Article

Planning impairments in frontal lobe dementia and frontal lobe lesion patients

February 2000
Neuropsychologia 38(5):655-665

Authors:

University of Maryland, Baltimore

Patients with frontal lobe brain damage are reportedly impaired on tasks that require plan development and execution. In this study, we examined the performance of 15 patients diagnosed with frontal lobe dementia and 14 patients with focal frontal lobe lesions on the Tower of London planning task. Patients with frontal lobe dementia committed a significantly higher number of rule violations, made more moves, and demonstrated longer solution time latencies compared to their matched controls. Patients with frontal lobe lesions demonstrated significantly delayed solution times and also made more moves compared to their matched controls. Frontal lobe lesion patient performance suggests an impairment in execution-related processes, while frontal lobe dementia patients appear to be impaired in both plan development and execution. Despite these findings, the identification of a specific cognitive impairment that induces these planning problems remains elusive.

A Frontal Neuropsychological Profile in Fitness to Drive

Article

Sep 2020
ACCIDENT ANAL PREV

Traffic accidents are a global concern due to the elevated mortality rates of both drivers and pedestrians. The World Health Organization declared 2011-2020 as the Decade of Action for Road Safety, endorsing initiatives to reduce traffic-related deaths. Yet, despite these incentives, fatal accidents still occur. Different studies have linked deficits in executive functions to risky driving attitudes and crashes. The present study focuses on demographic, cognitive and personality factors, related to the prefrontal cortex, that are characteristic of drivers prone to risky behavior behind the wheel. The penalty Points System was used to classify drivers as "safe", with no point loss over a two-year period, or "risky", with full point loss during the same interval. A neuropsychological assessment of prefrontal cognitive functions was carried out on each group to identify variables associated with safe and risky behavior. Neuropsychological indexes were obtained from a continuous performance task without cue (Simple Attention), a continuous performance task with cue (Conditioned Attention), the Tower of Hanoi test and the Neurologically-related Changes in Personality Inventory (NECHAPI). A Discriminant Analysis (DA) found that education level, reaction times in Simple and Conditioned Attention, learning errors in the Tower of Hanoi and vulnerability in the personality test, best predicted whether drivers were likely to be in the safe or risky group. Finally, a cross-validation analysis performed on the same sample correctly classified 87.5% of the drivers. These data suggest that prefrontal dysfunction contributes to risky behavior behind the wheel. The inclusion of cognitive programs to identify and train drivers with this propensity could reduce risky driving, and consequently, save lives on the road.

A Meta-analysis on the neural basis of planning: Activation likelihood estimation of functional brain imaging results in the Tower of London task

Article

Sep 2016
HUM BRAIN MAPP

The ability to mentally design and evaluate series of future actions has often been studied in terms of planning abilities, commonly using well-structured laboratory tasks like the Tower of London (ToL). Despite a wealth of studies, findings on the specific localization of planning processes within prefrontal cortex (PFC) and on the hemispheric lateralization are equivocal. Here, we address this issue by integrating evidence from two different sources of data: First, we provide a systematic overview of the existing lesion data on planning in the ToL (10 studies, 211 patients) which does not indicate any evidence for a general lateralization of planning processes in (pre)frontal cortex. Second, we report a quantitative meta-analysis with activation likelihood estimation based on 31 functional neuroimaging datasets on the ToL. Separate meta-analyses of the activation patterns reported for Overall Planning (537 participants) and for Planning Complexity (182 participants) congruently show bilateral contributions of mid-dorsolateral PFC, frontal eye fields, supplementary motor area, precuneus, caudate, anterior insula, and inferior parietal cortex in addition to a left-lateralized involvement of rostrolateral PFC. In contrast to previous attributions of planning-related brain activity to the entire dorsolateral prefrontal cortex (dlPFC) and either its left or right homolog derived from single studies on the ToL, the present meta-analyses stress the pivotal role specifically of the mid-dorsolateral part of PFC (mid-dlPFC), presumably corresponding to Brodmann Areas 46 and 9/46, and strongly argue for a bilateral rather than lateralized involvement of the dlPFC in planning in the ToL. Hum Brain Mapp, 2016. © 2016 Wiley Periodicals, Inc.

Analyses of Rule Breaks and Errors During Planning in Computerized Tower Tasks: Insights From Neurological Patients

Article

Sep 2016
ARCH CLIN NEUROPSYCH

Objective: Planning as a prototypical executive function is frequently compromised in clinical samples. Analyses of rule breaking during performance on tower tasks are highly informative for clinical inferences on planning deficits, but are as yet only available for manual task versions. Therefore, the present study investigated whether valid rule-break information can also be gained using a computerized Tower of London (TOL) version. Method: For patients with stroke (N = 60), Parkinson's disease (PD; N = 51), and Mild Cognitive Impairment (MCI; N = 29), rule breaks (e.g., selecting a blocked ball) and online-planning errors (re-considering the next move) on the TOL-Freiburg (TOL-F) were compared to that of matched healthy controls, and diagnostic accuracy for these measures was assessed. Results: Stroke and PD patients committed significantly more rule breaks and online-planning errors than matched controls, with this group difference being significantly greater for rule breaks. For MCI patients, only a trend for elevated numbers of rule breaks emerged. In all patients, rule breaks and errors increased as a function of problem complexity. Diagnostic accuracy was the highest for PD and lowest for MCI patients, with both rule breaks and errors demonstrating moderate sensitivity but higher specificity across all samples. Discussion: Direct attempts to break the TOL-F's task rules are particularly informative of clinical impairments in planning ability. Similar to findings from studies employing manual versions, using a computerized tower task revealed consistent rule break and error patterns across patients. Thus, computerized tower tasks can yield useful clinical information on rule-breaking behavior during planning in clinical populations.

Planeación mental y memoria de trabajo durante la resolución de la Torre de Londres

Chapter

Aug 2015

La planeación es una de las funciones ejecutivas de mayor jerarquía (Carder, Handley & Perfect, 2008) ya que permite la solución de problemas en situaciones no rutinarias y complejas. En neuropsicología uno de los instrumentos más usados para evaluar la planeación es la Torre de Londres (TOL) (Shallice, 1982) y en varias investigaciones se ha detectado la implicación de la memoria de trabajo en la solución de dicha prueba. El objetivo del presente estudio fue investigar la relación entre la planeación y la memoria de trabajo para la cual se plantearon dos modificaciones de la TOL. La primera fue en las instrucciones de aplicación, para evaluar el efecto de la planeación previa, y la segunda fue en el número de movimientos mínimos necesarios para igualar el patrón con la finalidad de incidir en las cargas de la memoria de trabajo. También se estudió la presencia de relaciones entre los indicadores de planeación de la TOL y la ejecución de una tarea de memoria de trabajo: la n-back en la modalidad verbal y en la visual. Los resultados mostraron que las condiciones de aplicación en las que se hace explícita la elaboración de un plan acción resultan más beneficiosas que la condición de inicio inmediato, sin embargo no hay diferencia significativa con la condición de aplicación clásica. En la segunda modificación no se presentó una disminución gradual en la precisión de la ejecución de la TOL, más bien se encontró una disminución a partir de los ensayos de cinco movimientos mínimos. Finalmente, se encontró una correlación positiva entre la ejecución de la tarea de carga mediana de la memoria de trabajo verbal y el número de soluciones perfectas de la TOL, y una correlación negativa entre la ejecución de la tarea de carga baja de la memoria de trabajo verbal con el número de movimientos excedentes. Lo anterior sugiere que la memoria de trabajo verbal se encuentra vinculada a los procesos de planeación de la TOL.

Investigaciones en neuropsicología y psicología educativa

Book

Aug 2015

Bernarda Téllez-Alanís

Contenido Introducción Ma. de la Cruz Bernarda Téllez Alanís................................................................... 9 Procesamiento semántico de conceptos concretos y abstractos. Estudio de spect cerebral con activación Víctor Manuel Patiño Torrealva, Josefina Ricardo Garcell y Juan Carlos García Reyna....................................................................................13 Planeación mental y memoria de trabajo durante la resolución de la Torre de Londres Amador Ocampo Flores y Ma. de la Cruz Bernarda Téllez Alanís....................41 Secuelas neuropsicológicas de la encefalopatía hipóxico-isquémica perinatal en niños de edad escolar Karen Assat Guerrero Moctezuma y Víctor Manuel Patiño Torrealva...............71 Evaluación neuropsicológica ecológica en pacientes con enfermedad de Alzheimer. Análisis del desempeño de las actividades de la vida diaria Adela Hernández Galván.................................................................................... 103 Psicoterapia breve en neuropsicología Guillermo Delahanty Matuk................................................................................ 129 El enfoque por competencias y los aprendizajes esperados, ¿cambiarán los malos indicadores de desempeño en español? Aldo Bazán Ramírez, Nayeli I. Vega Alcántara y Denisse E. Barrera Vázquez.............................................................................. 157 Importancia del desarrollo de la creatividad en la escuela Gabriela López Aymes, Santiago Roger Acuña y Xóchitl Yadira González Ramírez................................................................... 177 Característica socioafectivas de los adolescentes con aptitudes sobresalientes: ¿una necesaria disincronía entre lo cognitivo y lo afectivo? Doris Castellanos Simons y Xochitl Hernández Perdomo.............................. 205 Direcciones futuras Ma. de la Cruz Bernarda Téllez Alanís.............................................................. 239

Executive functions assessment in post-traumatic brain injury adults

Article

Full-text available

Sep 2024
Estud Psicolog

Objective Executive dysfunction after traumatic brain injury may lead to reduced daily functionality due to direct damage to the frontal lobe or to disruption of its connections to other brain regions. This study aimed to compare the performance of adults with and without traumatic brain injury on executive functions tasks. Method The present study had a descriptive transversal design and included 43 participants divided into a clinical group (N = 23, age M = 34.3 [10.86]) and a control group (N = 20, age M = 38.3 [10.7]). The battery consisted of traditional instruments and the Ecological Hotel Task. Results A significant difference was found in the performance of the groups in the planning measures (number of tasks [t = -3.06; p < 0.01] and planning score [t = -3.06; p < 0.01]), highlighting the advantages of using both the traditional performance paradigms and the ecological tasks in neuropsychological assessment of executive functions. Conclusion Results suggested that the ecological task might discriminate better executive dysfunction, emphasizing the importance of using activities that simulate real-life situations of the participants.

