Mental representation of knowledge following frontal-lobe or postrolandic lesions

Distinct mechanisms and functions of episodic memory

The concept of episodic memory (EM) faces significant challenges by two claims: EM might not be a distinct memory system, and EM might be an epiphenomenon of a more general capacity for mental time travel (MTT). Nevertheless, the observations leading to these arguments do not preclude the existence of a mechanically and functionally distinct EM system. First, modular systems, like cognition, can have distinct subsystems that may not be distinguishable in the system's final output. EM could be such a subsystem, even though its effects may be difficult to distinguish from those of other subsystems. Second, EM could have a distinct and consistent low-level function, which is used in diverse high-level functions such as MTT. This article introduces the scenario construction framework, proposing that EM crucially rests on memory traces containing the gist of an episodic experience. During retrieval, EM traces trigger the reconstruction of semantic representations, which were active during the remembered episode, and are further enriched with semantic information, to generate a scenario of the past experience. This conceptualization of EM is consistent with studies on the neural basis of EM and resolves the two challenges while retaining the key properties associated with EM. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

It's not a lie … If you believe it: Narrative analysis of autobiographical memories reveals over-confidence disposition in patients who confabulate

Humans perceive their personal memories as fundamentally true, and although memory is prone to inaccuracies, flagrant memory errors are rare. Some patients with damage to the ventromedial prefrontal cortex (vmPFC) recall and act upon patently erroneous memories (spontaneous confabulations). Clinical observations suggest these memories carry a strong sense of confidence, a function ascribed to vmPFC in studies of memory and decision making. However, most studies of the underlying mechanisms of memory overconfidence do not directly probe personal recollections and resort instead to laboratory-based tasks and contrived rating scales. We analyzed naturalistic word use of patients with focal vmPFC damage (N = 18) and matched healthy controls (N = 23) while they recalled autobiographical memories using the Linguistic Inquiry and Word Count (LIWC) method. We found that patients with spontaneous confabulation (N = 7) tended to over-use words related to the categories of 'certainty' and of 'swearwords' compared to both non-confabulating vmPFC patients (N = 11) and control participants. Certainty related expressions among confabulating patients were at normal levels during erroneous memories and were over-expressed during accurate memories, contrary to our predictions. We found no elevation in expressions of affect (positive or negative), temporality or drive as would be predicted by some models of confabulation. Thus, erroneous memories may be associated with subjectively lower certainty, but still exceed patients' report criterion because of a global proclivity for overconfidence. This may be compounded by disinhibition reflected by elevated use of swearwords. These findings demonstrate that analysis of naturalistic expressions of memory content can illuminate global meta-mnemonic contributions to memory accuracy complementing indirect laboratory-based correlates of behavior. Memory accuracy is the result of complex interactions among multiple meta-mnemonic processes such as monitoring, report criteria, and control processes which may be shared across decision-making domains.

Mental representations of daily activities throughout the course of dementia

BACKGROUND

Since dementia is a result of cognitive rather than physical impairment, cognitive aspects are important for care planning. This mixed-model study aims to understand how the loss of cognitive functioning affects mental representations of daily activities.

METHODS

Mental representations were assessed via the script generation task of daily activities (grocery shopping, dentist appointment, doing laundry, leaving the house, car accident) and a qualitative semi-structured interview from 25 people (age (mean: 67.64; SD: 23.625), gender (f: 14 (56%); m: 17 (68%)). Cognitive status was assessed via the Montreal Cognitive Assessment.

RESULTS

Mental representations of daily activities loose content and get inaccurate throughout the disease (i.e. number of actions, abstractions, unemotional content) with poorer cognitive status. People with mild dementia report the most strategies and extend their mental representation by including strategies to circumvent experienced problems. Overall, mental representations of daily activities seem to be largely intact throughout the course of dementia (i.e. sequencing, personalisations, intrusions, examples, emotional content).

CONCLUSION

This study outlines that even though the content of mental representations decreases with dementia, the mental representations themselves remain in good order. Performance of daily activities throughout dementia may be hampered by the loss of content of the generated actions.

