įor the purposes of simplification, five primary syndromes and numerous secondary syndromes may be delineated. For example, the stroke literature is replete with FNS that have been reported with discreet lesions outside the anatomical boundary of the frontal lobe, such as subcortical grey matter, subcortical white matter, with isolated lesions of the brainstem, cerebellum, temporal, and parietal lobes. The term, frontal network syndromes (FNS,) emphasizes the universal connectivity of the frontal lobes with all other brain regions. However, because the frontal lobes network with every other part of the brain, strictly speaking, frontal network syndromes constitute the most accurate neurobiological depiction. Anatomically they refer to those parts of the brain rostral to the central sulcus.

The latter include not only psychopharmacological options but also device-based therapies including mirror visual feedback therapy.Ĭlinically, frontal lobe syndromes, frontal network syndromes, frontal systems syndromes, executive dysfunction, and metacognition have all been used to describe disorders of frontal lobes and their extended networks although they are not all synonymous. New treatment options are also progressively becoming available, with recent evidence of dopaminergic augmentation, for example, being helpful in traumatic brain injury. 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. 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. Hence, the so-called networktopathies may be a better term for the syndromes encountered clinically. 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. 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.

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