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The effects of focal anterior and posterior brain lesions on verbal fluency

Published online by Cambridge University Press:  01 May 1998

DONALD THOMAS STUSS
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada Departments of Psychology and Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
MICHAEL PAXSON ALEXANDER
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada Harvard Medical School (Neurology), Boston, MA, USA Memory Disorders Research Centre, Boston VAMC, Boston, MA, USA
LISA HAMER
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada
CAROLE PALUMBO
Affiliation:
Memory Disorders Research Centre, Boston VAMC, Boston, MA, USA
REBECCA DEMPSTER
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada
MALCOLM BINNS
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada
BRIAN LEVINE
Affiliation:
Rotman Research Institute of Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada
DENNIS IZUKAWA
Affiliation:
Mississauga Hospital, Division of Neurosurgery, Mississauga, Ontario, Canada

Abstract

Seventy-four patients with focal brain lesions were compared to a neurologically normal control group on tasks of letter-based and category-based list generation. When patients were divided only by right frontal, left frontal, or nonfrontal lesion sites, the pattern of fluency impairments confirmed prior claims. When more precise lesion sites within the frontal lobes were compared between groups classified based on their fluency performance, much more specific brain–behavior relations were uncovered. Damage to the right dorsolateral cortical or connecting striatal regions, the right posterior area, or the medial inferior frontal lobe of either hemisphere did not significantly affect letter-based fluency performance. Superior medial frontal damage, right or left, resulted in moderate impairment. Patients with left dorsolateral and/or striatal lesions were most impaired. Left parietal damage led to performance relatively equivalent to the superior medial and left dorsolateral groups. The same lesion sites produced impairments in category based fluency, but so did lesions of right dorsolateral and inferior medial regions. Task analysis and correlations with other measures revealed that different cognitive processes related to different brain regions underlie performance on verbal fluency tests. (JINS, 1998, 4, 265–278.)

Type
Research Article
Copyright
© 1998 The International Neuropsychological Society

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