PsycAssist: A Web-Based Artificial Intelligence System Designed for Adaptive Neuropsychological Assessment and Training

Article

Full-text available

Jan 2024
BSRCCS

Assessing executive functions in individuals with disorders or clinical conditions can be challenging, as they may lack the abilities needed for conventional test formats. The use of more personalized test versions, such as adaptive assessments, might be helpful in evaluating individuals with specific needs. This paper introduces PsycAssist, a web-based artificial intelligence system designed for neuropsychological adaptive assessment and training. PsycAssist is a highly flexible and scalable system based on procedural knowledge space theory and may be used potentially with many types of tests. We present the architecture and adaptive assessment engine of PsycAssist and the two currently available tests: Adap-ToL, an adaptive version of the Tower of London-like test to assess planning skills, and MatiKS, a Raven-like test to evaluate fluid intelligence. Finally, we describe the results of an investigation of the usability of Adap-ToL and MatiKS: the evaluators perceived these tools as appropriate and well-suited for their intended purposes, and the test-takers perceived the assessment as a positive experience. To sum up, PsycAssist represents an innovative and promising tool to tailor evaluation and training to the specific characteristics of the individual, useful for clinical practice.

Real-life problem solving and executive function in relation to the frontal lobes

Thesis

Jan 2002

Sarah Crawford

Clinical accounts of the behaviour of people with frontal lobe lesions suggest that they often show marked difficulties in aspects of problem-solving and decision-making in their daily lives. Despite these real-life problems, studies have shown that some of these patients perform well on laboratory tests of executive function. This has led to a drive to create laboratory measures with greater ecological validity than those commonly used in neuropsychological assessment and rehabilitation, which differ from real-life problem situations in a number of ways, including the amount of structure and feedback provided by the test. In addition, real-life problems are likely to draw more heavily than abstract executive measures on factors such as interpersonal comprehension and judgement, and previous experience. This thesis describes a series of experimental studies designed to address these issues. The aim was to examine real-life problem-solving in participants with frontal lobe involvement, and the measures in each study were intended to have greater ecological validity than most standardised measures. The first study showed that participants with anterior lesions were impaired in a range of aspects of real-life problem-solving, and it was postulated that a range of important factors contributed to their deficits, including executive impairment, poor selection of courses of action, deficits in understanding interpersonal processes, and an inability to apply their previous experience to the task. The subsequent studies examined these factors further, both by manipulating the problem-solving measures, and by studying groups of participants with different types of frontal lobe involvement, who also differed in their life experience. Overall, it was concluded that these factors were all relevant to aspects of real-life problem-solving performance. The results are considered in the light of current models of frontal lobe functioning, and the implications of the findings are discussed.

Contribución del cerebelo a los procesos cognitivos: avances actuales

Article

Full-text available

Jan 2011
REV NEUROLOGIA

rEVISIÓN Introducción Tradicionalmente, se ha considerado al cerebelo como un sistema neuronal que participaba esencialmente en la coordinación y el control motor. Sin embargo , en las últimas décadas ha cobrado fuerza el con-cepto del cerebelo como un órgano relacionado con procesos cognitivos de alto nivel [1-5]. Esta nueva concepción del cerebelo viene apoya-da por estudios realizados en animales y humanos con lesiones cerebelosas, así como por la contribu-ción de las modernas técnicas de neuroimagen. Se sabe que el cerebelo posee una extensa red de conexiones eferentes y aferentes tanto corticales como subcorticales. Filogenéticamente, se cree que el cerebelo inicialmente participaba en actividades relacionadas con la coordinación del movimiento y el tono muscular para conservar el equilibrio, y que, a lo largo de la evolución, ha ido contribuyendo a procesos cognitivos cada vez más complejos: fun-ciones ejecutivas, aprendizaje, memoria procedimen-tal y declarativa, procesamiento del lenguaje y fun-ciones visuoespaciales y afectivas [2,6,7]. Datos anatómicos El hecho de que el cerebelo represente más de la mitad de la cantidad total de neuronas del cerebro, las amplias conexiones bidireccionales con distin-tas áreas del cerebro, junto con la evolución filoge-nética de ciertos núcleos cerebelosos (principal-mente, el aumento del tamaño del núcleo dentado), hacen pensar en un papel más importante que el de mero coordinador del movimiento. El cerebelo presenta ricas conexiones bidireccio-nales con los hemisferios cerebrales (tanto cortica-les como subcorticales), que no sólo se dirigen ha-cia las áreas responsables del funcionamiento motor , sino también hacia otras que se relacionan am-pliamente con la cognición y la emoción. El cerebe-lo recibe aferencias corticopontocerebelosas del córtex sensoriomotor, de la corteza prefrontal dor-solateral y dorsomedial, de las regiones frontales encargadas del lenguaje expresivo, de distintas re-giones parietales, del colículo superior y del córtex temporal superior. Envía eferencias a través del tá-lamo a áreas similares. La mayoría de las conexio-Introducción. Tradicionalmente, se ha considerado al cerebelo como un sistema neuronal que participaba esencialmente en la coordinación y el control motor. Sin embargo, en las últimas décadas ha cobrado fuerza el concepto del cerebelo como un órgano relacionado con procesos cognitivos de alto nivel, afirmación que viene apoyada por estudios realizados en animales y humanos con lesiones cerebelosas, así como por la contribución de las modernas técnicas de neuroimagen. Desarrollo. Se revisa la contribución del cerebelo en diferentes funciones cognitivas, como la regulación de las funciones motoras, la atención, el lenguaje, las habilidades visuoconstructivas, el aprendizaje, la memoria y las funciones ejecuti-vas. Los resultados de dicha revisión arrojan como dato más clarificador la influencia del cerebelo en procesos como la atención, la memoria de trabajo (articulación encubierta) y la fluidez verbal, así como el aprendizaje procedimental. Los resultados encontrados en lo que respecta al cerebelo y las funciones ejecutivas no son concluyentes. Conclusiones. Consideramos que es necesario aún sistematizar el cuadro que ha comenzado ya a delinearse. Esto nos lle-vará a poder responder a la cuestión no sólo de si el cerebelo desempeña algún papel en la cognición humana, sino de cuál es ese papel. Tal vez la base para comprender las funciones cognitivas del cerebelo no se encuentre en que el cerebe-lo contiene funciones, sino que pone en relación la intención con la acción tanto en el plano cognitivo, emocional como conductual, aunque este papel de 'interfaz' se encuentra más próximo a los procesos de output que de procesamiento, y parece claro que se halla más afectado en funciones con un importante componente motor. Palabras clave. Atención. Cerebelo. Funciones ejecutivas. Habilidades visuoconstructivas. Lenguaje. Memoria de trabajo. Síndrome cognitivo-afectivo.

The Tower of London (ToL) in Italy: standardization of the ToL test in an Italian population

Article

Apr 2017

Deficit in planning and problem-solving, affecting a wide range of neuropsychological patients, has been widely investigated using the Tower of London (ToL) test, as developed by Shallice (Philos Trans R Soc Lond Ser B Biol Sci 298:199–209, 1). The ToL taps on several executive functions (EF), such as planning, time for planning or rule breaks, which may be usefully indexed by different ToL measurements. However, in its original version, the different aspects involved in ToL are not evaluated in a specific way. Here, we report the standardization of the ToL, on 896 individuals aged 15–86 years, taking in account individual factors (i.e. gender, age, years of education) which may affect performances on ToL. We computed several indexes on the ToL including score, planning and execution times, perseverations, rule breaks and self-monitoring. We found that these indexes were affected by individual factors such as gender, age and education. Present results not only provide extensive normative data according to gender, as well as different age and education ranges, but also represent a very useful instrument for a more fine-grained diagnosis of EF deficits in a wide range of neuropsychological patients, including traumatic brain injury and brain-damaged patients, as well as Alzheimer’s disease and Parkinson’s disease patients.

A study of the influence of chess on the Executive Functions in school-aged children / Estudio del impacto del ajedrez sobre las Funciones Ejecutivas en niños de edad escolar

Article

Mar 2017

This study researched the influence of learning and practising chess on two executive functions (planning and flexibility) in childhood. The performance of a group of child chess players was compared to a group of children who did not play chess through a planning test (Tower of London) and a cognitive flexibility test (Wisconsin Card Sorting Test). The results showed a better performance in planning by the group of child chess players and suggested certain differences in flexibility (in favour of the group of chess players). This study adds evidence to the hypothesis that highly complex games like chess can favour the development of executive functions in childhood.

Cognitive planning in the context of neuropsychological assessment and research in cognitive neuroscience: a systematic review

Article

Full-text available

Dec 2022

Planning is defined as the ability to develop a sequenced plan of behavioral steps to achieve a goal and is part of a set of high-order cognitive functions called executive functions. This function is affected in various daily life situations and in a variety of neuropsychiatric disorders (e.g., depression, anxiety, attention deficit disorder, schizophrenia, etc.). Both the design of cognitive tests to assess planning in the clinical context, as well as the design of experimental paradigms for evaluating planning in research context, continues to be a challenge for clinical neuropsychology and neurosciences. In this PRISMA systematic review article, we review theory and research regarding clinical assessment and research into the neurobiological bases of planning and contributions to understanding the mechanisms of its implementation. Common methodological measures are reported and the theoretical approaches that contribute to their understanding are summarized. Our findings show the involvement of the prefrontal cortex in planning performance, particularly the dorsolateral area, the anterior cingulate cortex, and the frontopolar cortex. Further clinical, instrumental, and experimental studies are needed to better understand planning in the context of an integrative theory of executive functions and the role of the prefrontal cortex.

Allometry in the corpus callosum in neonates: Sexual dimorphism

Article

Full-text available

Jun 2022
HUM BRAIN MAPP

The corpus callosum (CC) is the largest fiber tract in the human brain, allowing interhemispheric communication by connecting homologous areas of the two cerebral hemispheres. In adults, CC size shows a robust allometric relationship with brain size, with larger brains having larger callosa, but smaller brains having larger callosa relative to brain size. Such an allometric relationship has been shown in both males and females, with no significant difference between the sexes. But there is some evidence that there are alterations in these allometric relationships during development. However, it is currently not known whether there is sexual dimorphism in these allometric relationships from birth, or if it only develops later. We study this in neonate data. Our results indicate that there are already sex differences in these allometric relationships in neonates: male neonates show the adult-like allometric relationship between CC size and brain size; however female neonates show a significantly more positive allometry between CC size and brain size than either male neonates or female adults. The underlying cause of this sexual dimorphism is unclear; but the existence of this sexual dimorphism in neonates suggests that sex-differences in lateralization have prenatal origins.

