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PubMed2002

The effects of adult aging and induced positive and negative mood on planning.

Changes in executive functions have been found in older adults and also in young adults experiencing positive or negative mood states. The current study investigated the hypothesis that older adults would show greater executive function impairment following mood induction than young adults. Ninety-six participants (half aged 19-37, half aged 53-80) completed a neutral, positive, or negative mood induction procedure, followed by the Tower of London planning task. Significant interactions were found between age and mood such that older adults showed greater planning impairment than young adults in both the positive and negative mood conditions. Emotionally salient events occurring before testing may interfere with executive function in older adults.

Adult↗

PubMed2005

White matter hyperintensities as a predictor of neuropsychological deficits post-stroke.

OBJECTIVES: Cerebral white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) are a recognised risk factor for post-stroke dementia. Their specific relations to cognitive impairment are still not well known. The purpose of this study was to explore how the severity and location of WMHs predict neuropsychological test performance in the context of other brain lesions in elderly stroke patients. METHODS: In the Helsinki Stroke Aging Memory Study, 323 patients, aged from 55 to 85 years, completed a detailed neuropsychological test battery and MRI 3 months after an ischaemic stroke. The demographic and MRI predictors of cognition were studied with sequential linear regression analyses. RESULTS: After age, education and total infarct volume were controlled for, the overall degree of WMHs predicted poor performance in tests of mental speed, executive functions, memory, and visuospatial functions, but not in those of short term memory storage or verbal conceptualisation. However, the contribution of separate white matter regions was relatively low. Only the lesions along the bodies of lateral ventricles were independently associated with speed and executive measures. Additionally, general cortical atrophy clearly predicted a wide range of cognitive deficits while infarct volume had less relevance. Further analyses revealed that executive functions act as a strong mediator between the relationship of WMHs to memory and visuospatial functions. CONCLUSIONS: The degree of WMHs is independently related to post-stroke cognitive decline. The most affected cognitive domains seem to be executive functions and speed of mental processing, which may lead to secondary deficits of memory and visuospatial functions.

Aged↗

PubMed2001

Factor versus cluster models of schizotypal traits. II: relation to neuropsychological impairment.

Heterogeneity in cognitive performance in schizophrenia and schizotypy may be accounted for, by differences in predominant symptom presentation. However, studies have not demonstrated consistent relations between specific cognitive impairments and specific trait dimensions in either population. Studies of group differences, particularly those using groups defined by cluster analyses are rare, but suggest that the negative trait dimension is more associated with executive function deficits, positive trait dimension with memory and attentional difficulties, and the disorganized trait dimension with attention problems. The present study examined the relation of schizotypal trait dimensions and executive function deficits in schizotypal individuals using two methods. Correlations between schizotypal factor scores and cognitive measures demonstrated that high negative symptoms were associated with poor performance on the WCST, while high scores on other trait dimensions were related to a better WCST performance. High scores in all trait dimensions were related to the naïve rater's observations of unusual social behavior. A cluster analysis revealed three groups of schizotypals (predominantly negative presentation, predominantly positive symptom presentation, and high on all dimensions). The cluster with predominantly negative symptoms performed worse, than all other schizotypal groups and unselected controls, on the WCST and a higher percentage of them were rated as clinically impaired on the neuropsychological battery. However, schizotypals who were high on all trait dimensions were rated as having the most unusual social behavior by the naïve raters. Overall, results support the hypothesis of a relation between executive function deficits and negative symptoms in schizotypal individuals.

Analysis of Variance↗

PubMed1996

The California Card Sorting Test may dissociate verbal and non-verbal concept formation abilities.

Most neuropsychological measures of executive function provide only global indices of performance and are relatively insensitive to lateralized dysfunction. The present paper presents a right temporal lobectomy patient whose performance indicates that the California Card Sorting Test, a new measure of executive function, may dissociate verbal and non-verbal concept formation abilities. This case highlights the potential research and clinical value of this test compared to that of existing tests of executive function.

Adult↗

PubMed2005

Is a perseveration a perseveration? An evaluation of cognitive error types in patients with subcortical pathology.

