Chapter 6: Pre-frontal lobes

Exam 2

Prefrontal dysfunction is characterized by…

• executive dysfunction

• impaired social communication

• impaired behavioral regulation

What is the role of boney projection in damage

when compressed they can cause damage to the underside of the pre-frontal lobe

Hallmark executive function symptoms of Frontotemporal Dementia (11)

• impaired judgement

• Disnhibition

• Apathy

• Loss of empathy and interest in others

• Declines in personal hygiene

• perseverative and compulsive behaviors

• pica (eating non-food items)

• emotional withdrawal

• distractibility

• agitation

• socially inappropriate behaviors

Regions that are impacted by frontotemporal deminta

• pre-frontal lobe

• perisylvian region (language processing)

Atrophy patterns in frontotemporal dementia

atrophy and shrinking of the frontal lobe. The gyrus begin to pull away from each other and you can see changes in the gray matter.

name the assessments for Fronto-temporal dementia

• Frontal assessment Battery (FAB)- prefrontal functions

• Social cognition and Emotional Assessment (SEA)- prefrontal function

FAB assessment includes ____ subtest which examine… what (6)

six

• conceptualization and abstract reasoning

• mental flexibility

• motor programming and executive control of action

• resistance to interference

• inhibitory control

• environmental autonomy

SEA assessment includes ____ subtest and examine orbitofrontal functions including… what (5)

five

• identification of facial emotions

• a reversa/extinction task

• a behavioral control task

• a theory of mind test

• an apathy scale

Treatments for Agitation and behavioral disinhibition include…

• validation therapy

• redirection and movement

• routines

which agitation and behavioral disinhibition recommended practice is being described

• affirms the individual’s emotional state rather than correcting them

• redirects to a positive interaction or activity

Validation therapy

which agitation and behavioral disinhibition recommened practice is being described

• in response to agitation, redirect the individual to another activity

• movement through space and to different environments typically reduces agitation as well

redirection and movement

which agitation and behavioral disinhibition recommend practice is being described

• Establishing a daily schedule and routine to help with orientation and foster positive behaviors (reduce agitation)

Routines

Recommended treatments for executive function deficits of frontal lobe

• environmental modification

• metacognitive strategy instruction

Which treatment is being described for executive dysfunction

• modify the physical environment to reduce distractions

• train partners to provide scaffolding and reduce demands

• educate staff and partners

environmental modification

Which treatment is being described for executive dysfunction

• break tasks or problems down into smaller steps. Practice strategies in the context of meaningful activities

metacognitive strategy instruction

Discourse production changes with pre-frontal damage…

Discourse comprehension changes with pre-frontal damage…

strengths across discourse genres

challenges across discourse genres

which network is being described

• sustained attention

• information processing

• problem-solving

• decision making

• working memory

central executive network (CEN)

which network is being described

• engaged when we are letting our minds wander or thinking about our past and future

Default mode network (DMN)

which network is being described

• responsible for directing our attention to salient stimuli and inhibiting (filtering) our attention from irrelevant stimuli

salience network

Name awareness impairments

• anosognosia

• impaired self-awareness (ISA)

Which awareness impairment is being described

• problems with recognizing one’s own deficits

anosognosia

Which awareness impairment is being described

• common phenomena following prefrontal damage

• frequently underestimate their struggles and overestimate their abilities

• in some cases, they can list off their weakness or impairments, but do not understand the functional consequences

impaired self-awareness

executive functions impairment domains

• restraint

• initiative

• order

executive function impairments to restraint include…

executive function impairments to initiative…

executive function impairments to order

swallowing disorders for pre-frontal lobe damage

primarily secondary to cognitive impairments

• includes inattention/distractibility, impulsivity, poor endurance, reduced interest in food