A thoroughly modern gage

We describe a 50-year-old male patient (MGS) with a right frontal ventromedial lesion who showed preserved general cognitive, abstract thinking and problem-solving abilities, in contrast to gross impairment in his social competence, social decision making and social conduct. MGS also demonstrated diminished sensitivity to socially relevant stimuli and situational nuances, impairment in sexual behavior, lost sense of responsibility, and disinhibition. We interpret his neurobehavioral profile, identical to the one of the famous 19th century patient Phineas Gage, in the light of the hypothesis that emotion and social conduct regulation depend on the ventromedial frontal cortex.