This study investigated several constructs of executive functioning in a group of 77 patients with subcortical pathology. Specifically, we examined the validity of categorizing perseverative errors as "recurrent," "stuck-in-set," or "continuous," as proposed by Sandson and Albert (1984). A principal components analysis of 2 measures of recurrent perseveration, 2 measures of stuck-in-set perseveration, and 2 measures of intrusive errors yielded a 2 component solution with stuck-in-set perseverations and intrusive errors loading on Component 1, and recurrent perseverations loading on Component 2. Presence of a continuous perseveration on a graphomotor test was significantly associated with higher factor scores on Component 1, but not Component 2. The stuck-in-set perseveration and intrusion component was associated with the majority of the other neuropsychological tests administered, including tests of executive function and memory. The recurrent perseveration component was not associated with the other measures of cognitive functioning. Presence of a continuous perseveration was associated with executive function but not memory measures. This study provides evidence that recurrent perseverations are distinct from the other types of perseverative and intrusive errors, and that stuck-in-set and intrusive errors are good indicators of general cognitive functioning in patients with subcortical pathology.

Adult↗

PubMedDate not supplied

Neuropsychological profile of cognitively impaired patients with schizophrenia.

OBJECTIVE: Our purpose in undertaking the present study was to explore the existence of specific areas of cognitive deficits within the context of generalized poor performance in a group of Greek patients with schizophrenia. We also sought to identify any patients who might be cognitively normal. METHOD: Participants were 70 patients with schizophrenia and 42 healthy control subjects. The 2 groups were matched on age and male-female ratio but differed in their level of education. A battery of neuropsychological tests was selected to assess executive functions/abstraction, fluency, verbal and spatial working memory, verbal and nonverbal memory, attention, visuospatial ability, and psychomotor speed. RESULTS: Patients with schizophrenia performed more poorly than healthy control subjects, when we controlled for differences in level of education, on executive functions, working memory, verbal memory, nonverbal memory, fluency, visuospatial ability, and attention. In contrast, no significant differences were found between the 2 groups on psychomotor speed. Patients showed a more pronounced deficit on executive functions, verbal and visual memory, and visuospatial ability. Overall, 13% to 62% of the patients with schizophrenia scored within 1 SD of the mean z scores of healthy control group depending on the cognitive domains examined. In the entire sample of patients with schizophrenia, however, no individual scored within 1 SD of the mean z scores of the control group in all cognitive domains. CONCLUSIONS: We found a generalized deficit in cognitive functioning in a group of patients with schizophrenia. We failed to find any individual patients who were healthy across all cognitive areas. The current neuropsychological profile, indicating widespread impairment, is comparable to that reported in the international literature and thus appears to be characteristic of schizophrenia. Our findings of increased difficulties with executive functions, verbal and visual memory, and visuospatial ability support previous suggestions of generalized brain dysfunction in the pathophysiology of schizophrenia.

Adult↗

PubMed2005

Prospective and declarative memory problems following moderate and severe traumatic brain injury.

PRIMARY OBJECTIVE: To examine prospective and declarative memory problems following moderate and severe traumatic brain injury (TBI) and the relationship between prospective memory (PM) and declarative memory and PM and other cognitive functions. RESEARCH DESIGN: The performance of persons who suffered a TBI (n = 25) was compared with that of a demographically matched control group (n = 25). METHODS AND PROCEDURES: Measures of time- and event-based PM, visual and verbal declarative memory, attention and executive functioning were administered to both groups. MAIN OUTCOME AND RESULTS: The group with a TBI performed more poorly on event- and time-based PM, verbal declarative memory, certain aspects of attention and executive functioning. The correlations between the measures of PM, declarative memory and the other cognitive tests were all non-significant. CONCLUSIONS: Problems with declarative memory, attention, and executive functioning do not adequately account for poorer PM performance following a TBI, suggesting that PM should also be assessed following TBI.

Adult↗

PubMed1993

The neurocognitive phenotype of female carriers of fragile X: additional evidence for specificity.

