Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T09:15:28.189Z Has data issue: false hasContentIssue false
  • English
  • Français

Performance on the Tower of London test after severe head injury

Published online by Cambridge University Press:  26 February 2009

Janet Cockburn
Janet Cockburn
Affiliation:
Department of Experimental Psychology, University of Oxford, and Rivermead Rehabilitation Centre, Oxford, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

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. (JINS, 1995, 7, 537–544.)

Keywords

Tower of London TestSevere head injuryFrontal lobes
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 1 , Issue 6 , November 1995 , pp. 537 - 544
Copyright
Copyright © The International Neuropsychological Society 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, S.W., Damasio, H., Jones, D., & Tranel, D. (1991). Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. Journal of Clinical and Experimental Neuropsychology, 13, 909–922.CrossRefGoogle ScholarPubMed
Baddeley, A.D. (1986). Working memory. Oxford: Oxford Science Publications.Google ScholarPubMed
Benton, A.L. (1968). Differential behavioural effects in frontal lobe disease. Neuropsychologia, 6, 53–60.CrossRefGoogle Scholar
Brooks, D.N. (1990). Cognitive deficits. In Rosenthal, M., Griffith, E.R., Bond, M.R., & Miller, J.D. (Eds.), Rehabilitation of the adult and child with traumatic brain injury (2nd ed., pp. 163–178). Philadelphia: F.A. Davis.Google Scholar
Brouwer, W.H., Schmidt, I., Vanier, M., Velten, J.C., Wever, A.M.E., & Van Zomeren, A.H. (1994). The relation between severity of closed head injury (CHI) and executive function: An inverse U-shaped function? Paper presented at 17th European Conference of the International Neuropsychological Society, Angers, France.Google Scholar
Crawford, J.R., Moore, J.W., Cameron, I.M. (1992). Verbal Fluency: A NART-based equation for the estimation of pre-morbid performance. British Journal of Clinical Psychology, 31, 327–329.CrossRefGoogle Scholar
Eslinger, P.J. & Damasio, A.R. (1985). Severe disturbance of higher cognition after bilateral frontal lobe ablation: Patient EVR. Neurology, 35, 1731–1741.CrossRefGoogle ScholarPubMed
Eslinger, P.J. & Grattan, L.M. (1993). Frontal lobe and fronto-striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31, 17–28.CrossRefGoogle Scholar
Heaton, R.K. & Pendleton, M.G. (1981). Use of neuropsychological tests to predict adult patients’ everyday functioning. Journal of Consulting and Clinical Psychology, 49, 807–821.CrossRefGoogle ScholarPubMed
Kimberg, D.Y. & Farah, M.J. (1993). A unified account of cognitive impairments following frontal lobe damage: The role of working memory in complex, organised behaviour. Journal of Experimental psychology: General, 122, 411–428.CrossRefGoogle Scholar
Luria, A.R. (1973). The working brain. London: Penguin.Google Scholar
Miller, E. (1984). Verbal fluency as a function of a measure of verbal intelligence and in relation to different types of cerebral pathology. British Journal of Clinical Psychology, 23, 53–57.CrossRefGoogle ScholarPubMed
Milner, B. (1963). Effects of different brain lesions on card sorting: The role of the frontal lobes. Archives of Neurology, 9, 90–100.CrossRefGoogle Scholar
Minitab, Inc. (1991). Minitab Reference Manual, Macintosh Version Release 8. Minitab, Inc. PA.Google Scholar
Nelson, H.E. (1976). A modified card sorting test sensitive to frontal lobe deficits. Cortex, 12, 313–324.CrossRefGoogle Scholar
Nelson, H.E. (1982). The National Adult Reading Test. Windsor: NFER-Nelson.Google Scholar
Owen, A.M., Downes, J.J., Sahakian, B.J., Polkey, C.E., & Robbins, T.W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28, 1021–1034.CrossRefGoogle ScholarPubMed
Pendleton, M.G., Heaton, R.K., Lehman, H.A.W., & Hulihan, D. (1982). Diagnostic utility of the Thurstone word fluency test in neuropsychological evaluation. Journal of Clinical Neuropsychology, 4, 307–317.CrossRefGoogle Scholar
Penfield, W. & Evans, J. (1935). The frontal lobe in man: A clinical study of maximum removals. Brain, 58, 115–133.CrossRefGoogle Scholar
Petrides, M. & Milner, B. (1982). Deficits on subject-ordered tasks after frontal and temporal lobe lesions in man. Neuropsychologia, 20, 249–262.CrossRefGoogle ScholarPubMed
Ponsford, J. & Kinsella, G. (1992). Attentional deficits following closed head-injury. Journal of Clinical and Experimental Neuropsychology, 14, 822–838.CrossRefGoogle ScholarPubMed
Prigatano, G.P., Fordyce, D.J., Zeiner, H.K., Roueche, J.R., Pepping, M., & Wood, B.C. (1986). Neuropsychological rehabilitation after brain injury, Baltimore: Johns Hopkins University Press.Google Scholar
Rezai, K., Andreasen, N.C., Alliger, R., Cohen, G., Swayze, V., & O’Leary, D.S. (1993). The neuropsychology of the pre-frontal cortex. Archives of Neurology, 50, 636–642.CrossRefGoogle Scholar
Richardson, J. (1990). Clinical and neuropsychological aspects of closed head injury. London: Taylor and Francis.Google Scholar
Russell, W.R. (1971). The traumatic amnesias. Oxford: OUP.Google Scholar
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions, Royal Society of London B, 298, 199–209.Google ScholarPubMed
Shallice, T. (1988). From neuropsychology to mental structure. Cambridge: CUP.CrossRefGoogle Scholar
Shallice, T. & Burgess, P. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741.CrossRefGoogle ScholarPubMed
Stuss, D.T. & Benson, D.F. (1984). Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 3–28.CrossRefGoogle ScholarPubMed
Wade, D.T. (1992). Measurement in neurological rehabilitation. Oxford: Oxford Medical Publications.Google ScholarPubMed
Walsh, K. (1985). Understanding brain damage. New York: Churchill Livingstone.Google Scholar