1. Frontotemporal Dementia
Thomas G. Bowers, Ph.D.
11/24/2018

2. Frontal Lobes Executive functions
Include attention, problem solving, hypothesis testing, social cognition and judgment
Relatively recent evolutionary development
Last structure to mature and develop (~25 years old)
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3. Pineas Gage
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4. Other Views of Gage
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5. Gages Actual Skull
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6. Impact of Frontal Lesion
Gage’s behavior became socially very inappropriate
Displayed consistently poor social judgment
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7. Basic Gross Anatomy Motor, Premotor and Prefrontal regions
Many projections to premotor from other cortical regions
Extensive limbic projections to the premotor region
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8. Frontal Organization From anterior 1. Prefrontal 2. Premotor 3. Motor
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9. Frontal Organization Prefrontal
Does not receive any primary sensory input except olfactory stimuli
Extensive projections from other cortical regions
Extensive projections from the limbic system
Reciprocating projections
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10. Frontal Organization Premotor Broca’s Area Critical convergence zone
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11. Frontal Organization Motor
Linked with the premotor cortex, sensory cortex, and the basal ganglia
Gives rise to pyramidal tacts that descend subcortically
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12. Frontal Organization Prefrontal – Limbic Links
Includes amygdala, hippocampus, thalamus, temporal lobe pole
Involves social processing as empathy, moral emotions, interpersonal judgment
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13. Frontal Organization Prefrontal – Subcortical Links Thalamofrontal
Frontial-striatal
Difficulties here can include disinhibition, perserveration, loss of motivation, attentional disorders, hemispatial neglect
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14. Vulnerable to Impairment
Traumatic brain injury
Axonal shearing, contusions, laceration, hemorrhage
Stroke
ACA, rostral aspects of MCA
Aneurysm
Neurodegenerative disease
Pick’s
Frontotemporal dementia
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15. Vulnerable to Impairment
Psychiatric disorders
Hydroencephalus
Brain tumors
Orbitofrontal meningioma
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16. Frontal Region is Vulnerable
Frontal pole and anterior horn of the temporal lobe in particular are sensitive to lesions
Coup injury
Contrecoup
Shearing injuries
Small petechial hemorrhage
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17. Degenerative Disorders
Pick’s Disease
Atrophy has an affinity for the frontotemporal region
Development of Pick’s bodies
Frontotemporal dementia
Not frequent, but 10% of degenerative dementias
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