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Dorsolateral, orbitofrontal and medial circuits — distinct bedside signatures
Prefrontal circuits mediate planning (dorsolateral), reward/social control (orbitofrontal) and initiation (medial/cingulate). Lesions produce executive failure, disinhibition or apathy respectively. Dr. Jitendra evaluates informant history, FAB/MoCA and MRI volumetry to localize and prognosticate.
Kathmandu Neurology Clinic & Cognitive Center
Authored and reviewed by Dr. Jitendra Prasad Yadav (MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM, NMC 8029). Evidence-based, no fabricated outcomes.
Prefrontal circuits mediate planning (dorsolateral), reward/social control (orbitofrontal) and initiation (medial/cingulate). Lesions produce executive failure, disinhibition or apathy respectively. Dr. Jitendra evaluates informant history, FAB/MoCA and MRI volumetry to localize and prognosticate.
Reviewed by Dr. Jitendra Prasad Yadav, MBBS, MD, FICN, FCNV, FIHM — Consultant Neurologist & Headache Specialist (NMC 8029), Kathmandu Neurology Clinic. For evaluation, book an appointment.
Dorsolateral: perseveration, reduced fluency; orbitofrontal: impulsivity, emotional lability; medial: apathy to akinetic mutism. Mixed syndromes are common in TBI or degeneration — systematic exam separates them.
Guidelines referenced:
doi:10.1017/S1355617711000695doi:10.1212/WNL.55.11.1621Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.