Basic and complex cognitive functions in Adult ADHD

Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.

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Transdiagnostic neurocognitive endophenotypes in major psychiatric illness

10.1101/2020.02.14.20022863 ◽

2020 ◽

Author(s):

Bharath Holla ◽

Pavithra Dayal ◽

Aswathy Das ◽

Mahashweta Bhattacharya ◽

V Manjula ◽

...

Keyword(s):

Working Memory ◽

Social Cognition ◽

Cognitive Flexibility ◽

Processing Speed ◽

Psychiatric Illness ◽

Parental Education ◽

Verbal Learning ◽

Multiplex Family ◽

Compulsive Disorder ◽

Neurocognitive Functions

AbstractWe aimed to characterize potential transdiagnostic neurocognitive endophenotypes in a large cohort of multiplex families affected with two or more individuals having a major psychiatric illness(MPI) i.e., schizophrenia(SCZ), bipolar disorder(BPAD), substance use disorders(SUD) and obsessive-compulsive disorder(OCD). We recruited 640 individuals that included 256 affected individuals with MPI, 227 of their unaffected first-degree relatives(FDR) and 157 population healthy-controls(PHC). Neurocognitive battery included assessments of executive function, working memory, social cognition, verbal learning and recall. Linear mixed effects models were applied to the neurocognitive components to examine their transdiagnostic and endophenotype status after accounting for demographic and family variables. We also examined the relationship of cognitive domains with diagnosis-specific Family History Density score(FHD).The deficits in cognitive flexibility, working memory and social cognition were transdiagnostic; processing speed was impaired in SCZ and BPAD groups while verbal learning and recall in SCZ, BPAD and SUD groups. These deficits with the exception of social cognition, worsened with age and parental education had protective effect. The unaffected FDRs had deficits in all the domains except processing speed in comparison to PHC; social cognition deficits were comparable to affected individuals. The diagnosis-specific FHD analysis showed that deficits in cognitive flexibility, working memory and social cognition were endophenotypes across disorders.Evaluation of neurocognitive functions across multiple affected individuals in a large multiplex family-based cross-disorder cohort, has the potential to elucidate transdiagnostic as well as endophenotype vulnerabilities to psychiatric illness. This study adds to the emerging conceptualization of psychiatric illness as a combination of both diagnosis-specific and transdiagnostic markers.

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Cognition in Early Relapsing-Remitting Multiple Sclerosis: Consequences May Be Relative to Working Memory

Journal of the International Neuropsychological Society ◽

10.1017/s1355617713000696 ◽

2013 ◽

Vol 19 (8) ◽

pp. 938-949 ◽

Cited By ~ 12

Author(s):

Lindsay I. Berrigan ◽

Jo-Anne LeFevre ◽

Laura M. Rees ◽

Jason Berard ◽

Mark S. Freedman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Working Memory ◽

Processing Speed ◽

Cognitive Functions ◽

Group Membership ◽

Equation Modeling ◽

Mediating Role ◽

Relapsing Remitting ◽

Disease Stages

AbstractThe Relative Consequence Model proposes multiple sclerosis (MS) patients have a fundamental deficit in processing speed that compromises other cognitive functions. The present study examined the mediating role of processing speed, as well as working memory, in the MS-related effects on other cognitive functions for early relapsing-remitting patients. Seventy relapsing-remitting MS patients with disease duration not greater than 10 years and 72 controls completed tasks assessing processing speed, working memory, learning, and executive functioning. The possible mediating roles of speed and working memory in the MS-related effects on other cognitive functions were evaluated using structural equation modeling. Processing speed was not significantly related to group membership and could not have a mediating role. Working memory was related to group membership and functioned as a mediating/intervening factor. The results do not support the Relative Consequence Model in this sample and they challenge the notion that working memory impairment only emerges at later disease stages. The results do support a mediating/intervening role of working memory. These results were obtained for early relapsing-remitting MS patients and should not be generalized to the broader MS population. Instead, future research should examine the relations that exist at other disease stages. (JINS, 2013, 19, 1–12)

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Cognitive dysfunction in adolescents with chronic fatigue: a cross-sectional study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-306764 ◽

2015 ◽

Vol 100 (9) ◽

pp. 838-844 ◽

Cited By ~ 14

Author(s):

Dag Sulheim ◽

Even Fagermoen ◽

Øyvind Stople Sivertsen ◽

Anette Winger ◽

Vegard Bruun Wyller ◽

...