The specificity of the neurocognitive profile among women with the fragile X gene, in relation to cytogenetic expression, was examined among 22 women with > or = 2% expression, 35 0% obligate carriers, and 60 controls. Measures were obtained for intellectual ability; achievement; and verbal, nonverbal, memory, and executive functions. Findings show that no group consistently demonstrated global deficits in the verbal, nonverbal or memory domains. In contrast, even when controlling for the effects of IQ, the expressing women exhibited (1) deficits on measures of executive function, (2) deficits in measures of attention and visual-spatial skills, and (3) enhanced performance on verbal, but not figural, memory. No deficits were seen among obligate carriers. This study supports the notion that executive function deficits and/or visual-spatial skills may account for the behavioral and cognitive manifestations of fragile X.

Adolescent↗

PubMed2001

Evolutionary recasting: ADHD, mania and its variants.

This paper reviews clinical observations and evolutionary theory in relation to attention deficit hyperactivity disorder (ADHD) on the one hand and mania and its variants on the other. Both groups of disorders resemble each other in regard to high levels of motor activity, perhaps occurring together more often than not, and are confounded in most existing research. Making distinctions requires isolating the contribution of activity level from other characteristics such as those of flawed executive functions for ADHD or grandiosity and lapses in reciprocity for mania. High activity level is an asset throughout nature except in extreme intensities or when it amplifies the characteristics of psychopathology. Fitness, social displays, and behavioral adaptations for survival are clues to some aspects of hypomania and ADHD. While hypomania can be a competitive advantage in certain niches, it appears there can be few opportunities for ADHD to do so. Indeed, the impulsiveness seen in ADHD is probably the outcome of flaws in executive functions rather than being the cause of them. Neither lapses in executive functions nor in reciprocity are apt to be domain general but may interact sharply with each person's repertoire of psychological adaptations. The author submits that a theoretical orientation as outlined here would not only help in better understanding the disorders under consideration, but could be useful in providing new directions to treatment decisions.

Adaptation, Psychological↗

PubMed2003

Effects of Attention Process Training on cognitive functioning of schizophrenic patients.

The goal of this study was to investigate the impact of Attention Process Training (APT) on cognitive functioning in schizophrenia. Twenty-four patients with schizophrenia were randomly assigned to one of the two following conditions: training by means of APT or no training. The dependent variables included measures of attention, memory and executive functions derived from a cancellation task, dichotic listening, dual task, Trail Making Test, Paced Auditory Serial Addition Task, Everyday Attention Questionnaire, Spain-Complutense Verbal Learning Test and Wisconsin Card Sorting Test (WCST). All participants were also rated on measures of positive and negative symptoms. The tasks were administrated to all participants at baseline. Participants in the training group received individual intensive APT twice a week, whereas the control group did not receive training. All participants were subsequently retested on the same tests. Although, contrary to expectations, neither group improved on clinical and information-processing measures of attention and memory, patients in the trained group had a significantly higher performance on executive function (as measured by the WCST) than did the control group. We conclude that it is feasible to use practice in attention to remediate executive function deficits in schizophrenia.

Adult↗

PubMed2000

Cognitive and familial contributions to conduct disorder in children.

Although young children with conduct disorder (CD) are suspected of having verbal and executive function deficits, most studies that investigated this hypothesis did not control for attention deficit hyperactivity disorder (ADHD). Furthermore, relatively little is known about the interaction between cognitive deficits and familial factors in explaining the onset and persistence of CD in children. The participants in this study were 57 children with CD and 35 controls aged 7 to 12 years. At 1-year follow-up, 41 of the participants with CD were reassessed. Children with CD were found to be significantly impaired in four of five executive function measures after ADHD symptoms and socioeconomic status (SES) were controlled. Executive function test performance, number of ADHD symptoms, and familial characteristics (SES, parental punishment) together correctly classified 90% of the participants. Only the number of ADHD symptoms was found to significantly improve prediction of CD 1 year later beyond that afforded by number of CD symptoms a year earlier. Findings indicate that children with CD and ADHD symptoms are especially at risk for persistent antisocial behaviour. Results also highlight the importance of treatment programs that cover both cognitive and familial aspects associated with CD.

Child↗

PubMed2002

Prospective memory functioning in people with and without brain injury.

