The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human

by V.S. Ramachandran

The answer has to do with how the accident affected the visual and auditory pathways in Jason’s brain. To a surprising extent, the activity of each pathway—vision and hearing—must be segregated all the way up to the critically important anterior cingulate. This collar of tissue, as we shall see, is where your sense of free will partly originates. If the anterior cingulate is extensively damaged, the result is the full picture of akinetic mutism; unlike Jason, the patient is in a permanent twilight state, not interacting with anyone under any circumstances. But what if the damage to the anterior cingulate is more subtle—say, the visual pathway to the anterior cingulate is damaged selectively at some stage, but the auditory pathway is fine. The result is telephone syndrome: Jason springs to action (speaking metaphorically!) when chatting on the phone but lapses into akinetic mutism when his father walks into the room.