Can Orbitofrontal Cortex Gray Matter Be Repaired
Prefrontal Cortex
Brief Definition
The prefrontal cortex (PFC) is the cerebral cortex covering the forepart part of the frontal lobe. This brain region has been implicated in planning complex cognitive behavior, personality expression, determination making, and moderating social behaviour. The basic activity of this brain region is considered to exist orchestration of thoughts and actions in accord with internal goals. The near typical psychological term for functions carried out by the prefrontal cortex area is executive function. Executive function relates to abilities to differentiate amidst conflicting thoughts, determine good and bad, amend and best, same and different, hereafter consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social "control" (the ability to suppress urges that, if non suppressed, could lead to socially unacceptable outcomes). The frontal cortex supports concrete dominion learning, while more than anterior regions along the rostro-caudal centrality of the frontal cortex support rule learning at college levels of abstraction. (adapted from Wikipedia – meet below for a more complete explanation)
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Clinical Relevance In Cursory:
- Reduced volume and interconnections of the frontal lobes with other brain regions has been observed in people diagnosed with mental disorders; those subjected to repeated stressors; suicides; those incarcerated; criminals; sociopaths; those afflicted by lead poisoning; and daily cannabis users.
- Feeling guilt or remorse, and to interpret reality, may be dependent on a well-functioning prefrontal cortex.
- The size and number of connections in the prefrontal cortex could chronicle directly to sentience, as the prefrontal cortex in humans occupies a far larger percentage of the encephalon than whatsoever other animal.
- The left and correct halves of the prefrontal cortex appear to go more than interconnected in response to consistent aerobic exercise.
- Practicing mindfulness can enhance prefrontal activation, which is correlated with increased well-existence and reduced anxiety.
Frontal Lobe Encephalon Anatomy. Image decade3d/bigstock.com
Frontal lobes
The frontal lobes are probably of most interest to psychotherapy interventions such as CBT because they are domicile to the PFC, an area vitally involved in executive functions such as concentration, system, sentence, reasoning, decision-making, inventiveness, emotional regulation, social–relational abilities, and abstract thinking—in other words, all the functionality nosotros rely on for healthy relationships with ourselves and others. We will look at the PFC separately because of its special importance to psychotherapy; nonetheless, the frontal lobes in general regulate voluntary movement, the retention of not-task-based memories that are often associated with emotions, dopamine-driven attention, reward motivations, and planning, to name just a few.
Prefrontal Cortex
The PFC is the part of the cerebrum that lies directly backside the eyes and the forehead. More than than any other part of the brain, this area dictates our personality, our goals, and our values. When we have a long-term goal, for instance, which we are pursuing with value-congruent action, we maintain a neural representation of that goal so as to not be distracted or influenced by competing goals or alternate values (Grawe, 2007). If the PFC is damaged, information technology affects our personalities and the power to orient our behaviour in line with our values and goals. The PFC is vital to the sense of self and others necessary for healthy interpersonal relationships and decision making.
As in the example of and then many discoveries in neuroscience, we often learn what a brain area tin practise when information technology becomes damaged in some way. Phineas Gage was a young, reflective, determined, and goal-oriented homo who, despite his youth, had been promoted to foreman on an American railroad construction project. But in an unfortunate accident on September 13, 1848, an explosion drove a tamping rod upward through the left side of his confront and out the top of his head. The rod passed through and destroyed much of his left PFC. Amazingly, Gage survived, and was even speaking within minutes of the accident. He was yet witting and talking to a dr. about half an hr later on, having introduced himself proverb, "Md, here is business enough for you." Post-obit his recovery, an early on observation of a change in Gage's personality was noted by Dr. John Harlow:
The equilibrium or residue, so to speak, between his intellectual faculties and beast propensities, seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when information technology conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner bundled than they are abandoned in plow for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the creature passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced heed, and was looked upon by those who knew him as a shrewd, smart business man, very energetic and persistent in executing all his plans of performance. In this regard his listen was radically changed, so incomparably that his friends and acquaintances said he was "no longer Cuff". (Harlow, 1869, pp. xiii-14)
1868 diagram of Phineas Gage's skull and the damaged acquired by the tamping rod – by John M. Harlow
Clearly, some important functions of Gage'due south personality had been altered by his injuries, although he did become more than functional and socially adaptable as the years went on. Given a structured environment in which articulate sequencing of tasks was part of the rehabilitation, Gage managed to retrain his brain to regulate itself in reference to values and goals.
