Is hoarding related to brain injury?...

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Posted: Thu May 08, 2008 8:18 pm

Guest

In this research “Brain region identified that controls collecting
behavior”
by Anderson's co-authors on the study were Antonio Damasio, M.D.,
Ph.D., the Maurice Van Allen Professor of Neurology and head of the
department, and Hanna Damasio, M.D., UI Foundation Distinguished
Professor in the Department of Neurology.

http://www.eurekalert.org/pub_releases/2004-12/uoi-bri121504.php

There are some problems with this study. When people had brain injury
there are usually problem with short term memory. They could end up
buying same things over and over. However this study says that:

"The UI team studied 86 people with focal brain lesions - very
specific areas of brain damage – to see if damage to particular brain
regions could account for abnormal collecting behavior. Other than the
lesions, the patients' brains functioned normally and these patients
performed normally on tests of intelligence, reasoning and memory."

I don’t quite follow. How could 86 brain injury victims have normal
intelligence, reasoning and most importantly memory?

Then the research says that:

"The questionnaire very clearly split the patients into two groups –
13 patients who had abnormal collecting behavior and a majority (73
patients) who did not... damage to a part of the frontal lobes of the
cortex, particularly on the right side, was shared by the individuals
with abnormal behavior," Anderson said. "Our study shows that when
this particular part of the prefrontal cortex is injured, the very
primitive collecting urge loses its guidance."

Are saying that only 13 out of 86 patients had damage to the right
side of their brain? So, 73 patients out of 86 had no damage to the
right side of their brain when they had brain injury? How could that
be possible? It looks like this research was tailor made and the
researcher found when they CHOSE to find.

...

Posted: Thu May 08, 2008 9:58 pm

Guest

Okay I was able to locate the actual article, here it is:
http://brain.oxfordjournals.org/cgi/content/full/128/1/201

A neural basis for collecting behaviour in humans
Steven W. Anderson, Hanna Damasio and Antonio R. Damasio
Department of Neurology, Division of Behavioral Neurology and
Cognitive Neuroscience, University of Iowa College of Medicine, Iowa
City, IA, USA

At the end there are descriptions of all 13 patients with hoarding
behavior. Some of them have obvious memory problems (subjects 5, 6, 8)

Some of them had ruptured artery aneurysm and I found this link that
may point to some type of memory problem:
http://www.kmrrec.org/neuropsychology/research.php
Dissociating Basal Forebrain and Medial Temporal (MT) Amnesia
"It is now well established that damage to the hippocampus and
associated medial temporal (MT) lobe structures can lead to
anterograde amnesia, a specific memory deficit sparing cognition and
attention.Other etiologies can also cause anterograde amnesia,
including basal forebrain damage resulting from aneurysm of the
anterior communicating artery (ACoA)."

Developmental subjects 1 and 2 were marked as thieves. But I think
that they were exhibiting utilization behavior?

Subject 8 went orbitofrontal meningioma had memory issues and maybe
others have same problem?

Thanks.

Subject 1
A right-handed female homemaker with 12 years of education underwent
resection of an olfactory groove meningioma at age 69 years

Subject 2
A right-handed man with 12 years of education underwent clipping of a
ruptured anterior communicating artery aneurysm at age 27 years

Subject 3
A right-handed college-educated businessman underwent resection of a
large orbitofrontal meningioma at age 31 years.
His home became filled with stacks of old papers and magazines that
reached to near the ceiling.

comment: memory problem?

Subject 4
A right-handed female homemaker with a high-school education underwent
resection of an olfactory groove meningioma at age 74 years.
She accumulated stacks of emptied plastic and glass food containers,
newspapers and empty boxes.

comment: memory problem?

Subject 5
A 35-year-old, right-handed salesman with 13 years of education
developed herpes simplex encephalitis, resulting in a severe amnesia.

Subject 6
A 28-year-old, right-handed man with a college education developed
herpes simplex encephalitis, which resulted in a severe amnesia.

Subject 7
A right-handed male welder with 8 years of formal education underwent
clipping of a ruptured anterior communicating artery aneurysm at age
47 years.
He collected corn almost daily when conditions permitted

Subject 8
A 70-year-old, right-handed, retired bank clerk with 13 years of
education underwent resection of an orbitofrontal meningioma.
She began to write notes to herself and leave these around the house

comment: obvious short term memory problem

Subject 9
A 33-year-old, right-handed, college-educated male counselor underwent
clipping of a ruptured anterior communicating artery aneurysm.

