problem solving frontal lobe

Frontal Lobe: What It Is, Function, Location & Damage

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

Learn about our Editorial Process

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

The frontal lobe is the brain’s largest region, located behind the forehead, at the front of the brain. These lobes are part of the cerebral cortex and are the largest brain structure.

The frontal lobe’s main functions are typically associated with ‘higher’ cognitive functions, including decision-making, problem-solving, thought, and attention .

It contains the motor cortex , which is involved in planning and coordinating movement; the prefrontal cortex, which is responsible for higher-level cognitive functioning; and Broca’s Area , which is essential for language production.

Frontal Lobe Functions

Below is a list of some of the associated functions of the frontal lobe:

Executive processes (capacity to plan, organize, initiate, and self-monitor) Voluntary behavior Problem-solving Voluntary motor control Intelligence Language processing Language comprehension Self-control Emotional control

The frontal lobes are believed to be our behavior and emotional control centers, meaning that this area is activated when needing to control our behaviors to be socially appropriate and to control our emotional responses, especially in social situations.

Moreover, the frontal lobes are thought to be the home of our personalities.

Alike to most lobes in the brain, there are two frontal lobes located in the left and right hemispheres.

Each lobe controls the operations on opposite sides of the body: the left hemisphere controls the right side of the body and vice versa.

It is believed the left frontal lobe is the most dominant lobe and works predominantly with language, logical thinking, and analytical reasoning.

The right frontal lobe, on the other hand, is most associated with non-verbal abilities, creativity, imagination, and musical and art skills.

The frontal lobe, like other structures of the brain, does not always work in isolation from each other. The frontal lobes work alongside other brain regions in order to control a variety of functions.

Substructures

The frontal lobe contains the motor cortex , which is involved in planning and coordinating movement; the prefrontal cortex, which is responsible for higher-level cognitive functioning; and Broca’s area, which is essential for language production.

Prefrontal Cortex

The prefrontal cortex is primarily responsible for the ‘higher’ brain functions of the frontal lobes, including decision-making, problem-solving, intelligence, and emotion regulation.

This area has also been found to be associated with the social skills and personality of humans.

This idea is supported by the famous case study of Phineas Gage , whose personality changed after losing a part of his prefrontal cortex after an iron rod impaled his head.

The frontal cortex has also been shown to be activated when an experience becomes conscious. Different ideas and perceptions are bound together in this region, both of which are necessary for conscious experience.  Concluding that this area may be especially important for consciousness.

Cognitive disorders that have been shown to be linked to this region are attention deficit hyperactivity disorder ( ADHD ), Autism, bipolar disorder, depression , and schizophrenia.

The prefrontal cortex can be further divided into the dorsolateral prefrontal cortex and the orbitofrontal cortex.

Motor and Premotor Cortex

The motor cortex is critical for initiating motor movements, as well as coordinating motor movements, hence why it is called the motor cortex.

Each area of the motor cortex corresponds precisely with specific body parts. For instance, there is an area that controls the left and the right foot.

The premotor cortex is associated with planning and executing motor movements. Within this area, voluntary movement is rehearsed, distinguishing these movements from unconscious reactions.

The premotor cortex has also been shown to be important for imitation learning through the use of mirror neurons.  These neurons essentially allow us to reflect the body language, facial expressions, and emotions of others.

Furthermore, the prefrontal cortex can support cognitive functions of a social kind, such as showing empathy.

Broca’s Area

Another region of the frontal lobes worth mentioning is Broca’s area . This region is located in the dominant hemisphere of the frontal lobes, which is the left side for around 97% of humans.

This region is associated with the production of speech and written language, as well as with the processing and comprehension of language.

The name is taken from the French scientist Paul Broca, whose work with language-impaired patients led him to conclude that we speak with our left brains.

Language differences in those with Autism may be correlated to differences in the structure and function of Broca’s area (Bauman & Kemper, 2005).

As the frontal lobes are situated at the front of the brain and are large in size, this makes them more susceptible to damage. This area is the most common for traumatic brain injuries, with damage to this region causing a variety of symptoms.

Below is a list of symptoms that may occur if an individual has experienced damage within their frontal lobe:

• Changes in mood
• Attention deficits
• Atypical social skills
• Difficulty problem-solving
• Lack of impulse control/ risk-taking
• Loss of spontaneity in social interactions
• Reduced motivation
• Impaired judgment
• Reduced creativity

Damage to Broca’s area, in particular, has been shown to affect the ability to speak, understand language, and produce coherent sentences.

One of the most famous case studies associated with frontal lobe damage is the case of Phineas Gage . He was a railway construction worker who suffered an unfortunate accident when a metal rod impaled his brain in the frontal region.

Gage survived this accident but was said to have experienced some personality changes because of the trauma. Before the accident, Gage was described as a ‘well-balanced’ and smart, energetic person.

After his accident, he was described as being childlike in his intellectual capacities and had a loss of social inhibition (behaving in ways that were considered socially inappropriate).

This case study implies that the frontal lobes are essential to our personalities, intelligence, and social skills. As well as trauma to the head is a cause of damage to the frontal lobes, there are many other causes that can lead to damage.

For instance, a brain tumor, stroke, or infection can cause deficits in this lobe. Similarly, conditions such as cerebral palsy, Huntington’s disease, dementia, or other neurodegenerative diseases can lead to associated damage.

If someone is suspected of having frontal lobe damage, there are methods to diagnose this. Magnetic resonance imaging (MRI) and computerized tomography (CT) scans can detect some differences in the frontal lobes after suffering a stroke or infection, as well as be able to detect dementia.

Also, neuropsychological evaluations can be completed to test for areas such as speech comprehension, social behavior, memory, problem-solving, and impulse control, among others.

One common test to establish frontal lobe damage is the Wisconsin Card Sorting task. Within this task, individuals will be shown cards of varying sorts, such as some having symbols, numbers, different shapes, and colors on them.

They will then be asked to sort the cards by a certain criterion, which will then change throughout the test. Those who have damage to a certain part of the frontal lobes may struggle with this task and will not adjust to new sorting criteria. They will stick with the original criteria (this is called perseveration).

Other tests worth noting as finger tapping tests, to test for motor skill ability, and the Token Test, which tests for language skills.

To be able to treat frontal lobe damage, occupational, speech, and physical therapy can be helpful for rehabilitating these lost or damaged skills.

Finally, a talking therapy called cognitive behavioral therapy (CBT) is common for working on regulating emotions and aiding impulse behaviors.

CBT may not fully treat physical damage to the frontal lobes, but it can help those with impairments cope and manage their symptoms.

