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.

Comments (7)

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Hi my name is less I am 44 years old and I have suffered two tbi's 1 in 1998 I fell off a mountain in Joshua Tree California estimated around age 60 to 70 footfall I was pronounced dead and retrieved in the helicopter I was in a coma for 15 days I was only in my twenties set my wife at the time didn't know what to do I didn't get any medical help and then again my next accident was in 2019 I was thrown from a back of a truck and left laying in the road when someone finally realized I was unconscious the police to pick me up I didn't realize that I had been hurt they then took me to the hospital to see if I was okay I was totally unconscious and once again was in a coma for four days somehow the hospital let me out because I was screaming and yelling that I wanted to go home the nurses didn't realize but I still had so much blood in my brain I went two months before even realizing what it happened to me confused after the second month they still found that I had too much blood in my brain I now suffer with a shrinking frontal lobe and my left temporal lobe still has specks of blood in it my memory is off no one likes me and I can't make any sense of my own self I get lost daily trying to figure life out I understand a lot of you on what you're saying on here sometimes I think yesterday what's today I can't remember what happened more than 3 days ago more less even yesterday when I look at numbers I get scared I can't spell worth crap I get mad very easy and think that everyone is against me and doesn't like me sometimes I talk so much and so fast people can't understand me my vision is all off and when I look at something we try to read it looks like roadmaps when people say things to me I sometimes don't understand them and they say that I put together things backwards I'm trying to fight for my disability now and waiting to see if the medicines are working I have had several seizures and I wake up a lot of times at night and my wife says I'm shaking really bad my headaches come and go sometime so bad they're like just to sit in the dark I talk to myself sometimes but don't make any sense I pray that I get my disability so I can try to start working on things help myself without having income it's really hard every job I have I lose within a week because they say I'm either too much or not enough I can't sit still and it bounced around like a rabbit trying to do projects sometimes I feel like a little kid trying to learn things that I should already know my my prayers and love are with all of you and we all tried to get through these days that I we are faced with the challenge of healing the scariest thing I find are the seizures sometimes when you wake up and your shaking and you can't stop it's kind of scary or when you're talking to someone in your arm just starts jerking are your legs twitch or your legs hurt so bad sometimes my wife gets upset with me a lot because she doesn't understand me and I don't really understand her sometimes I think I make sense but people say I'm the one that has something wrong with me when I think it's them once again I love all of you and send all my prayers we're all in this fight together thank you to the doctor for helping us

I am currently 41yrs old. When I was 3 ½ years old (was 6months from turning 4yrs old) the car I was in was hit by a drunk driver, drivers side to drivers side killing my dad on impact. The impact was like hitting a brick wall at 90mph.The sunroof caved in and sliced my head open causing a skull fracture & brain bleed. I was pronounced clinically dead ans was revived sometime after 5-7mins. I have 60 cross stitches (120 total) in my head to close my scalp. I was in a coma for a week, not expected to live. My mom said once I regained consciousness, that I was different & described me as a "fiery little thing." I do have motor skills deficients, tho they are not noticeable to others unless pointed out. Math is like a foreign language to me, I have tried, even with tutoring & still can't grasp things beyond basic math/algebra. Organization skills - what's that? I don't even know how to be organized & it drives my husband crazy, as wel as myself. I do have memory problems, but my biggest problem is my emotions. I have battled depression on/off since I can remember. Medications only work for a short time. My moods can vary throughout the day. My anger gets the best of me and I get mad over the slightest things. I also suffer from Aggression when I get really upset, I just want to break something or throw something. I speak before I think, which can be a big problem, too. I've tried counseling, but I have yet to find anyone who can really help me. They have treated me just as a normal person without a brain injury. I wish more than anything I could be "normal" - which I know everyone is not the same, but to be without a TBI & dealing with the issues from it would be absolutely wonderful. I have found the older I have gotten, the WORSE things are getting. Idk if there's been studies done or whatever, but I'd love to participate in one. I just want help so I can function normally, but no idea how to go about doing it.

I damaged my right frontal lobe about 14 years ago in a motorcycle accident ... i dont think anybody would really understand .. the longing to feel normal again ... i fully get what u are trying to say .... if only i could forget what "normal" feels like.

Iwas hit by a van when I was 5. I have major problems that I my loved ones dont understand. The intense headaches, & moods are unbearable. Is it possible for me to improve in any way.

MY son had an accident last July 4, 2019, frontal head trauma, Braun bleeds, refuses to seek help and doesn’t realize how serious this is . What is your advice?

Hello Dr. Gafman PhD
My name is Dan. I'm 49, I fell 20 to 30 feet in 1977. I've gone without treatment or diagnosis. I landed on cement and my forehead hit the lead gas line. I live in my car, I have no one to help me, I am wondering if there is some way you could help.

I too am convinced I have frontal,lobe dysfunction following a head injury. I am a doctor but can no longer wor and cannot get anyone to support this diagnosis