Constantin von Economo
Encyclopedia
Constantin Freiherr von Economo (born August 21, 1876 in Brăila
Braila
Brăila is a city in Muntenia, eastern Romania, a port on the Danube and the capital of Brăila County, in the close vicinity of Galaţi.According to the 2002 Romanian census there were 216,292 people living within the city of Brăila, making it the 10th most populous city in Romania.-History:A...

, Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...

; died October 21, 1931 in Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

) was a Romanian
Romanians
The Romanians are an ethnic group native to Romania, who speak Romanian; they are the majority inhabitants of Romania....

 psychiatrist and neurologist of Greek origin. He is mostly known for his discovery of encephalitis lethargica
Encephalitis lethargica
Encephalitis lethargica or von Economo disease is an atypical form of encephalitis. Also known as "sleepy sickness" , it was first described by the neurologist Constantin von Economo in 1917. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless...

 and his atlas of cytoarchitectonics.

Youth and schooling

Constantin Freiherr Economo von San Serff was born in Brăila
Braila
Brăila is a city in Muntenia, eastern Romania, a port on the Danube and the capital of Brăila County, in the close vicinity of Galaţi.According to the 2002 Romanian census there were 216,292 people living within the city of Brăila, making it the 10th most populous city in Romania.-History:A...

, Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...

, to Greek parents. In 1877, the family moved to Trieste
Trieste
Trieste is a city and seaport in northeastern Italy. It is situated towards the end of a narrow strip of land lying between the Adriatic Sea and Italy's border with Slovenia, which lies almost immediately south and east of the city...

, which then belonged to Austria-Hungary
Austria-Hungary
Austria-Hungary , more formally known as the Kingdoms and Lands Represented in the Imperial Council and the Lands of the Holy Hungarian Crown of Saint Stephen, was a constitutional monarchic union between the crowns of the Austrian Empire and the Kingdom of Hungary in...

, and Constantin spent his childhood and youth in Trieste. He was a good student, speaking several languages fluently. In 1906, his family was ennobled and Economo obtained the title “Freiherr
Freiherr
The German titles Freiherr and Freifrau and Freiin are titles of nobility, used preceding a person's given name or, after 1919, before the surname...

”.

At the request of his father, Economo began his study of mechanical engineering at the Polytechnic University of Vienna in 1893 but switched to medicine after two years. His first scientific work, “Zur Entwicklung der Vogelhypophyse” (“On the Development of the Pituitary Gland
Pituitary gland
In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g , in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity covered by a dural fold...

 in Birds”) was published in 1899. Economo worked as an assistant for Sigmund Exner
Sigmund Exner
Sigmund Exner-Ewarten was an Austrian physiologist who was a native of Vienna. He was the son of philosopher Franz Serafin Exner , and had three renowned brothers; law professor Adolf Exner , physicist Karl Exner and physicist Franz Exner .He studied in Vienna under Ernst Wilhelm von Brücke ,...

 from 1900 until 1903. He received his medical degree in 1901.

Scientific career

From 1903 to 1904, he was a resident at the Clinic of Internal Medicine under Carl Wilhelm Hermann Nothnagel. Subsequently, he travelled through Europe for two years and worked for several scientists. He studied neurology, histology, and psychiatry in Paris (under Alexis Joffroy, Valentin Magnan
Valentin Magnan
Valentin Magnan was a French psychiatrist who was a native of Perpignan.He studied medicine in Lyon and Paris, where he was a student of Jules Baillarger and Jean-Pierre Falret...

 and Pierre Marie). In Nancy, he was introduced to hypnosis
Hypnosis
Hypnosis is "a trance state characterized by extreme suggestibility, relaxation and heightened imagination."It is a mental state or imaginative role-enactment . It is usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary...

 (under Hippolyte Bernheim
Hippolyte Bernheim
Hippolyte Bernheim was a French physician and neurologist, born at Mülhausen, Alsace. He received his education in his native town and at the University of Strasbourg, where he was graduated as doctor of medicine in 1867...

), in Strasbourg he got in contact with methods of microscopic research of the nervous system (under Albrecht von Bethe). In Munich, von Economo worked with Emil Kraepelin
Emil Kraepelin
Emil Kraepelin was a German psychiatrist. H.J. Eysenck's Encyclopedia of Psychology identifies him as the founder of modern scientific psychiatry, as well as of psychopharmacology and psychiatric genetics. Kraepelin believed the chief origin of psychiatric disease to be biological and genetic...

 and Alois Alzheimer
Alois Alzheimer
Aloysius "Alois" Alzheimer, was a German psychiatrist and neuropathologist and a colleague of Emil Kraepelin. Alzheimer is credited with identifying the first published case of "presenile dementia", which Kraepelin would later identify as Alzheimer's disease....

 and wrote his article “Contribution to the normal anatomy of the ganglion cell
Ganglion cell
A retinal ganglion cell is a type of neuron located near the inner surface of the retina of the eye. It receives visual information from photoreceptors via two intermediate neuron types: bipolar cells and amacrine cells...

