Dysexecutives Syndromes

Question 1

dlPFC syndrome in TBI

Answer 1

• Primarily affects non-dominant dlPFC
• Common in frontal contusion and severe concussion
• Symptoms:
  
  • Abulia = decision-making difficulties
  • Apathy = lack of interest or enthusiasm in activity previously enjoyed
  • Psychomotor slowing (of voluntary movements & automatic reactions)
  • Preservation = inability to adapt to construct another strategy

Question 2

OFC syndrome in TBI

Answer 2

• Affects mPFC & orbital cortex affecting social behavior & decision making ++ Often described as «going through personality changes»
• Common in concussion/CTE
• Symptoms:
  
  • Childlike euphoria
  • Facetious humor = un appropriate saying
  • Shallow affect = don’t know how to react
  • Social disinhibition = when little to no fear of strangers
  • Impulsivity
  • Distractibility

Question 3

mPFC syndrome in TBI

Answer 3

• Common in vascular damage (EDH/SDH/ICB)
• Affects the executive component of movement processing
• Symptoms:
  
  • Reduced spontaneous movement & paused
  • Sparse verbal output & preserved repetition = invent words & repetition of it
  • Movement control loss (spasticity)
  • Loss of LL extremities sensitivity
  • Incontinence

Question 4

SMA syndrome in TBI

Answer 4

• Common post-tumor resection/lobotomy or sometimes vascular injuries
• Usually transient symptoms (days to weeks)
• Symptoms:
  
  • Hemiparesis
  • Speech impairment
  • Movement & speech hesitancy
  • Planning/navigation deficits