Rosch Keri Shiels, Mostofsky Stewart
Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States.
Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States.
Handb Clin Neurol. 2019;163:351-367. doi: 10.1016/B978-0-12-804281-6.00019-7.
Development of the frontal lobe is critical to acquisition, execution, and control of a wide range of functions, from basic motor response to complex decision-making. These functions are influenced by contingency-based (e.g., reward and response-cost/punishment) feedback that is mediated through the adaptive integration of fronto-subcortical neural circuitry. The frontal lobe manages incoming information and chooses the appropriate action based on one's goals in a particular context. This aspect of frontal function, while only one component, is crucial to development and maintenance of approach and avoidance behavior central to all human (and animal) behavior. Furthermore, disruptions in fronto-subcortical circuitry governing motivated behavior appear to contribute to a range of developmental disorders, including attention-deficit/hyperactivity disorder (ADHD), and confer vulnerability for psychopathology more broadly. The particular deficits that manifest in altered behavior depend upon the specific circuitry that is compromised due to the functional specificity of distinct regions of the frontal lobe and its interconnections with subcortical structures. Neurobiologic models of motivated behavior provide a valuable framework for characterizing developmental disorders from a transdiagnostic dimensional systems perspective. Improved characterization of approach and avoidance motivation across neurodevelopmental disorders has the potential to inform the development of novel interventions and personalized medicine.
额叶的发育对于从基本运动反应到复杂决策等广泛功能的获得、执行和控制至关重要。这些功能受到基于偶然性(例如奖励和反应成本/惩罚)的反馈的影响,这种反馈是通过额-皮质下神经回路的适应性整合来介导的。额叶管理传入信息,并根据个体在特定情境中的目标选择适当的行动。额叶功能的这一方面虽然只是一个组成部分,但对于所有人类(和动物)行为核心的趋近和回避行为的发展和维持至关重要。此外,控制动机行为的额-皮质下回路的破坏似乎导致了一系列发育障碍,包括注意力缺陷多动障碍(ADHD),并更广泛地导致心理病理学易感性。行为改变中表现出的特定缺陷取决于由于额叶不同区域及其与皮质下结构的连接的功能特异性而受损的特定回路。动机行为的神经生物学模型为从跨诊断维度系统的角度表征发育障碍提供了一个有价值的框架。改善对神经发育障碍中趋近和回避动机的表征有可能为新型干预措施和个性化医学的发展提供信息。