A Representational Approach to Executive Function Impairments in Young Adults with Down Syndrome

Based on a representational perspective, this paper examines executive functioning in Down syndrome. Sixteen young adults with Down syndrome, 16 mental age- and 16 age-matched controls were compared on script sequencing and sorting tasks. Participants were asked to reestablish the sequential structure of script actions given with or without irrelevant actions. Impairments in script information processing were observed only in young adults with Down syndrome, who performed more slowly than controls, making mistakes in ordering actions, but rejecting aberrant elements. These data are consistent with the view that Down syndrome impairs the syntactic but not semantic dimension of script representation.

The status of semantic memory in medial temporal lobe amnesia varies with demands on scene construction

Semantic memory is typically preserved in medial temporal lobe (MTL) amnesia. However, there are instances of impairment, such as in the recall of semantic narratives. As some forms of semantic knowledge play out in a spatial context, one possible explanation is that semantic memory impairments, when observed, relate to demands on scene construction - the ability to bind and maintain spatial information in a coherent representation. To investigate whether semantic memory impairments in MTL amnesia can be understood with reference to a deficit in scene construction, the current study examined knowledge of scripts that vary in the extent to which they play out in a scene context in nine patients with MTL amnesia and eighteen healthy control subjects. Scripts are routine activities characterized by an ordered set of actions, including some that are essential for completing the activity. Comparing performance on scene-based scripts (e.g., buying groceries at the grocery store) and object-based scripts (e.g., addressing a letter), we found that patients generated the same number of total action steps as controls for both types of script, but patients were selectively impaired at generating essential actions steps for scene-based scripts. Furthermore, patients made more sequencing and idiosyncratic errors than controls in the scene-based, but not in the object-based, scripts. These findings demonstrate that the hippocampus plays a critical role in the retrieval of semantic knowledge about everyday activities when such retrieval entails scene construction.

Script Generation and Executive Dysfunction in Patients with Anterior and Posterior Brain Lesions

Introduction: Studies on script processing have shown inconsistent relations between deficits in script action generation and frontal lobe pathology. Therefore, we investigated which difficulties in script action generation are linked to anterior lesions. Moreover, we explored whether verbal script generation can be predicted by specific executive processes.

Methods: Fifty-two patients with acquired brain injury (mean age: 44.23 years, 30 male/22 female) were included, of whom 30 had anterior and 22 had posterior lesions. Several indices of the Everyday Description Task were investigated: relevant central actions (RCAs); relevant trivial actions (RTAs); relevant and irrelevant intrusions (RI & IRI); sequencing (SEs) and perseverative (PEs) errors. Additionally, fivez-composite scores representing planning, response generation, working memory, inhibition and shifting were calculated. Correlations and multiple linear regression analyses were computed.

Results: Anteriorly lesioned patients produced significantly less RCAs and more PEs and SEs compared to posteriorly damaged patients. No differences were found with RTAs, RI and IRI. RCAs were predicted by planning, response generation and working memory, RI by response generation and working memory, IRI by inhibition, PEs and SEs by response generation and shifting. None of these executive processes predicted RTAs.

Conclusions: Difficulties in RCAs, PEs and SEs are sensitive indicators of anterior brain damage and script generation demands various executive abilities.

The cooking task: making a meal of executive functions

Current standardized neuropsychological tests may fail to accurately capture real-world executive deficits. We developed a computer-based Cooking Task (CT) assessment of executive functions and trialed the measure with a normative group before use with a head-injured population. Forty-six participants completed the computerized CT and subtests from standardized neuropsychological tasks, including the Tower and Sorting Tests of executive function from the Delis-Kaplan Executive Function System (D-KEFS) and the Cambridge prospective memory test (CAMPROMPT), in order to examine whether standardized executive function tasks, predicted performance on measurement indices from the CT. Findings showed that verbal comprehension, rule detection and prospective memory contributed to measures of prospective planning accuracy and strategy implementation of the CT. Results also showed that functions necessary for cooking efficacy differ as an effect of task demands (difficulty levels). Performance on rule detection, strategy implementation and flexible thinking executive function measures contributed to accuracy on the CT. These findings raise questions about the functions captured by present standardized tasks particularly at varying levels of difficulty and during dual-task performance. Our preliminary findings also indicate that CT measures can effectively distinguish between executive function and Full Scale IQ abilities. Results of the present study indicate that the CT shows promise as an ecologically valid measure of executive function for future use with a head-injured population and indexes selective executive function’s captured by standardized tests.