Research Studies

• Semmes, Weinstein, Ghent & Teuber (1963) suggested that the frontal lobes played a part in spatial orientation, particularly our body’s orientation in space.
• Eslinger & Grattan (1993) investigated damage to the prefrontal cortex. They suggested that people with damage to this area may not have problems with word comprehension or identifying objects by their names, but if asked to say or write as many words as possible or describe as many uses of an object, they would find this task difficult. This shows that damage to one area associated with language does not impair all aspects of language.
• Kolb & Milner (1981) discussed the involvement of the frontal lobes in facial expressions. They found that patients with frontal lobe damage had difficulty expressing spontaneous facial expressions and would also show fewer facial movements spontaneously.
• Kaufman, Geyer & Milstein (2017) reported that patients who suffered damage to their frontal lobes had changes to their personalities.
• It was found that these patients developed an abrupt, suspicious, and sometimes even argumentative manner.
• Some patients were reported to have displayed ‘emotional incontinence,’ whereby they would have bouts of pathological laughing or crying.
• Walker & Blummer (1975) found that damage to the frontal lobes resulted in displays of abnormal sexual behavior in the orbital region and reduced sexual interest if the dorsolateral region was damaged.
• Stuss et al. (1992) found that damage to certain areas of the frontal lobes resulted in ‘bland’ personalities. These patients also displayed fewer signs of distress in emotionally heightened situations.
• Catani et al. (2016) investigated the brains of people with Autism and found support for the hypothesis that Autism is associated with different connectivity in the frontal lobe region compared with neurotypical individuals.
• Mubarik & Tohid (2016) conducted a literature review of studies that investigated the frontal lobes of those with schizophrenia.
• They found that many people with schizophrenia have differences in the structure of white matter , grey matter , and functional activity in their frontal lobes compared to those without the condition.

Bauman, M. L., & Kemper, T. L. (2005). Neuroanatomic observations of the brain in autism: a review and future directions. International Journal of Developmental Neuroscience, 23 (2-3), 183-187.

Catani, M., Dell’Acqua, F., Budisavljevic, S., Howells, H., Thiebaut de Schotten, M., Froudist-Walsh, S., … & Murphy, D. G. (2016). Frontal networks in adults with autism spectrum disorder. Brain, 139 (2), 616-630.

Eslinger, P. J., & Grattan, L. M. (1993). Frontal lobe and frontal-striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31 (1), 17-28.

Kaufman, D. M., Geyer, H. L., & Milstein, M. J. (2017). Chapter 21-neurotransmitters and drug abuse. Kaufman’s Clinical Neurology for Psychiatrists . 8th ed. Amsterdam: Elsevier, 495-517.

Kolb, B., & Milner, B. (1981). Performance of complex arm and facial movements after focal brain lesions. Neuropsychologia, 19( 4), 491-503.

Mubarik, A., & Tohid, H. (2016). Frontal lobe alterations in schizophrenia: a review. Trends in Psychiatry and Psychotherapy , 38(4), 198-206.

Semmes, J., Weinstein, S., GHENT, G., Meyer, J. S., & Teuber, H. L. (1963). Correlates of impaired orientation in personal and extrapersonal space. Brain, 86 (4), 747-772.

Stuss, D. T., Ely, P., Hugenholtz, H., Richard, M. T., LaRochelle, S., Poirier, C. A., & Bell, I. (1985). Subtle neuropsychological deficits in patients with good recovery after closed head injury. Neurosurgery, 17 (1), 41-47.

Walker, A. E., & Blumer, D. (1975). The localization of sex in the brain. In Cerebral localization (pp. 184-199). Springer, Berlin, Heidelberg.

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Frontal Lobe Damage: Symptoms, Causes, and Treatments

Symptoms of dysfunction can be physical, behavioral, or cognitive

The frontal lobe is a large part of the brain. It extends from the front of the brain almost halfway to the back, and it helps humans perform complex tasks, innovate, and imagine.

Damage to the frontal lobe, also called frontal lobe syndrome, can cause a range of symptoms. These can include behavioral problems, depression, and a loss of strength in the muscles. A variety of conditions can damage the frontal lobe, including stroke , head trauma , and dementia .

This article discusses the frontal lobe of the brain, its functions, and the various conditions that can cause frontal lobe damage. It also discusses how frontal lobe damage is diagnosed and treated.

Illustration by Alex Dos Diaz for Verywell Health

Where Is the Frontal Lobe and What Does It Do?

The brain has two hemispheres, or halves: the left and right. The hemispheres are divided into three sections: the forebrain, midbrain , and hindbrain.

Each section has specific functions:

• The forebrain controls a range of social, emotional, and cognitive (thinking) functions, as well as motor function and memory.
• The midbrain is associated with coordination, alertness, vision, and hearing.
• The hindbrain controls involuntary functions (ones that happen without your control) like respiration and heart rate.

The forebrain includes a major part of the brain called the cerebrum . The outer layer of the cerebrum is called the cerebral cortex.

The frontal lobe is one of the four lobes of the cerebral cortex. The other lobes are the temporal lobe, the parietal lobe, and the occipital lobe.

Each of the four lobes has specific functions. Damage to any one of them will cause problems with these functions. The sections below describe the main functions of the frontal lobe.

Social and Emotional Skills

The frontal lobe is responsible for decision-making and self-control. It also helps regulate emotions. This is the part of the brain that manages your interactions with other people. The frontal lobe regulates your behavior and helps you know what is socially acceptable and what is not.

Motor Function

The back of the frontal lobe is called the motor strip. This region controls and directs deliberate body movements.

The left side of the motor strip controls the right side of the body. The right side of the motor strip controls the left side of the body.

Language, Thinking, Reasoning, and Imagining

The frontal lobe controls high-level thinking and problem-solving. It also helps you pay attention. Some functions are controlled primarily by the left frontal lobe. Others are controlled primarily by the right frontal lobe.

Everyone's frontal lobe has a dominant side . In most people, it is on the left, but it can also be on the right.

The dominant side of the frontal lobe is involved in a number of functions, including:

• Language and speech
• Rational and logical thinking, or the ability to make sense of things
• Quantitative thinking, or thinking that has to do with numbers and statistics
• Analytical reasoning, or the ability to make decisions after considering facts

The non-dominant frontal lobe is involved with more creative functions, including:

• Imagination
• Musical and artistic ability

Symptoms of Frontal Lobe Damage

Because the frontal lobe has so many functions, a wide variety of symptoms can occur when it's damaged. Frontal lobe damage may lead to one or more of the following:

• Weakness on one side of the body or one side of the face
• Inability to solve problems or organize tasks
• Reduced creativity
• Impaired judgment
• Reduced sense of taste or smell
• Difficulty controlling emotions
• Changes in behavior
• Low motivation
• Poor attention span, being easily distracted
• Reduced or increased sexual interest
• Odd sexual habits
• Impulsive or risky behavior
• Trouble with communication

Damage to the frontal lobe is often caused by a stroke. During a stroke, blood flow to arteries in the frontal lobe temporarily stops. This damages the surrounding area of the brain.

Multiple strokes can lead to dementia. Damage can also be caused by a degenerative disease, which is a disease that gets worse over time.

There are other, less common conditions that can also affect the frontal lobe.

Dementia is a term used to describe conditions that cause memory loss and other problems with thinking and reasoning.

Frontotemporal dementia (FTD) is a group of disorders that affect the frontal and temporal lobes. FTD is the second most common cause of dementia in people under 65.

People with FTD usually have behavior and personality changes. They may also have trouble with language.

People with a type of Alzheimer’s disease called frontal-variant Alzheimer’s disease may have similar symptoms. This form of Alzheimer's disease is sometimes misdiagnosed as FTD.

Strokes can also damage the frontal lobe. When blood flow to the frontal lobe is interrupted, it causes a loss of function in that part of the brain. This can also happen as a result of bleeding in the brain.