Prospective remembering has been relatively underinvestigated in neurological patients. This paper describes a group study in which the prospective memory performance of 36 people with brain injury and 28 control participants is compared. We used a new instrument, the Cambridge Behaviour Prospective Memory Test (CBPMT) to assess prospective memory. This comprises 4 time-based and 4 event-based tasks. Participants were allowed to take notes to help them remember the tasks. The relationships between CBPMT scores, scores on formal tests and subjective reports on memory, attention and executive functioning were analyzed. The key findings were that (1) note-taking significantly benefited prospective memory performance, (2) significant relationships were found between scores on the prospective memory test and scores on tests of memory and executive functions, and (3) participants had more difficulty with the time-based than with the event-based prospective memory tasks. The results suggest that compensatory strategies improve prospective memory functioning; memory for content as well as attention and executive functioning processes are involved in prospective memory; and that time-based tasks are more difficult than event-based tasks because they place higher demands on inhibitory control mechanisms. Discussion focuses on the implications of these results for neuropsychological assessment and rehabilitation.

Adaptation, Psychological↗

PubMed2006

Alcohol drinking and cognitive functions: findings from the Cardiovascular Risk Factors Aging and Dementia (CAIDE) Study.

BACKGROUND: Moderate alcohol drinking is suggested to be beneficial for cognitive functions, but the results of previous studies have varied greatly. Little is known about the effects of midlife alcohol drinking on the cognitive functions later in life. METHODS: Participants were derived from random, population-based samples studied in Eastern Finland in 1972, 1977, 1982, or 1987. A total of 1,341 participants were reexamined in 1998, after an average follow-up period of 21 years, at ages 65-79 years. RESULTS: The participants who did not drink alcohol at midlife had a poorer performance in episodic memory, psychomotor speed, and executive function in late life as compared with infrequent and frequent drinkers, adjusted for sociodemographic and vascular factors. Also late-life nondrinkers had poorer psychomotor speed and executive function. These findings were evident especially among nonsmokers. Further, no interactions between apolipoprotein E4 and alcohol or sex and alcohol were found. CONCLUSIONS: Alcohol drinking both at midlife and later is favorably related to the function in several cognitive domains, including episodic memory, psychomotor speed, and executive function, in late life. However, it is not clear whether the association is causal, what is the possible mechanism, and what would be a safe limit of drinking for the best cognitive function.

Aged↗

PubMed2005

Neuropsychological functions in anxiety disorders in population-based samples: evidence of episodic memory dysfunction.

Most of the available evidence on neuropsychological functioning in anxiety disorders is based on clinical samples, investigating persons affected by obsessive-compulsive disorder. Knowledge is sparse regarding cognitive functions in other types of anxiety disorders. The aim of this study was to examine whether persons diagnosed with an anxiety disorder show neuropsychological impairments relative to healthy controls in tasks tapping episodic memory, verbal fluency, psychomotor speed, and executive functioning. Population-based samples comprising individuals affected by panic disorder with and without agoraphobia or agoraphobia (n=33), social phobia (n=32), generalised anxiety disorder (n=7), obsessive-compulsive disorder (n=16), and specific phobia (n=24) were compared with healthy controls (n=175) in test performance. Overall, the total anxiety disorder group exhibited significant impairments in episodic memory and executive functioning. Separate analyses on the respective anxiety subgroup indicated that panic disorder with and without agoraphobia, and obsessive-compulsive disorder were related to impairments in both episodic memory and executive functioning. In addition, social phobia was associated with episodic memory dysfunction. Verbal fluency and psychomotor speed were not affected by anxiety. Specific phobia and generalised anxiety disorder did not affect neuropsychological functioning.

Adult↗

PubMed2006

A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder.

