Translating Prefrontal Cortex Insights to the Clinic and Society

Excerpt

The prefrontal cortex (PFC) is implicated in a wide range of neuropsychiatric disorders. Many of these become manifest in adolescence (e.g., anxiety, obsessive-compulsive disorders, addiction, attention-deficit hyperactivity disorders) while others arise from selective neurodegeneration of the frontal lobe in later life. A major challenge to research into the disorders associated with the PFC has been the lack of one-to-one mappings between clinical syndromes, their underlying pathophysiology, and root neurobiological causes. Here, we propose a multilevel framework in which syndromes can be linked to symptom profiles, symptoms to cognitive processes, and cognitive processes to pharmacological and computational processes embedded in PFC and its associated networks. This approach explains the frequency of multi-morbidity of neuropsychiatric disorders. The multilevel framework has enabled animal models of underlying biology and psychological processes to inform the understanding and treatment of clinical disorders without necessitating full recapitulation of the complexity of human neurological and psychiatric disorders. Discussion include the causes and treatment potential of the prefrontal cortical circuit disorders, based on convergent evidence across animal and human studies of the mechanisms of action of lesion, stimulation, pharmacological and cognitive behavioral therapies. Challenges are emphasized in the development, validation, and precision-medicine application of such treatments and consideration given to the prefrontal systems and prefrontal disorders in the context of global opportunities for education, health and social policy.