Vascular dementia can happen after multiple small strokes. It is a common cause of frontal lobe impairment. Vascular dementia can occur in a "mixed dementia" form with Alzheimer's disease.

Other Causes

Other conditions may cause damage or injury to the frontal lobe, including:

• Huntington’s disease
• Cerebral palsy
• Parkinson’s disease
• Brain tumors
• Traumatic brain injury

Diagnosis of Frontal Lobe Brain Injury

Healthcare providers can diagnose frontal lobe strokes and infections with diagnostic scans. Options include magnetic resonance imaging (MRI) and computed tomography (CT or CAT).

An MRI creates a two- or three-dimensional image of the brain using a magnetic field and radio waves. A CT scan creates a 3D image from multiple X-rays.

MRI and CT scans are both effective tools for diagnosing vascular dementia. Some causes, like dementia or a traumatic brain injury, may appear on a scan as atrophy, or brain tissue loss. The scan may also show nothing.

A complete neuropsychological evaluation or a concussion test can help a healthcare provider assess damage to the frontal lobe. These tests look at:

• Speech skills
• Motor skills
• Social behavior
• Spontaneity
• Impulse control
• Problem-solving

Frontal Lobe Syndromes

The symptoms and treatment of various frontal lobe syndromes aren't yet understood with precision, but there is growing evidence for how specific syndromes occur. Akinetic mutism, for example, is a rare disorder affecting speech. Disruptions to the medial frontal circuit lead to apathy, with motivation and planning problems.

Treatment of Frontal Lobe Brain Injury

Strategies for treating frontal lobe damage are different depending on the cause. For example, an infection can be treated with antibiotics. Brain tumors can be surgically removed or treated with chemotherapy or radiation.

There is currently no cure for degenerative diseases like Parkinson's disease, Huntington's disease, and dementia. Medication and lifestyle changes can help improve symptoms.

Rehabilitation

Motor weakness caused by frontal lobe damage can be treated with rehabilitation. This involves strengthening and optimizing remaining motor skills.

Cognitive and Behavioral Therapy

Rehabilitation can be difficult for cognitive and social problems caused by frontal lobe damage. Therapy that helps patients regulate emotions and curb impulsive behavior can be useful.

Helping Someone With a Frontal Lobe Injury

Some issues resulting from a frontal lobe traumatic brain injury, such as mood swings, may improve within a few months. Other issues will cause ongoing difficulty. Seek counseling and advice on medication to help with symptoms. Caregivers should model behaviors that the injured person can imitate and be calm when a loved one displays anxiety or extreme emotions. Be prepared to restrain the person if there's a risk they'll harm themselves or others.

The frontal lobe of the brain controls a number of important functions, including emotions, self-control, movement, language, and rational thought. Frontal lobe damage may affect any of these functions.

Frontal lobe damage can have many causes, including dementia and other degenerative brain diseases, stroke, infections, or brain tumors.

Frontal lobe damage can sometimes be diagnosed with imaging scans. In other cases, a neuropsychological evaluation may be necessary. 

Treatment for frontal lobe damage can include medication, surgery, rehabilitation, or therapy.

Reber J, Tranel D. Chapter 8 - Frontal lobe syndromes . Handbook of Clinical Neurology . Volume 163, 2019, Pages 147-164. doi:10.1016/B978-0-12-804281-6.00008-2. Justin Reber, Daniel Tranel,

Mitolo M, Zoli M, Testa C, Morandi L, Rochat MJ, Zaccagna F, et al . Neuroplasticity Mechanisms in Frontal Brain Gliomas: A Preliminary Study . Front Neurol . 2022 Jun 3;13:867048. doi:10.3389/fneur.2022.867048. 

Frontotemporal Disorders: Hope Through Research.  National Institutes of Health. National Institutes of Neurological Disorders and Stroke.

Han M, Kim DY, Leigh JH, Kim MW. Value of the Frontal Assessment Battery Tool for Assessing the Frontal Lobe Function in Stroke Patients . Ann Rehabil Med. 2020 Aug;44(4):261-272. doi:10.5535/arm.19111.

Olney NT, Spina S, Miller BL. Frontotemporal dementia . Neurol Clin. 2017;35(2):339-74. doi:10.1016/j.ncl.2017.01.008

Sawyer RP, Rodriguez-Porcel F, Hagen M, Shatz R, Espay AJ. Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road .  J Clin Mov Disord . 2017;4(1):1-9. doi:10.1186/s40734-017-0052-4

Johns Hopkins Medicine. Vascular Dementia.

Li L, Liu J. The effect of pediatric traumatic brain injury on behavioral outcomes: a systematic review .  Dev Med Child Neurol . 2013;55(1):37‐45. doi:10.1111/j.1469-8749.2012.04414.x

Arnts H, van Erp WS, Lavrijsen JCM, van Gaal S, Groenewegen HJ, van den Munckhof P. On the pathophysiology and treatment of akinetic mutism . Neurosci Biobehav Rev . 2020 May;112:270-278. doi:10.1016/j.neubiorev.2020.02.006. 

Model Systems Knowledge Translation Center (MSKTC). Emotional Problems After Traumatic Brain Injury .

By Jose Vega MD, PhD Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.

Frontal Lobes: Movement and Cognition

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The frontal lobes are one of the four main lobes or regions of the cerebral cortex . They are positioned at the front-most region of the cerebral cortex and are involved in movement, decision-making, problem-solving, and planning.

The frontal lobes can be subdivided into two main areas: the prefrontal cortex and the motor cortex . The motor cortex contains the premotor cortex and primary motor cortex. The prefrontal cortex is responsible for personality expression and the planning of complex cognitive behaviors. The premotor and primary motor areas of the motor cortex contain nerves that control the execution of voluntary muscle movement.

Directionally , the frontal lobes are located in the anterior portion of the cerebral cortex. They are directly anterior to the parietal lobes and superior to the temporal lobes. The central sulcus, a large deep groove, separates the parietal and frontal lobes.

The frontal lobes are the largest brain lobes and are involved in several functions of the body including:

• Motor Functions
• Higher-Order Functions
• Impulse Control
• Language and Speech

The right frontal lobe controls activity on the left side of the body and the left frontal lobe controls activity on the right side. An area of the brain involved in language and speech production, known as Broca's area , is located in the left frontal lobe.

The prefrontal cortex is the front portion of the frontal lobes and manages complex cognitive process such as memory, planning, reasoning, and problem-solving. This area of the frontal lobes functions to help us set and maintain goals, curb negative impulses, organize events in time order, and form our individual personalities.

The primary motor cortex of the frontal lobes is involved with voluntary movement. It has nerve connections with the spinal cord , which enable this brain area to control muscle movements. Movement in the various areas of the body is controlled by the primary motor cortex, with each area linked to a specific region of the motor cortex.

Body parts requiring fine motor control take up larger areas of the motor cortex, while those requiring simpler movements take up less space. For example, areas of the motor cortex controlling movement in the face, tongue, and hands take up more space than areas linked to the hips and trunk.

The premotor cortex of the frontal lobes has neural connections with the primary motor cortex, spinal cord, and brainstem . The premotor cortex enables us to plan and perform proper movements in response to external cues. This cortical region helps to determine the specific direction of a movement.