“Cognitive Reserve and Regional Brain Volume in Amyotrophic Lateral Sclerosis”

Article

Full-text available

Mar 2021
CORTEX

Objective We investigated whether cognitive reserve measured by education and premorbid IQ allow amyotrophic lateral sclerosis patients to compensate for regional brain volume loss. Methods This was a cross-sectional study. We recruited sixty patients with amyotrophic lateral sclerosis from two specialist out-patient clinics. All participants underwent neuropsychological assessment; the outcomes were standardized z-scores reflecting verbal fluency, executive functions (shifting, planning, working memory), verbal memory and visuo-constructive ability. The predictor was regional brain volume. The moderating proxies of cognitive reserve were premorbid IQ (estimated by vocabulary) and educational years. We hypothesized that higher cognitive reserve would correlate with better performance on a cognitive test battery, and tested this hypothesis with Bayesian analysis of covariance. Results The analyses provided moderate to very strong evidence in favor of our hypothesis with regard to verbal fluency functions, working memory, verbal learning and recognition, and visuo-constructive ability (all BF01>3): higher cognitive reserve was associated with a mild increase in performance. For shifting and planning ability, the evidence was anecdotal. Conclusions: These results indicate that cognitive reserve moderates the effect of brain morphology on cognition in ALS. Patients draw small but meaningful benefits from higher reserve, preserving fluency, memory and visuo-constructive functions. Executive functions presented a dissociation: verbally assessed functions benefitted from cognitive reserve, non-verbally assessed functions did not. This motivates future research into cognitive reserve in ALS and practical implications, such as strengthening reserve to delay decline.

The effect of physical activity on cognition relative to APOE genotype (PAAD-2): study protocol for a phase II randomized control trial

Article

Full-text available

Jun 2020
BMC NEUROL

Background: By 2050, the prevalence of Alzheimer's disease (AD) in the United States is predicted to reach 13.8 million. Despite worldwide research efforts, a cure for AD has not been identified. Thus, it is critical to identify preventive strategies that can reduce the risk of or delay the onset of AD. Physical activity (PA) has potential in this regard. This randomized clinical trial aims to (a) test the causal relationship between PA and AD-associated cognitive function for persons with a family history of AD (FH+), (b) determine the moderating role of apolipoprotein epsilon 4 (APOE4) carrier status on cognition, and (c) assess cerebral structure, cerebral function, and putative biomarkers as mediators of the effects of PA on cognition. Methods: We are recruiting cognitively normal, middle aged (40-65 years) sedentary adults with FH+. Participants are randomly assigned to a 12-month PA intervention for 3 days/week or to a control group maintaining their normal lifestyle. Saliva samples are taken at pre-test to determine APOE genotype. At pre-, mid-, and post-tests, participants complete a series of cognitive tests to assess information-processing speed, verbal and visual episodic memory, constructional praxis, mnemonic discrimination, and higher-order executive functions. At pre- and post-tests, brain imaging and blood biomarkers are assessed. Discussion: We hypothesize that 1) the PA group will demonstrate improved cognition compared with controls; 2) PA-derived cognitive changes will be moderated by APOE4 status; and 3) PA-induced changes in neural and blood biomarkers will contribute to cognitive changes and differ as a function of APOE4 status. Our results may provide important insights into the potential of PA to preserve neurocognitive function in people with a heightened risk of AD due to FH+ and as moderated by APOE4 status. By using sophisticated analytic techniques to assess APOE as a moderator and neurobiological mechanisms as mediators across trajectories of cognitive change in response to PA, we will advance our understanding of the potential of PA in protecting against AD. Trial registration: ClinicalTrials.gov NCT03876314. Registered March 15, 2019.

Measurement of Executive Functioning Using a Playful Robot in Kindergarten

Article

Full-text available

Nov 2019

We explored the potential of a robotics application in education as a measurement tool of child executive functioning skills. Sixty-five kindergarteners received assignments to go through a maze with a programmable robot, the Bee-Bot. Via observation we quantified how they solved these tasks. Their performance was successfully aggregated into a latent variable, which was used to predict the outcomes on standardized tasks that measure executive functioning. The latent variable significantly predicted performance on several tasks that measure problem-solving abilities, memory, visuospatial abilities and attention. It did not significantly predict pencil-and-paper tasks that measured visuospatial ability and nonverbal or design fluency. This study showed that it is possible to use a playful robotics task to obtain information on children’s ability. We recommend more research on using diverse robots in larger samples with different age groups to further explore the possibilities of robots as a test instrument.

To what extent should expert psychiatric witnesses comment on criminal culpability?

Article

Sep 2019

Nicholas Hallett

Following the Court of Appeal case of R v Edwards in England and Wales, there has been increasing pressure for expert psychiatric witnesses to comment explicitly on how a defendant’s mental disorder affects their culpability. Culpability is the degree to which a person can be held morally or legally responsible for their conduct, but defining culpability has proved difficult. Mental disorder does not translate easily into degrees of legal culpability. Although psychiatric evidence will often be central to such cases, the determination of culpability is a matter for the court, and experts should not comment on it explicitly. Nevertheless, certain areas of psychiatry may have a bearing on culpability, and ways in which experts may comment on these are suggested. Given the pressure on judges to determine culpability, experts need to be honest about the limits of medical science to answer legal questions and the professional necessity to remain within their area of expertise.

Relationships between executive function, working memory, and decision‐making on the Iowa Gambling Task: Evidence from ventromedial patients, dorsolateral patients, and normal subjects

Article

Full-text available

Jun 2017

The results of previous studies are inconsistent in regard to the relationship between the Iowa Gambling Task (IGT), working‐memory (WM), and executive tasks, and whether these cognitive processes could be considered as mechanisms underlying a decision‐making deficit. Moreover, the relationship between the IGT and executive measures is examined based on a limited number of executive tasks, within different populations showing diffuse damage. In addition, there are fewer studies carried out within control participants, with those studies also being inconclusive. It is also suggested that the association of the IGT performance with executive tasks depends on whether the IGT was running under ambiguity or under risk. In this work, all of these issues are studied. Results showed that both patients with ventromedial (VMPFC, N = 10) and dorsolateral (DLPFC, N = 10) prefrontal cortex lesions are significantly impaired on almost all executive tasks, WM tasks, and the IGT. Furthermore, when the IGT is run under risk, there are significant correlations between executive measures and the IGT for the DLPFC patients and the control participants (N = 34) but not the VMPFC patients. No correlation was found between WM tasks and the IGT for both frontal subgroups and control participants. These findings suggested that the mechanisms underlying the IGT deficit differ according to the lesion locations.

Planning ability impairments in probable Alzheimer's disease patients: Evidence from the Tower of London test

Article

Full-text available

Jun 2017

Objective: The purpose of the current study was to examine whether AD patients retain the ability to plan ahead, by analyzing specificities of their behavior in successfully achieving a pre-established goal. Methods: Twenty-one AD patients and thirty-three elderly controls underwent a problem-solving assessment using the Tower of London (TOL) test. Results: AD patients were less accurate and less efficient than controls. AD patients also committed more mistakes. This indicates a decline in working memory and inhibitory deficits, resulting in impulsive and inappropriate behaviors. Conclusion: These results are in agreement with previous studies, showing executive function problems in patients with AD. Specifically, this study demonstrates the presence of planning ability deficits in AD, considering both qualitative and quantitative approaches. The wide range of analysis presented in this study can aid clinicians in identifying the nature of the poor performance of AD patients during a planning task.

Erratum: Torre de Londres e Torre de Hanói: Contribuçõ es distintas para avaliação do funcionamento executivo (Jornal Brasileiro Psiquiatria (2007) 56:2 (134-139))

Article

Full-text available

Jan 2008

Goals and Plans: Their Relationship to Well-Being

Chapter

Oct 2012

Andrew Macleod

Individual well-being has been linked to having an approach to life that is goal-based. That is, those who have a goal-based orientation and a tendency towards planning report a higher sense of well-being. Furthermore, some more prescriptive approaches to defining well-being actually include goals and sense of purpose as being part of the construct well-being. Evidence is reviewed to assess the strength of the goal–well-being link, including goal content, goal orientation, and organisation. Areas where goals may be detrimental to well-being, including certain types of goals and the balance of investment in goals, are also discussed. Finally, evidence for the link between planning and well-being is outlined and mechanisms for its operation discussed.

Prefrontal cortex and behavioral disorders: Theoretical framework and neuropsychological evaluation

Article

Full-text available

Jun 2005

Dysfunction of prefrontal cortex explains the symptoms of many neurological and psychiatric disorders, such as the consequences of cerebral trauma and schizophrenia. Although the importance of frontal lobe functions in complex cognition has long been recognized, systematic research efforts to specify the nature, organization and roles of these functions have been difficult for theoretical, experimental and clinical reasons. Recently, two new theoretical frameworks have been proposed to explain the role of prefrontal cortex. In this paper, we present a revision of the main clinical manifestations secondary to prefrontal dysfunction, the frameworks proposed by Mesulam and Koechlin to explain the role of prefrontal cortex in behavior and the principal instruments available to evaluate executive and strategic self-regulation functions.

Assessment of Planning Performance in Clinical Samples: Reliability and Validity of the Tower of London Task (TOL-F)

Article

Jul 2015

Dissociable stages of planning and problem solving

Thesis

Jan 2014

Nina Ruh

The purpose of this work was to provide a better understanding of cognitive processes involved in planning and problem solving, especially in regard to the temporal and spatial characteristics of the early stages of problem solving. A wealth of existing literature suggests that these cognitive processes can be subdivided into different stages including cognitive operations of i) internalization, comprising the extraction of start and goal information and the creation of an internal problem representation and ii) proper planning in terms of mental manipulations of working memory contents in order to generate a solution sequence. To investigate the details of these operations, the experiments reported here employed a computerized version of the Tower of London (ToL) paradigm with specific variations of two structural problem parameters. It was expected that the systematic variation of the problem parameter Tower Configuration would affect demands on internalization, while manipulations of the parameter Search Depth would have an impact on the cognitive requirements concerning planning proper. Study 1 focused on the chronology of cognitive processes involved in planning and problem solving. Single-trial saccadelocked analyses of eye-movements revealed that processes of internalization coincided with an early phase of increased gaze alternations between start state and goal state, which was followed by a prolonged last inspection of the start state that was associated with proper planning. Study 2 enhanced the validity of these findings by excluding possible confounding factors due to differences in stimulus presentation on screen. Despite systematic variations of visual features, the findings of study 1 were replicated. Utilizing the insights from the previous experiments concerning temporal specifications, study 3 provided a novel perspective on the analysis of fMRI data in the problem domain. Time locked analyses of fMRI data for left and right dorsolateral prefrontal cortex (dlPFC) during problem solving in the ToL task showed that activation of the left dlPFC was elicited particularly during early processes of internalization, whereas activation of the right dlPFC was associated with later processes of actual planning. Taken together the findings reported in this thesis support the notion that processes of internalization and of core planning are at least to some extend dissociable in time and space concerning neural activation pattern.

