Transcribed by Jacqueline Heath

February 25, 2014

Cerebral Cortex and Higher Functioning Lecture by Dr. Schiff Note: this lecture did not have slides, so I separated the lecture as best as I could by themes. This is the beginning of the recording: (missing a few seconds, likely) the so called higher functions that are mediated by the cerebral cortex. Because after all, what we have inside our skulls is probably, at least as far as we know (we havent met any other versions from other planets yet), the most complicated machine around. And what we have to do is try to figure out how it works. Now, there was a big attempt at this in the middle of the 19th century when two things happened. One was the rather famous case of Mr. Phinneus Gage? Who worked for the transcontinental railroad when it was being built (1848), and had a bit of an accident. They would lay the rails (ties) and put the track nailed to the ties. And to keep the tracks from vibrating out of position, because they had to stay a certain distance apart to keep the train on top, they would put gravel in between the railroad ties. And Mr. Gage had a not very skilled job at the time- he was a temper. A tamping rod was a long cylindrical rod with a flat plate on the bottom. So after they dumped the gravel, he would tamp it down. And he would walk along the miles of track pounding the gravel down. But apparently someone left the blasting cap, which was needed to set off dynamite off, somewhere in the gravel, and he went bump and the cap went boom, and the rod he was holding went in here and out here. And he survived, which is the most amazing thing in the world. Lived for quite awhile afterwards. And his skull is still around somewhere, forget which museum has it. And you can see the hole here and hole there. And from the changes in his personality before compared to after, it was concluded that he underwent certain changes in his mechanisms of thought. He became irritable. It seems to me that if someone had driven an inch or so diameter steel rod through my head, Id get irritable too. And that this is not a very specific effect. But it got people thinking at least where functions are found in the brain. Because it was known that the brain does a lot of stuff and is responsible for personality and thinking, and the idea was that, the question was is it all distributed or are there specific locations that do specific jobs. And in the 1850s or so, a guy by the name of Francis Gall (I will never ask you anything about history on an exam- relax about that), um, developed the whole idea that there are different regions of the brain responsible for different aspects of brain function he called them motors by the way, and that you could tell which, once you knew which motor was dominant and which motor was inferior in quantity in the human brain, you could figure out the persons personality. Like, heres the generosity area. And heres the philanthropic area, and heres the evil greedy area. Things like that. And it developed into a science that was referred to as phrenology and the whole idea was that there were specific locations in the brain that were responsible for a number of things.

Uh, Now, a lot of this has been dismissed, but on the other hand, a lot of data came in during WWI, because during WWI there were a lot of bombs blowing up in the vicinity of a lot of soldiers, who really didnt want to be there, and little bits of shards of metal would puncture various parts of the nervous system, not as big as an inch diameter rod, but bits of metal, that caused lesions in various parts of the brain, that people survived, somehow. But they developed certain inabilities, damage here seemed to cause the inability to do arithmetic, and damage here tended to cause a defect in speech or in understanding language. That sort of thing. And so he was the perfect natural experiment (hardly natural), but you find a person that used to be able to do something, but cant do it anymore after having bits of metal shot into his head, and you wait til he dies, and you look at his brain and see where the lesions were, and conclude that that area was damaged and he could no longer do arithmetic center, so thats probably the arithmetic area of the brain. And so this sort of thing developed into much greater detail, essentially bringing back with what was considered with a more scientific basis, phrenology. Now, there is a certain amount of accuracy in this mapping function of the brain, because after all, youve had lectures on brain anatomy, there are areas associated with speech, Brocas area, Wernikes area, areas associated with body position, there are areas associated with sensory input from various parts of the body, somatosensory areas, and so on. And so there is something to this, but as I have said over the course of my lectures a number of times, its a little more complicated than that. Because there is an overall scheme of things, and within this overall scheme of things, you sometimes cant conclude what you think youre concluding. If you have a lesion here that prevents the brain from doing something, it might be that this is where that function is located, that his part of the brain is the center that manages hand movement, or counting, but it also might be possible that there are two areas that handle this specific process, and thats one of them. And if you were to produce lesions in either place, the ability might be lost. And theres a third possibility, which is generally referred to as the axons of passage type model. If this area is involved in doing something, and this area is also involved in doing that same thing, they have to communicate their axons moving from one to another, and if you have a lesion here, in the middle, cutting the axons, and the ability is lost, even though the ability is not really centered in this place at all, it just requires a way to get from A to B. So as I said, there are certain specific areas that seem to be associated with things, such as on your left hemispheres. Well, lets talk about lateralization. There are two hemispheres. They are approximately symmetric. Not exactly. There was a whole series of work done in the 70s looking for specific anatomical differences, and there are indeed in most people, slight different shapes in the Sylvian fissures, whether its horizontal, or sloped upward, its different on the language hemisphere and the non-language hemisphere. It seems to be, for one example, lateralization of function. Which is not present at birth. Well, we dont really speak at birth or understand language at birth, but over the course of a year or two, you begin to pick up language. And your whole brain is involved (both hemispheres). But by the age of six, most of your language seems to be focused, in most people, in the left hemisphere. In about 90% of people, thats where its located. Why that should be the case? Who knows. Most people, about 90% are right handed, about

