E.L., a modern-day Phineas Gage: Revisiting frontal lobe injury

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorUniversidade Federal do Rio de Janeiro (UFRJ)-
Autor(es): dc.contributorMiguel Couto Municipal Hospital-
Autor(es): dc.contributorVassar College-
Autor(es): dc.contributorUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)-
Autor(es): dc.contributorUniversidade do Estado de São Paulo-
Autor(es): dc.contributorPontificia Universidade Catolica do Rio de Janeiro-
Autor(es): dc.contributorCentro de Neurologia da Cognição e do Comportamento Ltda-
Autor(es): dc.contributorCentro Universitario IBMR-
Autor(es): dc.contributorMRI Clinica de Diagnostico por Imagem (CDPI/DASA)-
Autor(es): dc.contributorInstitute of Psychology-
Autor(es): dc.contributorHouston Methodist-
Autor(es): dc.contributorGeorgetown University-
Autor(es): dc.contributorGenome Explorations-
Autor(es): dc.contributorNorthwell Health-
Autor(es): dc.contributorDept Neurology-
Autor(es): dc.contributorSchool of Medicine-
Autor(es): dc.contributorAlbert Einstein Coll Medicine-
Autor(es): dc.contributorFIOCRUZ-
Autor(es): dc.creatorde Freitas, Pedro H.M.-
Autor(es): dc.creatorMonteiro, Ruy C.-
Autor(es): dc.creatorBertani, Raphael M.-
Autor(es): dc.creatorPerret, Caio M.-
Autor(es): dc.creatorRodrigues, Pedro C.-
Autor(es): dc.creatorVicentini, Joana-
Autor(es): dc.creatorde Morais, Tagore M. Gonzalez-
Autor(es): dc.creatorRozental, Stefano F.A.-
Autor(es): dc.creatorGalvão, Gustavo F.-
Autor(es): dc.creatorde Mattos, Fabricio-
Autor(es): dc.creatorVasconcelos, Fernando A.-
Autor(es): dc.creatorDorio, Ivan S.-
Autor(es): dc.creatorHayashi, Cintya Y.-
Autor(es): dc.creatordos Santos, Jorge R.L.-
Autor(es): dc.creatorWerneck, Guilherme L.-
Autor(es): dc.creatorTocquer, Carla T. Ferreira-
Autor(es): dc.creatorCapitão, Claudia-
Autor(es): dc.creatorda Cruz, Luiz C. Hygino-
Autor(es): dc.creatorTulviste, Jaan-
Autor(es): dc.creatorFiorani, Mario-
Autor(es): dc.creatorda Silva, Marcos M.-
Autor(es): dc.creatorPaiva, Wellingson S.-
Autor(es): dc.creatorPodell, Kenneth-
Autor(es): dc.creatorFederoff, Howard J.-
Autor(es): dc.creatorPatel, Divyen H.-
Autor(es): dc.creatorLado, Fred-
Autor(es): dc.creatorGoldberg, Elkhonon-
Autor(es): dc.creatorLlinás, Rodolfo-
Autor(es): dc.creatorBennett, Michael V.L.-
Autor(es): dc.creatorRozental, Renato-
Data de aceite: dc.date.accessioned2025-08-21T15:12:00Z-
Data de disponibilização: dc.date.available2025-08-21T15:12:00Z-
Data de envio: dc.date.issued2023-03-01-
Data de envio: dc.date.issued2023-03-01-
Data de envio: dc.date.issued2022-10-01-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1016/j.lana.2022.100340-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/241696-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/241696-
Descrição: dc.descriptionBackground: How the prefrontal cortex (PFC) recovers its functionality following lesions remains a conundrum. Recent work has uncovered the importance of transient low-frequency oscillatory activity (LFO; < 4 Hz) for the recovery of an injured brain. We aimed to determine whether persistent cortical oscillatory dynamics contribute to brain capability to support ‘normal life’ following injury. Methods: In this 9-year prospective longitudinal study (08/2012-2021), we collected data from the patient E.L., a modern-day Phineas Gage, who suffered from lesions, impacting 11% of his total brain mass, to his right PFC and supplementary motor area after his skull was transfixed by an iron rod. A systematic evaluation of clinical, electrophysiologic, brain imaging, neuropsychological and behavioural testing were used to clarify the clinical significance of relationship between LFO discharge and executive dysfunctions and compare E.L.