Abstract WP206: Cognitive Functioning Predicts Engagement in Inpatient Stroke Rehabilitation

Introduction: Patient engagement during inpatient stroke rehabilitation (ISR) is critical to long-term outcomes. Cognitive deficits have demonstrated impact on engagement in rehabilitation. Here, we prospectively investigated the relationship between specific cognitive domains and patient engagement during ISR. Methods: Of 423 patients completing ISR, 127 (30%) had complete data with mean age=67.63 + 15.46 years, NIHSS=6.78 + 5.68, and onset from stroke to ISR admission=8.55 + 7.72 days. The sample comprised 55% males and 56.7% had a college education or more. The National Institute of Neurologic Disorders - Canadian Stroke Network (NINDS-CSN) 30-minute cognitive screening battery was administered within 72 hours of ISR admission to assess verbal fluency, executive functioning, and memory. The Hopkins Rehabilitation Engagement Ratings Scale (HRERS; total score 0-30, higher=greater engagement) was completed by treating therapists at ISR discharge. Spearman rank-order correlations (r s ) examined the relationships between the HRERS total score and the NINDS-CSN total (the mean z-score across subtests) as well as its 8 subtests. Items with correlations p<.10 were entered into a logistic regression (controlling for age, comorbidity, and stroke severity) to predict low (HRERS ≤ 25) versus high engagers (HRERS > 26). Results: NINDS-CSN total and 6 subtests assessing verbal fluency and executive function were weakly to moderately correlated with HRERS scores (r s =0.23-.38, all p’s <.01). Memory subtests were not associated with HRERS. Higher NINDS-CSN total score and subtests reflecting executive functions modestly increased the odds of being a high engager (Odds Ratios ranged from 1.03-1.08, 95% CIs ranged from 1.013-1.134, all p’s < .01). Conclusion: Poor executive functioning may pose a barrier to patient engagement in ISR. Executive functions may impact patients’ ability to shift among activities, maintain attention, and rapidly process information during therapy. Rehabilitation therapists should consider making environmental modifications, providing more frequent guidance and positive reinforcement, and presenting simplified material to increase engagement in stroke patients with executive dysfunction.

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Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

Frontiers in Neurology ◽

10.3389/fneur.2020.629183 ◽

2021 ◽

Vol 11 ◽

Author(s):

Alfonso Delgado-Álvarez ◽

Jordi A. Matias-Guiu ◽

Cristina Delgado-Alonso ◽

Laura Hernández-Lorenzo ◽

Ana Cortés-Martínez ◽

...

Keyword(s):

Machine Learning ◽

Executive Functioning ◽

Cognitive Processes ◽

Cognitive Deficits ◽

Verbal Fluency ◽

Learning Algorithms ◽

Executive Dysfunction ◽

Machine Learning Algorithms ◽

Semantic Fluency ◽

Phonemic Fluency

Background: Verbal fluency (VF) has been associated with several cognitive functions, but the cognitive processes underlying verbal fluency deficits in Multiple Sclerosis (MS) are controversial. Further knowledge about VF could be useful in clinical practice, because these tasks are brief, applicable, and reliable in MS patients. In this study, we aimed to evaluate the cognitive processes related to VF and to develop machine-learning algorithms to predict those patients with cognitive deficits using only VF-derived scores.Methods: Two hundred participants with MS were enrolled and examined using a comprehensive neuropsychological battery, including semantic and phonemic fluencies. Automatic linear modeling was used to identify the neuropsychological test predictors of VF scores. Furthermore, machine-learning algorithms (support vector machines, random forest) were developed to predict those patients with cognitive deficits using only VF-derived scores.Results: Neuropsychological tests associated with attention-executive functioning, memory, and language were the main predictors of the different fluency scores. However, the importance of memory was greater in semantic fluency and clustering scores, and executive functioning in phonemic fluency and switching. Machine learning algorithms predicted general cognitive impairment and executive dysfunction, with F1-scores over 67–71%.Conclusions: VF was influenced by many other cognitive processes, mainly including attention-executive functioning, episodic memory, and language. Semantic fluency and clustering were more explained by memory function, while phonemic fluency and switching were more related to executive functioning. Our study supports that the multiple cognitive components underlying VF tasks in MS could serve for screening purposes and the detection of executive dysfunction.

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Postural control and executive functioning in patients with schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2132 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S195-S195

Author(s):

M. Yildirim ◽

A. Elvan ◽

G. Ercegil ◽

I.E. Simsek ◽

S. Savci ◽

...

