Dysexecutive syndrome
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The Dysexecutive Syndrome is a term for numerous cognitive, emotional & behavioural symptoms which tend to occur comorbidly following a brain injury to the frontal lobes, or more specifically to specific prefrontal cortex areas. Dysexecutive Syndrome is generally considered to be a dysfunction of the Executive system or Executive functions. The determined localisation of these cognitive functions within prefrontal cortex regions is due mainly to studies of patients with damage to these areas, although there is also increasing evidence from fMRI studies.
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[edit] Definition
The Dysexecutive Syndrome consists of a number of symptoms [1] which tend to occur together (hence it being described as a syndrome). Broadly speaking, these symptoms fall into three main categories; Cognitive, Emotional & Behavioural. Although many of these symptoms regularly co-occur, it is common to encounter patients who have several, but not all of these symptoms. This is one reason why some researchers are beginning to argue that the Dysexecutive Syndrome is not the best term to describe these various symptoms (see criticisms below).
[edit] Cognitive Symptoms
- Short attention span
- Poor working memory
- Poor short term memory
- Difficulty in planning & reasoning
- Utilization behavior
[edit] Emotional Symptoms
- Difficulty in inhibiting emotions, anger, excitement, sadness etc...
- Depression, possibly due to above.
- Occasionally, difficulty in understanding other peoples point of view, which can lead to anger & frustration.
[edit] Behavioural Symptoms
- Inappropriate aggression
- Inappropriate sexual behaviour
- Inappropriate humour & telling of pointless & boring stories
[edit] Criticisms
The fact that many of the Dysexecutive Syndrome symptoms can occur alone has led some researchers [2] to suggest that the symptoms should not be labelled as a "syndrome" as such. Some of the latest imaging research [3] on frontal cortex areas suggests that Executive Functions may be more discrete than was previously thought. The argument is that rather than damage to the frontal cortex areas causing Dysexecutive Function in general, that damage to multiple frontal cortex areas that are close together (but responsible for different cognitive functions) can cause the various symptoms of the Dysexecutive Syndrome.
The counter argument is that there is a Central Executive corresponding to areas within the frontal lobes which is responsible for much of the Executive system and Executive Function in general, and that damage to this area causes the Dysexecutive syndrome.
[edit] Patients of note
The classic example of a patient with the Dysexecutive syndrome is Phineas Gage who underwent dramatic personality change following severe frontal lobe injury, to the extent that his co-workers proclaimed that "he was simply no longer Gage".
[edit] See also
- executive functions
- executive system
- attention
- cognitive neuropsychology
- frontal lobe
- working memory
- Phineas Gage
[edit] External links
[edit] References
- ^ Halligan P.W, Kischka U. & Marshall J.C. (2004) Handbook of Clinical Neuropsychology. Oxford University Press, 2004.
- ^ Stuss, D.T. & Alexander, M.P. (2007) Is there a Dysexecutive Syndrome? Philosophical transactions of the Royal Society of London. Series B, Biological Sciences, 362 (1481), 901-15.
- ^ Gilbert, S.J. & Burgess, P.W. (2008). Executive Function. Current Biology, Vol.18, No. 3, 110 - 114.
