Cerebral Cortex, Vol 8, 18-27, Copyright © 1998 by Oxford University Press
M Freedman, S Black, P Ebert and M Binns
Object alternation (OA) is a well-established measure of perseveration and
orbitofrontal function in non-human primates. Although several studies have
used OA to examine orbitofrontal system dysfunction in humans with
neurological and psychiatric disease, this task itself has not been
validated as a bona fide measure of frontal dysfunction in humans. To
address this issue, six patients with bilateral frontal lobe lesions
documented by computerized tomography (CT) or magnetic resonance imaging
(MRI) and 15 healthy controls were given OA, as well as other measures of
frontal system dysfunction, delayed alternation (DA), delayed response
(DR), and the Wisconsin Card Sorting Test (WCST). The CT and MRI scans were
interpreted blindly. The patients with bilateral frontal lesions were
significantly impaired on OA, DA, DR and the WCST. Analyses of the CT/MRI
lesions suggest that the neuroanatomical regions involved in the deficits
on OA include Brodmann areas 10, 24, 32 and 47, as well as possibly 11, and
that OA is a sensitive measure of ventrolateral-orbitofrontal and medial
frontal dysfunction in humans. Our findings lend further support for the
use of experimental paradigms adopted from animal models to study the
functional neuroanatomy and neuropsychological mechanisms underlying
cognitive functions in humans with neurological and psychiatric disease.
ARTICLES
Orbitofrontal function, object alternation and perseveration
Department of Medicine, Mount Sinai Hospital and University of Toronto, Canada. morris.freedman@utoronto.ca
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