Lateralized frontal blood flow increases during fluency tasks: influence of cognitive strategy.

Difficulties with verbal fluency tasks (VFIT) have been shown mainly to be associated with left frontal lobe pathology in lesion studies. The design fluency test (DFT) is a non-verbal analogue of word fluency tasks and has, in patients with right frontal lobe pathology, been coupled to an inability to perform well. Regional cerebral blood flow measurements (rCBF) were made in normals to elucidate the involvement of frontal and frontotemporal brain regions during the performance of VFT and DFT. In addition, the subjects' reports were used for obtaining information about the cognitive strategy used when solving the tasks. The results confirm previous CBF findings showing a mainly left-sided frontal activation during the VFT. During the DFT significant flow augmentations were seen in both frontal lobes compared to baseline. Furthermore, the use of different strategies was reflected in different patterns of brain activation. Our results support the proposal that the left frontal cortical area is engaged in the generation of internally driven responses. Furthermore, we argue that the cortical areas engaged during the execution of these tasks may reflect differences in cognitive strategy.