Is the Brixton Spatial Anticipation Test sensitive to frontal dysfunction? Evidence from patients with frontal and posterior lesions

ABSTRACT

Introduction: The Brixton Spatial Anticipation Test is a widely used neuropsychological test, thought to assess executive functions and to be sensitive to frontal lobe lesions. Our aim was to investigate Brixton performance in patients with focal frontal or posterior lesions and healthy controls.

Method: We compared performance on the Brixton in a sample of 24 frontal patients, 18 posterior patients and 22 healthy controls. Both overall performance (total number of errors) and error types were analyzed.

Results: We found no significant differences between frontal and posterior patients and healthy controls in overall Brixton performance. Moreover, our error analysis showed no difference between frontal patients, posterior patients and healthy controls. The only exception was that posterior patients had a greater tendency to guess and make more errors when following specific rules than healthy controls but this was no longer significant once fluid intelligence was controlled for. We also found no significant difference between the performance of patients with left lateral (n = 11), right lateral (n = 10) or superior medial (n = 18) frontal lesions and healthy controls.

Conclusions: The Brixton test is not sensitive to frontal lobe dysfunction. It is likely that the test draws on a range of cognitive abilities not specific to frontal lobe lesions. Hence, caution should be taken when drawing conclusions about its neural substrates.

KEYWORDS:

• Rule detection
• rule induction
• focal lesions
• frontal lobes
• executive functioning
• neuropsychology

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

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Notes

1. There was no significant difference between frontal and posterior patients in terms of the proportion of lesions causes by stroke versus tumor resection, χ² (1) = .538, p = .531.

Additional information

Funding

This project was funded by the Wellcome Trust (grant numbers 066763, 089231/A/09/Z) and supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. The authors have no conflicts of interest to declare.