Neuropsychological Aspects of Bender Gestalt Test (BGT) Subtests
The Bender Visual-Motor Gestalt Test (BGT) is a widely used tool in neuropsychological assessment
that evaluates visuomotor integration and is particularly sensitive to brain dysfunction. Though
originally designed to assess perceptual-motor development in children, the BGT has been
extensively employed to identify neurocognitive impairments associated with specific cerebral lobe
dysfunctions and psychiatric disorders.
Neuropsychologically, BGT performance reflects the integrity of three major domains: visual
perception, motor coordination, and cognitive planning. These domains are mediated by distinct brain
regions, allowing the test to act as an indirect indicator of lobe-specific functioning. Studies have
shown that performance patterns on the BGT can differentiate between frontal, temporal, and parietal
lobe dysfunctions.
Frontal Lobe Lesions (FLL): The frontal lobe plays a key role in executive functions such as
planning, sequencing, motor regulation, and error monitoring. BGT drawings from individuals with
FLL are characterized by disorganized layout (e.g., confused order of figures), poor spatial planning,
lack of use of erasures, and impulsive execution (e.g., explosion of drawings, wavy lines, spontaneous
second attempts). Features like perseveration and inability to learn from prior errors suggest deficits
in executive control and cognitive flexibility, typical of frontal lobe impairment.
Temporal Lobe Lesions (TLL): The temporal lobe, essential for perceptual discrimination and
memory, shows a different BGT profile. Individuals with TLL often exhibit features such as
reinforced lines (indicative of overemphasis or anxiety), over-involvement, and perfectionism in
figure reproduction. These may reflect heightened emotional processing, as well as difficulties in
internal monitoring of perceptual-motor tasks-functions commonly associated with the medial
temporal structures.
Parietal Lobe Lesions (PLL): The parietal lobe supports spatial awareness and visuoconstructive
abilities. Correspondingly, BGT drawings in individuals with PLL exhibit shape distortions, poor
figure integration, and difficulties in closure and alignment. They also frequently rotate the stimulus
card, page, or entire drawings-suggesting impaired spatial orientation and constructional apraxia,
hallmarks of parietal lobe dysfunction.
In psychiatric populations, BGT patterns also yield valuable insight. For example, patients with
schizophrenia often produce drawings resembling those with frontal and parietal lesions, indicating
fronto-temporo-parietal dysfunction. Their drawings typically include poor planning, closure
difficulty, and rotation errors, reflecting perceptual disorganization and executive deficits. In contrast,
