Phineas Gage Brain Map Study Spotlights Neuroscience's Most Celebrated Case

Phineas Gage (1823-1861)

It's easy enough to understand the ghastly accident that befell poor Phineas Gage in Cavendish, Vermont on Sept. 13, 1848: the 25-year-old railroad worker was using an iron rod to tamp down blasting powder when the stuff exploded, sending the 43-inch-long, 13-pound rod through his left cheek and out the top of his head.

What's not so easy to understand is why Gage survived the accident--or the precise reason for the dramatic change in his personality afterward. John Harlow, the doctor who treated the once-affable Gage, wrote that he "could not stick to plans, uttered 'the grossest profanity' and showed 'little deference for his fellows,'" Smithsonian magazine reported in 2010.

But now researchers are closing in on answers.

For a new study published in the May 16 issue of the journal PLoS One, scientists at UCLA used brain-mapping data from computed tomography (CT) and magnetic resonance imaging (MRI) scans to determine the specific damage inflicted on the neurological "pathways" in Gage's brain.

"What we found was a significant loss of white matter connecting the left frontal regions and the rest of the brain," study co-author Jack Van Horn, an assistant professor of neurology at the university, said in a written statement. "We suggest that the disruption of the brain's 'network' considerably compromised it. This may have had an even greater impact on Mr. Gage than the damage to the cortex alone in terms of his purported personality change."

Only about 4 percent of Gage's cerebral cortex was directly affected by the rod, the study showed. But more than 10 percent of the white matter was damaged. The white matter is the fatty tissue within the brain that coordinates communication between its different regions.

In addition to helping explain Gage's deterioration, the study showcases the power of brain mapping--a technology that neurologists believe will lead eventually to an understanding of the links between the brain's "wiring" and specific mental disorders, according to the statement.

"The extensive loss of white matter connectivity, affecting both hemispheres, plus the direct damage by the rod, which was limited to the left cerebral hemisphere, is not unlike modern patients who have suffered a traumatic brain injury," Van Horn said in the statement, adding that the loss of connectivity was analogous to that seen in Alzheimer's disease and other neurodegenerative diseases.

What happened to Gage after the accident? He worked at a stable in New Hampshire and then as a stagecoach driver in Chile before moving to San Francisco. He died there after a series of seizures 12 years after the accident.

But not all of Gage is gone. His 189-year-old skull is on display at Warren Anatomical Museum in Boston. The tamping rod? It's there too.

Also on HuffPost:

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• Caffeine For Imprisoned Twins

  In the late 18th century, King Gustavus III of Sweden was rumored to have carried out a strange experiment to determine the harmful health effects of coffee. Two identical twins who had been condemned to death had their sentences commuted to life in prison on the condition that one would drink three pots of coffee per day, and the other three pots of tea, for the rest of their lives. The only problem was that the doctors assigned to monitor the cases died before either of the patients did, their observations lost--as the story goes, the tea drinker died first, and there's no record of the coffee-drinker's death. The experiment proved nothing, suffering from a lack of rigor (to say the least). Source: Uppsala University, "Coffee - rat poison or miracle medicine?"

• Simulated Anthrax On The Subway

  In June 1966, the U.S. Army's Special Operations Division secretly dispersed harmless bacteria in the New York Subway system to model the effects of an outbreak of more harmful germs. According to Army reports, "Test results show that a large portion of the working population of New York City would be exposed to disease if one or more pathogenic agents were disseminated covertly in several subway lines at a period of peak traffic." Source: Deadly Cultures: Biological Warfare Since 1945. Wheelis, Rózsa, and Dando. Harvard University Press, 2006.

• Weaponized Fleas In The Desert

  Operation Big Itch, 1954, was an attempt to discover the potential of weaponized fleas. The operation, part of the Cold War-era United States biological weapons program, took place at Dugway Proving Ground in Utah. According to "Using the flea as weapon," an article in the Army Chemical Review, "In the United States, the plague flea concept was competing against the use of mosquitoes, flies, ticks, and lice. Of these concepts, the United States put most of its energies behind weaponizing yellow fever in combination with the Aedes aegypti mosquito."

• Food Through A Hole In The Stomach

  U.S. Army Surgeon William Beaumont (above) found an extraordinary patient in Alexis St. Martin, a Canadian trapper who was injured in a hunting accident and left with a hole in his belly that led directly into his stomach. Beaumont attached a string to various foods, including oysters and rare roast beef, and introduced them into the wound to observe the rates of digestion. Despite the unorthodox techniques, this research would later lead to the discovery of the importance of stomach acid in digestion, earning Beaumont the epithet "father of gastric physiology." Source: Experiments and observations on the gastric juice, and the physiology of digestion. Beaumont, Martin and Combe. Maclachlan & Stewart, 1838

• Candy For Mental Patients

  In 1945, Sweden's new National Dental Service commissioned research, now known as the Vipeholm experiments, in which researchers gave subjects large amounts of sticky sugary candy in order to study the development of cavities. This might not have been so controversial, except that the subjects couldn't give consent to their participation: "The use of mentally handicapped subjects was criticized in the Swedish press and all studies on mentally handicapped individuals were stopped in 1954," according to Topics In Dental Biochemistry by Mark Levine (Springer, 2010).