Frontal Lobe Damage

Damage to the frontal lobes can result in a number of difficulties such as a loss of fine motor function, speech, and language processing difficulties, thinking difficulties, an inability to comprehend humor, a lack of facial expression, and changes in personality. Frontal lobe damage can also result in dementia, memory disorders, and a lack of impulse control.

More Cortex Lobes

• Parietal Lobes : These lobes are positioned directly posterior to the frontal lobes. The somatosensory cortex is found within the parietal lobes and is positioned directly posterior to the motor cortex of the frontal lobes. The parietal lobes are involved in receiving and processing sensory information.
• Occipital Lobes : These lobes are positioned at the back of the skull, inferior to the parietal lobes. The occipital lobes process visual information.
• Temporal Lobes : These lobes are located directly inferior to the parietal lobes and posterior to the frontal lobes. The temporal lobes are involved in a multitude of functions including speech, auditory processing, language comprehension, and emotional responses.
• What Does the Brain's Cerebral Cortex Do?
• Parietal Lobes of the Brain
• The Four Cerebral Cortex Lobes of the Brain
• Divisions of the Brain: Forebrain, Midbrain, Hindbrain
• Occipital Lobes and Visual Perception
• Temporal Lobes
• Gyri and Sulci of the Brain
• Discover the Mysteries of Broca's Area and Speech
• Anatomy of the Brain
• Get a Description and Diagram of Thalamus Gray Matter
• Anatomy of the Brain: Your Cerebrum
• Wernicke's Area in the Brain
• White Matter and Your Brain
• Functions of the Central Nervous System
• Anatomy of the Cerebellum and its Function
• Cingulate Gyrus and the Limbic System

• Help & FAQ

The effects of frontal lobe damage on everyday problem solving

• Physical Medicine and Rehabilitation

Research output : Contribution to journal › Article › peer-review

The prefrontal cortex plays an especially important role in human social-cognitive behavior. It has been difficult to quantify deficits in this domain in patients with frontal lobe lesions using standardized psychological instruments. We administered the Everyday Problem Solving Inventory (EPSI), which is composed of a range of scenarios depicting everyday social problems and their possible solutions, to a group of patients with frontal lobe lesions who were required to rate each of 4 possible solutions to each problem for their effectiveness. Our sample consisted of 27 normal controls (NCs), 33 patients with focal frontal lobe lesions (FLL), and 3 patients with frontal lobe dementia (FLD). The performance of the FLL patients on the EPSI instrument was also compared with their performance on traditional neuropsychological tests. The results indicated that the FLD patients' EPSI rank ordering of social problem solutions was uncorrelated with the performance of NCs and about half of the FLL patients EPSI rank orderings of solutions also varied substantially from those of the NCs. These same FLL patients also had the lowest scores, compared to FLL patients whose judgements on the EPSI were similar to that of the NCs, on a set of neuropsychological tasks sensitive to frontal lobe dysfunction. There was no obvious relationship between locus of lesion within the frontal lobes and performance on the EPSI. These results suggest that some patients with prefrontal lobe lesions may have impaired social judgement that can be directly revealed through the use of a conventional psychological inventory such as the EPSI.

ASJC Scopus subject areas

• Neuropsychology and Physiological Psychology
• Experimental and Cognitive Psychology
• Cognitive Neuroscience

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T1 - The effects of frontal lobe damage on everyday problem solving

AU - Dimitrov, Mariana

AU - Grafman, Jordan

AU - Hollnagel, Caroline

N1 - Funding Information: (Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland)

PY - 1996/6

Y1 - 1996/6

N2 - The prefrontal cortex plays an especially important role in human social-cognitive behavior. It has been difficult to quantify deficits in this domain in patients with frontal lobe lesions using standardized psychological instruments. We administered the Everyday Problem Solving Inventory (EPSI), which is composed of a range of scenarios depicting everyday social problems and their possible solutions, to a group of patients with frontal lobe lesions who were required to rate each of 4 possible solutions to each problem for their effectiveness. Our sample consisted of 27 normal controls (NCs), 33 patients with focal frontal lobe lesions (FLL), and 3 patients with frontal lobe dementia (FLD). The performance of the FLL patients on the EPSI instrument was also compared with their performance on traditional neuropsychological tests. The results indicated that the FLD patients' EPSI rank ordering of social problem solutions was uncorrelated with the performance of NCs and about half of the FLL patients EPSI rank orderings of solutions also varied substantially from those of the NCs. These same FLL patients also had the lowest scores, compared to FLL patients whose judgements on the EPSI were similar to that of the NCs, on a set of neuropsychological tasks sensitive to frontal lobe dysfunction. There was no obvious relationship between locus of lesion within the frontal lobes and performance on the EPSI. These results suggest that some patients with prefrontal lobe lesions may have impaired social judgement that can be directly revealed through the use of a conventional psychological inventory such as the EPSI.

AB - The prefrontal cortex plays an especially important role in human social-cognitive behavior. It has been difficult to quantify deficits in this domain in patients with frontal lobe lesions using standardized psychological instruments. We administered the Everyday Problem Solving Inventory (EPSI), which is composed of a range of scenarios depicting everyday social problems and their possible solutions, to a group of patients with frontal lobe lesions who were required to rate each of 4 possible solutions to each problem for their effectiveness. Our sample consisted of 27 normal controls (NCs), 33 patients with focal frontal lobe lesions (FLL), and 3 patients with frontal lobe dementia (FLD). The performance of the FLL patients on the EPSI instrument was also compared with their performance on traditional neuropsychological tests. The results indicated that the FLD patients' EPSI rank ordering of social problem solutions was uncorrelated with the performance of NCs and about half of the FLL patients EPSI rank orderings of solutions also varied substantially from those of the NCs. These same FLL patients also had the lowest scores, compared to FLL patients whose judgements on the EPSI were similar to that of the NCs, on a set of neuropsychological tasks sensitive to frontal lobe dysfunction. There was no obvious relationship between locus of lesion within the frontal lobes and performance on the EPSI. These results suggest that some patients with prefrontal lobe lesions may have impaired social judgement that can be directly revealed through the use of a conventional psychological inventory such as the EPSI.

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Frontal Lobe Development: Understanding Brain Development by Age

When it comes to the development of the human brain , the frontal lobe plays a vital role. The frontal lobe is responsible for cognitive functions such as decision making , problem-solving , attention, and emotional regulation . It is one of the last regions of the brain to fully develop, and its development can be affected by various factors such as genetics , environment , and experiences . In this blog post, we will cover everything you need to know about frontal lobe development, including how developed the brain is at 21, what affects frontal lobe development, at what age the frontal lobe is fully developed, and how to identify an underdeveloped frontal lobe.

How Developed is the Brain at 21?

By the age of 21, most of the structural development of the human brain is complete. However, the frontal lobe, which is responsible for executive functions such as decision-making , planning, and inhibitory control, continues to develop until the mid-20s. This period of development is crucial for shaping one’s personality, decision-making abilities, and behaviors.

What Affects Frontal Lobe Development?

Frontal lobe development can be impacted by a wide range of factors, including genetics, environment, and experiences. Studies have shown that a lack of stimulation and neglect in childhood can lead to underdeveloped frontal lobes. Other factors, such as alcohol and substance abuse, sleep deprivation, and head injuries, can also affect frontal lobe development negatively.

