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A post mortem examination (also referred to as an autopsy) is a technique used to examine the brain and body after death. Usually, a coroner (if the death is sudden or suspicious) or a doctor (to learn more about why the death occurred) request it. Nowadays, a pathologist is in charge of carrying out the post mortem examination. Post mortem examinations are useful to find damaged areas in the brain and to assign a function to those damaged areas based on how the patient behaved or suffered before their death.
After performing a post mortem on a patient who couldn’t speak and only said the word ‘tan,’ scientists found lesions in his brain’s left hemisphere in the frontal cortex. Therefore, they concluded that language function occurs in that area now known as Broca’s area.
Illustration of a post mortem of the brain in 1905 for students, Wikimedia Commons
In a post mortem, pathologists treat the brain using a chemical fixative (such as formaldehyde) to make it firm. This helps them cut the brain into sections and examine without it falling apart.
Once a post mortem is performed and completed, the pathologist will give a detailed report of the observed issues, including areas of damage or areas that are out of the norm. This helps the diagnosis process and helps people understand what could have been the cause of any abnormalities when the patient was alive.
A post mortem report format includes the examination of the head, neck, and facial features. They will also include measurements such as blood content, and tissue specimens (think liver, hair, bile, and brain tissues). Pathologists pay extra attention to this if the death involved drugs or poison.
Schizophrenic patients often take antipsychotic drugs that affect their neurotransmitter levels, such as dopamine and serotonin. Because of this, when a person with schizophrenia dies, a pathologist needs to take into account any abnormalities with their dopamine and serotonin levels alongside their potential drug level intakes.
If the patient had high dopamine levels in their brain, and we examined their brain tissue, we couldn’t simply conclude that ‘dopamine is the cause of schizophrenia.’ We would have to acknowledge the patient was taking a drug that contains dopamine. Otherwise, this would skew our results and conclusions!
A post mortem examination can be helpful in many different areas of psychology when trying to understand the reasons behind a patient’s atypical behaviour.
For instance:
Mackay et al. (1982) found that the brains of patients with schizophrenia in a post mortem examination had an increased amount of dopamine and dopamine receptors compared to a neurotypical person. This helped researchers understand the role dopamine plays in schizophrenia. Further research helped the development of the dopamine hypothesis.
When examining HM, a famous case cited in psychology, Annese et al. (2014) found that the patient had lesions in his hippocampus. He had suffered from epileptic seizures throughout his life and when he was 27 years old he had brain surgery to help alleviate the symptoms. However, after the surgery, HM couldn’t store new memories or remember previous moments of his life. His language and motor skills weren’t affected, but he couldn’t learn new things or store them in his brain. The discovery of the hippocampus’ lesions thus confirmed its in the storage and formation of new memories.
Like in other techniques of studying the brain, there are advantages and disadvantages of post mortem examination in psychology.
High spatial resolution (provides detailed examinations): as the post mortem examination allows scientists to dissect and analyse the brain to an extensive degree, it provides a detailed insight into the brain and its structural form. This means the post mortem has a high spatial resolution compared to other techniques. They can examine the brain on an anatomical and neurochemical level, and structures such as the amygdala and hippocampus are accessible. This is not possible with other techniques, such as an EEG.
Deeper understanding: as the studies above demonstrate post mortem examinations have allowed for a deeper understanding of dysfunction in the brain. This provides valuable evidence for different hypotheses and allows researchers to delve deeper into certain areas of the brain. Post mortem examinations act as a guide in some cases and have shone a light on potential brain functional areas, and how lesions affect them.
Functional evidence: researchers have found damage in certain areas of the brain and they have been able to attribute specific functions to those areas as a result. Broca’s and Wernicke’s areas are both great examples. They were discovered at a time when advanced techniques such as the EEG and an fMRI were not available.
Environmental and life factors: as post mortem examinations can only be done when a person is dead, they can’t take into account the effect of age and how the person operated through daily life.
Reynolds (1988) found that antipsychotic drug use increases the number of dopamine receptors. Antipsychotics are common treatments for schizophrenic patients, so someone could conclude that a high count of dopamine receptors in the brain causes schizophrenia. This, of course, isn’t true, but sometimes it’s difficult to isolate the variables and recognise that there is a correlational link, but no causation.
Age is also a factor that affects the post mortem examination’ results as is the time between death and the post mortem examination. The body decays after death, and this delay between the time of death and examination may affect the integrity of the organs.
Causation: a post mortem examination can only show what damage exists in the brain after death, and suggest that the damaged area may be responsible for any pathophysiology the patient experienced during life. It’s not possible to say the damage is the cause; therefore, post mortem examinations are only correlational, not causal.
Ethical issues: a post mortem examination occurs after death, and is incredibly invasive on the body. It isn’t always possible to get informed consent, especially if the person’s psychological state and their ability to give consent are severely affected by their disorder. If a person can’t fully understand what they’re agreeing to, it’s hard to gain full consent making the procedure ethically questionable.
It’s an examination performed on the body and brain after a person dies. It helps determine the possible causes of death and helps to gain a better understanding of any possible areas of damage or dysfunction.
The person’s body is taken into an examination room, where their organs are removed and examined. Afterward, the examiner gives a detailed report of their findings.
The top of the skull is usually cut and removed, allowing access to the brain for examination. This can include the removal of the brain.
Usually, it is used to assess whether or not a death is natural or is due to another reason, such as a health issue or something suspicious. Alternatively, if a person died of a disease, it can further a doctor’s understanding of said disease or illness if the patient can be examined thoroughly after death.
An autopsies type can include clinical or pathological autopsies, academic autopsies, and forensic autopsies.
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