WK8: Deficits in Planning I: Frontal Lobe Disorders

• What is the primary focus of the investigation into deficits in planning?

  To look at patients with Frontal Lobe Damage
• What functions are the frontal lobes involved in?

  Motor functions, higher order functions, planning, impulse control, reasoning, problem solving, and memory
• Who was Phineas Gage?

  A 25-year-old railroad worker who suffered a brain injury
• What happened to Phineas Gage after his accident?

  His behavior changed significantly
• How did Phineas Gage's behavior change after his accident?

  He became vulgar, intolerable, and impatient
• What does Gage's behavior suggest about the frontal lobes?

  They are involved in planning and maintenance of behaviors
• What was the task given to patients in Karpov et al. (1968)?

  To scan a picture to answer a specific question
• What difficulty did frontal lobe patients face in Karpov et al. (1968)?

  They had difficulty modulating eye movements and generating strategies
• Who was patient EVR in Saver and Damasio (1991)?

  A patient who underwent an operation to remove parts of the frontal lobes
• What were the consequences of EVR's operation?

  He developed socially abnormal behavior and had problems planning
• What does Luria (1966) suggest about the frontal lobes?

  They are responsible for programming and regulating behavior
• What is the Supervisory Activating System (SAS) according to Norman & Shallice (1986)?

  It controls responses in complex actions when routine control is insufficient
• What happens if there are problems with the SAS?

  Automatic actions will persist until inhibited by the SAS
• What is the Wisconsin Card Sorting Task (WCST)?

  A task where patients sort cards by changing rules
• What do frontal lobe patients struggle with in the WCST?

  They continue to sort by the old rule even after being told it has changed
• What is perseveration in the context of frontal lobe patients?

  Inability to inhibit actions, leading to repetitive behaviors
• What is the purpose of the Fluency Test?

  To measure how many words a patient can generate beginning with a certain letter
• How do patients with frontal lobe damage perform on the Fluency Test?

  They have problems generating a list of words and often perseverate
• What is the Alternate Uses Test designed to assess?

  How many different uses a patient can think of for an everyday object
• What difficulties do patients face in the Alternate Uses Test?

  They struggle to inhibit automatic responses and think of atypical uses
• What does the Hayling Sentence Completion test measure?

  Patients' ability to complete sentences with appropriate or nonsensical words
• How do frontal lobe patients perform on the Hayling Sentence Completion test?

  They show delays in Task A and difficulty in Task B
• What is the Stroop task designed to assess?

  Patients' ability to name the color of ink while ignoring the word
• How do frontal lobe patients perform on the Stroop task?

  They perform poorly due to increased distraction
• What is Utilization Behavior?

  Patients use objects near them even when not instructed to do so
• How does the SAS relate to Utilization Behavior?

  Without the SAS, actions triggered by perceptual input are carried out without inhibition
• What is the Tower of London task designed to assess?

  Participants must move discs to match a goal position in a limited number of moves
• How do patients perform on the Tower of London task according to Owens et al. (1990)?

  They are fine at making the first move but take longer on subsequent moves
• What is the difference between neuropsychological tests and real-life situations for patients?

  Neuropsychological tests often have clear goals and short trials, while real-life situations involve multiple goals and longer tasks
• What did Shallice & Burgess (1991) investigate with their tests?

  They investigated patients' ability to complete multiple tasks in open-ended situations
• What difficulties did patient AP face in everyday life?

  He had severe organizational difficulties and could only buy one item at a time
• What is the purpose of the Multiple Errands Test?


  To assess patients' ability to perform various simple tasks in a real-world setting
• How do patients perform on the Multiple Errands Test?

  They perform worse than controls, are inefficient with time, and break rules
• What do the tests highlight about the SAS's role in planning?

  They highlight the need for the SAS in goal articulation, provisional plan formation, evaluation of process, and plan modification
• What did Goldstein et al. (1993) find about their patient after a left frontal lobectomy?

  The patient had difficulty making decisions but no significant changes in IQ or memory
• How did the patient perform on various neuropsychological tests according to Goldstein et al. (1993)?

  He performed fine on WCST, Hayling sentence completion task, and Six Element Test
• What does the Multiple Errands Task reveal about frontal lobe impairment?

  It is a more sensitive measure of frontal lobe impairment than other tests
• What have we learned about the role of the frontal lobes?

  They act as an executive and are involved in planning
• What is the implication of impaired SAS in frontal lobe patients?

  They are likely to have difficulties with planning and executing tasks
• What types of tasks do neuropsychological assessments typically involve?

  Tasks that investigate problems with the SAS