Cognitive planning in humans: neuropsychological, neuroanatomical and neuropharmacological perspectives

In recent years, considerable progress has been made in understanding the cognitive and neuroanatomical basis of high-level planning behaviour through a combination of neuropsychological, neuropharmacological and functional neuroimaging approaches. In this article, early evidence suggesting a relationship between planning impairments and damage to the frontal lobe is reviewed and several contemporary studies of planning behaviour in patients with circumscribed frontal lobe excisions are described in detail. These neuropsychological investigations, together with recent functional neuroimaging studies of normal control subjects, have identified a specific area within the mid-dorsolateral frontal cortex of humans which appears to be critically involved in the cognitive processes that mediate efficient planning. The functions of this region, both in cognitive planning and in related functions such as working memory, are then discussed in the context of a general theoretical framework for understanding the functional organization of "executive" processes within the human lateral frontal cortex. In the final sections, the relationship between the planning deficits observed after intrinsic frontal lobe damage and those exhibited by patients with neuropathology of primarily sub-cortical origin, such as Parkinson's disease, is discussed. A central model for much of this work has been the concept of cortico-striatal circuitry which emphasizes the relationship between the neocortex and the striatum. The combined evidence from comparative studies in patients and from functional neuroimaging studies on Parkinson's disease suggests that altered cortico-striatal interactions may disrupt normal planning function at a number of levels, possibly consequent upon intrinsic striatal pathology on the one hand and the partial loss of (frontal) cortical input to the basal ganglia on the other.     

Cognitive impairment following frontal lobe damage and its relevance to human amnesia.

Whether frontal lobe pathology can account for some of the cognitive impairment oberved in amnesic patients with Korsakoff's syndrome was investigated. Various cognitive and memory tests were given to patients with circumscribed frontal lobe lesions, patients with Korsakoff's syndrome, non-Korsakoff amnesic patients, and control Ss. Patients with frontal lobe lesions were not amnesic. Nevertheless, they exhibited 2 deficits that were also exhibited by patients with Korsakoff's syndrome but not by other amnesic patients: (a) impairment on the Wisconsin Card Sorting Test and (b) impairment on the Initiation and Perseveration subscale of the Dementia Rating Scale. Thus, frontal lobe pathology can explain some of the cognitive deficits observed in patients with Korsakoff's syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Relation Between Brain Activity During Memory Tasks and Years of Education in Young and Older Adults.

Higher education is associated with less age-related decline in cognitive function, but the mechanism of this protective effect is unknown. The authors examined the effect of age on the relation between education and brain activity by correlating years of education with activity measured using functional MRI during memory tasks in young and older adults. In young adults, education was negatively correlated with frontal activity, whereas in older adults, education was positively correlated with frontal activity. Medial temporal activity was associated with more education in young adults but less education in older adults. This suggests that the frontal cortex is engaged by older adults, particularly by the highly educated, as an alternative network that may be engaged to aid cognitive function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolution of the frontal lobes: a volumetric analysis based on three-dimensional reconstructions of magnetic resonance scans of human and ape brains

Scenarios regarding the evolution of cognitive function in hominids depend largely on our understanding of the organization of the frontal lobes in extant humans and apes. The frontal lobe is involved in functions such as creative thinking, planning of future actions, decision making, artistic expression, aspects of emotional behavior, as well as working memory, language and motor control. It is often claimed that the frontal lobe is disproportionately larger in humans than in other species, but conflicting reports exist on this issue. The brain of the apes in particular remains largely unknown. In this report we measure the volume of the frontal lobe as a whole and of its main sectors (including cortex and immediately underlying white matter) in living humans, and in post-mortem brains of the chimpanzee, gorilla, orang-utan, gibbon and the macaque using three-dimensional reconstructions of magnetic resonance (MR) scans of the brain. On the basis of these data we suggest that although the absolute volume of the brain and the frontal lobe is largest in humans, the relative size of the frontal lobe is similar across hominoids, and that humans do not have a larger frontal lobe than expected from a primate brain of the human size. We also report that the relative size of the sectors of the frontal lobe (dorsal, mesial, orbital) is similar across the primate species studied. Our conclusions are preliminary, because the size of our sample, although larger than in previous studies, still remains small. With this caveat we conclude that the overall volume of the frontal lobe in hominids enlarged in absolute size along with the rest of the brain, but did not become relatively larger after the split of the human line from the ancestral African hominoid stock. Aspects other than relative volume of the frontal lobe have to be responsible for the cognitive specializations of the hominids.     

