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Page 1 85 Split Decisions GEORGE WOLFORD, MICHAEL B. MILLER B5 SpHtDecisions GEORGE \VOLFORD) N,IICII{EL B. NIILLER, AND \IICFL.\EL S. GAZZAT\IGA .\B: rR.\, r ::ril-irlain patients provide a lascinating look at some The split-brainoperation ,,;' tir, r..,:,. .irrr,trncling consciousness.lVe bricfl1' rL-viewpirst lin,i:ir..l-.,:r,: r:r..rghrsgained lrom studying thcsc patients. l\:€ Split-brain surgery is a treatment for certain tvpes o1' ill:( i.:. ::. r-.,,r,'cictail some of thc more irrteresting(ar us) findines intractable epilepsri Seizures in epilepsv are causecl bl.an .irr., 'lr.' ..,': cclition of this volurne. \\r conclude bl ruqgestinge abnormal electrical discharge that leads to a reverberating rrrr'r:ifltcL rer-sion of signal cletectiontheorv that mav shed some ii{l;r ,,rr aspcctsof consciousnessir thcse paticnts. or rhvthmic dischzrrge.In some individuals, the rhrthmic dis- charges recruit tissr,rein both l-remispheres.The split surgerv ( ' .,lri//d-rJin tlrcsplit brain involves severing all or part of the corpus callosum. the m:rjor fiber tract connectine the tr,r'or:erebral hen-risphercs, ,irr n:rtient. nll- I .._.-^ r*,-_^--_ _--e.f a Llnlqlle perspecuve on some and on occasion other {brcbrain commisures as rvell. The ': .- l{ conscious experienc:e.and pcrhaps on the nature corpus callosum is the largcst fiber tract in the brain. f'he ri.ciousness itself. Rogel Sperr',' once relerred to the human corpus callosum contains about 200 million axoris. "tu,o : ,\ separate realms o1' conscious a$'areness;t\'vo originating lrom layer 2/3 pyranriclal ncurons (r\boitiz et al.. :r:.- -. perceiving, thinkine arrd rernernbcring systtms." 1992). The first reported usc of' splittins the corpus cailo- 'i-l;' : nr-r'i'carh'ft'ar.sthrrt scvcringthe callosr"rmrvas:r bad surn to control epilepsv '"vasbv \hn !\'ascncn ancl Herren i<lt'a.,;r.i wonlcl iead to tlilc' cr)r)Scrluences.The tperation (1940). Van \!'aqenen got the iclealirr the sureery bv observ- miqfit !'r'i'irtea p{'rsortrririr tlt,'ultirrr:Lresplir personalitU just ing that one of his patients rvith severe seizureserperienced iike hr,.,:.rifrr,r ir.rii.lir: insicle the sarneboch,: (Jn,'ot'thc big considerable reliel' alter developing a tumor in his corpus earlr surplisr: rriis thc sccrningLvcornple tc absenccof ant. callosum. Based on tirat obser-vation,he and his collcagr,re splitncssin thr consciollsnessol personaliw of thcsepatients severed part or a1l of the cailosi in I 0 patients arrd reported '1'hev .\^.LrriLi..ilt l1: (lazzanisa.Bosen. and Spcrry 1962).Nlost considerable relief from seizures. perlbrnicd the , : ::r,' ir.rti.:nt,'seemed blithelv unatrvarethat anvthine had surgcrv on a second set o1-i4 patients as well. After a hiatus :r.,:r..,rL ir tlrcil ntent:rl proccsses.r,vith the pleasantexcep- of a couple o1' decacles,the procedure lvas tried in a ner,v ': 'r'..ir.ri tirr'ir:t'izurcs had lcssencdor even stopped.Whv set of patients in Calilbrnia (Bogen and \bgel, i962). The ,. r. .plit-irr:rin pnticr-rtsespt:r'ience duzrl consciousness? behavior o[' these paticnts lvas strldied extensively bv fl ,..ii-rireorrst'iorrsness is housecl in neural tissr-rethat is cr,rm- Gazzaniga and his colleas-Lres(Gazzariga, Boeen, and pirtt'ir l:itcraLizedto on. hemi*phcrr or the othcr. Perhaps Sperrli 1962, 1963, 1965). The treatment r'vasellbctive in cr)nsciousne-s-sis completell' ticcl to