Executive Function
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Jeevendra Kumar Darshini ◽  
Mohammed Afsar ◽  
Valiyaparambath Purushothaman Vandana ◽  
Dhaval Shukla ◽  
Jamuna Rajeswaran

Abstract Objectives Traumatic brain injury (TBI) is associated with deficits in cognition, language, and communication along with physical and psychosocial consequences. This study aimed at evaluating the association between cognition, language, and communication in a cohort of patients with TBI in southern India using standardized language specific assessment tools. Materials and Methods The present correlational study included 30 patients with TBI of any severity, that is, mild, moderate, and severe within the postinjury period of 6 to 36 months. Comprehensive evaluation of cognition, language, and communication was done using National Institute of Mental Health and Neurosciences Neuropsychology Battery, Indian adapted versions of Western Aphasia Battery and La Trobe Communication Questionnaire (LCQ) respectively. Data Analysis Measures of descriptive statistics, that is, mean, median, percentages, and frequencies, were used. Raw scores, that is, aphasia quotient (AQ), and subdomain scores for LCQ, that is, LCQ-quality, quantity, relation, manner, and cognition, were calculated. Composite scores for the three neuropsychological domains, that is, attention and processing speed, executive function, learning and memory, were evaluated. Partial correlation was computed for identifying the association between the three variables by controlling for age, education, duration, and severity of injury. Results A significant correlation was found between AQ and measures of attention and executive functioning and all measures of LCQ except LCQ-manner. Further, a significant correlation was found between executive functioning and LCQ-total, LCQ-quantity, and LCQ cognition. No correlation was found between measures of attention and memory with communication. Conclusion A good language and executive functioning are associated with better communication abilities in patients with TBI thus emphasizing on the importance of a multidisciplinary team for the management of cognitive-communication impairments following a TBI.

2021 ◽  
Vol 13 ◽  
Chen Xue ◽  
Wenzhang Qi ◽  
Qianqian Yuan ◽  
Guanjie Hu ◽  
Honglin Ge ◽  

Background: Subjective cognitive decline and amnestic mild cognitive impairment (aMCI) were widely thought to be preclinical AD spectrum disorders, characterized by aberrant functional connectivity (FC) within the triple networks of the default mode network (DMN), the salience network (SN), and the executive control network (ECN). Dynamic FC (DFC) analysis can capture temporal fluctuations in brain FC during the scan, which static FC analysis cannot. The purpose of the current study was to explore the changes in dynamic FC within the triple networks of the preclinical AD spectrum and further reveal their potential diagnostic value in diagnosing preclinical AD spectrum disorders.Methods: We collected resting-state functional magnetic resonance imaging data from 44 patients with subjective cognitive decline (SCD), 49 with aMCI, and 58 healthy controls (HCs). DFC analysis based on the sliding time-window correlation method was used to analyze DFC variability within the triple networks in the three groups. Then, correlation analysis was conducted to reveal the relationship between altered DFC variability within the triple networks and a decline in cognitive function. Furthermore, logistic regression analysis was used to assess the diagnostic accuracy of altered DFC variability within the triple networks in patients with SCD and aMCI.Results: Compared with the HC group, the groups with SCD and aMCI both showed altered DFC variability within the triple networks. DFC variability in the right middle temporal gyrus and left inferior frontal gyrus (IFG) within the ECN were significantly different between patients with SCD and aMCI. Moreover, the altered DFC variability in the left IFG within the ECN was obviously associated with a decline in episodic memory and executive function. The logistic regression analysis showed that multivariable analysis had high sensitivity and specificity for diagnosing SCD and aMCI.Conclusions: Subjective cognitive decline and aMCI showed varying degrees of change in DFC variability within the triple networks and altered DFC variability within the ECN involved episodic memory and executive function. More importantly, altered DFC variability and the triple-network model proved to be important biomarkers for diagnosing and identifying patients with preclinical AD spectrum disorders.

