The Executive Brain

The executive brain is Goldberg's diagnostic framework for the prefrontal cortex, developed across four decades of clinical neuropsychology. The framework rejects the popular conception of the prefrontal cortex as a specialized thinking region and reframes it as the coordinating system that directs thinking performed by other regions. Memory is stored posteriorly. Language is processed by specialized cortical areas. Pattern recognition operates across distributed networks. What the prefrontal cortex does is decide which of these operations to perform in which sequence at which intensity toward which goal. The executive brain is the orchestra conductor, not any instrument. Damage to the conductor does not silence the orchestra — the instruments continue to play, often with full competence — but the music collapses into coordinated incoherence, because coordination is what has been lost.