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The '''Wisconsin Card Sorting Test''' ('''WCST''') is a [[neuropsychological test]] of "[[set-shifting]]", i.e. the ability to display flexibility in the face of changing schedules of reinforcement.<ref>Monchi, O., Petrides, M. Petre, V., Worsley, K., & Dagher, A. (2001) |
The '''Wisconsin Card Sorting Test''' ('''WCST''') is a [[neuropsychological test]] of "[[set-shifting]]", i.e. the ability to display flexibility in the face of changing schedules of reinforcement.<ref>Monchi, O., Petrides, M. Petre, V., Worsley, K., & Dagher, A. (2001). Wisconsin card sorting revisited: Distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging. The Journal of Neuroscience, 21(19), 7733-7741.</ref><ref name=Berg>E. A. Berg. (1948). A simple objective technique for measuring flexibility in thinking J. Gen. Psychol. 39: 15-22.</ref> The WCST was written by David A. Grant and Esta A. Berg. ''The Professional Manual for the WCST'' was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtiss. |
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==Method== |
==Method== |
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Initially, a number of stimulus cards are presented to the participant. The participant is told to match the cards, but not how to match; however, he or she is told whether a particular match is right or wrong.<!--More detailed explanation violates the test's copyright and clinical validity--> |
Initially, a number of stimulus cards are presented to the participant. The participant is told to match the cards, but not how to match; however, he or she is told whether a particular match is right or wrong.<!--More detailed explanation violates the test's copyright and clinical validity--> |
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The original WCST used paper cards and was carried out with the experimenter on one side of the desk facing the participant on the other.<ref name=Berg/> Since the early 1990s, however, computerized versions of the task have been available, the most recent version being the [[Microsoft Windows]]-compatible version 4.0.<ref>Psychological Assessment Resources. Computerised Wisconsin Card Sort Task Version 4 (WCST). Psychological Assessment Resources; 2003.</ref> The latter has the advantage of automatically scoring the test, which was quite complex in the manual version. The test takes approximately 12–20 minutes to carry out and generates a number of [[psychometric]] scores, including numbers, percentages, and percentiles of: categories achieved, trials, errors, and [[Perseveration|perseverative]] errors. |
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==Clinical use== |
==Clinical use== |
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Clinically, the test |
Clinically, the test is widely used by [[neuropsychology|neuropsychologists]], [[clinical psychologists]], [[neurology|neurologists]] and [[psychiatry|psychiatrists]] in patients with [[acquired brain injury]], [[neurodegenerative disease]], or [[mental illness]] such as [[schizophrenia]]. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. The WCST allows the clinician to assess the following "frontal" lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding. The test can be administered to those from 6.5 years to 89 years of age. |
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Although successful completion of the test relies upon a number of intact [[cognitive]] functions including [[attention]], [[working memory]], and visual processing, it is loosely termed a "[[frontal lobe]]" test on the basis that patients with any sort of frontal lobe lesion generally do poorly at the test. In particular, patients with lesions of the dorsolateral frontal lobe make a higher number of perseverative errors than control participants.<ref>Milner B. Effect of Different Brain Lesions on Card Sorting. Archives of Neurology 1963; 9: 90-100.</ref> A recent [[factor analysis]] of the WCST has shown these perseverative errors to be the most useful outcome measure in assessing cases.<ref>Greve KW, Stickle TR, Love J, Bianchini KJ, Stanford MS. Latent structure of the Wisconsin Card Sorting Test: a confirmatory factor analytic study. Archives of Clinical Neuropsychology 2005; 20: 355-364.</ref> A more sophisticated description of deficits of this type is "[[executive dysfunction]]". |
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==Critical Update== |
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[[A Critical Update of the Wisconsin Card Sorting Test]]:<ref>US National Library of Medicine National Institutes of Health, 2009</ref> |
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==Use in research== |
