Neural correlates of script event knowledge: a neuropsychological study following prefrontal injury

Scripts sequentially link information about daily activities and event knowledge. Patients have difficulty sequencing script events following lesions of the prefrontal cortex while showing intact access to selective aspects of script knowledge. It has been suggested that the sequencing impairment is due to a deficit in an inhibitory gating mechanisms that usually enables selection of an item from competing alternatives. If this is the case, then an inhibitory task should reveal script processing impairments on a script categorization task that is not normally associated with poor performance following prefrontal damage. To test this hypothesis, we administered a simple untimed classification task and a modified Go/NoGo task in which subjects classified events from social and non-social activities (e.g., read the menu, order the food) and related semantic items (e.g., menu, order) in terms of whether they belonged to a target activity. Participants were patients with lesions of the prefrontal cortex and matched controls. The results showed that damage to the right orbitofrontal cortex was associated with social item classification errors in the simple untimed classification task. In addition, the damage to the right prefrontal cortex was associated with increased response times to respond correctly to Go trials in the modified Go/NoGo task. The data demonstrate that damage to the right orbitofrontal cortex results in impairment in the accessibility of script and semantic representations of social activities. This impairment is exacerbated by an inefficient inhibitory gating mechanism.