Comments

[IDIOTA]

05:42 PM on 05/20/2012

Doesn't damage to the left frontal lobe lead to diminished inhibition?

[neurogrl]

11:22 AM on 05/22/2012

Yes, which is why Gage was no longer a nice guy after his accident.

[Cari L Marvelli]

12:45 PM on 07/30/2012

yes...

[Robert Frano]

05:17 PM on 05/20/2012

Re: “…the 25-year-old railroad worker was using an iron rod to tamp down blasting powder when the stuff exploded, sending the 43-inch-long, 13-pound rod through his left cheek and out the top of his head….What's not so easy to understand is why Gage survived the accident--or the precise reason for the dramatic change in his personality afterward…

Sitting 3 feet off my left elbow, next to my old turn-out-coat, (aka, a black & yellow-reflective-stripped 'bunker coat'), is a steel bar, approximately .5 x 60-some-odd inches;
…It’s missing another 18 or so inches.

My partner & I encountered it, one morning, embedded in the ‘occipital’ portion of a patient’s head, after he was caught, having ‘stepped out’ on / by his wife…

Who registered her post-extramarital-displeasure the old fashioned, ('spear-chucking’) way...
The patient was conscious, drunk, as the proverbial skunk, (and/or, at least one of his rescuers, post shift, I can assure you!!), and…

Standing upright, face pointed to the ceiling, due to the weight of the steel-bar-protrusion being too much for his neck muscles to adjust to...
Except for the period clothing, (1800’s vs. 1980’s), he looked as awake, but not quite oriented as the pic of Mr. Gage accompanying this article…

…Ironically, he did just fine, post-injury, as far as I know...

[Anybodyseenthepopos]

12:32 AM on 05/21/2012

"Stepping out" on a wife with a temper like that might cause one to conclude that he's wasn't using all his grey matter to begin with.

Never mind his asking her to marry him in the first place. ;-))

[theyedster]

04:37 PM on 05/20/2012

Brain damage, huh? Woulda thunk it?

[viciousvirago]

04:23 PM on 05/20/2012

William Beaumont still comes up in medical school. I remember his name when we were dissecting cadavers and got to the stomach. Amazing, isn't it how long some works remain when deemed irrelevant when they happen.

[David Geschwind]

10:06 AM on 05/20/2012

This is not the first study of this kind. Please give credit to Antonio and Hanna DiMasio of the University of Iowa. They did this over 10 years ago.

[ctorgers]

05:17 PM on 06/04/2012

They are credited quite a bit in the article that is being discussed here (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0037454)

[TheBlueCoyote]

05:53 AM on 05/20/2012

The video is hilarious! With about 30 seconds of credits!

[kevin boomhower]

11:34 PM on 05/19/2012

The poor guy still died at a young age.

[chaya]

09:55 PM on 05/19/2012

"could not stick to plans, uttered 'the grossest profanity' and showed 'little deference for his fellows,'"

Maybe he was just in pain. I've known people in intolerable pain who acted just like this.

[Saint Brian the Godless]

03:17 PM on 05/20/2012

Sounds like he just became a republican. No big deal.

[synergie]

10:07 PM on 05/20/2012

If it was pain, I'm sure that would have been noted. I think the point is that there were not simple explanations for the change of personality, so they started looking at the brain architecture.

[ctlnaaia71]

04:25 PM on 05/19/2012

John Harlow, the doctor who treated the once-affable Gage, wrote that he "could not stick to plans, uttered 'the grossest profanity' and showed 'little deference for his fellows''... when I read this I thought they were talking about my husband! LOL

[Hexandra]

04:14 PM on 05/19/2012

Right Hemisphere,controls communication, behavior, Left side I believe controls body functions,movements.So loss of white matter, fatty tissue. Hm thinking about this one.Many people have been impaled by things, tree branches, large fish hooks, iron fencing,& gun shots. Brain white fatty tissue,called matter.Transplantation of the fatty tissue from the persons brain. They make organs, from stem cells.Can they transplant fatty tissue by needle sucking white fatty healthy tissue from person's brain.Transplanting the healthy tissue in the unhealthy side brain. I never went to college, but I am extreamly interested in brain science. Genetics and what we do to our own bodies. I know this sound like good old Dr Frankenstein. I also know, this will be a lot harder to actually perform, than I am thinking about it. There is a Dr. in TX helping people with spinal fusion. He is great, he does not do surgery, but does inject this gooey white substance between the disks. Same kind of jelly substance that actually comes from tomatoes. He is not using tomatoes.... I really think some Dr's feel he is wrong. Why because it will take away from the Ortho Dr's doing spinal surgery, and maybe for the knees too. It is still in the trial phase. I think that Dr. has good brain science in his brain. Right side brain, creativity. I also we all need to learn & practice "Brain Gym" To keep our brains functioning healthy.

