Increased variability accompanies frontal lobe damage in dementia

Performance variability on neuropsychological measures is not a unitary phenomenon, and different measures (consistency, dispersion, diversity) evaluate separate elements of variability. It has been suggested that increased variability may be a specific attribute of frontal lobe pathology. This hypothesis was tested in 2 matched groups of demented subjects, 8 with dementia of the Alzheimer type (DAT), 5 with frontal lobe dementia (FLD), compared with 10 elderly normal controls (ENC). A Stroop test and Reaction Time measures were administered weekly for 5 weeks to all subjects. Both measures contained three subtests varying in degree of complexity. The results from the Stroop task indicated that the FLD group showed significantly greater variability on measures of consistency (fluctuations over time) and diversity (between participant variability) regardless of the complexity of the subtest. For the Reaction Time subtests, measures of consistency and diversity showed significantly greater variability in FLD, but were affected in a different pattern. Greater variability in terms of consistency of performance was manifested only in the more attentionally demanding of the Reaction Time subtests (Choice Reaction Time, CRT). On the measure of diversity, variable performance was found to be greater on the Simple Reaction Time (SRT) subtest than on the more effortful CRT. Dispersion (within participant variability) was only assessed on the reaction time subtests. The results indicate no significant evidence for an increase in dispersion for the FLD patients. The hypothesis that variability will be increased in frontal lobe dementia is thus confirmed, and the independence of the three forms of variability measurement is demonstrated in dementia subjects. (JINS, 2002, 8, 360–372.)

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Neuropsychological performance of adults with attention deficit hyperactivity disorder (ADHD): Diagnostic classification estimates for measures of frontal lobe/executive functioning

Journal of the International Neuropsychological Society ◽

10.1017/s1355617799533055 ◽

1999 ◽

Vol 5 (3) ◽

pp. 222-233 ◽

Cited By ~ 88

Author(s):

DAVID W. LOVEJOY ◽

J.D. BALL ◽

MATTHEW KEATS ◽

MICHAEL L. STUTTS ◽

EDWARD H. SPAIN ◽

...

Keyword(s):

Executive Functioning ◽

Frontal Lobe ◽

Classification Accuracy ◽

Predictive Power ◽

Diagnostic Classification ◽

Neuropsychological Measures ◽

Hyperactivity Disorder ◽

Good Classification ◽

Summary Index ◽

Normal Controls

ADHD adults (N = 26) were compared to normal controls (N = 26) on 6 neuropsychological measures believed sensitive to frontal lobe–executive functioning. MANOVA analyses and subsequent univariate tests indicated that most of the neuropsychological measures discriminated between the two groups. To address clinical significance, diagnostic classification rates were also generated for each measure individually, and for the battery as a whole. Levels of positive predictive power (PPP) for each of the 6 measures (83–100%) indicated that abnormal scores on these tests were good predictors of ADHD. However, estimates of negative predictive power (NPP) suggested that normal scores poorly predicted the absence of ADHD. When classification rates were calculated for the overall battery classification accuracy improved substantially. Thus, neuropsychological tests can differentiate adults suffering from ADHD from adults without ADHD, while also providing good classification accuracy. Finally, the pattern of neurobehavioral impairments exemplified through the Summary Index scores was interpreted as consistent with conceptualizations of ADHD depicting mild neurologic dysfunction in networks associated with the frontal lobes. (JINS, 1999, 5, 222–233.)

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Regional Cerebral Blood Flow in Frontal Lobe Dementia of Non-Alzheimer Type

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000107321 ◽

1993 ◽

Vol 4 (3-4) ◽

pp. 186-187 ◽

Cited By ~ 2

Author(s):

Jarl Risberg ◽

Ulla Passant ◽

Siegbert Warkentin ◽

Lars Gustafson

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Frontal Lobe ◽

Regional Cerebral Blood Flow ◽

Regional Cerebral Blood ◽

Alzheimer Type ◽

Frontal Lobe Dementia

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Calbindin D-28k and parvalbumin immunoreactivity in the frontal cortex in patients with frontal lobe dementia of non-Alzheimer type associated with amyotrophic lateral sclerosis.

