Unilateral frontal lobectomy can produce strategy application disorder.
Open accessAbstract
Following a 5 cm left frontal lobectomy for the removal of a mixed astrocytoma-oligodendroglioma, a 51 year old right handed man showed a marked dissociation between his performance on standard neuropsychological tests and his everyday behaviour. In contrast to his intact neuropsychological test performance, he was impaired on a test of "strategy application" which requires goal articulation, plan specification, self-monitoring, and evaluation of outcomes, as well as the establishment of mental "markers" to trigger specific behaviour. Strategy application disorder can therefore be produced by a unilateral circumscribed frontal lobe lesions.
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By far the strongest relation with Intentionality was with the SET.
“By far the strongest relation, however, was with the SET, which supports previous interpretations of the test as tapping processes involved in the creation, maintenance and activation of intentions (Burgess, 1997; Burgess & Shallice, 1997; Goldstein et al., 1993; Shallice & Burgess, 1991a, 1991b).”
From The ecological validity of tests of executive function (1998) · cites this paper as Goldstein et al., 1993
In Additional Tests, the paper uses the Six Element Test (SET) to examine planning ability, which supports the broad interpretation of the test. The Discussion links prospective internal markers for behaviour change to the patient's errors on the Multiple Errands task, not specifically to the SET. The paper does not report a relation between SET performance and Intentionality; the citing sentence appears to present that relation as its own finding. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe SET taps processes involved in the creation, maintenance and activation of intentions.
“By far the strongest relation, however, was with the SET, which supports previous interpretations of the test as tapping processes involved in the creation, maintenance and activation of intentions (Burgess, 1997; Burgess & Shallice, 1997; Goldstein et al., 1993; Shallice & Burgess, 1991a, 1991b).”
From The ecological validity of tests of executive function (1998) · cites this paper as Goldstein et al., 1993
The Additional Tests section describes the Six Element Test as examining planning ability through six tasks completed within a fixed time. The Discussion links prospective triggers for changing behaviour to the patient's difficulties on the Multiple Errands task, not specifically to the Six Element Test. The paper therefore supports a planning-related interpretation of the SET but does not establish the full claim about creating, maintaining and activating intentions. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThese findings concurred with those from studies of patients with similar problems.
“These findings concurred with those from studies of patients with similar problems (e.g., Bird et al., 2004; Burgess, 2000b; Goldstein et al., 1993; Levine et al., 1998; 1999; see also Figure 3).”
From The case for the development and use of ecologically valid measures of executive function in experimental and clinical neuropsychology (2006) · cites this paper as Goldstein et al., 1993
Patients with rostral prefrontal damage achieved superior scores on IQ tests and excellent scores on traditional executive tasks such as the Wisconsin Card Sorting and Verbal Fluency Tests, but all showed significant behavioral organization problems in everyday life.
“All patients achieved superior scores on IQ tests, and all achieved excellent scores on traditional executive tasks such as the Wisconsin Card Sorting and Verbal Fluency Tests. However they all showed significant behavioral organization problems in everyday life.”
From The case for the development and use of ecologically valid measures of executive function in experimental and clinical neuropsychology (2006) · cites this paper as Goldstein et al., 1993
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Cites
DEFICITS IN STRATEGY APPLICATION FOLLOWING FRONTAL LOBE DAMAGE IN MAN
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Frontal Lobe Contributions to Theory of Mind
Stone, V. E., Baron-Cohen, S., & Knight, R. T. (1998) · Journal of Cognitive Neuroscience · doi:10.1162/089892998562942 · Cited by 1,524 · see citing works
The ecological validity of tests of executive function
BURGESS, P. W., ALDERMAN, N., EVANS, J., EMSLIE, H., & WILSON, B. A. (1998) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617798466037 · Cited by 932 · see citing works
Self-citationBURGESS, P. W., ALDERMAN, N., FORBES, C., COSTELLO, A., M-A.COATES, L., DAWSON, D. R., ANDERSON, N. D., GILBERT, S. J., DUMONTHEIL, I., & CHANNON, S. (2006) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617706060310 · Cited by 663 · see citing works
Self-citationFluid intelligence after frontal lobe lesions
Duncan, J., Burgess, P., & Emslie, H. (1995) · Neuropsychologia · doi:10.1016/0028-3932(94)00124-8 · Cited by 537 · see citing works
Self-citationROLE OF THE RIGHT PREFRONTAL CORTEX IN ILL-STRUCTURED PLANNING
Goel, V., & Grafman, J. (2000) · Cognitive Neuropsychology · doi:10.1080/026432900410775 · Cited by 194 · see citing works
Gerlach, K. D., Spreng, R. N., Madore, K. P., & Schacter, D. L. (2014) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsu001 · Cited by 148 · see citing works
BENNETT, P. C., ONG, B., & PONSFORD, J. (2005) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617705050423 · Cited by 105 · see citing works
The central executive does not exist
PARKIN, A. J. (1998) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617798005128 · Cited by 81 · see citing works
Midlife aging, open-ended planning, and laboratory measures of executive function.
Garden, S. E., Phillips, L. H., & MacPherson, S. E. (2001) · Neuropsychology · doi:10.1037/0894-4105.15.4.472 · Cited by 66 · see citing works
- Authors
- Goldstein, L. H., Bernard, S., Fenwick, P. B., Burgess, P. W., & McNeil, J.
- Affiliations
- Maudsley Hospital (GB)
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 1993-03-01
- Volume
- 56
- Issue
- 3
- Pages
- 274-276
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1014860
- OpenAlex
- W2165004469
- Cited by
- 109
- References
- 2
- Citations by year
- 2025: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 4 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 7 · 2013: 4 · 2012: 6
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- frontal lobe lesions, executive function, neuropsychological test performance, daily behavior, self-monitoring
- MeSH terms
- Anger, Astrocytoma, Awareness, Brain Damage, Chronic, Brain Neoplasms, Decision Making, Frontal Lobe, Humans, Male, Middle Aged, Neuropsychological Tests, Oligodendroglioma, Postoperative Complications, Problem Solving, Psychosurgery, Social Behavior, Neurocognitive Disorders
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