Frontal syndrome as a consequence of lesions in the pedunculopontine tegmental nucleus: A short theoretical review

In this review, it is argued that the consequence of bilateral damage to the pedunculopontine tegmental nucleus (PPTg) in experimental animals is the production of a form of frontal syndrome, Frontal syndrome is a term used to describe the behavioural consequences of damage to the frontal lobes in human patients. These behavioural changes can be classified as disinhibition of behaviour (a release of behavioural control), the production of inappropriate behaviour (which in patients can be either inappropriate actions or verbal behaviour), and the production of perseverative behaviour (the maintenance of an action beyond the point at which it should have been terminated). The psychological changes which underlie these behavioural changes are thought to involve executive functions, which include such things as the prospective planning of sequences of actions, attentional shifting and working memory. In this review, I attempt to demonstrate two things: first, that there are significant anatomical connections from frontostriatal systems to the PPTg, The motor cortex projects directly to the PPTg while the prefrontal cortex contacts it via striatal circuitry, forming dear routes by which the frontal lobes can communicate with the PPTg, Second, having established the existence of connections between frontostriatal systems and the PPTg, behavioural data are described. Experimental animals bearing bilateral lesions of the PPTg have been examined in a wide variety of tasks. Animals bearing such lesions are not impaired in basic processes of feeding, drinking, locomotion, or grooming and simple observation of lesioned rats' normal behaviour reveals no obvious gross impairment in function. However, the results of more subtle tests reveal a wide variety of deficits in various tasks. The outcome of these experiments are in many ways contradictory, but in the vast majority of cases, the changes can be described as involving disinhibition of behaviour, the release of inappropriate behaviour, and the production of perseverative behaviour. Anatomical and behavioural data support the conclusion that there are functional connections between frontal systems and the PPTg, This review also discusses what psychological processes might be served by such connections. (C) 1999 Elsevier Science Inc.