Qualitative features of semantic fluency performance in mesial and lateral frontal patients

Semantic verbal fluency is widely used in clinical and experimental studies. This task is highly sensitive to the presence of brain pathology and is frequently impaired after frontal lesions. Besides the total number of words generated, a qualitative analysis of their sequence can add valuable information about the impaired cognitive components. Thirty-four frontal patients and a group of matched controls were examined. Besides the number of words and subcategories retrieved by each group, we analysed two distinct aspects of the word sequence: the search strategy through a semantically organised store and the ability to switch from one subcategory to another. We checked whether the pattern of impairment changed according to the lesion site within the frontal lobe. Overall, patients produced fewer words than controls. However, only lateral frontal patients presented a reduced semantic relatedness between contiguously produced words and a specifically increased proportion of switches to different subcategories. The performance of lateral frontal patients was in line with the hypothesis of a search strategy impairment and cannot be attributed to a switching deficit. The performance of mesial frontal patients could be ascribed to a general deficit of activation.