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ISRN Neurology
Volume 2013 (2013), Article ID 892459, 34 pages
http://dx.doi.org/10.1155/2013/892459
Review Article

The Human Frontal Lobes and Frontal Network Systems: An Evolutionary, Clinical, and Treatment Perspective

1Director Stroke and Cognitive Neurology Programs, James A. Haley Veterans' Hospital, 13000 Bruce B. Down's Boulevard, Tampa, FL 33612, USA
2Cognitive Neurologist and Director SciBrain, Roskamp Neurosciences Institute, 2040 Whitfield Avenue, Sarasota, FL 34243, USA

Received 30 August 2012; Accepted 19 November 2012

Academic Editors: C.-M. Chen and B. Drukarch

Copyright © 2013 Michael Hoffmann. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Frontal lobe syndromes, better termed as frontal network systems, are relatively unique in that they may manifest from almost any brain region, due to their widespread connectivity. The understandings of the manifold expressions seen clinically are helped by considering evolutionary origins, the contribution of the state-dependent ascending monoaminergic neurotransmitter systems, and cerebral connectivity. Hence, the so-called networktopathies may be a better term for the syndromes encountered clinically. An increasing array of metric tests are becoming available that complement that long standing history of qualitative bedside assessments pioneered by Alexander Luria, for example. An understanding of the vast panoply of frontal systems' syndromes has been pivotal in understanding and diagnosing the most common dementia syndrome under the age of 60, for example, frontotemporal lobe degeneration. New treatment options are also progressively becoming available, with recent evidence of dopaminergic augmentation, for example, being helpful in traumatic brain injury. The latter include not only psychopharmacological options but also device-based therapies including mirror visual feedback therapy.