The Frontal Lobes and Neuropsychiatric Illness
This exciting volume brings together the latest work of 26 recognized experts in clinical neuropsychiatry, neuropsychology, neuroscience, and neuroimaging. Its chapters are organized into sections that cover a broad range of topics related to advances in our understanding of normal and abnormal frontal lobe functions.
- Part 1 introduces frontal lobe dysfunction as a common pathway leading to social and occupational disability, arguing that our aging population with its decline in executive cognitive abilities mandates corresponding eligibility and treatment changes in public and private health disability policies.
- Part 2 delineates the anatomy and neurochemistry of the extended frontal systems underlying neuropsychiatric illness, including colorful illustrations of three key prefrontal-subcortical circuits; a description of the functional anatomy of the orbitofrontal cortex and its relationship to obsessive-compulsive disorder (OCD); the intricate pharmacology of working memory systems and how they apply to schizophrenia; the lateralization of prefrontal cognitive functions; and a framework for understanding the role played by the prefrontal cortex in consciousness and self-awareness.
- Part 3 clarifies the overused diagnosis frontal lobe syndrome seen in clinical practice, identifying three prefrontal syndromes for further study—dorsolateral dysexecutive syndrome, orbitofrontal disinhibited syndrome, and mesial frontal apathetic syndrome—that align with the anatomical systems described in Part 2 of this volume. Also included are common problems—and suggested solutions—in diagnosis and treatment, a practical overview of the assessment of frontal lobe functions with guidelines for bedside and formal neuropsychological examination, and comprehensive treatment strategies.
- Part 4 covers the role of the frontal lobes in major neuropsychiatric illnesses, discussing evidence that shows prefrontal and anterior temporal hypometabolism in primary and secondary depression; reviewing anatomical, imaging, and neurochemical studies in schizophrenia; describing the neuropsychological and neuropsychiatric sequelae of closed head injury; summarizing the neurological substrates related to interesting and often dramatic cases of content-specific delusions; and concluding with a report on the stereotactic neurosurgical treatment of refractory OCD and its implications for understanding frontal lobe function.
This remarkable work is intended for psychiatrists, neurologists, psychologists, basic and clinical neuroscientists, and trainees from each of these disciplines, who will welcome it as a valuable tool in understanding the complexities of what was once considered the terra incognita of the brain.
- PART 1: Introduction
- Chapter 1. The Frontal Lobes and Neuropsychiatric Illness
- Chapter 2. The Significance of Frontal System Disorders for Medical Practice and Health Policy
- PART 2: Functional Organization of Prefrontal Lobe Systems
- Chapter 3. Frontal Subcortical Circuits: Anatomy and Function
- Chapter 4. The Orbitofrontal Cortex
- Chapter 5. Working Memory Dysfunction in Schizophrenia
- Chapter 6. Lateralization of Frontal Lobe Functions
- Chapter 7. Consciousness, Self-Awareness, and the Frontal Lobes
- PART 3: Prefrontal Syndromes in Clinical Practice
- Chapter 8. Regional Prefrontal Syndromes: A Theoretical and Clinical Overview
- Chapter 9. Assessment of Frontal Lobe Functions
- Chapter 10. Diagnosis and Treatment of Frontal Lobe Syndromes
- Chapter 11. Treatment Strategies for Patients With Dysexecutive Syndromes
- PART 4: Frontal Lobe Dysfunction in Neuropsychiatric Disorders
- Chapter 12. Frontal Lobe Dysfunction in Secondary Depression
- Chapter 13. The Frontal Lobes and Schizophrenia
- Chapter 14. The Frontal Lobes and Traumatic Brain Injury
- Chapter 15. The Frontal Lobes and Content-Specific Delusions
- Chapter 16. Neurosurgical Treatment for Refractory Obsessive-Compulsive Disorder: Implications for Understanding Frontal Lobe Function
About the Authors
Stephen P. Salloway, M.D., M.S., is Associate Professor of Neurosciences and Psychiatry and Human Behavior at Brown University School of Medicine, and Director of Neurology and the Memory Disorders Program at Butler Hospital in Providence, Rhode Island.
Paul F. Malloy, Ph.D., is Associate Professor of Psychiatry and Human Behavior at Brown University, and Director of Psychology at Butler Hospital in Providence, Rhode Island.
James D. Duffy, M.B., Ch.B., is Medical Director of the Huntington's Disease Program at the University of Connecticut Health Center; Associate Professor of Psychiatry at the University of Connecticut School of Medicine in Farmington, Connecticut; and Director of Psychiatric Consultation Services at Hartford Hospital in Hartford, Connecticut.
This book makes recent advances in the understanding of frontal function available to students, clinicians, and researchers who might not otherwise have experience in cognitive neuroscience. Frontal dysfunction is directly related to disability in neuropsychiatric disorders. Understanding how to help our patients begins with understanding the causes of their disability. This volume provides an excellent start.—Sheldon Benjamin, M.D., Journal of Clinical Psychiatry, 7/1/2002
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