FRONTAL LOBES--Planning, Organizing, Controlling
Diagram of Brain
The biggest and most advanced part of the brain is the frontal lobe. (It's called the frontal lobe because it's in the front part of brain.) One job of the frontal lobe is planning. You have probably heard of "frontal lobotomies." At the turn of the century, this surgery was done on people who were very violent or who were in a psychiatric hospital because they were very agitated. Doctors used surgery to damage this area of the brain. Following this surgery, people became very passive and less violent. At first, scientists saw this as a great thing. Neurosurgery could stop behavioral problems such as violence. The problem was that the patients stopped doing a lot of other things. They didn't take care of themselves and they stopped many activities of daily living. They basically sat there. In head injury, individuals with frontal lobe impairment seem to lack motivation and have difficulty doing any task that requires multiple steps (e.g., fixing a car or planning a meal). They have problems with planning.
The frontal lobe is also involved in organizing. For a lot of activities, we need to do step A, then step B, then step C. We have to do things in order. That's what the frontal lobes help us do. When the frontal lobe is injured, there is a breakdown in the ability to sequence and organize. A common example is people who cook and leave out a step in the sequence. They forget to add an important ingredient or they don't turn the stove off. I've met a lot of patients who've burned or melted a lot of pans.
Additionally, the frontal lobes also play a very important role in controlling emotions. Deep in the middle of the brain are sections that control emotions. They're very primitive emotions that deal with hunger, aggression, and sexual drive. These areas send messages to other parts of the brain to DO SOMETHING. If you're mad, hit something or someone. If you're hungry, grab something and eat it. The frontal lobes "manage" emotions. In general, the frontal lobe has a NO or STOP function. If your emotions tell you to punch your boss, it's the frontal lobes that say "STOP or you are going to lose your job." People have often said to me "a little thing will set me off and I'm really mad." The frontal lobes failed to stop or turn off the emotional system.
On the other hand, we have talked about how the frontal lobes plan activities. The frontal lobes may fail to plan for some types of emotion. For example, sexual interest involves some level of planning or preparation. Without this planning, there is a lack of sexual interest. A lack of planning can also affect the expression of anger. I've had some family members say "You know, the head injury actually improved him, he's not such a hot-head anymore." If you listen very carefully, you're also going to hear "he's not as motivated anymore." Remember, the frontal lobe plans activities as well as controls emotions.
Diagram of Brain