Pragmatic use of language by children who develop schizophrenia in adult life

At eleven years of age all children in a UK national birth cohort wrote short stories about the life they expected to be leading at age 25. Using a data linkage exercise, we identified those who later developed schizophrenia, affective psychosis, or other non-psychotic psychiatric disorders in later life based on the PSE CATEGO diagnostic system. The majority of these had completed the written essays. Controls from the reference population were selected, matched for gender, IQ and social and economic status. The essays were scored using well established methods for assessing pragmatic use of language, namely narrative coherence and linguistic cohesion. We hypothesised that children pre-morbid for schizophrenia (Pre-Scz) would obtain low scores on all these measures. However this general hypothesis was largely disproved by the data, although some unpredicted gender effects were found. It is concluded that thought is organised in an unexceptional way in adolescents before they develop schizophrenia, once the data are corrected for any lowering of general cognitive ability in the Pre-Scz cases.

Impairment of script comprehension in Lewy body spectrum disorders

A disabling impairment of higher-order language function can be seen in patients with Lewy body spectrum disorders such as Parkinson's disease (PD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB). We focus on script comprehension in patients with Lewy body spectrum disorders. While scripts unfold sequentially, constituent events are thought to contain an internal organization. Executive dysfunction in patients with Lewy body spectrum disorders may interfere with comprehension of this internal structure. We examined 42 patients (30 non-demented PD and 12 mildly demented PDD/DLB patients) and 12 healthy seniors. We presented 22 scripts (e.g., "going fishing"), each consisting of six events. Pilot data from young controls provided the basis for organizing associated events into clusters and arranging them hierarchically into scripts. We measured accuracy and latency to judge the order of adjacent events in the same cluster versus adjacent events in different clusters. PDD/DLB patients were less accurate in their ordering judgments than PD patients and controls. Healthy seniors and PD patients were significantly faster to judge correctly the order of highly associated within-cluster event pairs relative to less closely associated different-cluster event pairs, while PDD/DLB patients did not consistently distinguish between these event-pair types. This relative insensitivity to the clustered-hierarchical organization of events was related to executive impairment and to frontal atrophy as measured by volumetric MRI. These findings extend prior work on script processing to patients with Lewy body spectrum disorders and highlight the potential impact of frontal/executive dysfunction on the daily lives of affected patients.

The impact of semantic dementia on everyday actions: evidence from an ecological study

In theory, semantic memory may trigger and support the execution of everyday activities. This study explored this question by comparing three patients with semantic dementia to 40 normal controls performing different everyday activities. Participants were tested in their home using the Instrumental Activities of Daily Living Profile, an ecological measure of everyday functioning. Participants were informed that they had unknowingly invited two guests for lunch and should prepare accordingly. With these instructions, they dress to go outdoors, go to the grocery store, shop for food, prepare a hot meal, have the meal with the guests, and clean up after the meal. Performance was analyzed on the basis of four operations related to problem solving: formulate a goal, plan, execute, and verify attainment of the goal. Results indicate that compared to normal controls, two patients had significant difficulties and needed assistance with all operations of problem-solving, particularly while preparing a meal and cleaning up after the meal. One patient showed no difficulties despite severe semantic deficits. These results suggest that semantic deficits alone cannot explain the difficulties observed, but may contribute to some aspects of everyday actions such as those involved in everyday problem-solving.

