Frontal Lobe Disorders

Alberto J Espay, University of Cincinnati, Cincinnati, Ohio, USA

Published online: March 2009

DOI: 10.1002/9780470015902.a0021405

The frontal lobes are the largest and likely most complex structure in the brain. Among other functions, it allows the expression of personality and language, the planning and sequencing of desired movements or actions as well as inhibition of unwanted or undesirable ones. Given the regional distribution of function, lesions or dysfunction in the frontal lobes may lead to such range of personal and social disruptions as aphasia, perseveration, disinhibition, personality changes and acquired sociopathy. Besides trauma, tumours, infections and toxins, abnormal disorders of tau and ubiquitin proteins may lead to neurodegenerative diseases that predominantly affect the frontal lobes. These so-called frontotemporal dementias or frontotemporal lobar degenerations have become the most active and exciting field of research in the frontal lobes.

Key Concepts

These are the most salient functions and dysfunctions of the frontal lobes discussed here:

FunctionFrontal lobe-specific dysfunctionRecognition
LanguageExpressive aphasia (Broca's aphasia)Impairment in fluency, naming and ability to repeat. No problems comprehending
Executive functionExecutive dysfunctionPerseverative behaviours with inability to sequence goal-directed movements
Personality changesApathetic personality (dorsolateral)Either abulic/apathetic or disinhibited personality
‘Orbital’ personality (orbitofrontal)


Keywords: frontal lobes; personality changes; executive dysfunction; Broca's aphasia; frontemporal dementia

Figure 1. Illustration from ‘Recovery from a Passage of an Iron Bar through the Head’ demonstrating the direction in which the iron rod traversed the skull and penetrated the frontal lobes. Publications of the Massachusetts Medical Society (1868) 2: 327–347. See: http://en.wikisource.org/wiki/Image:Phineas_gage_-_1868_skull_diagram.jpg
Figure 2. Main regions of the frontal lobes, as seen from the mesial (inner aspect, left), basal (from below, middle) and lateral (from the side, right) views.
Figure 3. Large olfactory groove meningioma deforming the frontal lobe.
Figure 4. Mid-sagittal (a), coronal (b) and axial (© T2-weighted; (d) fluid-attenuated inversion recovery, FLAIR) magnetic resonance imaging of the brain of a patient with normal pressure hydrocephalus, demonstrating enlargement of the ventricles, particularly the anterior horns of the lateral ventricles (arrows in (a) and (b)), with an increase in the ventricle (v)/frontal lobe (f) ratio (known as the ‘Evans index’; hydrocephalus is present when v/f >0.3). Bright signal around the frontal horns of the ventricles in the FLAIR sequence (arrows in (d)) indicates transpendymal fluid.
Figure 5. Axial brain magnetic resonance imaging demonstrating predominant atrophy of the frontal lobes, bilaterally (arrows), in a patient with frontotemporal dementia.
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 Further Reading
    Alexander MP and Stuss DT (2000) Disorders of frontal lobe functioning. Seminars in Neurology 20: 427–437.
    Chow TW (2000) Personality in frontal lobe disorders. Current Psychiatry Report 2: 446–451.
    Damasio H, Grabowski T, Frank R, Galaburda AM and Damasio AR (1994) The return of Phineas Gage: clues about the brain from the skull of a famous patient. Science 264: 1102–1105.

Related Sub-Topics:

Neurobiology of Disease
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Article Title: Frontal Lobe Disorders
 
How to Cite close
Espay, Alberto J(Mar 2009) Frontal Lobe Disorders. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0021405]