Dissociation between Verbal Response Initiation and Suppression after Prefrontal Lesions

Abstract

Some of the most striking symptoms after prefrontal damage are reduction of behavioral initiation and inability to suppress automatic behaviors. However, the relation between these 2 symptoms and the location of the lesions that cause them are not well understood. This study investigates the cerebral correlates of initiation and suppression abilities assessed by the Hayling Sentence Completion Test, using the human lesion approach. Forty-five patients with focal brain lesions and 110 healthy matched controls were examined. We combined a classical group approach with 2 voxel-based lesion methods. The results show several critical prefrontal regions to Hayling Test performance, associated with either common or differential impairment in "initiation" and "suppression" conditions. A crucial role for medial rostral prefrontal cortex (BA 10) in the initiation condition was shown by both group and lesion-mapping methods. A posterior inferolateral lesion provoked both initiation and suppression slowness, although to different degrees. An orbitoventral region was associated with errors in the suppression condition. These findings are important for clinical practice since they indicate that the brain regions required to perform a widely used and sensitive neuropsychological test but also shed light on the regions crucial for distinct components of adaptative behaviors, in particular, rostral prefrontal cortex.

Right lateral prefrontal cortex—specificity for inhibition or strategy use?

“…The findings of Robinson and colleagues raise the question as to whether the right lateral PFC might be part of an inhibition network requiring the concerted interaction of various brain regions for inhibition/suppression to occur. This notion is supported by previous findings from Volle et al (2012) and from our lab (Hornberger et al, 2011) highlighting the fact that orbitofrontal cortex lesions/atrophy are also strongly related to inhibition/suppression deficits on the Hayling test. These orbitofrontal changes might be related more to the prediction and evaluation of specific behavioural outcomes (Rudebeck and Murray, 2014), with patients unable to resist the prepotent response due to a failure to reevaluate their responses.…”

Fifty Years of Prefrontal Cortex Research: Impact on Assessment

“…Deficits in the three different measures could doubly dissociate from each other but were unlikely to be due to differences in task format or stimuli. Later, Volle et al (2012) showed why this was the case: each of the three types of error was associated with lesions within different parts of PFC (see Figure 4). Figure 3).…”

Modafinil Increases the Latency of Response in the Hayling Sentence Completion Test in Healthy Volunteers: A Randomised Controlled Trial

“…Previous neuropsychological research has consistently shown that patients with neuropsychiatric disorders and those with brain damage perform significantly worse on the HSCT than neurologically healthy individuals [31], [34], as do patients with narcolepsy [35]. The HSCT requires quick and accurate responses and activates brain areas that are dependent on language retrieval, semantic activation and selection in semantic search [36].…”