Learning hierarchically structured action sequences is unaffected by prefrontal cortex lesion

This study tested the impact of prefrontal-cortex lesion on learning hierarchically structured action sequences. Using a visual-manual serial reaction time task, we had subjects first perform five blocks of trials with a hierarchically structured 14-element action sequence and then tested for sequence-specific learning by introducing a pseudo-random transfer sequence. Relative to control subjects (N = 39), we found that both lateral frontal (N = 16) and medial frontal (N = 18) patients showed reduced overall performance benefits across the training phase. In contrast, the negative transfer test showed significantly increased reaction times in all patient groups, indicating robust sequence-specific learning. This learning was not significantly different from that of the control group. Taken together, the data suggest that learning hierarchically structured action sequences is unimpaired in patients with prefrontal-cortex lesion.