scholarly journals Post-stroke executive function impairments in relation to white matter damage due to stroke lesions versus leukoaraiosis

2021 ◽  
Author(s):  
Georgina Hobden ◽  
Margaret Jane Moore ◽  
Evangeline Grace Chiu ◽  
Sarah Pendlebury ◽  
Nele Demeyere
Keyword(s):  
Executive Function ◽  
White Matter ◽  
Executive Functioning ◽  
Executive Dysfunction ◽  
Acute Stage ◽  
Cognitive Screening ◽  
White Matter Damage ◽  
Post Stroke ◽  
Age Related ◽  
Cognitive Screen

BACKGROUND There is a high prevalence of executive function impairments among stroke survivors. However, the underlying aetiology remains unclear. In particular, we address whether focal, stroke-specific white matter damage or diffuse comorbid white matter damage (leukoaraiosis) is more associated with executive function impairments. METHODS This project is a retrospective analysis of data collected within the Oxford Cognitive Screening programme. Patients were recruited in the acute stage of stroke if they had a confirmed diagnosis of stroke, were at least 18 years of age, were able to remain alert for 20 minutes, and were able to provide informed consent. Patients in the present analysis completed follow up neuropsychological assessment at six-months with the Oxford Cognitive Screen-Plus to assess executive function. Stroke lesions were manually delineated on acute clinical brain scans allowing us to quantify focal stroke-specific white matter damage using the HCP-842 tractography atlas. Leukoaraiosis was visually rated on clinical scans using the Age-Related White Matter Changes scale. RESULTS This study included data from 90 stroke patients (mean age = 73.76 years; 47.78% female). Multiple linear regression analyses showed that the presence of leukoaraiosis predicted poorer executive functioning six-months after stroke (B = -0.33, p = .031, 95% CI [-0.64 -0.03]). However, post-stroke executive functioning was not predicted by stroke-specific damage to white matter tracts. CONCLUSIONS Overall, these results provide novel insight into the neural substrates underlying post-stroke executive dysfunction and highlight the prognostic utility of using routine clinical CT scans to assess leukoaraiosis.

Executive dysfunction, brain aging, and political leadership

2014 ◽  
Vol 33 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Mark Fisher ◽  
David L. Franklin ◽  
Jerrold M. Post
Keyword(s):  
Decision Making ◽  
Prefrontal Cortex ◽  
Executive Function ◽  
White Matter ◽  
Cognitive Functions ◽  
Political Leadership ◽  
Executive Dysfunction ◽  
Amyloid Angiopathy ◽  
Political Leaders ◽  
Age Related

Decision-making is an essential component of executive function, and a critical skill of political leadership. Neuroanatomic localization studies have established the prefrontal cortex as the critical brain site for executive function. In addition to the prefrontal cortex, white matter tracts as well as subcortical brain structures are crucial for optimal executive function. Executive function shows a significant decline beginning at age 60, and this is associated with age-related atrophy of prefrontal cortex, cerebral white matter disease, and cerebral microbleeds. Notably, age-related decline in executive function appears to be a relatively selective cognitive deterioration, generally sparing language and memory function. While an individual may appear to be functioning normally with regard to relatively obvious cognitive functions such as language and memory, that same individual may lack the capacity to integrate these cognitive functions to achieve normal decision-making. From a historical perspective, global decline in cognitive function of political leaders has been alternatively described as a catastrophic event, a slowly progressive deterioration, or a relatively episodic phenomenon. Selective loss of executive function in political leaders is less appreciated, but increased utilization of highly sensitive brain imaging techniques will likely bring greater appreciation to this phenomenon. Former Israeli Prime Minister Ariel Sharon was an example of a political leader with a well-described neurodegenerative condition (cerebral amyloid angiopathy) that creates a neuropathological substrate for executive dysfunction. Based on the known neuroanatomical and neuropathological changes that occur with aging, we should probably assume that a significant proportion of political leaders over the age of 65 have impairment of executive function.

scholarly journals Laterality of the frontal aslant tract (FAT) explains externalizing behaviors through its association with executive function

2017 ◽  
Author(s):  
Dea Garic ◽  
Iris Broce ◽  
Paulo Graziano ◽  
Aaron Mattfeld ◽  
Anthony Steven Dick
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Executive Function ◽  
White Matter ◽  
Attention Deficit ◽  
Externalizing Behaviors ◽  
Executive Dysfunction ◽  
Attention Problems ◽  
Hyperactivity Disorder ◽  
Age Related ◽  
Frontal Aslant Tract

