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PubMed1999

Action (verb naming) fluency as an executive function measure: convergent and divergent evidence of validity.

Numerous studies have demonstrated dissociable neuroanatomic underpinnings for the retrieval of grammatical classes of words such as nouns and verbs. Whereas retrieval of common and proper nouns is primarily mediated by posterior and anterior temporal regions, respectively, verb retrieval is primarily mediated by frontal regions. The majority of studies evaluating verb production have utilized tasks requiring subjects to name a graphically depicted action (i.e. action naming), leaving tests of verb generation in the absence of prompting stimuli (i.e. action fluency) largely unexamined. In a recent study, Piatt, Fields, Paolo, Koller and Tröster (in press) found that an action fluency task discriminated demented Parkinson's disease (PD) patients from non-demented PD patients and healthy control subjects, whereas lexical and categorical fluency tasks did not. These authors suggested that action fluency was sensitive to the fronto-striatal pathophysiology associated with PD dementia, and thus, that action fluency might serve as an indicator of executive functioning. This study was undertaken to evaluate the construct validity of action fluency as an executive function measure in a group of healthy elderly control subjects. Findings revealed modest to moderate relationships between action fluency and several putative executive measures. Action fluency was unrelated to indices of semantic and episodic memory. Results support the construct validity of action fluency as an executive function measure and suggest that this task may provide some unique information not tapped by traditional executive function tasks.

Aged↗

PubMed1995

Impairments of discourse abilities and executive functions in traumatically brain-injured adults.

Preliminary findings from an ongoing investigation of the potential relationship between narrative discourse performance and executive functions in adults with traumatic brain injuries (TBI) are reported. Narrative stories were elicited from 32 adults with TBI. Stories were analysed at three levels: sentence production, intersentential cohesive adequacy, and story episode structure. These measures were then correlated with scores from the Wisconsin Card Sorting Test (WCST), the primary measure of executive function. A significant correlation was noted between a factor score from the WCST and the measure of story structure, but not sentence production or cohesive adequacy. These results suggest that executive functions may be a promising avenue to pursue in the search for underlying causal factors of narrative discourse dysfunction and, therefore to better delineate the nature of communicative deficits secondary to TBI.

Adolescent↗

PubMed2003

Insight in schizophrenia: associations with executive function and coping style.

It has been suggested that lack of awareness of illness in schizophrenia may result from deficits in executive function and/or an avoidant style of coping. To examine this question, 132 persons with schizophrenia spectrum disorders were rated as either "aware," "partially unaware" or "unaware" of: (a) their illness, (b) need for treatment and (c) consequences of disorder on the abbreviated Scale to Assess Unawareness of Mental Disorder. We next compared the performance of the aware, partially unaware and unaware groups on the "escape-avoidance" and "positive reappraisal" subtests of the Ways of Coping Questionnaire and on two tests of executive function: the Letter Number Sequencing Subtest of the WAIS III and Wisconsin Card Sorting Test. MANCOVA followed by ANCOVA and planned comparisons, controlling for age indicated that the participants who were unaware of symptoms, treatment need and consequences generally performed more poorly than the aware groups on tests of executive function. Participants unaware of symptoms also had a greater preference for positive reappraisal than aware or partially unaware participants. The participants unaware of the consequences of disorder endorsed a greater preference for escape-avoidance than the partially unaware participants. Implications for understanding the etiology of lack of awareness in schizophrenia are discussed.

Adaptation, Psychological↗

PubMed2004

The role of executive functioning in spontaneous confabulation.

OBJECTIVE: To follow the recovery course of a patient who exhibited an amnesic-confabulatory syndrome in conjunction with severe executive dysfunction in the first week following bithalamic infarction. BACKGROUND: Previous studies have shown that spontaneous confabulation originates from the combination of amnesia and executive dysfunction and that the degree of confabulation is determined by the degree of executive dysfunction. However, a few studies have also reported a dissociation between spontaneous confabulation and executive dysfunction. Therefore, the role of executive functioning in spontaneous confabulation is presently unclear. METHOD: Clinical examinations, magnetic resonance imaging (MRI), and cognitive and behavioral assessments with a focus on executive functions were conducted within the first week poststroke and after 6 months. RESULTS: MRI showed a bithalamic infarction involving the territory of the paramedian arteries predominantly affecting the dorsomedial and intralaminar nuclei of the thalami. Disappearance of spontaneous confabulation paralleled a specific recovery in mental flexibility, whereas all other executive components and long-term memory remained severely impaired at 6 months poststroke. CONCLUSIONS: Our case study provides additional evidence that mental flexibility, but not executive functioning in general, is a prerequisite for spontaneous confabulation. Direct or indirect functional deactivation of dorsolateral prefrontal cortex may be necessary for the development of spontaneous confabulation.

