Design (DF) and phonemic fluency tests (FAS; D-KEFS, 2001) are commonly used to investigate voluntary generation. Despite this, several important issues remain poorly investigated. In a sizeable sample of patients with focal left or right frontal lesion we established that voluntary generation performance cannot be accounted for by fluid intelligence. For DF we found patients performed significantly worse than healthy controls (HC) only on the switch condition. However, no significant difference between left and right frontal patients was found. In contrast, left frontal patients were significantly impaired when compared with HC and right frontal patients on FAS. These lateralization findings were complemented, for the first time, by three neuroimaging; investigations. A traditional frontal subgrouping method found significant differences on FAS between patients with or without Left Inferior Frontal Gyrus lesions involving BA 44 and/or 45. Parcel Based Lesion Symptom Mapping (PLSM) found lower scores on FAS were significantly associated with damage to posterior Left Middle Frontal Gyrus. An increase in rule break errors, so far only anecdotally reported, was associated with damage to the left dorsal anterior cingulate and left body of the corpus callosum, supporting the idea that conflict resolution and monitoring impairments may play a role. Tractwise statistical analysis (TSA) revealed that patients with disconnection; in the left anterior thalamic projections, frontal aslant tract, frontal; orbitopolar tract, pons, superior longitudinal fasciculus I and II performed significantly worse than patients without disconnection in these tracts on FAS. In contrast, PLSM and TSA analyses did not reveal any significant relationship between lesion location and performance on the DF switch condition. Overall, these findings suggest DF may have limited utility as a tool in detecting lateralized frontal executive dysfunction, whereas FAS and rule break behavior appears to be linked to a set of well localized left frontal grey matter regions and white matter tracts.

中文翻译：

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额叶皮层的流畅性和违规行为。


设计（DF）和音素流畅性测试（FAS；D-KEFS，2001）通常用于研究自愿生成。尽管如此，几个重要问题仍然没有得到很好的研究。在大量患有局灶性左额或右额叶病变的患者样本中，我们确定自主生成表现不能用流体智力来解释。对于 DF，我们发现仅在切换条件下患者的表现明显差于健康对照 (HC)。然而，左额叶和右额叶患者之间没有发现显着差异。相比之下，与接受 FAS 的 HC 患者和右额叶患者相比，左额叶患者明显受损。这些侧化研究结果首次通过三种神经影像学进行了补充：调查。传统的额叶分组方法发现，有或没有涉及 BA 44 和/或 45 的左额下回病变的患者之间的 FAS 存在显着差异。基于包裹的病变症状图 (PLSM) 发现 FAS 得分较低与左中后部损伤显着相关额回。迄今为止，仅有传闻称，违反规则错误的增加与左背侧前扣带回和胼胝体左体的损伤有关，这支持了冲突解决和监测损伤可能发挥作用的观点。 Tractwise 统计分析（TSA）显示，患者存在断线；在左前丘脑投射、额斜束、额叶；眶极束、脑桥、上纵束 I 和 II 的 FAS 表现明显比未断开这些束的患者差。 相反，PLSM 和 TSA 分析没有揭示病变位置和 DF 开关条件下的性能之间的任何显着关系。总体而言，这些发现表明 DF 作为检测侧额叶执行功能障碍的工具可能作用有限，而 FAS 和规则破坏行为似乎与一组定位良好的左额叶灰质区域和白质束有关。