Neuropsychology of Down syndrome

Article

Jan 2001

This study tested prefrontal and hippocampal functions in a sample of 28 school-aged (M 5 14.7 years, SD 5 2.7) individuals with Down syndrome (DS) compared with 28 (M 5 4.9 years, SD 5 .75) typically developing children individually matched on mental age (MA). Both neuropsychological domains were tested with multiple behavioral measures. Benchmark measures of verbal and spatial function demonstrated that this DS sample was similar to others in the literature. The main finding was a significant Group Â Domain interaction effect indicating differential hippocampal dysfunction in the group with DS. However, there was a moderate partial correlation (r 5.54, controlling for chronological age) between hippocampal and prefrontal composite scores in the DS group, and both composites contributed unique variance to the prediction of MA and adaptive behavior in that group. In sum, these results indicate a particular weakness in hippocampal functions in DS in the context of overall cognitive dysfunction. It is interesting that these results are similar to what has been found in a mouse model of DS. Such a model will make it easier to understand the neurobiological mechanisms that lead to the development of hippocampal dysfunction in DS.

Working Memory and Cognitive Flexibility Mediates Visuoconstructional Abilities in Older Adults with Heterogeneous Cognitive Ability

Article

Full-text available

Jun 2015
J INT NEUROPSYCH SOC

Previous studies suggest that executive functions influence the performance on visuoconstructional tasks. This study aims to investigate whether the relationship between planning ability and the copy of complex figures is mediated by distinct components of executive functions (i.e., working memory, inhibitory control and cognitive flexibility). We included a 129 older adults with Alzheimer’s disease ( n =36, AD), mild cognitive impairment (MCI, n =67), and with no evidence of cognitive impairment (controls, n =26). We evaluated the mediation effect of planning abilities, working memory, cognitive flexibility and inhibitory control on visuoconstructional tasks using a multiple mediation models. We found a significant direct effect of planning on visuoconstructional abilities and a partial mediation effect of working memory and cognitive flexibility on visuoconstructional abilities. The present results indicate that the performance on visuoconstructional task is mediated by multiple interrelated executive functions components, in particular working memory and cognitive flexibility. ( JINS , 2015, 21 , 392–398)

Willentliche Handlungssteuerung und kognitive Kontrolle

Chapter

Oct 2024

Thomas Goschke

Neurobiological characteristics associated with gender identity: Findings from neuroimaging studies in the Amsterdam cohort of children and adolescents experiencing gender incongruence

Article

Jul 2024
HORM BEHAV

Julie Bakker

Higher-Level Executive Functions in Healthy Elderly and Mild Cognitive Impairment: A Systematic Review

Article

Full-text available

Feb 2022

Mild Cognitive Impairment (MCI) is a clinical syndrome characterized by a moderate decline in one or more cognitive functions with a preserved autonomy in daily life activities. MCI exhibits cognitive, behavioral, psychological symptoms. The executive functions (EFs) are key functions for everyday life and physical and mental health and allow for the behavior to adapt to external changes. Higher-level executive functions develop from basic EFs (inhibition, working memory, attentional control, and cognitive flexibility). They are planning, reasoning, problem solving, and fluid intelligence (Gf). This systematic review investigates the relationship between higher-level executive functions and healthy and pathological aging, assuming the role of executive functions deficits as a predictor of cognitive decline. The systematic review was conducted according to the PRISMA Statement. A total of 73 studies were identified. The results indicate that 65.8% of the studies confirm significant EFs alterations in MCI (56.8% planning, 50% reasoning, 100% problem solving, 71.4% fluid intelligence). These results seem to highlight a strong prevalence of higher-level executive functions deficits in MCI elderly than in healthy elderly.

The role of steroid hormones in the sexual differentiation of the human brain

Article

Oct 2021

Julie Bakker

Widespread sex differences in human brain structure and function have been reported. Research on animal models has demonstrated that sex differences in brain and behavior are induced by steroid hormones during specific, hormone sensitive, developmental periods. It was shown that typical male neural and behavioral characteristics develop under the influence of testosterone, mostly acting during perinatal development. By contrast, typical female neural and behavioral characteristics may actually develop under the influence of estradiol during a specific prepubertal period. This review provides an overview of our current knowledge on the role of steroid hormones in the sexual differentiation of the human brain. Both clinical and neuroimaging data obtained in patients with altered androgen levels/actions, i.e., congenital adrenal hyperplasia (CAH) or complete androgen insensitivity syndrome (CAIS), point to an important role of (prenatal) androgens in inducing typical male neural and psychosexual characteristics in humans. In contrast to rodents, there appears to be no obvious role for estrogens in masculinizing the human brain. Furthermore, data from CAIS also suggest a contribution of sex chromosome genes to the development of the human brain. The final part of this review is dedicated to a brief discussion of gender incongruence, also known as gender dysphoria, which has been associated with an altered or less pronounced sexual differentiation of the brain.

Biophysiological Mental-State Monitoring during Human-Computer Interaction

Thesis

Full-text available

Sep 2021

Thea Radüntz

Die langfristigen Folgen von psychischer Fehlbeanspruchung stellen ein beträchtliches Problem unserer modernen Gesellschaft dar. Zur Identifizierung derartiger Fehlbelastungen während der Mensch-Maschine-Interaktion (MMI) kann die objektive, kontinuierliche Messung der psychischen Beanspruchung einen wesentlichen Beitrag leisten. Neueste Entwicklungen in der Sensortechnologie und der algorithmischen Methodenentwicklung auf Basis von KI liefern die Grundlagen zu ihrer messtechnischen Bestimmung. Vorarbeiten zur Entwicklung einer Methode zur neuronalen Beanspruchungsdiagnostik sind bereits erfolgt (Radüntz, 2017). Eine praxisrelevante Nutzung dieser Ergebnisse ist erfolgsversprechend, wenn die Methode mit Wearables kombiniert werden kann. Gleichzeitig sind die Evaluation und bedingungsbezogene Reliabilitätsprüfung der entwickelten Methode zur neuronalen Beanspruchungsdiagnostik in realitätsnahen Umgebungen erforderlich. Im Rahmen von experimentellen Untersuchungen der Gebrauchstauglichkeit von kommerziellen EEG-Registrierungssystemen für den mobilen Feldeinsatz wird die darauf basierende Systemauswahl für die MMI-Praxis getroffen. Die Untersuchungen zur Validierung der kontinuierlichen Methode zur Beanspruchungsdetektion erfolgt am Beispiel des Fluglotsenarbeitsplatzes beim simulierten „Arrival Management“.

Neuropsychology, social cognition, and loss of insight in frontotemporal dementia

Chapter

Jan 2021

Frontotemporal dementia (FTD) accounts for approximately 10%–20% of all dementias and is the second most common form of early-onset dementia after Alzheimer’s disease (AD). Four distinct clinical subtypes of FTD have been identified: behavioral variant FTD (bvFTD) and three variants of primary progressive aphasia (PPA) syndromes: a semantic variant PPA or semantic dementia (svPPA or SD), a nonfluent variant (PNFA), and logopenic variant (lvPPA). BvFTD is characterized by a progressive deterioration of personality, social behavior, and cognition and is the most common of the FTD subtypes. Executive dysfunction and social cognitive deficits are the main neuropsychological features that characterize bvFTD. Other primary neuropsychological abilities such as visual perception, spatial skills, and some aspects of memory tend to be generally well preserved. Loss of insight or impaired self-awareness is a characteristic feature, evident in over three-quarters of patients with FTD. Detailed neuropsychological assessment is essential for accurate diagnosis of FTD. Developing a robust evidence base for effective neuropsychological interventions is key to support patients with FTD and their families.

Anatomy and Disorders of Frontal Lobe Functions: Higher-Order Functions

Chapter

Full-text available

Jan 2020

The prefrontal cortex (PFC) is critical for elaborating and controlling goal-directed actions. It may be seen as a buffer space between perception and action where past experiences and prospective thoughts can be mentally represented and manipulated, allowing for decision-making and action selection based on mental deliberation. Fundamental processes such as attention, working memory, inhibition, set-shifting, motivation, and behavioral control mediate this general principle of functioning. The PFC also allows for higher-order functions that are particularly developed in humans, such as planning, abstraction, reasoning, creativity, and social cognition. In this second chapter, we detail the body of evidence that supports the involvement of the PFC in higher-order functions and how these functions are altered and assessed in neurological conditions affecting the PFC.

Anatomy and Disorders of Frontal Lobe Functions: Fundamental Functions

Chapter

Full-text available

Jan 2020

The prefrontal cortex (PFC) is critical for elaborating and controlling goal-directed actions. It may be seen as a buffer space between perception and action where past experiences and prospective thoughts can be mentally represented and manipulated, allowing for decision-making and action selection based on mental deliberation. Fundamental processes such as attention, working memory, inhibition, set-shifting, motivation, and behavioral control mediate this general principle of functioning. The PFC also allows for higher-order functions that are particularly developed in humans, such as planning, abstraction, reasoning, creativity, and social cognition. In this first article, we detail the body of evidence that supports the involvement of the PFC in this set of fundamental processes and how these functions are altered and assessed in neurological conditions affecting the PFC.

The long-term outcome of childhood leukaemia: Neuropsychological and neuroimaging investigations

Thesis

Jan 2004

Leasha Michelle Lillywhite

The recent introduction of pre-symptomatic central nervous system (PCNS) therapy in the treatment of childhood acute lymphoblastic leukaemia (ALL) has significantly improved the chances of long-term (LT) survival. However, the LT survival of ALL can be complicated by cognitive and behavioural impairments, and these problems may be related to the administration of PCNS therapy. This thesis investigated the role of PCNS therapies in determining the LT outcome of childhood ALL. In particular, attempts were made to identify the functional impairments associated with two PCNS therapies currently used in the treatment of standard-risk ALL, and to relate the profile of deficits identified to underlying structural abnormalities. Investigations were conducted in accordance with a proposed model of pathology. This model was based on the biochemical actions of the main component of both PCNS therapies, methotrexate (MTX). 32 LT survivors and 14 siblings participated in this research. Survivors were randomised to receive either (1) HD MTX + IT MTX + FAR (HD group), or (2) IT MTX-only (IT group) as PCNS therapy. Participants completed a battery of neuropsychological tests assessing the functional integrity of the frontal lobes and corpus callosum. In addition, the structural integrity of the brain was evaluated using conventional neuroradiological assessment and voxel-based morphometry (VBM). The neuropsychological and conventional neuroradiological investigations revealed minimal differences between the survivor and sibling groups. The VBM analyses, however, revealed common, subtle differences in brain structure between the survivors and their siblings. The differences included subtle pathology of the thalamus, caudate nucleus, and corona radiata. The pathology was regionally specific apparently sparing, for example, the pons and cerebellum. The methods used in the current research, however, were unable to establish a clear relationship between the subtle pathology identified and impairments in cognitive function.

