Patients Get Way Too Personal

ORLANDO, FLORIDA--All those nightmares about showing up for school naked might be partly the work of the orbitofrontal cortex. Research presented here 6 November at the Society for Neuroscience annual meeting suggests that damage to this brain region impairs the ability to recognize emotions such as shame and embarrassment. Patients with orbitofrontal damage also tell stories that contain inappropriate personal information, perhaps because of an inability to correctly apply such emotions.

People who have had strokes, tumors, or other damage centered on the orbitofrontal cortex are as smart and mobile as they were before, but their personality often suffers. Anecdotally, researchers describe formerly responsible patients who can't hold down jobs or maintain personal relationships. Some studies suggest that such patients have trouble monitoring their emotions and social behavior.

To get a better fix on the emotional knowledge of such patients, Erin Heerey and Robert Knight of the University of California, Berkeley, and colleagues showed standardized pictures of emotional faces to five people with orbitofrontal damage and five people matched for age. Some of the faces held expressions of shame or embarrassment, which psychologists classify as "self-conscious" emotions because they require an understanding of one's self in relation to other people. Other emotions were non-self-conscious, such as anger, fear, contempt, or disgust. The patients identified these emotions as well as healthy people did, but they were impaired at recognizing shame and embarrassment.

The researchers also asked patients to define and recount personal experiences of various emotions, and they established that the patients understood each emotion. But in the course of their stories, the patients gave what's commonly called "too much information." For instance, one patient revealed that he'd had a serious drinking problem. And his example of embarrassment involved being accused, in the middle of a crowded bar, of having given a woman a sexually transmitted disease. The researchers found that the patients who gave the most inappropriate information also tended to be worst at identifying self-conscious emotions, suggesting a general deficit in applying these emotions.

In the past few years, neural imaging studies have shown that the orbitofrontal cortex and a few other areas are active in a lot of emotional situations, says cognitive neuroscientist Cheryl Grady of the Rotman Research Institute in Toronto: "It's going to be interesting to figure out how [these areas] interact to relate emotions to the self."

Related sites
The Society for Neuroscience abstract
Robert Knight's site