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Previous studies have shown that cognitive impairments in patients with brain tumors are not severe. However, to preserve the postsurgical QOL of patients with brain tumors, it is important to identify “primary” cognitive functions and associated brain regions that are more vulnerable to cognitive impairments following surgery. The objective of this study was to investigate primary cognitive factors affecting not only simple cognitive tasks but also several other cognitive tasks and associated brain regions. Patients with glioma in the left (n=33) and the right (n=21) hemisphere participated in the study. Seven neuropsychological tasks from five cognitive domains were conducted pre- and 6 months postoperation. Factor analyses were conducted to identify “primary” common cognitive functions affecting the task performance in left and right glioma groups. Next, lesion analyses were performed using voxel-based lesion-symptom mapping (VLSM) to identify critical brain regions related to impairments of the primary cognitive functions. Factor analysis revealed two primary cognitive components in each glioma group. The first cognitive component in the left glioma group affected the digit span forward and backward tasks and concept shifting and the letter-digit substitution tasks. VLSM analysis revealed significant regions from the posterior middle temporal gyri to the supramarginal gyrus. The second cognitive component affected verbal memory, and verbal fluency tasks and VLSM analysis indicated two different significant regions, the medial temporal regions and the middle temporal gyrus to the posterior parietal lobes. The first cognitive component in the right glioma group affected positive and negative factor loadings on the task, such that the positive cognitive component affected only the Stroop color-word task. VLSM related to deficits of the Stroop task revealed significant regions in the anterior medial frontal cortex. On the other hand, the negative component affected concept shifting, word fluency, and digit span forward tasks, and VLSM revealed significant regions in the right inferior frontal cortex. It is suggested that primary cognitive functions related to specific brain regions were possibly affected by glioma resection.

Every day and every hour, we feel we perform numerous voluntary actions, i.e., actions under the control of our will. Individual’s ability to initiate goal-directed movement is classically described as a hierarchical motor organization, from an intentional module, mostly considered as a black box, to muscular activity supporting action execution. The general focus is usually set on the triggering of action by intention, which is assumed to be the only entry to the action cascade, rather than on the preceding formation of intentions. If intentions play a key role in the specification of movement kinematic parameters, it remains largely unknown whether unconscious cognitive processes may also affect action preparation and unfolding. Recently, a seemingly irrelevant variable, thirst, was shown to modulate a simple arbitrary action such as key-pressing. Thirsty individuals were shown to produce stronger motor inhibition in no-go trials when a glass of water was present. In the present experiment, we intended to explore whether motor inhibition operates not only upstream from the action cascade but may also affect the unfolding of reaching movements, i.e., at a lower-level control. Thirsty vs. non-thirsty control subjects were asked to reach and grasp green (go trial) or red glasses (no-go trial) filled with either water or transparent gel wax with a central candlewick. Thirsty subjects were faster to initiate actions toward the water glasses. They also exhibited an earlier maximal grip aperture and a global reduction of movement time which was mostly explained by a shortening of deceleration time. The deceleration phase was correlated with individual’s thirst rating. In addition, no-go trial toward a glass of water tended to inhibit the next movement toward a glass filled with gel wax. Thus, our results show that an unintentional influence of an internal state can reorganize voluntary action structure not only at the decision-making level but also at the level of motor control. Although subjects explicitly paid more attention and were more cautious to glasses filled with water, they reported no explicit sensation of an increased urge to grasp it, further suggesting that these effects are controlled by covert mechanisms.

Background. Perseveration has been observed in a number of behavioural contexts, including speaking, writing, and drawing. However, no previous report describes patients who show perseveration only for drawing a human figure. Objective. The present report describes a group of patients who show body awareness-related cognitive impairment during a human figure drawing task, a different presentation from previously described neuropsychological cases. Methods. Participants were 15 patients who had a frontal lobe brain tumour around the insula cortex of the right hemisphere and had subsequently undergone a neurosurgical resective operation. Participants were asked to draw a human figure in both “hands-down” and “hands-up” configurations. Results. Eight of the 15 patients drew a human figure with six fingers during the “hands-up” and the “hands-down” human figure drawing tasks (one patient drew eight fingers). A statistical analysis of potential lesion areas revealed damage to the right anterior frontal insula and operculum in this group of patients relative to the five-finger drawing group. Conclusions. Our findings reveal a newly described neuropsychological phenomenon that could reflect impairment in attention directed towards body representations.