Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
권호 표지

Cognitive Characteristics Associated with the Performance on Wisconsin Card Sorting Test in Patients with Parkinson's Disease

위스콘신카드분류검사 수행에 관여하는 인지적 특성: 파킨슨병 환자를 대상으로

  • Cho, Hui-Ran (Department of Neurology, Dong-A University College of Medicine, Dong-A University Medical Center) ;
  • Park, Kyung-Won (Department of Neurology, Dong-A University College of Medicine, Dong-A University Medical Center) ;
  • Kim, Jae-Woo (Department of Neurology, Dong-A University College of Medicine, Dong-A University Medical Center)
  • 조희란 (동아대학교 의과대학 신경과학교실 동아대학교병원 신경과) ;
  • 박경원 (동아대학교 의과대학 신경과학교실 동아대학교병원 신경과) ;
  • 김재우 (동아대학교 의과대학 신경과학교실 동아대학교병원 신경과)
  • Published : 2010.12.30
⟨ Previous Next ⟩

Abstract

Background: It is well known that the Wisconsin Card Sorting Test (WCST) is a representative test to evaluate executive function. Neuropsychological studies suggest that patients with frontal lobe damage perform worse on the WCST than do patients with non-frontal lobe injury. However, neuropsychological studies found considerable discrepancies in performances on the WCST in patients with frontal lobe damage. Established studies examined the neuro-cognitive functions in focal brain lesion patients. However, controversy remains over whether cognitive impairment is due to a focal brain lesion or due to diffuse brain lesions. Therefore, it is clinically valuable to examine cognitive functions in the performance on the WCST. We compared the results of the WCST with the results of the other neuropsychological tests. We also analyzed cognitive functions in the performance of the WCST in patients with Parkinson's disease using regression analyses. Methods: To examine cognitive functions in the performance of the WCST, we investigated the differences of WCST performance and other neuropsychological tests in patients with Parkinson's disease (n=143). Stepwise multiple regression analyses were performed with 4 indices (total correct response, perseverative response, perseverative errors and categories completed) of the WCST as regressand. Attention, visual-spatial function, naming ability, set shifting ability, verbal fluency, verbal delayed recall and non-verbal delayed recall were regressor. Results: Influential variables of the 4 WCST indices in Parkinson's disease patients were not only phonemic fluency and set shifting ability but also naming ability. Furthermore, the predicted variables included in this study explained WCST for only about 30%. The best influential variable of total correct response was K-BNT. Phonemic fluency was the best influential variable of perseverative response, perseverative errors and categories completed. Conclusions: These results suggest that the performance on the WCST cannot specifically identify frontal lobe damage and that WCST is a multi-factorial and complex test.

