The impact of frontal and non-frontal brain tumor lesions on Wisconsin Card Sorting Test performance

Goldstein, Bram H.; Obrzut, John E.; John, Cameron R.; Ledakis, George E.; Armstrong, Carol L.

doi:10.1016/s0278-2626(03)00269-0

Cited by 69 publications

(37 citation statements)

References 31 publications

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“…In this study, subregions of the left orbitofrontal cortex were associated with poor WCST performance, including PPE, PR and NPE, implying an inefficient use of recent contextual information to optimize set shifting [25], reflecting executive dysfunction in euthymic bipolar patients [26,27,28]. The left side lateralization was also in line with previous research showing that left frontal damage might affect WCST performance more than right frontal damage [29]. In our early work, we found that chronic inflammation with significant elevation of serum hs-CRP levels may exist in acute mania, partial remission and full remission [3].…”

Section: Discussionsupporting

confidence: 88%

The Link between High-Sensitivity C-Reactive Protein and Orbitofrontal Cortex in Euthymic Bipolar Disorder

Chung

Huang

et al. 2013

Neuropsychobiology

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Objective: C-reactive protein (CRP), a marker of underlying low-grade inflammation, has been associated with the pathophysiology of bipolar disorder. Additionally, bipolar disorder may be accompanied by functional or structural cerebral alterations. We attempted to discover whether serum high-sensitivity CRP (hs-CRP) levels are linked to the structural volume change of a specific brain region along with cognitive performance. Methods: We recruited 17 physically healthy patients with bipolar I disorder (DSM-IV), aged 18-45 years and euthymic, to undergo the Wisconsin Card Sorting Test (WCST) and volumetric magnetic resonance imaging at 1.5 T. The analytic method was based on the hidden Markov random field model with an expectation-maximization algorithm, and the volume of each brain region was presented as a percentage of the total intracranial volume. Results: Among the various regions, only the orbitofrontal cortex had a significantly negative correlation with serum hs-CRP levels after adjustment for age and gender (left and right orbitofrontal cortex: r = -0.62, p < 0.01, and r = -0.67, p < 0.005, respectively). Regarding cognitive function, poor WCST performance was also associated with certain subregions of the orbitofrontal cortex. Conclusion: Elevation of serum hs-CRP levels, an indicator of inflammation, may be associated with reduced volume of the orbitofrontal cortex. Persistent inflammation in the euthymic phase of bipolar disorder may involve the pathogenesis or pathophysiology of alteration of the frontal pathway.

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Section: Discussionsupporting

confidence: 88%

The Link between High-Sensitivity C-Reactive Protein and Orbitofrontal Cortex in Euthymic Bipolar Disorder

Chung

Huang

et al. 2013

Neuropsychobiology

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“…Patients 4 and 8 were suffering from additional thalamic lesions, known to impair recognition memory [15,19,40], short-term memory [8] and attention [16,34]. In patient 10, the dorsolateral prefrontal cortical lesion could account for the observed alteration in executive functioning [17,31,37] and short-term memory [24], whereas the temporal lesion might be related to the impaired language comprehension [13]. Likewise, some deficits might be attributable to higher fatigability in LIS patients.…”

Section: Discussionmentioning

confidence: 99%

Cognitive function in the locked-in syndrome

et al. 2008

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Results indicate that LIS patients can recover intact cognitive levels in cases of pure brainstem lesions, and that additional brain injuries are most likely responsible for associated cognitive deficits in the LIS. Furthermore, a systematic neuropsychological assessment in LIS patients would allow detecting their cognitive deficits,which will contribute to improve their quality of life and of communication with family and medical caretakers.

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“…The subject receives no cues about the relevant sensory dimension and its changes and therefore must find this based on the assessment of feedback and maintain it in working memory across trials. Patients with prefrontal cortex (PFC) damage show impaired performance on the WCST and other rule-switching tasks; they tend to apply the previously relevant rule even after it becomes inappropriate (Milner, 1963;Drewe, 1974;Anderson et al, 1991;Stuss et al, 2000;Goldstein et al, 2004). However, cognitive flexibility in rule-switching tasks such as the WCST relies on the interplay of multiple cognitive processes, and impairment in any one of them might lead to a performance deficit.…”

Section: Introductionmentioning

confidence: 99%

“…Neurological and lesion studies suggest an involvement of PFC in rule-switching tasks (Milner, 1963;Drewe, 1974;Anderson et al, 1991;Dias et al, 1996;Stuss et al, 2000;Goldstein et al, 2004). Imaging studies (Berman et al, 1995;Volz et al, 1997;Mentzel et al, 1998;Konishi et al, 1999;Monchi et al, 2001;Wang et al, 2001;Nakahara et al, 2002) have shown activation of different areas of PFC in rule-switching tasks.…”

Section: Introductionmentioning

confidence: 99%

Prefrontal Cell Activities Related to Monkeys' Success and Failure in Adapting to Rule Changes in a Wisconsin Card Sorting Test Analog

2006

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The cognitive flexibility to select appropriate rules in a changing environment is essential for survival and is assumed to depend on the integrity of prefrontal cortex (PFC). To explore the contribution of the dorsolateral PFC to flexible rule-based behavior, we recorded the activity of cells in this region of monkeys performing a Wisconsin Card Sorting Test (WCST) analog. The monkey had to match a sample to one of three test items by either color or shape. Liquid reward and a discrete visual signal (error signal) were given as feedback to correct and incorrect target selections, respectively. The relevant rule and its frequent changes were not cued, and the monkeys could find it only by interpreting the feedback. In one-third of cells, cellular activity was modulated by the relevant rule, both throughout the trial and between trials. The magnitude of the modulation correlated with the number of errors that the monkeys committed after each rule change in the course of reestablishing high performance. Activity of other cells differed between correct and error trials independently from the rule-related modulation. This difference appeared during actual responses and before the monkeys faced the problems. Many PFC cells responded to the error-signal presentation, and, in some of them, the magnitude of response depended on the relevant rule. These results suggest that the dorsolateral PFC contributes to WCST performance by maintaining the relevant rule across trials, assessing behavioral outcomes, and monitoring the processes that could lead to success and failure in individual trials.

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The impact of frontal and non-frontal brain tumor lesions on Wisconsin Card Sorting Test performance

Cited by 69 publications

References 31 publications

The Link between High-Sensitivity C-Reactive Protein and Orbitofrontal Cortex in Euthymic Bipolar Disorder

The Link between High-Sensitivity C-Reactive Protein and Orbitofrontal Cortex in Euthymic Bipolar Disorder

Cognitive function in the locked-in syndrome

Prefrontal Cell Activities Related to Monkeys' Success and Failure in Adapting to Rule Changes in a Wisconsin Card Sorting Test Analog

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