Temporal and spatial context memory in patients with focal frontal, temporal lobe, and diencephalic lesions

Patients with focal frontal, temporal lobe, or diencephalic lesions were investigated on measures of temporal (recency) and spatial (position) context memory, after manipulating exposure times to match recognition memory for targets (pictorial stimuli) as closely as possible. Patients with diencephalic lesions from an alcoholic Korsakoff syndrome showed significant impairment on the temporal context (recency) task, as did patients with frontal lesions penetrating the dorsolateral frontal cortex, according to MRI (and PET) evidence. Patients with temporal lobe lesions showed only a moderate (non-significant) impairment on this task, and patients with medial frontal lesions, or large frontal lesions not penetrating the dorsolateral cortical margins, performed as well as healthy controls at this task. On the spatial context memory task, patients with lesions in the temporal lobes showed significant impairment, and patients with right temporal lesions performed significantly worse than patients with left temporal lesions. Patients with diencephalic lesions showed only a modest (non-significant) impairment on this task, and the frontal lobe group performed normally. When a group of patients with temporal lobe lesions resulting from herpes encephalitis were examined separately, an identical pattern of results was obtained, the herpes group being significantly impaired on spatial memory and showing a trend towards impairment for temporal context memory. There were strong correlations between anterograde memory quotients and context memory performance (despite the use of an exposure time titration procedure) and a weak association in the frontal group with one frontal/executive task [corrected] (card-sorting perservations). It is predicted that correlations between temporal context memory and frontal/executive tasks will be greater in samples of patients all of whom have frontal lesions invading the dorsolateral cortical margin.     

Relationships between normal aging, frontal lobe function, and memory for temporal and spatial information.

Young and old participants were evaluated on tests of frontal lobe function, recognition memory, and memory for temporal and spatial information. Older participants showed significant impairments on memory for temporal order, and this impairment was found to correlate with deficits on frontal lobe tests measuring spontaneous flexibility but not reactive flexibility. However, spatial memory showed no evidence of an age effect. An interpretation of this latter finding based on the differential availability of contextual cues is ruled out because similar results were obtained when spatial memory was assessed in a different context to that used during learning. The researchers concluded that memory for temporal order and spatial memory are affected differentially by age. Theoretical interpretations of this difference are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age differences between children and young adults in the dynamics of dual-task prioritization: Body (balance) versus mind (memory).

Task prioritization can lead to trade-off patterns in dual-task situations. The authors compared dual-task performances in 9- and 11-year-old children and young adults performing a cognitive task and a motor task concurrently. The motor task required balancing on an ankle-disc board. Two cognitive tasks measured working memory and episodic memory at difficulty levels individually adjusted during the course of extensive training. Adults showed performance decrements in both task domains under dual-task conditions. In contrast, children showed decrements only in the cognitive tasks but actually swayed less under dual-task than under single-task conditions and continued to reduce their body sway even when instructed to focus on the cognitive task. The authors argue that children perform closer to their stability boundaries in the balance task and therefore prioritize protection of their balance under dual-task conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do young and older adults rely on different processes in source memory tasks? A neuropsychological study.

