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The relationship between executive functions and fluid intelligence in Parkinson's disease

  • M. Roca (a1) (a2) (a3), F. Manes (a1) (a2), A. Chade (a1) (a2), E. Gleichgerrcht (a1), O. Gershanik (a2), G. G. Arévalo (a1) (a2), T. Torralva (a1) (a2) and J. Duncan (a4)...



We recently demonstrated that decline in fluid intelligence is a substantial contributor to frontal deficits. For some classical ‘executive’ tasks, such as the Wisconsin Card Sorting Test (WCST) and Verbal Fluency, frontal deficits were entirely explained by fluid intelligence. However, on a second set of frontal tasks, deficits remained even after statistically controlling for this factor. These tasks included tests of theory of mind and multitasking. As frontal dysfunction is the most frequent cognitive deficit observed in early Parkinson's disease (PD), the present study aimed to determine the role of fluid intelligence in such deficits.


We assessed patients with PD (n=32) and control subjects (n=22) with the aforementioned frontal tests and with a test of fluid intelligence. Group performance was compared and fluid intelligence was introduced as a covariate to determine its role in frontal deficits shown by PD patients.


In line with our previous results, scores on the WCST and Verbal Fluency were closely linked to fluid intelligence. Significant patient–control differences were eliminated or at least substantially reduced once fluid intelligence was introduced as a covariate. However, for tasks of theory of mind and multitasking, deficits remained even after fluid intelligence was statistically controlled.


The present results suggest that clinical assessment of neuropsychological deficits in PD should include tests of fluid intelligence, together with one or more specific tasks that allow for the assessment of residual frontal deficits associated with theory of mind and multitasking.

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The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.

Corresponding author

*Address for correspondence: Dr J. Duncan, MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK. (Email:


