MORE ABOUT DORSOLATERAL PREFRONTAL CORTEX

My take on why manual therapy "works", part 6.

OLDER POSTS IN THIS SERIES

Part 1: IS MANUAL THERAPY EVEN NECESSARY? 

Part 2: NEUROTAGS! YOU'RE IT! 

Part 3: ABOUT "LEARNING" 

Part 4: SKIN STRETCHING AND MOVEMENT ILLUSIONS 

Part 5:  TACTILE DIRECTION DISCRIMINATION IN THE DORSOLATERAL PREFRONTAL CORTEX

NEWER POSTS IN THIS SERIES

Part 7: TREATMENT CONTEXT, NON-SPECIFIC EFFECTS  

Part 8: SOME FINAL THOUGHTS ON NON-SPECIFIC EFFECTS

..................

The next statement in the SomaSimple post is: 

6. If you already have the patient's DLPFC primed with some pain ed, you'll be able to get it to focus on skin stretch/ruffini input. 

What? How can we know that?

.........

We human primate social groomers are so accustomed to thinking bottom up that we may not even know what DLPFC even is. So this post will be a very simple tutorial about that.

What is DLPFC?
It's easy enough to look up in Wikipedia, so let's go do that. (1)

"The dorsolateral prefrontal cortex (DLPFC or DL-PFC) is an area in the prefrontal cortex of the brain of humans and primates. It is one of the most recently evolved parts of the human brain, that undergoes an extremely prolonged period of maturation that lasts until adulthood.^[1] DLPFC is not an anatomical structure, but rather a functional one. This region lays in the middle frontal gyrus of humans (i.e., lateral part of Brodmann's area (BA) 9 and 46 ^[2] and in macaque monkeys, this region is around the principal sulcus (i.e., in Walker's area 46 ^[3]).^[4][5] Other sources consider that DLPFC is attributed anatomically to BA 9 and 46 ^[6] and BA 8, 9 and 10.^[1]
DLPFC is connected to the orbitofrontal cortex, and to a variety of brain areas, which include the thalamus, parts of the basal ganglia (specifically, the dorsal caudate nucleus), the hippocampus, and primary and secondary association areas of neocortex, including posterior temporal, parietal, and occipital areas.^[7] Also, DLPFC is the end point for the dorsal pathway (stream) that tells the brain how to interact with the stimuli. On the other hand, the ventrolateral prefrontal cortex (located more inferior/ventral to DLPFC) is the end point of the ventral pathway (stream) that brings information about the stimuli’s characteristics.^[8]
An important function of the DLPFC is the executive functions, such as working memory, cognitive flexibility, planning, inhibition, and abstract reasoning.^[9] However, DLPFC is not exclusively responsible for the executive functions. All complex mental activity requires the additional cortical and subcortical circuits with which the DLPFC is connected.^[10]The DLPFC is also the highest cortical area that is involved in motor planning, organization and regulation.^[10]"

It's the bit we use for thinking. And socializing I guess. We human primates are usually very proud of this bit, even though we often have issues with whatever other peoples' dorsolateral prefrontal cortex comes up with or have come up with.

For example, using my own DLPFC, I can easily spot holes in other peoples' ideas about manual therapy. It's a lot harder for me to spot my own!

Anyway, this is the bit that Lundblad was viewing in the scanner when he examined his unique subject who had the iatrogenically wounded spinal cord on just one side in just one dorsal column pathway (see Part 5:  TACTILE DIRECTION DISCRIMINATION IN THE DORSOLATERAL PREFRONTAL CORTEX).
This is the bit he figured out had tactile direction discrimination. Yes, this area is not only cognitive-evaluative, it's also sensory-discriminative. With emphasis on discriminative.
(See Melzack's neuromatrix model (2)) 

SOURCE(3)

Here is a very nice picture of it. 

It's the purple area

right where horns would grow 

out of our heads (if we had horns). 

It does so very much much more however. It is so wired into other regions of the brain. Mostly it serves to inhibit. Everything else in there. When it wants to. Which is why we need to recruit it right up front so it can get busy busting up irrational ideation and dismantling unwanted detrimental neurotags for the long haul.

But we can also get it busy sensing what we are doing on the patient's skin surface. How cool is that!?

...................

1. Dorsolateral Prefrontal Cortex Wikipedia

2. Melzack R; Pain and the Neuromatrix in the Brain. Journal of Dental Education 2001,Volume 65, No. 12, 1378-1382 (full pdf)

3. Web Topic 8.7: Brains and Decision Making. Bradbury JW, Vehrencamp SL; Principles of Animal Communication 2nd Ed., online companion to the textbook Principles of Animal Communication, Second Edition by Jack W. Bradbury and Sandra L. Vehrencamp, published by Sinauer Associates.