At What Age Is the Frontal Lobe Fully Developed?

The frontal lobe’s development process is not linear, and it can vary depending on an individual’s genetic makeup, environment, and experiences. According to research, the frontal lobe is not fully developed until the mid-20s, with some studies suggesting that it can continue to develop into the early 30s.

How Do You Know if Your Frontal Lobe is Underdeveloped?

An underdeveloped frontal lobe can manifest in several ways. One of the most common signs of an underdeveloped frontal lobe is impulsivity, where an individual struggles to inhibit their actions and make good decisions. Other symptoms may include poor planning, difficulty with problem-solving, a lack of emotional control, and difficulty with task initiation.

Does the Frontal Lobe Develop Until 25?

The myth that the brain is fully developed by the age of 25 is widespread. While it is true that significant development of the brain occurs in early childhood and adolescence , the brain continues to develop and change throughout adulthood . The frontal lobe, responsible for decision-making and executive functions, continues to develop up until the mid-20s and maybe even beyond.

What Does the Prefrontal Cortex Do?

The prefrontal cortex is part of the frontal lobe and plays a critical role in cognitive functions such as planning, decision-making, and impulse control. It is responsible for setting and achieving goals, solving problems, and exhibiting appropriate social behaviors.

14-Year-Old Brain Development

During early adolescence, brain development accelerates in areas such as the limbic system, which is responsible for emotion regulation and memory formation. However, the frontal lobe, responsible for decision-making and cognitive control, is not fully developed until the mid-20s.

Female Brain Development Age 25

Studies have shown that the female brain continues to develop until the age of 25, with significant changes occurring in areas such as the prefrontal cortex, which is responsible for decision making and impulse control.

When is the Female Brain Fully Developed?

While studies have indicated that the female brain continues to develop until the age of 25, it is worth noting that individual developmental timelines can vary depending on genetics, environment, and experiences.

What Does Development of the Frontal Lobe Do for a Child?

The development of the frontal lobe is crucial for a child as it underpins their ability to regulate emotions, make good decisions, and behave appropriately. It enables children to understand consequences and make informed decisions that will positively impact their lives in the long term.

Male vs Female Brain Development Age

Research has shown that there are some differences in male and female brain development. For example, the frontal lobe, which is responsible for executive functions, continues to develop until the mid-20s for both males and females, but research suggests that males may experience slower development in this area. Additionally, the male brain tends to develop more gray matter, while the female brain tends to develop more white matter.

Brain Fully Developed at 30

While significant brain development occurs during childhood and adolescence, the brain continues to develop and change throughout adulthood. According to studies, the frontal lobe, responsible for cognitive functions such as decision-making and problem-solving, undergoes significant development until the mid-20s. However, research has also suggested that some parts of the brain continue to develop until the age of 30, highlighting the importance of continued brain health maintenance throughout adulthood.

When is the Brain Fully Developed?

While the brain undergoes significant development during childhood and adolescence, it is continually developing and changing throughout adulthood. Studies have shown that the frontal lobe, responsible for cognitive functions such as decision-making and problem-solving, continues to develop until the mid-20s, but some regions of the brain can continue to develop and change until the age of 30.

In conclusion, the development of the frontal lobe is crucial for executive functions such as decision-making, problem-solving, and emotional regulation, which shape a person’s personality, behaviors, and life outcomes. While it is true that significant brain development occurs during childhood and adolescence, the brain continues to change and develop throughout adulthood. It is essential to understand how the brain develops and how it can be affected by various factors to maintain and enhance its health.

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• Indian J Psychiatry
• v.50(3); Jul-Sep 2008

Neuropsychology of prefrontal cortex

Shazia veqar siddiqui.

Department of Clinical Psychology, Central Institute of Psychiatry, Ranchi, Jharkhand, India

Ushri Chatterjee

Devvarta kumar, aleem siddiqui, nishant goyal.

The history of clinical frontal lobe study is long and rich which provides valuable insights into neuropsychologic determinants of functions of prefrontal cortex (PFC). PFC is often classified as multimodal association cortex as extremely processed information from various sensory modalities is integrated here in a precise fashion to form the physiologic constructs of memory, perception, and diverse cognitive processes. Human neuropsychologic studies also support the notion of different functional operations within the PFC. The specification of the component ‘executive’ processes and their localization to particular regions of PFC have been implicated in a wide variety of psychiatric disorders.

Human neuropsychology studies brain-behavior relationship, representing a confluence of fields like neurology, psychology, neurophysiology, neurochemistry, and neuropharmacology.[ 1 ] The history of clinical frontal lobe study is long and rich. Harlow first presented the case of Phineas Gage who was accidentally struck by a pointed iron bar projected by an explosion which inflicted massive damage to his frontal lobes, apparently destroying the left orbitomedial PFC[ 2 ] who went on to develop personality changes. Regrettably, the empirical value of such cases is restricted because of the lesions and insults are not just limited to the frontal region. However, frontal lobe lobectomies as reported by Luria[ 3 ] have been informative as they best reveal the characteristic though subtle manifestations of discrete prefrontal damage. On this backdrop, this article tries to fathom the intricacies of prefrontal cortex (PFC) from neuropsychological perspective.

ANATOMICAL ORGANIZATION OF PFC

Surface features.

Development pattern of frontal lobes involve a hierarchical, dynamic, and multistage process.[ 4 ] The anterior part of the frontal lobe referred in the literature as ‘pre’-frontal lobe has been simultaneously referred to as ‘frontal granular cortex’ and ‘frontal association cortex.’ The anterior most portion of the frontal lobe is occupied by the PFC on its medial, lateral, and orbital surfaces. Its relative size reaches a maximum in the human where it constitutes 30% of the cerebral mantle.[ 5 ] PFC occupies one-third of the entire human cerebral cortex. The PFC is one of the last cortical regions to undergo full myelination during adolescence in the human.[ 6 ] PFC refers to the paralimbic and heteromodal (site for the integration of inputs from more than one sensory modality) components of the frontal lobes. The heteromodal component is known as granular cortex whereas the paralimbic component is known as dysgranular or agranular cortex. [ 7 ] This complex and distributed organization reflect the characterization of this brain area as a protean and heterogeneous entity, dedicated to sustaining rapid computations required to accomplish a wide range of mental activities.[ 8 ]

MAJOR SUBDIVISIONS

Lateral organization.

The Broca's area is interposed between the dorsolateral PFC (DLPFC) and the ventral portion of premotor cortex. This region is concerned in the abstract mediation of the verbal expression of language. Occasionally, there are two distinct sulci within the prefrontal region designated as the superior frontal sulcus and inferior frontal sulcus.[ 8 ]

Medial organization

The division between the paracentral and medial frontal gyri is occasionally formed by a vertical sulcus emerging from the cingulate sulcus above the midpoint of the corpus callosum.[ 9 ]

Orbitofrontal organization

The orbitofrontal cortex (OFC) lies in the base of the anterior cranial fossa on the ventral surface of the frontal lobe. It includes area 13 caudally, area 14 medially and cortex on the inferior convexity includes area 12 caudally, and area 11 anteriorly.[ 10 ] The posterior portion of the OFC is formed by agranular cortex, and the intermediate portion is formed by dysgranular cortex.[ 7 ] This region of cortex is categorized as limbic or paralimbic cortex. In the lateral region of the right dysgranular OFC is a postulated secondary gustatory or taste region[ 11 ] Caudal to the secondary gustatory is the orbital extension of primary olfactory cortex.[ 12 ] Granular cortex forms the rostral portion of the OFC.