Keyword(s):

Executive Functioning ◽

Postural Control ◽

Verbal Fluency ◽

Postural Sway ◽

Cognitive Task ◽

Motor Task ◽

Executive Dysfunction ◽

Proprioceptive Information ◽

Healthy Controls ◽

Eyes Closed

IntroductionPatients with schizophrenia commonly show deficits in executive functioning that allow a person to make plans, solve problems, do many tasks simultaneously and adapt to unexpected conditions. Executive dysfunction is associated with very simple and automatic activities, such as walking in schizophrenia patients. However, no study exists about its relation to postural control in these patients.AimTo investigate the effect of executive functioning on postural control using dual task paradigms.MethodsFifteen clinically stable schizophrenia outpatients and 15 healthy controls were enrolled in the study. Postural control was assessed with bilateral stance test using the Balance Master system under three different conditions with eyes open and eyes closed (EC): without a task, during a cognitive task (verbal fluency) and during a motor task (holding a cup of water).ResultsStanding on a foam surface with EC resulted in higher postural sway velocities in schizophrenia patients under all conditions (P = 0.009, P = 0.032, P = 0.013). During a cognitive task, both schizophrenia patients and healthy controls showed higher velocities on firm surface with EC in comparison to the condition without a task (P = 0.023). Both schizophrenia patients and healthy controls did not show higher postural sway velocities during the motor task.ConclusionThe effect of verbal fluency on postural sway shows the relationship between executive functioning and postural control in schizophrenia patients. Foam surface also higher postural sway velocities in schizophrenia patients in EC condition suggesting the difficulties in integrating the proprioceptive information in the absence of visual input.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Executive Functions in Adolescents With Idiopathic Generalized Epilepsy

Medicina ◽

10.3390/medicina47060044 ◽

2011 ◽

Vol 47 (6) ◽

pp. 44 ◽

Cited By ~ 2

Author(s):

Giedrė Gelžinienė ◽

Giedrė Jurkevičienė ◽

Vitalija Marmienė ◽

Virginija Adomaitienė ◽

Milda Endzinienė

Keyword(s):

Executive Functioning ◽

Executive Functions ◽

Short Duration ◽

Executive Dysfunction ◽

Juvenile Myoclonic Epilepsy ◽

Idiopathic Epilepsy ◽

Word Fluency ◽

Epileptiform Discharges ◽

And Gender ◽

Generalized Epilepsy

Disorders of executive functioning have recently been reported in patients with juvenile myoclonic epilepsy (JME); however, data on other syndromes of generalized idiopathic epilepsy (IGE) other than JME, especially in adolescence, are scarce. The aim of this study was to explore specific executive functions in a group of adolescents with IGE of short duration and to evaluate the possible factors that might influence these functions. Material and Methods. Neuropsychological investigation of executive functions (the Verbal Fluency Test, the Five-Point Test, the Trail-Making Test, and the Stroop test) was performed in 59 patients aged 14–17 years and meeting the diagnostic criteria for IGE, and in the group of 59 agematched controls without any history of epilepsy. Results. The IGE group subjects scored worse than the controls in most of the executive function tests: phonemic (P=0.008) and semantic (P=0.001) word fluency, figural fluency (P=0.008), visual search and sequencing of numbers (P=0.001), and alternate number-letter sequencing (P=0.018). None of the test scores differed between the new-onset and the established IGE groups, or between the groups of cases with and without myoclonias. No relationship between executive functioning and gender, age, duration or activity of epilepsy, treatment, or epileptiform discharges on electroencephalography was found. Conclusions. Executive dysfunction was present in adolescents with JME and other syndromes of IGE, manifesting with generalized tonic-clonic seizures without myoclonias, despite short duration and benign course of epilepsy

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Phonemic Verbal Fluency and Midbrain Atrophy in Progressive Supranuclear Palsy

Journal of Alzheimer s Disease ◽

10.3233/jad-210023 ◽

2021 ◽

pp. 1-6

Author(s):

Antonina Luca ◽

Alessandra Nicoletti ◽

Giulia Donzuso ◽

Claudio Terravecchia ◽

Calogero Edoardo Cicero ◽

...