Source memory has consistently been associated with prefrontal function in both normal and clinical populations. Nevertheless, the exact contribution of this brain region to source memory remains uncertain, and evidence suggests that processes used by young and older adults may differ. The authors explored the extent to which scores on composite measures of neuropsychological tests of frontal and medial temporal function differentially predicted the performance of young and older adults on source memory tasks. Results indicated that a frontal composite measure, consistently associated with source memory performance in older adults, was unrelated to source memory in young adults, although it was sensitive to a demanding working memory task. The memory composite score, however, predicted performance in the young group. In addition, item and source memory were correlated in young but not older people. Findings are discussed in terms of age-related differences in working memory and executive functions, and differential binding processes necessary for item and source memory. The requirement to integrate item and source information at encoding appears to place greater demands on executive or working memory processes in older adults than in younger adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between MR abnormalities and patterns of cognitive impairment in multiple sclerosis

OBJECTIVE: This study correlated the extent of abnormalities detected by different magnetic resonance imaging (MRI) techniques [proton density (PD)-weighted, T1-weighted, and magnetization transfer imaging (MTI)] with the overall cognitive, frontal lobe, and memory impairments in patients with MS. PATIENTS: There were 30 clinically definite MS patients, with different disease courses. Exclusion criteria: psychoactive/steroid treatments, mood disorders, acute relapse phase. MAIN OUTCOME MEASURES: Neuropsychological test results. Total (TLL) and frontal (FLL) lesion loads assessed from PD-weighted, T1-weighted (22 patients), and MTI (22 patients) MRI scans. Average lesion MT ratios (MTR) and analysis of the MTR histograms from brain tissue axial slabs on MTI scans. RESULTS: Patients with frontal lobe deficits (n=15) or memory impairment (n-17) had a higher TLL on PD scans (p=0.04 and p=0.01, respectively). Patients with frontal lobe deficits had higher FLL on PD scans (p=0.01) and TLL on MTI (p=0.03) scans. No significant relationships between the extent of T1-weighted lesion loads and the presence of any neuropsychological impairment. Mean MTR of both MS lesions and whole brain tissue was lower in patients with frontal lobe impairment (p=0.04). MRI lesion loads correlated significantly with some neuropsychological test scores. CONCLUSIONS: Lesion loads on PD-weighted MRI and MTI-derived measures are associated with cognitive decline in MS patients. Overall macroscopic and microscopic brain damage is more important than the corresponding regional brain disease in determining deficits of selective cognitive domains.     

Conceptual and perceptual implicit memory in Huntington's disease.

The aims of this study were to examine and compare perceptual and conceptual implicit memory (CIM) in Huntington's disease (HD) and to characterize the relationship between tests of frontal lobe functioning and CIM. Sixteen HD patients and 16 normal controls completed structurally parallel tests of perceptual implicit memory and CIM (i.e., rhyme and category exemplar generation), tests of explicit memory, and verbal fluency. HID patients showed intact implicit memory for both rhyme and category exemplars, despite evidence of frontal dysfunction on other tests. An unexpected finding was that patients showed a deficit in cued rhyme generation that correlated with severity of neurological impairment. The authors replicated findings in controls of a correlation between letter fluency and CIM but found no relationship in patients. Frontal dysfunction in HID may lessen the influence of generative strategies on tests of CIM without compromising performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dopamine-dependent frontostriatal planning deficits in early Parkinson's disease.

Three groups of medicated and nonmedicated patients at different stages of Parkinson's disease and a group of neurosurgical patients with localized frontal lobe excisions were assessed on 2 novel tests of planning and spatial working memory. Results demonstrate that, like other tests of frontal lobe dysfunction, planning and spatial working memory are vulnerable in nonmedicated patients with mild Parkinson's disease and suggest that certain aspects of the planning impairment in these patients may be ameliorated by dopaminergic therapy. Specifically, with medication there was an improvement in accuracy of planning, but not in latency, in a series of problems based on the Tower of London test of planning. The results in terms of the frontostriatal, dopamine-dependent nature of some of the cognitive deficits found in early Parkinson's disease versus the apparent dopamine-independent nature of deficits in other cognitive processes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental reversals in false memory: A review of data and theory.