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For over four decades the Wisconsin Card Sorting Test (WCST) has been used to test prefrontal function. Clinical research and [[recent brain imaging]] have brought into question the validity and specificity of this test as a marker of frontal dysfunction. Clinical studies with neurological patients have confirmed that, in its traditional form, the [[WCST fails to discriminate between frontal and non-frontal lesions.]] In addition, [[functional brain imaging studies]] show rapid and widespread activation across frontal and non-frontal brain regions during WCST performance. These studies suggest that the concept of [[an anatomically pure test of prefrontal function is not only empirically unattainable, but also theoretically inaccurate.]] The aim of the present review is to examine the causes of these criticisms and to resolve them by incorporating new methodological and conceptual advances in order to improve the construct validity of WCST scores and their relationship to prefrontal executive functions. These objectives can be achieved by drawing on theory-guided experimental design, and on precise spatial and temporal sampling of brain activity, and then exemplify this using an integrative model of prefrontal function [i.e., Miller, E. K. (2000). The prefrontal cortex and cognitive control. Nature Reviews Neuroscience, 1, 59-65.] combined with the formal information theoretical approach to cognitive control [Koechlin, E., & Summerfield, C. (2007). An information theoretical approach to prefrontal executive function. Trends in Cognitive Sciences, 11, 229-235.].<ref>Brain Cogn. 2009 Dec;71(3):437-51. doi: 10.1016/j.bandc.2009.03.005. Epub 2009 Apr 17.Department of Psychology, University of Colorado at Boulder, CO, USA.</ref> |
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The WCST has been used in [[neuroimaging]] paradigms such as [[Positron emission tomography|PET]] and [[fMRI]]. As predicted by the [[acquired brain injury]] literature, early PET studies have shown the task involves significant activation of the [[dorsolateral prefrontal cortex]].<ref>Berman KF, Ostrem JL, Randolph C et al. Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study. Neuropsychologia 1995; 33: 1027-1046.</ref><ref>Cabeza R, Nyberg L. Imaging cognition II: An empirical review of 275 PET and fMRI studies. J Cogn Neurosci 2000; 12: 1-47.</ref> However, more recent fMRI studies have shown that the ventrolateral prefrontal cortex<ref>{{cite journal |last=Konishi |first=Seiki |last2=Nakajima |first2=Kyoichi |last3=Uchida |first3=Idai |last4=Kameyama |first4=Masashi |last5=Nakahara |first5=Kiyoshi |last6=Sekihara |first6=Kensuke |last7=Miyashita |first7=Yasushi |date=1998 |title=Transient activation of inferior prefrontal cortex during cognitive set shifting |url=http://www.nature.com/neuro/journal/v1/n1/pdf/nn0598_80.pdf |journal=Nature Neuroscience |publisher=Nature America Inc. |volume=1 |issue=1 |pages=80-84 |doi=10.1038/283}}</ref> together with the caudate nucleus<ref>{{cite journal |last=Monchi |first=Oury |last2=Petrides |first2=Michael |last3=Petre |first3=Valentina |last4=Worsley |first4=Keith |last5=Dagher |first5=Alain |date=1 October 2001 |title=Wisconsin Card Sorting Revisited: Distinct Neural Circuits Participating in Different Stages of the Task Identified by Event-Related Functional Magnetic Resonance Imaging |url=http://unf-montreal.ca/oury/Site/publications/J_Neurosci_2001.pdf |journal=Journal of Neuroscience |publisher=Society for Neuroscience |volume=21 |issue=19 |pages=7733-7741 |issn=1529-2401}}</ref> may be the regions most important for the set-shifting process required in the WCST. These regions are also associated with working memory functions.<ref>{{cite journal |last=Frank |first=Michael J |last2=Loughry |first2=Bryan |last3=O'Reilly |first3=Randall C |date=2001 |title=Interactions between frontal cortexand basal ganglia in working memory: A computational model |url=http://ski.clps.brown.edu/papers/FrankLoughryOReilly01_fcbg.pdf |journal=Cognitive, Affective, & Behavioral Neuroscience |volume=1 |issue=2 |pages=137–160 |doi=10.3758/cabn.1.2.137}}</ref> The test's use in [[neurodegenerative disease]]s such as [[motor neurone disease]] has identified at least a subgroup of these patients for whom there is some subtle degree of cognitive dysfunction, in contrast to the traditional view that these were pure disorders of the [[motor system]]. |
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The test is also widely used in research into [[schizophrenia]].<ref>Cannon TD, Glahn DC, Kim J, Van Erp TG, Karlsgodt K, Cohen MS, Nuechterlein KH, Bava S, Shirinyan D., Dorsolateral Prefrontal Cortex Activity During Maintenance and Manipulation of Information in Working Memory in Patients With Schizophrenia, Arch Gen Psychiatry 2005;62:1071-1080.</ref><ref>Rossi A, Daneluzzo E, Tomassini A, Struglia F, Cavallaro R, Smeraldi E, Stratta P., The effect of verbalization strategy on Wisconsin Card Sorting Test performance in schizophrenic patients receiving classical or atypical antipsychotics. BMC Psychiatry. 1290 Jan 26;6:3.</ref> |