Keyword(s):

Working Memory ◽

Cognitive Function ◽

Processing Speed ◽

Sleep Problems ◽

Verbal Learning ◽

Chronic Fatigue ◽

Cross Sectional Study ◽

Cognitive Inhibition ◽

Sectional Study ◽

Cross Sectional

ObjectiveTo compare cognitive function in adolescents with chronic fatigue with cognitive function in healthy controls (HC).Study designCross-sectional study.SettingPaediatric department at Oslo University Hospital, Norway.Participants120 adolescents with chronic fatigue (average age 15.4 years; range 12–18) and 39 HC (average age 15.2 years; range 12–18).MethodsThe adolescents completed a neurocognitive test battery measuring processing speed, working memory, cognitive inhibition, cognitive flexibility, verbal learning and verbal memory, and questionnaires addressing demographic data, depression symptoms, anxiety traits, fatigue and sleep problems. Parents completed the Behaviour Rating Inventory of Executive Function (BRIEF), which measures the everyday executive functions of children.ResultsAdolescents with chronic fatigue had impaired cognitive function compared to HC regarding processing speed (mean difference 3.3, 95% CI 1.1 to 5.5, p=0.003), working memory (−2.4, −3.7 to −1.1, p<0.001), cognitive inhibition response time (6.2, 0.8 to 11.7, p=0.025) and verbal learning (−1.7, −3.2 to −0.3, p=0.022). The BRIEF results indicated that everyday executive functions were significantly worse in the chronic fatigue group compared to the HC (11.2, 8.2 to 14.3, p<0.001). Group differences remained largely unaffected when adjusted for symptoms of depression, anxiety traits and sleep problems.ConclusionsAdolescents with chronic fatigue had impaired cognitive function of clinical relevance, measured by objective cognitive tests, in comparison to HC. Working memory and processing speed may represent core difficulties.

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Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

International Journal of Social Psychiatry ◽

10.1177/0020764019897697 ◽

2020 ◽

Vol 66 (3) ◽

pp. 240-248 ◽

Cited By ~ 1

Author(s):

Afaf Hamed Khalil ◽

Marwa Abd el-Meguid ◽

Mostafa Bastawy ◽

Samah Rabei ◽

Ramy Ali ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Problem Solving ◽

Cognitive Functions ◽

Visual Learning ◽

Verbal Learning ◽

General Psychopathology ◽

Cognitive Domains ◽

Reasoning Problem ◽

Egyptian Patients

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

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The relationship between premorbid adjustment and cognitive dysfunction in schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.023 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S78-S79

Author(s):

P. Stefanatou ◽

C.S. Karatosidi ◽

E. Kattoulas ◽

N. Stefanis ◽

N. Smyrnis

Keyword(s):

Processing Speed ◽

Cognitive Functions ◽

Developmental Stages ◽

Verbal Learning ◽

Prognostic Indicators ◽

Intellectual Quotient ◽

Premorbid Adjustment ◽

Before And After ◽

Competing Interest ◽

The Relationship

IntroductionPremorbid adjustment (PA) is one of the main prognostic indicators of schizophrenia. Both social and cognitive deficits observed during the premorbid period hold a predictive value for the onset of schizophrenia.ObjectivesTo investigate how cognitive functions are related to aspects of PA.AimsTo examine the relationship of each PA domain (academic and social) at each of the three developmental stages (childhood, early adolescence and late adolescence), as well as their course with the cognitive functions in schizophrenia patients.MethodsPA, intellectual quotient (IQ), verbal learning, memory, processing speed, executive functions and verbal fluency were assessed using PAS, WAIS, RAVLT, TMT, WCST and COWAT measures respectively in a sample of 85 clinically stabilized male schizophrenia inpatients.ResultsNegative correlations emerged between academic PA during adolescence and both verbal IQ and processing speed, while positive correlations were found with working memory. Negative correlations emerged between deterioration in academic PA during adolescence and both processing speed and immediate auditory verbal recall, while correlations with verbal learning were positive. There was no relationship between cognitive functions and either social PA or its deterioration.ConclusionOur findings revealed significant associations between both academic PA and its course with cognitive functions in schizophrenia patients. In summary, deficits in several fields of cognitive functions seem to follow a different path long before and after the onset of the disease, but further investigation is necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Processing speed impairment in schizophrenia is mediated by white matter integrity

Psychological Medicine ◽

10.1017/s0033291714001111 ◽

2014 ◽

Vol 45 (1) ◽

pp. 109-120 ◽

Cited By ~ 40

Author(s):

H. Karbasforoushan ◽

B. Duffy ◽

J. U. Blackford ◽

N. D. Woodward

Keyword(s):

