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[Memory impairment due to circumscribed infarct at the left dorsolateral prefrontal lobe]

Motoaki Yoshida1, Hirohisa Kuroda

  • 1Department of Neurology, Health Science University, Minamitsuru-gun, Yamanashi 401 0380, Japan.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|April 12, 2008
PubMed

Insights

A rare case of brain embolism in the left dorsolateral prefrontal lobe caused episodic memory and working memory impairment. This study highlights the impact of specific brain lesions on cognitive functions.

Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurology

Background:

  • The dorsolateral prefrontal cortex plays a crucial role in executive functions and memory.
  • Embolic events can lead to focal brain lesions with diverse neurological deficits.

Observation:

  • A 65-year-old male with diabetes mellitus and atrial fibrillation presented with episodic memory impairment.
  • Neuropsychological testing revealed significant verbal memory deficits and normal working memory on objective tests, despite subjective complaints.
  • Brain imaging identified an embolism in the left dorsolateral prefrontal region, affecting the inferior and middle frontal gyri.

Findings:

  • The patient exhibited marked impairment in episodic verbal memory and subjective working memory deficits.
  • Objective working memory tests (WMS-R attention/concentration, Trail Making Test A & B) were within normal limits.
  • Executive function testing showed a mild disturbance in set-exchange on the Wisconsin Card Sorting Test-Keio version.

Implications:

  • This case suggests that lesions in the left dorsolateral prefrontal lobe can selectively impair episodic verbal memory and subjective working memory.
  • The discrepancy between objective and subjective working memory highlights the complexity of assessing cognitive function in clinical settings.
  • Rarely reported prefrontal lobe lesions causing such specific memory deficits underscore the need for detailed neuropsychological evaluation in stroke patients.

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