[The Many Faces of Orbitofrontal Syndrome]

Orbitofrontal syndrome is a neuropsychiatric syndrome composed of cognitive, affective and behavioural symptoms, disrupting some of the traits that define us as a species, like cognitive flexibility and affective regulation. In order to effectively treat the condition, the clinician needs to be familiar with both the functional neuroanatomy and the neuropsychiatric semiology of the syndrome. A review of the literature is presented, emphasising the broad spectrum of clinical manifestations of the syndrome, together with three clinical vignettes showing the many faces of the syndrome. Several factors influencing the heterogeneity of clinical presentation are discussed. Taking a hierarchical model of neural networks, two core concepts, loss of interoceptive/exteroceptive integration and loss of affective regulation, are proposed in looking for invariants in orbitofrontal syndrome.