XADREZ TERAPÊUTICO

Article

Full-text available

May 2020

O jogo de xadrez, além de esporte e lazer, é um instrumento auxiliar para o desenvolvimento cognitivo e terapêutico. Nas escolas, a utilização do jogo de xadrez contribui para que crianças possam interagir e aprender de forma lúdica outras disciplinas, dentre elas a matemática. Como instrumento terapêutico, o jogo de xadrez chegou a hospitais psiquiátricos, consultórios psicopedagógicos e psicológicos, com resultados satisfatórios para pacientes, tais como, dependentes químicos, autistas, portadores de esquizofrenia, transtorno de déficit de atenção e hiperatividade, dislexia, entre outros. Professores de xadrez tem formado grupos de idosos que buscam no jogo uma alternativa prazerosa de exercitar o raciocínio. A literatura a respeito do xadrez terapêutico tem crescido nos últimos anos, porém ainda é pouco conhecida dos profissionais que lidam com as atividades de estimulação cognitiva. O objetivo deste artigo é levantar e relatar casos em que o jogo de xadrez serve como instrumento de estimulação cognitiva e terapêutica, com o intuito de contribuir com a divulgação para profissionais da saúde sobre uma nova abordagem de reabilitação. Esta nova abordagem de utilização do jogo de xadrez expressa uma visão da sociedade que busca alternativas aos tratamentos tradicionais, inclusive, como prevenção de doenças neurodegenerativas, em virtude do envelhecimento crescente da população, desejosa em preservar suas habilidades cognitivas, além de criar novas possibilidades de interação social.

The Effect of Planning, Strategy Learning, and Working Memory Capacity on Mental Workload

Article

Full-text available

Apr 2020

Thea Radüntz

In our modern society, planning and problem solving are crucial for handling a wide range of situations. Investigation of the experienced mental workload connected to planning, strategy learning, and working memory capacity is of particular interest for adjusting conditions according to the mental state of the individual. In our study, we examined 21 subjects during a planning and a working memory task. We applied the method of Dual Frequency Head Maps (DFHM) from the electroencephalogram for capturing mental workload objectively. We evaluated the DFHM-workload index and performance data during the learning and main phase of the planning task and linked the results to subjects’ working memory capacity. The DFHM-workload index indicated that subjects with higher working memory capacity experienced a gradual decrease in mental workload during strategy learning of the planning task. However, the effect of learning on mental workload disappeared during the main phase.

Dementias and the Frontal Lobes

Chapter

Dec 2017

Dementing diseases with predominant frontal and frontostriatal involvement are often characterized by early progressive behavioral and executive symptoms. This phenomenon is seen not only in individuals with frontotemporal lobar degeneration but also in patients with early-onset Alzheimer’s disease, vascular dementia, and dementias associated with movement disorders. The assessment of executive deficits in patients with dementia is challenging, especially in the context of more general decline. Thus, scores on tasks aimed to assess executive function need to be interpreted only in light of full cognitive and language profile as well as qualitative observations, whereas behavioral assessment should be based both on clinician’s observations and the interview with the patient’s caregiver. This chapter characterizes the most common dementing diseases that may affect frontal lobe function. Particular attention has been paid to behavior, affect, and executive function. Some implications for assessment of frontal lobe function have been also discussed.

Attention and the Frontal Cortex

Chapter

Jul 2014

Ronald Cohen

Sensory selective attention often occurs covertly, as a relatively automatic response to salient stimuli that occur in the environment. Demands for controlled processing increase as the number of targets and stimulus complexity increase and response demands become greater. Yet, many of the processes necessary for orienting, allocating, engaging, and shifting attention can occur automatically, without overt response intention or specific response demands. Yet, in everyday life, people routinely direct their attention to either external stimuli, particular responses (e.g., swinging a tennis racket), or cognitive operations based on their momentary disposition, motivation, and prevailing situational demands and reinforcements. At these times, their attention tends to be subjectively experienced as voluntary or intentional, and it usually occurs with conscious awareness.

The Relationship between Executive Function and Fine Motor Control in Young and Older Adults

Article

Nov 2017
HUM MOVEMENT SCI

The present study examined the relationship between executive function (EF) and fine motor control in young and older healthy adults. Participants completed 3 measures of executive function; a spatial working memory (SWM) task, the Stockings of Cambridge task (planning), and the Intra-Dimensional Extra-Dimensional Set-Shift task (set-shifting). Fine motor control was assessed using 3 subtests of the Purdue Pegboard (unimanual, bimanual, sequencing). For the younger adults, there were no significant correlations between measures of EF and fine motor control. For the older adults, all EFs significantly correlated with all measures of fine motor control. Three separate regressions examined whether planning, SWM and set-shifting independently predicted unimanual, bimanual, and sequencing scores for the older adults. Planning was the primary predictor of performance on all three Purdue subtests. A multiple-groups mediation model examined whether planning predicted fine motor control scores independent of participants’ age, suggesting that preservation of planning ability may support fine motor control in older adults. Planning remained a significant predictor of unimanual performance in the older age group, but not bimanual or sequencing performance. The findings are discussed in terms of compensation theory, whereby planning is a key compensatory resource for fine motor control in older adults.

Volition und kognitive Kontrolle

Chapter

Oct 2017

Thomas Goschke

Die Forschung zur Volition und kognitiven Kontrolle befasst sich mit den kognitiven und neuronalen Mechanismen, die der willentlichen Steuerung zielgerichteter Handlungen zugrunde liegen. Der Fokus liegt dabei auf Situationen, in denen automatisierte Routinehandlungen nicht ausreichen, sondern Verhaltensdispositionen und kognitive Prozesse auf neue Weise konfiguriert oder konkurrierende Motivationstendenzen und Gewohnheiten unterdrückt werden müssen, um langfristige oder übergeordnete Ziele zu erreichen. Das Kapitel gibt einen Überblick über ausgewählte Theorien und Ergebnisse dieser Forschung anhand von drei Leitfragen: (1) Was sind die kognitiven Grundlagen willentlicher Handlungen? (2) Welche Mechanismen liegen der Fähigkeit zugrunde, Absichten gegen konkurrierende Motivationstendenzen oder Gewohnheiten abzuschirmen? (3) Welche neuronalen Systeme liegen kognitiven Kontrollprozessen und selbstkontrolliertem Verhalten zugrunde? Schlüsselwörter: Volition; Kognitive Kontrolle; Exekutive Funktionen; Willenshandlungen; Selbstkontrolle; Zielgerichtete Handlungen; Intentionen; Präfrontaler Cortex; Wille

The effect of task complexity on planning in preterm-born children

Article

Full-text available

Oct 2016

Objective: Planning is an important executive function (EF) skill that is fundamental to the capacity to achieve everyday goals that require a series of intermediate steps. This study examined the effect of preterm birth on planning skills in early and middle childhood using Tower problems that made different cognitive workload demands. Method: We administered a novel touchscreen Tower of Hanoi task (Monkey Tree Task; MTT) in three age cohorts (3, 6, and 9 years) to 485 children born between 2000 and 2010 (105 extremely low birth weight [ELBW], 248 late preterm [LP], and 132 term-born [Term]). Results: Children born with ELBW completed significantly fewer Tower problems with higher cognitive demands than children born at Term or LP. Likewise, Term- and LP-born children completed more Tower problems than children born with ELBW. In the youngest cohort, Term-born children solved Tower problems more efficiently than either preterm group, and LP-born children solved problems more efficiently than those born with ELBW. However, there were no group differences in efficiency in the older age cohorts. Significant correlations between our MTT measures and performance on other EF tasks were found. Conclusions: The MTT captured significant performance differences in planning skills between children born term vs. preterm. This study provides important information on the impact that cognitive workload, as a function of Tower problem complexity, has on planning skills in preterm children. This study adds to a growing body of research that distinguishes LP birth as having subtle, but distinguishable, adverse neuropsychological outcomes at earlier ages.

Reliability and validity of neurobehavioral function on the Psychology Experimental Building Language test battery in young-adults

Article

Full-text available

Dec 2015

Background. The Psychology Experiment Building Language (PEBL) software consists of over one-hundred computerized tests based on classic cognitive neuropsychology and behavioral neurology measures. Although the PEBL tests are becoming more widely utilized, there is currently very limited information about the psychometric properties of these measures. Methods. Study I examined inter-relationships among ten PEBL tests including indices of motor-function (Pursuit Rotor and Dexterity), attention (Test of Attentional Vigilance and Time-Wall), working memory (Digit Span Forward), and executive-function (PEBL Trail Making Test, Berg/Wisconsin Card Sorting Test, Iowa Gambling Test, and Mental Rotation) in a normative sample (N = 189, ages 18-22). Study II evaluated test-retest reliability with a two-week interest interval between administrations in a separate sample (N = 79, ages 18-22). Results. Moderate intra-test, but low inter-test, correlations were observed and ceiling/floor effects were uncommon. Sex differences were identified on the Pursuit Rotor (Cohen’s d = 0.89) and Mental Rotation (d = 0.31) tests. The correlation between the test and retest was high for tests of motor learning (Pursuit Rotor time on target r = .86) and attention (Test of Attentional Vigilance response time r = .79), intermediate for memory (digit span r = .63) but lower for the executive function indices (Wisconsin/Berg Card Sorting Test perseverative errors = .45, Tower of London moves = .15). Significant practice effects were identified on several indices of executive function. Conclusions. These results are broadly supportive of the reliability and validity of individual PEBL tests in this sample. These findings indicate that the freely downloadable, open-source, PEBL battery http://pebl.sourceforge.net is a versatile research tool to study individual differences in neurocognitive performance.

