A FOLLOW-UP STUDY OF MOTOR WITHDRAWAL REACTION TO HEAT DISCOMFORT IN PATIENTS BEFORE AND AFTER FRONTAL LOBOTOMY
WILLIAM P. CHAPMAN M. D.1,
AUGUSTUS S. ROSE M. D.2, , and
HARRY C. SOLOMON M. D.3
1 Instructor in Medicine, Department of Medicine, Harvard Medical School, and Assistant in Medicine, Massachusetts General Hospital, Boston, Mass.
2 Instructor in Neurology and Psychiatry, Harvard Medical School, and Associate in Therapeutic Research, Boston Psychopathic Hospital, Boston, Mass.
3 Professor of Psychiatry, Harvard Medical School, and Medical Director, Boston Psychopathic Hospital, Boston, Mass.
1. A second-year follow-up study has been made of the intensity of heat stimulus causing motor withdrawal reaction in lobotomized patients. Measured amounts of heat were applied to the forehead by the Hardy-Wolff-Goodell pain threshold apparatus. The endpoints of motor withdrawal were the levels of heat causing the patient (1) to pull the head away from the apparatus and (2) to wince. Thirteen of the 23-patients originally tested were included in this study.
2. The results of the 13-24 months' follow-up test indicate that the decreased tolerance to heat discomfort noted in lobotomized patients during the first year after operation probably represented only a temporary change after lobotomy.
3. We have no adequate explanation either for the decreased tolerance to heat discomfort during the first postoperative year or for the tendency of the motor reaction pattern to return to the preoperative levels during the second postoperative year. A reasonable speculation could be that transection of the white matter in the frontal lobes removes a mechanism that inhibits withdrawal from discomfort. With the passage of time, some other mechanism in the central nervous system may take over such a role, which was previously the concern of the frontal lobes.
