Brain Advance Access published online on April 8, 2003
Brain, doi:10.1093/brain/awg128
© 2003 by Guarantors of Brain
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Article
1 Rotman Research Institute of Baycrest Centre for Geriatric Care, University of Toronto, Toronto, ON, Canada; Department of Neurology, Harvard University, Beth Israel Deaconess Medical Center, Boston and Boston University School of Medicine Healthnet, Healthsouth Braintree Rehabilitation Hospital, Braintree, MA, USA
* Corresponding author. E-mail: malexand{at}bidmc.harvard.edu.
Received 25 June 2002
; revised 2 January 2003
; accepted 6 January 2003
Although frontal lobe lesions do not cause classic amnesia, they may disrupt learning and memory in a number of ways. To investigate in finer detail the regions of frontal injury that are associated with impaired learning and to define the cognitive processing deficits specific to each region that disrupt memory, we compared 33 patients with focal frontal injury with patients with non-frontal injury and with normal controls on a standard neuropsychological instrument, the California Verbal Learning Test (CVLT). Subgroups of patients with distinct lesion site profiles were compared in a number of learning measures. All of the subgroups of patients with frontal lesions (with one exception) had inefficient learning due to poor implementation of a strategy of subjective organization. Despite this organizational deficiency, the performance of patients with frontopolar lesions normalized across trials. Only the subgroups with lesions centred either on the left posterior dorsolateral frontal region or the posterior medial frontal region had overall impaired learning and recall. The left posterior dorsolateral frontal group was most significantly impaired on all measures. This recall impairment was secondary to a mild lexical-semantic deficit. A recognition memory deficit in the same group was due to an abnormal response bias. Several groups had a modest increase in perseverative recalls; the underlying mechanisms differed. Disruption of different cognitive processes associated with specific frontal regions underlies the varied patterns of memory impairment. This study has demonstrated even finer differentiations within the frontal region than previously known.
Keywords: list learning; memory; frontal lobe; recognition memory; strategic deficits
California Verbal Learning Test: performance by patients with focal frontal and non-frontal lesions
2 Rotman Research Institute of Baycrest Centre for Geriatric Care; Departments of Psychology and Medicine (Neurology, Rehabilitation Science), University of Toronto, Toronto, ON, Canada
3 Rotman Research Institute of Baycrest Centre for Geriatric Care, University of Toronto, Toronto, ON, Canada
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