Reliability and validity of neurobehavioral function on the Psychology Experimental Building Language test battery in young-adults

Article

Full-text available

Aug 2015

Frontal–Subcortical Real Estate: Location, Location, Location

Chapter

Dec 2009

The previous chapter described the functional neuroanatomy of the basal ganglia. This chapter describes the functions of the separate prototypical circuits that connect the basal ganglia with the cortex. It also describes the current role of neuropsychological testing in evaluating this circuitry. The original conceptualization of these cortical–subcortical loops consisted of five parallel, segregated circuits between the frontal cortex and the basal ganglia (Alexander, DeLong, & Strick, 1986). These circuits were the skeletomotor, oculomotor, dorsolateral prefrontal, orbitofrontal, and anterior cingulate circuits. However, it is now evident that the basal ganglia receive afferents from nearly all cortical regions while sending efferents back to the diverse thalamic nuclei that project to those same cortical areas (Middleton & Strick, 2002).

Neuropsychologie

Chapter

Jan 2002

Adrian Danek

Zu Recht wird vor „frontaler Lobologie“ als „neuer Pseudowissenschaft der Psychiatrie“ gewarnt (David 1992), wenn man beobachtet, wie häufig eine Störung im Frontalhirn unterstellt wird, ohne dass strukturelle Nachweise vorliegen (Dubois et al. 2000). Oft werden Symptome auch nur als statistische Effekte bei Patienten mit heterogenen frontalen Läsionen beschrieben, ohne dass angegeben werden kann, wie ein Befund im Einzelfall zu werten ist.

Adaptation and validation of the Tower of London test in Mexican adults older than 60 years

Article

Sep 2013

The Tower of London (ToL) is a neuropsychological test focused on assessing mental planning (Shallice, 1982). There is little evidence about its functioning in elderly population. The objective of this work is to obtain data from reliability and validity for adults over 60 years. The test was administered to 256 participants selected by accidental sampling stratified by age and gender. The sample was obtained at community centers in Guadalajara city (Mexico). Internal consistency was estimated using Cronbach's α, and Pearson linear correlations were conducted to assess the effects of age and education. Construct validity was studied with an exploratory factor analysis and, finally, the items were analized with the Item Response Theory (IRT). It was found an effect between age and some indicators such as rating, run time, total time and time violations. Internal consistency for the indicators ranged from α = .329 to α = .794. The initiation time is the indicator that showed a higher α. In the factor analysis, for initiation time indicator the factor accounted for 41% of the total variance, while for the other indicators did not explain variance at a satisfactory level. Therefore, to use the ToL in adult population requires some psychometric adjustments, especially to solve some problems of homogeneity in the items.

Reliability and validity of neurobehavioral function on the Psychology Experimental Building Language test battery in young adults

Article

Full-text available

Dec 2015

Background. The Psychology Experiment Building Language (PEBL) software consists of over one-hundred computerized tests based on classic and novel cognitive neuropsychology and behavioral neurology measures. Although the PEBL tests are becoming more widely utilized, there is currently very limited information about the psychometric properties of these measures. Methods. Study I examined inter-relationships among nine PEBL tests including indices of motor-function (Pursuit Rotor and Dexterity), attention (Test of Attentional Vigilance and Time-Wall), working memory (Digit Span Forward), and executive-function (PEBL Trail Making Test, Berg/Wisconsin Card Sorting Test, Iowa Gambling Test, and Mental Rotation) in a normative sample (N = 189, ages 18–22). Study II evaluated test–retest reliability with a two-week interest interval between administrations in a separate sample (N = 79, ages 18–22). Results. Moderate intra-test, but low inter-test, correlations were observed and ceiling/floor effects were uncommon. Sex differences were identified on the Pursuit Rotor (Cohen’s d = 0.89) and Mental Rotation (d = 0.31) tests. The correlation between the test and retest was high for tests of motor learning (Pursuit Rotor time on target r = .86) and attention (Test of Attentional Vigilance response time r = .79), intermediate for memory (digit span r = .63) but lower for the executive function indices (Wisconsin/Berg Card Sorting Test perseverative errors = .45, Tower of London moves = .15). Significant practice effects were identified on several indices of executive function. Conclusions. These results are broadly supportive of the reliability and validity of individual PEBL tests in this sample. These findings indicate that the freely downloadable, open-source PEBL battery (http://pebl.sourceforge.net) is a versatile research tool to study individual differences in neurocognitive performance.

Assessment of Planning Ability: Psychometric Analyses on the Unidimensionality and Construct Validity of the Tower of London Task (TOL-F)

Article

Full-text available

Nov 2015

Objective: The Tower of London (TOL) is widely used to assess planning ability as a prototypical executive function in healthy and clinical populations. Despite its popularity, there is still no consensus on (a) whether the TOL measures a psychometrically unidimensional trait, and (b) how differences in problem structure relate to the difficulty of individual items. Method: Employing the framework of factor analysis and item response theory we investigated these issues of construct validity in a sample of 798 participants (443 female; 16 to 84 years). Participants worked on the TOL-Freiburg version (TOL-F) comprising a set of 24 4- to 6-move problems, which-based on comprehensive cognitive task analyses-systematically differ with regard to several structural problem parameters (minimum number of moves, search depth, goal hierarchy). Results: Results revealed that TOL-F performance is mainly explained by 1 major factor, while further minor factors additionally account for smaller, but possibly still informative, shares of variance. Individual item difficulties can be predicted by the experimentally varied problem parameters to a high degree (r = .89) and can be considered stable across different levels of age, sex, education, and planning ability. Conclusion: These findings demonstrate the TOL-F's construct validity as measuring planning ability in terms of an essentially unidimensional cognitive function while adhering to theory-driven concepts of task difficulty. TOL-F task performance hence represents an accurate, robust, and theoretically grounded estimation of a participant's planning ability. The results further highlight the merit of using established concepts from experimental psychology for improving neuropsychological assessment. (PsycINFO Database Record

The neuropsychology of attention: Second edition

Book

Dec 2013

Ronald Cohen

It has been 15 years since the original publication of Neuropsychology of Attention. At the time of its publication, attention was a construct that had long been of theoretical interest in the field of psychology and was receiving increased research by cognitive scientists. Yet, attention was typically viewed as a nuisance variable; a factor that needed to be accounted for when assessing brain function, but of limited importance in its own right. There is a need for a new edition of this book within Neuropsychology to present an updated and integrated review of what is know about attention, the disorders that affect it, and approaches to its clinical assessment and treatment. Such a book will provide perspectives for experimental neuropsychological study of attention and also provide clinicians with insights on how to approach this neuropsychological domain. © Springer Science+Business Media New York 2014. All rights reserved.

A Study of the Performance of Patients with Frontal Lobe Lesions in a Financial Planning Task.

Article

Full-text available

Nov 1997
BRAIN

Summary It has long been argued that patients with lesions in the prefrontal cortex have difficulties in decision making and problem solving in real-world, ill-structured situations, particularly problem types involving planning and look ahead components. Recently, several researchers have questioned our ability to capture and characterize these deficits adequately using just the standard neuropsychological test batteries, and have called for tests that reflect real-world task requirements more accurately. We present data from 10 patients with focal lesions to the prefrontal cortex and 10 normal control subjects engaged in a real-world financial planning task. We also introduce a theoretical framework and methodology developed in the cognitive science literature for quantifying and analyzing the complex data generated by problem-solving tasks. Our findings indicate that patient performance is impoverished at a global level but not at the local level. Patients have difficulty in organizing and structuring their problem space. Once they begin problem solving, they have difficulty in allocating adequate effort to each problem-solving phase. Patients also have difficulty dealing with the fact that there are no right or wrong answers nor official termination points in real-world planning problems. They also find it problematic to generate their own feedback. They invariably terminate the session before the details are fleshed out and all the goals satisfied. Finally, patients do not take full advantage of the fact that constraints on real-world problems are negotiable. However, it is not necessary to postulate a ‘planning’ deficit. It is possible to understand the patients’ difficulties in real world planning tasks in terms of the following four accepted deficits: inadequate access to ‘structured event complexes’, difficulty in generalizing from particulars, failure to shift between ‘mental sets’, and poor judgment regarding adequacy and completeness of a plan.

Tower of London Performance in Relation to Magnetic Resonance Imaging Following Closed Head Injury in Children

Article

Full-text available

Apr 1994

To investigate the relationship of severity of pediatric closed head injury (CHI), the contribution of frontal lobe lesions, and age at testing (6–10 yr olds vs 11–15 yr olds) to cognitive deficit, 134 head-injured patients were given the Tower of London (TOL) task and underwent magnetic resonance imaging. 89 normal controls were given the TOL for comparison. Severity of CHI and age at testing were strongly related to cognitive performance on the TOL, including the frequency of breaking the rules. Volume of frontal lobe lesion (but not extrafrontal lesion) contributed to the prediction of perfomance on the TOL even after severity of injury was taken into account. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Dopamine-Dependent Frontostriatal Planning Deficits in Early Parkinson's Disease

Article

Full-text available

Jan 1995

Three groups of medicated and nonmedicated patients at different stages of Parkinson's disease and a group of neurosurgical patients with localized frontal lobe excisions were assessed on 2 novel tests of planning and spatial working memory. Results demonstrate that, like other tests of frontal lobe dysfunction, planning and spatial working memory are vulnerable in nonmedicated patients with mild Parkinson's disease and suggest that certain aspects of the planning impairment in these patients may be ameliorated by dopaminergic therapy. Specifically, with medication there was an improvement in accuracy of planning, but not in latency, in a series of problems based on the Tower of London test of planning. The results in terms of the frontostriatal, dopamine-dependent nature of some of the cognitive deficits found in early Parkinson's disease versus the apparent dopamine-independent nature of deficits in other cognitive processes are discussed. (PsycINFO Database Record (c) 2004 APA, all rights reserved)

Specific Impairments of Planning

Article

Full-text available

Jul 1982

Tim Shallice

An information-processing model is outlined that predicts that performance on non-routine tasks can be impaired independently of performance on routine tasks. The model is related to views on frontal lobe functions, particularly those of Luria. Two methods of obtaining more rigorous tests of the model are discussed. One makes use of ideas from artificial intelligence to derive a task heavily loaded on planning abilities. A group of patients with left anterior lesions has a specific deficit on the task. Subsidiary investigations support the inference that this is a planning impairment.

Are the frontal lobes implicated in “planning” functions? Interpreting data from the Tower of Hanoi

Article

Full-text available

Jun 1995
NEUROPSYCHOLOGIA

Twenty adult patients with lesions in the prefrontal cortex were tested on the Tower of Hanoi puzzle. The performance of patients was significantly worse than that of controls. This difference could not be accounted for in terms of a general decline in intelligence or memory, or by the size of the lesion. The results further suggest that both patients and controls used the same general strategy to solve the problem and that patients' difficulties with the task have little to do with planning or "look ahead" deficits (as is generally assumed in the neuropsychology literature). Patient performance is best explained in terms of an inability to see or resolve a goal-subgoal conflict. This interpretation is compatible with several existing accounts of frontal lobe dysfunction that postulate a failure of inhibition of a prepotent response to explain poor performance on the Wisconsin Card Sorting task, the Stroop task, the Antisaccade task, the A-Not-B task, and the Delayed Alternation task.

Tower of London procedure: A standard method and developmental dataJournal of Clinical and Experimental Neuropsychology

Article

Full-text available

Jan 1995

The Tower of London procedure (TOL) is being utilized increasingly in clinical and experimental contexts, although there is considerable variation in how it is administered and scored. The procedure detailed here was developed using Shallice's original problems and, along with the Porteus Maze Test (PMT), was administered to 205 elementary school students and 74 young adults. TOL scores increased with age in a linear fashion, and the performance of the sixth, seventh, and eighth grade subjects were not statistically different from the young adults. The TOL was moderately correlated with the PMT suggesting that these procedures share a planning component. These data provide initial developmental standards, and the materials, administration, and scoring procedures documented here provide a standard method for utilization of this instrument.

Neural correlates of planning ability: Frontal lobe activation during the Tower of London test

Article

Full-text available

Jan 1994
NEUROPSYCHOLOGIA

Single-photon emission computerised tomography (SPECT) was used to investigate whether pre-frontal cerebral blood flow in normal adults is increased during planning activity. A subtraction technique was used in which regional cerebral blood flow (rCBF) was measured in subjects during a computerised version of the Tower of London task. Both rCBF and performance on this task were compared to a motor control condition requiring the same responses and using the same visual display. The level of rCBF was significantly increased in the left pre-frontal cortex during the Tower of London task. In addition, subjects who took more time planning their moves, and less moves to complete a problem had a significantly higher level of rCBF in the left pre-frontal cortex. Subsequent execution latencies for the task were correlated negatively with both left and right rCBF.

Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive-compulsive disorder

Article

Full-text available

Dec 1996

Synopsis Forty patients with obsessive–compulsive disorder (OCD) were compared to matched healthy controls on neuropsychological tests which are sensitive to frontal lobe dysfunction. On a computerized version of the Tower of London test of planning, the patients were no different from healthy controls in the accuracy of their solutions. However, when they made a mistake, they spent more time than the controls in generating alternative solutions or checking that the next move would be correct. The results suggest that OCD patients have a selective deficit in generating alternative strategies when they make a mistake. In a separate attentional set-shifting task, OCD patients were impaired in a simple discrimination learning task and showed a continuous cumulative increase in the number who failed at each stage of the task, including the crucial extra-dimensional set shifting stage. This suggests that OCD patients show deficits in both acquiring and maintaining cognitive sets. The cognitive deficits in OCD may be summarized as: (i) being easily distracted by other competing stimuli; (ii) excessive monitoring and checking of the response to ensure a mistake does not occur; and (iii) when a mistake does occur, being more rigid at setting aside the main goal and planning the necessary subgoals. Both studies support the evidence of fronto-striatal dysfunction in OCD and the results are discussed in terms of an impaired Supervisory Attentional System.

On testing the validity of planning/problem-solving tasks in a normal population

Article

Full-text available

Apr 1997

Clinically, tests of executive functions tend to be chosen on face validity. If such tests are to be used to evaluate a clinical population, their ability to measure executive functions should be reliably demonstrated in a normal population. In order to investigate the reliability of such tests, a sample of 130 normal adults (74 women, 56 men) ages 17 to 55 years were administered 4 tests purporting to measure planning/problem-solving: the Tower of London Test, the Six Element Test, the Twenty Questions Test, and the Rey Complex Figure Test. A structural equation modeling approach provided by the LISREL 8 program was used to evaluate three models hypothesized to explain the relationship among the test variables and the latent construct of planning/problem-solving. An adequate model was unable to be estimated, thus raising questions about the meaning of the latent construct planning/problem-solving and the psychometric structure of the Tower of London Test.

A hierarchical neuronal network for planning behavior

Article

Full-text available

Dec 1997

Planning a goal-directed sequence of behavior is a higher function of the human brain that relies on the integrity of prefrontal cortical areas. In the Tower of London test, a puzzle in which beads sliding on pegs must be moved to match a designated goal configuration, patients with lesioned prefrontal cortex show deficits in planning a goal-directed sequence of moves. We propose a neuronal network model of sequence planning that passes this test and, when lesioned, fails in a way that mimics prefrontal patients' behavior. Our model comprises a descending planning system with hierarchically organized plan, operation, and gesture levels, and an ascending evaluative system that analyzes the problem and computes internal reward signals that index the correct/erroneous status of the plan. Multiple parallel pathways connecting the evaluative and planning systems amend the plan and adapt it to the current problem. The model illustrates how specialized hierarchically organized neuronal assemblies may collectively emulate central executive or supervisory functions of the human brain.

Dimensions of cognition measured by the Tower of London and other cognitive task of head-injured children and adolescents

Article

Jan 1996

To determine the factor structure of executive functioning in head‐injured (n = 81) and normal children (n = 102), we administered tests of concept formation and problem solving, plus planning, verbal fluency, design fluency, memory (to evaluate semantic organization), and response modulation using a Go/No‐Go task. The children who sustained closed head injury (CHI) were divided into subgroups who sustained severe (n = 39) and mild/moderate (n = 42) injury. The CHI groups and normal controls were also grouped according to age at the time of testing (6–8, 9–12, and 13–16). The principal components analysis disclosed a five‐factor solution that accounted for 79% of the variance: Conceptual‐Productivity (Factor 1), Planning (Factor 2), Schema (Factor 3), Cluster (Factor 4), and Inhibition (Factor 5). Age had a significant effect on Factors 1, 2, and 5, whereas severity of CHI affected Factors 1,2,4, and 5. Using hierarchial regression in which the Glasgow Coma Scale score, age, and their interaction were entered first, the volume of frontal lobe lesion contributed significantly to predicting Factors 1 (Conceptual‐Productivity) and 2 (Planning), whereas the volume of left frontal lesions also predicted Factor 3 (Schema). The volume of extrafrontal lesions augmented the prediction of Factor 3, supporting the general relation of left hemisphere abnormality to the cognitive variables loading on this factor. Pending replication in a different sample of head‐injured children, caution is advised in interpreting the findings due to potential instability of the factor structure.

Wechsler Adult Intelligence Scale—Revised UK

Article

Jan 1997

Wechsler DA

1988: From Neuropsychology to Mental Structure

Article

Sep 1991
BEHAV BRAIN SCI

Tim Shallice

Neuropsychological results are increasingly cited in cognitive theories although their methodology has been severely criticised. The book argues for an eclectic approach but particularly stresses the use of single-case studies. A range of potential artifacts exists when inferences are made from such studies to the organisation of normal function – for example, resource differences among tasks, premorbid individual differences, and reorganisation of function. The use of “strong” and “classical” dissociations minimises potential artifacts. The theoretical convergence between findings from fields where cognitive neuropsychology is well developed and those from the normal literature strongly suggests that the potential artifacts are not critical. The fields examined in detail in this respect are short-term memory, reading, writing, the organisation of input and output speech systems, and visual perception. Functional dissociation data suggest that not only are input systems organised modularly, but so are central systems. This conclusion is supported by findings on impairment of knowledge, visual attention, supervisory functions, memory, and consciousness.

Attention to action: Willed and automatic control of behavior

Article

Jan 1986

The frontal lobe in man: a clinical study of maximum removals.

Article

Jan 1935

Two cases of amputation of the right and of the left frontal lobe as far caudally as the border of the precentral area showed, as the most important detectable sequel, a slight impairment "of those mental processes which are prerequisite to planned initiative." Removal of approximately the anterior half of the right frontal lobe in a third case was not associated with any noticeable alteration, neurological or psychological. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Planning and Spatial Working Memory: A Positron Emission Tomography Study in Humans

Article

Feb 1996
EUR J NEUROSCI

Previous work with both neurosurgical and neurodegenerative patient groups has suggested that high level planning is mediated by neural circuitry which includes both the prefrontal cortex and the striatum. In this study, the functional anatomy of cognitive planning was investigated further, using positron emission tomography (PET). Regional cerebral blood flow (rCBF) was measured in 12 normal volunteers while performing easy and difficult versions of (i) a modified Tower of London planning task; (ii) a mnemonic variant of this task that required short-term retention and reproduction of problem solutions; and (iii) a control condition that involved identical visual stimuli and motor responses. Significant increases in rCBF were observed in the left hemisphere, in both the mid-dorsolateral frontal cortex and in the head of the caudate nucleus, when the difficult planning task was compared with the control condition. Moreover, subtraction of a simple planning condition from the more difficult one revealed focal increases in rCBF in the caudate nucleus and the thalamus only. During both mnemonic variants of the planning task, changes were also observed in the mid-dorsolateral frontal cortex and in more ventral frontopolar regions, bilaterally. When compared directly, the planning and memory conditions differed in terms of these ventral activation foci, but not in the pattern of activation observed in the mid-dorsolateral frontal cortex. These findings further implicate frontostriatal circuitry in high-level planning and provide evidence for functionally distinct contributions from ventral and dorsolateral frontal regions to spatial working memory.

Owen AM, Downes JJ, Sahakian BJ, Polkey CE, Robbins TW. Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia 28: 1021-1034

Article

Feb 1990
NEUROPSYCHOLOGIA

Twenty-six patients with unilateral or bilateral frontal lobe excisions were compared with age and IQ matched controls on a computerized battery of tests of spatial working memory and planning. A computerized test of spatial short term memory capacity revealed no significant impairment in the patients' ability to execute a given sequence of visuo-spatial moves. In contrast, a paradigm designed to assess spatial working memory capacity, revealed significant impairments in the patient group in both possible types of search errors. Furthermore, additional analysis showed that the frontal lobe patients were less efficient than controls in their usage of a strategy for improving performance on this test.Higher level planning was also investigated using a test based on the “Tower of London” problem [Shallice, T. Phil. Trans. R. Soc. Lond. B. 298, 199–209, 1982]. Patients with frontal lobe damage required more moves to complete the problems and a yoked motor control condition revealed that movement times were significantly increased in this group. Taking both of these factors into consideration, initial thinking (planning) time was unimpaired in the patient group although the thinking time subsequent to the first move was significantly prolonged. These data are compared to previous findings from patients with idiopathic Parkinson's disease and are discussed in terms of an impairment of higher cognitive functioning following frontal lobe damage.

