The utility of the Wisconsin Card Sorting Test in detecting and localizing frontal lobe lesions

123 normal adults and 107 patients with focal and diffuse cerebral lesions were administered the Wisconsin Card Sorting Test (WCST) and the Halstead-Reitan Neuropsychological Test Battery (HRTB). Significant differences were found between the neurologically normal group and the total brain-damaged sample on WCST perseverative responses. Among brain-damaged groups, frontal groups were significantly more impaired than nonfrontal groups on perseverative responses but were not more impaired than a diffuse group, even when generalized neuropsychological impairment was controlled. Two discriminant functions were developed to assess the utility of the perseverative response measure in classifying individual frontal and nonfrontal cases in conjunction with demographic and HRTB variables. Results suggest that the WCST is a clinically useful tool for discriminating frontal from nonfrontal lesions and a better single discriminant than any test currently in the HRTB. (15 ref)