Connections

Inherent connections of the frontal lobe form vital feed-forward and feedback circuits from the center of prefrontal information processing. The PFC through its extensive association connections is linked with distant and broadly dispersed parts of the association and limbic cortices. Prefrontal interconnections with the amygdala, hypothalamus, midbrain, and pons represent important subcortical linkages of the extended prefrontal neural system. These are likely to integrate higher-order brain functions mediated by the PFC with more developmentally fundamental brain activities such as emotion and visceral, or autonomic, functions.[ 13 ] Practically, all-prefrontal connections are reciprocal, exceptional in that regard are the basal ganglia, to which the PFC sends unreciprocated direct efferent.[ 14 ] It is also of singular interest that the PFC is the only neocortical region directly projecting to the hypothalamus and the septal region.[ 15 ] Different sub-areas of the PFC have different connections. The orbital region is primarily connected to the medial thalamus, hypothalamus, ventromedial caudate, and amygdala; the DLPFC, on the other hand, is primarily connected to the lateral thalamus, the dorsal caudate nucleus the hippocampus, and the neocortex.[ 16 ]

FUNCTIONAL ORGANIZATION OF PFC

PFC is often classified as multimodal association cortex as extremely processed information from various sensory modalities is integrated here in a precise fashion to form the physiologic constructs of memory, perception and intricate action, and diverse cognitive processes are monitored here.[ 17 ]

Lateral prefrontal cortex

Functional magnetic resonance imaging (MRI) and event-related potential (ERP) research have defined the spatial and temporal contributions of lateral prefrontal cortex (LPFC) including portions of inferior, middle, and superior frontal gyri in language, attention, memory,[ 18 ] response conflict, novelty processing which is crucial for new learning, creativity, and new learning.[ 19 , 20 ] This region is also responsible for the temporal ordering of events,[ 21 ] explicit memory,[ 22 ] and metamemory.[ 23 ] Simulation, i.e., process of generating internal modes of external reality, the absence of which can lead to stimulus-bound behavior thereby resulting in utilization behavior[ 24 ] and reality monitoring is too subserved by this region which is proposed as a major mechanism in self-awareness.[ 25 ] The caudal-most portion of the LPFC is important for attention and orientation. DLPFC activation which belongs to a neural circuit that includes posterior parietal cortex, head of the caudate nucleus, and the dorsomedial thalamic nucleus[ 7 ] has been associated with a diverse set of cognitive processes, including actively maintaining information in working memory,[ 26 ] changing behavior according to task demands[ 27 ] or representing past events, current goals, and future predictions[ 28 ] and organization and conceptualization of finances.[ 29 ] Increased memory-related activity in mid-ventrolateral PFC has been related to actively encoding and retrieving information,[ 30 ] updating and maintaining the contents of working memory.[ 31 ] Right DLPFC mediates negative attitudes and left ventrolateral PFC mediates positive attitude, spatial and conceptual reasoning process,[ 32 ] planning,[ 9 ] and integration of perception with action across time.[ 33 ]

Specifically, the medial frontal region (anterior cingulate area) appears to be involved in bimanual coordination, attention to demanding cognitive tasks, modulation of body arousal, spatial memory, self-initiated movement, and conflict resolution (medial prefrontal and medial orbital regions).[ 29 ] The anterior cingulate cortex is also involved in the perception of pain and possibly in mediating the emotional response behind it. Reward and goal-related activity are thought to correspond to the unique patterns of connections that link the rostral cingulate motor cortex with the prefrontal and limbic cortices.[ 8 ] Ventromedial region plays a role in decision making[ 29 ] and the retrieval of information from long-term memory and metacognitive processes.[ 34 ]

Orbitofrontal cortex

OFC functions as a component of the paralimbic ring involved in autonomic, response inhibition, and stimulus significance functions,[ 35 ] mnemonic functions and delayed response.[ 36 ] It plays a role in reward expectations[ 37 ] and in the anticipation and processing of outcomes even if the outcome does not produce any reward.[ 38 ] This region has been shown to have a significant role in social and emotional behavior.[ 39 ] Anterior OFC is activated in case of aversive tastes[ 40 ] and pleasurable taste is mediated by caudomedial regions of PFC.[ 41 ] PFC interactions with the hypothalamus mediate reward aspects of eating like food cravings.[ 42 ] Ventral PFC emerging from OFC is connected with limbic system and is involved in emotional processing.[ 43 ] This region is intimately associated with amygdala and anterior cingulate, and is involved in behavioral self-regulation.[ 44 ]

THE SOMATIC MARKER HYPOTHESIS: A MODEL FOR SELF-REGULATION

Damasio[ 35 ] postulated that the OFC does not contain factual information pertinent to the current contingency, but provides “somatic markers” that enable the individual to “learn by experience.” Damasio postulated that portions of the ventromedial PFC provide a repository for the linkage of current contingencies with the individual's previous emotional experience of similar situations. This linkage of factual sets (held in the appropriate association cortices) and emotional sets (held in the ventromedial frontal cortex) is thought to modify the response of the individual to environmental stimuli and to facilitate logical reasoning. According to this hypothesis, individuals who fail to develop context appropriate somatic markers, either through a “sociopathic temperament” or through injury to the ventromedial frontal cortex will have inappropriate stimulus-bound behavior typical of sociopathy.

FUNCTIONS OF PFC

Executive functions.

These functions as mediated by the PFC with its rich cortical and subcortical connections include ability to initiate and carry out new and goal-directed patterns of behavior, sustained attention,[ 3 ] motor attention, i.e., enactment of action schemas requires attention directed to events in the motor or executive sector[ 45 ] short-term memory tasks,[ 46 ] inhibitory control of interference, filtering or gating mechanism for information processing[ 21 ] working memory,[ 18 ] stimulus detection and sequencing tasks,[ 47 ] planning, set shifting, flexibility, delayed responding, and active problem solving.[ 48 ] Executive functions are closely linked to emotional regulation as well.

PFC plays a significant role in encoding and retrieval of memory. Neuroimaging studies found left frontal activation with memory encoding and right PFC activation with retrieval of episodic memory.[ 49 ] Studies on frontal lobe patients have yielded important insights on the role of PFC in recent memory,[ 3 ] source memory, i.e., memory involving contextual factors associated with learning, sequential memory, i.e., encoding and representation of temporal information.[ 50 ]

Intelligence

Intelligence being a complex construct, certain aspects of it are known to be mediated by PFC. Prominent among these are verbal expression, memory, abstraction, and the ability to formulate behavioral plans and to pursue them to their goal,[ 51 ] ability to perceive the spatial relationships between one's self and the environment, or to perform tasks that require the guidance of one's actions by visual information, spatial, or otherwise.[ 52 ]

Neuroimaging, neuropsychologic, and neurophysiologic studies have reported consistently the role PFC in regulating spontaneous speech, narrative expression, and verbal fluency.

