QUESTION:
Hi!
I am curious to know if individuals who have suffered from a prefrontal cortex lesion (and have had a personality change) realize that their personality has been altered? Are they aware that they are now a different person than before?
Thank you.
ANSWER:
The answer is simple – some do and some dont. I recently had an elderly woman who had a stroke in the right prefrontal cortex. She developed classic signs of attention deficit disorder that responded well to Ritalin. She recognized something had changed, however Ive had many patients who didnt recognize that something had changed.
Interestingly the closer the lesion is to the frontal lobes, the more depressed people get. Some brain lesions (especially strokes and head trauma) can get a total personality change that can be very impressive. Those with alcohol damage to some brain areas totally lose their short term memory and cant read a book or watch a movie because they cant remember what just happened. Memory loss usually causes significant personality changes, including depression.
Sometimes an illness will cause someone to rethink their priorities because they faced their mortality. This is commonly the case after a heart attack or cancer, but can also happen after brain damage. Whether the personality change is due to this, depression or other mental health problem, or due to brain structural changes can sometimes be difficult to determine.