Theories of frontal lobe executive function: Clinical applications

© Oxford University Press, 2005. All rights reserved. Many of the symptoms that are particularly difficult to treat are associated with damage to the frontal lobes. There are a very large number of symptoms which are collectively referred to as 'dysexecutive symptoms'. This chapter describes some of the latest findings about the functional anatomy of the frontal lobes, the main clusters of frontal lobe symptoms, how they relate together, and their relative importance. It explains the main theories of how the frontal lobe executive system works and how they relate to the symptoms seen day to day. It also offers some predictions about therapeutic methods that might be worth pursuing based on these theories. Many of the symptoms that are particularly difficult to treat are associated with damage to the frontal lobes. There are a very large number of symptoms which are collectively referred to as 'dysexecutive symptoms'. These are not only problematic in themselves, but can also affect a patient's ability to benefit from therapy aimed at ameliorating other forms of deficit (e.g. physical therapy), and are often associated with a generally poor response to treatment (Alderman 1991). Considerable treatment advances have been made in this area in the last few years. However, in order to develop new methods we need to understand the causes of the particular symptoms. This chapter has four aims: (1) To describe some of the latest findings about the functional anatomy of the frontal lobes; (2) to describe the main clusters of frontal lobe symptoms, how they relate together, and their relative importance; (3) to explain the main theories of how the frontal lobe executive system works and how they relate to the symptoms you can expect to see day to day, and (4) to give some 'blue-sky' predictions about which therapeutic methods might be worth pursuing based on these theories.