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CITE EMAIL PRINT SHARE
MESULAM'S FRONTAL LOBE MYSTERY RE-EXAMINED
Issue title: Cognitive Plasticity and Training
Article type: Research Article
Authors: Burgess, Paul W. | Alderman, Nick | Volle, Emmanuelle | Benoit, Roland
G. | Gilbert, Sam J.
Affiliations: Institute of Cognitive Neuroscience, UCL (University College
London), 17 Queen Square, London WC1N 3AR, UK | Kemsley National Centre for
Neurorehabilitation, St Andrew's Hospital, Northampton NN1 5DG, UK
Note: [] Corresponding author: Prof. Paul. W. Burgess, Institute of Cognitive
Neuroscience, UCL (University College London), 17 Queen Square, London WC1N 3AR,
UK. Tel.: +44 207 679 1177; Fax: +44 207 679 1177; E-mail:
p.burgess@psychol.ucl.ac.uk
Abstract: Purpose: Mesulam's (1986) mystery is that some patients with frontal
lobe damage may show no cognitive impairment according to traditional
office-based assessment procedures, yet nevertheless show marked cognitive
handicap in everyday life. Mesulam suggested that "the office setting may
introduce sufficient external structure to suppress some of these behavioral
tendencies" (p. 322). We ask if it is indeed the office setting that is the
problem, or whether it is that traditional assessments do not measure the full
range of cognitive functions supported by prefrontal cortex. Method:
Neuropsychological case series study and review. Results: Traditional methods
for assessing cognitive deficits following frontal lobe damage typically do not
measure the full range of deficits that can occur. In particular, rostral
prefrontal cortex supports functions which are not routinely assessed yet are
crucial to competent everyday life performance. These include meta-memory
functions (e.g. context and source memory), complex behavioural co-ordination
(e.g. prospective memory and multitasking), and mentalizing. Conclusions: New
clinical assessment procedures are required urgently. These could be based, in
principle, both on recent experimental findings from cognitive neuroscience, and
observation of behaviour outside office settings. These procedures could then be
administered in an office setting.
DOI: 10.3233/RNN-2009-0511
Journal: Restorative Neurology and Neuroscience, vol. 27, no. 5, pp. 493-506,
2009
Received 16 October 2009
|
Accepted 16 October 2009
|
Published: 2009
Price: EUR 27,50
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