Ventromedial prefrontal cortex modulates fatigue after penetrating TBI

Pardini M, Krueger F, Raymont V, Grafman J.  Neurology 2010; 74:749-754.

97 PBI patients and 37 controls from Vietnam Head Injury Study were enrolled.  Fatigue was assessed via questionnaires (Krupp Fatigue Scale).  CT scan localization of lesions was made to nonfrontal, ventromedial prefrontal, and dorsolateral /lateral prefrontal.  All 3 areas were associated with fatigue, but only VM was associated with increasing fatigue with larger lesion volume.  Authors note this may allow linkage of fatigue to other ventromedial functions such as  effort and reward participation. 

Note one of references was a John Deluca functional MRI paper showing role for same area in MS related fatigue J Neurol Sci 2008; 270:28-39.

Cognitive effects of pregabalin in healthy volunteers

a double blind, placebo controlled trial  Salinsky M, Storzbach D, Munoz S.  Neurology 2010; 74: 755-761.

32 healthy volunteers were randomized to pregabalin (300 bid) or placebo for twelve weeks and underwent cognitive tests before and after.  Subjects on pregabalin showed worse performance on 3 of 6 target cognitive measures, including digit symbol test, Stroop, and Controlled Oral Word Association Test.  They were paralleled by changes on the Portland Neurotoxicity Scale.

Parcelling frontal functions

Van Snellenberg JC, Wager TD.  Cognitive and motivational functions of the human prefrontal cortex.   from Christensen AL, Goldberg E, Bougakov D.  Luria's Legacy in the 21st Century. Oxford, University Press, 2009.  pp. 30-61.


Chapter summarized authors' (esp Wager's) meta-analyses of functional imaging studies.  These involve working memory, task switching, response inhibition, and emotion. cites Stuss and Alexander, 2007. See chapter.