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Results for “Executive function”

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PubMed2003

Depression and cognitive functioning in alcoholism.

AIMS: Studies on cognitive processes in alcoholism have reported changes with respect to executive functions and memory, which have been interpreted within the context of different neuropsychological models. The aims of the present study were to investigate (1) the validity of these models and (2) the influence of depression on cognitive functioning in alcoholism. DESIGN, SETTING AND PARTICIPANTS: In the present investigation, patients suffering from alcoholism (Alc; n = 30), patients with depression but without alcoholism (Dep; n = 28) and healthy controls (HC; n = 28) were compared on a neuropsychological test battery. MEASUREMENTS: The test battery included measurements of mood, memory and executive functions. The possible cumulative effect of alcohol and depression was analysed by comparison of depressed alcoholic patients (Dalc) and non-depressed alcoholic patients (NDAlc). FINDINGS: Group comparisons revealed impairments of alcoholic patients with respect to response inhibition, reasoning and free recall, irrespective of depression. Priming, short-term memory as well as verbal fluency abilities were unaffected. Depressive patients showed verbal fluency as well as free recall deficits. However, there was no difference in performance between depressed and non-depressed alcoholics. CONCLUSIONS: The specific pattern of neuropsychological deficits of the alcoholic patients supports the frontal lobe hypothesis. The results of the present investigation suggest that these deficits are not generally exacerbated by comorbid depressive symptoms. Further studies, however, are desirable to investigate the relation between executive deficits and depression in alcoholics with evidence of major depression.

Adult↗

PubMed2004

Changes in neuropsychological functioning with progression of HIV-1 infection: results of an 8-year longitudinal investigation.

Despite the advent of more effective treatments for HIV-1 infection, cognitive impairment is still frequent and questions remain regarding which areas of impairment are more common in the different disease stages. This study investigated cognitive performance over an 8-year period of time in 59 HIV-1 seropositive (HIV-1+) men who were clinically asymptomatic at study entry, in comparison to a cohort of 55 HIV-1 seronegative (HIV-1-) men. Every 6 months we examined cognitive functioning in 5 domains-fine motor speed, attention, verbal memory, executive functioning, and speed of information processing. We found that patients with AIDS scored significantly worse on fine motor speed and speed of information processing than HIV-1- individuals and the HIV-1+ non-AIDS patients. In addition, the HIV-1+ non-AIDS patients performed more poorly than the HIV-1- group on speed of information processing. Depressive symptoms were also associated with diminished performance on measures of attention, executive functioning, and speed of information processing. Further research is needed to examine the effects of disease stage and depression on cognitive impairment in the era of new HIV treatments.

AIDS Dementia Complex↗

PubMed2005

PDE10A inhibition reverses subchronic PCP-induced deficits in attentional set-shifting in rats.

Persistent suppression of N-methyl-d-aspartate (NMDA) receptor function produces enduring structural changes in neocortical and limbic regions in a pattern similar to changes reported in schizophrenia. This similarity suggests that chronic NMDA receptor antagonism in animals may represent a useful model of neurobiological and related cognitive deficits in schizophrenia. Schizophrenia is associated with impairments in frontal lobe-dependent cognitive functions, including working memory and attentional shifting. Deficits in attention and executive function have not been well characterized in animal models of schizophrenia using chronic NMDA receptor antagonist administration. We investigated whether subchronic systemic administration of the NMDA receptor antagonist phencyclidine (PCP) to rats followed by a drug washout period would produce enduring cognitive deficits on an attentional set-shifting task. The task is functionally analogous to a sensitive test of frontal function in humans and non-human primates. Subchronic PCP administration selectively impaired extradimensional shift learning without affecting other discrimination or reversal tasks. Moreover, acute treatment with the PDE10A inhibitor papaverine immediately prior to testing attenuated the PCP-induced deficits in extradimensional shift learning across a range of doses. These data suggest that subchronic PCP administration may model effectively some of the cognitive deficits that are observed in schizophrenia, and that PDE10A inhibition may be an effective therapeutic route to improve executive function deficits associated with schizophrenia.