[Hexandra]

07:20 PM on 05/19/2012

How is this one makavelinnne6 I never went to college only High School, I read a lot on brain science. I give a lot of credit to Dr's that really want to be Dr's and be proud of themselves. I am a lot like my dad, I think outside the box, I create things & figure things out. My dad was from Europe. came to the USA and became a builder was able to read blueprints. He never had schooling to be a builder and read blueprints. I feel he had an idea n went with that. Like the erector set was invented 1911 then bankruptcy 1967 the another Coin PA purchased the name and continued , Lincoln logs, and Lego's came way after he started building.

[new beginning]

03:30 PM on 05/20/2012

You have an interesting idea, but its not just the loss of what matter - its the loss of the neural connections that went with it, that caused the problem. Therefore, you couldn't just inject some more into his head and expect it to "work" properly.

[Susan Shaffer]

07:56 PM on 05/21/2012

isn't the white matter just like insulation for the neurones

[streettalk]

12:21 PM on 05/19/2012

lets examine the brain, what is it we know it is made up of matter and is constructure to control the body,which is call human not human being human is driven by instinct and the human being is control by the mind, we need to know the difference between them, but how are we to know this, i need you to go to your first dream and nightmare,what did you see your dreams with, and why was you afaid in your nightmare.so the brain recalls and the mind has memories, the brain recalls its fears and the mind has the memories of it. so the brain can be tutored and the mind remembers what it it has be tutored. but what is a mind and how does it function where is it. freud say we have an id ego and super ego, karl young says we have a body soul and spirit, but know one as what they where i think am running out of space so please check your memories first then your recall and get back to me. god bless

[ccgndy]

09:42 AM on 05/19/2012

I guess behaviorial changes happened when the brain re-mapped itself after a traumatic injury.Remember this man beaten in the head and became genius after recovery.Lobotomy was a standard procedure for mentally ill during the old days.

[drbillybob]

08:19 AM on 05/19/2012

I remember this unfortunate soul had his images on the cover of "Science" in 1994.

Science 20 May 1994: Vol. 264 no. 5162 pp. 1102-1105, DOI: 10.1126/science.8178168

I'll post their image below as a link (it may or may not show up).

[drbillybob]

08:20 AM on 05/19/2012

http://inside.salve.edu/~walsh/gagefromscience.jpg

[Wela Kalhoefer]

07:23 AM on 05/19/2012

In his book, Mystery of the Mind, the great American neurosurgeon, Wilder Penfield, concludes that the mind is absolutely independent from the brain. The mind is higher even than our consciousness, and it is, in fact, an absolutely independent entity. The mind gives orders, the brain executes them like a computer, and sends them to the consciousness.

Researchers say that we only use 2% of our brain. Other physical researchers also believe that the mind exists “outside of the body” and that they have not yet discovered its material form. So, what’s the purpose of the remaining 98% and the function of this excess volume? Is this the part that is connected to the upper level that receives instructions and nourishment from spirituality, working as a receptor for spiritual information?

[luke1511ff]

07:39 AM on 05/19/2012

It is a myth that we only use a small fraction of our brain. We use all of it, just not at the same time or for the same thing. Different areas control different functions.
If the mind is independent of the brain, how come brain injuries or diseases radically affect personality and mental performance, as in Gage's case? My father in law has no short term memory left because small strokes cut off blood supply to the part of the brain that controls such memory. If memory is part of the mind, and the mind is independent of the brain, how can that be? If a certain part of the brain is damaged, a person thinks his hand has a different will than his, and it will do things contrary to his conscious wishes. Another brain disorder causes a person to believe that his parents are impostors played by others. No one has yet observed a "mind" operating independently of a "brain," so Penfield is clearly wrong.

[drbillybob]

08:12 AM on 05/19/2012

Well said ...

The quote I like to use is, "Every brain has a mind of its own." This reflects the complexity, and difficulty in developing therapies for fixing neurological disorders.

[stz66]

08:33 AM on 05/20/2012

Good points. From what reading I have done on the subject, there is a debate in the field about whether mind and brain are the same or separate at some level. There are interesting arguments on both sides of the issue. But you are correct about the 10% use issue - that seems to be more of a popular perception than a scientific fact.

[J Owen Williams]

02:18 AM on 05/20/2012

I think you spend too much time at Jesus Camp.

[wtfstfu]

07:11 AM on 05/19/2012

"What's not so easy to understand is why---or the precise reason for the dramatic change in his personality afterward"
Because he had a friggin rod through his head.

[new beginning]

03:37 PM on 05/20/2012

LOL. Fanned for humor if nothing else!