Frontal lobe disorder
Frontal lobe disorder is an impairment of the frontal lobe that
occur due to disease or head trauma. The frontal lobe of the brain
plays a key role in higher mental functions such as motivation,
planning, social behavior, and speech production.
A frontal lobe syndrome can be caused by a range of conditions
including head trauma, tumors, degenerative diseases, neurosurgery
and cerebrovascular disease. Frontal lobe impairment can be
detected by recognition of typical clinical signs, use of simple
screening tests, and specialist neurological testing.
Frontal lobe anatomy and function:
The brain has two hemispheres, the left and the right, which are
further divided into three sections, the forebrain, the midbrain.
Differentiation if these separate parts occur during fetal
development. Each has specific functions:
- The hindbrain controls respiration and heart rate.
- The midbrain controls reflex actions such as eye movement
- The forebrain controls emotional perceptions and responses,
involuntary movements, sleep patterns, memory, and organizational
ability.
The forebrain eventually develops into the cerebrum, the outer layer
of which is called the cerebral cortex. The frontal lobe is one of the
four lobes of the cerebral cortex, which also includes the temporal
lobe, the parietal lobe, and the occipital lobe. Each of these regions
carries out specific functions and damage to any of these lobes
results in corresponding impairment. The frontal lobes are relatively
large compared to other regions of the brain, and the extensive
functions controlled by the frontal lobe is reflected in its proportional size.
Frontal lobe anatomy and function:
The brain has two hemispheres, the left, and the right, which are further divided into three sections, the forebrain the midbrain, and the hindbrain. Differentiation of these separate parts occurs during fetal development. Each has specific functions:
- The hindbrain controls respiration and heart rate
- The midbrain controls reflex actions such as eye movement
- The forebrain controls emotional perceptions and responses, involuntary movements, sleep patterns, memory, and organizational ability.
The forebrain eventually develops into the cerebrum, the outer layer of which is called the cerebral cortex. The frontal is one of the four lobes of the cerebral cortex, which also includes the temporal lobe, the parietal lobe, and the occipital lobe.
Each of these regions carries out specific functions and damage to any of these lobes results in corresponding impairment.
The frontal lobes are relatively large compared to other regions of the brain, and the extensive functions controlled by the frontal lobe is reflected in its proportional size.
Social and emotional skills:
The frontal lobe plays a substantial role in decision making, self-control, and emotional regulation, providing the ability to behave appropriately in interpersonal situations and to regular behavior in a socially acceptable manner.
Cognitive skills:
The frontal lobe also integrates thinking skills by maintaining attention, high-level thinking, and problem-solving. It is believed humans' large frontal lobes are responsible for advanced thinking and innovation, as well as the ability to imagine situations.
Motor function:
There are some differences between the right and left frontal lobes. The back of the frontal lobe is a
Motor Function:
There are some differences between the right and left frontal lobes. The back of the frontal lobe is a region called the motor strip, which controls and directs the body's voluntary physical movements. The left motor strip controls movements of the right side of the body, while the right motor strip controls movements of the left side of the body.
Language and spatial abilities:
There are also functions that are predominantly controlled by the frontal lobe or the right frontal lobe. Along with neighboring parietal
Language and Spatial Abilities:
There are also functions that are predominantly by the left frontal lobe or the right frontal lobe. Alonge with the neighboring parietal and temporal lobes, the dominant frontal lobe is involved in language, rational, quantitative, and logical thinking, and analytical reasoning.
Signs and Symptoms:
The signs and symptoms of frontal lobe disorder can be indicated by Dysexecutive syndrome which consists of a number of symptoms that tend to occur together.
- Cognitive movement and speech, emotional or behavioral. Although many of these symptoms regularly co-occur, it is common to encounter patients who have several, but not all of these symptoms. This is one reason why some researchers are beginning to argue that dysexecutive syndrome is not the best term to describe these various symptoms.
- The fact many of the dysexecutive syndromes can occur alone has led some researchers to suggest that the symptoms should not be labeled as a syndrome as such. Some of the latest imaging research on frontal cortex areas suggests that executive functions may be more discrete than was previously thought.
Signs/ symptoms can be divided as follows:
Movement:
- Tremor
- apraxia
- Dystonia
- Gait disorder
- Clumsiness
Emotional:
- Difficulty in inhibiting emotions, anger, excitement
- Depression
- Difficulty in understanding other's points of view.
Behavioral:
- Utilization behavior
- Perseveration behavior
- social inhibition
- compulsive eating
Language signs:
- Aphasia
- Expressive aphasia
Causes:
Damage to the frontal lobe is most commonly caused by degenerative disease or a stroke, and there are other, less common conditions that affect the frontal lobes as well.
Dementia:
The second-most common cause of dementia in people under 65 is frontotemporal dementia(FTD), a group of disorders affecting the frontal and temporal lobes of the brain
As neurons in the frontal and temporal lobes become atrophied over time difficulty in thinking, controlling emotions, inability to organize, trouble communicating, and unusual behavior develop.
Stroke:
Stroke and transient ischemic attacks can also impair the function of the frontal lobe. When blood flow through one or more of the blood vessels that provides blood to an area of the frontal lobe becomes interrupted or blood, the corresponding region of the brain suffers and cannot functions as it should.
Other causes:
Causes of damage or injury to the frontal lobe may include the following:
- Huntington's disease
- Cerebral palsy
- Brain tumors
- Infections
- Traumatic brain injury
Diagnosis:
Frontal lobe disorders may be recognized through a sudden and dramatic change in a person's personality, for example with loss of social awareness, disinhibition, emotional instability, irritability, or impulsiveness.
Examination:
On mental state examination, a person with frontal lobe damage may show speech problems, with reduced verbal fluency. Typically the person is lacking in insight and judgment but does not have marked cognitive abnormalities or money impairment, with more severe impairment there may be echolalia or mutism.
Further investigation:
A range of neuropsychological tests is available for clarifying the nature and extent of the frontal lobe dysfunction. Concept formation and ability to shift mental sets can be measured with the Wisconsin card sorting test, planning can be assessed with the mazes subtest of the WISC. Individuals with pick's disease will show frontal cortical atrophy on MRI'S. Frontal impairment due to head injuries, tumors, or cerebrovascular disease will also appear on brain imaging.
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