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Motor perseverative behavior on a line cancellation task

From the Department of Neurology (Drs. Na, Kang, Chung, and Lee), College of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea; the Department of Neurology (Dr. Adair), University of New Mexico, Albuquerque; the Department of Neurology (Dr. Heilman), University of Florida, and the Neurology Service (Dr. Heilman), Veterans Affairs Medical Center, Gainesville, FL.

Address correspondence and reprint requests to Dr. Kenneth M. Heilman, Department of Neurology, College of Medicine, University of Florida, P.O. Box 100236, Gainesville, FL 32610-0236; e-mail: heilman{at}medicine.ufl.edu

OBJECTIVES: To study the behavioral and neuroanatomic characteristics of perseverative behavior encountered on a target cancellation task in patients with neglect.

METHODS: Motor perseverative behavior during line cancellation task was evaluated retrospectively in 60 patients with left hemispatial neglect from right hemispheric stroke.

RESULTS: More than 30% of the patients (21 of 60) showed perseveration, manifested as either repetitive cancellation of the same target (18/21) or cancelling extra lines created by the patients themselves (3/21). Neglect severity correlated positively with the frequency of perseverative errors. Perseveration was most prominent in the rightmost portion of the array. Anterior lesions or massive lesions involving anterior and posterior regions were more likely to be associated with motor perseveration than were lesions restricted to posterior areas.

CONCLUSIONS: Although the mechanism of motor perseveration remains to be elucidated, our findings suggest that the combination of aberrant approach behaviors associated with frontal lobe injury and an attentional or intentional bias toward the rightsided targets might explain the behavior.

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