Traumatic brain injury: relation to executive dysfunction and the frontal lobes

This review examines the applicability of a framework of frontal lobe functioning to understand the sequelae of traumatic brain injury (TBI).

TBI research illustrates the need for improved phenotyping of TBI outcome. The functions of the frontal lobes are divisible into four distinct anatomically discrete categories: executive functions, speed of processing, personality changes, and problems with empathy and social cognition. Research on the outcome after TBI demonstrates several different types of impairment that map onto this framework.

TBI predominantly causes damage to the frontal/temporal regions, regardless of the pathophysiology. Limiting the spotlight to the frontal lobes, a model is presented describing four separate general categories of functions within the frontal lobes, with specific types of processes within each category. A selective review of TBI literature supports the importance of evaluating TBI patients with this framework in mind. In addition, there is growing evidence that rehabilitation of TBI patients must consider this broader approach to direct rehabilitation efforts and improve outcome.