Long-term effects of prefrontal leucotomy - an overview of neuropsychologic residuals

Abstract

A battery of neuropsychologic tests was administered to 16 schizophrenics who had undergone prefrontal leucotomy approximately 25 years earlier. The 16 were divided into three groups based on their recovery after surgery. Five non-leucotomized chronic schizophrenics and five normal subjects served as controls. This paper presents a description of the subject population, a listing of the neuropsychologic battery administered, as well as main results from each major psychologic function tested. This information serves as an introduction and an overview for later detailed results.

Individual differences in distinct components of attention are linked to anatomical variations in distinct white matter tracts

“…Functional imaging studies have provided strong consistent support for the notion that the frontal lobes, particularly the anterior cingulate gyrus, is associated with attentional control during the Stroop Task and the conflict portion of the Attention Network Task (Casey et al, 2000; Gruber et al, 2002; Fan et al, 2005). Additionally, neuropsychological data clearly highlight the central role of the frontal lobes in executive attention (Stuss et al, 1981; Stuss and Benson, 1984; Vendrell et al, 1995; Stuss and Alexander, 2000). Previous DTI studies have also implicated frontal white matter tracts with attention performance.…”

Historical Evolution of the Frontal Lobe Syndrome

“…the dorsolateral prefrontal, the orbitofrontal circuit and the anterior cingulate circuit. Damage to these circuits is associated with three distinct frontal behavioral syndromes: a dysexecutive, disinhibited and apathetic syndrome, respectively [18,19,21,22] . The symptoms associated with these behavioral syndromes (in short, resulting in the lost ability to integrate internal and external stimuli and direct attention into appropriate and adequate behavior) and their anatomical correlates have been confirmed in functional connectivity studies [63] .…”

“…FLS was summarized by Nauta [16] as an impairment to integrate information from the internal milieu with the environment, provided by neocortical processing. In the 1980s Stuss et al [18] collected information on long-term effects of leucotomies and suggested that the prefrontal cortex consisted of three major anatomical regions: the orbitofrontal, anterior cingulate and dorsolateral prefrontal cortex. After this, regional specialization within the frontal lobes was increasingly recognized and these three cortical prefrontal regions repeatedly turned out to be correlated with specific neuropsychiatric features [17] .…”

Behavioral inhibition deficits in juvenile psychopaths

“…Lapierre et al [1995] used this test as a frontodorsolateral measure. Although Milner [1964] reported more perseverative errors in patients with dorsolateral than in those with orbitofrontal lobectomies, the specific sensitivity of the WCST for the dorsolateral part of the frontal lobe remains controversial, as contradictory results have been reported [Drewe, 1974;Stuss and Benson, 1986;Stuss et al, 1981]. It is more appropriate, consequently, to consider this task a measure of diffuse frontal functioning.…”