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Relationship between frontal lobe lesions and Wisconsin Card Sorting Test performance in patients with multiple sclerosis
Abstract
Conceptual reasoning deficits are common in patients with multiple sclerosis (MS) and are typically associated with focal lesions involving the frontal lobes. In this study, we predicted that MS patients with frontal white matter lesions (MS-F) would be more impaired on a standard conceptual reasoning task (Wisconsin Card Sorting Test; WCST) than patients with minimal frontal lesions (MS-NF), even if the total cerebral lesion area (TLA), measured from MRI, was equivalent across groups. We subdivided 43 definite MS patients into three groups based on MRI findings: seven in the MS-F group (mean TLA = 41.4 cm2) and seven in the MS-NF group (mean TLA = 50.0 cm2); 29 MS patients served as a low lesion burden control group (MS-C; mean TLA = 6.4 cm2). The groups did not differ with regard to demographic and illness characteristics. Although the three subgroups obtained comparable scores on a measure of global cognitive functioning (verbal intelligence), the MS-F group achieved significantly fewer categories and made more total errors on the WCST than did the MS-NF and MS-C groups. The MS-F group made significantly more perseverative responses than the MS-C group and nonsignificantly more than the MS-NF group. These results suggest that the pattern of cognitive decline in MS is a function of the location of demyelinating lesions within the cerebral hemispheric white matter. Finally, we supplement the group study results with a case report of an MS patient who was studied serially with MRI and cognitive testing.
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“In many ways, set-shifting tasks are similar to the Wisconsin Card Sorting Task in that they form the gold standard for assessing executive function (Drewe, 1974; Robinson et al., 1980; Arnett et al., 1994).”
From Using mice to model Alzheimer's dementia: an overview of the clinical disease and the preclinical behavioral changes in 10 mouse models (2014) · cites this paper as Arnett et al., 1994
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Items 201–279 of 279
Douchemane, D., Isingrini, M. L., & Souchay, C. (2007) · L’Année psychologique · doi:10.4074/s0003503307004046 · Cited by 8
Cognitive dysfunction in multiple sclerosis: natural history and impact on productive living
Beatty, W. W. (1998) · Neurological Sciences · doi:10.1007/bf00539592 · Cited by 8
“Published examples of these strategies include papers on metamemory [35] and frontal lobe dysfunction [36].”
BackgroundCognitive Impairment in Multiple Sclerosis
Santos, T., Pinheiro, J., & Barros, P. (2015) · European Neurological Review · doi:10.17925/enr.2015.10.02.157 · Cited by 6
Françoise Reuter, A., Audoin, B., Rico, A., Irina Malikova, A., Ranjeva, J., & Pelletier, J. (2009) · Revue Neurologique · doi:10.1016/s0035-3787(09)72122-8 · Cited by 5
The neuropsychology of multiple sclerosis: Contributions of neuroimaging research
Wishart, H. A., Flashman, L. A., & Saykin, A. J. (2001) · Current Psychiatry Reports · doi:10.1007/s11920-996-0029-8 · Cited by 6
Impact of executive dysfunction on naming ability in multiple sclerosis
Joly, H., Cohen, M., Bresch, S., et al. (2019) · Revue Neurologique · doi:10.1016/j.neurol.2019.02.008 · Cited by 5
Amato, N., Cursi, M., Rodegher, M., Moiola, L., Colombo, B., Falautano, M., Possa, F., Comı, G., Martinelli, V., & Leocani, L. (2016) · Multiple Sclerosis and Demyelinating Disorders · doi:10.1186/s40893-016-0007-x · Cited by 5
“However, the oddball task, used to evoke P3, is not specifically challenging executive function, which is generally a key feature of cognitive involvement observed in MS [5, 16, 17, 21, 47, 57].”
MethodNeuroimaging and genetic correlates of cognitive dysfunction in multiple sclerosis
Guenter, W., Jabłońska, J., Bieliński, M. K., & Borkowska, A. (2015) · Psychiatria Polska · doi:10.12740/pp/32182 · Cited by 5
Cognitive impairment in multiple sclerosis
Feinstein, A. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511543760.008 · Cited by 5
EEG correlates of cognitive impairment in MS
Leocani, L., Magnani, G., Locatelli, T., et al. (1998) · Neurological Sciences · doi:10.1007/bf00539598 · Cited by 5
Neuroimaging correlates of cognitive dysfunction
Feinstein, A. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511543760.011 · Cited by 5
Introzzi, I. M., López-Ramón, M. F., & Urquijo, S. (2008) · Acta Académica (Acta Académica) · Cited by 4
Quantitative analysis of multiple sclerosis: a feasibility study
Li, L. C., Li, X., Wei, X., et al. (2006) · Proceedings of SPIE, the International Society for Optical Engineering/Proceedings of SPIE · doi:10.1117/12.654181 · Cited by 4
“The relationship between cognitive impairment in MS and changes in cerebral structure has been studied using the magnetic resonance (MR) techniques [2-4].”
