The prefrontal network plays an important role in behaviors that require an integration of thought with emotion and motivation. There is no simple formula for summarizing the diverse functional affiliations of the prefrontal network. Its integrity appears important for the simultaneous awareness of context, options, consequences, relevance, and emotional impact so as to allow the formulation of adaptive inferences, decisions, and actions. Damage to this part of the brain impairs mental flexibility, reasoning, hypothesis formation, abstract thinking, foresight, judgment, the online (attentive) holding of information, and the ability to inhibit inappropriate responses. Behaviors impaired by prefrontal cortex lesions, especially. | Chapter 027. Aphasia Memory Loss and Other Focal Cerebral Disorders Part 13 The prefrontal network plays an important role in behaviors that require an integration of thought with emotion and motivation. There is no simple formula for summarizing the diverse functional affiliations of the prefrontal network. Its integrity appears important for the simultaneous awareness of context options consequences relevance and emotional impact so as to allow the formulation of adaptive inferences decisions and actions. Damage to this part of the brain impairs mental flexibility reasoning hypothesis formation abstract thinking foresight judgment the online attentive holding of information and the ability to inhibit inappropriate responses. Behaviors impaired by prefrontal cortex lesions especially those related to the manipulation of mental content are often referred to as executive functions. Even very large bilateral prefrontal lesions may leave all sensory motor and basic cognitive functions intact while leading to isolated but dramatic alterations of personality and behavior. The most common clinical manifestations of damage to the prefrontal network take the form of two relatively distinct syndromes. In the frontal abulic syndrome the patient shows a loss of initiative creativity and curiosity and displays a pervasive emotional blandness and apathy. In the frontal disinhibition syndrome the patient becomes socially disinhibited and shows severe impairments of judgment insight and foresight. The dissociation between intact cognitive function and a total lack of even rudimentary common sense is striking. Despite the preservation of all essential memory functions the patient cannot learn from experience and continues to display inappropriate behaviors without appearing to feel emotional pain guilt or regret when such behaviors repeatedly lead to disastrous consequences. The impairments may emerge only in real-life situations when behavior is under minimal external control and
