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Perseveration in behavioral neurology

Department of Neurology, Boston University School of Medicine and Boston Veterans Administration Medical Center, Boston, MA.

We tested a new taxonomy of perseverative behavior consisting of three categories: (1) repetition of a previous response to a subsequent stimulus (recurrent), (2) inappropriate maintenance of a category of activity (stuck-in-set), and (3) abnormal prolongation of a current activity (continuous). Three groups of neurologically impaired subjects (with aphasia, right hemisphere damage, and Parkinson's disease) were administered tests to elicit each category of perseveration. Patients with aphasia produced significantly more recurrent peneveration than did patients with right hemisphere damage or healthy controls. Stuck-in-set perseveration was associated with dopamine system dysfunction, and continuous perseveration with right hemisphere damage. We propose a theory of perseveration dependent on anatomic, neuropsychological, and pharmacologic factors related to cerebral dominance. According to this theory, disruption of specific anatomic and pharmacologic systems produces different forms of perseveration which, in turn, underlie particular neurobehavioral disorders.

Address correspondence and reprint requests to Dr. Albert, Department of Neurology, Boston Veterans Administration Medical Center, 150 South Huntington Avenue, Boston, MA 02130.

Supported in part by the Veterans Administration Medical Research Service, the National Institutes of Health (NS 06209–20), and the Seidel Fund for the Study of Dementia.

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received June 30, 1986. Accepted for publication in final form February 9, 1987.

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