Prefrontal syndrome

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Denotes involvement of the front precental gyrus, it was previously referred to as an organic psychosyndrome.

Prefrontal system[edit | edit source]


The prefrontal system is one of the largest cortical regions of the brain. It forms (together with the central region) one of the two parts of the frontal lobe.

Function[edit | edit source]

  • integration of information from different sources, planning, decision-making, new ideas (see below)
  • integration of sensory perceptions (connection with the visual, auditory, olfactory, etc. cortex)
  • integration of learning and memory (connecting with the limbic system)
  • leading role on the regulation of the limmbic system (projection to the hypothalamus).
  • various specifically human functions: abstract thinking, creativity, social relations, responsibility, etc.
  • attention, perception, movement, temporal integration, emotions

Connections[edit | edit source]

  • connections from the whole brain, mainly with the rostral thalamus (mediodorsal nucleus of the thalamus)
  • connections with mediodorsal nucleus of the thalamus:
  • large cell part : to the orbital and medial parts of the prefrontal cortex
    • lesions: euphoria, hyperkinesia, inappropriate social behavior.
  • small cell part : to the dorsolateral parts of the prefrontal cortex
    • lesions; apathetic-ablous syndrome, hypokinesia, congenitive disorders

Clinical signs[edit | edit source]

Clinical symptoms of prefrontal syndrome include:

  • the so-called apathetic-abulous syndrome: (sometimes also referred to as amotivational syndrome),
    • apathy (numbness,surrender),
    • abulia (loss of will to do any activity).
  • significant deterioration of memory in the implantable component,
  • bradypsychism,
  • the patient has no insight into his illness (anosognosia),
  • undue euporia,
  • moria (indecent jokes and vulgarisms),
  • gatism (does not observe cleanlines, gives the impression of approval),
  • ganserism (he tals about himself in the third person),
  • gives approximate answers,
  • puerilism (childish behaviour),
  • amotional lability - apathy alternates wit bouts of rage.

The most serious manifestation of frontal lobe involvement is a comatose state.

Examination[edit | edit source]

During the examination, we objectify a number of reflexes reflecting prefrontal deliberation. Positivity of axial phenomena appears (nasolabial, mentolabial and sucking reflexes). A bilateral lesion of the prefrontal area leads to disorder of standing and walking, the so-called frontal gait [1] Henner's crescendo retropulse – when the center of gravity is shifted backwards, the patient backs up with accelerating steps until he falls (impairment of the fronto-ponto-cerebellar pathway). When the frontal base is affected, hyposmia or anosmia from the olfactory pathway.

Links[edit | edit source]

related article[edit | edit source]

Reference[edit | edit source]

  1. AMBLER, Zdeněk. Základy neurologie. 6. edition. Prague : Galen, 2006. 0 pp. ISBN 80-7262-433-4.

Literature[edit | edit source]

  • SEIDL, Zdeněk – OBENBERGER, Jiří. Neurologie pro studium i praxi. 2. edition. Praha : Grada Publishing, 2004. ISBN 80-247-0623-7.