retrieve old ones … in short, to understand who he was.

It’s a wonderfully written piece that is subtly recursive, like memory itself.
 

Link to Atlantic piece on memory and identity (via @edyong209)