10% are right handed. Why that should be the case- we dont know. What we do know, is that its a long standing statistic referenced somewhere, and I should have dug out the reference for this lecture, uh, there is a Biblical reference to a description of an army that there were so many men, of which, so many (10%) were left handed. So at least a few thousand years that ratio has been fairly constant. For whatever thats worth. Incidentally, the 90% of those with left hemisphere language function, and the 90% of those who are right handed, arent necessarily the same 90%. They sort out randomly. 90% of left language people are right handed, and 10% are left handed, just as of the 10% who are right hemisphere for language, 90% are right handed and 10% are left handed. They arent linked. We have however, always, for a long time, considered something to be wrong about left handed people. I dont know why. Whats the Latin word for left handed? Sinister. We talk about dexterity (dexter means right handed the right side). So there is a tendency to lump these things into stereotypic categories that dont make any sense at all. So you have this breakdown of left and right hemispheres each doing a different sort of problem. They used to refer to the left hemisphere as dominant. I have never liked the word dominant, and it does seem to be losing out a little bit. If there are two halves of a brain, and one of them, when you talk to it, answers you, and the other doesnt, you tend to think of the one talking back (picture Penn and Teller? (I dont know who those people are, love, your scribe)). Pen does all the talking, Teller, never. So then one thinks, well the fact that Penn outweighs Teller by 100 pounds or so, might contribute to that, but we tend to think about the half of the brain we are communicating with as dominant, but thats not really accurate. Its the linguistic half, the language half of the brain. If youre going to communicate with it with language, youre going to tend to focus on the half that can hear you and understand you. There are generally of course the two halves of the brain that tend to communicate with each other, largely through this heavy band called the corpus callosum. There are a number of people, especially back in the 80s or so, who have alright, Dr. Sirois will be discussing epilepsy and seizures and the like. There are certain forms of epilepsy in which the trigger in one hemisphere will go through the corpus callosum to the other hemisphere, back and forth, and resonate, getting stronger and stronger. Now adays, there are anti-epileptic drugs to prevent this, but back then, they didnt have good anti-epileptic pharmacology, so what they would do is cut the corpus callosum so the signal couldnt resonate from hemisphere to hemisphere and back again. And these people had split brains. Lets just assume that such a person has left hemisphere language. If you speak to him, his left hemisphere can understand you but cant communicate with the right hemisphere, it doesnt understand whats going on at all. Theres a phenomenon called sterognosis with your eyes closed, something put in your hand you can feel it and figure out what it is. Gnosis means knowledge. If you have one of these split-brained people and you put a block in his right hand, and you put a piece of chalk in his left hand, and you ask him, what are you holding? What will he say? A block. Why? Because the left hemisphere, which is getting input from the right hand, feels a block in the right hand.

And the left hemisphere hears your question and answers. It also controls speech, and he says a block. What about the piece of chalk in the left hand? The right hemisphere knows its a piece of chalk. Doesnt know it and cant say its name but if you put that person in front an array of items, say a block and a piece of chalk and a key, and you sort of gesture, indicating, what were you holding before? Or somehow restrain the situation so he has to reach with his left hand, hell point to the piece of chalk with his left hand. So, youve got this separation of function between the two hemispheres, we also have another separation of function in a way. If you consider the brain before the lateral fissure and after it, the anterior part seems to be involved in motor control. The precentral gyrus seems to be your primary motor area and anterior to that is your secondary motor area. And the area before that, referred to as frontal lobe, is also involved at a more abstract level in motor. You see, the precentral gyrus is a motor center in that if you trigger an action potential in a certain area, that muscle or bit of muscle on the opposite site of the body will contact. If you go further forward in the secondary motor area and stimulate a little are with action potentials and you get a coordinated group of muscle contracting. So there is sort of a more abstract level of, you close all the fingers lets say, not just a single muscle. But if you go further forward to the frontal lobe, you see centers that are planning ahead and anticipating in finding your role in the world youre in. It plans where youre going to be moving your hand muscles later, and what would be appropriate. Now lets go back to Mr. Gage. One of the things that was concluded from his experiment was that the rod going through his skull essentially severed part of the prefrontal area, the part that is furthest anterior, from the rest of the brain. So it might as well not have been there, because communications with that part of the brain and everything beyond it was more or less messed up. And it was found that, besides being irritable, which I think it kind of a given, one of the symptoms of this is an inability to plan ahead for the future. And damage to the prefrontal area seems to affect this whole idea that were motivated, we know what is expected of us in a situation and we act appropriately. The thing here is that was lost. Now somebody, and this is one of the most, should I call it tragic, most stupid periods of neuroscience was in the 1920s 30s, a fellow named Agon Moniz, decided that well, if you sever the frontal lobe from the rest of the brain, this person would lose the ability to plan ahead. If he was a criminal, he would lose the ability to plan crimes, and thus this procedure would reform criminals. And in one of the greatest acts of stupidity, ever, he was awarded a Nobel Prize for that. And hundreds of people throughout the world were forced to undergo this procedure after criminal conviction. And not only that, but a lot of papers were published on fast and easy ways to do this. Better technique. One of which, that got great praise, ever heard of the practical joke of giving someone a banana that was already sliced and when he opened it all of the banana would fall out, haha, and the way you do that is you take a needle and punch it into the banana and swing it back and forth, cutting it while keeping the skin intact. That was the major great scientific breakthrough. You stick a needle in the skull and wiggle it back and forth (to make cuts), and if you do it reasonably cleanly, there is no infection. I dont