Developmental subject 1
A right-handed girl sustained focal trauma to the prefrontal region at
age 15 months.
From early childhood she showed a strong tendency to pick up and keep
objects that did not belong to her.

comment: utilization behavior?

Developmental subject 2
Following a normal birth, a 3-month-old boy underwent resection of a
malignancy in the right frontal region.
He had a tendency to pick up items that caught his attention and he
engaged in petty thievery.

comment: utilization behavior?

Developmental subject 3
A right-handed girl had a normal development until age 16 years, when
she underwent clipping of an A-com artery aneurysm.
She had several copies of many items, such as five manual and two
electric can openers.

comment: memory problem?

Developmental subject 4
This subject was born with a cystic lesion in the right frontal lobe
and hydrocephalus; the latter was successfully treated with a shunt,
but a shunt revision at age 4 years resulted in an additional small
area of damage in the left frontal lobe
he would pick up and keep items

comment:
memory problem?
utilization behavior

...

Posted: Thu May 08, 2008 11:43 pm

Guest

Here is another research related to hoarding and this is from Saxena:

http://ajp.psychiatryonline.org/cgi/content/full/161/6/1038
Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding
Sanjaya Saxena, M.D., Arthur L. Brody, M.D., Karron M. Maidment, R.N.,
M.F.T., Erlyn C. Smith, B.S., Narineh Zohrabi, B.S., Elyse Katz, B.S.,
Stephanie K. Baker, B.S., and Lewis R. Baxter, Jr., M.D.

In the conclusion it says:

CONCLUSIONS: OCD patients with the compulsive hoarding syndrome had a
different pattern of cerebral glucose metabolism than nonhoarding OCD
patients and comparison subjects. Obsessive-compulsive hoarding may be
a neurobiologically distinct subgroup or variant of OCD whose symptoms
and poor response to anti-obsessional treatment are mediated by lower
activity in the cingulate cortex.

This preliminary study had several limitations that reduced its power
and generalizability. Because the original study was designed to
compare OCD to major depressive disorder and normal comparison subjects
—not to examine OCD symptom factors—the analysis of hoarders and
nonhoarders was a post hoc exploratory analysis. Hoarders and
nonhoarders were classified retrospectively. No standardized or
validated measurements of hoarding severity were used. Compulsive
hoarders were significantly older than nonhoarders and comparison
subjects, so all analyses had to covary for age. In addition, the use
of two different PET scanners also required analyses to covary for
scanner type and could have caused artifactual results. The addition
of multiple covariates may have decreased the statistical power for
finding significant differences among groups. Our results will require
replication in a new group of compulsive hoarders and age- and sex-
matched groups of normal comparison subjects and nonhoarding OCD
patients who are defined prospectively.

Comment: I have doubts about this research as well and it is already
outlined above. This study involves OCD and it had already been
established that OCD patients have very high activity in the orbito-
frontal and other frontal regions. Also, this study does not include
patients who are typical hoarders (without the OCD). However, I wanted
to post this because it shows that hoarders don’t have a brain injury
as stated by Anderson et all in “A neural basis for collecting
behavior in humans”. If they (hoarders) had problems (specifically
damage in the right frontal region) then it would have showed up in
PET and MRI. Maybe we need to test hoarders only (without OCD as
suggested) to find out if they have normal brains scans or not. I
doubt if that would make ay difference.

Day Brown...

Posted: Sat May 10, 2008 9:47 pm

Guest

Given the long history of famine, tribes that had people who hoarded
survived better. So, of course, there'd be an instinct for it.

...

Posted: Sun May 11, 2008 7:22 pm

Guest

On May 11, 8:47 am, Day Brown <daybr... at (no spam) hughes.net> wrote:

Quote:

Given the long history of famine, tribes that had people who hoarded
survived better. So, of course, there'd be an instinct for it.

That’s right Day. I think saving and hoarding are two distinct
behavioral components although people tend to lump them together
(research done by Saxena et all). People who like to save might not be
a hoarder and vice versa. Savers could also be too attached to save
objects and might have perfectionist component as well. However,
people with head injury who become hoarder might not have saving
behavior. They could be hoarding things maybe due to memory problems,
utilization behavior etc.

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