Temporal information processing in short- and long-term memory of patients with schizophrenia

Cognitive deficits of patients with schizophrenia have been largely recognized as core symptoms of the disorder. One neglected factor that contributes to these deficits is the comprehension of time. In the present study, we assessed temporal information processing and manipulation from short- and long-term memory in 34 patients with chronic schizophrenia and 34 matched healthy controls. On the short-term memory temporal-order reconstruction task, an incidental or intentional learning strategy was deployed. Patients showed worse overall performance than healthy controls. The intentional learning strategy led to dissociable performance improvement in both groups. Whereas healthy controls improved on a performance measure (serial organization), patients improved on an error measure (inappropriate semantic clustering) when using the intentional instead of the incidental learning strategy. On the long-term memory script-generation task, routine and non-routine events of everyday activities (e.g., buying groceries) had to be generated in either chronological or inverted temporal order. Patients were slower than controls at generating events in the chronological routine condition only. They also committed more sequencing and boundary errors in the inverted conditions. The number of irrelevant events was higher in patients in the chronological, non-routine condition. These results suggest that patients with schizophrenia imprecisely access temporal information from short- and long-term memory. In short-term memory, processing of temporal information led to a reduction in errors rather than, as was the case in healthy controls, to an improvement in temporal-order recall. When accessing temporal information from long-term memory, patients were slower and committed more sequencing, boundary, and intrusion errors. Together, these results suggest that time information can be accessed and processed only imprecisely by patients who provide evidence for impaired time comprehension. This could contribute to symptomatic cognitive deficits and strategic inefficiency in schizophrenia.

The temporal unraveling of autobiographical memory narratives in patients with temporal lobe epilepsy or excisions

Medial temporal lobe epilepsy (TLE), a condition known to affect the integrity and function of medial temporal lobe structures such as the hippocampus, has been shown to disrupt memory for real-life episodes. Here, patients with unilateral TLE, patients who received a unilateral temporal lobe resection to cure TLE, and healthy controls produced free narratives of autobiographical memories (AMs). To assess temporal resolution, narratives were segmented into bits of information, or details, which were classified according to how precisely they could be located within the time course of the AM. Categories included details corresponding to the entire AM, to parts or subevents within the AM, and to actions taking place within seconds to minutes. The number of details per category was tallied and compared between patients and controls. Temporal order was assessed by determining the correct (internally consistent) chronological order of the sequence of events within the narrative. Results indicate that while patients' memory for the parts or subevents of personal episodes was intact, as was their temporal order, their memory for the minute-by-minute unraveling of the episode was impaired. We believe this loss of temporally specific details may contribute to the reduced vividness of AM recollection in TLE patients. Our findings provide further evidence that patients with hippocampal damage retrieve skeletal AMs for which the gist of the memory is maintained, but the specific details are lost.

Script Generation Following Frontal and Parietal Lesions

The purpose of this investigation was to distinguish putative effects of parietal lobe lesions on script generation, in distinction from the better known and established effects of frontal lobe lesions. Nine patients, most with excised parietal lesions, were compared to nine age, gender and education matched normal participants. Eleven patients with excised tumors of the frontal lobe were compared to twelve age, gender and education matched normal subjects. Participants were requested to generate, out loud, scripts corresponding to everyday activities. Half the scripts were relatively more demanding with respect to temporal representation (understanding the time line of events) and the other half with respect to spatial representation (understanding the layout of the actions in space). These two conditions were further broken down into conditions of high and low demands on working memory (reciting the scripts backwards versus forward). The frontal lobe patients enunciated significantly fewer actions overall. They were also significantly more impaired than the normal participants on all tasks with high demands on working memory, and more often, high temporal demands (sequencing and perseverative errors). The parietal lobe patients had significant difficulty in sequencing in all conditions, and manifested no perseveration. Though script generation tasks have been primarily associated with frontal lobe function until now, consideration should be given to the type of activity being scripted as a function of relative demands on spatial or temporal representation, as well as working memory, and the contributions of other lobes ought to be taken into consideration.

The neural substrates of script knowledge deficits as revealed by a PET study in Huntington's disease

INTRODUCTION

Previous neuropsychological investigations have suggested that both the prefrontal cortex and the basal ganglia are involved in the management of script event knowledge required in planning behavior.

METHODS

This study was designated to map, the correlations between resting-state brain glucose utilization as measured by FDG-PET (positron emission tomography) and scores obtained by means of a series of script generation and script sorting tasks in 8 patients with early Huntington's disease.