Keywords

References

  1. Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF. Validity of the executive function theory of Attention-Deficit Hyperactivity Disorder: a meta-analytic review. Biol Psychiatry 2005; 57: 1336-46. https://doi.org/10.1016/j.biopsych.2005.02.006
  2. Milner B. Effects of different brain lesion on card sorting: the role of the frontal lobe. Arch Neurol 1963; 9: 90-100. https://doi.org/10.1001/archneur.1963.00460070100010
  3. Robinson AL, Heaton RK, Lehman RAW, Stilson DW. The utility of the Wisconsin Card Sorting Test in detecting and localizing frontal lobe lesions. J Consult Clinic Psychol 1980; 48: 605-14. https://doi.org/10.1037/0022-006X.48.5.605
  4. Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. Wisconsin Card Sorting Test Manual: Revised and Expanded. FL: Psychology Assessment Resources, Inc. 1993.
  5. Teuber HL, Battersby WS, Bender MB. Performance of complex visual tasks after cerebral lesions. J Nerv Ment Dis 1951; 114: 413-29.
  6. Shallice T, Burgess PW. Deficits in strategy application following frontal lobe damage in man. Brain 1991; 114: 727-41. https://doi.org/10.1093/brain/114.2.727
  7. Anderson SW, Damasio H, Tranel D, Damasio AR. Neuropsychological correlates of bilateral frontal lobe lesions in humans. Soci Neurosci 1988; 14: 1288.
  8. Eslinger PJ, Damasio AR. Severe disturbance of higher cognition after bilateral frontal lobe ablation. Neurology 1985; 35: 1731-41. https://doi.org/10.1212/WNL.35.12.1731
  9. Heck ET, Bryer JB. Superior sorting and categorizing ability in a case of bilateral frontal lobe atrophy: an exception to the rule. J Clin Exp Neuropsychol 1986; 8: 313-6. https://doi.org/10.1080/01688638608401321
  10. Anderson SW, Damasio H, Jones RD, Tranel D. Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. J Clin Exp Neuropsychol 1991; 13: 909-22. https://doi.org/10.1080/01688639108405107
  11. Anderson CV, Bigler ED, Blatter DD. Frontal lobe lesions, diffuse damage, and neuropsychological functioning in traumatic brain-injured patients. J Clin Exp Neuropsychol 1995; 17: 900-8. https://doi.org/10.1080/01688639508402438
  12. Damasio H, Anderson SW, Jones RD, Tranel D. Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. J Clin Exp Neuropsychol 1991; 13: 909-22. https://doi.org/10.1080/01688639108405107
  13. Morris RG, Downes JJ, Sahakian BJ, Evenden JL, Heald A, Robbins TW. Planning and spatial working memory in Parkinson's disease. J Neurol Neurosurg Psychiatry 1988; 51: 757-66. https://doi.org/10.1136/jnnp.51.6.757
  14. Rinne JO. Other important dementias. In: Qizilbash N, Schneider LS, Chui H, Tariot P, Brodaty H, Kaye J, et al, editors. Evidence-based Dementia Practice. Oxford: Blackwell, 2002: 312-29.
  15. Taylor AE, Saint C, Lang AE. Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain 1986; 109: 845-83. https://doi.org/10.1093/brain/109.5.845
  16. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinic-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55: 181-4. https://doi.org/10.1136/jnnp.55.3.181
  17. Kim HH, Na DL. Normative data on the Korean version of the Boston Naming Test. J Clin Exp Neuropychol 1999; 21: 127-33. https://doi.org/10.1076/jcen.21.1.127.942
  18. Lezak MD. Neuropsychological assessment. 4nd ed. New York: Oxford. 2004.
  19. Kang YW, Na DL. Seoul Neuropsychological Screening Battery. Incheon: Human Brain Research & Consulting Co. 2003.
  20. Brandt J. The Hopkins Verbal Learning Test: development of a new verbal memory test with six equivalent forms. Clin Neuropsychol 1991; 5: 125-42. https://doi.org/10.1080/13854049108403297
  21. Sullivan EV, Mathalon DH, Zipursky RB, Kersteen-Tucker Z, Knight RT, Pfefferbaum A. Factors of the Wisconsin Card Sorting Test as measures of frontal-lobe function in schizophrenia and in chronic alcoholism. Psychiatry Res 1993; 46: 175-99. https://doi.org/10.1016/0165-1781(93)90019-D
  22. Jeseph JL, Suzanne C, John HG. Relation between clinical characteristics of Parkinson's disease and cognitive decline. J Clin Exp Neuropsychol 2003; 25: 94-109. https://doi.org/10.1076/jcen.25.1.94.13624
  23. John RH. Cognitive assessment for clinicians. 2nd ed. New York: Oxford, 2007: 115-23.
  24. Foster M, Satz P, Ganzell S, Vaclav JF. Wisconsin card sorting test performance in schizophrenias: remediation of a stubborn deficit. Am J Psychiatry 1992; 149: 62-7. https://doi.org/10.1176/ajp.149.1.62
  25. Bayles KA, Tomoeda CK, Kaszniak AW, Trosset MW. Alzheimer's disease effects on semantic memory: loss of structure or impaired processing? J Cogn Neurosci 1991; 3: 166-82. https://doi.org/10.1162/jocn.1991.3.2.166
  26. Hermann BP, Wyler AR, Richey ET. Wisconsin Card Sorting Test performance in patients with complex partial seizures of temporal lobe origin. J Clin Exp Neuropsychol 1988; 10: 467-76. https://doi.org/10.1080/01688638808408253
  27. Jessica AG, John AP, Adrian MO. The role of the basal ganglia in learning, memory: neuropsychological studies. Behav Brain Res 2009; 199: 53-60. https://doi.org/10.1016/j.bbr.2008.11.020