AbstractWe investigated the development of a recently-identified white matter pathway, the frontal aslant tract (FAT) and its association to executive function and externalizing behaviors in a sample of 129 neurotypical children ranging in age from 7 months to 19-years. We found that the FAT could be tracked in 92% of those children, and that the pathway showed age-related differences into adulthood. The change in white matter microstructure was very rapid until about 6-years, and then plateaued, only to show age-related increases again after the age of 11-years. In a subset of those children (5-18-years; n = 70), left laterality of the microstructural properties of the FAT was associated with greater attention problems as measured by the Child Behavior Checklist (CBCL). However, this relationship was fully mediated by higher executive dysfunction as measured by the Behavior Rating Inventory of Executive Function (BRIEF). This relationship was specific to the FAT—we found no relationship between laterality of the white matter of the brain in general and attention problems, or executive function. These findings suggest that the degree to which the developing brain favors a right lateralized structural dominance of the FAT is directly associated with executive function and attention. This novel finding provides a new potential structural biomarker to assess attention deficit hyperactivity disorder (ADHD) and associated executive dysfunction during development.Significance StatementTo investigate the function of a recently-identified white matter fiber pathway, the frontal aslant tract (FAT), we tracked the pathway in 129 typically developing children using diffusion-weighted magnetic resonance imaging (DW-MRI). We then examined whether laterality of the tract is associated with attention problems and executive function. We found that reduced right laterality of the tract was associated with greater executive dysfunction, which predicted increased reports of attention problems. The findings suggest that the degree to which the developing brain favors a right lateralized structural dominance of the FAT is directly associated with executive function and attention. This novel finding provides a new potential structural biomarker to assess attention deficit hyperactivity disorder (ADHD) and associated executive dysfunction during development.

The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults

2021 ◽  
pp. 1-13
Author(s):  
Marissa A. Gogniat ◽  
Catherine M. Mewborn ◽  
Talia L. Robinson ◽  
Kharine R. Jean ◽  
L. Stephen Miller
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Executive Function ◽  
White Matter ◽  
Diffusion Tensor ◽  
Vigorous Physical Activity ◽  
Neuropsychological Testing ◽  
Activity Level ◽  
Average Intensity ◽  
Age Related

The population of older adults is increasing, indicating a need to examine factors that may prevent or mitigate age-related cognitive decline. The current study examined whether microstructural white matter characteristics mediated the relation between physical activity and executive function in older adults without any self-reported psychiatric and neurological disorders or cognitive impairment (N = 43, mean age = 73 y). Physical activity was measured by average intensity and number of steps via accelerometry. Diffusion tensor imaging was used to examine microstructural white matter characteristics, and neuropsychological testing was used to examine executive functioning. Parallel mediation models were analyzed using microstructural white matter regions of interest as mediators of the association between physical activity and executive function. Results indicated that average steps was significantly related to executive function (β = 0.0003, t = 2.829, P = .007), while moderate to vigorous physical activity was not (β = 0.0007, t = 1.772, P = .08). White matter metrics did not mediate any associations. This suggests that microstructural white matter characteristics alone may not be the mechanism by which physical activity impacts executive function in aging.

scholarly journals Microstructural degeneration underlies executive dysfunction after stroke

2020 ◽  
Author(s):  
Michele Veldsman ◽  
Emilio Werden ◽  
Natalia Egorova ◽  
Mohamed Salah Khlif ◽  
Amy Brodtmann
Keyword(s):  
Executive Function ◽  
White Matter ◽  
Structural Equation ◽  
Executive Dysfunction ◽  
White Matter Integrity ◽  
Stroke Severity ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Cerebrovascular Risk ◽  
Microstructural Integrity

ABSTRACTObjectiveExecutive dysfunction affects 40% of stroke patients and is associated with poor quality of life. Stroke severity and lesion volume rarely predict whether a patient will have executive dysfunction. Stroke typically occurs on a background of cerebrovascular burden, which impacts cognition and brain network structural integrity. We investigated whether measures of white matter microstructural integrity and cerebrovascular risk factors better explain executive dysfunction than markers of stroke severity.MethodsWe used structural equation modelling to examine multivariate relationships between cerebrovascular risk, white matter microstructural integrity (fractional anisotropy and mean diffusivity), stroke characteristics and executive dysfunction in 126 stroke patients (mean age 68.4 years), three months post-stroke, and compared to 40 age- and sex-matched control participants. Executive function was measured using the Trail Making Tests, Clock Drawing task and Rey Complex Figure copy task. Microstructural integrity was estimated using a standard pipeline to process diffusion weighted images.ResultsExecutive function was below what would be expected for age and education level in stroke patients (t-test compared to controls t(79)=5.75, p<0.001). A multivariate structural equation model illustrated the complex relationship between executive function, white matter integrity, stroke characteristics and cerebrovascular risk. Pearson’s correlations confirmed a stronger relationship between executive dysfunction and white matter integrity, than executive dysfunction and stroke severity. Mediation analysis showed the relationship between executive function and white matter integrity is mediated by cerebrovascular burden.InterpretationWhite matter microstructural degeneration of the superior longitudinal fasciculus in the executive control network better explains executive dysfunction than markers of stroke severity.