Cameron Hicks ◽  
Erika M. Pliner ◽  
Stephen R. Lord ◽  
Daina L. Sturnieks

Ladder fall and injury risk increases with age. People who present to a hospital after an injurious ladder fall have been surveyed, but little is known about ladder use in the community. The purpose of this study was to: (1) document salient factors related to ladder safety, and (2) determine physical, executive function, psychological and frequency-of-use factors associated with unsafe ladder use in older people. One hundred and two older people (aged 65+ years) were recruited. Participants completed questionnaires on demographics, health, and ladder use (type, frequency, task, behaviours) and underwent assessments of physical and executive function ability. Results showed both older men and women commonly use step ladders (61% monthly, 96% yearly), mostly inside the home for tasks such as changing a lightbulb (70%) and decorating (43%). Older men also commonly use straight ladders (27% monthly, 75% yearly), mostly outside the home for tasks such as clearing gutters (74%) and pruning trees (40%). Unsafe ladder use was more common in males and individuals with greater ladder use frequency, greater quadriceps strength, better upper limb dexterity, better balance, better stepping ability, greater self-reported everyday risk-taking, a lower fear of falling, and fewer health problems compared to their counterparts (all p < 0.05). These findings document ladder use by older people and provide insight into unsafe ladder behaviours that may be amenable to interventions to reduce ladder falls and associated injuries.

Assessment ◽  
2021 ◽  
pp. 107319112110451
Alan Smerbeck ◽  
Lauren Olsen ◽  
Lindsay F. Morra ◽  
Jeremy Raines ◽  
David J. Schretlen ◽  

The Global Neuropsychological Assessment (GNA) is an extremely brief battery of cognitive tasks assessing episodic memory, processing speed, working memory, verbal fluency, executive function, and mood. It can be given in under 15 minutes, has five alternate forms, and does not require an examinee to be literate. The purpose of this study was to quantify practice effects over repeated administrations and assess comparability of the GNA’s five alternate forms, preparing the battery for repeated administration in research and clinical settings. Forty participants each completed all five GNA forms at weekly intervals following a Latin square design (i.e., each form was administered at every position in the sequence an equal number of times). In a cognitively intact population, practice effects of 0.56 to 1.06 SD were observed across GNA measures when comparing the first and fifth administration. Most GNA tests showed nonsignificant interform differences with cross-form means differing by 0.35 SD or less, with the exception of modest but statistically significant interform differences for the GNA Story Memory subtest across all five forms. However, post hoc analysis identified clusters of two and three Story Memory alternate forms that were equivalent.

2021 ◽  
Vol 13 ◽  
Shraddha Sapkota ◽  
G. Peggy McFall ◽  
Mario Masellis ◽  
Roger A. Dixon

Background: Multiple modalities of Alzheimer’s disease (AD) risk factors may operate through interacting networks to predict differential cognitive trajectories in asymptomatic aging. We test such a network in a series of three analytic steps. First, we test independent associations between three risk scores (functional-health, lifestyle-reserve, and a combined multimodal risk score) and cognitive [executive function (EF)] trajectories. Second, we test whether all three associations are moderated by the most penetrant AD genetic risk [Apolipoprotein E (APOE) ε4+ allele]. Third, we test whether a non-APOE AD genetic risk score further moderates these APOE × multimodal risk score associations.Methods: We assembled a longitudinal data set (spanning a 40-year band of aging, 53–95 years) with non-demented older adults (baseline n = 602; Mage = 70.63(8.70) years; 66% female) from the Victoria Longitudinal Study (VLS). The measures included for each modifiable risk score were: (1) functional-health [pulse pressure (PP), grip strength, and body mass index], (2) lifestyle-reserve (physical, social, cognitive-integrative, cognitive-novel activities, and education), and (3) the combination of functional-health and lifestyle-reserve risk scores. Two AD genetic risk markers included (1) APOE and (2) a combined AD-genetic risk score (AD-GRS) comprised of three single nucleotide polymorphisms (SNPs; Clusterin[rs11136000], Complement receptor 1[rs6656401], Phosphatidylinositol binding clathrin assembly protein[rs3851179]). The analytics included confirmatory factor analysis (CFA), longitudinal invariance testing, and latent growth curve modeling. Structural path analyses were deployed to test and compare prediction models for EF performance and change.Results: First, separate analyses showed that higher functional-health risk scores, lifestyle-reserve risk scores, and the combined score, predicted poorer EF performance and steeper decline. Second, APOE and AD-GRS moderated the association between functional-health risk score and the combined risk score, on EF performance and change. Specifically, only older adults in the APOEε4− group showed steeper EF decline with high risk scores on both functional-health and combined risk score. Both associations were further magnified for adults with high AD-GRS.Conclusion: The present multimodal AD risk network approach incorporated both modifiable and genetic risk scores to predict EF trajectories. The results add an additional degree of precision to risk profile calculations for asymptomatic aging populations.

