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Results for “Executive function”

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PubMed1999

Neuropsychological test performances of young depressed outpatient women. An examination of executive functions.

Thirty young, unmedicated, outpatient, depressed women were compared to an equal number of matching controls on a series of neuropsychological tests purported to be sensitive to the executive functions. Specifically, the measures included the Design Fluency Test, Hand Dynamometer tasks of grip strength, perseveration, and fatigue, the FAS Verbal Fluency Test, the Stroop Color and Word Test, and the Trail Making Test (Parts A and B). Despite past research which has indicated anterior hemispheric asymmetries and impaired neurocognitive performances in depressives, this research failed to identify any reliable differences between depressed and nondepressed women on any of the neuropsychological measures. These results argue against the frequently held stereotype that depressed individuals typically display impaired performances on neurocognitive tasks. Furthermore, since the profile of the depressed sample appeared to differ significantly from past studies, a discussion is provided as to how the characteristics of this group may have impacted the results. Implications of these findings for clinical practice and future research are also provided.

Journal Article↗

PubMed2003

Executive function, memory, and learning in Tourette's syndrome.

Young people with Tourette's syndrome (TS) alone, TS plus attention-deficit/hyperactivity disorder (+ADHD), or TS plus obsessive-compulsive disorder (+OCD) were compared with a healthy control group on a set of measures of executive functioning, memory, and learning. The TS-alone group was impaired on one executive measure involving inhibition and strategy generation but did not differ significantly from the healthy control group on other measures. The TS+ADHD group showed impairment on several executive measures. There was no evidence of impairment in implicit aspects of memory and learning for any of the TS groups. The findings are discussed in terms of the frontostriatal hypothesis of TS and the contribution of comorbid symptomatology.

Adolescent↗

PubMed1997

Executive function and psychosocial adjustment in children with early treated phenylketonuria: correlation with historical and concurrent phenylalanine levels.

The issue of what level of phenylalanine (phe) constitutes a safe upper limit for the therapeutic range in dietary treatment of phenylketonuria (PKU) remains unsettled. It has been proposed that the previous guideline figure of 600 mumol l-1 may result in specific impairment of executive functions such as attention, planning and set maintenance. The executive dysfunction theory was investigated by correlation historical and concurrent phe with executive, non-executive and personality tests in a group of early and continuously treated children, aged 10-13 years, with classical PKU, whose average phe levels of 355 mumol l-1 (SD = +/-144) for the pre-school period and 480 mumol l-1 (SD +/-193) for the primary school period corresponded to the upper limits presently recommended in the UK of 360 and 480 mumol l-1 for these age ranges. No clear associations were found between historical or concurrent phe levels and any of the neuropsychological or personality measures, thereby weakening the case for the emergence of executive deficits, at least when average phe levels remain close to the upper limits now considered safe. Furthermore no significant differences were found on psychological variables where comparison with population norms was possible.

Adjustment Disorders↗

PubMed2005

Impact of gender and age on executive functioning: do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years?

ADHD is known to have neuropsychological correlates, characterized mainly by executive function (EF) deficits. However, most available data are based on studies of boys through age 12. Our goal was to assess whether girls with ADHD express neuropsychological features similar to those found in boys, and whether these impairments are found in both preteen and teen samples. Participants were 101 girls and 103 boys with DSM-III-R ADHD, and 109 comparison girls and 70 boys without ADHD, ages 9 to 17 years. Information on neuropsychological performance was obtained in a standardized manner blind to clinical status. Primary regression analyses controlled for age, socioeconomic status, learning disability, and psychiatric comorbidity. Girls and boys with ADHD were significantly more impaired on some measures of EFs than healthy comparisons but did not differ significantly from each other. With the exception of 1 test score there were no significant Sex x Diagnosis interactions. Moreover, there were no more significant interactions among age, gender, and diagnosis than would be expected by chance. Neuropsychological measures of EFs were comparably impaired in girls compared to boys with ADHD, and these impairments are found at ages 9 to 12 and ages 13 to 17. These findings suggest that executive dysfunctions are correlates of ADHD regardless of gender and age, at least through the late teen years.

Adolescent↗

PubMed1998

Factors affecting cognitive, motor, behavioral and executive functioning in children with phenylketonuria.