scholarly journals Executive functioning in preschool children born very preterm: Relationship with early white matter pathology

2007 ◽  
Vol 14 (1) ◽  
pp. 90-101 ◽  
Author(s):  
JAMIE O. EDGIN ◽  
TERRIE E. INDER ◽  
PETER J. ANDERSON ◽  
KELLY M. HOOD ◽  
CARON A.C. CLARK ◽  
...  
Keyword(s):  
Preschool Children ◽  
White Matter ◽  
Executive Functioning ◽  
Executive Dysfunction ◽  
Full Term ◽  
Cerebral White Matter ◽  
Preterm Children ◽  
Very Preterm ◽  
White Matter Pathology ◽  
Prospective Longitudinal

Despite evidence for executive dysfunction in school-aged preterm children, less is known about the early development of these difficulties or their underlying neuropathology. This study used prospective longitudinal data from a regional cohort of 88 very preterm and 98 full-term comparison children to examine the executive functioning (EF) of preschool children born very preterm. The relationship between the severity of neonatal cerebral white matter (WM) abnormalities on magnetic resonance imaging (MRI) at term equivalent and children's EF at ages two and four years (corrected age) was examined. At age four, very preterm children with WM abnormalities performed less well than full-term children on the Detour Reaching Box, a measure of behavioral inhibition and cognitive flexibility, even after controlling for child IQ, SES, and medical background. Examination of patterns of EF performance between the ages of 2 and 4 years showed that the performance of all groups improved with age. However, very preterm children with mild and moderate-severe WM abnormalities were characterized by higher rates of consistent performance impairments. These findings support the presence of early and persistent executive difficulties in preschool children born very preterm, and highlight the importance of white matter pathology in the development of executive impairments. (JINS, 2008,14, 90–101.)

INECO Frontal Screening (IFS): A brief, sensitive, and specific tool to assess executive functions in dementia–CORRECTED VERSION

2009 ◽  
Vol 15 (5) ◽  
pp. 777-786 ◽  
Author(s):  
TERESA TORRALVA ◽  
MARÍA ROCA ◽  
EZEQUIEL GLEICHGERRCHT ◽  
PABLO LÓPEZ ◽  
FACUNDO MANES
Keyword(s):  
Differential Diagnosis ◽  
Alzheimer Disease ◽  
Executive Functioning ◽  
Neurodegenerative Diseases ◽  
Rating Scale ◽  
Executive Dysfunction ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Clinical Dementia Rating ◽  
Per Se

AbstractAlthough several brief sensitive screening tools are available to detect cognitive dysfunction, few have been developed to quickly assess executive functioning (EF) per se. We designed a new brief tool to evaluate EF in neurodegenerative diseases. Patients with an established diagnosis of behavioral variant frontotemporal dementia (bvFTD; n = 22), Alzheimer disease (AD; n = 25), and controls (n = 26) were assessed with a cognitive screening test, the INECO Frontal Screening (IFS), and EF tests. Clinical Dementia Rating Scale (CDR) scores were obtained for all patients. Internal consistency of the IFS was very good (Cronbach’s alpha = .80). IFS total (out of 30 points) was 27.4 (SD = 1.6) for controls, 15.6 (SD = 4.2) for bvFTD, and 20.1 (SD = 4.7) for AD. Using a cutoff of 25 points, sensitivity of the IFS was 96.2%, and specificity 91.5% in differentiating controls from patients with dementia. The IFS correlated significantly with the CDR and executive tasks. The IFS total discriminated controls from demented patients, and bvFTD from AD. IFS is a brief, sensitive, and specific tool for the detection of executive dysfunction associated with neurodegenerative diseases. The IFS may be helpful in the differential diagnosis of FTD and AD. (JINS, 2009, 15, 777–786.)

scholarly journals Dysexecutive syndrome and cerebrovascular disease in non-amnestic mild cognitive impairment: a systematic review of the literature

2012 ◽  
Vol 6 (3) ◽  
pp. 145-151 ◽  
Author(s):  
Felipe Kenji Sudo ◽  
Carlos Eduardo Oliveira Alves ◽  
Gilberto Sousa Alves ◽  
Letice Ericeira-Valente ◽  
Chan Tiel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Executive Dysfunction ◽  
Subcortical White Matter ◽  
Review Of The Literature ◽  
Extrapyramidal Signs ◽  
Made In

