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PubMed1994

Relationships between measures of auditory verbal learning and executive functioning.

Relationships between performance on the California Verbal Learning Test (CVLT) and executive abilities were examined. In a sample of 115 neurological cases principal components factor analysis produced five theoretically and clinically meaningful CVLT factors. The five CVLT factors reflected general verbal learning (CVLT1), response discrimination (CVLT2), a proactive interference effect or "working memory" (CVLT3), serial learning strategy (CVLT4), and a retroactive interference effect (CVLT5). Canonical correlation between executive function measures and the five CVLT factor scores yielded one significant canonical variable accounting for 29 percent of the variance in the data. Two CVLT factors (CVLT1 and CVLT3), the Trail Making Test Part B, and Digit Span were significantly correlated with the canonical variate. Higher levels of memory performance were associated with better attention and mental tracking. Based on the present findings, attentional aspects of executive abilities appear to play a role in learning and working memory. Other aspects of executive abilities (abstraction, problem-solving, planning) appear to have minimal relationships with memory processes.

Adolescent↗

PubMed2004

Characterizing alterations in executive functioning across distinct subtypes of cortical and subcortical dementia.

Differential patterns of executive function deficits (EFD) exist in cortical and subcortical dementia; however, little work exists attempting to integrate these findings into a conceptual framework. The current study aimed to characterize EFD in cortical and subcortical dementia. Patients with Alzheimer's disease (AD; n = 65), subcortical ischemic vascular dementia (IVD; n = 64), or Parkinson's disease with dementia (dPD; n = 21) completed a variety of measures purported to require executive systems. We extracted variables of interest from measures shown in a growing body of literature to be associated with EFD in dementia. These measures included the Boston Revision of the WMS Mental Control subtest, letter fluency, WAIS-R Similarities subtest, CVLT, the Graphical Sequence Test-Dementia version, and Clock Drawing. When submitted to a PCA with varimax rotation, these variables produced a four-component solution (62% of the variance). Component 1 appeared to reflect adequacy of working memory, Component 2 irrelevant or context nonspecific interference, Component 3 reflected response preparation and Component 4 relevant or context-specific interference. Post hoc analyses of z-transformed composite scores revealed that AD differentially affected context-specific interference, IVD and dPD disrupted working memory and response preparation while IVD differentially affected context non-specific interference. EFD in dementia can be divided into specific components that are differentially impaired by cortical and subcortical dementias. Implications for an overall conceptual framework of EFD in dementia are discussed.

Aged↗

PubMed2002

Assessment and development of executive function (EF) during childhood.

This review paper outlines the issues associated with the assessment of executive function (EF) in children and adolescents, and describes the developmental profile of executive processes across childhood. At the outset, EF is defined, and cognitive and behavioral impairments associated with executive dysfunction (EDF) are described. A developmental model of EF is proposed incorporating four discrete but inter-related executive domains (attentional control, cognitive flexibility, goal setting, and information processing) which operate in an integrative manner to enable "executive control". Characteristics that constitute traditional EF measures are discussed, as are the problems associated with test interpretation. The ecological validity of EF tests and neuropsychological assessment procedures are examined, and adjunct methods of measurement are presented to enable a more comprehensive and valid assessment of EF. Based on developmental and normative studies, the maturation of executive domains is mapped. Attentional control appears to emerge in infancy and develop rapidly in early childhood. In contrast, cognitive flexibility, goal setting, and information processing experience a critical period of development between 7 and 9 years of age, and are relatively mature by 12 years of age. A transitional period is thought to occur at the beginning of adolescence, and shortly after "executive control" is likely to emerge. In order to confirm our current understanding of EF development and further enhance our understanding of brain-behavior relationships, longitudinal studies incorporating structural and functional neuroimaging are required.

Adolescent↗

PubMed2006

The influence of difficult temperament on alcohol-related aggression: better accounted for by executive functioning?

The purpose of this investigation was to test the hypothesis that executive functioning (EF) would mediate the relation between difficult temperament (DT) and intoxicated aggression. Participants were 165 social drinking men and women between the ages of 21-35years old. DT was measured using the Dimension of Temperament Scale - Revised and EF was measured using seven well-established neuropsychological tests. Following consumption of an alcoholic beverage, participants were tested on a laboratory aggression measure in which electric shocks were received from and administered to a fictitious opponent under the guise of a competitive reaction time task. Aggression was operationalized as shock intensities administered to the fictitious opponent under conditions of low and high provocation. Results indicated that EF successfully mediated the relation between DT and intoxicated aggression for men but not for women. These findings are discussed with regard to how they influence current models of aggressive behavior as well as their implications for future violence prevention efforts.

Adult↗

PubMed1999

Quantitative analyses of schooling effects on executive function in young children.