." He also worked in the psychiatry of Berlin under Theodor Ziehen
Theodor Ziehen
Georg Theodor Ziehen was a German neurologist and psychiatrist born in Frankfurt am Main. He was the son of noted author, Eduard Ziehen ....

 and in the neurologic ambulatory under Hermann Oppenheim
Hermann Oppenheim
Hermann Oppenheim was one of the leading neurologists in Germany. He studied medicine at the Universities of Berlin, Göttingen and Bonn. He started his career at the Charité-Hospital in Berlin as an assistant of Karl Westphal...

 and, finally, did experimental animal research in Trieste (under Carl Isidor Cori).
After these two years, he returned to Vienna and worked as assistant at the Clinic for Psychiatry and Nervous Diseases (headed by Julius Wagner-Jauregg
Julius Wagner-Jauregg
Julius Wagner-Jauregg was an Austrian physician, Nobel Laureate, and Nazi supporter.-Early life:...

) at Vienna’s General Hospital. Von Economo obtained his habilitation in 1913. In 1919 at age 43, he married Princess Karoline von Schönburg-Hartenstein. In 1921, von Economo was appointed Professor of Psychiatry and Neurology. He was to conduct his research in the Clinic for Psychiatry and Nervous Diseases in Vienna for the rest of his life, but only in 1931 was he made head of a newly established department of brain research. Tragically, he would die only five months later.

Aeronautics

Von Economo was not only an eminent scientist but also a passionate pilot. In 1907, he developed an interest in aeronautics and balloon-flying and became the first Austrian having an international pilot's diploma in 1912. From 1910 until 1926 he was President of the Austrian Aero-Club and chairman of the Aviation Board at the Austrian Ministry of Commerce and Transport. During World War I, he served first in the automobile corps at the Russian front and in 1916 as a pilot at the front in South Tyrol. In the same year, at the request of his parents, he returned to Vienna to care as a military physician for patients with head injuries. Here, he saw his first cases of Encephalitis lethargica
Encephalitis lethargica
Encephalitis lethargica or von Economo disease is an atypical form of encephalitis. Also known as "sleepy sickness" , it was first described by the neurologist Constantin von Economo in 1917. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless...

.

Death

In 1931, von Economo died aged 55 of the sequelaea of a heart attack. He was honored by an Austrian stamp in 1976. Since 1966, a bust portraying him can be found in the “Arkadenhof“ of the University of Vienna.

Scientific Work

Economo has published about 150 articles and books. In his early studies, he concentrated on the neuroanatomy and physiology of the midbrain, pons
Pons
The pons is a structure located on the brain stem, named after the Latin word for "bridge" or the 16th-century Italian anatomist and surgeon Costanzo Varolio . It is superior to the medulla oblongata, inferior to the midbrain, and ventral to the cerebellum. In humans and other bipeds this means it...

 and trigeminal nerve
Trigeminal nerve
The trigeminal nerve contains both sensory and motor fibres. It is responsible for sensation in the face and certain motor functions such as biting, chewing, and swallowing. Sensory information from the face and body is processed by parallel pathways in the central nervous system...

 pathway and wrote articles dealing for example with choreic hemiplegia, pontine tumors, mastication
Mastication
Mastication or chewing is the process by which food is crushed and ground by teeth. It is the first step of digestion and it increases the surface area of foods to allow more efficient break down by enzymes. During the mastication process, the food is positioned between the teeth for grinding by...

 and deglutition.

Encephalitis lethargica

This encephalitis
Encephalitis
Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...

 with acute inflammation of the gray matter
Gray Matter
"Gray Matter" is a short story by Stephen King, first published in the October 1973 issue of Cavalier magazine, and later collected in King's 1978 collection Night Shift. It is set in the same area as King's novel Dreamcatcher.-Setting:...

  occurred in epidemic form worldwide from 1915 until about 1924, mainly in Europe and North-America, causing lesions in the substantia nigra
Substantia nigra
The substantia nigra is a brain structure located in the mesencephalon that plays an important role in reward, addiction, and movement. Substantia nigra is Latin for "black substance", as parts of the substantia nigra appear darker than neighboring areas due to high levels of melanin in...

. Von Economo described in detail the symptoms, pathology and histology of the disease which was soon called Von Economo’s Disease. Three types of this illness could be distinguished. The symptoms of the somnolent-opthalmoplegic form were somnolence
Somnolence
Somnolence is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods . It has two distinct meanings, referring both to the usual state preceding falling asleep, and the chronic condition referring to being in that state independent of a circadian rhythm...

, often leading to coma
Coma
In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...

 and death, paralysis of cranial nerves
Cranial nerves
Cranial nerves are nerves that emerge directly from the brain, in contrast to spinal nerves, which emerge from segments of the spinal cord. In humans, there are traditionally twelve pairs of cranial nerves...