2021 ◽  
Philipp Berger ◽  
Charlotte Grosse Wiesmann

The rapid detection and resolution of conflict between opposing action tendencies is crucial for our ability to engage in goal-directed behavior. Research in adults suggests that emotions might serve as a ‘relevance detector’ that alarms attentional and sensory systems, thereby leading to more efficient conflict processing. In contrast, previous research in children has almost exclusively stressed the impeding influence of emotion on the attentional system, as suggested by the protracted development of performance in ‘hot’ executive function tasks. How does emotion modulate conflict processing in development? We addressed this question applying a modified version of a color flanker task that either involved or did not involve emotional stimuli in preschool children (N = 43, with preregistered Bayesian sequential design, aged 2.8 – 7.0 years). Our results show a robust conflict effect with higher error rates in incongruent compared to congruent trials. Crucially, conflict resolution was faster in emotional compared to neutral conditions. Furthermore, while efficient conflict processing increases with age, we find evidence against an age-related change in the influence of emotion on conflict processing. Taken together, these findings provide first indication that emotion can trigger efficient control processes already from early on in life. In contrast to previous findings and theories in developmental psychology, this indicates that, depending on the role that emotion has in conflict processing, emotion may show a facilitative or impeding effect.

2021 ◽  
Vol 11 (9) ◽  
pp. 1220
Christy L. Hom ◽  
Katharine A. Kirby ◽  
Joni Ricks-Oddie ◽  
David B. Keator ◽  
Sharon J. Krinsky-McHale ◽  

Accurate identification of the prodromal stage of Alzheimer’s disease (AD), known as mild cognitive impairment (MCI), in adults with Down syndrome (MCI-DS) has been challenging because there are no established diagnostic criteria that can be applied for people with lifelong intellectual disabilities (ID). As such, the sequence of cognitive decline in adults with DS has been difficult to ascertain, and it is possible that domain constructs characterizing cognitive function in neurotypical adults do not generalize to this high-risk population. The present study examined associations among multiple measures of cognitive function in adults with DS, either prior to or during the prodromal stage of AD to determine, through multiple statistical techniques, the measures that reflected the same underlying domains of processing. Participants included 144 adults with DS 40–82 years of age, all enrolled in a larger, multidisciplinary study examining biomarkers of AD in adults with DS. All participants had mild or moderate lifelong intellectual disabilities. Overall AD-related clinical status was rated for each individual during a personalized consensus conference that considered performance as well as health status, with 103 participants considered cognitively stable (CS) and 41 to have MCI-DS. Analyses of 17 variables derived from 10 tests of cognition indicated that performance reflected three underlying factors: language/executive function, memory, and visuomotor. All three domain composite scores significantly predicted MCI-DS status. Based upon path modeling, the language/executive function composite score was the most affected by prodromal AD. However, based upon structural equation modeling, tests assessing the latent construct of memory were the most impacted, followed by those assessing visuomotor, and then those assessing language/executive function. Our study provides clear evidence that cognitive functioning in older adults with DS can be characterized at the cognitive domain level, but the statistical methods selected and the inclusion or exclusion of certain covariates may lead to different conclusions. Best practice requires investigators to understand the internal structure of their variables and to provide evidence that their variables assess their intended constructs.

2021 ◽  
Joshua McCall ◽  
Jonathan Vivian Dickens ◽  
Ayan Mandal ◽  
Andrew Tesla DeMarco ◽  
Mackenzie Fama ◽  

Optimal performance in any task relies on the ability to detect and repair errors. The anterior cingulate cortex and the broader posterior medial frontal cortex (pMFC) are active during error processing. However, it is unclear whether damage to the pMFC impairs error monitoring. We hypothesized that successful error monitoring critically relies on connections between the pMFC and broader cortical networks involved in executive functions and the task being monitored. We tested this hypothesis in the context of speech error monitoring in people with post-stroke aphasia. Diffusion weighted images were collected in 51 adults with chronic left-hemisphere stroke and 37 age-matched control participants. Whole-brain connectomes were derived using constrained spherical deconvolution and anatomically-constrained probabilistic tractography. Support vector regressions identified white matter connections in which lost integrity in stroke survivors related to reduced error detection during confrontation naming. Lesioned connections to the bilateral pMFC were related to reduced error monitoring, including many connections to regions associated with speech production and executive function. We conclude that connections to the pMFC support error monitoring. Error monitoring in speech production is supported by the structural connectivity between the pMFC and regions involved in speech production and executive function. Interactions between pMFC and other task relevant processors may similarly be critical for error monitoring in other task contexts.

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