As one of our most important organs, the brain oversees vital functions, ranging from our thoughts and emotions to our movements and how we respond to stimuli, among many other tasks.
It is not surprising that when a person suffers a brain injury, the reaction of his physiology depends on the part of the brain affected. Since the brain consists of billions of neurons that participate in different functions of high-level regions and sub-regions, what happens if the prefrontal cortex (PFC) is damaged? What is PFC anyway?
What does the prefrontal cortex do?
The PFC is made up of the front part of the frontal lobe in the cerebral cortex. It is located just behind the eyes and is the part of the brain responsible for executive functions.
Executive functions are high-level control processes or life activities that regulate cognitive and social behavior, personality, and decision-making – the latter being one of the most important executive functions.
The PFC is part of the brain that controls our actions and thoughts and makes sure they align with our values and goals. Unfortunately, to be involved in high-level sophisticated functions, the The PFC is also more likely to experience the brunt of the stressors.
The sub-regions of the prefrontal cortex
The PFC is divided into three subsections: dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). Overall, these sub-regions are involved in several cognitive processes. But because they connect to different parts of the brain, each has its specificities.
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Dorsolateral prefrontal cortex
The DLPFC is the highest area of the PFC that oversees cognitive processes such as planning, problem solving, and attention to the task at hand (working memory). Yet, as it establishes a strong interconnection with the motor and sensory cortices, the DLPFC also controls our thoughts and actions. For example, when activating working memory, this part of the brain connects to the hippocampus to process long-term memories.
The OFC is the area of the brain responsible for decision making, emotional regulation, and social attachments. It is closely related to the limbic system (in charge of processing emotions). Not surprisingly, the decisions processed in the OFC are rooted in emotional data.
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Ventromedial prefrontal cortex
The vmPFC is the most sophisticated sub-region when it comes to responsibilities. It connects to several areas of the brain including the amygdala, thalamus, olfactory system, temporal lobe, and ventral segmental area. Like the orbitofrontal cortex, the vmPFC plays a critical role in emotion-derived decision-making.
The two regions work together to help us regulate our emotional responses, including negative ones. But on the other hand, while making decisions, the vmPFC also considers the bigger picture, which makes its role vital in social situations. Take, for example, our ability to make sound judgments, learn from our mistakes, and show courage or guilt.
What can happen if the prefrontal cortex is damaged?
If the PFC is damaged, you would have your executive functions, including decision making, self-control, judgment and goal-oriented behavior, impaired. Yet there is more to it.
Specialists struggle to identify immediate signs of PFC damage. It is because individuals do not show the usual symptoms of brain damage, such as motor impairment or sensory and perception problems. Nevertheless, people in the patient’s inner circle notice drastic changes over time, especially in personality and emotional responses.
Patients with damaged PFC tend to show irritability, short-term memory loss, lack of empathy, difficulty planning, impulsivity, and inflexibility. Overall, when the PFC is damaged, the individual exhibits problems with complex cognitive skills, including planning, behavior, and emotional expressions.
Risks of damage to the prefrontal cortex
The most famous example is Phineas Gage, a railroad foreman who had much of his PFC destroyed after a terrible explosion of works in 1848. According to reports, his personality and behavior changed noticeably after the accident – for example, from hardworking and well-mannered to dismissive and troublemaker. He also became unable to regulate emotions (or impulses), showing a significant decline in executive functions.
And the signs can be more pronounced if they occur during childhood. Researchers have shown that the damaged layers of the brain (anatomical and functional) interact with the psychosocial environment — depending on age, the child’s personality may still be developing — altering the regulation of neural activities. But that’s not all.
According to a study in the Neuropsychopharmacology log“a disruption or even a slight slowing of the rate of neuronal production, migration and synaptogenesis by genetic or environmental factors, can induce both gross and subtle changes that can eventually lead to cognitive impairment”.
How to strengthen the prefrontal cortex
People with PFC damage have difficulty functioning in unstructured environments. There are exercises or a series of simple activities that you can do to strengthen your cognitive functions and, therefore, the prefrontal cortex. Some of these activities include:
Choose a daily task and write down the steps needed to complete it on separate sheets of paper. Then shuffle those notes and try to arrange the task in the correct order. This activity is excellent for working on planning skills and improving cognitive functions.
By creating a regimen, it’s easier to take the initiative to do tasks or things that you need to do on a daily basis. Also, for people with a damaged PFC, routine prevents them from expending a lot of mental energy on daily activities.
Training is another way to strengthen the prefrontal cortex. A study published in the Behavioral sciences review suggests that exercise intensity influences PFC oxygenation, which contributes to the improvement of cognitive performance. Also, if you like to train frequently, your brain has a slight advantage, because exercise helps boost memory.
Playing memory games – including mnemonics, puzzles, and math memory games – helps improve concentration, problem solving, and memory skills. Thus, as a PFC injury can lead to short-term memory loss, amnesia and impaired executive functions, memory games are valuable ways to support brain cognition and neuroplasticity.
If you like to put your cooking skills to the test, this might be one of the best exercises to strengthen the prefrontal cortex. That’s because you’re engaging all five senses, which use multiple regions of the brain while cooking. Additionally, cooking requires planning and concentration while relying on working memory to complete the task at hand.
It should be noted that the treatment of this area is not an easy task. Most of the time, patients need the help of a behavioral specialist.
Learn more: Could brain damage explain King Henry VIII’s bullying behavior?