Impact of Frontal Lobe Surgeries on Personality and Mood: A Comprehensive Review (Atena Editora)

Abstract

INTRODUCTION Frontal lobe surgeries, originating from early 20th-century procedures like prefrontal lobotomies, have evolved significantly, reflecting advancements in medical science and surgical technologies. The frontal lobe, encompassing areas critical for executive functions, motor activities, and emotional regulation, plays a pivotal role in cognitive and social behaviors. Surgeries are indicated for conditions such as brain tumors, epilepsy, and severe psychiatric disorders, with various techniques including lesionectomy, lobectomy, and deep brain stimulation. These interventions, while therapeutic, can lead to significant personality and mood changes due to the disruption of neural circuits within the frontal lobe. OBJETIVE To investigate the impact of frontal lobe surgeries on personality; mood changes; patients' daily lives and quality of life. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Frontal Lobe Surgery” AND “Personality Change” AND “Mood Disorders” AND “Cognitive Functions” AND “Neuroplasticity” in the last years. RESULTS AND DISCUSSION The efficacy of frontal lobe surgeries varies, with different techniques offering specific benefits and risks. Lesionectomy and lobectomy can significantly reduce symptoms in refractory epilepsy and large tumors, respectively, but they also carry a risk of cognitive and emotional changes. Mood changes, including depression and anxiety, are common due to the involvement of the orbitofrontal cortex and anterior cingulate cortex in emotional regulation. Identifying risk factors, such as the extent of resection and patient-specific factors like genetics and pre-existing conditions, is crucial for optimizing outcomes. Rehabilitation, including cognitive and emotional support, plays a critical role in recovery, while patient satisfaction and quality of life are significantly influenced by the degree of these changes. CONCLUSION Frontal lobe surgeries provide significant therapeutic benefits for various neurological and psychiatric conditions but pose risks of cognitive and emotional changes. Advances in surgical techniques and neuroimaging, along with a multidisciplinary approach, are essential for improving outcomes. Personalized treatment plans that consider genetic, demographic, and socioeconomic factors, as well as comprehensive post-operative care, including psychological support and cognitive rehabilitation, are critical for optimizing patient recovery and quality of life. Future research should focus on long-term impacts, ethical considerations, and the development of targeted interventions to mitigate adverse effects and enhance recovery.