Frontal Lobe Disorders

Abstract

The frontal lobes are the largest and most likely the 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 a wide variety of presentations, including weakness, 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 soÔÇÉcalled frontotemporal dementias or frontotemporal lobar degenerations have become one of the most active and exciting field of research.

Key Concepts:

  • Frontal lobes mediate various processes, ranging from simple motor function to personality and inhibition.

  • The frontal lobes can be divided in different areas, which can be associated with different functions.

  • Multiple pathologic processes can affect the frontal lobes.

  • Disorders affecting the frontal lobes can present in various ways ranging from weakness to personality changes.

  • Some of these changes might be undetectable at the bedside examination and might require thorough neuropsychological evaluation.

Keywords: frontal lobes; personality changes; executive dysfunction; Broca's aphasia; frontotemporal 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. J. Harlow. Publications of the Massachusetts Medical Society (1868) 2: 327–347. Available at: http://en.wikisource.org/wiki/Image:Phineas_gage_‐_1868_skull_diagram.jpg © Massachusetts Medical Society.

Figure 2.

Main regions of the frontal lobes, as seen lateral (from the side, right) views.

Figure 3.

Large olfactory groove meningioma deforming the frontal lobe.

Figure 4.

Axial brain magnetic resonance imaging demonstrating predominant atrophy of the frontal lobes, bilaterally (arrows), in a patient with FTD.

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References

Alexander MP and Stuss DT (2000) Disorders of frontal lobe functioning. Seminars in Neurology 20(4): 427–437.

Chow TW (2000) Personality in frontal lobe disorders. Current Psychiatry Report 2(5): 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(5162): 1102–1105.

Kolb B and Whishaw I (2009) Fundamentals of Human Neuropsychology. New York, NY: Worth Publishers.

Miller BL and Cummings J (eds) (2006) The Frontal Lobes: Functions and Disorders. New York, NY: The Guilford Press.

Further Reading

Arciniegas D, Anderson A and Filley C (eds) (2013) Behavioral Neurology and Neuropsychiatry. New York, NY: Cambridge University Press.

Brazis P, Masdeu J and Biller J (2011) Localization in Clinical Neurology. Philadelphia, PA: Lippincott Williams & Wilkins.

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How to Cite close
Rodríguez‐Porcel, Federico, and Espay, Alberto J(Jun 2014) Frontal Lobe Disorders. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0021405.pub2]