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Azuma, T, Cruz, RF, Bayles, KA, Tomoeda, CK, Montgomery, EB Jr. (2003). A longitudinal study of neuropsychological change in individuals with Parkinson's disease. International Journal of Geriatric Psychiatry 18, 11151120.
Badre, D, D'Esposito, M (2009). Is the rostro-caudal axis of the frontal lobe hierarchical? Nature Reviews Neuroscience 10, 659669.
Baron-Cohen, S, Jolliffe, T, Mortimore, C, Robertson, M (1997). Another advanced test of theory of mind: evidence from very high functioning adults with autism or Asperger syndrome. Journal of Child Psychology and Psychiatry 38, 813822.
Baron-Cohen, S, Ring, HA, Wheelwright, S, Bullmore, ET, Brammer, MJ, Simmons, A (1999). Social intelligence in the normal and autistic brain: an fMRI study. European Journal of Neuroscience 11, 18911898.
Basić, J, Katić, S, Vranicć, A, Zarevski, P, Babić, T, Mahović-Lakusić, D (2004). Cognition in Parkinson's disease. Croatian Medical Journal 45, 451456.
Benton, AL, Hamsher, K (1976). Multilingual Aphasia Examination. University of Iowa Press: Iowa City, IA.
Bishop, SJ, Fossella, J, Croucher, CJ, Duncan, J (2008). COMT val158met genotype affects neural mechanisms supporting fluid intelligence. Cerebral Cortex 18, 21322140.
Bodden, ME, Dosel, R, Kalbe, E (2010). Theory of mind in Parkinson's disease and related basal ganglia disorders: a systematic review. Movement Disorders 25, 1327.
Bostantjopoulou, S, Kiosseoglou, G, Katsarou, Z, Alevriadou, A (2001). Concurrent validity of the Test of Nonverbal Intelligence in Parkinson's disease patients. Journal of Psychology 135, 205212.
Burgess, PW, Dumonheil, I, Gilbert, S (2007). The gateway hypothesis of rostral prefrontal cortex (area 10) function. Trends in Cognitive Sciences 11, 290298.
Burin, DI, Jorge, RE, Arizaga, RA, Paulsen, JS (2000). Estimation of premorbid intelligence: the Word Accentuation Test – Buenos Aires version. Journal of Clinical and Experimental Neuropsychology 22, 677685.
Butman, J, Allegri, RF, Harris, P, Drake, M (2000). Spanish verbal fluency. Normative data in Argentina. Medicina 50, 15.
Carroll, JB (1993). Human Cognitive Abilities: A Survey of Factor-Analytic Studies. Cambridge University Press: New York.
Dreher, JC, Koechlin, E, Tierney, M, Grafman, J (2008). Damage to the fronto-polar cortex is associated with impaired multitasking. PLoS One 3, e3227.
Duncan, J, Burgess, P, Emslie, H (1995). Fluid intelligence after frontal lobe lesions. Neuropsychologia 33, 261268.
Duncan, J, Schramm, M, Thompson, R, Dumontheil, I (in press). Task rules, working memory and fluid intelligence. Psychonomic Bulletin and Review.
Duncan, J, Seitz, RJ, Kolodny, J, Bor, D, Herzog, H, Ahmed, A, Newell, FN, Emslie, H (2000). A neural basis for general intelligence. Science 289, 457460.
Esposito, G, Kirkby, BS, Van Horn, JD, Ellmore, TM, Berman, KF (1999). Context-dependent, neural system-specific neurophysiological concomitants of ageing: mapping PET correlates during cognitive activation. Brain 122, 963979.
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.
Foltynie, T, Brayne, CE, Robbins, TW, Barker, RA (2004). The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study. Brain 127, 550560.
Frith, C, Frith, U (2006). Theory of mind. Current Biology 15, 644646.
Gallagher, HL, Frith, CD (2003). Functional imaging of ‘theory of mind’. Trends in Cognitive Sciences 7, 7783.
Gilbert, SJ, Williamson, ID, Dumontheil, I, Simons, JS, Frith, CD, Burgess, PW (2007). Distinct regions of medial rostral prefrontal cortex supporting social and nonsocial functions. Social Cognitive and Affective Neuroscience 2, 217226.
Goldstein, LH, Bernard, S, Fenwick, P, Burgess, PW, McNeil, JE (1993). Unilateral frontal lobotomy can produce strategy application disorder. Journal of Neurology, Neurosurgery and Psychiatry 56, 274276.
Green, J, McDonald, WM, Vitek, JL, Evatt, M, Freeman, A, Haber, M, Bakay, RA, Triche, S, Sirockman, B, DeLong, MR (2002). Cognitive impairments in advanced PD without dementia. Neurology 59, 13201324.
Hebb, DO, Penfield, W (1940). Human behavior after extensive removal from the frontal lobes. Archives of Neurology and Psychiatry 44, 421438.
Hoehn, MM, Yahr, MD (1967). Parkinsonism: onset, progression and mortality. Neurology 17, 427442.
Lewis, SJ, Foltynie, T, Blackwell, AD, Robbins, TW, Owen, AM, Barker, RA (2005). Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach. Journal of Neurology, Neurosurgery and Psychiatry 76, 343348.
Manly, T, Hawkins, K, Evans, J, Woldt, K, Robertson, IH (2002). Rehabilitation of executive function: a facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychology 40, 26712681.
Mengelberg, A, Siegert, RJ (2003). Is theory-of-mind impaired in Parkinson's disease? Cognitive Neuropsychiatry 8, 191209.