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Adapted version of the WCST were also developed for monkeys.<ref>Bonté, E., Flemming, T. & Fagot, J. (2011). Executive control of perceptual features and abstract relations by baboons (Papio papio). Behavioural Brain Research, 222, 176-182</ref> They tend to show a faster decline of performance with age than humans. |
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==Legal ownership of trademark== |
==Legal ownership of trademark== |
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==Further reading== |
==Further reading== |
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*{{cite book |title=A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary |last1=Strauss |first1=Esther |last2=Sherman |first2=Elizabeth M. |last3=Spreen |first3=Otfried |date=2006 |publisher=Oxford University Press |location=Oxford |isbn=978-0-19-515957-8 |url=http://global.oup.com/academic/product/a-compendium-of-neuropsychological-tests-9780195159578 |accessdate=14 July 2013 |ref=harv}} |
*{{cite book |title=A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary |last1=Strauss |first1=Esther |last2=Sherman |first2=Elizabeth M. |last3=Spreen |first3=Otfried |date=2006 |publisher=Oxford University Press |location=Oxford |isbn=978-0-19-515957-8 |url=http://global.oup.com/academic/product/a-compendium-of-neuropsychological-tests-9780195159578 |accessdate=14 July 2013 |ref=harv}} |
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{{Neuropsychology tests}} |
{{Neuropsychology tests}} |
Revision as of 12:35, 31 August 2015
The Wisconsin Card Sorting Test (WCST) is a neuropsychological test of "set-shifting", i.e. the ability to display flexibility in the face of changing schedules of reinforcement.[1][2] The WCST was written by David A. Grant and Esta A. Berg. The Professional Manual for the WCST was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtiss.
Method
Initially, a number of stimulus cards are presented to the participant. The participant is told to match the cards, but not how to match; however, he or she is told whether a particular match is right or wrong. The original WCST used paper cards and was carried out with the experimenter on one side of the desk facing the participant on the other.[2] Since the early 1990s, however, computerized versions of the task have been available, the most recent version being the Microsoft Windows-compatible version 4.0.[3] The latter has the advantage of automatically scoring the test, which was quite complex in the manual version. The test takes approximately 12–20 minutes to carry out and generates a number of psychometric scores, including numbers, percentages, and percentiles of: categories achieved, trials, errors, and perseverative errors.
Clinical use
Clinically, the test is widely used by neuropsychologists, clinical psychologists, neurologists and psychiatrists in patients with acquired brain injury, neurodegenerative disease, or mental illness such as schizophrenia. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. The WCST allows the clinician to assess the following "frontal" lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding. The test can be administered to those from 6.5 years to 89 years of age.
Although successful completion of the test relies upon a number of intact cognitive functions including attention, working memory, and visual processing, it is loosely termed a "frontal lobe" test on the basis that patients with any sort of frontal lobe lesion generally do poorly at the test. In particular, patients with lesions of the dorsolateral frontal lobe make a higher number of perseverative errors than control participants.[4] A recent factor analysis of the WCST has shown these perseverative errors to be the most useful outcome measure in assessing cases.[5] A more sophisticated description of deficits of this type is "executive dysfunction".
Use in research
The WCST has been used in neuroimaging paradigms such as PET and fMRI. As predicted by the acquired brain injury literature, early PET studies have shown the task involves significant activation of the dorsolateral prefrontal cortex.[6][7] However, more recent fMRI studies have shown that the ventrolateral prefrontal cortex[8] together with the caudate nucleus[9] may be the regions most important for the set-shifting process required in the WCST. These regions are also associated with working memory functions.[10] The test's use in neurodegenerative diseases such as motor neurone disease has identified at least a subgroup of these patients for whom there is some subtle degree of cognitive dysfunction, in contrast to the traditional view that these were pure disorders of the motor system.