Visual search and gaze control

It involves ability to analyze pictorial detail, and integrative scanning of all the pertinent details.[ 53 ] Damage can result in a failure to direct gaze and correct erroneous or unnecessary eye movements in visual tasks under instructions.[ 3 ]

NEUROPSYCHOLOGY OF PFC

Development and involution.

According to Piaget,[ 54 ] logical reasoning, which in turn depends upon the cognitive functions of the PFC, does not attain full development till age 12, which is the time when the prefrontal reaches full development. The greater period of development occurs at the age 6-9 years with more moderate effects between ages 9 and 12 years, and performance-moderating adult levels during adolescence and sometimes also until age 20.[ 55 ] Further development of frontally mediated executive functions may continue through age 16[ 56 ] with continued development throughout adulthood.[ 57 ] Working memory develops by age 8 months, which is demonstrated by the successful completion of delayed tasks.[ 58 ] By the age of 1.5-5 years, attention, executive and self-reflexive skills emerge.[ 4 ] By the age of 5-8 years, cognitive abilities in the area of recognition memory, concept formation, set shifting, and rudimentary planning skills emerge.[ 59 ] Both selective attention and exclusionary attention also develop at that time with maximum development at age 6-9 years. Planning and motor memory appear to have the same timetable, possibly also with rapid development between 6 and 9 years.[ 55 ]

Localization vs. network model

Do the different regions carry out distinctive functions, e.g., inhibitory control, motor planning, and spatial memory as argued at different times by different investigators[ 60 ] or is there a hierarchical relationship between superior and inferior dorsolateral cortex as proposed by Owen and colleagues.[ 61 ] In contrast to the popular view, a critical review of functional neuroimaging studies including both positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies suggest that specific regions within dorsolateral and ventrolateral PFC make identical functional contributions to both spatial and nonspatial information. Human neuropsychologic studies also support the notion of different functional operations within the PFC.[ 62 ] The notion of cortical centers controlling specific capacities has still not entirely disappeared, but it has largely given way to that of networks, i.e., aggregation of interconnected neural loci as the core concept of localization. According to this network model, cognitive functions such as attention, memory, and perception are not localized, but they accompany or emerge from the information processes in the networks. The primary objectives of computational network models of the PFC are to specify certain principles of operation of frontal networks-(i) in the performance of tasks that are known to be sensitive to frontal injury and (ii) in cognitive functions such as short-term memory, planning, inhibitory control that are ascribed to the PFC.[ 5 ]

Are all prefrontal ‘cognitive functions’ ‘executive’ in nature?

The terms ‘executive’ and ‘frontal lobe’ functions are often used interchangeably. The terms should be denoted separately as it cannot be assumed that all of the cognitive functions of the PFC are ‘executive’ in nature. Executive function should not be confounded with prefrontal except at a hypothesis level because of the nonprefrontal contribution to executive function and function of prefrontal lobes that extend beyond the list of cognitive abilities for which executive function is an umbrella[ 63 ] [ Table 1 ]

Important functions and corresponding impairments associated with prefrontal cortex

Neuropsychologic test findings related to PFC damage

The behavioral changes that occur as a result of damage to PFC are very difficult to capture with many neuropsychologic tests.[ 50 ] Patients with large prefrontal lesions can perform within the normal range on tests of memory, intelligence, and other cognitive functions. Even supposedly sensitive tests like Wisconsin Card Sorting Test (WCST) sometimes fail to discriminate patients with frontal lesions from people with normal functions or those with lesions in other regions.[ 64 ] Tests such as WCST appear to be more sensitive to dorsolateral than orbitofrontal PFC damage. Other tasks often employed to detect lateral PFC deficits are Stroop test which is particularly sensitive to failures in inhibitory control and tests of divided attention. However, patients with inferior parietal lobe damage also fail tests of divided attention and thus do not provide accurate information. In contrast to lateral PFC, damage to orbitofrontal damage leaves the cognitive skills relatively intact but affects all spheres of social behavior.[ 65 ]

NEUROPSYCHOLOGIC ASSESSMENT OF PREFRONTAL FUNCTION

Assessment of attention.

Most statistical studies have shown that there are two factors that are relevant in our choice of attentional tests. The factors are speed or processing capacity and control or working memory. On this basis, there are three levels of attentional tests.[ 50 ]

• Operational level with high speed of information processing where highly structured stimulus driven tasks are used, e.g., Trail Making A test, Stroop Test, and Digit Symbol of WAIS-R.
• Tactical level with tests for focused and/or divided attention where partially structured memory-driven tasks are used, e.g., continuous performance test, paced auditory serial additive tasks.
• Strategic level where unstructured tasks like WCST and Stroop tests are used.

Assessment of memory

For assessment of short-term memory/working memory, digit span; letter number sequencing (WMS),[ 66 ] Ray auditory verbal learning test (RAVLT),[ 67 ] California verbal learning test (CVLT)[ 68 ] spatial span (WMS), and visual pattern test[ 69 ] are used. Battery for assessment of working and logical memory includes Wechsler Memory Scale (WMS-III).[ 66 ] Tests for assessment of emotional and executive functioning disorders associated with prefrontal lobe dysfunction are given in Tables ​ Tables2 2 and ​ and3, 3 , respectively.

Tests for assessing emotional disorders associated with prefrontal lobe dysfunction

Tests for assessing executive functioning associated with prefrontal lobe dysfunction

Assessment of language functions

Numerous tests of language function have been developed including comprehensive batteries for adults and children as well as “aphasia” screening tests. Some of these include Boston Naming Test[ 81 ] which is part of Boston Diagnostic Aphasia Battery, Peabody Picture Vocabulary Test - Revised [PPVT-R] which assesses auditory comprehension of picture names and Token Test[ 82 ] which assesses verbal comprehension of commands of increasing severity.

DISORDERS ASSOCIATED WITH DAMAGE TO PFC

As it has been known that frontal lobe not only mediates cognitive aspects of the personality, but also its affective and emotional aspects as well.

It results from widespread lesions of the PFC. In the affective sphere, the hallmark of the disorder is the generalized blunting of affect and emotional responses. The patient's underlying mood is frequently one of profound indifference, and so is his or her attitude toward others.[ 16 ]

Experience of depressed mood, can be a result of left PFC lesions, especially those involving anterior (polar) aspects of the frontal lobes.[ 83 ]

Social behavior

PFC lesions are likely to have great impact on social behavior particularly in case of OFC lesion. It commonly results in euphoria. Instinctual urges may be released or exacerbated. Some patients with OFC lesions show a tendency to have voracious appetite, driven to satiate an apparently insatiable hunger. The sexual drive also appears frequently disinhibited by prefrontal, especially orbital lesions.[ 84 ]

Prefrontal syndromes

To have a holistic and comprehensive understanding of these syndromes, a more specific terminology based on structural, functional, and clinical features, which recognize dorsolateral, medial, and orbital prefrontal regions, was developed.

