Brain Damage from the Perspective of a Spouse

Depending on which area of the hypothalamus is damaged, the biological and behavioral effects differ.

For example, if one were to damage the preoptic area of the hypothalamus, one would experience a “deficit in physiological mechanisms of temperature regulation,” (Kalat, 2004). From the perspective of the spouse, the subject might complain of being perpetually hot or cold regardless of environmental temperature. Sleeping in the same bed with the subject could cause problems, as they might need several blankets and/or none at all. In addition, the need to carry warm clothing on warm day might be necessary, and/or shorts or t-shirts on a cold day.

Damage to the “medial preoptic area/anterior hypothalamus (MPAH) or a subthalamic region that includes the caudal zona incerta,”
(Maillard-Gutekunst, et. al., 1994) has been show to “eliminate mating” in rats. In other words, from the spousal perspective, damage to this area might cause a lowering – if not complete annihilation – of the subject’s sex drive.

When the lateral preoptic area of the brain has a lesion, osmotic thirst, “the thirst that results from an increase in the concentration of solutes in the body,” (Kalat, 2004) is decreased. This is thought to be partly a result of cell damage and “partly to interruption of passing axons,” (Kalat, 2004). A spouse might notice that the subject drinks less, unless regularly reminded to do so. They might also hear the subject complain of highly concentrated urine and a burning sensation accompanying urination. They should also be alert to any signs of dehydration, “the physiological state in which cells lose water and metabolic processes are hindered,” (Brown, 2002). The initial symptom of thirst is, in this case, non-existence, but secondary symptoms of dehydration include “economy of movement, flushed skin, sleepiness, apathy, nausea, tingling in arms, hands, feet, headache, heat exhaustion in fit men, increases in body temperature, pulse rate, respiratory rate,” (Brown, 2002). If dehydration reaches an even higher level signs such as
“dizziness, slurred speech, weakness, confusion?. [and] delirium,” (Brown, 2002) begin to show, as well.

The lateral hypothalamus, when damaged, effects a subject’s eating habits. “Undereating, weight loss, low insulin level? underarousal, [and] underresponsiveness,” (Kalat, 2004) are all symptoms of a lesion on the lateral hypothalamus. A spouse might notice a decreased appetite and a change in the way their spouse’s clothing fits. In addition, they might find it hard to wake their spouse or to keep their attention. Low insulin levels cause the body to be unable to process glucose, depriving it of important nutrients. Without the correct nutrients, the body starts breaking down it’s own stores of fats for energy.
“This process produces a weak acids, called ketones,” (Hales, 2003). If these ketones build up, ketoacidosis occurs, the symptoms of which include “nausea, vomiting, abdominal pain, lethargy, and drowsiness,” (Hales, 2003) and, if levels of ketones are extreme enough, death. Insulin injections might be necessary for the subject’s day to day living, but even so, a spouse might want to watch out for symptoms of ketoacidosis.

A person whose spouse has a lesion on their ventromedial hypothalamus might notice “increased meal frequency, weight gain, [and] high insulin level,” (Kalat, 2004). Their spouse might complain about their regular meal schedule, wanting four or five meals a day as opposed to the normal three. A spouse might notice a change in their partner’s size, as well as an outgrowing of their clothes. Part of this is due to the increasing amount of food that their spouse is ingesting, but some is also due to the higher insulin levels. High levels of insulin can cause the body to convert more glucose than normal into energy. If that is not expended, the body stores it for a later date in the form of fat.

If damage is done to the paraventricular nucleus, an increase in meal size occurs (Kalat,2004). From the perspective of the spouse, it would seem that the subject had a “hollow leg” or
“bottomless stomach.” The subject would eat far more than they had prior to the brain damage. As a result, weight gain might occur.

Brain Damage from the Perspective of an Employer

Though the effects of brain damage to different areas of the hypothalamus would be, for the subject, similar to those described above, an employer’s perception of the effects of these symptoms would be quite different.

An employer with an employee who had a lesion on their preoptic area would probably not notice their employee’s problems with temperature regulation (Kalat, 2004) quite as much as a spouse would. If the employee works in an open office, the employer might hear complaints from the subject about the thermostat, or if the subject has access to the thermostat controls, the employer might hear from the subject’s co-workers. If the employee has their own office, the employer might notice a spike in power usage from that particular office due to high usage of the heater/air conditioner.

