Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices

Carissa L Philippi; Justin S Feinstein; Sahib S Khalsa; Antonio Damasio; Daniel Tranel; Gregory Landini; Kenneth Williford; David Rudrauf

doi:10.1371/journal.pone.0038413

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Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices

Journal article

Open access

Peer reviewed

Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices

Carissa L Philippi, Justin S Feinstein, Sahib S Khalsa, Antonio Damasio, Daniel Tranel, Gregory Landini, Kenneth Williford and David Rudrauf

PloS one, Vol.7(8), pp.e38413-e38413

2012

DOI: 10.1371/journal.pone.0038413

PMCID: PMC3425501

PMID: 22927899

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Abstract

It has been proposed that self-awareness (SA), a multifaceted phenomenon central to human consciousness, depends critically on specific brain regions, namely the insular cortex, the anterior cingulate cortex (ACC), and the medial prefrontal cortex (mPFC). Such a proposal predicts that damage to these regions should disrupt or even abolish SA. We tested this prediction in a rare neurological patient with extensive bilateral brain damage encompassing the insula, ACC, mPFC, and the medial temporal lobes. In spite of severe amnesia, which partially affected his "autobiographical self", the patient's SA remained fundamentally intact. His Core SA, including basic self-recognition and sense of self-agency, was preserved. His Extended SA and Introspective SA were also largely intact, as he has a stable self-concept and intact higher-order metacognitive abilities. The results suggest that the insular cortex, ACC and mPFC are not required for most aspects of SA. Our findings are compatible with the hypothesis that SA is likely to emerge from more distributed interactions among brain networks including those in the brainstem, thalamus, and posteromedial cortices.

Humans

Middle Aged

Prefrontal Cortex - physiopathology

Male

Awareness - physiology

Behavior - physiology

Brain Injuries - physiopathology

Consciousness - physiology

Recognition (Psychology) - physiology

Magnetic Resonance Imaging

Smell - physiology

Functional Neuroimaging

Gyrus Cinguli - injuries

Prefrontal Cortex - injuries

Gyrus Cinguli - physiopathology

Face

Details

Title: Subtitle: Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices
Creators: Carissa L Philippi - Division of Behavioral Neurology and Cognitive Neuroscience, Department of Neurology, University of Iowa, Iowa City, Iowa, United States of America
Justin S Feinstein
Sahib S Khalsa
Antonio Damasio
Daniel Tranel
Gregory Landini
Kenneth Williford
David Rudrauf
Resource Type: Journal article
Publication Details: PloS one, Vol.7(8), pp.e38413-e38413
DOI: 10.1371/journal.pone.0038413
PMID: 22927899
PMCID: PMC3425501
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: United States
Grant note: R01 DA022549 / NIDA NIH HHS P01 NS19632 / NINDS NIH HHS
Language: English
Date published: 2012
Academic Unit: Neurology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Philosophy
Record Identifier: 9984002364902771

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