Mimura, M, Oeda, R, Kawamura, M (2006). Impaired decision-making in Parkinson's disease. Parkinsonism and Related Disorders 12, 169175.
Muslimovic, D, Post, B, Speelman, JD, Schmand, B (2005). Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65, 12391245.
Nagano-Saito, A, Washimi, Y, Arahata, Y, Kachi, T, Lerch, JP, Evans, AC, Dagher, A, Ito, K (2005). Cerebral atrophy and its relation to cognitive impairment in Parkinson disease. Neurology 64, 224229.
Nelson, HE (1976). A modified card sorting test sensitive to frontal lobe defects. Cortex 12, 313324.
Nelson, HE, Willison, JR (1991). The Revised National Adult Reading Test – Test Manual. NFER-Nelson: Windsor, UK.
Nettelbeck, T (1987). Inspection time and intelligence. In Speed of Information Processing and Intelligence (ed. Vernon, P. E.), pp. 295346. Ablex: Norwood, NJ.
Ong, JC, Seel, RT, Carne, WF, Brown, R, Pegg, PO, Jehle, PJ (2005). A brief neuropsychological protocol for assessing patients with Parkinson's disease. NeuroRehabilitation 20, 191203.
Perfetti, B, Varanese, S, Mercuri, P, Mancino, E, Saggino, A, Onofrj, M (2010). Behavioural assessment of dysexecutive syndrome in Parkinson's disease without dementia: a comparison with other clinical executive tasks. Parkinsonism and Related Disorders 16, 4650.
Péron, J, Vicente, S, Leray, E, Drapier, S, Drapier, D, Cohen, R, Biseul, I, Rouaud, T, Le Jeune, F, Sauleau, P, Vérin, M (2009). Are dopaminergic pathways involved in theory of mind? A study in Parkinson's disease. Neuropsychologia 47, 406414.
Pillon, B, Gouider-Khouja, N, Deweer, B, Vidailhet, M, Malapani, C, Dubois, B, Agid, Y (1995). Neuropsychological pattern of striatonigral degeneration: comparison with Parkinson's disease and progressive supranuclear palsy. Journal of Neurology, Neurosurgery and Psychiatry 58, 174179.
Prabhakaran, V, Smith, JAL, Desmond, JE, Glover, GH, Gabrieli, JDE (1997). Neural substrates of fluid reasoning: an fMRI study of neocortical activation during performance of the Raven's Progressive Matrices Test. Cognitive Psychology 33, 4363.
Raven, JC (1995). Colored Progressive Matrices Sets A, Ab, B. Oxford Psychologists Press Ltd: Oxford.
Roca, M, Parr, A, Thomson, R, Woolgar, A, Torralva, T, Antoun, N, Manes, F, Duncan, J (2010 a). Executive function and fluid intelligence alter frontal lobe lesions. Brain 133, 234247.
Roca, M, Torralva, T, Gleichgerrcht, E, Chade, A, Arévalo, GG, Gershanik, O, Manes, F (2010 b). Impairments in social cognition in early medicated and unmedicated Parkinson disease. Cognitive Behavioral Neurology 23, 152158.
Roca, M, Torralva, T, Gleichgerrcht, E, Woolgar, A, Thompson, R, Duncan, J, Manes, F (2011). The role of Area 10 (BA10) in human multitasking and in social cognition: a lesion study. Neuropsychologia 49, 35253531.
Rowe, AD, Bullock, PR, Polkey, CE, Morris, RG (2001). ‘Theory of mind’ impairments and their relationship to executive functioning following frontal lobe excisions. Brain 124, 600616.
Saltzman, J, Strauss, E, Hunter, M, Archibald, S (2000). Theory of mind and executive functions in normal human aging and Parkinson's disease. Journal of the International Neuropsychological Society 6, 781788.
Shallice, T, Burgess, PW (1991). Deficits in strategy application following frontal lobe damage in man. Brain 114, 727741.
Spearman, C (1904). General intelligence objectively determined and measured. American Journal of Psychology 15, 201293.
Spearman, C (1927). The Abilities of Man. Macmillan: New York.
Stone, VE, Baron-Cohen, S, Knight, RT (1998). Frontal lobe contributions to theory of mind. Journal of Cognitive Neuroscience 10, 640656.
Stuss, DT, Gallup, GG, Alexander, MP (2001). The frontal lobes are necessary for ‘theory of mind’. Brain 124, 279286.
Torralva, T, Roca, M, Gleichgerrcht, E, Bekinschtein, T, Manes, F (2009). A neuropsychological battery to detect specific executive and social cognitive impairments in early frontotemporal dementia. Brain 132, 12991309.
Williams-Gray, CH, Foltynie, T, Brayne, CE, Robbins, TW, Barker, RA (2007). Evolution of cognitive dysfunction in an incident Parkinson's disease cohort. Brain 130, 17871798.
Woolgar, A, Parr, A, Cusack, R, Thompson, R, Nimmo-Smith, I, Torralva, T, Roca, M, Antoun, N, Manes, F, Duncan, J (2010). Fluid intelligence loss linked to restricted regions of damage within frontal and parietal cortex. Proceedings of the National Academy of Sciences USA 107, 1489914902.


The relationship between executive functions and fluid intelligence in Parkinson's disease

  • M. Roca (a1) (a2) (a3), F. Manes (a1) (a2), A. Chade (a1) (a2), E. Gleichgerrcht (a1), O. Gershanik (a2), G. G. Arévalo (a1) (a2), T. Torralva (a1) (a2) and J. Duncan (a4)...


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