RESULTS

These patients exhibited a selectively greater impairment for the organizational aspects of scripts compared to the semantic aspects of scripts. We showed significant negative correlations between the number of sequencing, boundary, perseverative and intrusion errors and the metabolism of several cortical regions, not only including frontal, but also posterior regions.

CONCLUSION

Our findings suggest that, within the fronto-striatal system, the cortical frontal regions are more crucial in script retrieval and script sequencing than the basal ganglia.

Hierarchical organization of scripts: converging evidence from FMRI and frontotemporal degeneration

The present study examined the organization of complex familiar activities, known as "scripts" (e.g., "going fishing"). We assessed whether events in a script are processed in a linear-sequential manner or clustered-hierarchical manner, and we evaluated the neural basis for this processing capacity. Converging evidence was obtained from functional neuroimaging in healthy young adults and from behavioral and structural magnetic resonance imaging (MRI) data in patients with focal neurodegenerative disease. In both studies, participants judged the order of consecutive event pairs taken from a script. Event pairs either were clustered together within a script or were from different clusters within the script. Controls judged events more accurately and quickly if taken from the same cluster within a script compared with different clusters, even though all event pairs were consecutive, consistent with the hierarchical organization of a script. Functional magnetic resonance imaging associated this with bilateral inferior frontal activation. Patients with progressive nonfluent aphasia or behavior-variant frontotemporal dementia did not distinguish between event pairs from the same cluster or from different clusters within a script. Structural MRI associated this deficit with significant frontal cortical atrophy. Our findings suggest that frontal cortex contributes to clustering events during script comprehension, underlining the role of frontal cortex in the hierarchical organization of a script.

How to make a spaghetti sauce with a dozen small things I cannot name: a review of the impact of semantic-memory deficits on everyday actions

The purpose of this article is to present current evidence regarding the role of semantic memory in everyday actions. First we describe key models of everyday actions. We then discuss current evidence regarding the role of semantic memory in everyday actions. We reviewed articles reporting on the execution and representation of everyday actions in populations with semantic-memory deficits and single-object use in patients with semantic dementia. Although the evidence is sparse, the general conclusion of this review is that semantic memory seems necessary to support everyday actions. Finally, future challenges and research perspectives are discussed.

The factorial validity and internal consistency of the Instrumental Activities of Daily Living Profile in individuals with a traumatic brain injury

The objective of the study was to investigate the factorial validity and internal consistency of the Instrumental Activities of Daily Living (IADL) Profile. A group of 96 patients aged 16 to 65 years, with moderate to severe traumatic brain injuries, was recruited from 12 rehabilitation hospitals in Quebec. The IADL Profile was administered by an occupational therapist in each subject's home and community environment. Principal axis factoring and confirmatory factor analysis provide preliminary support for six correlated factors (F): (F1) going to grocery store/shopping for groceries, (F2) having a meal with guests/cleaning up, (F3) putting on outdoor clothing, (F4) obtaining information, (F5) making a budget, (F6) preparing a hot meal for guests. Total explained variance was 73.6%. Cronbach's alpha analysis revealed high to very high internal consistency for all scales ranging from .81 to .98; internal consistency of the total scale was very high (0.95). The findings suggest that the IADL Profile is a promising means of documenting both IADL independence and the repercussions of executive function deficits on everyday tasks in real-world environments.

Generalised script sequencing deficits following frontal lobe lesions

Neuropsychological investigations have consistently shown that frontal cortices are relevant in processing temporal and sequential features of actions. However, one of the main theoretical issues that has been discussed in the last 25 years is whether these brain areas store some abstract representations of actions or, conversely, act upon action representations stored within other posterior associative cortices. We administered to 19 patients with frontal lobe lesions and 19 normal controls, script sequencing and generating tasks concerning actions, natural events and "époques" (ordered events such as the days of the week). The main findings from frontal lobe patients were a generalised sequencing deficit concerning actions and natural phenomena (and not what we labelled "époques") with almost intact ability to verbally generate, from the long-term memory, scripts' sequences. These findings are discussed within two of the main theoretical frameworks on frontal lobes: the "processing" perspective of the Supervisory Attentional System, SAS (Norman and Shallice, 1986) and the "representational" one represented by the Structure Event Complex (SEC) theory (Grafman, 2002).

