Cummings J L
Department of Neurology, UCLA School of Medicine.
Arch Neurol. 1993 Aug;50(8):873-80. doi: 10.1001/archneur.1993.00540080076020.
This synthetic review was performed to demonstrate the utility of frontal-subcortical circuits in the explanation of a wide range of human behavioral disorders.
Reports of patients with degenerative disorders or focal lesions involving frontal lobe or linked subcortical structures were chosen from the English literature. Individual case reports and group investigations from peer-reviewed journals were evaluated.
Studies were included if they described patient behavior in detail or reported pertinent neuropsy-chological findings and had compelling evidence of a disorder affecting frontal-subcortical circuits.
Information was used if the report from which it was taken met study selection criteria.
Five parallel segregated circuits link the frontal lobe and subcortical structures. Clinical syndromes observed with frontal lobe injury are recapitulated with lesions of subcortical member structures of the circuits. Each prefrontal circuit has a signature behavioral syndrome: executive function deficits occur with lesions of the dorsolateral prefrontal circuit, disinhibition with lesions of the orbitofrontal circuit, and apathy with injury to the anterior cingulate circuit. Depression, mania, and obsessive-compulsive disorder may also be mediated by frontal-subcotical circuits. Movement disorders identify involvement of the basal ganglia component of frontal-subcortical circuits.
Frontal-subcortical circuits mediate many aspects of human behavior.
进行这项综合性综述以证明额叶 - 皮质下环路在解释多种人类行为障碍方面的作用。
从英文文献中选取涉及额叶或相关皮质下结构的退行性疾病或局灶性病变患者的报告。对同行评审期刊上的个案报告和群体研究进行评估。
纳入那些详细描述患者行为或报告相关神经心理学发现且有确凿证据表明存在影响额叶 - 皮质下环路疾病的研究。
若所采用报告符合研究选择标准，则使用其中的信息。
五条平行且分离的环路连接额叶和皮质下结构。额叶损伤时观察到的临床综合征在环路的皮质下成员结构受损时也会重现。每个前额叶环路都有其典型的行为综合征：背外侧前额叶环路受损会出现执行功能缺陷，眶额环路受损会出现去抑制，前扣带回环路受损会出现淡漠。抑郁、躁狂和强迫症也可能由额叶 - 皮质下环路介导。运动障碍表明额叶 - 皮质下环路的基底神经节部分受累。
额叶 - 皮质下环路介导人类行为的许多方面。