MethodCognitive Dysfunctions in Multiple Sclerosis
Nocentini, U., Romano, S., & Caltagirone, C. (2012) · Springer eBooks · doi:10.1007/978-88-470-2676-6_17 · Cited by 3
Función ejecutiva y uso de estrategias semánticas en pacientes con esclerosis múltiple
Introzzi, I. M., & Ledesma, R. D. (2008) · Digitum: Institutional Repository of the University of Murcia (University of Murcia) · Cited by 3
Chapter 8 Neuropsychiatry: Cognition and Mood Disorders
Foong, J., & Ron, M. A. (2003) · Blue books of practical neurology · doi:10.1016/s1877-3419(09)70037-6 · Cited by 3
Wisconsin Card Sorting Test with macaque monkeys
Mansouri, F. A., & Tanaka, K. (2003) · International Congress Series · doi:10.1016/s0531-5131(03)00975-0 · Cited by 3
Sartori, É., Belliard, S., Chevrier, C., Trébon, P., Chaperon, J., & Edan, G. (2006) · Revue Neurologique · doi:10.1016/s0035-3787(06)75054-8 · Cited by 3
Estudio de un caso de síndrome frontal
Rodríguez, J. L. S., Alburquerque, J. T. L., & Arenas, A. M. S. (1999) · Anales de Psicología · Cited by 3
ALTERACIONES NEUROPSICOLÓGICAS EN LA ESCLEROSIS MÚLTIPLE
Nieto, A., Barroso, J., Olivares, T., et al. (1996) · Cited by 3
Regional Magnetic Resonance Imaging Lesion Burden and Cognitive Function in Multiple Sclerosis
Sperling, R. A., Guttmann, C. R. G., Hohol, M. J., et al. (2015) · Cited by 2
Houtchens, M. K., & Khoury, S. J. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-384978-6.00052-2 · Cited by 2
Faiss, J. H. (2020) · Springer Reference Medizin · doi:10.1007/978-3-662-60676-6_158 · Cited by 2
Sleep Disorders in Multiple Sclerosis
González-Platas, M., & Pérez-Martín, Y. (2018) · InTech eBooks · doi:10.5772/intechopen.72831 · Cited by 2
“Several factors have a negative influence on cognition in MS patients, such as depression [53], fatigue and sleep disturbances.”
BackgroundOlek, M. J., & Khoury, S. J. (2000) · Elsevier eBooks · doi:10.1016/b978-012288145-9/50063-2 · Cited by 2
Filippi, M., Rovaris, M., & Comı, G. (1996) · Neurological Sciences · doi:10.1007/bf01997712 · Cited by 2
“[1] have reported strong correlations between MRI lesion areas and neuropsychological testing.”
BackgroundCOGNITIVE DYSFUNCTION IN A POPULATION-BASED SAMPLE OF MULTIPLE SCLEROSIS PATIENTS
Hansen, K. R. (1998) · Cited by 2
Neuropsychologische Befunde und Therapieoptionen bei Multipler Sklerose
Haupts, M. R., Calabrese, P., Greim, B., & Zettl, U. K. (2001) · Springer eBooks · doi:10.1007/978-3-642-59453-3_23 · Cited by 2
Impact of Gray Matter Pathology on Cognitive Function in Multiple Sclerosis
Andrea, M., Guttmann, C. R. G., & Zsolt, I. (2012) · InTech eBooks · doi:10.5772/25166 · Cited by 1
“Assessment of the global and regional white matter (WM) lesion burden, derived from T2or T1-weighted MRI shows modest association with cognitive status (Arnett et al., 1994; Hohol, et al., 1997; Patti et al., 2009; Rao et al., 1989; Rovaris et al., 2001; Swirsky-Sacchetti et al., 1992).”
