Based on the functions of different brain regions, which specific area within the frontal lobe is most likely affected, and why do the patient's symptoms point to this conclusion?

Clinical Scenario: Brain Injury

After a small, localized brain injury, a patient finds they can no longer purposefully wiggle their left toes on command. They can still feel when their toes are touched, and they understand the instruction perfectly, but they cannot seem to send the correct signal to initiate the specific, voluntary action. Based on this isolated symptom, which functional area of the brain was most likely damaged? Explain your reasoning.

Clinical Scenario: Movement Deficit

The motor cortex is the part of the frontal lobe which is involved in planning and coordinating movement.

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Located at the front of the brain and extending back to the central sulcus. It receives signals from all senses in order to coordinate them. Also involved in reasoning, motor control, emotion, language, and higher cognitive functions such as thinking, speech and problem solving.
It contains Broca's area, the Prefrontal Cortex, and the Motor Cortex.

Frontal Lobe

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

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Contained in the left hemisphere of the frontal lobe of the brain and specialized in producing speech. People with damage to Broca's area can't speak fluently.

Broca's Area

A part of the frontal lobe that is responsible for higher-level cognitive functioning and focuses on "in the moment" or rash behavior (decision-making, problem solving, and so on). This area is also responsible for the development of personality. The PFC has a handful of (not universally agreed upon) subdivisions:

- Dorsomedial
- Dorsolateral
- Ventromedial
- Ventrolateral
- Orbitofrontal

Prefrontal Cortex (PFC)

The left hemisphere deals with working memory, concentration, executive planning, and positive emotions. 

Left Hemisphere of Frontal Lobe

The right hemisphere of the frontal lobe is involved in several cognitive functions, including episodic memory, social awareness, and the retrieval of information. It also contains the primary motor centers that control voluntary movement on the left side of the body, meaning damage to this area can lead to motor impairment on the contralateral side.

Right Hemisphere of Frontal Lobe

The following areas of brain lobes can be considered when implementing neurofeedback:

- Parietal lobes
- Frontal lobes
- Temporal lobes
- Occipital lobes
- Sensorimotor cortex
- Cingulate gyrus
- Broca's area
- Left hemisphere
- Right hemisphere

Brain Lobe Considerations When Using Neurofeedback

Motor Cortex

Phineas Gage, a 25-year-old railroad foreman in 1848, is one of the most renowned cases in neuroscience. He suffered a severe brain injury when an explosion drove a tamping iron through his face and skull, damaging his frontal lobe. Miraculously, Gage survived the accident, remaining conscious and able to walk and speak immediately after. However, in the following months, he underwent a profound personality transformation. Previously known as a well-mannered man, he began to exhibit strange and inappropriate behavior. This shift in personality is attributed to a loss of impulse control, a key function managed by the frontal lobe.

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