- a railroad foreman who had a railroad rod shoot through his prefrontal cortex (and face) that survived and had drastic personality changes as a result.
- His case influenced 19th-century thinking about the brain and the localization of its functions, and was perhaps the first to suggest that damage to specific regions of the brain might affect personality and behavior.
a procedure where ice picks are placed in the orbital sockets, up into the prefrontal cortex and wiggled around, destroying tissue, in order to treat a wide variety of mental illnesses
Dorsolateral prefrontal cortex (DLPFC)
the highest cortical area responsible for motor planning, organization, and regulation, which is involved in the integration of sensory and memory information and the regulation of intellectual function and action (executive function), and is also involved in working memory.
cognitive tasks such as working memory, cognitive flexibility, planning, inhibition, and abstract reasoning
Working (short-term) memory
- limited, active, transient traces of experiences that happened in the very recent past (no longer than a few seconds ago).
- It's the "RAM" of human memory (see Unit 8 for further discussion)
Frontal convexity syndrome
a disorder characterized by apathy, indifference, occasional outbursts, loss of self, stimulus-bound behavior, lack of planning, psychomotor retardation, motor perseveration and programming deficits, poor word list generation, poor abstraction and categorization, and working memory deficits
persistent use of a specific strategy to solve a problem, despite the fact that the strategy is wrong or the rule of the task has changed
Wisconsin Card Sorting Task
One example of a test that can reveal the problems with executive function associated with DLPFC damage.
Anterior cingulate cortex (ACC)
- part of cortex that subserves primarily executive functions related to emotional control and the reward system.
- It plays key roles in decision making, empathy, and reward anticipation, and it also is involved in autonomic functions like blood pressure and heart rate (together with the brain stem).
Medial frontal syndrome
- a syndrome characterized by akinetic mutism: a paucity of spontaneous
- movement and gesture, sparse verbal output, lower extremity weakness and loss of sensation, and incontinence (loss of bladder and bowel control). Caused by damage to the medial wall of the frontal lobe, usually including the anterior cingulate cortex.
- Treatment varies by patient: stimulants, L-Dopa (to increase dopamine)
cortex that is involved in sensory integration, affective value of reinforcers, decision making, expectation, taste, flavor, and regulates planning behavior associated with sensitivity to reward and punishment
a syndrome caused by damage to the orbitofrontal cortex that is characterized by disinhibited & impulsive behavior, inappropriate jocular affect (laughing/excited mood), emotional lability (large/rapid shifts in emotions), poor judgment and insight (understanding of self and disease), sexual disinhibition (wilder sexual habits), lack of concern for others, and distractibility
Antisocial personality disorder
- A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture.
- Antisocial personality disorder is a condition in which an adult has a long term pattern of manipulating, exploiting, or violating the rights of others. This disorder is thought to be associated with criminal behavior in many cases.
- Related terms: psychopathic personality disorder and sociopathic personality disorder.
- Dissocial personality disorder is a term that has been proposed to cover all of these terms.
- There is no recognized treatment.
- juvenile diagnosis that may turn into antisocial personality disorder in the adult
- behaviors include bedwetting, animal abuse, pyromania, and general problems with authority
- a syndrome in which patients exhibit multiple motor tics and at least one vocal tic, which change over time.
- Typical onset is during childhood, and it may be as common as 1 in 100 children.
- ~10% have coprolalia
- Tourette’s frequently cooccurs with OCD, ADHD, and depression/anxiety.
Motor and vocal tics
- movements or vocalizations characteristic of Tourette’s syndrome that are stereotypic, temporarily suppressible, non-rhythmic, and often preceded by an unwanted premonitory urge (like a feeling of needing to sneeze).
- Patients can sometimes suppress tics for a little while, but then will typically have a rebound effect of more tics.
- Possible treatments target symptoms and include: behavioral approaches (habit reversal training; cognitive behavioral therapy – CBT), deep brain stimulation (of basal ganglia), and medications (antipsychotics that decrease dopamine; antidepressants, blood pressure meds).
- a condition associated with Tourette’s syndrome in which the person has a vocal tic consisting of socially inappropriate exclamations.
- Only 10% of patients with Tourette’s have coprolalia (unlike the common media portrayal).
- o Causes: Likely genetic cause that affects frontal lobe and basal ganglia
- development. Decreased size of the caudate nucleus of the basal ganglia is
- correlated with increased severity of symptoms. Tics worsen with stress.
- o Treatments:
- Behavioral – CBT, habit reversal training DBS – can have dramatic symptom improvement, but is invasive
- Medications – variable effect; Antipsychotics for tics, antidepressants (SSRIs), blood pressure medications
a syndrome characterized by placidity, diminished fear responses, inability to recognize emotional importance of an event, eating inappropriate objects, over-eating, hyper-orality, altered sexuality (compulsive sex drive, sex with inappropriate objects), visual agnosia, and hypermetamorphosis.
- impulse to notice and react to everything within sight
- o Causes: Thought to be caused by damage to the amygdala (fear response region) of the limbic system and connections between limbic system and frontal cortex
- o Treatments: not very good; they target symptoms and include antipsychotic meds to decrease dopamine.