Keyword(s):

Executive Functioning ◽

Progressive Supranuclear Palsy ◽

Verbal Fluency ◽

Brain Mri ◽

Executive Dysfunction ◽

Cognitive Status ◽

Test Time ◽

Neuropsychological Profile ◽

Phonemic Verbal Fluency ◽

The Relationship

Background: The neuropsychological profile of progressive supranuclear palsy (PSP) patients is mainly characterized by executive dysfunction, but the relationship between the latter and midbrain atrophy is still unclear. Objective: The aims of the study were to investigate which test evaluating executive functioning is more frequently impaired in PSP patients and to evaluate the relationship between midbrain-based MRI morphometric measures and executive dysfunction. Methods: PSP patients who had undergone a neuropsychological battery assessing executive functioning with the Frontal Assessment Battery (FAB), the phonemic verbal fluency F-A-S, the Raven’s Progressive Colored Matrix, and the Stroop word colors test (time and errors) were enrolled in the study. A group of Parkinson’s disease (PD) patients matched by age, sex, education, and global cognitive status was selected. All the enrolled patients also underwent a volumetric T1-3D brain MRI. Results: Thirty-five PSP patients and 35 PD patients were enrolled. Patients with PSP as compared to patients with PD showed a significant greater impairment in verbal fluency (16.0±7.9 and 23.4±8.7 words/180 s; p < 0.001) and a significant lower score at the FAB total score (11.5±3.8 and 13.7±3.4; p = 0.013). Midbrain area was significantly smaller in PSP patients than in PD patients (83.9±20.1 and 134.5±19.9 mm2; p < 0.001). In PSP patients, a significant positive correlation between verbal fluency and the midbrain area (r = 0.421; p = 0.028) was observed. Conclusion: Our findings suggest that the phonemic verbal fluency is among the most frequently impaired executive functions in PSP patients and is strongly correlated to midbrain atrophy.

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Meta-analysis of executive functioning in ecstasy/polydrug users

Psychological Medicine ◽

10.1017/s0033291716000258 ◽

2016 ◽

Vol 46 (8) ◽

pp. 1581-1596 ◽

Cited By ~ 20

Author(s):

C. A. Roberts ◽

A. Jones ◽

C. Montgomery

Keyword(s):

Executive Functioning ◽

Executive Functions ◽

Degrees Of Freedom ◽

Meta Analysis ◽

Executive Dysfunction ◽

Long Term Memory ◽

Performance Deficits ◽

Significant Performance ◽

The Brain

Ecstasy/3,4-methylenedioxymethamphetamine (MDMA) use is proposed to cause damage to serotonergic (5-HT) axons in humans. Therefore, users should show deficits in cognitive processes that rely on serotonin-rich, prefrontal areas of the brain. However, there is inconsistency in findings to support this hypothesis. The aim of the current study was to examine deficits in executive functioning in ecstasy users compared with controls using meta-analysis. We identifiedk= 39 studies, contributing 89 effect sizes, investigating executive functioning in ecstasy users and polydrug-using controls. We compared function-specific task performance in 1221 current ecstasy users and 1242 drug-using controls, from tasks tapping the executive functions – updating, switching, inhibition and access to long-term memory. The significant main effect demonstrated overall executive dysfunction in ecstasy users [standardized mean difference (SMD) = −0.18, 95% confidence interval (CI) −0.26 to −0.11,Z= 5.05,p< 0.001,I2= 82%], with a significant subgroup effect (χ2= 22.06, degrees of freedom = 3,p< 0.001,I2= 86.4%) demonstrating differential effects across executive functions. Ecstasy users showed significant performance deficits in access (SMD = −0.33, 95% CI −0.46 to −0.19,Z= 4.72,p <0.001,I2= 74%), switching (SMD = −0.19, 95% CI −0.36 to −0.02,Z= 2.16,p <0.05,I2= 85%) and updating (SMD = −0.26, 95% CI −0.37 to −0.15,Z= 4.49,p <0.001,I2= 82%). No differences were observed in inhibitory control. We conclude that this is the most comprehensive analysis of executive function in ecstasy users to date and provides a behavioural correlate of potential serotonergic neurotoxicity.

