[Executive dysfunction in frontal lesions and frontal epilepsy].
BACKGROUND
To explore the functions of the frontal lobe that are associated with high order cognitive and behavioral aspects such as the organization and execution of thoughts and behavior by neuropsychological methods is difficult. These so called executive functions are in close connection with the prefrontal thalamocortical circuits, damage of which can cause deficits in cognitive functions and even changes in personality.


METHODS
The aim of this study is to present a neuropsychological battery for testing frontal lobe functions. 31 patients (with frontal epilepsy and/or frontal lesion) and 38 healthy control subjects participated in the study. The control subjects were matched to the patient group in age, gender and education.


RESULTS
Comparing to the controls the patient group showed significant deficits in most of the measured executive functions, except two tests which show that the short time selective attention is preserved. We divided the patient group into three subgroups (frontal epilepsy only FLE, frontal lesion only FL, frontal lesion and epilepsy FLE+FL) and we found that except working memory deficits and problems in inhibition, there were no difference between the FLE patients and the control group. We found most frequently perseveration and errors in a strategy making task among the FL (mainly medial) patients. We didn't find any difference in these tests according to the lateralization of the lesion.


CONCLUSIONS
In conclusion we found that working memory deficits and problems in inhibition differentiated the frontal patient group from the controls in all cases. We emphasize that in frontal epilepsy (with no reported MR lesion) there are the same type, however more limited neuropsychological alterations as in lesional frontal dysfunction.
Tárnok
Zsanett
Z
Országos Pszichiátriai es Neurológiai Intézet, Budapest. tarnok@vadasnet.hu
Barsi
Péter
P
Gádoros
Júlia
J
Halász
Péter
P
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D017034:Epilepsy, Frontal Lobe / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests