title: Prefrontal lobe structural integrity and trail making test, part B: converging findings from surface-based cortical thickness and voxel-based lesion symptom analyses.
abstract: Surface-based cortical thickness (CT) analyses are increasingly being used to investigate variations in brain morphology across the spectrum of brain health, from neurotypical to neuropathological. An outstanding question is whether individual differences in cortical morphology, such as regionally increased or decreased CT, are associated with domain-specific performance deficits in healthy adults. Since CT studies are correlational, they cannot establish causality between brain morphology and cognitive performance. A direct comparison with classic lesion methods is needed to determine whether the regional specificity of CT-cognition correlations is similar to that observed in patients with brain lesions. We address this question by comparing the neuroanatomical overlap of effects when 1) whole brain vertex-wise CT is tested as a correlate of performance variability on a commonly used neuropsychological test of executive function, Trailmaking Test Part B (TMT-B), in healthy adults and 2) voxel-based lesion-symptom mapping (VBLSM) is used to map lesion location to performance decrements on the same task in patients with frontal lobe lesions. We found that reduced performance on the TMT-B was associated with increased CT in bilateral prefrontal regions in healthy adults and that results spatially overlapped in the left dorsomedial prefrontal cortex with findings from the VBLSM analysis in patients with frontal brain lesions. Findings indicate that variations in the structural integrity of the left dorsomedial prefrontal lobe, ranging from individual CT differences in healthy adults to structural lesions in patients with neurological disorders, are associated with poor performance on the TMT-B. These converging results suggest that the left dorsomedial prefrontal region houses a critical region for the complex processing demands of TMT-B, which include visuomotor tracking, sequencing, and cognitive flexibility.
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Nityanand
authors.initials: N
authors.lastname: Miskin
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.|Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thesen
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Barr
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Butler
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Xiuyuan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Dugan
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Ruben
authors.initials: R
authors.lastname: Kuzniecky
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Werner
authors.initials: W
authors.lastname: Doyle
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, 145 East 32nd Street, #216, New York, NY, 10016, USA. karen.blackmon@nyumc.org.
authors.forename: Karen
authors.initials: K
authors.lastname: Blackmon
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000523:psychology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes; D008875:Middle Aged; D009929:Organ Size; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014145:Trail Making Test; D055815:Young Adult
keywords: Cognitive flexibility; Cortical thickness; Trailmaking test; Voxel-based lesion symptom mapping; morphometry