think there are any survivors of that left, but if you ever read or see Ken Caseys One who flew over the Cookoos nest, there are a lot of references to that, where the threat of this frontal lobectomy was used to intimidate and punish patients in psychiatric institutes. Ok. The back half of the brain is involved in sensory type stuff. I mean part of the phrenology that is correct is that there is a primary visual area in the back of the occipital lobe and you have, um, and visual inputs project there, although there are other areas that visual inputs project as well. And damage there can cause a loss of the subjective ability to see. But you sometimes find that there are people that have, as a result of stroke or trauma, damage to the occipital lobe, and they say Im blind. And then you say, well look, Im going to put this screen in front of you and flash lights, and you try to point to where they are. Everytime there is a ping, we will have shown a light, and you point to it. well I cant see it, Im blind you idiot! And so, well guess. Its just a random thing. And you find that they are a lot more accurate than you would expect. And we tell them, you got 8/10 right! Well I couldnt, Im blind, Im just guessing! Well there are multiple visual pathways besides your optic nerve/tract, back to the occipital lobe. There are other areas in the brainstem that receive optic input. There are areas that they occipital lobe and lateral geniculate nuclei in the thalamus, then project to in addition to the cortex. And there are different aspects of vision that people get information about. There are certainly the occipital lobe telling you what you see. If your occipital lobe works perfectly and the optic nerve/ tract pathway goes there and you see something in your visual field, you know what it is. But there are other things that your visual system does. One of them is orienting. If you have a little prey animal, sometimes a predator sometimes a prey. Say a frog. Put a frog here. And a fly is going by. The frog will turn til he is facing the fly and then whip out his tongue. Thats how they make a living. The whole thing is orientation. That seems to involve a whole different set of pathways that are different from identifying. There are blind people with occipital cortex lesions who, if put in a room with bits of furniture scattered about, can walk through it without bumping into things, totally unaware of how theyre doing it. There are specific pathways from the occipital lobe running along the base of the brain that are involved in recognizing faces, for example. There is a syndrome called prosopagnosia, in which people cant recognize faces. Certainly cannot distinguish face of person A from face of person B. They can identify you by your voice and take in what youre wearing, and the next time they see you, they will recognize the clothing you were wearing and know who theyre talking to and it will be confirmed by your voice, but will not recognize a face. There is a classic book by Oliver Sacs named the man who mistook his wife for a hat about a man with prosopagnosia, prosop- means face and agnosia means non-knowledge, ignorance of faces. Whats more interesting is this. Even if you see a face that youve never seen before, or something abstract, looking like a face, (he draws a face), if you see that, you think face. These people dont. They see a circle with a couple of dots and a line. Emoticons are lost on them!

