Meetings of the New York Psychoanalytic Society

May 12, 1953. A PSYCHOANALYTIC CONTRIBUTION TO THE STUDY OF BRAIN FUNCTION: I. THE FRONTAL LOBES. Mortimer Ostow, M.D.

This first paper in a series on the correlation of psychoanalytic metapsychology and neurophysiology presents a study of the frontal lobes, their structure and their function. Following a review of the anatomy of the frontal lobes, an outline is given of those areas whose function is known to some extent. In the main the frontal lobes are without known functions and studies of lobotomized patients have presented little conclusive evidence to clarify this unknown portion of the brain although phylogenetically certain changes are noted. As we ascend the scale of animals, the premotor frontal cortex expands in size so that it finally is larger than the motor area in the chimpanzee and in man. Concomitant with the expanding premotor cortex, the dorsal medical nucleus of the thalamus sends more and more of its fibers into the anterior frontal lobes. In lower mammalian forms these fibers extend to the striatum, the old motor system. The dorsal median nucleus receives impulses from the viscera through the hypothalamus and sends them on to the anterior frontal lobes. In psychotic patients, lesions of this nucleus produce effects comparable to prefrontal lobotomy. From a review of the literature on frontal lobotomized and lobectomized humans and animals, the findings are indifference, poor judgment, loss of higher sentiments such as friendship, gratitude, jealousy, sociability, while the more primitive emotions dealing with hunger, thirst, and other primitive needs persist. Through correlation of the anatomy, the literature on frontal lobe damage and psychoanalytic theory of instincts and their derivation in fantasy formation, Dr. Ostow postulates that one of the functions of the frontal lobes is the creation of derivates of instinctual drives. This liberates the human from the stereotyped instinctual gratification seen in animals and results in