Executive Function Assessment in Patients With Idiopathic Generalized Epilepsy: Applyingthe Frontal Assessment Battery

   Background: Executive dysfunction is seen in idiopathic generalized epilepsy (IGE). The Frontal Assessment Battery (FAB) is a short neuropsychological instrument designed in clinical settings to evaluate frontal lobe activity. We aimed to assess the clinical use of FAB in patients with IGE for to detect executive impairment. Method: In this study, 30 patients with IGE and 30 age- and sex-matched healthy controls were included. The presence and severity of executive dysfunction was investigated with FAB. Cognitive flexibility, decision making, working memory, and general intelligence level were examined using Wisconsin Card Sorting Task (WCST), Iowa Gambling Task (IGT), N-back, and Wechsler Adult Intelligence Scale, respectively. In patients with IGE, FAB results were related to their neuropsychological task performance. Results: The FAB score in patients with IGE was significantly lower compared to healthy participants. In motor programming tasks, patients with IGE performed substantially worse. However, no correlation was found between FAB and neuropsychological task and clinical characteristics. Conclusion: Executive dysfunction was present in patients with IGE and FAB may be used in these patients as an effective tool for evaluating frontal lobe function

Avaliação neuropsicológica do comportamento impulsivo de sujeitos dependentes de álcool em abstinência

OBJECTIVE: Poor impulse control is thought to be one of the characteristics of alcohol addiction. The capacity to remain abstinent may be linked to cognitive bias related to three dimensions of impulsivity: motor, non-planning, and attentional impulsivity. The aim of this study was to evaluate the neuropsychological profile related to these impulsivity dimensions in alcohol-dependent patients within 15 -120 days of abstinence. METHOD: We compared 31 alcohol-dependent patients to 30 matched healthy controls regarding their performances on the Continuous Performance Task, the Iowa Gambling Test, and the Wisconsin Card Sorting Test, each of which is thought to tax primarily one of the three dimensions of impulsivity just outlined. RESULTS: When compared to controls, alcohol-dependent patients presented more commission errors on the Continuous Performance Task; made more disadvantageous choices on the Iowa Gambling Test; and made more perseverative errors on the Wisconsin Card Sorting Test. There was no significant correlation between performance on these tests and the length of abstinence. CONCLUSIONS: These results suggest that deficits related to motor, non-planning and attentional components of impulsivity exist in alcohol-dependent patients, in the period immediately after acute alcohol withdrawal. These results may help guide interventions designed to prevent the risk of relapse in alcohol-abstinent patients.OBJETIVO: O controle deficiente dos impulsos é considerado uma das características da dependência do álcool. A capacidade de permanecer abstinente pode estar ligada a viés cognitivo relacionado a três dimensões da impulsividade: motora, de atenção e por falta de planejamento. O presente estudo objetivou avaliar o perfil neuropsicológico relacionado a estas dimensões da impulsividade em pacientes dependentes de álcool em 15 a 120 dias de abstinência. MÉTODO: Nós comparamos o desempenho de 31 pacientes dependentes de álcool a 30 controles saudáveis na Continuous Performance Task, no Iowa Gambling Test e no Wisconsin Card Sorting Test, que são considerados testes capazes de avaliar primariamente as citadas dimensões de impulsividade. RESULTADOS: Em relação aos controles, o grupo pacientes dependentes de álcool cometeu mais erros de comissão na Continuous Performance Task; fez escolhas menos vantajosas no Iowa Gambling Test e mais erros perseverativos no Wisconsin Card Sorting Test. Não houve correlação significativa entre o desempenho nestes testes e o tempo de abstinência. CONCLUSÕES: Estes resultados sugerem que há déficits relacionados aos componentes da impulsividade (motores, atencionais e por não-planejamento) em pacientes dependentes de álcool, no período imediatamente após a fase aguda de retirada do álcool. Estes resultados podem ajudar a guiar intervenções para impedir o risco do recaída em pacientes em curto período de abstinência de álcool

Impairment in Proverb Interpretation as an Executive Function Deficit in Patients with Amnestic Mild Cognitive Impairment and Early Alzheimer's Disease

Background/Aims: Proverb interpretation is assumed to reflect executive functions. We hypothesized that proverb interpretation is impaired in patients with amnestic mild cognitive impairment (aMCI) diagnosed as single-domain impairment by common neuropsychological testing. Methods: We compared performance in a proverb interpretation test in single-domain aMCI patients and patients with early Alzheimer’s disease (EAD). Results: The groups with aMCI and EAD performed significantly worse than healthy controls. Both patient groups gave concrete answers with a similar frequency. However, patients with EAD tended to give senseless answers more frequently. Conclusions: Our data suggest that in patients diagnosed as single-domain aMCI, deterioration of executive functions is detectable with subtle and appropriate neuropsychological testing. Implementation of these procedures may improve the early prediction of AD

Quadrupedal movement training improves markers of cognition and joint repositioning

