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Neurosonography of the Pre-Term Neonate

The next four chapters report the more obvious, most sensational and/or the most frequently described findings following frontal lobe damage." These include disorders of motor function, attention, awareness, personality and emotion. Aphasia, despite its obvious and classical association with frontal lobe pathology is not discussed at this point, but is reserved for more detailed discussion later in the text. Throughout the book, the authors point out that the frontal lobes cannot be regarded as an autonomous and homogeneous anatomical entity, serving any single, obvious function. Rather, damage to the frontal cortex seems to have an influence on almost all aspects of cognitive behavioural function, forcing us to break down rigid anteriorposterior distinctions of brain organisation. This integrative approach is emphasised in the chapters on sensory-perceptual function, language and speech, memory, cognition and executive functions. The authors argue further that many of the neuropsychological instruments which we have available to us are unsuitable for analysing the true nature of frontal lobe function. They emphasise the need for more controlled, experimental procedures, an approach which would be of benefit to neuropsychology as a whole. The final three chapters attempt to tie up some loose ends. Chapter 15 considers what we can and cannot say about localisation of function in the frontal lobes, while Chapter 16 reviews some of the major theories of frontal lobe function, both historical and contemporary. This latter chapter might have been usefully placed early in the text. The theoretical context within which studies were undertaken is of help in appreciating the diverse literature. Placed at the end, the theory seems little more than an afterthought. More validly, the final chapter is the author's own attempt to integrate the mass of accumulated behavioural and anatomical evidence, ranging in the process, from attention to free will. The attempt is, as the authors recognise, premature and incomplete. It is also, inevitably, disquietingly vague. It is clear that we have become locked into an approach to neuropsychology which demands clearly definable symptoms on which to base our theories. The book illustrates that we have yet to clearly define those symptoms when it comes to the frontal lobes. We also need a new language of neuropsychology to allow us to redefine existing evidence, and derive future theory. This book attempts to gather up a vast and amorphous body of knowledge. Hopefully the exercise will serve to stimulate a new direction for future research.