Forced collectionism after orbitofrontal damage

Volle E, Beato R, Levy R, Dubois B. Neurology 2002; 58:488-490. Authors describe a patient who collected household electrical appliances folllowng bilateral orbitofrontal and polar prefrontal damage. The collectionism was goal directed and selective but involuntary and irrepressive. In background, the authors put on a spectrum prehensile forced grasping, hoarding behavior and collectionism. In this case the lesion was due to an OF meningioma which was treated surgically. Besides collecting old TV sets , in all rooms of the house, he could stay in the car for hours doing absolutely nothing. Neuro exam was normal. Neuropsych exam (including frontal tests) were normal except "marked inertia." The authors attribute the finding (with homage to L"hermitte) to uninhibited stimulation from parietal cortex that activates a prehension or imitation behavior, due to disruption of parietal and frontal interactions. L"hermitte expressed it as the expression of physical adherence to external stimuli and loss of autonomy of subjects from their environment. Sarazin M (Neurology 1998) described a correlation between collectionism and on PET scans, low metabolism in DLF regions bilaterally.

Hoarding behavior has been described as part of the syndrom after rupture of an ACOM aneurym that are alternately characterized as part of an obcessive compulsive behavior or impulse control disorder (Cohen et al.,Lancet 1999). In degenerative diseases "collectors" are typically hoarders without specific selection.

The authors distinguish collectionism, or "forced colectionism" , prehension, hoarding and compulsive behaviors. Collectionism depends upon 1) adequate motivation and mental representations of specific goals 2) absent severe planning deficit 3) release of a searching behavior .