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Bieth T, Facque V, Altmayer V, Poisson I, Ovando-Tellez M, Moreno-Rodriguez S, Lopez-Persem A, Mandonnet E, Volle E. Impaired creative cognition after surgery for an IDH-mutated glioma: A proof-of-concept study. Cortex 2024; 174:219-233. [PMID: 38593576 DOI: 10.1016/j.cortex.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/11/2023] [Accepted: 02/27/2024] [Indexed: 04/11/2024]
Abstract
Assessment of high cognitive functions, such as creativity, is often overlooked in medical practice. However, it is crucial to understand the impact of brain tumors, specifically low-grade gliomas, on creative cognition, as these tumors predominantly affect brain regions associated with cognitive creativity. In this study, we investigated creative cognition using the Alternative Uses Task (AUT) and the Combination of Associates Task (CAT) in a cohort of 29 patients who underwent brain surgery for a low-grade glioma, along with 27 control participants. While the group of patients did not exhibit deficits in clinical neuropsychological assessments, our results revealed significant impairment in generating original and creative ideas compared to the control group. Furthermore, when analyzing the specific brain regions affected by the tumors, patients with lesions overlapping the left rostro-lateral prefrontal cortex, a critical region for creativity, displayed more pronounced impairments in the CAT compared to patients with lesions outside this region. These findings provide proof of concept that patients can experience impaired creative cognition following surgery for low-grade glioma, highlighting the importance of assessing higher-order cognitive functions, including creativity, in neurosurgical patients. Moreover, beyond its clinical relevance, our study contributes to advancing our understanding of the neuroscience of creativity.
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Affiliation(s)
- Théophile Bieth
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France; Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
| | - Valentine Facque
- Humans Matter, France; Department of Neurosurgery, Lariboisière Hospital, Paris, France
| | - Victor Altmayer
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France; Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Isabelle Poisson
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
| | - Marcela Ovando-Tellez
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Sarah Moreno-Rodriguez
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Alizée Lopez-Persem
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Emmanuel Mandonnet
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France; Department of Neurosurgery, Lariboisière Hospital, Paris, France; Université de Paris Cité, Paris, France.
| | - Emmanuelle Volle
- Sorbonne University, Institut du Cerveau - Paris Brain Institute -ICM-, Inserm, CNRS, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France.
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Robinson GA, Tjokrowijoto P, Ceslis A, Biggs V, Bozzali M, Walker DG. Fluency test generation and errors in focal frontal and posterior lesions. Neuropsychologia 2021; 163:108085. [PMID: 34793818 DOI: 10.1016/j.neuropsychologia.2021.108085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 11/24/2022]
Abstract
The number produced on fluency tasks is widely used to measure voluntary response generation. To further evaluate the relationship between generation, errors, and the area of anatomical damage we administered eight fluency tasks (word, design, gesture, ideational) to a large group of focal frontal (n = 69) and posterior (n = 43) patients and controls (n = 150). Lesions were analysed by a finer-grained frontal localisation method, and traditional subdivisions (anterior/posterior, left/right frontal). Thus, we compared patients with Lateral lesions to patients with Medial lesions. Our results show that all fluency tasks are sensitive to frontal lobe damage for the number of correct responses and, for the first time, we provide evidence that seven fluency tasks show frontal sensitivity in terms of errors (perseverations, rule-breaks). Lateral (not Medial) patients produced the highest error rates, indicative of task-setting or monitoring difficulties. There was a right frontal effect for perseverative errors when retrieving known or stored items and rule-break errors when creating novel responses. Left lateral effects were specific to phonemic word fluency rule-breaks and perseverations for meaningless gesture fluency. In addition, our generation output and error findings support a frontal role in novelty processes. Finally, we confirm our previous generation findings suggesting critical roles of the superior medial region in energization and the left inferior frontal region in selection (Robinson et al., 2012). Overall, these results support the notion that frontal functions comprise a set of highly specialised cognitive processes, supported by distinct frontal regions.
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Affiliation(s)
- Gail A Robinson
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia; School of Psychology the University of Queensland, St Lucia, Brisbane, Australia.
| | | | - Amelia Ceslis
- School of Psychology the University of Queensland, St Lucia, Brisbane, Australia
| | - Vivien Biggs
- BrizBrain & Spine, The Wesley Hospital, Brisbane, Australia
| | - Marco Bozzali
- Department of Neuroscience, University of Turin, Torino, Italy; Brighton and Sussex Medical School, University of Sussex, East Sussex, UK; Neuroimaging Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - David G Walker
- BrizBrain & Spine, The Wesley Hospital, Brisbane, Australia
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