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.56.3.257 ◽

1993 ◽

Vol 56 (3) ◽

pp. 257-261 ◽

Cited By ~ 30

Author(s):

I Ferrer ◽

T Tunon ◽

M T Serrano ◽

R Casas ◽

S Alcantara ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Frontal Cortex ◽

Frontal Lobe ◽

Alzheimer Type ◽

Frontal Lobe Dementia ◽

Calbindin D ◽

Lateral Sclerosis

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Structural and Topographic Aspects of Degenerative Dementia: Diagnostic Considerations

International Psychogeriatrics ◽

10.1017/s104161020500116x ◽

1991 ◽

Vol 3 (S1) ◽

pp. 75-83

Author(s):

Arne Brun

Keyword(s):

Frontal Lobe ◽

Senile Plaques ◽

Common Factor ◽

Neurofibrillary Tangle ◽

Signs And Symptoms ◽

Alzheimer Type ◽

Frontal Lobe Dementia ◽

Disease Pattern ◽

Degenerative Dementia ◽

Degenerative Disorder

A thorough neuropathological analysis of several hundred cases from a prospective dementia study shows degenerative disorders such as dementia of Alzheimer type (DAT) and frontal lobe dementia (FLD) of non-Alzheimer type to be the prevailing disorders.The pattern of basic changes relatable to neuronal atrophy in DAT correlates better to functional parameters and symptomatology than do senile plaques and neurofibrillary tangle density and distribution. The etiological or pathogenetic role of amyloid and of a cholinergic deficit also remains unclear. The dominating disease pattern may be blurred by confounding additional alterations with more pronounced frontal case pathology, as found in a limited number of cases. Another and much more common factor is structural white matter attenuation associated with cerebrovascular pathology as well as frank infarctions in a smaller but still important number of DAT cases. The concurrence of degenerative and other brain changes each at subthreshold levels may cause signs and symptoms of a dementia difficult to classify.Frontal lobe dementia of non-Alzheimer type, the next most common dementing degenerative disorder, displays only the basic changes found in DAT but derives its separate clinical profile from the frontal predominance of lesions. It may be confounded with Pick's disease and others possibly belonging to the same group, but also with frontally projected dementias due to lesions ranging from thalamic infarcts to brain stem afflictions.The topographic pattern of lesions rather than the structural details forms a useful basis for a clinical classification of the dementing disorders.

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Social and emotional functions in three patients with medial frontal lobe damage including the anterior cingulate cortex

Cognitive Neuropsychiatry ◽

10.1080/13546800444000245 ◽

2006 ◽

Vol 11 (4) ◽

pp. 369-388 ◽

Cited By ~ 32

Author(s):

Amee Baird ◽

Bonnie‐Kate Dewar ◽

Hugo Critchley ◽

Ray Dolan ◽

Tim Shallice ◽

...

Keyword(s):

Anterior Cingulate Cortex ◽

Frontal Lobe ◽

Cingulate Cortex ◽

Anterior Cingulate ◽

Social And Emotional ◽

Frontal Lobe Damage

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Do reaction time measures enhance diagnosis of early-stage dementia of the Alzheimer type

Archives of Clinical Neuropsychology ◽

10.1016/s0887-6177(02)00220-2 ◽

2004 ◽

Vol 19 (1) ◽

pp. 119-124 ◽

Cited By ~ 4

Author(s):

M Storandt

Keyword(s):

Reaction Time ◽

Early Stage ◽

Alzheimer Type

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Reaction time assessment in children with ADHD

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000200025 ◽

2010 ◽

Vol 68 (2) ◽

pp. 282-286 ◽

Cited By ~ 9

Author(s):

Cristiana Bolfer ◽

Erasmo Barbante Casella ◽

Marcus Vinícius Chrysóstomo Baldo ◽

Amanda Manzini Mota ◽

Miriam Harumi Tsunemi ◽

...

Keyword(s):

Reaction Time ◽

Attention Deficit ◽

Test Results ◽

Voluntary Attention ◽

Statistical Manual ◽

Children With Adhd ◽

Hyperactivity Disorder ◽

Diagnostic And Statistical Manual ◽

Attentional System ◽

Normal Controls

Attention deficit, impulsivity and hyperactivity are the cardinal features of attention deficit hyperactivity disorder (ADHD) but executive function (EF) disorders, as problems with inhibitory control, working memory and reaction time, besides others EFs, may underlie many of the disturbs associated with the disorder. OBJECTIVE: To examine the reaction time in a computerized test in children with ADHD and normal controls. METHOD: Twenty-three boys (aged 9 to 12) with ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 2000 (DSM-IV) criteria clinical, without comorbidities, Intelligence Quotient (IQ) >89, never treated with stimulant and fifteen normal controls, age matched were investigated during performance on a voluntary attention psychophysical test. RESULTS: Children with ADHD showed reaction time higher than normal controls. CONCLUSION: A slower reaction time occurred in our patients with ADHD. This findings may be related to problems with the attentional system, that could not maintain an adequate capacity of perceptual input processes and/or in motor output processes, to respond consistently during continuous or repetitive activity.

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