Developmental studies have demonstrated the utility of select executive function (EF) tasks for the early diagnosis of specific learning-related problems (e.g., Snow, 1998). However, previous data demonstrating schooling effects on EF measures suggests potential pitfalls in clinical interpretation. In the present study three common EF measures, (Wisconsin Card Sort, Thurstone Word Fluency, and a mazes task) in addition to a VIQ estimating task, were administered to a cross-section of 115 children aged 7 to 9. Using a school-entrance cut-off design the unique contributions of formal schooling versus age-related changes to performance on the EF measures were examined. Schooling effects were both task and age-dependent supporting the conclusion that the proper use of EF measures with children in this age range depends upon consideration of factors beyond that usually depicted in net-effect models.

Age Factors↗

PubMed1996

Executive functions and developmental psychopathology.

In this paper, we consider the domain of executive functions (EFs) and their possible role in developmental psychopathologies. We first consider general theoretical and measurement issues involved in studying EFs and then review studies of EFs in four developmental psychopathologies: attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), autism, and Tourette syndrome (TS). Our review reveals that EF deficits are consistently found in both ADHD and autism but not in CD (without ADHD) or in TS. Moreover, both the severity and profile of EF deficits appears to differ across ADHD and autism. Molar EF deficits are more severe in the latter than the former. In the few studies of more specific EF tasks, there are impairments in motor inhibition in ADHD but not in autism, whereas there are impairments in verbal working memory in autism but not ADHD. We close with a discussion of implications for future research.

Adolescent↗

PubMed2005

Assessment of hot and cool executive function in young children: age-related changes and individual differences.

Although executive function (EF) is often considered a domain-general cognitive function, a distinction has been made between the "cool" cognitive aspects of EF more associated with dorsolateral regions of prefrontal cortex and the "hot" affective aspects more associated with ventral and medial regions (Zelazo and Mller, 2002). Assessments of EF in children have focused almost exclusively on cool EF. In this study, EF was assessed in 3- to 5-year-old children using 2 putative measures of cool EF (Self-Ordered Pointing and Dimensional Change Card Sort) and 2 putative measures of hot EF (Children's Gambling Task and Delay of Gratification). Findings confirmed that performance on both types of task develops during the preschool period. However, the measures of hot and cool EF showed different patterns of relations with each other and with measures of general intellectual function and temperament. These differences provide preliminary evidence that hot and cool EF are indeed distinct, and they encourage further research on the development of hot EF.

Age Factors↗

PubMed1988

Executive functions in unipolar depression before and after electroconvulsive therapy.

A neuropsychological investigation of executive functions in patients with unipolar depression was conducted. Ten patients with unipolar depression were tested before, 48 hours after, and 3 months after ECT. Control subjects were tested at similar intervals. Measures included 10 executive and related tasks (20 variables) on which frontal lobe lesion patients have been previously shown to be differentially impaired, and 1 "nonexecutive" task. Patients were significantly inferior to controls on 9 of the executive and related variables before treatment and performed slightly worse 48 hours after treatment. Significant improvement after 3 months was absent. Depressed patients were not impaired on the "nonexecutive" task.

Depressive Disorder↗

PubMed2006

The effect of polymorphism at the serotonin transporter gene on decision-making, memory and executive function in ecstasy users and controls.

RATIONALE: 3, 4-Methylenedioxymethamphetamine (MDMA or "ecstasy") is a popular drug of abuse known to result in depletions of the serotonin (5-HT) system. A number of studies have reported that ecstasy users differ from controls on a variety of measures of cognitive function. However, the literature is not consistent and many negative findings were also reported. One reason for such inconsistency might be interindividual variance in vulnerability to the deleterious effects of ecstasy due to a number of factors, both genetic and environmental. OBJECTIVES: To investigate the hypothesis that carriers of the s allele at the 5-HT transporter gene-linked polymorphic region (5-HTTLPR), which was associated with reduced serotonergic neurotransmission relative to the l allele, would be most vulnerable to the effects of ecstasy on cognitive function. METHODS: We assessed memory, decision-making, and executive function in ecstasy users and controls, stratifying by genotype at the 5-HTTLPR. RESULTS: We observed that the 5-HTTLPR genotype groups differed on a number of measures in both the ecstasy users and the controls. While performing a risky decision-making task, ss and ls controls attended to differences in the probability of winning chosen gambles to a greater extent than the ll controls. However, this difference was dramatically attenuated in the ss ecstasy users. Furthermore, independent of ecstasy use, volunteers of the ss genotype outperformed the ll genotype on a visual planning task. CONCLUSIONS: The results are consistent with the hypothesis that cognitive impairment in ecstasy users may depend on genetic variation at the 5-HTTLPR.

Case-Control Studies↗

PubMed2006

No differences in performance on test of working memory and executive functioning between healthy elderly postmenopausal women using or not using hormone therapy.

BACKGROUND: On average, ovarian function ceases at the age of 52 years so that estrogen (E) levels are chronically low following the menopause. Numerous studies have found that hormone therapy (HT) helps to protect verbal memory, a hippocampal function. Estrogen receptors are also found in the prefrontal cortex (PFC), suggesting that estrogen may modulate executive and working memory functions, both mediated by the PFC. The possible role of progesterone (P) on executive functions and working memory is unknown. OBJECTIVE: To examine the relationship between neuropsychological performance, age of initiation of HT, and duration of HT use. METHOD: In this cross-sectional study, the neuropsychological performance of 37 postmenopausal women (mean age, 65 years) who used either estrogen-only or sequential E + P (E-alone group)(n = 22) or E + P continuously (n = 15) was compared to that of 28 healthy postmenopausal women matched for age and education who had never used HT. It was hypothesized that the E-only users would perform better then the E + P and the never-users on neuropsychological tests of verbal memory, executive function and working memory. RESULTS: Results showed only minor between-group differences on working memory scores such that the E + P users were slowest to generate a response on the N-Back test of working memory. No group differences on tests of executive functions were found. CONCLUSION: There was no relationship between neuropsychological performance, age of initiation of HT, or duration of HT use.

Affect↗

PubMed2002

Active and passive executive function disorder subsequent to closed-head injury.

BACKGROUND: Executive dysfunction is one of the most destructive sequelae of closed head injuries (CHI), often impeding or even preventing the patient's return to normal functioning. On the basis of extensive clinical testing of patients with neurobehavioral disturbances resulting from CHI, the authors propose a new typology of executive dysfunction based on the primary behavioral distinction between active ('acting without thinking') and passive ('thinking without acting') forms of executive function disorder. MATERIAL/METHODS: Two patients were selected for detailed presentation. Both present with mild to moderate motor and cognitive symptoms resulting from closed head injury. The medical histories of the two patients are similar (educated professionals, mid-40s, married with children, injuries suffered in a traffic accident, 2 months in coma) except for the location of focal injuries. RESULTS: Despite considerable progress in rehabilitation, the extent of functional disorder is disproportionately large in comparison to the degree of objective disability measured by standard instruments. It is suggested that the reason for this disparity lies in executive dysfunction. In particular, a model for executive functioning will be presented to explain why and how selective destruction of particular anatomical/functional components leads to the behavioral consequences known as 'executive dysfunction'. CONCLUSIONS: Executive dysfunction is a distinct clinical syndrome which occurs in at least two distinguishable varieties, active and passive.

Accidents, Traffic↗

PubMed2005

A model of executive functions in very old community dwellers: evidence from The Sydney Older Persons Study.

Executive functions (EF) are generally described as showing greater sensitivity to ageing compared to other cognitive domains. Numerous pitfalls exist in the measurement of EF due to loose definitions and lack of agreement on these concepts and uncertainty about the constructs being measured. To this date, the validity of EF constructs has not been examined in the old-old population. Performance of 122 randomly selected community dwellers aged between 81 and 97 years on nine EF tasks (seven of which commonly used in clinical practice) was examined. Factor analytic procedures using structural equation modelling (SEM) failed to satisfactorily explain the data according to four a priori models, the first two models reflecting two major constructs commonly found in current models of EF ("set" and "switch"), the last two reflecting task requirements. The best measure for each task was extracted using statistically driven analyses and further SEM revealed an orthogonal two-factor model which provided a good fit of the data, explaining between 8% and 25% of the total variance. This model can be interpreted in terms of reactive and spontaneous flexibility as proposed by Eslinger and Grattan (1993), with the first factor reflecting internally driven strategies and the second environment dependent strategies. Furthermore, these findings also suggest that: (a) unique tasks of EF may not be applicable to all age groups due to individual experience and changes in strategies; and (b) current clinical instruments may be inadequate to measure very specific aspects of the complex construct of EF.

Aged↗

PubMed2006

Executive functions and seizure-related factors in children with epilepsy in Western Norway.

Executive functions (EFs), seizure-related factors, and school performance were studied in a population-based sample of children with epilepsy (n=117; 71 males, 46 females; mean age 10y 5mo [SD 2y]; range 6y-12y 11mo) and a comparison group (n=124; 71 males, 53 females; mean age 10y 1mo [SD 2y 1mo]; range 6y-12y 11mo). EF, cognitive function, depression, socioeconomic status, and school performance were examined. Patients with epilepsy performed significantly lower than the comparison group on all EF measures except incidental memory. Intellectual dysfunction and depression accounted for 43% of EF problems. All epilepsy syndrome groups (except Rolandic epilepsy) were associated with decreased EF in addition to early epilepsy onset, high seizure frequency, and polytherapy. Patients had more school performance problems than comparison children which were attributed partly to EF difficulties. All aspects of EF were affected in children with epilepsy and all epilepsy syndrome groups, except Rolandic epilepsy, influenced EF negatively. EF problems contributed to patients' school difficulties beyond intellectual dysfunction.

Catchment Area, Health↗

PubMed2006

Executive functions in the heterozygous reeler mouse model of schizophrenia.

Deficits in working memory and executive functions are now considered among the most reliable endophenotypes for schizophrenia. To determine whether cognitive deficits exist in mouse models of the disease, the authors trained heterozygous reeler (+/rl) mice on a series of visual discriminations similar to those used to test executive abilities in primates. These mice resemble schizophrenia patients in that both have reduced levels of reelin protein and altered gamma aminobutyric acid neurotransmission in the prefrontal cortex. The +/rl mice showed a selective deficit in reversal learning, with a pattern of errors that suggested impaired visual attention rather than a deficiency in perseveration and inhibitory control. These results show that cognitive dysfunction may serve as a useful biomarker in mouse models of neuropsychiatric disease.

Animals↗

PubMed1996

Recovery of memory and executive function following anterior communicating artery aneurysm rupture.

We studied the recovery of memory and executive function in 10 patients following anterior communicating artery aneurysm (ACoA) rupture and repair. Patients were tested at 2 consecutive points in time following surgery (approximately at 2 and 3 months). At the first testing, the patients divided into 2 groups based on the severity of impairment on executive measures. Both groups had severe anterograde amnesia, but only patients with severe executive impairments had retrograde amnesia with a temporal gradient. At second testing, both groups had persistent severe anterograde amnesia. The dysexecutive group showed significant improvement in executive deficits and in retrograde amnesia, with attenuation of the temporal gradient. Patients with more severe executive impairments had more extensive bilateral frontal lesions than other patients. These results suggest that the cognitive profile following ACoA rupture changes with time. Time postonset following aneurysm rupture and lesion site are both critical for defining the neuropsychological profile, and determining the underlying cognitive mechanisms in this neurological disorder.

Adult↗

PubMed2005

Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis.

BACKGROUND: Executive dysfunctions in relatives of schizophrenic patients may be trait markers of genetic liability and thus help us to elucidate the aetiology of schizophrenia. As a large amount of data has been published, a synthesis through a meta-analysis was needed to demonstrate the existence of executive impairments in relatives of schizophrenic patients and to assess their magnitude. METHOD: We conducted a meta-analysis of articles that compared performances of controls and relatives of schizophrenic patients on the four tests most frequently used to assess executive functions: the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), the Stroop Test and the Verbal Fluency (VF) Test. When needed and possible, published data were supplemented with information from the authors. After assessing the homogeneity of the data, effect sizes were estimated and publication bias was tested by use of funnel plots. RESULTS: Relatives of schizophrenic patients performed less well than controls on all executive tests analysed. Effect estimates were in the small to moderate range (from 0.26 to 0.49) for Stroop, WCST and TMT, but were greater for the fluency tests (0.65 for phonological and 0.87 for semantic VF). CONCLUSION: Relatives of schizophrenic patients appear to have wide, although not severe, executive dysfunctions. As the sensitivity of the different tests for impairments in relatives is not the same, the choice of test and method used should be carefully assessed.

Cognition Disorders↗

PubMed2007

Executive function in preschoolers with autism: evidence consistent with a secondary deficit.

Recent research on executive function (EF) deficits in autism has led investigators to conclude that EF deficits are secondary to the disorder. The current study has two major goals: (1) Examine whether specific EF deficits are present in the youngest autism group to date (mean=2.9 years), and (2) examine whether such deficits are secondary to autism, or act as an early non-specific cognitive risk factor for autism by comparing EF abilities of this autism group to a CA-matched typically developing group. Results from Experiment 1 suggest no specific EF deficits in autism relative to MA-matched controls, while results from Experiment 2 are consistent with the hypothesis that EF deficits may emerge as a secondary deficit in autism. Alternative hypotheses are also considered.

Aptitude↗

PubMed2002

How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder?

A selective review of research in the executive functioning (EF) is given for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), higher functioning autism (HFA) and Tourette syndrome. The review is restricted due to changes in the classification of the disorder in recent years and secondly the heterogeneity of EF is restricted to five key areas of concern, inhibition, set shifting, working memory, planning, and fluency. The review makes clear that there are strong differences between child psychopathological groups and controls on these EFs. However, future research will be needed to identify an EF deficit or profile, which is specific for these disorders.

Adolescent↗