We administered measures of cognitive, frontal lobe (executive), behavioral and motor functioning to 18 children with classical phenylketonuria, aged 12-101 months, in order to determine the relationship of age, current and lifetime average phenylalanine levels, and individual variation (standard deviation of lifetime average levels) to these functions. On measures of cognitive function, in children > or = 3 y of age lower current phenylalanine levels were associated with higher cognitive functioning. On a behavioral temperament scale designed for normal children, we found that higher current and average phenylalanine levels correlated with more difficult temperament. Motor function was also poorer in children with phenylketonuria, and was most impaired in children with current phenylalanine levels >360 micromol/l. We also identified a previously unreported correlation between increased individual variation and poorer executive function performance, a finding that may raise new management concerns about level fluctuations. Maintenance of phenylalanine levels <360 micromol/l may be necessary for optimal performance in children with phenylketonuria.

Child↗

PubMed2005

The role of executive functioning in CBT: a pilot study with anxious older adults.

Cognitive behavior therapy (CBT) is an effective treatment for late life anxiety and depression. The successful use of CBT is assumed to rely on cognitive skills known as executive functions (EF; e.g., hypothesis generation, allocation of attention, self-monitoring) governed by the prefrontal cortex. Because older adults sometimes have executive deficits as a consequence of normal aging, EF may be a mediator of CBT outcome in older samples. The current pilot study tested the hypothesis that older adults with executive deficits (as measured by neuropsychological tests) would show decreased therapeutic benefit from CBT for generalized anxiety disorder, as compared to a group with intact EF. Results indicated differential response to CBT within the dysfunction group depending on the stability (and possibly, the etiology) of executive deficits from pre- to posttreatment. Those whose EF scores remained low from pre- to posttreatment did not respond to CBT, while those whose scores improved responded quite well, similar to an Intact EF group. Results indicate that some, but not all, older adults with executive dysfunction show decreased benefit from CBT, and are consistent with the assumption that executive skills are important for the successful use of CBT. However, some participants may show improvement on both mood and cognitive skills during treatment, which is discussed further.

Aged↗

PubMed2006

Longitudinal genetic analysis of executive function in elderly men.

The objective of this study was to characterize the relative contribution of genetic and environmental influences to individual differences in longitudinal performance and decline of executive function (EF) using a population-based prospective study of male, WWII veteran twins (NHLBI twin study). Three tests of EF were administered when the twins were 59-70 years old, with 9- and 13-year follow-up. APOE epsilon4 allele status was incorporated in the genetic models to determine its contribution to longitudinal genetic variability. Mean EF performance significantly worsened over time. EF performance was highly genetically correlated across repeat assessment. There were significant genetic influences on 9- and 13-year decline in digit symbol performance. For all tasks decline over the last 4-year follow-up was influenced by individual-specific environmental effects. Controlling for APOE epsilon4 allele presence did not appreciably change the magnitude of genetic effects. These results suggest that common genetic factors underlie longitudinal EF task performance. Genetic influences on EF decline, however, appear to be evident at longer time intervals between assessments.

Aged↗

PubMed2002

Executive function deficits in patients with dementia of the Alzheimer's type: a study with a Tower of London task.

A growing number of studies report a deterioration of the executive function (EF) in dementia of the Alzheimer type (DAT). To evaluate EFs in DAT, a new version of the Tower of London (TOL) task, originally developed by Shallice (1982), was adapted. The new version of the test was built up in its easiest possible feature in order to be administrable to early- or middle-stage demented patients. Seventeen DAT patients, and 17 controls matched for age and sex, were administered the TOL. The protocol followed a "hierarchical paradigm," that is, simpler problems were embedded in more complex, subsequent problems. Results showed that DAT patients were impaired compared to controls. Both control and DAT groups showed a decrease in percentage of success rate in relation to the number of movements required by the task. On the more complex problems, the performance of DAT subjects was proportionally more impaired. Qualitative analysis revealed that rule breaking was a salient performance feature of the DAT group. These findings are consistent with the presence of an EF deficit in DAT.

Journal Article↗

PubMed2005

Anxiety and depression, attention, and executive functions in hypothyroidism.