Lesion Analysis in Neuropsychology

Book

Jan 1989

Go - No Go Learning After Frontal Lobe Lesions in Humans

Article

Apr 1975
CORTEX

E.A. Drewe

48 patients with unilateral frontal or non-frontal cortical lesions were given a go - no go learning task. Patients with frontal lesions in either hemisphere took longer to learn the task and made more false "go" responses than control patients. They also, unlike controls, took longer to make in correct positive responses than correct positive ones. Medial frontal lesions were found to be particularly important in giving rise to poor performance on this task. It is suggested that this task is non-unitary in nature and that the medial area may be important for more than one ability.

Evidence for Executive Dysfunctioning in Autism

Article

May 1994
NEUROPSYCHOLOGIA

A group of young people with autism (ranging in ability from high functioning to moderately learning disabled), and ability-matched control groups of (i) non-autistic individuals with moderate learning disabilities, and (ii) normally developing children, were presented with two tests of executive function: the Intra-dimensional/Extra-dimensional set-shifting task and the Tower of London planning task. These tests were graded in difficulty and included internal control measures. On each task, the autistic group was differentially impaired with respect to both control groups. Moreover, this impairment was specific to the stages of each task which placed greatest demands upon executive control. This evidence for executive dysfunction in autism is discussed in the context of Norman and Shallice's (Centre for Human Information Processing Technical Report 99, 1980) "Supervisory Attentional System" model of frontal function.

The Neuropsychology of the Prefrontal Cortex

Article

Jul 1993
ARCH NEUROL-CHICAGO

Single photon emission computed tomography with the xenon inhalation technique is used to compare activation of regional cerebral blood flow in frontal brain regions during the performance of four widely used neuropsychological tests: the Continuous Performance Test, the Wisconsin Card Sorting Test, the Tower of London, and Porteus Mazes. Healthy normal volunteers performing these tasks show significant increases in frontal regions during the Continuous Performance Test, the Wisconsin Card Sorting Test, and the Tower of London, but not the Porteus Mazes. Activation produced by the Continuous Performance Test and the Tower of London are mesial and bilateral and may reflect stimulation of midline attentional circuits. The Wisconsin Card Sorting Test produces a left dorsolateral area of prefrontal activation. These findings indicate that regional activation of the frontal lobes occurs in response to cognitive challenges produced through performance of standard neuropsychological tests.

Article

Jan 1996

Jordan Grafman

Planning and spatial working memory: A positron emission tomography study in humans

Article

Mar 1996

Previous work with both neurosurgical and neurodegenerative patient groups has suggested that high level planning is mediated by neural circuitry which includes both the prefrontal cortex and the striatum. In this study, the functional anatomy of cognitive planning was investigated further, using positron emission tomography (PET). Regional cerebral blood flow (rCBF) was measured in 12 normal volunteers while performing easy and difficult versions of (i) a modified Tower of London planning task; (ii) a mnemonic variant of this task that required short-term retention and reproduction of problem solutions; and (iii) a control condition that involved identical visual stimuli and motor responses. Significant increases in rCBF were observed in the left hemisphere, in both the mid-dorsolateral frontal cortex and in the head of the caudate nucleus, when the difficult planning task was compared with the control condition. Moreover, subtraction of a simple planning condition from the more difficult one revealed focal increases in rCBF in the caudate nucleus and the thalamus only. During both mnemonic variants of the planning task, changes were also observed in the mid-dorsolateral frontal cortex and in more ventral frontopolar regions, bilaterally. When compared directly, the planning and memory conditions differed in terms of these ventral activation foci, but not in the pattern of activation observed in mid-dorsolateral frontal cortex. These findings further implicate frontostriatal circuitry in high-level planning and provide evidence for functionally distinct contributions from ventral and dorsolateral frontal regions to spatial working memory.

Neural systems engaged by planning: A PET study of the Tower of London task

Article

Jul 1996
NEUROPSYCHOLOGIA

The functional anatomy of planning was investigated using the Tower of London task. Activation was observed in a distributed network of cortical areas incorporating prefrontal, cingulate, premotor, parietal and occipital cortices. Activation in corresponding areas has been observed in visuospatial working memory tasks with the exception of the rostral prefrontal cortex. This area may be identified with the executive components of planning comprising response selection and evaluation. Enhanced neural activity in both this rostral prefrontal area and the visuospatial working memory system was associated with increased task difficulty.

Prefrontal dysfunction in depressed patients performing a complex planning task: A study using positron emission tomography

Article

Aug 1997

Patients with unipolar depression show impaired performance on the Tower of London planning task. Positron emission tomography, which has previously identified resting state blood flow abnormalities in depression, was used to investigate neural activity associated with performance of this task in depressed patients and normal controls. Six patients with unipolar depression and six matched controls were scanned while performing easy and hard Tower of London problems in a one-touch computerized paradigm and while performing a perceptuomotor control task. The patients in this study showed an expected task-related performance deficit compared with normal subjects. In normal subjects, the task engaged a network of prefrontal cortex, anterior cingulate, posterior cortical areas and subcortical structures including the striatum, thalamus and cerebellum. Depressed patients failed to show significant activation in the cingulate and striatum; activation in the other prefrontal and posterior cortical regions was significantly attenuated relative to controls. Crucially, patients also failed to show the normal augmentation of activation in the caudate nucleus, anterior cingulate and right prefrontal cortex associated with increasing task difficulty. These findings provide evidence for cingulate, prefrontal and striatal dysfunction associated with impaired task performance in depression. The present results are consistent with a central role of cingulate dysfunction in depression as well as suggesting impaired frontostriatal function.

Performance on the Tower of London test after severe head injury

Article

Dec 1995

Janet Cockburn

Efficient solution of the Tower of London (T of L) test (Shallice, 1982) has been hypothesized to depend on frontal lobe mediation. Performance on the test by 20 patients with severe, diffuse, traumatic head injury was compared with that of control subjects, matched on age and years of education, and, within the patient group, according to broad location of damage (frontal or nonfrontal). Scores were also compared with those obtained on two commonly used tests of frontal lobe function, Verbal Fluency, and the Wisconsin Card Sorting test (WCST). Results indicated that whereas the Verbal Fluency test and WCST discriminated well between patients and control subjects, the T of L test did not, nor did it discriminate well between patients with and without documented frontal lobe damage. However, there were large individual differences in planning and solution times across all subjects. Interpretation of results was complicated by interaction of other variables such as premorbid IQ and duration of posttraumatic amnesia. It is suggested that closer attention to the relation between planning and total times separately for correct and incorrect solutions might be informative. A need for systematic study of the relationship between test performance and everyday behavior is also identified.

Concept formation and problem-solving following closed head injury in children

Article

Dec 1997

To further investigate the usefulness of 3 purported measures of executive function (EF) in head injured children, we administered the Twenty Questions Test (TQT), Tower of London (TOL), and the Wisconsin Card Sorting Test (WCST) to 151 children who had sustained a closed head injury (CHI) of varying severity about 3 years earlier. In addition, we tested 89 normal controls. Fifty-seven of the patients were included in a longitudinal study that compared performance at 3 months and 36 months. All of the head injured children underwent magnetic resonance imaging for investigational purposes. Severity of CHI, as defined by the lowest Glasgow Coma Scale (GCS) score, affected performance on all 3 EF measures. Focal lesion volume incremented prediction of performance on TOL and WCST, but not TQT. Moderate intercorrelations of the test variables were obtained. Although all three EF measures depicted changes in performance over 3 years, a ceiling effect detracted from the sensitivity of the TOL to the impact of CHI on development. Implications of the findings for clinical applications are discussed. (JINS, 1997, 3, 598–607.)

The Functional Emergence of Prefrontally-Guided Working Memory Systems in Four- to Eight-Year-Old Children

Article

Apr 1998
NEUROPSYCHOLOGIA

The neural processes that underlie the functional emergence of human cognitive functions, particularly those associated with the prefrontal cortex (PFC), are of growing interest to developmental psychologists and neuroscientists. Specifically, working memory functions have been correlated with PFC activity in nonhuman primates and adult humans but have not been extensively studied in children. We examined the developmental emergence of functions involved in working memory through the use of the Cambridge Neuropsychological Test Automated Battery (CANTAB), a computerized battery of nonverbal visually-presented neuropsychological tests designed to dissociate frontal from temporal lobe behavioral functions. Participants were normal children, aged 4-8 (n = 181) and a small group of young adults (n = 24) who completed measures of Spatial Memory Span, Spatial Working Memory, the Tower of London planning task, Visual Pattern and Spatial Recognition tasks, and a Set-Shifting task. Findings indicate a general age-related progression in ability levels on frontal lobe tasks, with 4-year-olds performing worse than 5- to 7-year-olds on all measures. Eight-year-olds are superior to younger children in their ability to solve complex problems but have not yet reached adult levels of performance on the most difficult items of the Tower of London and Spatial Working Memory tasks. We conclude that the development of working memory functions proceeds dimensionally, starting with refinement of basic perceptual and sensorimotor functions and culminating with the physiological maturation of widespread neural networks that integrate complex processing demands inherent to working memory tasks.

Clinical and neuropathological criteria for frontotemporal dementia

Jan 1994
416

The Lund

The Lund, Manchester Groups. Clinical and neuropathological criteria for frontotemporal dementia. Journal of Neurology, Neurosurgery, and Psychiatry 1994;57(4):416±8.

Attention to action: willed and auto-matic control of behaviour Consciousness and self-regulation

Jan 1986

Norman D T Shallice

Norman D, Shallice T. Attention to action: willed and auto-matic control of behaviour. In: Davidson RA, Schwartz GE, Shapiro D, editors. Consciousness and self-regulation. New York: Plenum Press, 1986.

Planning, neuropsychology and artificial intelligence: cross-fertilization

Jan 1994
377

Spector

Spector L, Grafman J. Planning, neuropsychology and arti®cial intelligence: cross-fertilization. In: Boller F, Grafman J, editors. Handbook of neuropsychology, vol. 9, 1994. p. 377±92. D. Carlin et al. / Neuropsychologia 38 (2000) 655±665

Planning and spatial working memory following frontal lobe lesions in man

Jan 1990
1021

Owen

Planning impairments in frontal lobe dementia and frontal lobe lesion patients

Abstract

No full-text available

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