Dorsal convexity Dysexecutive syndrome

It is characterized by deficits in cognitive flexibility, temporal ordering of recent events, planning, regulating ones actions based upon internal, and external stimuli.[ 85 ] This results in a reduced state of mental control, perseveration, and impairment of sustained attention. The capability to retrieve information is altered despite evidence of intact recognition. Patients present with diminished judgment, impaired working memory, insight, self-care, and there is often a general reduction in verbal and nonverbal fluency. There is impaired priming of stereotypes if the lesion is of ventromedial PFC.[ 86 ]

Medial frontal apathetic syndrome

The hallmark feature of medial apathetic syndrome is a severe reduction in spontaneity, motivation, and lack of interest in the environment. Memory of recent events is relatively intact. It is thought that the overall alteration in motivation and motor activity is a result of the lesion involving the medial motor cortices.[ 3 ]

Orbitofrontal disinhibition syndrome

Patients with OFC damage are characterized generally by an acquired disturbance of personal and social behaviors.[ 39 ] There are marked abnormalities in the realms of reasoning, decision-making, and emotional control. This often results in explosive aggressive outbursts characterized by socially unacceptable, tactless, and vulgar presentation.[ 3 ]

Association with expression of psychiatric disorders

The specification of the component “executive” processes and their localization to particular regions have been implicated in a wide variety of psychiatric disorders ranging from depression to anxiety disorders to schizophrenia as well as in a number of other disorders like attention deficit hyperactivity disorder (ADHD), autism, conduct disorder, etc.

Schizophrenia:

Findings from WM studies in schizophrenia indicate that schizophrenia patients are consistently impaired on WM tasks irrespective of WM domain or processing requirements. This pattern of WM performance may further implicate DLPFC dysfunction in the liability for schizophrenia and has implications for future cognitive, genetic, and developmental research.

Study conducted by Lebowitz et al . indicated that impairment in verbal fluency was found to be greater with the increase in number of episodes of mania.[ 87 ] Both number of episodes and total number of hospitalizations have been found to be related to poorer performance on several aspects of WCST.[ 88 ]

Depression:

Based on a meta-analysis of 13 studies, Veiel concluded that cognitive deficiencies associated with major depression are similar to those seen in moderately traumatic head injury.[ 89 ] Merriam et al. reported that unipolar major depression patients demonstrated significant deficits on the WCST.[ 90 ]

Patients with Alzheimer's disease (AD) and Parkinson's disease can be distinguished on the basis of certain cognitive and behavioral features. Performances on different tests have given rise to the similarities and differences in the cognitive profile of these two groups.[ 91 ] Similarities between the groups were seen in visuo-motor speed and attention, but differences were found in executive functioning, memory, sequencing abilities, set shifting, and word fluency. Thus, cortical patients (AD) perform significantly worse than the subcortical group (Parkinson's disease) in the memory abilities while the latter group showed greater deficits on the executive functions. Studies have found that patients with a high-cognitive reserve, i.e., higher education, occupation, etc. attain a higher neuropsychologic performance than those with a low cognitive reserve and this plays an important protective role in the incidence of cognitive deterioration and dementia.[ 92 ]

Large-scale distributed networks coordinate all complex behavior domains. The performance of a relevant task engages all components of the pertinent network, and damage to any network component can impair behavior in the relevant domain. Experimental data and lesion based-behavioral analyses and functional imaging observations demonstrate that the appropriate and skilled execution of higher-order tasks depend not only on PFC, but also on the integrity of other cortical and subcortical structures that are interconnected with the PFC.

Source of Support: Nil

Conflict of Interest: None declared

Frontal lobe dysfunction and everyday problem-solving: social and non-social contributions

Affiliation.

• 1 Subdepartment of Clinical Health, Department of Psychology, University College London, UCL, Gower Street, London WC1E 6BT, UK.
• PMID: 14962402
• DOI: 10.1016/j.actpsy.2003.12.008

Everyday problem-solving involves both non-social executive processes, social and emotional processes, and draws upon social and practical knowledge. A series of studies including both adult-acquired lesions and neurodevelopmental disorders is reviewed examining problem-solving on a real-life-type task that involves generating a range of solutions to brief problem scenarios and selecting preferred solutions to solve the problems. Impairments in problem-solving are described in groups of participants with left anterior frontal lobe lesions, Tourette's syndrome and Asperger's syndrome. By contrast, healthy older people did not show problem-solving deficits on the same task. The possible contributions of non-social executive skills, social and emotional skills, and knowledge acquired from experience are each considered in relation to everyday performance. Multiple cognitive/emotional routes to the development of everyday life difficulties pose a complex challenge both in understanding the nature of the relevant processes and in developing adequate methods for management and rehabilitation.

• Analysis of Variance
• Asperger Syndrome / psychology*
• Brain Damage, Chronic / psychology*
• Case-Control Studies
• Frontal Lobe*
• Middle Aged
• Problem Solving*
• Social Behavior*
• Tourette Syndrome / psychology*

Frontal Lobe Functioning and Behavior

This essay about the pivotal role of the frontal lobe in human behavior and cognition. It highlights how this brain region acts as a conductor, orchestrating executive functions, emotional regulation, and social interactions. Through its intricate neural networks, the frontal lobe guides decision-making, shapes personalities, and influences moral reasoning. Dysfunction in this area can lead to challenges in impulse control, social behavior, and ethical decision-making. By exploring the complexities of the frontal lobe, we gain valuable insights into the mechanisms underlying human behavior and the impact of neurological disorders.

How it works

In the grand symphony of the human brain, the frontal lobe takes center stage as the virtuoso conductor, directing the intricate melodies of cognition and behavior. Positioned at the helm of the cerebral cortex, this enigmatic region orchestrates a harmonious blend of executive functions, emotional regulation, and social interactions.

Imagine the frontal lobe as the master strategist, mapping out the blueprints for our actions and decisions. Through its vast neural networks, it coordinates the intricate dance of planning, problem-solving, and goal pursuit.

Like a skilled navigator, it steers us through the maze of daily challenges, guiding us towards optimal outcomes. Yet, when discord arises in this cerebral ensemble, disruptions in impulse control, organization, and decision-making may ensue, casting a shadow over our cognitive landscape.

Beyond its role in executive control, the frontal lobe serves as the custodian of our social selves, shaping our personalities and interpersonal dynamics. Deep within its folds lies the prefrontal cortex, the seat of empathy, self-awareness, and moral reasoning. Here, the intricate tapestry of social cognition is woven, allowing us to navigate the complexities of human interaction with finesse. However, when the threads of connectivity fray, individuals may find themselves adrift in a sea of social ambiguity, struggling to interpret cues and regulate emotions.

Moreover, recent explorations into the neural substrates of morality have unveiled the frontal lobe’s pivotal role in ethical decision-making. Like a moral compass, it guides us through the ethical labyrinth, helping us discern right from wrong and navigate the murky waters of moral ambiguity. Yet, when the compass malfunctions, individuals may find themselves adrift in a moral quagmire, grappling with conflicting impulses and ethical dilemmas.

In essence, the frontal lobe stands as a sentinel at the crossroads of cognition and behavior, shaping our thoughts, emotions, and actions in profound ways. As we delve deeper into its mysteries, we unravel the intricacies of human nature and gain invaluable insights into the complexities of the mind. Through the lens of the frontal lobe, we embark on a journey of discovery, charting new territories in our quest to understand what it means to be human.

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