Executive functions in their broadest sense may be
impaired in patients with frontal lobe lesions. The
Wisconsin Card Sorting Test, perhaps the most robust test
sensitive to frontal lobe dysfunction, requires the flexibility
to switch a response pattern to meet the change in task
demands. However this task has only two category switches
and normal respondents tend to score at ceiling. Verbal
fluency tasks also incorporate a switching component and
it was hypothesized that a word generation task that maximized
a switching requirement might provide a more satisfactory
verbal measure of frontal lobe dysfunction. A new test
of homophone meaning generation that requires multiple
switches between verbal concepts (e.g., tick =
insect, correct, etc.) was devised. Normative data was
obtained from a sample of 170 control participants. Seventy-one
patients with unilateral anterior or posterior cerebral
lesions were also tested. A normal distribution of scores
was obtained in the standardization sample. The anterior
lesion groups were more impaired than the posterior groups.
There were no significant differences due to laterality.
This homophone meaning generation task is a measure of
frontal lobe dysfunction that has the advantage of psychometric
properties that permit measurement of the degree of impairment.
(JINS, 2000, 6, 643–648.)