What Does Damage to the Frontal Lobes Look Like 30 Years Post-Brain Injury?

Researchers studying Vietnam veterans with TBI are now looking more closely at how TBI can alter a person's social beliefs — from religious and political to legal and moral.

See more videos with Dr. Jordan Grafman.

There's a number of new areas we've become interested in for Phase 4 and for our current evaluations. One of them has to do with further studies of so-called executive functions, so we're very interested in seeing how people plan, execute, and interpret on-going activities in front of them-- in essence showing them movies and asking them to make comments about what they're seeing--for example, to divide up a series of actions into episodes. When does 1 episode begin and end, and then when does another 1 begin, and what is the meaning of what they're seeing. This is like real life, in essence. When people go into a situation, they may want to recognize the objects in a room, remember the name of the person they're with, but in essence they want to know why am I here? What's happening? What's going to go on? That is something the frontal lobe does. It does it very well. It allows us to have foresight, so we're studying that in a little bit more detail for Phase 4. In addition, we've become much more interested in human social beliefs, a very high-level aspect of social functioning. This includes everything from religious, to political, to legal, and to moral beliefs. And we're studying them in a lot more detail because it's likely that damage to the frontal lobes of the brain and the temporal lobes of the brain that we see with our vets with traumatic brain injury will affect in some way the nature of those higher-level social beliefs. Now, is this meaningful for our day-to-day functioning in life? Well, it could be. I'll give you 1 example--the example of legal beliefs. We might have somebody judge how much they want to punish a perpetrator who's committed a crime, and we vary the severity of the crimes. We want to see which crime they rank as the worst. They might want to execute somebody or give them capital punishment all the way to probation on the other end. So, we have them make these judgements and rankings, and we know from a previous study--a smaller study--that patients who have frontal lobe lesions in particular--compared to lesions elsewhere in the brain-- due to traumatic brain injury have a more difficult time doing that rank ordering. All right, so you say, well, we're not going to put them on a jury. And they're not going to do very well if they're on a jury, but forget about a jury. Let's say they're at home and they have kids, and the kids misbehave. That creates more conflicts with their spouse, for example, in determining how to punish those kids. The spouse might have 1 point of view, which is consistent with sort of the normal view of how to punish, but the person who's had the traumatic brain injury may be less able to do that and may not punish effectively because of that. So, that's a place where we study a higher belief, which is how you punish somebody for misbehavior, and it could be translated directly into the home and how to punish a child, for example, for misbehavior.
Posted on BrainLine February 11, 2013.

Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.