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                                        Role of the Dorsolateral

              Prefrontal Cortex in Schizophrenia

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                                                            The Frontal Cortex

            The classified negative symptoms of schizophrenia are characterized similarly to the cognitive and behavioral aspects of frontal lobe disease including impaired motivation, paucity of thought, and shallow affect. Frontal lobe impairment has consistently been implicated by the characteristic pattern of cognitive impairment in schizophrenics. Clinical observations of schizophrenics and inferences made by researchers surrounding frontal lobe dysfunction have been supported by various lines of research. Studies of frontal lobe lesions (damage) and brain imaging of regional blood flow have been the significant areas of study. The frontal cortex has also been found to be a heterogeneous region in terms of cognitive and behavioral influences. Over twenty years of research has led to a more accurate focus on specific regions of the frontal cortex associated with schizophrenia. Neuroanatomic, neurochemical and neuropharmachological data, along with the characteristic defect symptoms, all point to the dorsolateral aspect of the prefrontal cortex (DLPFC).

                                                                   The DLPFC

            The DLPFC is a very unique part of the frontal cortex specific to almost only humans.  This would lead us to believe apart from other reasons that it is one of the more highly evolved units of the human neocortex. The DLPFC's relation to schizophrenia is supported by the fact that frontal lobe disease or damage by tumors, aneurysms, infarction or psychosurgery, produces symptoms resembling that of schizophrenia

           The role of the DLPFC is considered very complex and important for higher human brain functions like working memory and conscious control of behavior. What is physically known about the DLPFC is extensive in terms of its neural projections to other parts of the brain and the time period in which these projections develop.

            The DLPFC has been found to be the last brain region to complete myelination. It is unknown just how long the DLPFC keeps developing but it has been found to still be active up into the third decade of life. Amazingly these connections have been found to extend and act on almost every lobe in the brain and every type of association cortex.

Sections of the brain with which the DLPFC interacts:

·        Limbic, Diencephalic, and Mesencephalic nucleii (important for regulation of behavior)

·        Direct projections to the locus coeruleus and raphe nuclei of the subcortical brain. It is the only known cortical area to do this and this suggests that it can directly control its own neurotransmitter input.

·        It also receives input from the substantia nigra and ventral tegmental area.

 

                                            Behavioral Manifestations of DLPFC Damage           

            Subtle cognitive and behavioral changes have been found characteristic of negative schizophrenic symptoms among patients who suffered brain injuries specific to the dorsolateral prefrontal cortex. Flat affect, social withdrawal and ineffectiveness, impairment of goal related behaviors, inattentiveness, poor motivation, and poor insight, are just a few of the major cognitive/behavioral traits that appear strikingly similar in both schizophrenic patients and those with DLPCF damage.  Another particular area of cognitive performance affected by DLPCF damage surrounds IQ levels and problem-solving skills that rely on the information processing resource known as working memory.   

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