BACKGROUND: A number of studies have reported evidence of cognitive deficits in euthymic bipolar patients. Qualitative reviews of the literature have indicated impairments in executive functions and declarative memory are most consistently reported. However, not all primary studies conducted to date have had sufficient power to detect statistically significant differences and there have been few attempts to quantify the magnitude of impairments. This review aims to combine data from available studies to identify the profile of neuropsychological deficits in euthymic bipolar patients and quantify their magnitude. METHOD: Systematic literature review and meta-analysis. RESULTS: Large effect sizes (d>or=0.8) were noted for aspects of executive function (category fluency, mental manipulation) and verbal learning. Medium effect sizes (0.5<or=d<0.8) were found for aspects of immediate and delayed verbal memory, abstraction and set-shifting, sustained attention, response inhibition, and psychomotor speed. Small effect sizes (0.2<or=d<0.5) were reported for verbal fluency by letter, immediate memory, and sustained attention. LIMITATIONS: Sufficient data were not available to investigate all domains. For example analyses did not include measures of visuospatial function. CONCLUSION: Euthymic bipolar patients demonstrate relatively marked impairment in aspects of executive function and verbal memory. It is not yet clear whether these are two discrete areas of impairment or are related to one another. Future investigations should clarify the functional significance of deficits and indicate whether patients will benefit from ameliorative interventions.

Affect↗

PubMed2003

Mesial temporal lobe epilepsy and hippocampal sclerosis: cognitive function assessment in Hispanic patients.

PURPOSE: The goal of this study was to assess the cognitive function status in patients with mesial temporal lobe epilepsy and hippocampal sclerosis (TLE+HS) to determine their cognitive function profile and to correlate material-specific memory deficits with HS laterality diagnosed by MRI. METHODS: Seventy-one patients were assessed with a neuropsychological protocol that includes IQ, attention, handedness, verbal memory, visual memory, language, and the executive function. chi(2) and correlation tests were used. RESULTS: Memory impairment was found in 46 patients (66%): patients without any memory deficit (n=25), patients with verbal memory deficit (n=21), patients with visual memory deficit (n=17), patients with deficit for both types of memory (n=8). Correlation between MRI lesion and memory was 66%. Language was impaired in 33 patients (46%). Eighteen patients (25%) had a deficit of the executive function. CONCLUSIONS: Patients with TLE+HS presented with a deficit in material-specific episodic memory correlating in large proportion with HS lateralization. We also found language and executive function impairments.

Adult↗

PubMed2002

An examination of perceptual and cognitive set shifting tasks in acute anorexia nervosa and following recovery.

OBJECTIVES: People with anorexia nervosa have a broad spread of symptoms including disturbances in perception, cognition, emotions and behaviour. The aim of this study was to examine tests of executive function (in particular, perceptual and cognitive set shifting tasks) in patients with a current or past diagnosis of anorexia nervosa (AN). METHOD: 30 AN patients, 16 subjects recovered from anorexia nervosa (ANR) and 23 healthy controls were examined using tests of executive function (initiation tasks and perceptual and cognitive set shifting). RESULTS: The AN and ANR subjects had significantly higher perceptual and cognitive set shifting scores than the controls. CONCLUSIONS: Impaired executive function in terms of set shifting tasks could represent a vulnerability factor for AN.

Adult↗

PubMed2004

Insidious cognitive decline in CADASIL.

BACKGROUND AND PURPOSE: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) causes repeated ischemic attacks leading to subcortical vascular dementia. The aim of this study was to characterize cognitive function in subjects with a C475T (R133C) mutation in the Notch3 gene, leading to CADASIL. METHODS: Prestroke (n=13) and poststroke (n=13) mutation carriers and mutation carriers with dementia (n=8) were compared with healthy noncarriers from the same families using a comprehensive set of neuropsychological tests. RESULTS: Changes in working memory and executive function were observed in the very early phase of the disease before transient ischemic attack (TIA) or stroke. Later, in the poststroke phase, the cognitive impairment concerned also mental speed and visuospatial ability. Finally, the subjects with dementia had multiple cognitive deficits, which engaged even verbal functions, verbal episodic memory, and motor speed. The 2 mutation carrier groups without dementia and the controls could be reliably distinguished using 3 tests that assessed working memory/attention, executive function, and mental speed. Episodic memory was relatively well-preserved late in the disease. CONCLUSIONS: A deterioration of working memory and executive function was already observed in the prestroke phase, which means that cognitive decline may start insidiously before the first onset of symptomatic ischemic episodes.

Adult↗