Frontal Lobe Syndrome

Question 1

Frontal Lobe Syndrome?

Answer 1

FLS is a term used to describe the damage of higher functioning processes of the brain such as motivation, planning, social behaviour, and language/speech production.

Question 2

Anatomy of FL

Answer 2

The frontal lobe can be divided into 3 categories:

Motor cortex
sends muscle signals down to the spinal cord. The left motor cortex controls the right side of the body, and the right motor cortex controls the left side of the body. (BA 4)

Premotor
anterior to the primary motor cortex. Prepares and executes movements of the limbs, through coordination with other parts of the brain in choosing the appropriate motions. It occupies (BA 6). Damage to premotor cortex may result in apraxia for example, the inability to carry out skilled actions that could be previously performed.

Prefrontal
functions of cognitive control. Involved in working memory via central executive processes. The brain region has been implicated in executive functions, such as planning, decision-making, short-term memory, personality expression and controlling certain aspects of speech and language.

Question 3

Symptoms of FL damage

Answer 3

1.Loss or impairment of movement
2.Impairment of working memory
3.Acquired perseveration/loss of creativity.
4.Lack of spontaneity/decision-making
5.Change in personality, often including grossly inappropriate social/sexual behaviour.

Question 4

Loss or impairment of movement

Answer 4

1. Disturbances of motor function

Damage to primary motor cortex results in loss of ability to make fine, independent finger movements.
-Likely results from loss of direct corticospinal projections to motor neurons.
-Also results in loss in strength and speech in hand and limb contralateral to injury (this also results from FL lesions outside primary motor cortex

2. Deficits in motor programming

Can result in problems with sequencing movements in the correct order.
-One common result of premotor damage is ideational apraxia (the loss of ability to select appropriate movements)

Question 5

Lack of spontaneity

Answer 5

Behavioural Spontaneity
-Can be reflected in a loss of speech in general and/or more specifically in problems with word generation.
-Can be a consequence of perseveration in behaviour.
-OCD is an instance of pathological perseveration.
-In general, can appear lethargic and lazy.
-Can have serious consequences for work performance.

Question 6

Lack of decision-making

Answer 6

Can have serious problems with developing new plans or strategies for solving problems.

-Shallice and Burgess “shopping list” study:
-Patients were to go and buy a list of items and return to experimenter as quickly as possible.
-FL patients performed very poorly at this task.

Question 7

Social and Sexual behaviour

Answer 7

FL damage can lead to radical changes in personality.

• Can make the person aggressive.

-These can include serious impairments in the appropriateness of social and sexual behaviours.

Question 8

Phineas Gage

Answer 8

Damage to frontal lobe can lead to
-Immature behaviour
-Coarse language
-serious impairments in the appropriateness of social and sexual behaviours.

Phineas Gage became quick-tempered and foul-mouthed and had serious impairments in the appropriateness of sexual behaviours.

Question 9

Personality changes can include:

Answer 9

• Lack of inhibition
• Motivational/energising deficits
• Inappropriate social behaviour
• Changes in sexual behaviour