BACKGROUND: Divergences in cognitive disturbances in hypothyroidism reported in the literature are a result of a methodological bias. METHODS: By using a precise methodology, we examined attention and executive functions in hypothyroidism, verified the presence of anxiety and depressive symptoms in hypothyroidism, and examined the possible link between these symptoms and the cognitive disturbances (searching for attentional bias for words with a negative emotional valence). We administered a battery of cognitive tests to 23 participants who had undergone thyroidectomy for thyroid carcinoma: for the first time in an euthyroid state, then 3 weeks later (still in the euthyroid state) to assess the test/retest effect, and finally 4 weeks later in an hypothyroid state. We compared their performance with that of a group of 26 control participants who were also administered the same cognitive tests, also 3 times. RESULTS: In hypothyroidism, the thyroid participants were more anxious and depressed than the controls and presented attentional and executive disturbances that reflected general slowing and difficulties in using their capacities of inhibition. However, they did not exhibit an attentional bias for words with a negative emotional valence. CONCLUSIONS: Contrary to what was expected, symptoms of anxiety and not symptoms of depression interfered with the cognitive performance of participants in hypothyroidism.

Adult↗

PubMed2005

Fronto-parietal EEG coherence in theta and upper alpha reflect central executive functions of working memory.

For human working memory the neural correlates of the phonological loop and the visuospatial sketch pad are well explored. In contrast, less is known about central executive processes. Neuroimaging studies suggest that central executive processes are related to a complex fronto-parietal network. In the present study we investigate the question whether varying demands on central executive processes are reflected by differences in coherent activity between and within a fronto-parietal network. We calculated coherence during a visuospatial working memory task. Under an easy executive condition subjects had to mentally imagine previously studied abstract patterns, whereas in the difficult condition, subjects had to mentally manipulate these patterns. The results indicate the involvement of prefrontal areas in executive functions reflected by a decrease of anterior upper alpha short-range connectivity and a parallel increase of fronto-parietal long-range coherence mirroring activation of a fronto-parietal network.

Adult↗

PubMed2003

Assessment of executive function in clinical trials.

Cerebrovascular disease and stroke are related to high risk of cognitive impairment. One of the main neuropsychological features in vascular cognitive impairment and vascular dementia is executive dysfunction. Definition of the essential subcomponents and concepts of executive function is important before determining the methodology in clinical trials. The scientific research and new methods on this topic are rapidly growing. We present some most commonly used neuropsychological tests and discuss the methodological aspects in light of clinical trials.

Aged↗

PubMed1997

Memory and executive functions in amnesic and non-amnesic patients with aneurysms of the anterior communicating artery.

Ruptured and repaired anterior communicating artery (ACoA) aneurysm can result in devastating impairments involving memory, executive function, confabulation and personality change. Importantly, traditional cerebral areas implicated in amnesia are not damaged, yet amnesia can still be manifested. While ACoA patients show normal visual-constructional skills (i.e. copy scores) on the Rey-Osterrieth complex figure test, recall is often impaired. What is unclear is whether impaired recall is attributable to problems in encoding, accelerated rates of forgetting, retrieval or some combination. To disentangle these issues, we examined 10 patients with ruptured aneurysms of the ACoA, using the Rey-organizational and extended memory procedure which uses an organizational procedure for enhancing immediate recall and provides added sensitivity by combining recall with non-recall measures (e.g. recognition, spatial discrimination and spatial assembly). The major findings were: (i) immediate recall in amnesics was improved by providing an organizational strategy; (ii) following the organization trials, amnesics and non-amnesics retained information to a comparable extent over a 30-min delay; (iii) two subgroups of amnesics emerged, those subjects impaired in acquisition and a second group with impaired retrieval; (iv) all subjects showed preserved memory on non-recall measures. These findings have important implications with respect to using organizational strategies in cognitive treatments and in using non-recall measures in improving the validity and reliability of patient assessment.

Adult↗

PubMed1992

Cerebral correlates of disturbed executive function and memory in survivors of severe closed head injury: a SPECT study.

Thirty six patients in the chronic stage after severe closed head injury were examined with tests of executive function, memory, intelligence, and functional capacities in daily living. Correlations were sought between test results and Tc-99m-HMPAO uptake of frontal, temporal, and thalamic regions assessed by SPECT. Neither the number of significant correlation coefficients between memory tests and regional uptake nor that between temporal uptake and tests exceeded chance. For the remaining tests, correlations to thalamic regions were stronger than those to the frontal regions, and those to right brain regions stronger than those to homologous left brain regions. Relationships of thalamic isotope uptake to neuropsychological performance may reflect the impact of diffuse brain damage and particularly of diffuse axonal injury on mental capacities.

Adult↗

PubMed2006

Self- and informant reports of executive function on the BRIEF-A in MCI and older adults with cognitive complaints.