Neuropsychological and activity of daily living script performance in patients with positive or negative schizophrenia

Cognitive and psychiatric determinants of impairment of complex activities of daily living (ADLs) were investigated in 33 schizophrenic patients and 16 normal comparison subjects. The schizophrenic patients were cognitively impaired and were deficient in the ADL. However, the impairment of ADL could not be explained specifically by impairment of higher-order executive function or by negative symptoms: memory functions were more related to impairment of ADL and positive symptoms as much as the negative ones. Positive symptoms were significantly related to commissive errors in the ADL, whereas negative symptoms were nonsignificantly related to omissive errors. Negative symptoms were significantly more related to memory impairment than to impairment on measures of higher-order executive function (working memory). This investigation demonstrates that an ecologically oriented approach to test development and measurement of ADL is fruitful in understanding schizophrenia-especially if it is constrained by cognitive constructs compatible with the phenomenology of the disease.

Gender differences in performance of script analysis by older adults

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

Cognitive structure of executive deficits in patients with frontal lesions performing activities of daily living

OBJECTIVE

Executive function in activities of daily living (ADL) were investigated in 10 patients with excised frontal lobe tumours.

METHOD

The patients with frontal lesions were compared to 10 normal controls with a neuropsychological test battery, a script generation task and a realistic implementation of complex multi-task ADL (planning and preparing a meal).

RESULTS

The patients manifested numerous basic executive deficits on the paper-pencil tests, were unimpaired on the script generation task despite an aberrant semantic structure and manifested marked anomalies in the meal preparation task.

CONCLUSION

Frontal lobe deficits in lengthy complex multi-task ADL can be explained by impairment of several executive functions, generalized slowness of performance and paucity of behaviour.

How does the brain support script comprehension? A study of executive processes and semantic knowledge in dementia

The neuropsychological substrate of scripts, routines which guide much of human behavior, is unclear. We propose a model of script comprehension characterized by the interaction of semantic knowledge for script content, and executive resources that organize this knowledge into goal directed behavior. We examined these neuropsychological components by asking participants with Alzheimer's disease (AD) and frontotemporal dementia (behavioral disorder/dysexecutive syndrome (BDD) and semantic dementia (SD) subtypes), to judge the coherence of four-phrase scripts. The BDD group detected significantly fewer sequencing errors than semantic errors; the AD and SD groups detected these errors with equal frequency. Independent semantic measures predicted both semantic and sequencing script errors, while executive measures predicted sequencing errors only. Findings support a multi-component model of script comprehension.

Neural Correlates of Script Event Knowledge: a Neuropsychological Study Following Prefrontal Injury

Scripts sequentially link information about daily activities and event knowledge. Patients have difficulty sequencing script events following lesions of the prefrontal cortex while showing intact access to selective aspects of script knowledge. It has been suggested that the sequencing impairment is due to a deficit in an inhibitory gating mechanisms that usually enables selection of an item from competing alternatives. If this is the case, then an inhibitory task should reveal script processing impairments on a script categorization task that is not normally associated with poor performance following prefrontal damage. To test this hypothesis, we administered a simple untimed classification task and a modified Go/NoGo task in which subjects classified events from social and non-social activities (e.g., read the menu, order the food) and related semantic items (e.g., menu, order) in terms of whether they belonged to a target activity. Participants were patients with lesions of the prefrontal cortex and matched controls. The results showed that damage to the right orbitofrontal cortex was associated with social item classification errors in the simple untimed classification task. In addition, the damage to the right prefrontal cortex was associated with increased response times to respond correctly to Go trials in the modified Go/NoGo task. The data demonstrate that damage to the right orbitofrontal cortex results in impairment in the accessibility of script and semantic representations of social activities. This impairment is exacerbated by an inefficient inhibitory gating mechanism.

