Superior sorting and categorizing ability in a case of bilateral frontal atrophy: an exception to the rule

This report presents the case of a patient with a naturally occurring, nonsurgical, frontal lesion who exhibited superior performances on the Wisconsin Card Sorting Test (WCST) and Halstead's Category Test (HCT) as an exception to the widely accepted clinical rule that patients with dorsolateral frontal damage are necessarily impaired with respect to maintaining cognitive set, shifting set, and sorting objects on the basis of different categories. The normal performance of this patient with unquestionable orbitofrontal and dorsolateral atrophy probably reflects a limitation of the WCST and HCT rather than true capacity on her part to perform the cognitive operations of set formation, maintenance, and categorization.