What is the significance of increased activity in the prefrontal cortex (PFC)?

From the Guidelines

Increased activity in the prefrontal cortex (PFC) is crucial for improving executive functions, such as planning and impulse control, which are often impaired in individuals with attention-deficit/hyperactivity disorder (ADHD) 1. The prefrontal cortex plays a significant role in regulating various cognitive and emotional processes, and its dysfunction has been implicated in several psychiatric disorders, including ADHD and bipolar disorder.

Key Findings

• Recent studies have shown that increased activity in the dorsolateral prefrontal cortex (DL-PFC) is associated with improved mood symptoms and reduced suicidal ideation in adolescents with bipolar disorder 1.
• Family-focused treatment (FFT) has been found to alter emotion regulation networks and increase DL-PFC activation, leading to improved symptoms and functioning in adolescents with bipolar disorder 1.
• Increased activity in the PFC can be achieved through various evidence-based approaches, including regular aerobic exercise, mindfulness meditation, cognitive challenges, adequate sleep, stress management, and a balanced diet rich in omega-3 fatty acids.

Clinical Implications

• Regular aerobic exercise and mindfulness meditation should be recommended as adjunctive treatments for individuals with ADHD and bipolar disorder to enhance prefrontal function and improve symptoms 1.
• Cognitive challenges and stress management techniques can also be beneficial in improving prefrontal activity and overall brain health.
• A balanced diet and adequate sleep are essential for maintaining optimal prefrontal function and reducing the risk of psychiatric disorders.
• Family-focused treatment (FFT) may be a useful therapeutic approach for adolescents with bipolar disorder, particularly those with comorbid substance use disorder.

From the Research

Significance of Increased Activity in the Prefrontal Cortex (PFC)

• Increased activity in the PFC is associated with improved cognitive performance, particularly in tasks that require attention, motor planning, and executive functions 2.
• The PFC plays a crucial role in inhibitory control over behavior and cognitive processes, including the ability to intentionally stop the retrieval process of memories 3.
• Stimulation of the PFC, such as through transcranial direct current stimulation (tDCS), can reduce intentions to commit aggressive acts and enhance perceptions of the moral wrongfulness of aggressive acts 4.
• The PFC is also involved in the treatment of attention-deficit/hyperactivity disorder (ADHD), with medications such as methylphenidate (MPH) and atomoxetine (ATM) enhancing PFC function and improving symptoms of inattention and hyperactivity 5, 6.
• The PFC's role in ADHD treatment is thought to involve the indirect stimulation of α2 adrenoceptors and D1 dopamine receptors, which contributes to the therapeutic effects of these medications 6.

Mechanisms Underlying PFC Activity

• The PFC's activity is influenced by various factors, including postural control and cognitive tasks, which can affect each other through common brain areas 2.
• The PFC's functional connectivity with other brain regions, such as the default mode network, is also important for its role in cognition and behavior 5.
• The PFC's anatomical pathways, including those involving the anterior cingulate cortex and the medial temporal lobes, are critical for its inhibitory control over cognition 3.