A region of right posterior superior temporal sulcus responds to observed intentional actions

Human adults and infants identify the actions of another agent based not only on its intrinsic perceptual features, but critically on the contingent relationship between its motion path and the environmental context [Trends Cogn. Sci. 7 (1995) 287; Cognition 72 (2003) 237]. Functional neuroimaging studies of the perception of agents and intentional actions, on the other hand, have mostly focussed on the perception of intrinsic cues to agency, like a face or articulated body motion (e.g. [J. Neurosci. 17 (1997) 4302; Neuroimage 8 (1998) 221; Trends Cogn. Sci. 4 (2000) 267; Nat. Neurosci. 3 (2000) 80; Neuroimage 13 (2001) 775; Proc. Natl. Acad. Sci. U.S.A. 98 (2001) 11656; Neuron 35 (2002) 1167; Neuron 34 (2002) 149, Neuroscience 15 (2003) 991; J. Neurosci. 23 (2003) 6819; Philos. Trans. R Soc. Lond. B. Biol. Sci. 358 (2003) 435]. Here we describe a region of the right posterior superior temporal sulcus that is sensitive not to articulated body motion per se, but to the relationship between the observed motion and the structure of the surrounding environment. From this and other aspects of the region's response, we hypothesize that this region is involved in the representation of observed intentional actions.

Arrangement de scripts dans la maladie de Huntington

According to Norman and Shallice, the basal ganglia are involved in the activation and maintenance of overlearned or routine scripts in action planning. This study aimed to investigate how patients with Huntington disease manipulate scripts. Ten patients with Huntington's disease and 12 normal control subjects matched by age and education were asked to re-establish the sequential order of series of script actions which were given with or without distractor elements (i.e. with or without actions belonging to trivial scripts). Compared with normal controls, patients with Huntington disease made significantly more errors in script sequencing. However there was no significant difference in performance between patients with Huntington disease and normal control subjects in inhibiting irrelevant actions. These results suggest that early Huntington's disease patients exhibit early impairment in their ability to produce temporally coherent sequences without deficit in their ability to eliminate distractors in the action domain. These results support in part the predictions of Norman and Shallice's model. From a neuroanatomical point of view, this dissociation of performance fits with what is known about the neuropathological progression of Huntington's disease in which neuronal loss progresses in a dorsal-to-ventral direction and with what was shown in patients with circumscribed frontal lobe damage. In these patients, impairment in script sequencing is related to lesions in the lateral prefrontal regions.

Syndromes dysexécutifs et maladies dégénératives

A dysexecutive syndrome is observed not only in frontotemporal lobar degeneration, but also in subcortical degenerative diseases, and even in Alzheimer's disease whose lesions predominate in temporoparietal associative areas. The association between a dysexecutive syndrome and various cerebral localisations may be explained by the fact that cognitive and behavioral organisation recruits anatomofunctional frontostriatal and frontoparietal circuits. Both animal experimentation and human clinical observation argue in favour of a functional continuity and complementarity among these loops. The prefrontal cortex would be particularly needed in new situations, to inhibit old programs of action not adapted to the present context and to elaborate new ones; the basal ganglia would be rather required by the repetition of the situation to progressively transform the new program in routine. If we refer to Shallice model, we can hypothesize that optimal executive functions require the preservation not only of the Supervisory Attentional System, mainly dependent on the prefrontal cortex, but also of the Contention Scheduling, recruiting the basal ganglia, and of the Schemas of Action, represented in parietal and premotor areas. Therefore, the neuropsychological assessment of patients with degenerative diseases contributes to the understanding of the anatomofunctional architecture of executive functions.

A case study of selective impairment of the central executive component of working memory after a focal frontal lobe damage

RC is a 36-year-old man who sustained a closed head injury with bilateral frontal lobe hypometabolism in 1978. In 1994, after a lobectomy of a large part of the left frontal lobe, he presented no behavioral disruption and normal performances on most of intelligence, long-term memory, and executive tests. However, he showed deficits in tasks that implicate short-term storage (i.e., span tasks). These deficits in working memory were explored with regard to Baddeley's model using computerized tasks. On these tasks RC showed normal functioning of the articulatory loops and dysfunction of the central executive component in dual tasks. These results confirm those reported in another single case study by Van Der Linden, Coyette, and Seron (1992) and indicate that dual-task performance may assess one separable feature of executive functions.