Working Memory ◽

White Matter ◽

Executive Functioning ◽

Functional Outcome ◽

Processing Speed ◽

Healthy Subjects ◽

Verbal Learning ◽

Group Differences ◽

Neural Basis ◽

Mediation Effects

BackgroundProcessing speed predicts functional outcome and is a potential endophenotype for schizophrenia. Establishing the neural basis of processing speed impairment may inform the treatment and etiology of schizophrenia. Neuroimaging investigations in healthy subjects have linked processing speed to brain anatomical connectivity. However, the relationship between processing speed impairment and white matter (WM) integrity in schizophrenia is unclear.MethodIndividuals with schizophrenia and healthy subjects underwent diffusion tensor imaging (DTI) and completed a brief neuropsychological assessment that included measures of processing speed, verbal learning, working memory and executive functioning. Group differences in WM integrity, inferred from fractional anisotropy (FA), were examined throughout the brain and the hypothesis that processing speed impairment in schizophrenia is mediated by diminished WM integrity was tested.ResultsWM integrity of the corpus callosum, cingulum, superior and inferior frontal gyri, and precuneus was reduced in schizophrenia. Average FA in these regions mediated group differences in processing speed but not in other cognitive domains. Diminished WM integrity in schizophrenia was accounted for, in large part, by individual differences in processing speed.ConclusionsCognitive impairment in schizophrenia was mediated by reduced WM integrity. This relationship was strongest for processing speed because deficits in working memory, verbal learning and executive functioning were not mediated by WM integrity. Larger sample sizes may be required to detect more subtle mediation effects in these domains. Interventions that preserve WM integrity or ameliorate WM disruption may enhance processing speed and functional outcome in schizophrenia.

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Processing Speed Mediates Executive Function Difficulties in Very Preterm Children in Middle Childhood

Journal of the International Neuropsychological Society ◽

10.1017/s1355617711000373 ◽

2011 ◽

Vol 17 (3) ◽

pp. 445-454 ◽

Cited By ~ 44

Author(s):

Hanna Mulder ◽

Nicola J. Pitchford ◽

Neil Marlow

Keyword(s):

Working Memory ◽

Executive Function ◽

Middle Childhood ◽

Behavioral Problems ◽

Processing Speed ◽

Verbal Fluency ◽

Very Preterm ◽

Attention Tasks ◽

Basic Functions ◽

Attention Difficulties

AbstractExecutive function and attention difficulties are reported in very preterm (VPT) children at school entry, but it is unclear if these remain at later ages and/or if these difficulties are mediated by more basic functions, such as processing speed. Processing speed has been shown to underlie academic and behavioral problems in VPT children in middle childhood (Mulder, Pitchford, & Marlow, 2010, 2011), so may also underpin executive function and attention difficulties. We investigated this by comparing VPT (gestational age <31 weeks; N = 56) to term children (N = 22) aged 9–10 years on a comprehensive battery of executive function and attention tasks from the Test of Everyday Attention for Children (Manly, Robertson, Anderson, & Nimmo-Smith, 1999) and NEPSY (Korkman, Kirk, & Kemp, 1998). Selective and sustained attention, inhibition, working memory, shifting, verbal fluency, planning, and processing speed were examined. Group differences favoring term children were shown on most executive function tasks (i.e., inhibition, working memory, verbal fluency, and shifting), all of which were mediated by slow processing speed in the VPT group, except response inhibition. Seemingly, processing speed is an important determinant underpinning many neuropsychological deficits seen in VPT children in middle childhood. (JINS, 2011, 17, 445–454)

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Cannabis and cognitive performance in psychosis: a cross-sectional study in patients with non-affective psychotic illness and their unaffected siblings

Psychological Medicine ◽

10.1017/s0033291711001656 ◽

2011 ◽

Vol 42 (4) ◽

pp. 705-716 ◽

Cited By ~ 23

Author(s):

J. H. Meijer ◽

N. Dekker ◽

M. W. Koeter ◽

P. J. Quee ◽

N. J. M. van Beveren ◽

...

Keyword(s):

Working Memory ◽

Cognitive Functioning ◽

Processing Speed ◽

Verbal Learning ◽

Cross Sectional Study ◽

Cannabis Use ◽

Cognitive Test ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge Reasoning

BackgroundThe relationship between cannabis use and cognitive functioning in patients with psychosis has yielded contradictory findings. In individuals at genetic high risk for psychosis, information is sparse. The aim of this study was to assess the association between recency and frequency of cannabis use and cognitive functioning in patients with psychosis and their unaffected siblings.MethodWe conducted a cross-sectional study in 956 patients with non-affective psychosis, 953 unaffected siblings, and 554 control subjects. Participants completed a cognitive test battery including assessments of verbal learning, set shifting, sustained attention, processing speed, working memory, acquired knowledge, reasoning and problem solving and social cognition. Cannabis use was assessed by urinalysis and by the Composite International Diagnostic Interview. Using random-effect regression models the main effects of cannabis (recency and frequency) and the interaction with status (patient, sibling, control) on cognitive functioning were assessed.ResultsCurrent cannabis use was associated with poorer performance on immediate verbal learning, processing speed and working memory (Cohen's d −0.20 to −0.33, p<0.005). Lifetime cannabis use was associated with better performance on acquired knowledge, facial affect recognition and face identity recognition (Cohen's d+0.17 to +0.33, p<0.005). There was no significant interaction between cannabis and status on cognitive functioning.ConclusionsLifetime cannabis-using individuals might constitute a subgroup with a higher cognitive potential. The residual effects of cannabis may impair short-term memory and processing speed.

