Wisconsin Card Sorting Test - Clinical Use

Clinical Use

Clinically, the test is widely used by neuropsychologists, clinical psychologists, neurologists and psychiatrists in patients with acquired brain injury, neurodegenerative disease, or mental illness such as schizophrenia. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. As such, the WCST allows the clinician to assess the following "frontal" lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding. The test can be administered to those from 6.5 years to 89 years of age.

Although successful completion of the test relies upon a number of intact cognitive functions including attention, working memory, and visual processing, it is loosely termed a "frontal lobe" test on the basis that patients with any sort of frontal lobe lesion generally do poorly at the test. In particular, patients with lesions of the dorsolateral frontal lobe make a higher number of perseverative errors than control participants. A recent factor analysis of the WCST has shown these perseverative errors to be the most useful outcome measure in assessing cases. A more sophisticated description of deficits of this type is "executive dysfunction".