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ESTUDIO SOBRE EL LENGUAJE Y LAS FUNCIONES EJECUTIVAS DE UN CASO DE SÍNDROME DE X-FRÁGIL

International Journal of Developmental and Educational Psychology Revista INFAD de psicología ◽

10.17060/ijodaep.2014.n1.v3.496 ◽

2016 ◽

Vol 3 (1) ◽

pp. 213

Author(s):

Eva Herraiz Llongo ◽

Mª Inmaculada Fernández Andrés ◽

Gemma Pastor Cerezuela ◽

Irene Puchol Fraile ◽

Pilar Sanz Cervera

Keyword(s):

Mental Retardation ◽

Executive Functioning ◽

Executive Functions ◽

Fragile X Syndrome ◽

Verbal Fluency ◽

Fragile X ◽

Auditory Memory ◽

Auditory Attention ◽

Lexical Knowledge ◽

Language Variables

Abstract:STUDY ON LANGUAGE AND EXECUTIVE FUNCTIONS OF A CASE OF FRAGILE X SYNDROMEThe main objective of this study is to compare a subject with a clinical diagnosis of Fragile X Syndrome with other disorders (ADHD, Mental Retardation and ASD) in executive functioning and language. The language variables analyzed are lexical knowledge, lexical access, free induced verbal fluency, comprehension instruction and verbal reasoning. On the other hand, the executive functioning variables evaluated are visual and auditory memory, visual and auditory attention, and visual and auditory planning and inhibition. After evaluation, it is checked that Fragile X Syndrome resembles to Mental Retardation and ASD in many of the variables evaluated.Keywords: Fragile X Syndrome, language, executive functions and behavioral profile.Resumen:El objetivo principal de este estudio es comparar un sujeto con diagnóstico clínico de Síndrome de X-Frágil con otros trastornos (TDAH, Retraso Mental y TEA) en funcionamiento ejecutivo y lenguaje. Las variables analizadas en lenguaje son el conocimiento del léxico, el acceso al léxico, la fluencia verbal inducida y libre, la comprensión de instrucciones y el razonamiento verbal. Por otra parte, las variables evaluadas de funcionamiento ejecutivo son la memoria auditiva y visual, la atención auditiva y visual, la planificación, y la inhibición auditiva y visual. Después de la evaluación se comprobó que este caso de síndrome de X-frágil se asemeja al caso de Retraso Mental y de TEA en muchas de las variables evaluadas.Palabras claves: Síndrome de X-Frágil, lenguaje, perfil conductual y funciones ejecutivas.

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Unity or diversity of executive functioning in children and adolescents with posttraumatic stress symptoms? A meta-analysis

10.31234/osf.io/gbv89 ◽

2021 ◽

Author(s):

Otelie Nyvold ◽

Egil Nygaard ◽

Else-Marie Augusti ◽

Christian K. Tamnes

Keyword(s):

Working Memory ◽

Executive Functioning ◽

Executive Functions ◽

Posttraumatic Stress ◽

Verbal Fluency ◽

Meta Analysis ◽

Effect Sizes ◽

Posttraumatic Stress Symptoms ◽

Healthy Controls ◽

Stress Symptoms

For some children the psychological reactions to a traumatic event develop into severe or persistent posttraumatic stress symptoms (PTSS) or the clinical condition of posttraumatic stress disorder (PTSD). Cognitive problems in children with PTSS have been reported, but it is not clear which specific functions are affected. Executive functions is a domain of particular interest, given its importance for academic performance and social and emotional functioning. A systematic literature search was performed and 12 studies with 55 comparisons of executive functions in children with PTSS and healthy controls were eligible for meta-analysis. A subset of the studies also included a comparison group of children with traumatic experienced but without PTSS. Overall, across all tasks and measures, children with PTSS showed lower executive functioning than healthy controls (SMD = -0.57). The effect sizes between the subdomains complex tasks, verbal fluency, inhibition, shifting and working memory were not significantly different from each other, but were largest for verbal fluency (SMD = -1.29) and working memory (SMD = -0.59). Analyses comparing children with traumatic experiences with and without PTSS similarly showed overall lower executive functioning in the PTSS group (SMD = -0.34) and no significant differences in effect sizes between subdomains. The results have implications for assessment and clinical work with youth exposed to traumatic events. We should be aware of the poor executive functioning that may be an issue for some children with a history of trauma and subsequent development of PTSS, and the impact this could have on everyday functioning.

