1 Executive Control Chris Rorden Executive

1 Executive Control • Chris Rorden • Executive Control, Problem Solving

2 Prefrontal Cortex l Prefrontal Cortex are all regions of the frontal lobe exceot the motor and premotor regions.

3

4

5

6 Dolphin Brain

7

8 l Phineas Gage – – – Injured in 1848 Foreman for construction Railway tamping iron accidently launched through skull l 1. 1 meters long l Over 6 kg l Landed 25 meters behind him l Treated by Dr John Harlow – Lived until 1860

9 Phineas Gage l l Harlow (1868) wrote report on Gage Before – – – l efficient foreman well-balanced mind shrewd smart business man After – – – Fitful Irreverent, and grossly profane Little deference for his fellows Impatient and obstinate, yet capricious and vacillating Poor planning

10 Frontal Lobotomy (Leucotomy) l Moniz (1936) Severed frontal lobe nerve fibers – – l In USA, Freeman became advocate – – l l l 20 patients Anxiety, depression, schizophrenia ‘Improvement’ subjective Moniz was already famous for X-ray angiography, this added acceptance for his new work Reported substantial improvements Noted that patients lost some spontaneity, sparkle 5, 000 lobotomies performed in 1949 alone Moniz won 1949 Nobel prize for medicine Popularity only declined with introduction of neuroleptic drugs.

11 Early criticism of lobotomy l Hoffman (1949) – "these patients are not only no longer distressed by their mental conflicts but also seem to have little capacity for any emotional experiences - pleasurable or otherwise. They are described by the nurses and the doctors, over and over, as dull, apathetic, listless, without drive or initiative, flat, lethargic, placid and unconcerned, childlike, docile, needing pushing, passive, lacking in spontaneity, without aim or purpose, preoccupied and dependent. "

12 Was lobotomy effective? l Tooth et al. (1961) – – – l 9, 284 patients examined 41% improved 28% minimally improved 25% no change 2% worse However, about 30% spontaneous recovery rate.

13 Classic consequences of frontal damage l Frontal lobe patients can show normal IQ on standard tests. However, they are typically impaired in many functions: – – – Poor control of reasoning, planning and emotions Poor mental flexibility: perseveration Frontal lobe modulates functions of other regions Disinhibition: poor control of emotions Perseveration: e. g. trouble stopping action once initiated, e. g. dialing 999.

14 Consequences of PFC damage l l Ventromedial: Cofabulation, poor creativity, poor attention, inappropriate emotions and behavior. Orbital Fibers: (Connects to amygdala and hypothalamus): inappropriate emotions. VLPFC: Language impairments DLPFC: Motor impairments: perseveration, incoordination, hypokinesia

15 Real world difficulties l l Goel et al. (1997) describes difficulty in financial planning task. Asked to evaluate different costs for family and economize Control patients came up with realistic suggestions (e. g. hand down clothes to younger children). Patients were less practical: – – – PATIENT: Shelter was the biggest expense. Now, if they eliminate that, $10, 800 they save a year. EXPERIMENTER: But you need a place to live. PATIENT: Yes. Course I know a place that sells tents cheap. You can buy one of those.

16 A: Tower of London l WAIS blocks Shallice (1982) – Two tasks: l l – Tower of London WAIS block design Two patient groups l l Parietal Frontal Start Position Goal 2 (2 moves) Goal 10 (5 moves)

17 B: Results l Shallice (1982) – Frontal patients: l l – Parietal Patients l l l Impaired with Tower of London (requires planning) Fine with WAIS blocks Fine with Tower of London Impaired with WAIS blocks (spatial skills) Conclusion: double dissociation highlights frontal deficit in strategic planning.

18 A: Thompson-Schill et al. , 1998 l Inferior Frontal Gyrus – – Language comprehension intact following Left IFG damage. However, neuroimaging suggests region is activated in verb generation. IFG aka VLPFC

19 B: Verb generation task l l Present noun and ask participant to say what object does or what it is used for. Low selection nouns: few relevant verbs: ‘scissors>cut’, ‘kite>fly’ High selection nouns: ‘string’ has many correct answers: ‘swing’, ‘tie’, ‘hang’ High selection nouns appear easier: many chances of providing a correct answer. – But we must choose between competing responses.

20 C: Patient Groups l 4 groups: – – Left IFG Left frontal (IFG spared) Right frontals Controls Lesion incidence for Left IFG patients

21 D: Results/Conclusions l Results: – – l Left IFG deficit is not in semantic retrieval per se: – l Left IFG impaired when faced with high selection nouns, fine with low selection nouns. BA 44 correlated with deficit. They have no problem retrieving correct answer to low selection nouns. Left IFG required to select between competing semantic information. High Selection Low Selection

22 Verb generation l l l Hillis et al. describe patients who had hypoperfusion of the left posterior inferior frontal and precentral gyri. Impaired writing names of verbs, but fine for nouns. Deficits eliminated with perfusion intervention. before intervention Case 1 Case 2 after intervention Verbal : Written Naming 60 pictures of nouns 50: 58 56: 48 30 pictures of verbs 10: 28 16: 21

23 A: Task switching Perseveration is a common feature of frontal lobe patients: difficulty stopping a task. l What portions of the frontal lobe are responsible for this? l Aron et al. (2003) examined this with a stop-signal task. l

24 B: Design l On each trial, arrow presented. – – l l Left arrow: press left button Right arrow: press right button On a few trials (25%) beep occurs after arrow. This means you should not press a button. The time between arrow and beep varies, allowing us to calculate how much time is required to repress a planned response.

25 C: Patients l 18 patients with right focal frontal lesions – For each patient, the damage in 5 anatomical regions was measured. medial orbital IFG MFG SFG

26 D: Results l l Correlation analysis: relate patient lesion size in each region to deficit. Damage to the right inferior frontal gyrus (IFG) best predictor of deficit. – l In particular, pars triangularis damage BA 45 Poor correlation in other regions.

27 Swainson et al. (in press) How about healthy people? l Swainson et al. (in press, Journal of Cognitive Neuroscience) has shown similar right hemisphere IFG activity in healthy adults during response suppression. l Additional evidence of cortical assymetry. l

28 A: Knight and Grabowecky (1995) l P 30 is initial response found 30 ms after presentation of auditory stimulus l P 30 occurs regardless of whether participant is required to make response.

29 B: Results l l l Parietal patients intact P 30 Temporal patients: reduced P 30 (auditory cortex damaged) Frontal patients show enhanced P 30 (stronger response than in controls) Control Signal Lesion Signal

30 C: Conclusions l Study indicates failure to inhibit irrelevant information. l Suggests early role of frontal cortex in inhibition of redundant sensory information.