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Investigation of a Model-Based Working Memory Training With and Without Distractor Inhibition and Its Comparative Efficacy: A Randomized Controlled Trial on Healthy Old Adults

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.682474 ◽

2021 ◽

Vol 13 ◽

Author(s):

Priska Zuber ◽

Emanuel Geiter ◽

Dominique J.-F. de Quervain ◽

Stefano Magon

Keyword(s):

Working Memory ◽

Processing Speed ◽

Verbal Learning ◽

Practice Effects ◽

Comparative Efficacy ◽

Far Transfer ◽

Distractor Inhibition ◽

Randomized Controlled ◽

Model Based ◽

Univariate Analyses

Background: Various working memory (WM) trainings have been tested, but differences in experimental designs, the lack of theoretical background, and the need of identifying task-related processes such as filtering efficiency limit conclusions about their comparative efficacy.Objectives: In this study, we compared the efficacy of a model-based WM training with (MB+) and without (MB) distractor inhibition on improving WM capacity to a dual n-back and active control condition.Methods: This randomized clinical trial included 123 healthy elderly adults (78 women, 45 men; aged 64.1 ± 8.3 years). All groups underwent 12 40-min training sessions over 3 weeks and four cognitive testing sessions. The first two sessions served as double baseline to account for practice effects. Primary outcome was WM capacity post-training measured by complex span tasks. Near and far transfer was assessed by simple span, n-back, visuospatial and verbal learning, processing speed, and reasoning tasks.Results: Due to preliminary termination (COVID-19), 93 subjects completed the post-training and 60 subjects the follow-up session. On a whole group level, practice effects occurred from prebaseline to baseline in WM capacity (b = 4.85, t(103) = 4.01, p < 0.001, r = 0.37). Linear mixed-effects models revealed a difference in WM capacity post-training between MB+ and MB (b = −9.62, t(82) = −2.52, p = 0.014, r = 0.27) and a trend difference between MB+ and dual n-back (b = −7.59, t(82) = −1.87, p = 0.065, r = 0.20) and control training (b = −7.08, t(82) = −1.86, p = 0.067, r = 0.20). Univariate analyses showed an increase between pre- and post-training for WM capacity within MB+ (t(22) = −3.34, p < 0.05) only. There was no difference between groups pre- and post-training regarding near and far transfer. Univariate analyses showed improved visuospatial learning within MB+ (t(21) = −3.8, p < 0.05), improved processing speed (t(23) = 2.19, p< 0.05) and n-back performance (t(23) = 2.12, p < 0.05) in MB, and improved n-back performance (t(25) = 3.83, p < 0.001) in the dual n-back training.Interpretation: A model-based WM training including filtering efficacy may be a promising approach to increase WM capacity and needs further investigation in randomized controlled studies.

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Executive functions in children with dyslexia

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190033 ◽

2019 ◽

Vol 77 (4) ◽

pp. 254-259

Author(s):

Thais Barbosa ◽

Camila Cruz Rodrigues ◽

Claudia Berlim de Mello ◽

Mariana Cristina de Souza e Silva ◽

Orlando Francisco Amodeo Bueno

Keyword(s):

Working Memory ◽

Executive Function ◽

Selective Attention ◽

Executive Functions ◽

Inhibitory Control ◽

Neuropsychological Tests ◽

Memory Deficits ◽

Typical Development ◽

Phonological Skill ◽

Memory Inhibition

ABSTRACT This study aimed to verify whether children with dyslexia have difficulties in executive functions (shifting, working memory, inhibition). Methods: A sample of 47 children (ages 8-13 years) participated in the study: 24 who were dyslexic and 23 controls with typical development. A battery of neuropsychological tests was used. Results: Results revealed executive function difficulties among the dyslexic children when compared with controls, encompassing selective attention modulation processes, shifting, and inhibitory control. These difficulties appeared to be affected by phonological working memory deficits, typically associated with dyslexia. Conclusion: Our findings support the consensus among scholars regarding the central involvement of phonological skill dysfunctions in dyslexia.

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