Brain-Damaged "Gourmand Syndrome" Foodies Can't Register Your Disgust

Until his forties, the patient known as “RG” was a marathon runner. But at 42, he became a gourmand, a real foodie. He bought food guides, drove long distances to try fancy restaurants, at one point he even began hallucinating tastes. That’s when the doctors found a benign brain tumor, a fibroblastic meningioma, in his brain. They removed it, and RG continued on his taste journey, going so far as to become a highly regarded food critic.

Then, at the age of 58, during a routine MRI, lingering brain damage was found—some tumor tissue remained and was pushing on RG’s right amygdala. He had another surgery to reduce it. Then, within a month after the surgery, RG lost interest in gastronomy.

Rather than following the normal path of a gourmand and becoming a self-described “foodie” after reading a Michael Pollan book and signing up for Instagram, RG was afflicted with “gourmand syndrome.” First diagnosed in the late 1990s, gourmand syndrome was described in the journal Neurology as a “benign eating disorder associated with lesions involving parts of the right anterior cerebral hemisphere.” In other words, it’s a love of fancy restaurants and plates born out of brain damage.

A new study by Spanish researchers looked into how gourmand syndrome works and what specific changes come from lesions of the right amygdala and temporal pole. And it may explain why foodies don’t pick up on your revulsion when they begin describing brunch in excruciating detail.

Contrary to what you might think, there wasn’t any clear difference in abilities to taste or smell. The only real difference was that RG “had an unusual liking for salt (NaCl) at low and moderate concentrations, or, to put it another way, did not dislike the taste of salt as much as age-matched controls,” according to the study.

One other unexpected revelation was that RG had a marked “reduction in the ability to detect face expressions of disgust.” Damaged amygdalas are associated with a reduced ability to recognize facial expressions, but damage to it has mostly be associated with an inability to recognize fear.  The researchers didn’t see this disgust thing coming.

It's a fascinating finding, as it shows a correlation between a brain region and emotional and cognitive functions. But it's also not clear if it had any effect on RG's gourmand syndrome. As the authors write, "In relation to the impairment in identifying face expressions of disgust, it will be of interest to investigate whether other people with the gourmand syndrome associated with right temporal lobe damage also show this change in face emotion expression processing."

Gourmand syndrome is a benign condition in itself, so studying it and its weird expression of mild brain damage functions more as a way of better understanding the geography of the brain better. This is the first systematic study of the taste and olfactory status of a patient with a gourmand syndrome associated with damage to the right temporal lobe, and the researchers are eager to see if other patients with gourmand syndrome also show a deficit in understanding facial expressions.

On a personal level, I’d be interested in how patients respond to sighing and rolling of eyes as they enthusiastically describe how kale was used in the meal, since my own preliminary research finds a huge deficit in understanding when I’d rather not hear it.