Amnesia↗

PubMed2003

Gambling as an executive function task.

The Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) was investigated in relation to fluid intelligence and two conventional executive function tasks: letter fluency and the Wisconsin Card Sorting Test. Fifty-one children aged 8-10 years and a heterogeneous group of 40 adults served as participants. Adults outperformed children on all measures except one; this was the number of good cards selected in the IGT. Intercorrelations among executive function tasks were low. The number of good cards in the IGT appeared to be lower than in previous studies. Reasons for poor performance are discussed. The IGT may possess some shortcomings, which should be investigated in future studies. In clinical usage, the IGT may best serve as a complementary tool to the executive functions test battery.

Adult↗

PubMed2005

Executive function correlates with walking speed in older persons: the InCHIANTI study.

OBJECTIVES: To study the association between performance on psychological tests of executive function and performance on lower extremity tasks with different attentional demands in a large sample of nondemented, older adults. DESIGN: Cross-sectional study. SETTING: Community-based. PARTICIPANTS: Nine hundred twenty-six persons aged 65 and older, without dementia, stroke, parkinsonism, visual impairment, or current treatment with neuroleptics, enrolled in a large epidemiological study. MEASUREMENTS: Trail Making Test (TMT) parts A and B and two performance-based measures of lower extremity function that require different executive/attentional-demanding skills: walking speed on a 4-m course at usual pace and walking speed on a 7-m obstacle course at fast pace. A difference score (Delta TMT), obtained by subtracting time to perform part A from time to perform part B of the TMT, was used as an indicator of executive function. Based on Delta TMT, subjects were divided into poor performance, intermediate performance, and good performance. RESULTS: After adjustment, no association between Delta TMT and 4-m course usual-pace walking speed was found. Participants with poor Delta TMT and with intermediate Delta TMT performance were more likely to be in the lowest tertile for 7-m obstacle course walking speed. CONCLUSION: In nondemented older persons, executive function is independently associated with tasks of lower extremity function that require high attentional demand.

Aged↗

PubMed2006

Aging and strategic retrieval in a cued-recall test: the role of executive functions and fluid intelligence.

Cued-recall in episodic memory was investigated in relation to low and high cognitive support at retrieval, executive function level and fluid intelligence level in 81 healthy adults divided first into two age groups (young and elderly adults). The first analyses showed that age-related differences were greater when a low cognitive support was provided to recall the words. An individual index of loss of performance when the number of cues was decreased was then calculated. Hierarchical regression analysis revealed that the executive functions measure (perseverative errors on the Wisconsin Card Sorting Test) was a better candidate than the fluid intelligence measure (Cattell's culture fair test) to account for the age-related variance of the size of performance loss. These findings suggest that age differences in implementing strategic retrieval may be mainly due to a decline in executive functions.

Adult↗

PubMed2001

Dissociation of social cognition and executive function in frontal variant frontotemporal dementia.

In this paper, we adopt a neurodevelopmental stance to examining frontal variant frontotemporal dementia (fv-FTD) by using experimental procedures from the literature on the growth of social behaviour in children to examine the deficits in social reasoning which may underpin behavioural disturbance in fv-FTD. We present the case of a 47-year-old man with a diagnosis of fv-FTD and severe antisocial behaviour. Tests of general neuropsychology and of executive function were performed. In addition, the patient, JM, was assessed on tasks which test theory of mind. Theory of mind develops in distinct stages through childhood and is a core ability to represent the thoughts and feelings of others, independent of the level of intellectual ability. The results indicate relatively intact general neuropsychological and executive function, but extremely poor performance on tasks of theory of mind. This indicates a dissociation of social cognition and executive function suggesting that in psychiatric presentations of fv-FTD there may be a fundamental deficit in theory of mind independent of the level of executive function. The implications of this finding for diagnostic procedures and possible behavioural management are discussed.

Antisocial Personality Disorder↗

PubMed2001

Memory and executive function impairments in deficit syndrome schizophrenia.

