Sydney Medical School-Nepean, University of Sydney, Nepean Hospital, Penrith, Australia.
Cortex. 2012 Jan;48(1):97-119. doi: 10.1016/j.cortex.2011.03.014. Epub 2011 Mar 31.
The suppression of automatic prepotent behaviour in favour of more successful, more 'appropriate' behaviour is the primary function of the frontal lobe. Five frontal-subcortical circuits connect the frontal lobe to the basal ganglia and the thalamus. We report 17 patients with small lesions in the downstream structures of the frontal-subcortical circuits displaying severe dysexecutive behaviour. Positron emission tomography (PET) demonstrated hypometabolism of the frontal lobe in some of these patients. The literature on frontal lobe dysfunction after lesions in the basal ganglia and thalamus is discussed and the semiology of frontal lobe dysfunction in relation to the frontal-subcortical circuits is highlighted. Derived from our findings we suggest a disconnection syndrome of the frontal lobe caused by lesions in the downstream structures of the frontal-subcortical circuits.
抑制自动优势行为，转而支持更成功、更“适当”的行为，是额叶的主要功能。五个额皮质下回路将额叶与基底节和丘脑连接起来。我们报告了 17 例患者，他们的额皮质下回路下游结构有小的病变，表现出严重的执行功能障碍。正电子发射断层扫描（PET）显示其中一些患者额叶代谢降低。本文讨论了基底节和丘脑病变后额叶功能障碍的文献，并强调了额叶功能障碍与额皮质下回路的关系。根据我们的发现，我们建议由额皮质下回路下游结构病变引起的额叶断开综合征。
