Prefrontal Cortex and Historical Cases

Jul 4, 2025

Overview

This lecture covers the functions of different parts of the prefrontal cortex, historical case studies, and the history and impact of frontal lobotomies.

Prefrontal Cortex Functions

  • The dorsolateral prefrontal cortex is involved in working memory, motor planning, organization, and intellectual function.
  • The ventromedial prefrontal cortex contributes to executive functions, planning, foresight, personality, and some aspects of intelligence.

Case Studies and Historical Context

  • Phineas Gage survived a severe brain injury that destroyed his ventromedial prefrontal cortex, leading to drastic personality changes.
  • Gage’s case showed that brain damage can profoundly affect behavior, responsibility, and social interactions.

Frontal Lobotomies

  • Dr. Walter Freeman popularized frontal lobotomies from the 1930s to 1960s to treat severe mental illnesses before medications like thorazine were available.
  • The procedure involved applying local anesthesia, then inserting an ice-pick device through the orbital frontal region to sever connections.
  • Frontal lobotomies were performed on patients with suicidal behaviors, hallucinations, and severe headaches.
  • Dr. Freeman performed over 200 lobotomies in West Virginia, sometimes up to 25 in one day.
  • Frontal lobotomies are rarely performed today due to advances in psychiatric medications and understanding of brain function.

Key Terms & Definitions

  • Dorsolateral Prefrontal Cortex — brain area regulating working memory, planning, and organizational skills.
  • Ventromedial Prefrontal Cortex — brain region involved in personality, planning, and social behavior.
  • Frontal Lobotomy — surgical procedure severing frontal lobe connections to treat mental illness.
  • Phineas Gage — famous case study illustrating the effects of prefrontal cortex damage on personality.

Action Items / Next Steps

  • Review case study details on Phineas Gage for deeper understanding.
  • Read about the history and controversy of frontal lobotomies.
  • Study prefrontal cortex function and its role in behavior and decision-making.