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Behavioural Neurology
Volume 2014 (2014), Article ID 405726, 7 pages
Research Article

Perseveration Found in a Human Drawing Task: Six-Fingered Hands Drawn by Patients with Right Anterior Insula and Operculum Damage

1Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
2Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan
3Graduate School of Informatics, Kyoto University, Kyoto, Japan

Received 20 May 2013; Accepted 8 March 2014; Published 30 April 2014

Academic Editor: Annalena Venneri

Copyright © 2014 Chiharu Niki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Perseveration has been observed in a number of behavioural contexts, including speaking, writing, and drawing. However, no previous report describes patients who show perseveration only for drawing a human figure. Objective. The present report describes a group of patients who show body awareness-related cognitive impairment during a human figure drawing task, a different presentation from previously described neuropsychological cases. Methods. Participants were 15 patients who had a frontal lobe brain tumour around the insula cortex of the right hemisphere and had subsequently undergone a neurosurgical resective operation. Participants were asked to draw a human figure in both “hands-down” and “hands-up” configurations. Results. Eight of the 15 patients drew a human figure with six fingers during the “hands-up” and the “hands-down” human figure drawing tasks (one patient drew eight fingers). A statistical analysis of potential lesion areas revealed damage to the right anterior frontal insula and operculum in this group of patients relative to the five-finger drawing group. Conclusions. Our findings reveal a newly described neuropsychological phenomenon that could reflect impairment in attention directed towards body representations.