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Neuroanatomical Correlates of Executive Functions: A Neuropsychological Approach Using the EXAMINER Battery

Published online by Cambridge University Press:  13 June 2013

Heather Robinson
Department of Psychology, University of Iowa, Iowa City, Iowa
Matthew Calamia
Department of Psychology, University of Iowa, Iowa City, Iowa
Jan Gläscher
Department for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Joel Bruss
Department of Neurology, Division of Behavioral Neurology and Cognitive Neuroscience, University of Iowa College of Medicine, Iowa City, Iowa
Daniel Tranel*
Department of Psychology, University of Iowa, Iowa City, Iowa Department of Neurology, Division of Behavioral Neurology and Cognitive Neuroscience, University of Iowa College of Medicine, Iowa City, Iowa
Correspondence and reprint requests to: Daniel Tranel, Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242. E-mail:


Executive functions (EF) encompass a variety of higher-order capacities such as judgment, planning, decision-making, response monitoring, insight, and self-regulation. Measuring such abilities quantitatively and establishing their neural correlates has proven to be challenging. Here, using a lesion-deficit approach, we report the neural correlates of a variety of EF tests that were developed under the auspices of the NINDS-supported EXAMINER project (Kramer, 2011; We administered a diverse set of EF tasks that tap three general domains—cognitive, social/emotional, and insight—to 37 patients with focal lesions to the frontal lobes, and 25 patients with lesions outside the frontal lobes. Using voxel-based lesion-symptom mapping (VLSM), we found that damage to the ventromedial prefrontal cortex (vmPFC) was predominately associated with deficits in social/emotional aspects of EF, while damage to dorsolateral prefrontal cortex (dlPFC) and anterior cingulate was predominately associated with deficits in cognitive aspects of EF. Evidence for an important role of some non-frontal regions (e.g., the temporal poles) in some aspects of EF was also found. The results provide further evidence for the neural basis of EF, and extend previous findings of the dissociation between the roles of the ventromedial and dorsolateral prefrontal sectors in organizing, implementing, and monitoring goal-directed behavior. (JINS, 2013, 19, 1–12)

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Copyright © The International Neuropsychological Society 2013 

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