Can susceptibility to false memory and suggestion increase dramatically with age? The authors review the theoretical and empirical literatures on this counterintuitive possibility. Until recently, the well-documented pattern was that susceptibility to memory distortion had been found to decline between early childhood and young adulthood. That pattern is the centerpiece of much expert testimony in legal cases involving child witnesses and victims. During the past 5 years, however, several experiments have been published that test fuzzy-trace theory's prediction that some of the most powerful forms of false memory in adults will be greatly attenuated in children. Those experiments show that in some common domains of experience, in which false memories are rooted in meaning connections among events, age increases in false memory are the rule and are sometimes accompanied by net declines in the accuracy of memory. As these experiments are strongly theory-driven, they have established that developmental improvements in the formation of meaning connections are necessary and sufficient to produce age increases in false memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Double dissociation between item and source memory.

The present experiment provides evidence for a double dissociation between item and source memory, thereby strengthening the claim that the 2 kinds of memory rely on different brain structures. Elderly participants were divided preexperimentally into 2 groups on the basis of their scores on a composite measure of frontal lobe function. In a subsequent test of sentence memory, the 2 groups did not differ; on a test of memory for the voice in which sentences were spoken, participants with high-frontal function outperformed those with low-frontal function. When the same participants were divided according to a composite measure of medial temporal lobe function, the high-functioning adults outperformed the low-functioning adults on memory for the sentence, but the groups did not differ on memory for voice. Results focus on different theories of frontal lobe function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Letter and category fluency in patients with frontal lobe lesions.

This study examines the hypothesis that patients with frontal lobe lesions are impaired on tests of letter but not category fluency. This hypothesis was proposed by Moscovitch (1994), based on a series of cognitive studies with young, normal participants. A group of patients with lateral prefrontal lesions and age-matched controls were tested on 2 tests of verbal fluency, the FAS task and a category fluency task that used semantic categories as cues (e.g., animals). Patients with frontal lobe lesions generated fewer items than controls on both letter and category fluency. This effect did not interact with the type of fluency test, suggesting that the frontal lobes are more generally involved in verbal fluency. Moreover, this pattern of findings, along with previous results of impaired free recall and remote retrieval in this patient group, suggests that patients with frontal lobe lesions do not efficiently organize and develop retrieval strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive abstraction, shifting, and control: Clinical sample comparisons of psychopaths and nonpsychopaths.

Gorenstein (1982) suggested that psychopaths exhibit deficits in cognitive processes commonly associated with frontal lobe functioning, but other investigators reported collecting findings (Hare, 1984; Sutker, Moan, & Allain, 1983). There is also evidence indicating that intellectual level influences performances in measures of frontal lobe integrity and mitigates against expression of cognitive dyscontrol especially among psychopaths. The present study extended previous research by comparing clinical samples of psychopaths and nonpsychopaths identified by object instrument and behavioral self-report data. Dependent measures included test of concept formation, abstraction, flexibility, planning, and control. Compared to men defined as normal controls, male psychopaths showed no greater deficits in abstraction, flexibility, control, or planning. Intelligence significantly influenced performances on dependent measures for both groups. Results suggest that analogies between psychopathy and frontal lobe deficits are premature, if not unsupported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory for facts, source, and context: Can frontal lobe dysfunction explain age-related differences?

Age-related differences in memory for facts, source, and contextual details were examined in healthy young (aged 18–35 yrs) and old (aged 65–80 yrs) volunteers. In all tested memory functions, decline over time was greater in the elderly than in the young. A time-dependent increase in the prevalence of source amnesia errors was clearly associated with old age. Contrary to several recent reports, measures of frontal lobe functions did not predict source memory. Nevertheless, some of these putative frontal function measures were related to memory for contextual details. The number of perseverative responses on the Wisconsin Card Sorting Test was inversely related to performance on both factual and contextual memory tests, but the association with contextual memory was stronger. Difficulties with response selection on a Stroop task predicted poor contextual memory in young but not in old adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term control of GABA synthesis in brain