Analysis of Variance↗

PubMed1997

Attention-deficit/hyperactivity disorder, self-regulation, and time: toward a more comprehensive theory.

This article describes the current clinical view of attention-deficit/hyperactivity disorder (ADHD) and suggests a model of prefrontal lobe executive functions that explains better than current theories the cognitive and behavioral deficits associated with ADHD. The model shows how behavioral inhibition is related to and necessary for the proficient performance of four executive functions that subserve self-regulation: nonverbal working memory; the internalization of speech; the self-regulation of affect, motivation, and arousal; and reconstitution. These functions permit the construction, execution, and control of behavior by internally represented information, which removes behavior from control by the immediate context and brings it under the control of time. ADHD disrupts this process and returns control of behavior to the temporal now. A blindness to past, future, and time more generally, as well as an inability to direct behavior toward the future and to sustain it are among many of the deficits predicted by this model for persons with ADHD.

Attention↗

PubMedDate not supplied

[Executive dysfunction in attention deficit hyperactivity disorder in childhood].

INTRODUCTION: The principal problem of ADHD is the difficulty to execute inhibitory control. The inhibition is an executive function that is develop during childhood. AIM: To know if other executive functions shower a lower performance in ADHD versus control group and these were different between ADHD-I and ADHD-C. PATIENTS AND METHODS: Fifty three children, between 7 to 10 years old, participated and were assess with EMIC and Simon task. RESULTS: The results showed similar profile in working memory and verbal span. In contrast, ADHD-C showed lower performance in Simon task and more impulsively. On an other hand, ADHD-I showed lower performance in memory working tasks and planning. CONCLUSIONS: These results suggest differences in the executive profile between ADHD-I and ADHD-C and these support the hypothesis of Barkley about the necessity to differ both clinical subtypes.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

Patients with Parkinson's disease learn to control complex systems-an indication for intact implicit cognitive skill learning.

Implicit memory and learning mechanisms are composed of multiple processes and systems. Previous studies demonstrated a basal ganglia involvement in purely cognitive tasks that form stimulus response habits by reinforcement learning such as implicit classification learning. We will test the basal ganglia influence on two cognitive implicit tasks previously described by Berry and Broadbent, the sugar production task and the personal interaction task. Furthermore, we will investigate the relationship between certain aspects of an executive dysfunction and implicit learning. To this end, we have tested 22 Parkinsonian patients and 22 age-matched controls on two implicit cognitive tasks, in which participants learned to control a complex system. They interacted with the system by choosing an input value and obtaining an output that was related in a complex manner to the input. The objective was to reach and maintain a specific target value across trials (dynamic system learning). The two tasks followed the same underlying complex rule but had different surface appearances. Subsequently, participants performed an executive test battery including the Stroop test, verbal fluency and the Wisconsin card sorting test (WCST). The results demonstrate intact implicit learning in patients, despite an executive dysfunction in the Parkinsonian group. They lead to the conclusion that the basal ganglia system affected in Parkinson's disease does not contribute to the implicit acquisition of a new cognitive skill. Furthermore, the Parkinsonian patients were able to reach a specific goal in an implicit learning context despite impaired goal directed behaviour in the WCST, a classic test of executive functions. These results demonstrate a functional independence of implicit cognitive skill learning and certain aspects of executive functions.

Aged↗

PubMed2006

Neuropsychological testing in the diagnosis of dementia.

Neuropsychological testing can play a major role in the diagnosis of dementia by documenting cognitive deficits, the key criteria for the diagnosis. Because the most common dementia diagnosis, Alzheimer's disease, focuses on memory impairment, tests to assess this domain and to detect and characterize memory deficit are well established with recognized predictive value. Other neuropsychological domains are less well characterized and there are fewer tools to assess them. One domain that has been characterized as important in a number of other dementias is executive function. Improved neuropsychological assessment and characterization of other domains, such as executive function and attention, may assist in better identifying the pathophysiology of deficits in these areas, perhaps in combination with new technologies such as functional imaging. Finally, improved assessment tools for specific cognitive domains should assist in identifying a broad range of cognitive deficits at earlier stages and ultimately lead to more effective interventions for a wider range of cognitive deficits.

