Frontal brain activation during the Wisconsin Card Sorting Test assessed with two-channel near-infrared spectroscopy

Near-infrared spectroscopy (NIRS) is a new non-invasive optical technique suitable to assess the concentration changes of oxygenated (O2HB) and deoxygenated (HHB) hemoglobin in brain tissue. Previous NIRS studies showed distinct patterns of blood oxygenation changes during different cognitive tasks. In particular, bilateral frontal hypo-oxygenation was found during reading, right frontal hyper-oxygenation during the Continuous Performance Test, and left frontal hyper-oxygenation during the Verbal Fluency Test. The Wisconsin Card Sorting Test (WCST) is a neuropsychological test which is presumed to activate prevalently the frontal lobes. This was demonstrated by lesion studies and functional imaging (single photon emission computed tomography and positron emission tomography). In the present study, a two-channel NIRS system was applied to investigate frontal brain areas of ten healthy subjects during performance of the WCST. A significant bilateral increase of O2HB in frontal brain regions without hemispheric differences was found during the WCST compared with a baseline at rest. This result indicates an enhanced perfusion of the frontal lobes consistent with local activation. The findings add further evidence that the NIRS technique is sensitive enough to detect physiological blood oxygenation changes. Furthermore, a comparison with previous studies revealed an activation pattern distinct from those observed during other cognitive tasks. It is concluded that the results reflect local responses to specific task demands of the WCST.