Frontal lobe and basal ganglia lesions have been associated with similar cognitive impairments, although their specialized roles in behavior are likely to be different. We examined whether these structures mediate distinctive or overlapping aspects of a complex behavioral process that has been associated with both neural sites, i.e. cognitive flexibility. Patients with focal ischemic lesions to the frontal lobe and basal ganglia were compared on two forms of cognitive flexibility: (1) shifting response set (i.e. reactive flexibility), and (2) producing a diversity of ideas (i.e. spontaneous flexibility). Results indicated that frontal lobe and basal ganglia damage each caused a similar degree of impairment in reactive flexibility, both groups performing at a significantly lower level than posterior cortical lesion and normal comparison groups. However, frontal lobe damage markedly disturbed spontaneous flexibility, while performance after basal ganglia lesion was significantly higher and comparable to posterior cortical lesions. Findings suggest that the frontal lobe and basal ganglia participate differently in the neural substrate of cognitive flexibility. The frontal lobe appears to mediate spontaneous flexibility. The production of diverse ideas may require direct cortical-cortical interactions by the frontal lobe in order to access knowledge systems with novel strategies that transcend the most common semantic linkages. In contrast the corticostriate system appears to mediate reactive flexibility, as the frontal lobe, basal ganglia and their interconnections are required for its operation.     

Age differences in implicit memory: Fragmented object identification and category exemplar generation.

In a cross-sectional study of 164 participants aged 21 to 91, the authors examined age differences on two implicit tests, fragmented object identification (FOI) and category exemplar generation (CEG), and on tests of explicit memory, attention, and verbal fluency. FOI results revealed impaired perceptual skill learning in those over 60 and a decrease in perceptual priming across young, middle-aged, and older groups. CEG priming was impaired in those over 80. Regression analysis revealed explicit contamination of priming on both the FOI and CEG tests. Across the three implicit measures, age accounted for 4 to 13% of the variance when explicit memory was controlled. Semantic fluency predicted CEG priming, suggesting possible frontal lobe involvement on the test. Altogether, results indicate that age has a small but reliable influence on implicit memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Picture naming by young children: norms for name agreement, familiarity, and visual complexity

Researchers concerned with the development of cognitive functions are in need of standardized material that can be used with both adults and children. The present article provides normative measures for 400 line drawings viewed by 5- and 6-year-old children. The three variables obtained-name agreement, familiarity, and visual complexity-are important because of their potential effect on memory and other cognitive processes. The normative data collected in the present study indicate that young children are different from adults in both the name most frequently assigned and the number of alternative names provided. The alternative names given by the children are either coordinate names or names of objects that are visually similar to the pictured object. In addition, the failure (to name) rate is higher among young children compared to adults. Thus, we conclude that unequivocal interpretation of age-related differences in cognitive functions can be made only when age-appropriate pictorial stimuli are chosen.     

Hippocampal and prefrontal cortex contributions to learning and memory: Analysis of lesion and aging effects on maze learning in rats.

Young adult rats with bilateral lesions to the hippocampus or prefrontal cortex, young operated controls, and normal old rats were tested on two complex mazes in the Hebb–Williams series. Approximately half the animals were previously trained on one of the mazes; the remainder received no previous training. The trained hippocampal rats showed sparing of memory for the general skill of maze learning but poor recall of the specific maze on which they had been previously trained. The opposite pattern was observed in trained prefrontal rats. In contrast, the aged rats' memory for maze-specific and maze-general information was impaired. The results confirmed the importance of the hippocampus for recalling highly specific information and pointed to a possible role for the frontal lobes in learning and remembering nonspecific skill-related information. The generalized deficit of the aged rats indicates that both types of memory were compromised and offers further evidence of frontal lobe and hippocampal dysfunction in normal aging. (PsycINFO Database Record (c) 2010 APA, all rights reserved)