Psychiatric Side Effects
Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish in Retinoids in Dermatology, 2019
The prefrontal cortex is the anterior region of the frontal lobe responsible for personality, decision making, and controlling social behaviors. Individuals who suffer damage to this region typically experience significant dysregulation of emotional responses and goal-directed behavior. Both MRI studies and postmortem examination have found reduced volume and density of neurons in the orbitofrontal cortex, a region of the prefrontal cortex, among patients with major depression (9,15). Increased metabolism of the orbitofrontal lobe has been seen in patients with obsessive-compulsive disorder (OCD) (16). RA has been shown to affect the executive networks found in the frontal cortex of adult rat brains (17). Retinoid treatment could alter neuronal functioning in the prefrontal cortex and may be responsible for the psychiatric effects seen with therapy.
Disorders of brain structure and function and crime
John C. Gunn, Pamela J. Taylor in Forensic Psychiatry, 2014
Damage to the prefrontal cortex, made up of the anterior frontal lobes, has also been implicated in violence. Anderson and colleagues (1999) found normal basic cognitive abilities but impaired social behaviour, insensitivity to future consequences of decisions, defective autonomic responses to punishment contingencies, and failure to respond to behavioural interventions in two patients who had suffered early damage to the ventromedial/lateral area of the prefrontal cortex specifically. One patient had been run over by a vehicle at age 15 months and the other had undergone resection of a right frontal tumour at age 3 months. Their actions and their defective social and moral reasoning resembled those of high scorers on the PCL-R. Severely impaired decision-making and inappropriate social behaviour have also been observed in patients with adult-onset prefrontal cortex damage, although retaining factual knowledge of social conventions and moral rules (for a review, see Grafman, 1995).
100 MCQs from Dr. Michael Reilly and Colleagues
David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly in MCQs for the New MRCPsych Paper A, 2017
Damage to the prefrontal cortex results in changes in personality that broadly fit into categories of disturbed mood, poor judgement, impaired social awareness, and motivation and perseveration of speech and movement. Childishness may be a feature, including making jokes and performing pranks (witzelsucht). Other features include perseveration, both of speech and movements; palilalia, or repetition of phrases and sentences; and decreased verbal fluency. Damage to the temporal lobe can result in amnesia, personality disturbances and visual field or sensory deficits depending on the location of the lesion. Lesions in the dominant occipital lobe results in alexia without agraphia, colour agnosia and visual object agnosia. Lesions in the non-dominant occipital lobe result in visuospatial agnosia, prosopagnosia, metamorphopsia and complex visual hallucinations. The parietal lobe is involved in attention, integration of information and appropriate connections of sensory input to actions. Damage to the amygdala can result in impaired emotional processing of stimuli, impaired emotional learning and deficits in emotional perception and expression. (9, pp 15–17, 22)
Acute improvement in the attention network with repetitive transcranial magnetic stimulation in Parkinson’s disease
Published in Disability and Rehabilitation, 2022
Wei Wei, Xingyang Yi, Zexiu Wu, Jianghai Ruan, Hua Luo, Xiaodong Duan
In our study, regarding the ANT, although the RT on almost every subtask was reduced, the improvements in the three attention networks by rTMS were not identical. The reduction in RT under the incongruent condition was greater than that under the congruent condition. Therefore, the RTs based on the executive control network were significantly reduced. The ANT is a useful test for evaluating the executive control network by assessing elapsed time differences between tasks involving congruent and incongruent targets [70]. The executive control network is related to addressing conflict produced by different stimuli [5]. This network is impaired in PD probably because the executive control network is modulated by dopamine [71], and there is abnormal activation in frontoparietal and dorsal attention networks during executive challenges in PD [14]. The prefrontal cortex prompts more effective responses to conflicting stimuli and coordinates the executive control network [72]. The prefrontal cortex is a common anatomical region shared by the executive control network and executive functions. However, although rTMS showed a selective effect on executive functions as assessed by the neuropsychological tests mentioned above, the ANT data showed definite effects of rTMS on the executive control network.
Reduction of white matter integrity correlates with apathy in Parkinson's disease
Published in International Journal of Neuroscience, 2018
Yang Zhang, Jiayong Wu, Wenbo Wu, Renyuan Liu, Lingen Pang, Dening Guan, Yun Xu
Our study also found lower FA values in the bilateral ACR and the left superior corona radiata in apathetic PD patients. ACR is part of the limbic–thalamo–cortical loops, and connects the internal capsule to the prefrontal cortex [32,33]. The prefrontal cortex covers the frontal parts of the frontal lobe and is interconnected with other cortical and subcortical regions, which are involved with attention, cognition, action and emotion [34]. Studies show that abnormality in the WM of the ACR may result in attention deficit [35] and emotional [36] or cognitive disorders [37]. Although similar results were not reported in apathetic PD patients, there are several studies which show that corona radiata changes correlate with apathy in HIV infection [38], behavioural variant frontotemporal dementia [39] and stroke [25]. Our findings here support that damage to the WM fibres of the ACR may result in impaired emotional and cognitive functions, and thus in apathy.
Pressures on Kids for Early Measurable Achievement
Published in Issues in Mental Health Nursing, 2020
More and more research is showing that future success is not determined by good grades, Ivy League acceptances, or inflated self-esteem. In fact, success is correlated with psychological capacities including: optimism, curiosity, a sense of oneself as capable, and the ability to manage negative emotions and weather obstacles (Levine, 2006). Karlgaard (2019) would add to this the normal sequence of development of cognitive processes resulting in a fully formed adult brain – the biological maturation of the brain. Cognitive researchers have found that in adolescent and young adult brains, the prefrontal cortex—the processing center of our frontal lobe—is the last part to fully develop, often only in our early-to-mid 20 s (Fuster, 2002; Mills, Goddings, Clasen, Giedd, & Blakemore, 2014). Located just behind the forehead, the prefrontal cortex is responsible for complex processes like planning and organizing, problem-solving, memory recall, response inhibition, and attention allocation.
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