Amnestic mild cognitive impairment (MCI) is characterized by impaired episodic memory, although subtle executive problems have been noted on neuropsychological tests. Recent research also has described a group of healthy, non-depressed older adults with significant cognitive complaints (CC) but normal performance on neuropsychological testing. These individuals show structural and functional brain changes intermediate between those seen in MCI and healthy older adults without such complaints (HC). We evaluated executive functions in MCI and CC using the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A), a newly developed self- and informant report questionnaire in 29 patients with amnestic MCI, 28 CCs, and 30 demographically matched HCs. MCI and CC participants reported significant difficulties with selective aspects of executive functioning relative to HCs despite clinically normal performance on neuropsychological tests of this cognitive domain. Scores were generally in the pattern of MCI>CC>HC, and findings were most pronounced for working memory. Additionally, MCI and CC participants were more likely than their informants to report clinically meaningful executive problems, though informants identified a similar pattern of difficulty overall. Results failed to reveal strong relations between the BRIEF-A and standardized neuropsychological tests of executive function. Overall findings indicate that the BRIEF-A is sensitive to subtle executive changes in MCI and CC and suggest the need for research to determine if executive complaints are predictive of clinical course.

Aged↗

PubMed2006

Impaired working speed and executive functions as frontal lobe dysfunctions in young first-degree relatives of schizophrenic patients.

The aim of the investigation was to detect neuropsychological markers, such as sustained and selective attention and executive functions, which contribute to the vulnerability to schizophrenia especially in young persons. Performance was assessed in 32 siblings and children of schizophrenic patients and 32 matched controls using Wisconsin Card Sorting Test, Colour-Word-Interference-Test, Trail Making Test, and d2-Concentration-Test. The first-degree relatives showed certain impairments on all four tests, in particular, slower times on all time-limited tests. These results suggest the need for more time when completing neuropsychological tasks involving selected and focused attention, as well as cognitive flexibility, as a possible indicator of genetic vulnerability to schizophrenia.

Adolescent↗

PubMed2005

TEACH-M: A pilot study evaluating an instructional sequence for persons with impaired memory and executive functions.

PRIMARY OBJECTIVE: The purpose of this pilot study was to evaluate an instructional package that facilitates learning and retention of multi-step procedures for persons with severe memory and executive function impairments resulting from traumatic brain injury. RESEARCH DESIGN: The study used a multiple baseline across participants design. METHODS AND PROCEDURES: Four participants, two males and two females, ranging in age from 36-58 years, were taught a 7-step e-mail task. The instructional package (TEACH-M) was the experimental intervention and the number of correct e-mail steps learned was the dependent variable. MAIN OUTCOMES AND RESULTS: Treatment effects were replicated across the four participants and maintained at 30 days post-treatment. Generalization and social validity data further supported the treatment programme. CONCLUSIONS: The results suggest that individuals with severe cognitive impairments are capable of learning new skills. Directions for future research include application of the instructional package to other multi-step procedures.

Adult↗

PubMed2003

Memory and executive functions in aneurysms of the anterior communicating artery.

The cognitive outcome of three groups of patients, who had undergone surgery for repair of a single ruptured intracranial aneurysm, was evaluated. We assessed performance on tests of executive functions and memory in a group of 15 patients tested at least 3 months after an aneurysm of the anterior communicating artery (ACoA) and in a group of 12 patients tested in the first month after the same pathology. Acute patients were more impaired overall than chronic ones, but the two groups significantly differed on two executive and one memory test. The performance of the ACoA patients was also compared to the performance of a group of 10 patients who had undergone surgery for an aneurysm located on the posterior communicating artery (PCoA) at least 3 months before the examination. Chronic ACoA and PCoA patients significantly differed in two memory and in two executive tests performance, with posterior patients being more impaired than anterior. An unexpected finding was the impairment of semantic memory in ACoA patients.

Adult↗

PubMed2001

Executive function in traumatic brain injury and obsessive-compulsive disorder: an overlap?

Thirteen individuals with traumatic brain injury, 13 individuals with obsessive-compulsive disorder (OCD) and 10 normal controls were compared on neuropsychological measures of executive function. Individuals with a traumatic brain injury performed significantly poorer than the other two groups on a test measuring visuo-spatial strategy. Although the traumatic brain injury group made more errors on a test of maze learning and the OCD group less than the control group, this did not reach statistical significance. No support for an overlap in executive dysfunction in traumatic brain injury and OCD was found. It may be that the 'error prevention system' in the brain was influenced in a contrasting way by executive dysfunction in these disorders. This difference may reveal itself clinically in impulsivity/perseveration and slowness, respectively. Further studies were needed to test this hypothesis.

Adolescent↗