Prefrontal Cortex and Executive Functioning

Question 1

What are some of the functions of the frontal lobe?

Answer 1

Motor control
Language
Higher level cognition
- Executive functioning

Question 2

What kind of presentation can a lesion in a particular nucleus of the thalamus lead to?

Answer 2

Similar to what you’d see if lesion in connected cortical area

Question 3

What is the difference between lobotomy and locotomy?

Answer 3

Lobotomy = removal of tissue
Locotomy = severing of connections

Question 4

What is the anterior unit in Luria’s functional systems?

Answer 4

Prefrontal cortex

Question 5

What is executive function?

Answer 5

Inter-related processes responsible for goal directed, purposeful behaviour
Includes emotional and social behaviour, and cognition
“Frontal lobe” function

Question 6

What are the areas of the prefrontal cortex responsible for executive function?

Answer 6

Lateral
Orbital
Medial

Question 7

Does damage to each area responsible for executive function present the same way?

Answer 7

No

Question 8

Which part of the prefrontal cortex is usually tested, in regards to executive function?

Answer 8

Usually only lateral function routinely tested

Question 9

What does the dorsolateral prefrontal cortex do?

Answer 9

Working memory
Response selection
Planning and organised
Hypothesis generation
Flexibility maintaining/shifting set
Insight
Moral judgement

Question 10

What supplies the dorsolateral prefrontal cortex?

Answer 10

Largely middle cerebral artery

Question 11

What is working memory?

Answer 11

Keep information in mind and manipulate it a little

Question 12

What is response selection?

Answer 12

What is best response in this situation?

Question 13

What is planning and organising?

Answer 13

How to carry out simple tasks; eg: making cup of tea

Question 14

What is hypothesis generation?

Answer 14

Reason through different solutions to a problem

Question 15

What is flexibility maintaining/shifting set?

Answer 15

Maintain train of thought but shift if need to

Question 16

What does the medial prefrontal cortex do?

Answer 16

Emotional-motivational interface

• At most extreme: akinetic mutism
• Apathy
• Lack of initiative
• Indifference

Question 17

What is the blood supply of the medial prefrontal cortex?

Answer 17

Anterior cerebral artery

Question 18

What is akinetic mutism?

Answer 18

Lack of desire to talk > don’t talk at all

Question 19

What does the orbitofrontal prefrontal cortex do?

Answer 19

Highly connected to limbic areas
Inhibition
- Emotional
- Cognitive
- Social
Impulsivity

Question 20

What is the blood supply to the orbitofrontal prefrontal cortex?

Answer 20

Anterior and middle cerebral arteries

Question 21

Which area is the last to develop in the brain?

Answer 21

Frontal lobe

Question 22

Which area is the first to degenerate in the brain?

Answer 22

Frontal lobe

Question 23

Which abilities are amongst the last to reach maturity?

Answer 23

Executive functions

• Lower order functions develop first
• Higher order develop later

Question 24

In which order to executive functions develop?

Answer 24

1. Theory of mind
2. Cognitive flexibility
3. Inhibitory control
4. Affective decision-making
5. Working memory

Question 25

Are executive and frontal lobe dysfunction the same disorder?

Answer 25

No

Question 26

What is important to note when thinking about executive dysfunction?

Answer 26

Can occur because of disruption at any level of system; eg: executive symptoms from subcortical lesions

Question 27

What are the positive symptoms of executive dysfunction?

Answer 27

``` Distractability Social dysinhibition Emotional instability Perseveration Impulsivity Hypergraphia ```

Question 28

What are the negative symptoms of executive dysfunction?

Answer 28

``` Lack of concern Restricted emotion Deficient empathy Failure to complete tasks Lack of initiation ```

Question 29

How are medial and orbitofrontal prefrontal cortical lesions formally assessed?

Answer 29

Difficult to do Clinical judgement History taking

Question 30

What executive dysfunction does the "tower of London" test?

Answer 30

Disinhibition and problem solving In dysfunction - Disregard rules - Can't figure out strategy to complete task

Question 31

What executive dysfunction does the "stroop test" test?

Answer 31

Disinhibition

Question 32

What executive dysfunction does the "Rey complex figure test" test?

Answer 32

Planning deficit

Question 33

What are some common causes of executive dysfunction?

Answer 33

``` Closed head injury Stroke Psychiatric conditions Dementias Focal lesions Inflammatory Developmental ```