Planning

Patients with frontal lobe dysfunction have been reported to demonstrate impairments in the ability to plan. A wide spectrum of neuropsychological measures have been designed to assess numerous aspects of planning behavior. The Porteus Maze Test is a maze tracing task commonly used to assess planning and foresight. The subject's task is to trace the maze without entering any blind alleys. Performance level is usually measured on the basis of completion time and the test age level of the most difficult task the subject is able to successfully complete. In 1991, Harvey Levin and colleagues reported that patients with frontal lesions solved the Porteus mazes more slowly than severely injured nonfrontal head trauma patients and control subjects.

A number of tower puzzles have been designed to gauge more abstract forms ofplanning ability. Some of the most popular are the Tower of London, Tower of Hanoi, Tower of Toronto, and Tower of California. In all these tasks, the subject sees a set of pegs on which a number of beads or disks are placed in an initial starting position. The subject is instructed to move the disks to the appropriate pegs in order to reach a predetermined goal state. Two common test rules include only moving one disk at a time and never placing a larger disk on top of a smaller disk.

In 1991, Tim Shallice and Paul Burgess found that patients with predominantly left anterior lesions performed more poorly on the Tower of London test than patients with posterior lesions and normal controls. Guila Glosser and Harold Goodglass reported similar results using the Tower of Hanoi: Patients with anterior lesions performed worse than the patients with posterior lesions.

Planning ability can also be measured by an individual's ability to prepare and execute target behaviors required for simulated real-life situations and events. In 1998, Eliane Miotto and Robin Morris developed the Virtual Planning Test with the intention of investigating the planning and organizational abilities of patients with frontal lobe neurosurgical lesions. The simulated planning tasks involved preparations for a fictional "trip" abroad or planning events that related to the subject's immediate environment. The frontal lobe patients were found to be impaired on this task and showed a tendency to select inappropriate activities associated with their immediate environment.

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