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Fluency and rule breaking behaviour in the frontal cortex.

Lisa Cipolotti1, Pascal Molenberghs2, Juan Dominguez3

  • 1Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK.

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|December 24, 2019
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Summary
This summary is machine-generated.

Phonemic fluency tests (FAS) effectively detect left frontal lobe damage, unlike Design Fluency (DF). Neuroimaging confirms FAS

Keywords:
ExecutiveFluid intelligenceFunctionsParcel based lesion symptom mapping tract-wise statistical analysisPhonemic and design fluencyPrefrontal cortexRule break errors

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Area of Science:

  • Neuropsychology
  • Cognitive Neuroscience
  • Neurology

Background:

  • Voluntary generation is commonly assessed using Design Fluency (DF) and phonemic fluency tests (FAS).
  • The neural correlates and lateralization of executive functions assessed by these tests remain incompletely understood.
  • Previous research has not fully clarified the utility of these tests in detecting focal frontal lobe dysfunction.

Purpose of the Study:

  • To investigate the utility of DF and FAS in detecting lateralized frontal executive dysfunction.
  • To identify specific grey and white matter regions associated with performance on these tests using neuroimaging.
  • To examine the relationship between fluid intelligence and voluntary generation performance.

Main Methods:

  • A sizeable sample of patients with focal left or right frontal lesions and healthy controls (HC) were assessed.
  • Neuroimaging techniques including traditional frontal subgrouping, Parcel Based Lesion Symptom Mapping (PLSM), and Tractwise Statistical Analysis (TSA) were employed.
  • Performance on DF and FAS, including rule break errors, was analyzed in relation to lesion location and connectivity.

Main Results:

  • Patients with frontal lesions performed significantly worse than HC on the DF switch condition, but no lateralization was observed.
  • Left frontal patients showed significant impairment on FAS compared to HC and right frontal patients.
  • FAS performance was associated with lesions in the Left Inferior Frontal Gyrus (BA 44/45) and posterior Left Middle Frontal Gyrus.
  • Rule break errors correlated with damage to the left dorsal anterior cingulate and left corpus callosum.
  • Tractwise analysis linked poorer FAS performance to disconnections in specific left-sided white matter tracts.
  • No significant relationship was found between lesion location and DF switch performance using PLSM and TSA.

Conclusions:

  • Design Fluency (DF) may have limited utility in detecting lateralized frontal executive dysfunction.
  • Phonemic fluency tests (FAS) and rule break behavior are sensitive to localized left frontal grey and white matter abnormalities.
  • These findings highlight the distinct neural underpinnings of tasks assessing voluntary generation.