Cognitive estimation: Performance of patients with focal frontal and posterior lesions

Abstract

The Cognitive Estimation Test (CET) is a widely used test to investigate estimation abilities requiring complex processes such as reasoning, the development and application of appropriate strategies, response plausibility checking as well as general knowledge and numeracy (e.g., Shallice and Evans, 1978; MacPherson et al., 2014). Thus far, it remains unknown whether the CET is both sensitive and specific to frontal lobe dysfunction. Neuroimaging techniques may not represent a useful methodology for answering this question since the complex processes involved are likely to be associated with a large network of brain regions, some of which are not functionally necessary to successfully carry out the CET. Instead, neuropsychological studies may represent a more promising investigation tool for identifying the brain areas necessary for CET performance. We recently developed two new versions of the CET (CET-A and CET-B; MacPherson et al., 2014). We investigated the overall performance and conducted an error analysis on CET-A in patients with focal, unilateral, frontal (n = 38) or posterior (n = 22) lesions and healthy controls (n = 39). We found that frontal patients’ performance was impaired compared to healthy controls on CET. We also found that frontal patients generated significantly poorer estimates than posterior patients on CET-A. This could not be explained by impairments in fluid intelligence. The error analyses suggested that for CET-A, extreme and very extreme responses are impaired following frontal lobe damage. However, only very extreme responses are significantly more impaired following frontal lobe than posterior damage and so represent a measure restricted to frontal “executive” impairment, in addition to overall CET performance.

The right anterior temporal lobe critically contributes to magnitude knowledge

“…While the hypothesized parietal involvement was not found, RLSM further disclosed a frontal lesion correlate, as expected on the basis of previous, relatively coarse lesion studies ( Shallice and Evans, 1978 ; Smith and Milner, 1984 ; Cipolotti et al , 2018 ). More precisely, brain damage to orbital parts of the right inferior frontal gyrus was associated with poor cognitive estimation in this study.…”

“…Many authors have suggested that executive functions such as planning, reasoning or monitoring are involved, and also working memory and semantic memory/knowledge ( Brand et al , 2003 ; Della Sala et al , 2004 ; Levinoff et al , 2006 ; D'Aniello et al , 2015 b ). Others added language comprehension ( Shallice and Evans, 1978 ) and numeracy ( Cipolotti et al , 2018 ) to that list. Emphasizing the role of semantic knowledge, D'Aniello et al (2015 a ) hypothesized that cognitive estimation performance might reflect crystallized intelligence as conceptualized by Cattell (1963) .…”

“…Some evidence comes from lesion studies. It has been shown that patients with frontal brain damage perform significantly worse on cognitive estimation tasks than healthy controls ( Smith and Milner, 1984 ; Della Sala et al , 2004 ; MacPherson et al , 2014 ) or than patients with more posterior lesions ( Shallice and Evans, 1978 ; Smith and Milner, 1984 ; Cipolotti et al , 2018 ), suggesting a dominant role of the frontal lobe in cognitive estimation. As a notable exception, Taylor and O'Carrol (1995) found no difference in estimation performance between frontal and non-frontal lesion groups.…”

“…that it is impaired, and that the impairment results from overestimation. In addition, VLSM was expected to reveal critical lesion sites for estimation impairment in two areas: the relatively coarse lesion evidence ( Shallice and Evans, 1978 ; Smith and Milner, 1984 ; Cipolotti et al , 2018 ) suggests frontal involvement, while prominent cognitive theories about number processing in the brain ( Dehaene et al , 2003 ; Walsh 2003 ; Hubbard et al , 2005 ) point towards the parietal lobe.…”

Mapping functional brain organization: Rethinking lesion symptom mapping and advanced neuroimaging methods in the understanding of human cognition

“…Although lesion symptom mapping has been traditionally used as a method of progressing our understanding of human cognition (human brain mapping) and the neuroanatomy of neurological disorders following brain damage, the lesion-symptom mapping methods have been also used to validate specific neuropsychological tests for the assessment of discrete cognitive functions (e.g., executive function by the Cognitive Estimation Test; see Cipolotti, et al, 2017 in this special issue), in decomposing cognitive mechanisms underlying distinct deficits in performance of specific behavioural tasks (e.g. figure drawing Chechlacz, et al, 2014;trial making test Varjacic, Mantini, Demeyere, & Gillebert, 2018 in this special issue) and to assess the prospects of recovery following brain damage (e.g., recovery of language function following stroke; Crinion, Holland, Copland, Thompson, & Hillis, 2013;Forkel & Catani, 2018 in this special issue).…”