language, and since reducing seizures in these patients. (Jverall there was about langtrtrgc is generallv laterzrlized. consciotrsnessis as lvell. a 60% 7070 seizurc reductior] in B0(J/oof' tl.rc patients. Perlinps tlier trvo hernisphcres hzrve."vorked out a division ol Holvever, thele r'r'ereserious compliczrtions in m:rnv of tl'rese labr-rrsuclr th:rt conscir-usncssftrliows the task or materials earlier cases.N'Iore than 509'o ol the early patients cxpeli- ancl that dii-lt'r'cnt ht,:r-nispheresarc consciouslv ar,vzireat clif- enccd aseptic meningitis or h,vdror:epha1us.often resultinc ft:rent tinre-..\\'e rvill crplore th:rt final possibilitv later in this in death. An.rorig othcr difficulties, the w:111separ:rtins tlie chapter. bottom of the corpus callosum tiom the ventricles is onl,v four cells thick in places :rnd is easiiv punctured. D. H. Wilson at Dartnrouth perl-ected the lrse of nricroturgcrv in splitting the corpns callosun arrclrevived the use of the pro- ccclure in controlling scizures (lVilson et al.. 1977). Split- cEoRGE woLl'oRD and .urrcg-rtL s. cAzz.q.rvrc.\ Department of brain surqerv lvas llever perlblmcd et a high rate and w'as Psychological and Ii ain Scicrrr:es,Dartmouth Collcec, Hanover considerecl zr tl-ezrtmentof last resort. The procedure is less N.H. comrnon toclay; u.ith the availabili[r of ncwer and better NncHAEr-B. \rrI-lirn l)epartment of Psvchological and Brain Sci- pharmacolo$cal treatments coupled with advances in ner-r- cnces. L):rrtnloutjr Clollcge, Hanovet N.H., and Department ol' Ps.,'clroioqr. L-nil:r'sitv oi' Cali{brnia :rt Santa Barbara. Santa rolocation arld morc fircrisedneurosLlrgerv. Furdrer, a highcr Il,rrlran. (,ali1. percentaqe of rccent split-brain operations have involvecl I l89 r.**t , rn1r.l poLtion of the corplls cailosunr. In theorv, paticnts that ltoth hemispheres of tr,vosplit-brain patients (one r,vith rrlr,, Iriive ulr.lcrqonc :r complete callosotonrylblrn :rn icleal a con-rpletesplit, the othcr ir parti:1l split) coulcl cliscliminate P,,Pu1.rri.rr firl stuclvingthe inclepenclentlrutctioning of thc nvo ob.jectsu'ith dillcrcnt ick:ntitics cc1uall,vr,r'ell, but th:rt the rr'r irt-nrisplrclc:.]n plir-r:ti<-e,onlv a rclativelv srnall pcr- right her-nispl-rcrcpcrformed better than the lclt hcmisphcrc ( r-nrllgr ,l tht'se irntirrLts -rle eppropriete tbr behavirtral in discliminatins tr,voic1cntical objects r,vith diflcrent spatial srllrlies.,\ll ol' tlrt: P:rtit:ntshalc hacl a long histon' of' scvcre locations. In subsequent str-rdiesthe-v lirund tlrat the right cpiLeptic -.rizrrrt'.. atrcl nitnv sr"rller liom other cognitive hemisphere !\ras better zrt line oricntation and vernier dcficits. Althougir rt:lativcll' rarc. thcrc :1re morc split-l-rrain :rcuiq.,but that both hemispheres performed equallv well in paticnts than there arc p.itients lbr manr, of the other inler- sizc comparisons and lr-rminar-rcediscrirnination (Corbaliis, esting brziin anomalies. Funnell, and Gazzaniea. i 999, 2000a). Furtherrlore. Corballis ancl colieagucs havc sr-rggested Htmisphericlsymme tries thart these hemisphcric asrrrmctries in visuospatial process- ing are not erntirL-lvdue to hemispheric specializations for Since at least the tinre o{' Broca, rve have believed that somc particuiar hpes of sensory input bi-rtinvolve lateralization of behavioral functions snch as language are lateralized in the spccilic tl?cs of processing, such as visual groupins. One brain. Brocir studied a patient ."vho r'r'asparurlvzed on the piece o{'er.'iclcncclor this idea involves the line motion ellect. right side and hacl lost the abilitv to speak. The man died This occurs u'hen a line is presented briefly bet'"veen tr,vo shortl,v thercafter, zrnd his brain rvas prcscn'ed. Nlost of our sqLlares.Just prior to the appezrranceof the line, one of the kno',vleclee allout hcn-rispheric asyrnrnetrics or.