The relationship between deficit syndrome schizophrenia, as determined by the Schedule for the Deficit Syndrome, and impairments in memory and executive function was investigated by administering the Wisconsin Card Sorting Test, the Wechsler Adult Intelligence Test, and the Wechsler Memory Scales to outpatients with deficit (n=33) and non-deficit (n=57) syndrome. A factor analysis of test variables revealed three factors: executive functioning; simple verbal memory; and semantic verbal memory. Results indicated that the deficit group performed significantly worse on the executive functioning factor, but not on either of the verbal memory factors. These findings support the hypothesis that deficit syndrome schizophrenia represents a specific cognitive impairment in executive processing and not necessarily graver global cognitive impairment.

Adult↗

PubMed2002

Attention and executive function deficits in adolescent sex offenders.

Thirty male adolescent sex offenders and 20 age-matched male adolescents completed an extensive battery of attention and executive function tests. Controls were obtained from adolescents from a socially and economically deprived background, typical of the offending group. The attention battery was based on Mirksy, Anthony, Duncan, Ahearn, and Kellam (1991) and the executive function battery on Kelly (2000a). Successful matching for IQ was not achieved and therefore ANCOVA comparisons were made between the groups, with IQ as the covariate. In attention a highly significant difference was found on the focus-execute factor and a significant difference on the shift factor. In executive function there was a highly significant difference only on the response speed factor. In all cases better abilities were demonstrated by the control group. The importance of thorough neuropsychological investigation in the clinical assessment of this forensic group is supported. The clinical implications of neuropsychological deficits in terms of risk assessment and clinical management are discussed.

Adolescent↗

PubMed2007

A double-blind placebo-controlled experimental study of nicotine: II--Effects on response inhibition and executive functioning.

RATIONALE: Smokers may show abnormal functioning in prefrontal cortex during acute abstinence, reflecting deficient activity in mesocorticolimbic circuitry. Cognitive correlates of this putatively include impaired response inhibition and other aspects of executive functioning. OBJECTIVES: To investigate whether inhibitory control and other executive functions in smokers are impaired during acute abstinence relative to post-nicotine. METHODS: 145 smokers were tested twice after overnight abstinence-once after nicotine and once after placebo lozenges (order counterbalanced, double-blind)-on an antisaccade task, a continuous performance task (CPT), a delayed response spatial working memory task and a verbal fluency test. RESULTS: Compared with placebo, nicotine was associated with better inhibitory control on the antisaccade task and fewer impulsive responses to filler stimuli (motor errors) on the CPT; at the first assessment only, nicotine also reduced impulsive responses to 'catch' stimuli on the CPT. However, it did not affect CPT response bias (an index of impulsive vs cautious decision-making), spatial working memory, or verbal fluency. CONCLUSIONS: Smoking abstinence appears to be associated with a difficulty in inhibiting prepotent motor responses, and with nicotine to attenuate this difficulty. However, more 'cognitive' forms of inhibitory control (e.g. decision-making) and the other aspects of executive function tested here appear to be unaffected.

Adult↗

PubMedDate not supplied

[Executive functions: the need for the integration of concepts].

INTRODUCTION: The new cognitive neuropsychology approaches have aroused an increasing interest in understanding the higher cognitive processes as well as the neural substrates linked to them. Particularly, the executive functions, reckoned to be essential to control the information processing and to co ordinate behaviour, have received preferential treatment from specialised literature on the subject. DEVELOPMENT: From obsessive compulsive disorder to schizophrenia, from Parkinson s disease to multiple sclerosis, there are many reports that show the affectation of these functions in all these morbid processes. On the other hand, the part that the prefrontal cortex plays in human behaviour in general, and in executive functions in particular, constitutes one of the most important fields of research of neurosciences nowadays. Thus, this cortical area appears closely linked to the executive processes, affecting different respects of the cognitive functions. Working memory, supervisory attentional system, somatic marker, information processing, behaviour planning, social judgement, are processes which have been related to the prefrontal cortex activity as a structure, and to the executive processes as a function. CONCLUSIONS: The aim of this article is to revise the concept of executive functions, and give rise reflections about the usefulness of the aforementioned concept and its practical applicability. It is essential that we understand the difference between structure and function, cognition and emotion, brain activity and behaviour, category and dimension, and between mind and brain, to achieve a more comprehensive approach to this concept of executive functions we all use, and many times find difficult to define and to understand.

Cognition Disorders↗

PubMed2005

Executive functions in autism and Asperger's disorder: flexibility, fluency, and inhibition.

