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33 Cards in this Set
- Front
- Back
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Name the 4 functional zones of the Frontal Lobes:
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-Dorsolateral prefrontal cortex (DLPFC)
-Orbitofrontal cortex (OFC) -Anterior Cingulate Cortex (ACC) -Motor/Supplementary Motor Area |
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Name 4 common clinical presentations associated with injury/illness to frontal regions:
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-Perseveration/disinhibition
-traumatic brain injury (TBI) -frontotemporal dementia (FTD) -amotivation/akinetic mutism |
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What 4 broad functions do the frontal lobes perform?
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Organization of incoming information
Working Memory Self regulation: Impulse inhibition Initiation/Drive |
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What do the frontal lobes do to organize incoming information?
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Response selection
Maintenance of goal (set selection) Behavioral flexiblity |
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What BAs are included in the frontal lobes?
OFC? DLPFC? ACC? Frontal eye fields? Premotor area? Motor area? Broca? |
OFC BA 10 11 12
DLPFC BA 9, 46 ACC 12 32 33 24 Frontal eye fields BA 8 Premotor/SMA 6 /Motor 4 Broca 42 44 |
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OFC inputs: 6
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-limbic and olfactory regions
-amygdala -temporal pole -entorhinal cortex -olfactory nerve -inferotemporal lobe areas -ventral visual pathways |
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OFC output: 5
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autonomic, musculature and endocrine system (basal forebrain cholinergic system, caudate)
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OFC functions: 2
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-Integration of memory and emotional valence: Leads to behavior modification
-Smell discrimination |
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What happens in OFC dysfunction? 3
What's the OFC particularly vulnerable to? |
-Disinhibition, socially inappropriate behavior
-Anosmia -Confabulation -Susceptible to traumatic brain injury (TBI) |
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What are the DLPFC functions? 6
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Executive functions:
-Integration of multimodal sensory information -Generation of multiple response alternatives -Selection of appropriate response -Set selection and persistence -Set shifting, flexibility -Working memory |
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What happens in DLPFC dysfunction? 5
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-Difficulty integrating sensory information
-Generation of few, stereotyped response alternatives -Poor judgment in response selection -Impersistence -Perseveration |
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Frontal eye field functions: 2
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-Volitional eye movement in contralateral visual field
-Active visual search |
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What happens in frontal eye field dysfunction? 2
What is still intact? |
-Failure to move eyes volitionally to contralateral visual field
-Poor visual search -Intact passive eye movement |
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What are the premotor area's functions? 2
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-Integration of sensory and motor information
-Praxis |
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What does the premotor area get input from? 2
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-Input from ventral anterior thalamic nucleus and secondary somatosensory area
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Where does output from the premotor area go? 2
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-Output to motor area
-connections via corpus callosum to contralateral premotor area |
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What happens in premotor area dysfunction? 3
What is preserved? |
Apraxia
Contralateral fine motor deficits Difficulty using sensory feedback Preserved postural praxis via basal ganglia |
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What are the functions of the ACC? 3
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Drive and motivation
Environmental exploration Basic attention |
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What connections does the ACC have? 2
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Connections with primitive cortical and limbic structures
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What occurs in ACC dysfunction? 5
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Apathy
akinetic mutism Alien hand syndrome Complex attentional deficits delayed habituation |
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Functions of the primary motor area? 2
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Homunculus
Pyramidal motor functions |
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Inputs to the primary motor area? 2
Outputs from it? 1 |
Input from ventral lateral thalamic nucleus, primary somatosensory area in parietal lobe.
Output to internal capsule. |
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What happens in primary motor area dysfunction? 2
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Initially, flaccid hemiparesis or hemiplegia on contralateral side
-Later, spastic hemiparesis or hemiplegia |
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inputs to broca's area? 4
outputs from it? |
-Inputs from prefrontal, temporal (auditory), parietal, motor
-Outputs: Wernicke’s (arcuate fasciculus) |
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Function of broca's area?
What are the two parts of BA called? |
-language production
-Pars opercularis and pars triangularis |
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How do the frontal lobes connect with other cortical structures? Where do most connections go?
How do the frontal lobes connect subcortically? |
Via white matter tracts. Most connections are to other frontal regions, and to associative regions.
Subcortically, frontal lobes connect via the basal ganglia and thalamus. |
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List 4 surgeries/procedures that manipulate/destroy subcortical frontal lobe connections:
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Frontal Lobotomies
Cingulotomy/Leukotomy Gamma Knife Surgery Deep Brain Stimulation |
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What happens to the brain in frontotemporal dementia?
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-Atrophy in frontal, temporal cortex.
-Enlarged ventricles |
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What kind of symptoms can a frontal TBI/hemorrhage cause?
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-executive function loss
-disinhibition -perseveration |
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What causes hallucinations in psychosis/schizophrenia? What type of hallucinations are most common?
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Auditory hallucinations: loss of prefrontal-mediated self discrimination
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What happens to the frontal lobes in MDD? What part specifically?
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-Hypoactive DLPFC
-Loss of modulation of emotional perception -Bias towards negative perceptions--> “Depressed Mood” |
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What part of the frontal lobes does TMS target? What is it FDA approved for?
What other disorders might it be helpful for? 3 |
Targeted stimulation of the DLPFC
FDA Approved in 2008 for MDD Post-traumatic stress disorder Refractory hallucinosis associated with schizophrenia Obsessive compulsive disorder |
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What's the timeline of TMS? Strength and frequency?
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6 weeks
3T 10 Hz |