So the back half of the brain is involved in taking in sensory information and trying to figure out what to do with it. Sort of surrounded by the visual area and the somatosensory area on the postcentral gyrus and again, that projects to the next level, the secondary sensory, is whats known as a sensory association area on both hemispheres on the parietal lobe, but they function differently because of the lateralization of the brain. The left parietal lobe is involved with information processing as a sort of digital exercise or linguistic exercise. It deals with sorting things in order, counting arithmetic, counting a column of numbers, lining things up in size and place, keeping track of which fingers youre being touched on. If someone touches your fingers, you know which one they touched. If someone asks you which finger you use to salute a taxi driver that just cut you off. But lesions in the left parietal cortex tend to lose that ability. These people cant, in addition to whatever speech areas are messed up, they cant do arithmetic, they cant count, they cant line things up in space. The right side parietal lobe, the non-linguistic parietal lobe, is involved in a whole bunch of other things, it recognized patterns, music, abstract art. But what it also does is, is keeping track of your body image. Close your eyes right now, you know where your right hand, left hand, and feet are. You know whether youre sitting or standing. You have this picture of your body image. If you had to get dressed in the dark, you could probably do it. After all, if you get soap in your eyes in the shower, youre basically washing yourself with your eyes closed, and you can do it because you can basically find all the parts. A person with a lesion in the parietal lobe of the right hemisphere will lose knowledge of parts of the left side of his body. He might put on just his right glove, not the left, right shoe but not his left. Because hes lost his left foot. Its lost. It doesnt exist, its not part of him. Its essentially a disassociation with the uh, with that part of the body. And generally that is a purely right hemisphere thing for people with a left hemisphere language and that lesion only affects that side of the body. But its more than that because these people also, well, as a classic story of a patient with a parietal lobe stroke lying in a hospital bed, and suddenly there was a loud thump and the nurse ran in to see what had happened, and the patient was on the floor, screaming in horror. What happened? Well there was this leg in my bed! So I grabbed it and threw it out! And next thing I knew I was on the floor! But again its more than that. Everything is a little more. If you give a person this (draws a circle), and tell them to draw a clock face, most people will do an approximation, most people can do it and draw the hands. But a person with a right parietal lobe lesion will tend to ignore the whole left half and will do something like this (draws a clock with all the numbers on the right side). In other words, the left half of the universe doesnt exist if this is an extreme case. But let me just go on for a couple of other cases. How many of you since Im sure you all read the handout on NYU classes, how many of you went to the youtube video on the McGurk phenomenon? Boy, what a response. Do me a favor. See it. Watch it. Its worth 6 minutes. What I suggest you do is watch the video, Ill give you a link, watch the video and absorb it for a minute or so. And watch it again with your eyes closed (well not watch it, play the audio). Youll find it very interesting. The whole key is here that

senses interact. Your brain is receiving senses, a lot of different senses giving information about the same thing but from different points of view, from different transducers. You know which way up is, for example, in this room. How do you know? Your eyes are giving you visual input. Your somatosensory area is sensing that there is a certain amount of pressure on your tush, so then that direction must be down, and also your vestibular system, your utricle is telling you which way is up, and down, and so on. So youre getting multiple inputs about your position in space. Right? Normally, these are all telling you the same thing. But suppose they tell you something different. Ever been in one of those tilted rooms in exploratory rooms, with various ramps, and you find a room where everything is off by about 20-30 degrees. And your eyes are telling you which way is up, your ventricular system is telling you something is up, and youre getting a different answer, and the pressure receptors on the soles of your feet are saying something consistent with what your vestibular system is saying, but not consistent with what your eyes are telling you. And what happens when you get an inconsistent input? Well, in this particular case, you probably throw up. Because there are a lot of poisonous plants that a person might eat, so if your vestibular system is telling you something different from what everything else is telling you, that might be a sign that you ate something you shouldnt have, and the reflex that has evolved over millions of years is, unswallow it. But as you will see, and believe me, you will see it. Watch that tape! Um because if I didnt put any on the quiz, its gonna be on the midterm and if not, the final. So. Um. We take visual input as well as say, hearing which helps us understand language. People who hear, also lipread, not consciously. But what you see of other peoples mouth moving helps you interpret what is being said. And if you dont believe me, watch that video on the McGurk effect. There is also what is widely known as the cocktail party problem. Say youre in a room with all sorts of conversations going on around you and youre trying to talk to one specific person. You look at that persons lips. You try to focus on, if youre facing that person, you want the sounds to be equal on both sides. So you tell your brain to reject anything thats off to the side. Tune out all of the other sounds in the room so you can focus on this particular voice. And we do that. If on the other hand, the person youre having this conversation with is as dull and boring as I am, you might be more interested in that conversation over there. So while you keep facing me to be polite, you readjust your focus on that conversation over there. And what do you do? Well, anything there is going to be louder in your right ear than your left and its going to appear in your right ear input sooner than your left ear, and you have ways to selectively focus on sounds with those properties so youre tuned to sounds coming from that direction, Okay. So, this is the most complicated machine as far as we know (hes referring to the brain). Now it might be that when the aliens stop for a visit, their brains may be a lot more complicated from ours. But as far as we know, is the most complicated machine you can get. And there is a lot going on. And you know, you should be aware of it. After all, very few neuro courses actually have a lecture on the brain. And I dont know why. After all, isnt this what its all about. And there ya have it.

Ah. Ill be seeing you early tomorrow morning in Septodont. Gotten that notification? Read your mail. Look for announcements on NYU classes. Hows it going to work without a blackboard? We will find out.