BackgroundCruz-Gómez, Á. J., Belenguer, A., González-Rosa, J. J., et al. (2011) · Revista de Neurología · doi:10.33588/rn.5306.2011155 · Cited by 1
“Estos resultados han sido corroborados en estudios posteriores [12,13].”
BackgroundNeuropsychological Evaluation of Subcortical Dementia
Lovell, M. R., & Smith, S. S. (1997) · Critical issues in neuropsychology · doi:10.1007/978-1-4899-1857-4_13 · Cited by 1
Poreh, A., Pastel, D., Miller, A. K., & Levin, J. B. (2012) · Applied Neuropsychology Adult · doi:10.1080/09084282.2011.643952 · Cited by 1
Metacognition and Frontal Lobe Functioning.
Burton, L. A. (2021) · PubMed Central · doi:10.36131/cnfioritieditore20210202 · Cited by 1
“…viewed as the gold standard index of executive functions (see Kopp, Lange, and Steinke, 2021; Rabin, Barr and Burton, 2005; Strauss, Sherman, and Spreen, 2006), and has shown strong association with dorsolateral frontal lobe functioning (e.g., Arnett et al., 1994; Milner, 1963; Stuss et al., 2000).”
BackgroundArnett, P. A., Barwick, F. H., & Beeney, J. E. (2019) · Springer eBooks · doi:10.1007/978-3-030-14895-9_20 · Cited by 1
Self-citationLobato, E. F. (2009) · Gredos (University of Salamanca) · doi:10.14201/gredos.76237 · Cited by 1
I deficit cognitivi nella sclerosi multipla
Nocentini, U., Romano, S., & Caltagirone, C. (2011) · Springer eBooks · doi:10.1007/978-88-470-1711-5_8 · Cited by 1
Filippi, M. (1998) · Neurological Sciences · doi:10.1007/bf00539595 · Cited by 1
Visuoconstructional impairment: What are we assessing, and how are we assessing it?
Ruffalo, J. S. (2004) · doi:10.23860/diss-somerville-ruffalo-jessica-2004 · Cited by 2
Multitasking and vocational functioning in multiple sclerosis
Morse, C. L., & Schultheis, M. T. (2014) · iDEA - Drexel University Institutional Repository · doi:10.17918/etd-4560 · Cited by 1
Jovanovski, D. (2011) · TSpace (University of Toronto) · Cited by 1
Neuroimaging and Cognitive Function in Multiple Sclerosis
Sweet, L. H., & Vandermorris, S. (2010) · Springer eBooks · doi:10.1007/978-1-4419-6373-4_21 · Cited by 1
Prédiction d'une atteinte cognitive dans la sclérose en plaques : à qui se fier ?
Grosset-Janin, D. (2014) · HAL
Mickens, M. (2014) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/p2h5-r326
The Specificity and Neural Basis of Impaired Inhibitory Control
Lipszyc, J. (2009) · TSpace (University of Toronto)
Psychological predictors of fitness to drive
Leung, J. (2004) · Research Online (University of Wollongong)
Arnett, P., Barwick, F., & Beeney, J. E. (2010) · Springer eBooks · doi:10.1007/978-1-4419-1364-7_18 · Cited by 1
“There is some evidence that frontal lobe lesions are associated with deficits on executive tasks like Wisconsin Card Sorting Test (WCST) [27].”