´s disorders to that attributed to Gage (1848), a landmark in the history of neurology and neuroscience. Findings: Selective recruitment of the non-injured left hemisphere during execution of unimanual right-hand movements resulted in the emergence of robust LFO, an EEG-detected marker for disconnection of brain areas, in the damaged right hemisphere. In contrast, recruitment of the damaged right hemisphere during contralateral hand movement, resulted in the co-activation of the left hemisphere and decreased right hemisphere LFO to levels of controls enabling performance, suggesting a target for neuromodulation. Similarly, transcranial magnetic stimulation (TMS), used to create a temporary virtual-lesion over E.L.’s healthy hemisphere, disrupted the modulation of contralateral LFO, disturbing behaviour and impairing executive function tasks. In contrast to Gage, reasoning, planning, working memory, social, sexual and family behaviours eluded clinical inspection by decreasing LFO in the delta frequency range during motor and executive functioning. Interpretation: Our study suggests that modulation of LFO dynamics is an important mechanism by which PFC accommodates neurological injuries, supporting the reports of Gage´s recovery, and represents an attractive target for therapeutic interventions. Funding: Fundação de Amparo Pesquisa Rio de Janeiro (FAPERJ), Universidade Federal do Rio de Janeiro (intramural), and Fiocruz/Ministery of Health (INOVA Fiocruz).-
Descrição: dc.descriptionInstituto de Ciências Biomédicas CCS Universidade Federal do Rio de Janeiro-
Descrição: dc.descriptionMiguel Couto Municipal Hospital-
Descrição: dc.descriptionVassar College-
Descrição: dc.descriptionDept Neurocirurgia HUGG Universidade Federal do Estado do Rio de Janeiro (UNIRIO)-
Descrição: dc.descriptionDept Neurologia Universidade do Estado de São Paulo-
Descrição: dc.descriptionPontificia Universidade Catolica do Rio de Janeiro-
Descrição: dc.descriptionCentro de Neurologia da Cognição e do Comportamento Ltda-
Descrição: dc.descriptionCentro Universitario IBMR-
Descrição: dc.descriptionMRI Clinica de Diagnostico por Imagem (CDPI/DASA)-
Descrição: dc.descriptionUniversity of Tartu Institute of Psychology-
Descrição: dc.descriptionInstituto de Biofísica Universidade Federal do Rio de Janeiro-
Descrição: dc.descriptionDept Neurologia HUCFF Universidade Federal do Rio de Janeiro-
Descrição: dc.descriptionNeurological Institute Houston Methodist-
Descrição: dc.descriptionGeorgetown University-
Descrição: dc.descriptionGenome Explorations-
Descrição: dc.descriptionNorthwell Health-
Descrição: dc.descriptionDept Neurology-
Descrição: dc.descriptionPhysiology and Neuroscience New York University School of Medicine-
Descrição: dc.descriptionDept Neuroscience Albert Einstein Coll Medicine-
Descrição: dc.descriptionCentro Desenvolvimento Tecnológico (CDTS) FIOCRUZ-
Idioma: dc.languageen-
Relação: dc.relationThe Lancet Regional Health - Americas-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectCorpus callosum (C.C.)-
Palavras-chave: dc.subjectLow Frequency Oscillations-
Palavras-chave: dc.subjectMagnetic Resonance Imaging (MRI)-
Palavras-chave: dc.subjectNeuropsychological tests-
Palavras-chave: dc.subjectPhineas Gage-
Palavras-chave: dc.subjectPrefrontal cortex (PFC)-
Palavras-chave: dc.subjectTranscranial Magnetic Stimulation-
Palavras-chave: dc.subjectTraumatic brain injury (TBI)-
Título: dc.titleE.L., a modern-day Phineas Gage: Revisiting frontal lobe injury-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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