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

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.