Introduction - Exercise, and in particular balance and coordination related activities such as dance, appear to have positive effects on cognitive function, as well as neurodegenerative conditions such as dementia and Parkinson’s disease. Quadrupedal gait training is a movement system requiring coordination of all four limbs that has previously been associated with cognitive development in children. There is currently little research into the effect of complex QDP movements on cognitive function in adults. Purpose - To determine the effects of a novel four-week quadrupedal gait training programme on markers of cognitive function and joint reposition sense in healthy adults. Methods - Twenty-two physically active sports science students (15 male and 7 female) were divided into two groups: a training group (TG) and a control group (CG). All participants completed the Wisconsin Card Sorting Task (WCST) and were tested for joint reposition sense before and after a four-week intervention, during which time the TG completed a series of progressive and challenging quadrupedal movement training sessions. Results - Participants in the TG showed significant improvements in the WCST, with improvements in perseverative errors, non-perseverative errors, and conceptual level response. This improvement was not found in the CG. Joint reposition sense also improved for the TG, but only at 20 degrees of shoulder flexion. Conclusions - Performance of a novel, progressive, and challenging task, requiring the coordination of all 4 limbs, has a beneficial impact on cognitive flexibility, and in joint reposition sense, although only at the specific joint angle directly targeted by the training. The findings are consistent with other studies showing improvements in executive function and joint reposition sense following physical activity

Selective neuronal damage and Wisconsin Card Sorting Test performance in atherosclerotic occlusive disease of the major cerebral artery

In atherosclerotic internal carotid artery (ICA) or middle cerebral artery (MCA) disease, selective neuronal damage can be detected as a decrease in central benzodiazepine receptors (BZRs) in the normal-appearing cerebral cortex. This study aimed to determine whether a decrease in the BZRs in the non-infarcted cerebral cortex is associated with poor performance on the Wisconsin Card Sorting Test (WCST), which assesses executive functions

The two-factor structure of cognitive flexibility : tempo of switching and overcoming of prepotent responses

Prezentowane badanie miało na celu odkrycie struktury procesów latentnych leżących u podstaw wykonania kilku zadań, które hipotetycznie mierzą spontaniczną i adaptacyjną giętkość poznawczą, dostarczając dowodów na ich trafność zbieżną. Grupa zdrowych ochotników (N = 121) ukończyła dwa zestawy zadań do oceny spontanicznej i adaptacyjnej giętkości poznawczej. Spontaniczna giętkość poznawcza obejmowała test myślenia dywergencyjnego (do oceny płynności i giętkości myślenia) oraz werbalny test płynności. Miary giętkości adaptacyjnej obejmowały test przełączania się między zadaniami jako miarę kosztów przełączania oraz test przerzucania uwagi jako miarę wyuczonej nieistotności i perseweracji. Natomiast test znajomości słownictwa dostarczył zastępczej miary inteligencji skrystalizowanej . Analiza klastrów hierarchicznych analiza metodą Warda wykazała istnienie dwóch odrębnych podgrup zmiennych. Pierwsza grupa obejmowała płynność i giętkość myślenia, inteligencję skrystalizowaną, płynność werbalną oraz koszty przełączania się. Druga grupa obejmowała zmienne z zadania wymagającego przełączania uwagi, czyli wyuczoną nieadekwatność i persewerację. Uważamy, że te wyniki są znaczące i wskazują na udział dwóch oddzielnych czynników kształtujących giętkość poznawczą: (a) tempo przełączania i (b) przezwyciężanie dominujących reakcji. W podsumowaniu omówiono implikacje tych wyników dla oceny giętkości poznawczej.The current study aimed to uncover the structure of common latent processes underlying the execution of several tasks that hypothetically measure spontaneous and adaptive cognitive flexibility, providing evidence for their convergent validity. A group of healthy volunteers (N = 121) completed two sets of tasks to assess spontaneous and adaptive cognitive flexibility. Spontaneous flexibility measures included a divergent thinking test (to assess fluency and flexibility of thinking) and a verbal fluency test. Adaptive flexibility measures involved a set-switching test as a measure of switch costs and an attentional set-shifting test as a measure of learned irrelevance and perseveration). A vocabulary knowledge test provided a proxy measure of crystallized intelligence. Hierarchical cluster analysis using Ward's method revealed the existence of two separate subgroups of variables. The first group comprised fluency and flexibility of thinking, crystallized intelligence, verbal fluency, and switch costs. The second group included attentional shift variables, that is, learned irrelevance and perseveration. We consider these results meaningful and indicative of two separate factors contributing to cognitive flexibility: (a) speed of switching and (b) overcoming of prepotent responses. We discuss the implications of our results for the assessment of cognitive flexibility

Disrupted Functional Network Topology in Children and Adolescents With Post-traumatic Stress Disorder

Neuroimaging studies in children and adolescents with post-traumatic stress disorder (PTSD) have focused on abnormal structures and the functionality of a few individual brain regions. However, little is known about alterations to the topological organization of whole-brain functional networks in children and adolescents with PTSD. To this end, we investigated the topological properties of brain functional networks derived from resting-state functional magnetic resonance imaging (r-fMRI) in patients suffering from PTSD. The r-fMRI data were obtained from 10 PTSD patients and 16 trauma-exposed non-PTSD subjects. Graph theory analysis was used to investigate the topological properties of the two groups, and group comparisons of topological metrics were performed using nonparametric permutation tests. Both the PTSD and non-PTSD groups showed the functional brain network to have a small-world architecture. However, the PTSD group exhibited alterations in global properties characterized by higher global efficiency, lower clustering coefficient, and characteristic path length, implying a shift toward randomization of the networks. The PTSD group also showed increased nodal centralities, predominately in the left middle frontal gyrus, caudate nucleus, and hippocampus, and decreased nodal centralities in the left anterior cingulate cortex, left paracentral lobule, and bilateral thalami. In addition, the clustering coefficient and nodal betweenness of the left paracentral lobule were found to be negatively and positively correlated with the re-experiencing and hyper-arousal symptoms of PTSD respectively. The findings of disrupted topological properties of functional brain networks may help to better understand the pathophysiological mechanism of PTSD in children and adolescents