EMOTION-RELATED LEARNING IN PATIENTS WITH SOCIAL AND EMOTIONAL CHANGES ASSOCIATED WITH FRONTAL-LOBE DAMAGE

A group of patients with damage to the ventral part of the frontal lob es was severely impaired relative to a group of patients without damag e in this area (the non-ventral group) in the reversal and in the exti nction of simple visual discrimination tests. In these tests they cont inued to make responses to a previously rewarded stimulus. Patients of ten reported verbally that the contingencies had changed, but were una ble to alter their behaviour appropriately. These impairments occurred independently of IQ or verbal memory impairments. The perseverative t ouching of a previously rewarded stimulus is consistent with work with non-human primates showing impaired reversal and extinction after orb itofrontal lesions. Performance on these reversal and extinction tests was highly correlated with scores obtained on a behaviour questionnai re, which reflected the degree of disinhibited and socially inappropri ate behaviour exhibited by patients. It is suggested that a difficulty in modifying responses, especially when followed by negative conseque nces, as manifested in these simple laboratory tests, may contribute t o the inappropriate behaviour shown in daily life by patients with fro ntal lobe damage.