The test is also widely used in research into schizophrenia.[11][12] Adapted version of the WCST were also developed for monkeys.[13] They tend to show a faster decline of performance with age than humans.
Legal ownership of trademark
The trademark "Wisconsin Card Sorting Test" was registered in 2000 with the United States Patent and Trademark Office (Reg. #2320931, Ser # 75-588988) by Wells Print and Digital Services of Madison, Wisconsin. Although filed in 1998, the trademark application states the mark has been in use in commerce since at least 1970. The trademark covers "psychological testing materials, namely printed tests, printed cards, and printed instruction manuals in the field of psychological evaluation." This trademark does not cover the computer implementation of the test, distributed by Psychological Assessment Resources, Inc., sometimes referred to as simply WCST.
References
- ^ Monchi, O., Petrides, M. Petre, V., Worsley, K., & Dagher, A. (2001). Wisconsin card sorting revisited: Distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging. The Journal of Neuroscience, 21(19), 7733-7741.
- ^ a b E. A. Berg. (1948). A simple objective technique for measuring flexibility in thinking J. Gen. Psychol. 39: 15-22.
- ^ Psychological Assessment Resources. Computerised Wisconsin Card Sort Task Version 4 (WCST). Psychological Assessment Resources; 2003.
- ^ Milner B. Effect of Different Brain Lesions on Card Sorting. Archives of Neurology 1963; 9: 90-100.
- ^ Greve KW, Stickle TR, Love J, Bianchini KJ, Stanford MS. Latent structure of the Wisconsin Card Sorting Test: a confirmatory factor analytic study. Archives of Clinical Neuropsychology 2005; 20: 355-364.
- ^ Berman KF, Ostrem JL, Randolph C et al. Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study. Neuropsychologia 1995; 33: 1027-1046.
- ^ Cabeza R, Nyberg L. Imaging cognition II: An empirical review of 275 PET and fMRI studies. J Cogn Neurosci 2000; 12: 1-47.
- ^ Konishi, Seiki; Nakajima, Kyoichi; Uchida, Idai; Kameyama, Masashi; Nakahara, Kiyoshi; Sekihara, Kensuke; Miyashita, Yasushi (1998). "Transient activation of inferior prefrontal cortex during cognitive set shifting" (PDF). Nature Neuroscience. 1 (1). Nature America Inc.: 80–84. doi:10.1038/283.
- ^ Monchi, Oury; Petrides, Michael; Petre, Valentina; Worsley, Keith; Dagher, Alain (1 October 2001). "Wisconsin Card Sorting Revisited: Distinct Neural Circuits Participating in Different Stages of the Task Identified by Event-Related Functional Magnetic Resonance Imaging" (PDF). Journal of Neuroscience. 21 (19). Society for Neuroscience: 7733–7741. ISSN 1529-2401.
- ^ Frank, Michael J; Loughry, Bryan; O'Reilly, Randall C (2001). "Interactions between frontal cortexand basal ganglia in working memory: A computational model" (PDF). Cognitive, Affective, & Behavioral Neuroscience. 1 (2): 137–160. doi:10.3758/cabn.1.2.137.
- ^ Cannon TD, Glahn DC, Kim J, Van Erp TG, Karlsgodt K, Cohen MS, Nuechterlein KH, Bava S, Shirinyan D., Dorsolateral Prefrontal Cortex Activity During Maintenance and Manipulation of Information in Working Memory in Patients With Schizophrenia, Arch Gen Psychiatry 2005;62:1071-1080.
- ^ Rossi A, Daneluzzo E, Tomassini A, Struglia F, Cavallaro R, Smeraldi E, Stratta P., The effect of verbalization strategy on Wisconsin Card Sorting Test performance in schizophrenic patients receiving classical or atypical antipsychotics. BMC Psychiatry. 1290 Jan 26;6:3.
- ^ Bonté, E., Flemming, T. & Fagot, J. (2011). Executive control of perceptual features and abstract relations by baboons (Papio papio). Behavioural Brain Research, 222, 176-182
Further reading
- Strauss, Esther; Sherman, Elizabeth M.; Spreen, Otfried (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford: Oxford University Press. ISBN 978-0-19-515957-8. Retrieved 14 July 2013.
{{cite book}}
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