Cognition↗

PubMed1990

Disorders in executive control functions among aphasic and other brain-damaged patients.

Four experimental procedures for assessing disorders of executive control (Nonverbal Continuous Performance, Graphic Pattern Generation, Sequence Generation Test, and Tower of Hanoi) were administered to 22 left-brain-damaged aphasic patients, 19 right-brain-damaged nonaphasic patients, and 49 healthy controls. Aphasic patients with frontal-lobe lesions were significantly more impaired on these tasks than aphasics with retrorolandic or mixed lesions in the left hemisphere. Patients with right-hemisphere lesions, especially those with frontal-lobe lesions, showed even greater impairments on these visual/spatial tasks. The results suggest that aphasics' impairments in executive control are independent of their linguistic and visuospatial deficits and are specific to lesions in left frontal and prefrontal regions. The clinical utility of the experimental procedures is discussed.

Adult↗

PubMed2003

Chronic cognitive impairment following laterothalamic infarcts: a study of 9 cases.

BACKGROUND: The occlusion of the lateral thalamic arteries leads to infarcts of ventrolateral thalamic nuclei, the ventroposterior nucleus, and the rostrolateral part of pulvinar, and produces hemisensory loss with or without hemiataxia. Cognitive impairment after such strokes has not been systematically studied. OBJECTIVE: To determine the nature and the extent of long-lasting cognitive deficits following lateral thalamic strokes. DESIGN: Case series. SETTING: Neurology department, Lausanne University Hospital, Lausanne, Switzerland. PATIENTS: Nine patients with hemisensory loss due to an isolated laterothalamic infarct. MAIN OUTCOME MEASURES: Three to 6 months after stroke onset, standard neuropsychologic evaluation, including testing of language, ideomotor and constructive praxis, visual gnosis, spatial attention, learning abilities, and executive functions. RESULTS: Six of 9 patients showed some degree of cognitive impairment. Executive functions tasks, particularly verbal fluency, were impaired in 5 patients (4 with right and 1 with left lesion). Learning and delayed recall in visuospatial and verbal tasks, but not in recognition, were impaired in 3 patients (2 with right and 1 with left lesion). Difficulties in visual gnosia were observed in 1 patient with right lesion while word-finding difficulties were observed in 1 patient with left lesion. CONCLUSIONS: Our observations show that while learning, naming, and gnosic difficulties fit with the classical verbal/nonverbal dichotomy (left and right hemisphere, respectively), executive dysfunctions, including verbal fluency tasks, were more dominant after right thalamic infarcts. Although the observed deficits appeared to be less severe than those generally found with dorsomedial and polar thalamic strokes, the dominance of executive dysfunction suggests that ventrolateral thalamic lesions may disrupt frontothalamic subcortical loops.

Aged↗

PubMed2000

The external validity of Asperger disorder: lack of evidence from the domain of neuropsychology.

The present study compared individuals with high-functioning autism (HFA) and Asperger disorder (AD) in intellectual, motor, visuospatial, and executive function domains. Participants with AD demonstrated significantly higher Verbal and Full Scale IQ scores, significantly larger Verbal-Performance IQ discrepancies, and significantly better visual-perceptual skills than those with HFA. Once the superior intellectual abilities of the AD group were controlled (both statistically through analysis of covariance and by examining IQ-matched subgroups of HFA and AD participants), no significant group differences in motor, visuospatial, or executive functions were evident, save a marginally significant trend toward poorer fine motor performance in the AD group. This suggests that AD may simply be "high-IQ autism" and that separate names for the disorders may not be warranted. The relation of these findings to theories of autism and AD are discussed.

Asperger Syndrome↗

PubMed2005

Cognitive functions in relation to MRI findings 30 years after traumatic brain injury.

