title: Perseveration found in a human drawing task: six-fingered hands drawn by patients with right anterior insula and operculum damage.
abstract: BACKGROUND
  Perseveration has been observed in a number of behavioural contexts, including speaking, writing, and drawing. However, no previous report describes patients who show perseveration only for drawing a human figure.
  
  
  OBJECTIVE
  The present report describes a group of patients who show body awareness-related cognitive impairment during a human figure drawing task, a different presentation from previously described neuropsychological cases.
  
  
  METHODS
  Participants were 15 patients who had a frontal lobe brain tumour around the insula cortex of the right hemisphere and had subsequently undergone a neurosurgical resective operation. Participants were asked to draw a human figure in both "hands-down" and "hands-up" configurations.
  
  
  RESULTS
  Eight of the 15 patients drew a human figure with six fingers during the "hands-up" and the "hands-down" human figure drawing tasks (one patient drew eight fingers). A statistical analysis of potential lesion areas revealed damage to the right anterior frontal insula and operculum in this group of patients relative to the five-finger drawing group.
  
  
  CONCLUSIONS
  Our findings reveal a newly described neuropsychological phenomenon that could reflect impairment in attention directed towards body representations.
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Niki
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan ; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan ; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.affiliation: Graduate School of Informatics, Kyoto University, Kyoto, Japan.
authors.forename: Takatsune
authors.initials: T
authors.lastname: Kumada
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D003072:Cognition Disorders / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult