The cerebral correlates of different types of perseveration in the Wisconsin Card Sorting Test.
OBJECTIVE
To explore the neural substrates corresponding to the perseverative errors in the Wisconsin Card Sorting Test (WCST).


METHODS
The study examined the correlations between the WCST performances and the SPECT measurements of regional cerebral blood flow (rCBF) in subjects with neurodegenerative dementia. Negative non-linear correlations between the rCBF and the two different types of the perseverative errors ("stuck-in-set" and "recurrent" perseverative errors) were calculated on a voxel basis and volume-of-interest basis in the mixed groups of 72 elderly and dementia patients.


RESULTS
The stuck-in-set perseverative error was associated with the reduced rCBF in the rostrodorsal prefrontal cortex, whereas the recurrent perseverative error was related to the left parietal activity but not to the prefrontal activity.


CONCLUSIONS
These findings augment evidence that the rostrodorsal prefrontal cortex crucially mediates attentional set shifting, and suggest that the stuck-in-set perseverative errors would be a true pathognomonic sign of frontal dysfunction. Moreover, this study shows that the recurrent perseverative errors may not be associated closely with the prefrontal function, suggesting that this error and the stuck-in-set error should be differentially estimated in the WCST.
Nagahama
Y
Y
Department of Geriatric Neurology, Shiga Medical Center, Moriyama-city, Shiga 524-8524, Japan. nagahama@kuhp.kyoto-u.ac.jp
Okina
T
T
Suzuki
N
N
Nabatame
H
H
Matsuda
M
M
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000098:blood supply* / Q000473:pathology; D011594:Psychometrics; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon