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PubMed2004

Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s.

OBJECTIVE: To determine the frequency, nature, and severity of executive dysfunction (EDF) at 8 years of age in extremely low birth weight (ELBW)/very preterm infants who were born in the 1990s, compared with normal birth weight (NBW) control subjects. METHODS: A geographically determined cohort study was conducted in Victoria, Australia. The ELBW/very preterm cohort comprised 298 consecutive survivors at 2 years of age who had gestational ages <28 completed weeks or birth weights <1000 g and were born during 1991-1992. The NBW cohort comprised 262 randomly selected children of birth weight >2499 g matched on date of birth, gender, ethnicity, and health insurance status. The participation rate was 92% (275 of 298) for the ELBW/very preterm cohort and 85% (223 of 262) for the NBW cohort. Cognitive and behavioral measures of executive functioning were administered. RESULTS: The ELBW/very preterm cohort exhibited significant EDF compared with their NBW peers in all areas assessed. The cognitive assessment revealed global impairment rather than deficits in specific executive domains. The ELBW/very preterm children also displayed more behavioral problems indicative of EDF than the NBW children. Severe impairments were exhibited in only a small minority of ELBW/very preterm children. No statistical conclusions were altered after adjustment for sociodemographic variables or when children with substantial neurosensory impairment were excluded. CONCLUSIONS: School-aged children who were born in the 1990s and were very preterm or had ELBW are at greater risk for developing EDF and require ongoing neuropsychological review throughout middle childhood.

Child↗

PubMed2003

Psychometrically matched measures of global cognition, memory, and executive function for assessment of cognitive decline in older persons.

Item response theory methods were used to derive psychometrically sophisticated measures of global cognition, memory, and executive function. Goals were that these measures (a) could be derived from commonly used neuropsychological tests, (b) would have linear measurement properties, and (c) would be psychometrically matched. Scale development was based on a sample of 400 older individuals with cognitive function ranging from normal to demented. Scales were reasonably matched with linear measurement over an ability range relevant to many important clinical applications. Cognitively normal, mild impairment, and dementia participant groups differed on baseline measures and rate of decline. Association of measures with quantitative structural magnetic resonance imaging variables followed expected patterns. This approach to scale development may have applications for other neuropsychological assessment problems.

Aged↗

PubMed2005

Executive function and theory of mind in 2 year olds: a family affair?

Although numerous studies of preschoolers report robust associations between performance on tests of executive function (EF) and theory of mind (ToM), a lack of developmentally appropriate tasks so far has limited research on these cognitive skills in younger children. Here, we present new batteries of EF and ToM tasks that were administered to 140 two-year-olds from predominantly disadvantaged families, with analyses based on 129 children. Our results showed a strong association between EF and ToM, which remained significant when effects of verbal ability were controlled. Individual differences in EF and ToM were also examined in relation to both distal family factors (social disadvantage, number of siblings) and proximal family factors (quality of child's relationships with parents and siblings). Social disadvantage predicted significant variance in both EF and ToM but did not contribute to the association between these domains. Associations between positive parent-child relationships and both EF and ToM were nonsignificant when verbal ability was controlled. In contrast, positive sibling relationships predicted significant variance in ToM, even controlling for age, verbal ability, EF, social disadvantage, and parent-child relationships.

Affect↗

PubMed1998

The Tower of London(DX): a standardized approach to assessing executive functioning in children.

In the current study, the Tower of London (Shallice, 1982) was modified to enhance its clinical utility as a measure of childhood executive functioning. The Tower of London-Drexel (TOL(DX)) was administered to normal control (NC; N = 56) and attention-deficit hyperactivity disorder (ADHD; N = 99) children (ages 7 to 12) to determine whether age-related changes in performance were evident, to gather normative data, and to evaluate the test-retest reliability and criterion-validity of the measure. The results revealed age-related changes in score performance, age-group normative data, an acceptable level of reliability and significant differences in performance of NC and ADHD subjects. Further, discriminant analysis classification rates determined that the TOL(DX) was sensitive and highly specific to ADHD. Implications and limitations of the study are discussed.

Journal Article↗

PubMedDate not supplied

Prospective memory and executive function in schizophrenia.

Experimental studies of normal subjects have shown that the intention to perform an action speeds word recognition for items related to that intention (Goschke & Kuhl, 1993). This phenomenon--the intention superiority effect (ISE)--is thought to be mediated by frontal executive functions. Since schizophrenia is characteristically associated with forms of frontal-executive dysfunction, an impaired ISE might be expected in this patient group. A script-learning paradigm was used to investigate the ISE in 10 schizophrenics who do show evidence of executive dysfunction and in 10 who do not. As predicted, only the former showed an ISE; however, all schizophrenics showed an ISE to words semantically related to the intention. It seems that the ability to form specific intentions is impaired only in schizophrenics with executive dysfunction; however, they retain the ability to form more generalized intentions.

Adult↗

PubMed1997

Executive function and uptake of 99mTc-exametazime shown by single photon emission tomography after oral idazoxan in probable Alzheimer-type dementia.

Preliminary reports suggest improved executive function in patients with lobar dementia after treatment with single doses of the alpha 2 adrenoceptor antagonist, idazoxan. The potential for use in probable Alzheimer-type dementia prompted the present study. Fifteen patients with probable Alzheimer-type dementia were examined twice with neuropsychological measures and 14 also with single photon emission tomography (SPET) after a single double blind oral administration of 40 mg idazoxan or placebo in a balanced cross-over design. Brain perfusion maps were spatially transformed into standard stereotactic space and compared pixel-by-pixel. A parametric analysis was used to examine the relationship between the drug effect, verbal fluency and brain perfusion. Two to 3 h after idazoxan, measures of reaction time, Stroop test, category fluency and anxiety were unchanged. Verbal fluency (letter) and spatial working memory were impaired and performance on the Tower of London test in a sub-set of patients showed a trend to impairment in the idazoxan condition. Idazoxan produced a modest relative activation in left thalamus and inferior occipital cortex: decreases occurred in inferior anterior cingulate and left insular cortex. There were significant correlations on both days between measures of fluency and brain perfusion in left lateral prefrontal cortex. The reduced performance with idazoxan was directly correlated with reduced perfusion in left lateral prefrontal cortex, supporting an important interaction between drug and task performance. The imaging component of the study therefore suggested that activation of frontal networks is necessary for performing fluency tasks in Alzheimer-type dementia. Brain networks involving prefrontal cortex are the locus for the primary cognitive effects of noradrenergic drugs. The direction of the effect of any dose of agonist or antagonist may depend critically upon the age and pathology of the experimental subjects and the relationship between performance, noradrenergic drive and task difficulty.

Adrenergic alpha-Antagonists↗

PubMed2004

The relationship between motor coordination, executive functioning and attention in school aged children.

Given the high level of comorbidity of attention deficit hyperactivity disorder (ADHD) and developmental coordination disorder (DCD), deficits in executive function (EF), shown to be present in children with ADHD, may also be implicated in the motor coordination deficits of children with DCD. The aim of this study was to explore the relationship between EF and motor ability. A sample of 238 children, 121 girls and 117 boys, aged between 6 and 15 years was recruited for this project. Motor ability was assessed using the McCarron Assessment of Neuromuscular Development (MAND), level of inattention using the Child Behavior Checklist (CBCL), and Verbal IQ (VIQ) was estimated using subtests of the WISC-III. A reaction time task and three EF tasks measuring response inhibition, working memory and the ability to plan and respond to goal-directed tasks were administered. It was found that motor ability significantly accounted for variance in tasks measuring speed of performance, whereas inattention appeared to influence performance variability. Despite past evidence linking poor motor ability with inattention, there was little overlap in the processes that are affected in children with motor coordination or attention problems.

Adolescent↗

PubMed2004

Memory and executive function in aging and AD: multiple factors that cause decline and reserve factors that compensate.

Memory decline in aging results from multiple factors that influence both executive function and the medial temporal lobe memory system. In advanced aging, frontal-striatal systems are preferentially vulnerable to white matter change, atrophy, and certain forms of neurotransmitter depletion. Frontal-striatal change may underlie mild memory difficulties in aging that are most apparent on tasks demanding high levels of attention and controlled processing. Through separate mechanisms, Alzheimer's disease preferentially affects the medial temporal lobe and cortical networks, including posterior cingulate and retrosplenial cortex early in its progression, often before clinical symptoms are recognized. Disruption of the medial temporal lobe memory system leads directly to memory impairment. Recent findings further suggest that age-associated change is not received passively. Reliance on reserve is emerging as an important factor that determines who ages gracefully and who declines rapidly. Functional imaging studies, in particular, suggest increased recruitment of brain areas in older adults that may reflect a form of compensation.

Aging↗

PubMed2006

Theory of mind and executive function: working-memory capacity and inhibitory control as predictors of false-belief task performance.

This study of the relationship between theory of mind and executive function examined whether on the false-belief task age differences between 3 and 5 ears of age are related to development of working-memory capacity and inhibitory processes. 72 children completed tasks measuring false belief, working memory, and inhibition. Significant age effects were observed for false-belief and working-memory performance, as well as for the false-alarm and perseveration measures of inhibition. A simultaneous multiple linear regression specified the contribution of age, inhibition, and working memory to the prediction of false-belief performance. This model was significant, explaining a total of 36% of the variance. To examine the independent contributions of the working-memory and inhibition variables, after controlling for age, two hierarchical multiple linear regressions were conducted. These multiple regression analyses indicate that working memory and inhibition make small, overlapping contributions to false-belief performance after accounting for age, but that working memory, as measured in this study, is a somewhat better predictor of false-belief understanding than is inhibition.

Adult↗

PubMed2003

Task-set switching deficits in early-stage Huntington's disease: implications for basal ganglia function.

Executive functions are likely mediated by interconnected circuits including frontal lobe and basal ganglia structures. We assessed the executive function of task switching in patients with early-stage Huntington's disease (HD), a neurodegenerative disease affecting the basal ganglia. In two experiments, the HD patients had greater difficulty when switching than when repeating a task than matched controls, and this was true even when scaling for the overall slowing of the patients. In the first experiment, HD patients had a switching deficit even in a "pure" condition where they had to switch, predictably, and with substantial preparation time, between stimuli having only one possible response, indicating a switching deficit different from that for patients with Parkinson's disease or frontal lobe trauma, and possibly relating to inadequate activation of stimulus-response links or "response set." In the more elaborate second experiment, we could not account for the switching deficit of the patients in terms of inadequate preparation in advance of a switch, deficient suppression of task-set processing from the preswitch trial, or impaired suppression of interference due to the presence of a competing task set. Instead, we found that part of the switching deficit was due to elevated reaction time and errors on switch trials for a repeated response (same button press as on preswitch trial) relative to an alternated response (different button press from preswitch trial). We argue that this elevated "repetition effect" for the HD patients is due to excessive inhibition of the just-performed response in advance of a switch. Alterations in the "response-setting" process alone (Experiment 1) and both the response-setting and "response inhibition" process (Experiment 2) probably arise from striatal pathology in HD, thus accounting for the task-switching deficits and showing how basal ganglia implemented response processes may underpin executive function.

Adult↗

PubMed2005

Working memory and executive function: the influence of content and load on the control of attention.

In a series of three experiments, increasing working memory (WM) load was demonstrated to reduce the executive control of attention, measured via task-switching and inhibitory control paradigms. Uniquely, our paradigms allowed comparison of the ability to exert executive control when the stimulus was either part of the currently rehearsed memory set or an unrelated distractor item. The results demonstrated a content-specific effect-insofar as switching attention away from, or exerting inhibitory control over, items currently held in WM was especially difficult-compounded by increasing WM load. This finding supports the attentional control theory that active maintenance of competing task goals is critical to executive function and WM capacity; however, it also suggests that the increased salience provided to the contents of WM through active rehearsal exerts a content-specific influence on attentional control. These findings are discussed in relation to cue-induced ruminations, where active rehearsal of evocative information (e.g., negative thoughts in depression or drug-related thoughts in addiction) in WM typically results from environmental cuing. The present study has demonstrated that when information currently maintained in WM is reencountered, it is harder to exert executive control over it. The difficulty with suppressing the processing of these stimuli presumably reinforces the maintenance of these items in WM, due to the greater level of attention they are afforded, and may help to explain how the cue-induced craving/rumination cycle is perpetuated.

Attention↗

PubMed1999

Executive function in depression: the role of performance strategies in aiding depressed and non-depressed participants.

OBJECTIVES: Depression has been found to be associated with dysfunction in executive processes, whereas relatively automatic processes are thought to remain intact. Failure to generate or implement adequate performance strategies has been postulated in depressed participants. The present study investigated spontaneous strategy usage in depressed and control participants, and the effectiveness of providing a hint about performance strategies. METHODS: Unipolar depressed participants were compared with matched healthy controls on three tasks sensitive to executive function: memory for categorised words, response suppression, and multiple scheduling. Participants in each group were randomly allocated to strategy aid and no strategy aid conditions. Those in the strategy aid condition were given a hint about the use of an appropriate performance strategy for each task, in addition to the standard instructions given to those in the no strategy aid condition. RESULTS: Depressed participants performed worse than controls on each of the three tasks, and were found to use appropriate performance strategies less often. Provision of strategy hints increased the use of performance strategies in two of the three tasks, memory for categorised words, and response suppression, but did not significantly improve overall performance for either group. CONCLUSIONS: The findings were consistent with the view that depressed participants fail to use appropriate performance strategies spontaneously to the same extent as controls. However, provision of information alone does not seem to be an adequate means of enhancing performance. The role of performance strategies in cognitive impairment in depression is discussed, both in terms of initiating use of such strategies and carrying these out efficiently.

Adult↗

PubMed2006

Methylphenidate improves aspects of executive function in African American children with ADHD.

OBJECTIVE: The undertreatment of ethnic minority children with ADHD prompted a study on the effects of methylphenidate (MPH) on the executive functions of African American children with ADHD. METHOD: Nineteen African American children with ADHD are tested on the Tower of Hanoi (TOH) and the Paired Associates Learning Task (PAL) in a double-blind crossover acute challenge of MPH and placebo. RESULTS: Under MPH, TOH rule breaks decrease, especially in the second testing session, and TOH planning time increases, particularly for incorrect solutions; PAL recall in the final learning trial improves with MPH. CONCLUSION: Similar to previous findings with predominantly majority samples of patients with ADHD, MPH enhances planning, precision, and persistence in African American children with ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Neural correlates of executive function in autistic spectrum disorders.

BACKGROUND: Some clinical characteristics of high-functioning individuals with autistic spectrum disorder (ASD) such as repetitive stereotyped behaviors, perseveration, and obsessionality have been related to executive function (EF) deficits, more specifically to deficits in inhibitory control and set shifting and mediating frontostriatal neural pathways. However, to date, no functional imaging study on ASD has investigated inhibition and cognitive flexibility and no one has related EF brain activation to brain structure. METHODS: We compared brain activation (using functional magnetic resonance imaging) in 10 normal intelligence adults with ASD and 12 healthy control subjects during three different EF tasks: 1) motor-inhibition (GO/NO-GO); 2) cognitive interference-inhibition (spatial STROOP); and 3) set shifting (SWITCH). Using voxel-based morphometry, we investigated if cortical areas which were functionally different in people with ASD were also anatomically abnormal. RESULTS: Compared with control subjects, ASD individuals showed significantly increased brain activation in 1) left inferior and orbital frontal gyrus (motor-inhibition); 2) left insula (interference-inhibition); and 3) parietal lobes (set shifting). Moreover, in individuals with ASD, increased frontal gray matter density and increased functional activation shared the same anatomical location. CONCLUSIONS: Our findings suggest an association between successful completion of EF tasks and increased brain activation in people with ASD, which partially may be explained by differences in brain anatomy.

Adolescent↗

PubMed2003

Switching attention and resolving interference: fMRI measures of executive functions.

Is there a single executive process or are there multiple executive processes that work together towards the same goal in some task? In these experiments, we use counter switching and response inhibition tasks to examine the neural underpinnings of two cognitive processes that have often been identified as potential executive processes: the switching of attention between tasks, and the resolution of interference between competing task responses. Using functional magnetic resonance imaging (fMRI), for both event-related and blocked design tasks, we find evidence for common neural areas across both tasks in bilateral parietal cortex (BA 40), left dorsolateral prefrontal cortex (DLPFC; BA 9), premotor cortex (BA 6) and medial frontal cortex (BA 6/32). However, we also find areas preferentially involved in the switching of attention between mental counts (BA 7, BA 18) and the inhibition of a prepotent motor response (BA 6, BA 10), respectively. These findings provide evidence for the separability of cognitive processes underlying executive control.

Adolescent↗

PubMed1995

Executive functions of the frontal lobes: psychometric properties of a self-rating scale.

This study investigated the psychometric properties of a self-rating scale designed to test the executive functions of the frontal lobes. A set of 16 items was selected, based on face validity, from the 200-item Coolidge Axis II Inventory. Cronbach scale reliability for the new scale was .72 on 1,223 purportedly normal participants. A factor analysis yielded a three-factor structure, Decision-making difficulties (8 items, 23% of the variance, scale reliability .77), Poor planning (4 items, 15% of the variance, scale reliability .63), and Task incompletion (6 items, 9% of the variance, scale reliability .66). A multivariate analysis of variance, performed on the overall scale sum and the three subscales, between 17 closed head-injured patients and a matched control group was significant. The head-injured patients scored significantly higher on the over-all measure of executive dysfunction and higher on the decision-making difficulties subscale but not on the other two subscales.

Adolescent↗

PubMed2001

Constructive thinking, executive functioning, antisocial behavior, and drug use involvement in adolescent females with a substance use disorder.

The main aim of this study was to determine how constructive thinking (CT), executive functioning (EF), and antisocial behavior (ASB) are related to drug use involvement in 282 adolescent females, 14-18 years of age, with a substance use disorder (SUD) and in controls. CT was measured using the Constructive Thinking Inventory (S. Epstein & P. Meier, 1989), EF was measured using a battery of neuropsychological tests, and ASB was measured using the Youth Self-Report Inventory (T. Achenbach, 1991) and a psychiatric interview. Females with an SUD demonstrated lower CT and EF scores and higher ASB scores compared with the controls. Low CT and low EF were significantly related to increased drug use involvement even when controlling for age, socioeconomic status, and vocabulary level. ASB partially mediated the relation between CT and drug use involvement, and it fully mediated the relation between EF and drug use involvement. Moreover, ASB moderated the relation between EF and drug use involvement.

Adolescent↗

PubMed2002

Effects of IQ on executive function measures in children with ADHD.

The present study compared children with Attention-Deficit Hyperactivity Disorder (ADHD) and controls on a selected set of clinical measures of executive function (EF). A total of 92 children (51 ADHD, 41 control), ages 6-16, completed measures chosen from a larger neuropsychological battery to illustrate diverse components of the EF construct (planning, inhibitory control, response preparation, memory search). The selected measures were moderately correlated with one another, and moderately correlated with IQ. After controlling for age, sex, presence of learning disability (LD), ADHD, and IQ test version, Full Scale IQ was significantly related to four of the five selected EF measures. A second analysis showed group differences on the EF measures at different IQ levels. After covarying for age, there was a significant multivariate effect for IQ level (average, high average, superior) and a significant multivariate interaction between group (ADHD vs. control) and IQ level. Three of the five selected EF measures showed significant univariate group effects (controls performing better than ADHD) at the average IQ level; however, there were no significant group differences between children with ADHD and controls at high average or superior IQ levels. These results suggest that clinical measures of EF may differ among children with ADHD and controls at average IQ levels, but there is poorer discriminatory power for these measures among children with above average IQ.

Adolescent↗