OBJECTIVE: The aim of the study was to relate cognitive effects of a remote traumatic brain injury (TBI) to MRI findings and severity of injury. METHOD: Sixty-one patients were assessed on average 30 years after a TBI of variable severity. A comprehensive cognitive test battery was used to evaluate memory, executive functions and cognitive overall impairment. Multiple regression analyses were used to examine the relationships between cognitive variables and MRI volumetric findings (the volumes of the hippocampus and the lateral ventricles) and local contusions on MRI. Also, the effect of injury severity on cognitive outcome was evaluated. RESULTS: Reductions in hippocampal volumes and lateral ventricular enlargement were significantly associated with impaired memory functions, memory complaints and executive functions. Of the MRI parameters used, the best predictor for cognitive outcome was the volume of the lateral ventricle. There was only a modest relationship between severity of injury and cognitive performance. CONCLUSIONS: The results show that long-term memory impairments after TBI are associated with MRI volumetric measures. This suggests that the degree of diffuse injury leading to atrophic changes is prognostically more important than the initial severity of TBI.

Adult↗

PubMed1995

Frontal lobe lesions, diffuse damage, and neuropsychological functioning in traumatic brain-injured patients.

This study quantified lesion volume in relation to damage location and executive functioning in traumatic brain-injured (TBI) patients. Magnetic resonance (MR) scans of 68 TBI patients were analyzed by taking volumetric measures of lesion sites. Patients were grouped according to the presence/absence of frontal lobe lesions. Measures of frontal lesion volume were studied as predictors for outcome on designated tests of executive functioning (Halstead Category Test and Wisconsin Card Sorting Test). Results showed no significant differences in level of deficit between groups. In addition, no significant differences were found between groups on other tests of neuropsychological functioning (Trail Making Test, Parts A and B, and Wechsler Adult Intelligence Scale-Revised). These results suggest that tests that are traditionally used to detect "frontal lobe" damage may not be adequate for distinguishing specific frontal lobe dysfunction, and do not add anything unique about frontal lobe integrity and neuropsychological functioning in TBI patients.

Brain Damage, Chronic↗

PubMed2000

Neuropsychological function in mild hyperphenylalaninemia.

Whether specific cognitive deficits related to frontal-lobe dysfunction that have been reported in individuals with phenylketonuria (PKU) are also characteristic of mild hyperphenylalaninemia (MHP) was investigated. Tests of executive function and control tasks not assessing executive function were administered to a group of individuals with MHP and a group without MHP, similar in age, gender, and IQ. Tests of academic skills and behavior-rating questionnaires were also administered to the group with MHP. No group differences were found for any measure, suggesting that the mild elevations of phenylalanine in individuals with MHP are not sufficient to produce behavioral and cognitive impairments characteristic of PKU.

Adolescent↗

PubMed2002

Aging and time-sharing aspects of executive control.

A particularly important aspect of executive functioning involves the ability to coordinate two simultaneous activities. The role of this aspect of executive functioning in adult-age differences in cognitive performance was examined in a study involving 150 adults between 20 and 91 years of age who performed the same visual-motor tracking task with three different primary tasks. The participants also performed several additional cognitive tasks that allowed examination of the relation of time-sharing efficiency to other types of cognitive functioning The results were consistent with the existence of a distinct time-sharing ability because the time-sharing costs in the three dual-task combinations were significantly correlated with one another but only weakly correlated with other cognitive variables. Increased age was associated with reductions in time-sharing ability, and greater efficiency in performing two tasks at once was associated with better performance on tasks assessing spatial, reasoning, and memory abilities. Although this pattern is what one would expect if executive processes contribute to age differences in cognitive functioning, the effects were smaller than those associated with a perceptual speed construct.

Aging↗

PubMed2001

Pattern of neuropsychological deficits in patients with treated Wilson's disease.

The study aimed to describe the neuropsychological profiles in patients with treated Wilson's disease (WD). The series included 19 symptomatic and 2 asymptomatic patients with a mean age of 35.3 +/- 9.2 years. They were tested with the Automated Psychological Test system (APT), a comprehensive computerised neuropsychological test battery. APT comprised eleven separate tests and assessed five essential types of neuropsychological functions: motor functions, basic neuropsychological functions, specific cognitive functions, memory, and executive functions. The results were compared to current norms of the test battery. The symptomatic WD patients had significantly lower performance than the norms on all finger tapping tasks, the simple reaction time, the simultaneous capacity background task, the short-term memory test, the index of word decoding speed, the grammatical reasoning test, and the perceptual maze test. They were significantly higher on the index of impulsive errors, and used a significantly more global processing mode in the test of selective attention. The female symptomatic patients displayed more pronounced neuropsychological deficits than the males in the complex tasks. WD patients displayed a specific profile of moderate neuropsychological impairment. The results are theoretically interesting and have practical implications for the management of WD patients, e.g. some patients confronted with the results have had increased compliance.

