Adaptability is a defining characteristic of the human species. Our ability to solve logical problems, to plan ahead, to focus despite distraction and to adapt when circumstances change far exceeds that of even our closest relatives. These abilities are closely associated with the most developed structure in the human brain: the frontal lobes. When the frontal lobes are damaged, the consequence is can be a debilitating impairment referred to as ‘dysexecutive syndrome’. Dysexecutive syndrome is one of the most commonly documented cognitive impairments across psychiatric and neurological populations. Whilst in many ways, dysexecutive patients may be unimpaired, with normal speech, perception and motor control, they are often unable to lead normal lives, because their behaviour becomes disorganised, disinhibited, maladaptive, and socially inappropriate. The long-term outlook for such patients can be particularly poor as they cannot adapt to their environments or maintain normal relationships. Despite this clinical importance, even the most rudimentary questions regarding how the frontal lobes support executive cognition remain controversial. For example, it is unknown how many specialised circuits exist within the frontal lobes or relatedly what the different forms of executive process are that those circuits support. Consequently, the questions of how dysexecutive patients should most appropriately be categorised and how they may most effectively be treated remain altogether unclear. The overarching aim of the current proposal is to impact on these issues by applying a multidisciplinary research program to: 1) advance our understanding of the neural mechanisms by which the frontal lobes support executive cognition; 2) leverage that understanding in order to provide novel tools to improve patient stratification; and 3) develop novel Internet-based tools that can deliver automated, affordable and accessible supplements to traditional face-to-face therapies.
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