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Study Protocol: The influence of Running Therapy on executive functions and sleep of prisoners

F1000Research ◽

10.12688/f1000research.6469.1 ◽

2015 ◽

Vol 4 ◽

pp. 152 ◽

Cited By ~ 2

Author(s):

Jesse Meijers ◽

Joke Harte ◽

Gerben Meynen ◽

Pim Cuijpers

Keyword(s):

Executive Functioning ◽

Sleep Quality ◽

Executive Functions ◽

Cognitive Functioning ◽

Neuropsychological Tests ◽

Sleep Disturbances ◽

Neuropsychological Test ◽

Executive Dysfunction ◽

Baseline Measurement ◽

Positive Effect

Background: Executive dysfunction appears to be related to increased recidivism. Of note is that sleep disturbances, which are highly prevalent in prisons, may attenuate executive functions. Thus, improving executive functions, either directly or indirectly through the improvement of sleep, may reduce recidivism. It is hypothesised that physical exercise, in the form of Running Therapy, has a direct positive effect on executive functions as well as an indirect effect through the improvement of sleep.Methods/Design: Seventy two (N = 72) detainees in various penitentiary institutions in the Netherlands will be recruited in this study. A baseline measurement, including six neuropsychological tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), an assessment of sleep quality and duration using the Actiwatch (Actiwatch 2, Philips Respironics, Murrysville, PA, USA) and various other measurements will be administered before the start of the treatment. After 3 months of Running Therapy, participants will be assessed again with the same tests for neuropsychological and physical functioning. Primary outcomes are executive functioning and various sleep variables.Discussion: This study will be the first to investigate the possible influence of Running Therapy on the cognitive functioning, sleep and aggression in prisoners.

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Executive Dysfunction Mediates the Association Between Older Age and Online Health Information Search Performance

10.31234/osf.io/cjnyu ◽

2020 ◽

Cited By ~ 1

Author(s):

Victoria Kordovski ◽

Savanna M. Tierney ◽

Samina Rahman ◽

Luis D. Medina ◽

Michelle A. Babicz ◽

...

Keyword(s):

Older Adults ◽

Executive Functions ◽

Information Search ◽

Search Task ◽

Executive Dysfunction ◽

Older Age ◽

The Internet ◽

Younger Adults ◽

Related Information ◽

Health Related

Objective: Searching the Internet for health-related information is a complex and dynamic goal-oriented process that places demands on executive functions, which are higher-order cognitive abilities that are known to deteriorate with older age. This study aimed to examine the effects of older age on electronic health (eHealth) search behavior, and to determine whether executive functions played a mediating role in that regard. Method: Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom diagnosis (Symptom Search), a neurocognitive battery, and a series of questionnaires. Results: Multiple regression models with relevant covariates revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Nevertheless, executive functions mediated the relationship between older age and eHealth Fact Search and Symptom Search accuracy. Conclusions: Older adults can experience difficulty searching the Internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of Internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

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The Impact of Idiopathic Generalized Epilepsy on Executive Functions

Annals of Neurosciences ◽

10.1177/0972753120968751 ◽

2021 ◽

pp. 097275312096875

Author(s):

Haritha Koganti ◽

Shasthara Paneyala ◽

Harsha Sundaramurthy ◽

Nemichandra SC ◽

Rithvik S Kashyap ◽

...

Keyword(s):

Executive Functions ◽

Executive Dysfunction ◽

Cross Sectional Study ◽

Idiopathic Epilepsy ◽

Idiopathic Generalized Epilepsy ◽

Word Fluency ◽

Cross Sectional ◽

Generalized Epilepsy ◽

Multiple Domains ◽

The Impact

Background: Idiopathic generalized epilepsy is defined as seizures with a possible hereditary predisposition without an underlying cause or structural pathology. Assessment of executive dysfunction in idiopathic generalized epilepsies based on standard Indian battery is not available in the literature. Aims and Objectives: To assess specific executive functions affected in patients with idiopathic epilepsy and their association with various variables. Materials and Methods: Type of observational cross-sectional study, where clinical profile of all idiopathic epilepsy patients attending the neurology OPD was studied and their executive higher mental functions were assessed using the NIMHANS battery. Results: A total of 75 idiopathic generalized epilepsy patients were included in the study. Executive functions that were commonly found abnormal in our study were word fluency ( P ≤ .001), category fluency ( P < .001), verbal n-back ( P < .001), Tower of London ( p < 0.01), and Stroop test ( P < 0.01). Executive functions showed a significant correlation with age at symptom onset, duration of epilepsy, and in those with uncontrolled seizures. Conclusion: Patients of idiopathic generalized epilepsy according to the present study were found to have significant executive dysfunction in multiple domains. This necessitates the screening for executive dysfunctions, which if detected should prompt the clinician to initiate cognitive retraining.

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