Frontal syndrome in schizophrenia and frontotemporal dementia: diagnostic and therapeutic implications

The prefrontal cortex in humans plays a pivotal role in higher brain functions such as executive functions, working memory, action planning, decision making and processing of emotional signals. Its dysfunction may lead to significant deterioration of behaviour manifesting with symptoms of "frontal syndrome". Evidence from neuropsychological and neuroimaging studies suggests the involvement of prefrontal cortex disturbance in schizophrenia. Structural and functional abnormalities of the prefrontal cortex are considered as an underlying cause of negative symptoms. Frontotemporal dementia (FTD) is a neurodegenerative disorder which results from frontotemporal lobar degeneration. It manifests with development of neuropsychiatric symptoms. Since diverse conditions may cause alterations in prefrontal cortex functioning, manifestations of these disorders may overlap. These similarities may lead to diagnostic problems particularly in cases with early onset FTD and schizophrenia with predominant negative symptomatology.