BackgroundSelf-citationOttimizzazione della riabilitazione cognitiva in pazienti con sclerosi multipla
Graceffa, A. M. S., Baradello, A., Salvo, A. D., et al. (2008)
y Martín, J. M. B., Carrión, J. L., Sánchez, M. D. L. A. M., et al. (1999) · Revista española de neuropsicología
Nakatsuji, Y. (2014) · Clinical and Experimental Neuroimmunology · doi:10.1111/cen3.12143
Introzzi, I. M., López-Ramón, F., & Urquijo, S. (2008) · Dialnet (Universidad de la Rioja)
Depression and executive dysfunction after stroke
Vataja, R. (2005) · Työväentutkimus Vuosikirja
Filley, C. M. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781139548878.008
Cruz-Gómez, Á. J., Belenguer, A., Ventura‐Campos, N., et al. (2011) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
An investigation of the cognitive nature of general intelligence
Davies, S. P. (2004) · UWA Profiles and Research Repository (University of Western Australia)
Lapshin, Y. (2013) · TSpace (University of Toronto)
Decision making under risk in multiple sclerosis
Radomski, A. D. (2013) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r3bg2hh5w
Large-Scale Network Dynamics of Visual Working Memory
Cebulski, S. (2017) · doi:10.22215/etd/2017-12104
López, M. E. (2014) · doi:10.18002/10612/3601
Cognition and the cerebellum in multiple sclerosis
Hinchliffe, J. R. (2017)
Brochet, B., Grassiot, B., & Defer, G. L. (2010) · Elsevier eBooks · doi:10.1016/b978-2-294-70469-7.00015-0
Carbonell, J. P., & Pérez, T. O. (2011) · Elsevier eBooks · doi:10.1016/b978-84-458-2066-7.00012-4
Ondansetron and its use in preventing spinal anesthesia-induced hypotension
Carroll, C., Schultz, S., & Specht, D. M. (2021) · iDEA - Drexel University Institutional Repository · doi:10.17918/etd-4122
Faiss, J. H., & Wiethölter, H. (2011) · Springer eBooks · doi:10.1007/978-3-642-16920-5_45
“…»stumme« Läsionen in der grauen und weißen Substanz und sind möglicherweise exaktere Prädiktoren für Krankheitsprogression als das Ausmaß physischer Behinderung, weil kognitive Dysfunktion eine hohe Korrelation mit der MRI-Läsionslast und dem Ausmaß der Hirnatrophie aufweist (Arnett et al.1994).”
BackgroundFilley, C. M. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781139548878.009
Faiss, J. H. (2018) · Springer Reference Medizin · doi:10.1007/978-3-662-44768-0_158-1
Inflammatory, immune-mediated, and systemic disorders
Larner, A. J. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139176095.008
The Nature of Cognitive Impairment in Multiple Sclerosis
Carlew, A. R. (2018) · doi:10.12794/metadc1248461
Haq, I. U., Sirica, D., Wheelock, V., Benedict, R. H. B., Sarno, M., Tjaden, K., Ozelius, L. J., Firth, R. S., Napoli, E., Sweadner, K. J., et al. (2026) · medRxiv · doi:10.64898/2026.02.18.26345928
Preziosa, P., Azzimonti, M., Storelli, L., Valsasina, P., Tedone, N., Margoni, M., Filippi, M., & Rocca, M. A. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-03921-x
Modifications émotionnelles dans la sclérose en plaques : étude en neuropsychologie et neuroimagerie
Pfaff, L. (2018) · theses.fr (ABES) · doi:10.70675/bf935117z62f7z461bz8258zdae1d6e2e306
Towards a unified view of metacognition : Insights from metamemory
Mazancieux, A. (2020) · theses.fr (ABES) · doi:10.70675/f37dcebbz4e30z4da4za014z74039ef3666f
Khayat-Khoei, M., Houtchens, M. K., & Khoury, S. J. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-45863-7.00078-0
Mesocortical dopamine hypofunction and prefrontal plasticity deficits in the cuprizone model
Dazzi, L., Talani, G., Biggio, F., Mostallino, M. C., Puliga, R., Pau, M., Cocco, E., & Sanna, E. (2026) · Neurobiology of Disease · doi:10.1016/j.nbd.2026.107617
Aspetti cognitivi nella sclerosi multipla
Grossi, P., & Possa, M. F. (2012) · Springer eBooks · doi:10.1007/978-88-470-2724-4_12
Clinical and Paraclinical Outcomes for Treatment Trials in Multiple Sclerosis
Comi, G., & Rovaris, M. (1999) · Springer eBooks · doi:10.1007/978-88-470-2153-2_2
Metadata
- Authors
- Arnett, P. A., Rao, S. M., Bernardin, L., Grafman, J., Yetkin, F. Z., & Lobeck, L.
- Affiliations
- National Institutes of Health (US)
- Venue
- Neurology
- Published
- 1994-03
- Volume
- 44
- Issue
- 3_part_1
- Pages
- 420-420
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2041731350
- Cited by
- 279
- References
- 0
- Citations by year
- 2026: 4 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 7 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 13 · 2013: 5 · 2012: 12
- FWCI
- 8.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k04ns001055-03, 5r01ns022128-07)
- National Institute of Neurological Disorders and Stroke (K04 NS01055, NINDS R01 NS22128)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- multiple sclerosis, frontal lobe lesions, Wisconsin Card Sorting Test, conceptual reasoning, perseveration, white matter lesions, lesion localization, cognitive decline, demyelinating lesions, frontal lobe
- MeSH terms
- Adult, Aged, Cognition, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Neuropsychological Tests
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