Defective representation of knowledge in Parkinson's disease: evidence from a script-production task

The deficits seen in frontal-lobe patients and in the elderly show clearly that spontaneous script generation depends on good frontal-lobe function. Shallice, however, has proposed that one aspect of script generation (contention scheduling, CS) which is involved in the activation and maintenance of overlearned or routine scripts may depend more on the basal ganglia. Patients with Parkinson's disease would thus be expected to manifest deficits somewhat different from those observed in frontal-lobe patients when generating scripts. The performances of 16 nondemented and nondepressed patients with idiopathic Parkinson's disease were compared to those of 16 age-matched normal control subjects under two experimental conditions; routine, forward script generation and nonroutine, backward script generation. Parkinsonian patients generated scripts significantly deprived of contextual elements in the forward condition and made significantly more sequencing and perseverative errors in both forward and backward conditions than did normal subjects. They also produced a significantly higher number of irrelevant intrusions, in both conditions, than did controls. These results support, in a general sense, Shallice's notion that the basal ganglia are important in script generation; however, other specific predictions of Shallice's model were not supported by our findings.

An ecological approach to planning dysfunction: script execution

Planning, which concerns many activities in everyday life, is a two-stage process. The first one predetermines a course of actions aimed at achieving some specific goals. It is founded on managerial knowledge or overlearned sequences of events and may be tested by script generation. The second stage entails monitoring and guiding the execution of the plan to a successful conclusion. It must take into account environmental contingencies and may be tested by script execution. If the frontal lobes intervene not only in managerial knowledge (Grafman, 1989) but also in binding the plan with contextual environment (Damasio, Tranel and Damasio, 1991; Shallice and Burgess, 1991), script execution would be more sensitive than script generation to planning deficits. To test this hypothesis, script execution and script generation were compared in 11 patients with a dysexecutive syndrome and 10 matched controls, using three scripts of daily life activities: (1) 'shopping for groceries'; (2) 'cooking'; (3) 'answering a letter and finding the way to post the reply'. Two way ANOVAs showed more errors in execution than in generation, more errors in patients than in controls, and a greater difference between execution and generation in patients than in controls. Furthermore, 'context neglect' and 'environmental adherence' were the two types of errors that best differentiated patients from controls. Finally, the total number of errors in execution correlated with the score on behavioral questionnaires answered by occupational therapists. These results confirm our hypothesis and suggest that script execution may be a valid ecological approach to estimate the severity of deficits in daily life activities.

Virtual planning in patients with frontal lobe lesions

The VIrtual Planning Test (VIP) was developed to investigate the planning and organisational abilities of 25 patients with frontal lobe neurosurgical lesions, comparing their performance with 25 matched control subjects. The task, presented in the form of a board game, simulates planning and execution of a set of target activities that have to take place over a four day period, involving those that are either preparatory for a fictional "trip" abroad, or those that relate to the subject's current environment (context). The frontal lobe patients were impaired overall, tending to select inappropriate activities associated with their current context and showing greater impairment on subtasks requiring only one, rather than two, preparatory acts. The findings are discussed in terms of the validity of the VIP test in identifying executive functioning impairment and the degree to which the pattern of deficits are consistent with neuropsychological models of executive function.

Learning and forgetting processes in Parkinson's disease: a model-based approach to disentangling storage, retention and retrieval contributions

Learning and forgetting a prose passage was studied in 20 patients with Parkinson's disease and in 20 normal control subjects by means of stochastic models, with the aim of identifying the learning and retaining abilities that are affected by Parkinson's disease. Results suggested that Parkinson's disease patients are impaired in developing automatic processing both during learning and retaining, while functions that require active attention are spared. The automatic/intentional dissociation, which is the hallmark of motor disturbance in Parkinson's disease, extends to memory abilities, and, on the grounds of neuroanatomical, neurochemical and neurophysiological correlates, suggests that the memory deficit in Parkinson's disease may be contingent on a dysfunction of the medial prefrontal-cingulate cortex.