-el the next squaresflashcs. To observers, it appears that thc line is prop- century camc lrom studr,'ing people rvith varior-rsnpes of asatins lrom the flashing square- Hil<osaka, Nfiyauchi, and brain injuries. Rescarchers also exrrnined liemispheric dil'- Shimojo (1993) proposed a krrv-levcl visual processto explain I'erences in pcople r,vithout bririn damage. using t:Lchisto- the eflect in rvhich the flashins square dralvs attention to the scopic prescrltation to one visLral field or the othcr. l'he Iocation prior to the onset o{'the line. However, subsequent research on nenroiogicallv intact subjccts confil'mecl much rescarchcrs have clemonstrated that changing the properties ol' the paticnt r,vork, but irrterpretation ot' the results of thc stimtrli can creilte quite difl'erent illr-rsions(von Grrinau 'Lse, obtained in sr,rchsubjccts is alr'r,aysclor-rcled bv the lirct that and Faubert, 199'[; Cavannqh, ancl Nakavarna. 1998). anv inlormation prescnted to a specific hemisphcre can cross Rrr cxaniple , using zrred line betrvcerta recl and green square to thc other hemisphcre at rvill, and that crossins'takes onlv rvill creatc the illr-rsionthat the red lirre is propag;atins ti'om a fcr'vmilliseconds (Rerlucchi et al., 197l). the red square. In this c:rse.the efli:ct of apparent motion :ti Split-brain patients provided an idcal en'ironrnent Ibr must relv on visual gror-rpinealtcr the onset oi' the line. Cor- ".+:' stuclying these henrisphcric zrsyrnmetries,because informa- birllis ancl colleagues founcl thzrt the lelt hemisphcrc in a tion presented to a specific hemisphcre more or less had to split-brain paticnt r,vzrsindifl'erent to the color man\rulation st:r,vthere. Earlv studies r,vith split-brain patients conlrrmed Lrut that the right hemispirere almost al'uvavsperceived the that ianguagc was usr-rallyiateralized to the left hcmisphcrc Iinc as moving awav fl'orn the square with the matching and coniirmed advantases in the right hcrnisphere firr spatial color (fiorballis. Funnell, and Gazzaniga, 2000b; Corballis, processing. l'here l-rasbeen interesting eviclence that pro- Barnett, :urd Corballis, 2004). cessingin the right hemisphere is rclatively more literal, r,vhilc Corbzrllis and collcagrres reached similar conclnsions processirrgin the lclt is more constructive (Nletcallb, Funnell, using paradigrns involving the perception ol subjective :Lnclf):rzzaniga, 1995). Sevcral sttrdiesor,'er tht-'last fi:w,vcars figurr:s bv rnodal and amoclzrl bor.rndary completion l-ravehclpcd ciaril,r,'tlioscitsvmmetries. In this chapter, r'r't:r,r.ill (Corballis ertal.. 1999).Nrlodal cornpletion can be solved by It-.,cr-rson severalncr,v cleveloprncrrts concLrrning the role of thc relying solelv on low-lcvcl visual processing.Two split-brain tlvo her-nispheresin attclrtion and mernon-, and lve rvill patients w'erc ibund to perform rnoclal cornplction equally present sonreintriguins stucliesaimt--cl at clarilving thc precise well in both hemispheres.
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