J Neuropsychiatry Clin Neurosci 11:444-453, November 1999
© 1999 American Psychiatric Press, Inc.
Alteration of Intention and Self-Initiated Action Associated With Bilateral Anterior Cingulotomy
Ronald A. Cohen, Ph.D.,
Richard F. Kaplan, Ph.D.,
Paula Zuffante, Ph.D.,
David J. Moser, Ph.D.,
Melissa A. Jenkins, Ph.D.,
Stephen Salloway, M.D. and
Harold Wilkinson, M.D.
Received September 14, 1998; revised March 15, 1999; accepted March 25, 1999. From the Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, Rhode Island; Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut; and Department of Neurosurgery, University of Massachusetts Medical Center, Worcester, Massachusetts. Address correspondence to Dr. Cohen, Neuropsychology, The Miriam Hospital, Brown University School of Medicine, 164 Summit Avenue, Providence, RI 02906.
Neuropsychological manifestations of bilateral anterior cingulate cortex lesions were studied in patients treated with cingulotomy for chronic intractable pain. Cingulotomy patients more than 1 year postsurgery were contrasted with nonsurgical chronic pain patients. Patients were assessed on a neuropsychological battery, including measures of response intention, initiation, generation, and persistence. Cingulotomy patients were intact across most cognitive domains, but they showed deficits of focused and sustained attention as well as mild executive dysfunction. Self-initiated responding—including spontaneous verbal utterances and unstructured design fluency—was most impaired. Results indicate that the greatest impact of cingulotomy lesions is on response intention and self-initiated behavior, with reduced behavioral spontaneity.
Key Words: Attention • Executive Function • Cingulotomy
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