ABSTRACT Objective: Non-amnestic dysexecutive Vascular Mild Cognitive Impairment (VaMCI) may represent preclinical Vascular Dementia (VaD). The aim of this study was to summarize the clinical, neuropsychological and neuroimaging aspects of VaMCI; and to assess its patterns of progression to dementia. Methods: Searches were made in the ISI Web of Knowledge, PubMed and Lilacs databases, using the terms "mild cognitive impairment" and "executive function". Altogether, 944 articles were retrieved. Results: VaMCI cases had poorer performances on fronto-executive tasks, a higher prevalence of stroke, presence of periventricular and profound white matter hyperintensities on MRI images, as well as more extrapyramidal signs and behavioral symptoms. Executive dysfunction might be associated with disconnection of fronto-parietal-subcortical circuits. Progression to dementia was associated with baseline deficits in executive function, in simple sustained attention and language, and large periventricular WMH. Discussion: VaMCI develops with impairment in non-memory domains and subcortical white matter changes on MRI images, which are consistent with clinical and neuroimaging findings in VaD.

scholarly journals Age-related macular degeneration affects the optic radiation white matter projecting to locations of retinal damage

2018 ◽  
Author(s):  
Shoyo Yoshimine ◽  
Shumpei Ogawa ◽  
Hiroshi Horiguchi ◽  
Masahiko Terao ◽  
Atsushi Miyazaki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
White Matter ◽  
Age Related Macular Degeneration ◽  
Retinal Damage ◽  
Optic Radiation ◽  
Resonance Imaging ◽  
White Matter Damage ◽  
Age Related ◽  
The Impact

ABSTRACTPurposeWe investigated the impact of age-related macular degeneration (AMD) on visual acuity and the visual white matter.MethodsWe combined an adaptive cortical atlas and diffusion-weighted magnetic resonance imaging (dMRI) and tractography to separate optic radiation (OR) projections to different retinal eccentricities in human primary visual cortex. We exploited the known anatomical organization of the OR and clinically relevant data to segment the OR into three primary components projecting to fovea, mid- and far-periphery. We measured white matter tissue properties – (fractional anisotropy, linearity, planarity, sphericity) along the aforementioned three components of the optic radiation to compare AMD patients and controls.ResultsWe found differences in white matter properties specific to OR white matter fascicles projecting to primary visual cortex locations corresponding to the location of retinal damage (fovea). Additionally, we show that the magnitude of white matter properties in AMD patients’ correlates with visual acuity. In sum, we demonstrate a specific relation between visual loss, anatomical location of retinal damage and white matter damage in AMD patients. Importantly, we demonstrate that these changes are so profound that can be detected using magnetic resonance imaging data with clinical resolution. The conserved mapping between retinal and white matter damage suggests that retinal neurodegeneration might be a primary cause of white matter degeneration in AMD patients.ConclusionsThe results highlight the impact of eye disease on brain tissue, a process that may become an important target to monitor during the course of treatment.

scholarly journals Microstructural degeneration and cerebrovascular risk burden underlying executive dysfunction after stroke

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Michele Veldsman ◽  
Emilio Werden ◽  
Natalia Egorova ◽  
Mohamed Salah Khlif ◽  
Amy Brodtmann
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
White Matter ◽  
Structural Equation ◽  
Executive Dysfunction ◽  
White Matter Integrity ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Cerebrovascular Risk Factors ◽  
Cerebrovascular Risk

Abstract Executive dysfunction affects 40% of stroke patients, but is poorly predicted by characteristics of the stroke itself. Stroke typically occurs on a background of cerebrovascular burden, which impacts cognition and brain network structural integrity. We used structural equation modelling to investigate whether measures of white matter microstructural integrity (fractional anisotropy and mean diffusivity) and cerebrovascular risk factors better explain executive dysfunction than markers of stroke severity. 126 stroke patients (mean age 68.4 years) were scanned three months post-stroke and compared to 40 age- and sex-matched control participants on neuropsychological measures of executive function. Executive function was below what would be expected for age and education level in stroke patients as measured by the organizational components of the Rey Complex Figure Test, F(3,155) = 17, R2 = 0.25, p < 0.001 (group significant predictor at p < 0.001) and the Trail-Making Test (B), F(3,157) = 3.70, R2 = 0.07, p < 0.01 (group significant predictor at p < 0.001). A multivariate structural equation model illustrated the complex relationship between executive function, white matter integrity, stroke characteristics and cerebrovascular risk (root mean square error of approximation = 0.02). Pearson’s correlations confirmed a stronger relationship between executive dysfunction and white matter integrity (r = − 0.74, p < 0.001), than executive dysfunction and stroke severity (r = 0.22, p < 0.01). The relationship between executive function and white matter integrity is mediated by cerebrovascular burden. White matter microstructural degeneration of the superior longitudinal fasciculus in the executive control network better explains executive dysfunction than markers of stroke severity. Executive dysfunction and incident stroke can be both considered manifestations of cerebrovascular risk factors.

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