Brain exam

As one of our most important organs, the brain controls vital functions ranging from our thoughts and emotions to our movements and how we respond to stimuli, among many other tasks.

Not surprisingly, when a person suffers a brain injury, how their physiology responds to it depends on the part of the brain affected. Since the brain is made up of billions of neurons that participate in different functions of high-level regions and subregions, what happens if the prefrontal cortex (PFC) is damaged? What is a PFC anyway?

What does the prefrontal cortex do?

The PFC consists of the anterior part of the frontal lobe in the cerebral cortex. It is located just behind the eyes and is part of the brain responsible for executive functions.

Executive functions are top-level control processes or vital activities that regulate cognitive and social behavior, personality, and decision-making—the latter being one of the most important executive functions.

The PFC is the part of the brain that commands our actions and thoughts and ensures that they are aligned with our values ​​and goals. Unfortunately, for being involved in complex high-level functions, The PFC is also more likely to bear the brunt of stressors.

Subregions of the prefrontal cortex

PFC is divided into three subsections: dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). Overall, these subregions are involved in several cognitive processes. But since they connect to different parts of the brain, each has its own specifics.

  • Dorsolateral prefrontal cortex

The DLPFC is the uppermost area of ​​the PFC that controls cognitive processes such as planning, problem solving, and attention to task (working memory). Yet, because it establishes a strong interconnection with the motor and sensory cortex, the DLPFC also controls our thoughts and actions. For example, during working memory activation, this part of the brain connects with the hippocampus to process long-term memories.

The OFC is the area of ​​the brain responsible for decision making, emotional regulation, and social attachments. It is closely related to the limbic system (responsible for processing emotions). Not surprisingly, decisions processed in the OFC are rooted in emotional data.

  • Ventromedial prefrontal cortex

The vmPFC is the most complex subregion in terms of responsibilities. It connects to several areas of the brain, including the amygdala, thalamus, olfactory system, temporal lobe, and ventral segmental area. Like the orbitofrontal cortex, the vmPFC plays an essential role in emotion-driven decision making.

Both regions work together to help us regulate our emotional responses, including negative ones. But on the other hand, while making decisions, the vmPFC also considers the bigger picture, which makes its role vital in social situations. Take, for example, our ability to make sound judgments, learn from mistakes, and show courage or guilt.

What can happen if the prefrontal cortex is damaged?

If the PFC is damaged, you will have yours executive functions, including decision-making, self-control, judgment, and purposeful behavior impaired. There’s more to it, though.

Specialists have a hard time identifying immediate signs of PFC damage. This is because individuals do not show the usual symptoms of brain lesions, such as impaired motor skills or sensory and perceptual problems. However, people in the patient’s inner circle notice drastic changes over time – especially in terms of personality and emotional responses.

Patients with a damaged PFC tend to exhibit irritability, short-term memory loss, lack of empathy, difficulty planning, impulsivity, and inflexibility. In general, when the PFC is damaged, the individual has problems with complex cognitive skills, including planning, behavior, and emotional expressions.

Risks of damage to the prefrontal cortex

The most famous example is Phineas Gage, a railroad foreman whose large portion of PFC was destroyed after a terrible explosion at work in 1848. According to reports, his personality and behavior noticeably changed after the incident – for example, he went from hardworking and well-mannered to contemptuous and troubled. He also became unable to regulate emotions (or impulses), showing a significant decline in executive functions.

And the signs can be more pronounced if they appear in childhood. Researchers have shown that damaged layers of the brain (anatomical and functional) engagement with the psychosocial environment – depending on the age, the child’s personality may still be in the process of development – a change in the regulation of nervous activity. But that’s not all.

According to a study in Neuropsychopharmacology diary“disruption or even mild slowing of the rate of neuronal production, migration, and synaptogenesis by genetic or environmental factors can cause gross as well as subtle changes that can ultimately lead to cognitive impairment.”

How to strengthen the prefrontal cortex

Individuals with PFC damage have difficulty functioning in unstructured environments. There are some exercises or a series of simple activities that you can do to strengthen your cognitive functions and, therefore, your prefrontal cortex. Some of these activities include:

Choose a daily task and write down the steps needed to complete it on separate sheets of paper. Then shuffle these notes and try to arrange the task in the correct order. This activity is excellent for working on planning skills and improving cognitive function.

By creating a routine, it’s easier to take the initiative to complete tasks or things you need to do on a daily basis. In addition, for people whose PFC is damaged, routine prevents them from expending much mental energy on daily activities.

Exercise is another way to strengthen the prefrontal cortex. A study published in Behavioral Sciences magazine suggests that exercise intensity affects PFC oxygenation, which contributes to improving cognitive performance. What’s more, if you like to exercise often, your brain has a slight advantage, because exercise helps improve memory.

Playing memory games – including mnemonics, puzzles and math memory games – helps improve concentration, problem solving and memory skills. Thus, because injury to the PFC can lead to short-term memory loss, amnesia, and executive function impairment, memory games are valuable ways to support brain cognition and neuroplasticity.

If you want to test your culinary skills, this may be one of the best exercises to strengthen the prefrontal cortex. This is because you engage the five senses that use several areas of the brain while cooking. Also, cooking requires planning and concentration while engaging working memory to complete the task at hand.

It should be noted that the treatment of this area is not easy. Most of the time, patients need the help of a behavioral specialist.


Read more: Could Brain Injuries Explain King Henry VIII’s Behavior?


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