, extremities and eye muscles and expressionless faces. The hyperkinetic form manifested itself with restlessness, motor disturbances as twitching of muscle groups, involuntary movements, anxious mental state and insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...

 or inversion of sleep patterns. The amyostatic-akinetic form often lead to a chronic state similar to Parkinson's disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...

, called postencephalitic parkinsonism. The symptoms were weakness of muscles, rigidity of movements and insomnia or sleep inversion.
Von Economo published his findings for example in an article of 1917, “Die Encephalitis lethargica,” and in the monography "Die Encephalitis lethargica, ihre Nachkrankheiten und ihre Behandlung" in 1929 (Encephalitis lethargica - Its sequelae and treatment). The condition has not occurred since 1940. Von Economo was inspired by this illness to search for a centre of sleep in the brain.

Cytoarchitectonic studies

After the first attempts to divide the human cortex into areas according to the cytoarchitecture by Theodor Meynert
Theodor Meynert
Theodor Hermann Meynert was a German-Austrian neuropathologist and anatomist who was born in Dresden.In 1861 he earned his medical doctorate, and in 1875 became director of the psychiatric clinic associated with the University of Vienna. One of his better known students in Vienna was Sigmund...

, Vladimir Betz
Vladimir Betz
Vladimir Alekseyevich Betz - Russian anatomist and histologist, professor of the Kiev University, famous for the discovery of giant pyramidal neurons of primary motor cortex....

, Alfred Walter Campbell
Alfred Walter Campbell
-Further reading:...

, Grafton Elliot Smith
Grafton Elliot Smith
Sir Grafton Elliot Smith, FRS FRCP was an Australian anatomist and a proponent of the hyperdiffusionist view of prehistory.-Professional career:Smith was born in Grafton, New South Wales...

 and Korbinian Brodmann
Korbinian Brodmann
Korbinian Brodmann was a German neurologist who became famous for his definition of the cerebral cortex into 52 distinct regions from their cytoarchitectonic characteristics.-Life:...

, von Economo started his own project in 1912 and was joined by Georg N. Koskinas
Georg N. Koskinas
Georg N. Koskinas was a Greek neurologist-psychiatrist. He was born on December 1, 1885 in Geraki, near Sparta. He studied medicine at the University of Athens, graduating in 1910, and subsequently trained as a resident in the Clinic of Psychiatry and Neurology of Aiginiteion Hospital under Michel...

 in 1919. In 1925, their monumental work “Die Cytoarchitektonik der Hirnrinde des erwachsenen Menschen” ("Cytoarchitectonics of the Adult Human Cerebral Cortex
Cerebral cortex
The cerebral cortex is a sheet of neural tissue that is outermost to the cerebrum of the mammalian brain. It plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness. It is constituted of up to six horizontal layers, each of which has a different...

") was published. This work was presented in two volumes, a textbook of more than 800 pages and an atlas with 112 large-sized microphotographic plates of the cortex. The textbook contains detailed descriptions of their studies and an introduction to the history of cytoarchitectonic research. Two years later, a shorter version, “Zellaufbau der Großhirnrinde” ("The Cellular Architecture of the Cerebral Cortex") was published and translated into French, Italian and English. With their atlas, von Economo and Koskinas hoped to create a basis for future brain research and the localisation of brain functions since they assumed that cytoarchitectonic differences reflect functional differences. The atlas was republished in 2008.

Von Economo and Koskinas divided the cortex into seven lobes with further subdivisions: frontal lobe with 35 areas (divided into prerolandic, frontal, orbitomedial regions), superior limbic lobe with 13 areas (anterior, posterior, retrosplenial), parietal lobe with 18 areas (postcentral, superior, inferior, basal), temporal lobe with 14 areas (supratemporal, temporal proper, fusiform, temporopolar), insular lobe with 6 areas, occipital lobe with 7 areas and finally the inferior limbic lobe with 14 areas.

Von Economo neurons

The term “von Economo neurons” or spindle neurons has been given to large bipolar nerve cells identified by von Economo in layer V of the anterior cingulate and fronto-insular cortex
Insular cortex
In each hemisphere of the mammalian brain the insular cortex is a portion of the cerebral cortex folded deep within the lateral sulcus between the temporal lobe and the frontal lobe. The cortical area overlying it towards the lateral surface of the brain is the operculum...

.

Progressive cerebration

For von Economo, cerebration meant the evolution
Evolution
Evolution is any change across successive generations in the heritable characteristics of biological populations. Evolutionary processes give rise to diversity at every level of biological organisation, including species, individual organisms and molecules such as DNA and proteins.Life on Earth...

of the mind through generations, the increase of the brain mass, and the acquisition of new "organs of thought" due to differentiation of cortical areas. In this context, Economo was interested in "élite brains." He hoped to find microstructural characteristics in these brains distinguishing them from "average brains."
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