Cited by 196Advanced Neuroimaging Techniques and ApplicationsFunctional Brain Connectivity StudiesTraumatic Brain Injury Research

Mapping Connectivity Damage in the Case of Phineas Gage

Open access
Van Horn, John Darrell, Irimia, Andrei, Torgerson, Carinna M., Chambers, Micah C., Kikinis, Ron, Toga, Arthur W.·2012·PLoS ONE

Abstract

White matter (WM) mapping of the human brain using neuroimaging techniques has gained considerable interest in the neuroscience community. Using diffusion weighted (DWI) and magnetic resonance imaging (MRI), WM fiber pathways between brain regions may be systematically assessed to make inferences concerning their role in normal brain function, influence on behavior, as well as concerning the consequences of network-level brain damage. In this paper, we investigate the detailed connectomics in a noted example of severe traumatic brain injury (TBI) which has proved important to and controversial in the history of neuroscience. We model the WM damage in the notable case of Phineas P. Gage, in whom a "tamping iron" was accidentally shot through his skull and brain, resulting in profound behavioral changes. The specific effects of this injury on Mr. Gage's WM connectivity have not previously been considered in detail. Using computed tomography (CT) image data of the Gage skull in conjunction with modern anatomical MRI and diffusion imaging data obtained in contemporary right handed male subjects (aged 25-36), we computationally simulate the passage of the iron through the skull on the basis of reported and observed skull fiducial landmarks and assess the extent of cortical gray matter (GM) and WM damage. Specifically, we find that while considerable damage was, indeed, localized to the left frontal cortex, the impact on measures of network connectedness between directly affected and other brain areas was profound, widespread, and a probable contributor to both the reported acute as well as long-term behavioral changes. Yet, while significantly affecting several likely network hubs, damage to Mr. Gage's WM network may not have been more severe than expected from that of a similarly sized "average" brain lesion. These results provide new insight into the remarkable brain injury experienced by this noteworthy patient.

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  • The simulated trajectory of the iron bar in Phineas Gage confirmed notable local injury and identified patterns of widespread and long-range connectivity loss that could have contributed to postinjury behavioral patterns.

    “While this indeed confirmed notable local injury, it also identified patterns of widespread and longrange connectivity loss that could also have contributed to the characteristic postinjury behavioral patterns described.”

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  1. [25]Dupuy E 1877 A critical review of the prevailing theories concerning the physiology and pathology of the brain. Medical Times and Gazette ii 11 490
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Authors
Van Horn, J. D., Irimia, A., Torgerson, C. M., Chambers, M. C., Kikinis, R., & Toga, A. W.
Affiliations
  • University of California, Los Angeles (US)
  • Brigham and Women's Hospital (US)
Venue
PLoS ONE
Published
2012-05-16
Volume
7
Issue
5
Pages
e37454
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2043275179
Cited by
196
References
95
Citations by year
2026: 6 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 16 · 2020: 34 · 2019: 29 · 2018: 18 · 2017: 8 · 2016: 15 · 2015: 19 · 2014: 9 · 2013: 15 · 2012: 4
FWCI
11.35
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • University of California, Los Angeles
  • National Institute of Mental Health (RC1MH088194)
  • National Institute of Biomedical Imaging and Bioengineering (U54EB005149)
  • National Center for Research Resources (P41RR013642, P41RR013218)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
Phineas Gage, traumatic brain injury, white matter injury, connectomics, diffusion MRI, brain network connectivity, frontal lobe lesions, network hubs, history of neuroscience
MeSH terms
Adult, Brain Injuries, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Nerve Fibers, Myelinated, Personality Disorders, Tomography, X-Ray Computed, Vermont, History, 19th Century, Neuroimaging

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