The Color-Word Interference Test, Trail Making Test, Verbal Fluency Test, and Design Fluency Test from the Delis-Kaplan Executive Function System (Delis, Kaplan, & Kramer, 2001) were administered to 12 high-functioning adults and adolescents with autistic disorder or Asperger's disorder. Each test included a switching condition in addition to baseline and/or other executive-function conditions. Participants performed significantly below average on a composite measure of executive functioning adjusted for baseline cognitive ability. Complex verbal tasks that required cognitive switching and initiation of efficient lexical retrieval strategies produced the most consistent deficits, whereas cognitive inhibition was intact. We discuss implications of these findings for understanding the neurocognitive substrates of autistic spectrum disorders.

Adolescent↗

PubMed2002

Positive mood and executive function: evidence from stroop and fluency tasks.

Contrasting predictions have been made about the effects of positive mood states on the performance of frontal lobe tests that tap executive functions such as inhibition, switching, and strategy use. It has been argued that positive mood is likely to improve some cognitive processes, particularly those dependent on the frontal cortex and anterior cingulate of the brain. However, there is some evidence that happy mood may impair executive functioning. The current experiments investigated the effects of positive mood on Stoop and fluency tests, which are frequently used to assess executive function. Positive mood impaired performance on a switching condition of the Stroop test, but improved performance on a creative uses test of fluency. The effect of positive mood on an executive task may therefore depend on whether a task is inherently motivating or is impaired by diffuse semantic activation.

Adolescent↗

PubMed2004

How well do measures of inhibition and other executive functions discriminate between children with ADHD and controls?

The aim of the present study was to evaluate the usefulness of Barkley's (1997a) model of inhibition and executive functioning in describing the deficits associated with Attention Deficit Hyperactivity Disorder (ADHD). Besides group differences, the present study addressed the question of independent effects of inhibition and the other executive functions in discriminating between children with ADHD and controls and how well, in terms of sensitivity and specificity, these measures can classify the children into the correct group. The results showed that children with ADHD differed significantly from controls with regard to measures of inhibition as well as all other executive function measures, except repetition of hand movements. In logistic regression models, three different measures tapping inhibition, working memory and emotion regulation were shown to be significant independent predictors of group membership. The sensitivity for these three variables as a set was 76.2, the specificity was 90.5, with a total of 86% of the sample correctly classified. When excluding the parental rating of emotion regulation, the overall classification rate decreased some, but was still relatively high in comparison with previous studies within this area of research.

Arousal↗

PubMed2000

Investigation of executive function change following anterior temporal lobectomy: selective normalization of verbal fluency.

The nociferous cortex hypothesis predicts that electrophysiological normalization to distal extratemporal brain regions following anterior temporal lobectomy (ATL) will result in improvements in executive functioning. The present study examined the effects of seizure laterality and seizure control on executive function change. The authors administered the Wisconsin Card Sorting Test (WCST), Trails B, and the Controlled Oral Word Association Test to 174 temporal lobe epilepsy patients who underwent ATL. No significant changes were found on the WCST or Trails B tests, regardless of surgery side or seizure-free status. However, verbal fluency significantly improved in seizure-free patients. Findings were consistent with the nociferous cortex hypothesis suggesting selective executive function improvement following ATL. These findings are discussed in terms of recent research demonstrating extrahippocampal metabolic normalization following surgery.

Adolescent↗

PubMed1992

Biological and psychological development of executive functions.

The purpose of this overview is to provide a background for understanding the relation between the biological maturation of the frontal lobes and the development of the psychological concept of executive functions. In the first section, an interactive hierarchical feedback model is presented as a heuristic way of conceptualizing the relationship of the frontal lobes and executive functions to other brain regions and abilities. The following two sections present a synopsis of research on biological maturation and the psychological development of executive functions.

Child↗

PubMed2002

Apathy and executive function in Alzheimer's disease.

Apathy is a common behavioral disturbance in patients with Alzheimer's disease (AD). Recent studies have linked the presence of apathy to alterations in frontal lobe functions, but few studies have explored the relationship using standard neuropsychological measures in patients with AD. We administered a comprehensive battery of neuropsychological tests and a behavior rating scale to 80 patients with AD. We explored the relationship of apathy to executive dysfunction. AD patients with apathy performed significantly worse on tests of executive function (WAIS-R Digit Symbol, Trail-Making, Stroop Color Interference Test) than AD patients without apathy. The presence of dysphoria did not modify these results and no significant relationships were found between tests of executive functions and dysphoria. Performance on executive measures as a group were effective in correctly classifying patients as apathetic or nonapathetic with 75% accuracy. Neuropsychological measures not dependent on executive functions were unrelated to apathy. Apathy is associated with executive dysfunction and not with other neuropsychological deficits. Apathy is distinct from dysphoria.

Aged↗