The left and right sides of the PFC have dissimilar biases, with the left side oriented more toward approach, positive goals, and emotions, and the right side specialized more in avoidance and negative emotions. It is as well worth noting that the left side of the PFC hosts more dopamine receptors/action (associated with motivation and reward), while the right has greater norepinephrine activity (associated with anxiety). Individuals who appear to have a bias toward positive emotions may have a more than activated left PFC, whereas right PFC activation is correlated with more negative emotional experiences. Any suggestion of a articulate binary division is an oversimplification, as the experience of positive or negative emotions does not swivel purely on left/right PFC activation, but there is nonetheless testify of a strong correlation.
In studies of the neural correlates of depression, it has been found that left PFC action is underactive relative to right PFC action. It seems that less access to the positive bias of the left PFC may make it more hard for the depressed individual to appoint in positive goal-oriented thought and behaviour. Similarly, the left PFC is more responsive to rewards than the right PFC, which is more responsive to penalty. Studies have found that the depressed individual is by and large more sensitive to what may be perceived as penalty and does non reply as well to rewards. Moreover, the relative underactivation of the whole PFC in depressed individuals could business relationship for them having less motivation for planning, problem solving, creativity, and then forth. In depression, not but is there underactivation of the PFC, but its volume has been found to be reduced equally well. A depressed person with an underactive PFC of reduced book is not going to demonstrate the rational problem solving abilities of someone without such deficits—the neural integrity to back up such resilience is simply non there. This is where the active, approach-oriented and positively biased PFC of a therapist tin can be of great value to the depressed customer. Nosotros will talk over the supportive right brain-to-correct brain activity of therapy further when nosotros address specific psychopathologies.
The PFC has been divided into a number of functionally distinct regions, described below.
Dorsolateral prefrontal cortex (DLPFC). The DLPFC is the topmost part of the PFC and is considered to take overall direction of cognitive processes such as planning, cognitive flexibility, and working retentiveness. This is an area specialising in problem solving and how to direct and maintain attention to a task. When nosotros are focused on what is happening at present, our working memory is engaged with the DLPFC and connecting with the hippocampus for the retrieval and consolidation of long-term explicit memories. A dysfunction in this expanse may lead to bug with working memory, processing in the hippocampus, and long-term memory, likewise every bit the integration of verbal expression with emotions. Such memory deficits accept been associated with PTSD due to an underactive left DLPFC. Other DLPFC deficits can manifest as a lack of spontaneity and affect (flat rather than negative), and attention deficit—due to an inability to maintain sufficient attending to see a job through to completion. In obsessive–compulsive disorder (which we volition consider separately in a later section the DLPFC plays an important role in strengthening attentional skills to momentarily break the compulsion circuit and give the orbitofrontal cortex a risk to inhibit the delinquent activation of the amygdala. As with many encephalon regions, there are significant hemispherical differences within the dorsolateral prefrontal cortex, the left DLPFC existence associated with approach behaviours and the right with more than avoidant behaviours.
Orbitofrontal cortex (OFC). The OFC, like the DLPFC, is involved in the cognitive processing of decision making; however, because of its close connection with the limbic system, it is particularly associated with our ability to brand decisions based on emotional information. The OFC besides plays a major role in forming social attachments and regulating emotions. This region can be thought of as a convergence zone for sensory and emotional information, effectively integrating external and internal worlds. Social information is processed and used to guide us in our perceptions and interactions, and the OFC plays an important part in the estimation of these complex social interactions, including, for example, the ability to empathize a joke. The OFC may help us predict the reactions of others and modulate our behaviour accordingly. When in that location is a dysfunction in the orbitofrontal cortex, the normal cortical–subcortical modulation is not optimal—as is probable the example in borderline personality disorder (Schore, 2022). Every bit with other areas of the PFC, the OFC has hemispherical differences. The left OFC is associated with positive emotions, while the right OFC is associated with more than negative emotions.
Ventromedial prefrontal cortex (vmPFC). This office of the PFC helps united states make decisions based on the bigger pic gathered from connections to the amygdala, temporal lobe, ventral segmental surface area, olfactory system, and the thalamus. It is very well connected, receiving and sending a lot of information that influences many brain regions, including the amygdala. The vmPFC plays an important role with the OFC in regulating our emotions, particularly in social situations. It is also vital for personal and social decision making and the ability to acquire from our mistakes. Our capacity to brand judgements and let our emotions to assist in decision making is mediated by this region of the brain. Activation of the vmPFC is as well associated with backbone, suppression of negative emotions, compassion, shame, and guilt.
https://www.thescienceofpsychotherapy.com/glossary/orbitofrontal-prefrontal-cortex-ofc/
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