Utilization behavior

Neurobehavioral phenomena involving irresistible usage of objects in view
Utilization behavior (UB) is a type of neurobehavioral phenomena that involves someone grabbing objects in view and starting the 'appropriate' behavior associated with it at an 'inappropriate' time. Patients exhibiting utilization behavior have difficulty resisting the impulse to operate or manipulate objects which are in their visual field and within reach. Characteristics of UB include unintentional, unconscious actions triggered by the immediate environment. The unpreventable excessive behavior has been linked to lesions in the frontal lobe. UB has also been referred to as "bilateral magnetic apraxia" and "hypermetamorphosis".

Individuals who display utilization behavior tend to reach out and begin to automatically use objects in the visual field of their environment. This may not seem incorrect but the difference in action to a person without UB is that the "object appropriate" action taken is performed at the inappropriate time. For example, a person will be shown a pair of glasses and automatically put them on. This demonstrates the appropriate action at the "inappropriate" time. This causes the inappropriate motor responses to specific objects in the environment.

People with utilization behavior may be unable to resist grasping or using an object placed in front of them, regardless of the context or environment. It is not known what triggers them to exhibit UB with certain external stimuli and not others. An effect related to UB consists of the feeling that a body part is separate from the rest of the body and has a mind of its own. This set of symptoms may be related to Alien Hand Syndrome (AHS), a neurological disorder in which the subject does not acknowledge ownership of a limb when visual cues are lacking. AHS can involve damage to the anterior cingulate gyrus, the medial prefrontal cortex and the anterior corpus callosum when a patient has frontal AHS. The other type of AHS, callosal AHS, is due to an anterior callosal lesion and affects dominant hemisphere control.

The cause of utilization behavior can be attributed to many diseases including Alzheimer's disease, Cerebrovascular disease, Frontotemporal dementia, neoplasm, and corticobasal degeneration. Imitation Behavior (IB) has been studied by Lhermitte et al. in conjunction with UB which showed an imbalance between the dependence on and independence from external stimuli. It was thought that UB was an imbalance in the frontal and parietal lobes, but the study demonstrated that only damage to the frontal lobe affects UB as patients with damage to both areas did not demonstrate UB or IB.

The anterior cingulate cortex forms connections with dorsolateral prefrontal cortex meaning prefrontal regions have strong connections with limbic structures. This can be seen in the following study conducted by Eslinger et al. A woman with bilateral encephalomalacia had a damaged medial thalamus and showed behavioral problems including utilization behavior. She conducted unnecessary motor use of objects in her immediate environment. The effect of the damage to the paramedian thalamic region did not astonish researchers because of its connection to the cingulate cortex. Thalamic infarctions have produced hypometabolism, a decrease in metabolic rate, in the frontal areas and hypoperfusion resulting in UB. The patient was marked with the behavior, and brain imaging noticed the infarctions in the thalamus.

Although no specific cure has been found for UB, steps can be taken to reduce its symptoms and severity. If UB is a symptom of an underlying disease or disorder, treatment of the disease itself can reduce the severity of UB and may eradicate it completely. This was seen in patients with Moyamoya disease who had bilateral frontal lobe infarctions which resulted in UB. Upon treatment, the UB was resolved due to 60–70% shrinkage of the anterior lobe hypodensities. Concerning general frontal lobe damage, rehabilitation is known to help a patient function with their disorder.

Utilization behavior is present in patients that have ranging diseases and disorders. For example, if the patient was told that they were in an art gallery, they would start to look at pictures hung on the wall and interpret them as if in an actual art gallery.

With manual groping behavior (MGB), the patient's hand or eye is attracted to an object and follows it in a magnetic manner while manipulating the object. This behavior is involuntary and occurs constantly except for the brief stops due to diverted attention. Similar to the grasp reflex, MGB is normal in infants but presents as a symptom in adults.

Imitation behavior (IB) is another behavior established by Lhermitte (1983) and it explains a patient's replication of the examiner's movements. This may be seen if for example, the experimenter claps their hands and yawns, the patient would do the same in the same order. The behavior is still present even when the patient is told not to follow the actions of the experimenter resulting in the belief that a patient with IB cannot stop the involuntary response. IB is important in the development of children but if it is present in adulthood, it is an abnormality.