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Yıl:2003; Cilt: 23; Sayı: >> Özet
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Psikoloji Çalışmaları; 2003;23():1-26
Prefrontal Lob Nöropsikolojik Test Bataryası: Sağlıklı Yetişkinlerden Elde Edilen Test Sonuçları
A Ayçiçeği, WM Dinn, CL Harrıs
İstanbul Üniversitesi, İstanbul
Prefrontal lobu hasarlı oîan hastaların, gerek genel bilişsel yeteneklerle ilgili testlerdeki gerekse sözel ve sözel olmayan testlerdeki performansları prefrontal lobımda hasar olmayan deneklerin performansına benzemesine rağmen dikkatli bir nöropsikolojİk incelemenin sonucunda, bu hastalarda az oranda da olsa bilişsel yetersizlikler gözlenmektedir. Frontal lob bozukluğuyla ilgili semptomlar, davranışsal dizınhibisyon, yürütücü fonksiyon bozukluklarını ve apatİyi kapsamaktadır. Orbitafrontal bozuklukta davranışsal dİzinhibisyon, dorsalateral-prefontal bozuklukta yürütücü fonksiyon bozuklukları, mesial/anterior singulate bozuklukta ise apatİ görülmektedir. Araştırmacılar prefrontal lobun tek bir parçadan meydana gelmediği, fonksiyonel olarak birbirinden ayrı olan alt sistemlerden oluştuğu ve alt sistemlerinde diğer kortikal ve alt kortikal sistemlerle oldukça yoğun karşılıklı bir iletişimde olduğu konusunda hem fikirdirler. Çalışmalardan elde edilen verilerin çoğu, dorsalateral prefrontal korteksin (DLPF) yürütücü işlevleri idare ettiğini (Smith ve Jonides, 1999), orbitafrontal korteksin (OFK) ise mükafat ve cezanın dinamik olarak değiştirilmesine karşı duyarlı (Rolls, 1995) olduğunu göstermektedir. Bu çalışmada, OFK veya DLPF bozukluğa duyarlı olan yedi tane nöropsikolojİk testin ve Grace ve Malloy (1992) tarafından geliştirilen Frontal Lob Kişilik Skalasmın (Hasta Versiyonu) sağlıklı yetişkinlere uygulanmasından elde edilen veriler sunulmakta ve bu testler arasındaki ilişkiler üzerinde durulmaktadır. Genel olarak, elde edilen sonuçlar bilinen prefrontal alt sistemlerin işlevleriyle uyumludur. Bu çalışmada sunulan testlerin, frontal lob sendromu olduğu şüphelenilen hastaların incelenmesi sırasında klinisyenlere yararlı olacağı ümit edilmektedir.
Prefrontal Lobe Neuropsychological Test Battery: Performance Patterns Among Healthy Adults
Patients with prefrontal damage perform similarly to controls on measures of general cognitive ability. However, careful neuropsychological examination will reveal subtle cognitive deficits. Symptoms associated with frontal lobe dysfunction include behavioral disinhibition, executive function deficits, and apathy, reflecting orbitafrontal, dorsalateral-prefrontal, and mesial/anterior cingulate dysfunction, respectively. Researchers have come to appreciate that the prefrontal region is not a unitary structure; rather, it is fractionable into anatomically and functioanally distinct subsystems. An extensive body of evidence suggests that dorsalateral prefrontal cortex (DLPF) mediates executives functions, while orbitafrontal cortex (OFC) modulates sensitivity to reinforcement contingencies. In this paper, we present data for seven neurocognitive tasks considered sensitive to orbitafrontal dysfunction and measures of frontal executive function and the Frontal Lobe Personality Scale (Patient version) developed by Grace and Malloy (1992) to Turkish healty adults. In addition, we examined the relationship between performance on the various neuropsychological tests. In general, results formed a meaningful pattern consistent with our understanding of the function prefrontal subsystems. The composite neuropsychological test battery presented in this paper may prove useful to clinicians during screening of patients with suspected frontal syndromes.

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