Due to the sexual nature of the effects of damage to the “medial preoptic area/anterior hypothalamus (MPAH) or a subthalamic region that includes the caudal zona incerta,” (Maillard-
Gutekunst, et. al., 1994), an employer would probably not notice any difference in job performance. The exception to this would be if the employee had previously been highly sexualized, flirting and/or pursuing sexual contact with co-workers. In this case, such extracurricular activities would decline, if not disappear altogether.

Another area to which the effects of damage would be unpronounced from the perspective of an employer would be the lateral preoptic area. As stated above, the effects of damage in this area cause osmotic thirst to dissipate. The only difference that might be noted by an employer would be symptoms of dehydration (e.g. apathy, slurred speech, etc.) if the employee were to allow him/herself to become dehydrated.

Damage to an employee’s lateral hypothalamus would be slightly more obvious to an employer. The employee’s decline in weight would be, of course, a side effect visible to their employer, but more importantly to the employer would be their employee’s
“underarousal, [and] underresponsiveness,” (Kalat, 2004). A lesion in this area would most likely effect an employee’s work performance, making it difficult for them to pay attention and respond to their work environment. Assignments would, no doubt, become much more difficult to attend to, much less complete. Also, the employer might notice signs of diabetes due to the low insulin levels like hyperglycemia if the employee’s blood sugar gets high enough. If blood sugar levels get high enough, the subject can go into ketacidosis (described above), or a diabetic coma (American Diabetes Association, 2005).

An employee with a lesion on their ventromedial hypothalamus would also draw the attention of their employer. Due to the desire for more frequent meals, the employee would most likely take more frequent breaks. In addition, weight gain (Kalat, 2004) would be apparent. High insulin would not be necessarily apparent unless blood glucose levels got low enough, inducing a state of hypoglycemia. Symptoms of hypoglycemia include:
“shakiness, dizziness, sweating, hunger, headache, pale skin color, sudden moodiness or behavior changes, such as crying for no apparent reason, clumsy, jerky movements, seizure, difficulty paying attention, or confusion, [and] tingling sensations around the mouth,” (American Diabetes Association, 2005). Hypoglycemia can be fatal, so in the off-chance that this could occur, the employer and co-workers of the employee would probably know of the situation and be informed how to deal with a hypoglycemic attack.

From the perspective of an employer, an employee with a lesion in the paraventricular nucleus would not necessarily be apparent. The increased meal size (Kalat, 2004) would probably be consumed on a lunch break, away from the employer. The only way it might be observed would be if the employer and employee ate together on a consistent basis, both before and after damage occurred.

References

American Diabetes Association (2005). Diabetes symptoms. Retrieved May 1, 2005 from the World Wide Web: http://www.diabetes.org/utils/printthispage.jsp?PageID=DIABETESS YMPTOMS_23316

American Diabetes Association (2005). Hypoglycemia. Retrieved May 1, 2005 from the World Wide Web: http://www.diabetes.org/type-2-diabetes/hypoglycemia.jsp

American Diabetes Association (2005). Hyperglycemia. Retrieved May 1, 2005 from the World Wide Web: http://www.diabetes.org/utils/printthispage.jsp?PageID=TYPE1DIAB ETES3_232942

Brown, J.E. (2002). Nutrition through the life cycle. Belmont, CA: Wadsworth/Thomson Learning.

Childtrauma.org (2005). Diencephalon. Retrieved April 29, 2005 from the World Wide Web: http://www.childtrauma.org/CTAMATERIALS/brain_i.asp

Finger, S., & Almli, C.R. (Eds.) (1984). Early brain damage: vol 2 neurobiology and behavior. London: Academic Press, Inc.

Hales, D. (2003). An invitation to health (10th ed.). Belmont, CA: Wadsworth/Thomson Learning.

Kalat, J.W. (2004). Biological psychology (8th ed.). Belmont, CA: Wadsworth/Thomson Learning.

Maillard-Gutenkunst, C.A., & Edwards, D.A. (1994). Preoptic and subthalamic connections with the caudal brainstem are important for copulation in the male rat. Behavioral Neuroscience, 108 (4), 758-66.

Semrud-Clikeman, M. (2001). Traumatic brain injury in children and adolescents. New York: Guilford Press.

Women’s Health Law Weekly (2005, February 27). U.S. Food & Drug Administration; new findings in the area of endocrinology described. Retrieved April 29, 2005 from the World Wid