Adult↗

PubMed2005

Neuropsychological performance and quality of life of 10 year survivors of childhood medulloblastoma.

PURPOSE: Survivors of medulloblastoma, the most frequently occurring malignant brain tumor of childhood, suffer neuropsychological damage in the first decade after diagnosis. Cognitive performance, psychosocial functioning and quality of life were assessed in medulloblastoma survivors in the second decade after diagnosis. METHODS: Ten year survivors were evaluated with a battery of neuropsychological tests, and self-report questionnaires regarding quality of life and emotional functioning. Clinical variables examined included the patient's age at diagnosis, duration since diagnosis, treatment, and complications. RESULTS: Sixteen medulloblastoma survivors [mean age at diagnosis: 7.2 years, range: 1-15 years; 6 males] were tested at a mean age of 22.2 years [range: 13.6-27.9 years]. All survivors had been treated with craniospinal radiation therapy; nine were treated with chemotherapy. Significant impairments were identified in more than 50 of survivors on tests within all neuropsychological domains, including attention, memory, visuospatial abilities, motor functioning, language, and executive functioning. Significant impairments were also identified in all psychosocial domains examined, including employment, ability to drive an automobile, participation in normal education, independent living, and dating history. Most importantly, quality of life scores, reported by both survivors and their caretakers, were in the normal range. CONCLUSION: Survivors of childhood medulloblastoma frequently suffer severe persistent deficits in a wide-range of neuropsychological functional domains. Nevertheless, survivors and their families do not report impaired quality of life. These severe neuropsychological and psychosocial deficiencies justify further attempts to reduce or delay the use of craniospinal radiation therapy for childhood medulloblastoma.

Activities of Daily Living↗

PubMed2005

Factor structure of the Hooper Visual Organization Test: a cross-cultural replication and extension.

To investigate construct validity of the Hooper Visual Organization Test (VOT), a principal-axis analysis was performed on the neuropsychological test results of 200 German-speaking neurological patients who received a comprehensive battery, encompassing tests of visuospatial functions, memory, attention, executive functions, naming ability, and vocabulary. A four-factor solution was obtained with substantial loadings of the VOT only on the first factor, interpreted as a global dimension of non-verbal cognitive functions. This factor loaded significantly on numerous measures of visuospatial processing and attention (with particularly high loadings on WAIS-R Block Design, Trails A and B, and Raven's Standard Progressive Matrices). The remaining three factors were interpreted as memory, verbal abilities (vocabulary), and a separate factor of naming abilities.

Adolescent↗

PubMed2006

Neuropsychiatric profiles of patients with juvenile myoclonic epilepsy treated with valproate or topiramate.

In this cross-sectional study, the neuropsychiatric profiles of 42 patients with juvenile myoclonic epilepsy (JME) who were treated with valproate (VPA) or topiramate (TPM) in monotherapy were compared with the aim of verifying the relationship between cognitive dysfunction, psychiatric disorders, and factors related to epilepsy. Patients with JME taking VPA 500-1750 mg/day or TPM 50-175 mg/day were selected. For all patients, psychiatric profiles were evaluated with the Scheduled Clinical Interview, axes I and II (SCID I and SCID II), or the Brazilian version of the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS-PL). Neuropsychological measures included intellectual functions, attention, memory, executive functions, and language. Patients taking TPM exhibited worse neuropsychological performance on attention, short-term memory, processing speed, and verbal fluency functions related to frontal lobes, which may be dysfunctional in JME. Anxiety disorders were associated with lack of seizure control and having had more than 20 lifetime generalized tonic-clonic seizures.

Adolescent↗