Control functions of the frontal lobes. Modularity of the central-supervisory system?

Same, Same but Different? A Multi-Method Review of the Processes Underlying Executive Control

Attention, working memory, and executive control are commonly considered distinct cognitive functions with important reciprocal interactions. Yet, longstanding evidence from lesion studies has demonstrated both overlap and dissociation in their behavioural expression and anatomical underpinnings, suggesting that a lower dimensional framework could be employed to further identify processes supporting goal-directed behaviour. Here, we describe the anatomical and functional correspondence between attention, working memory, and executive control by providing an overview of cognitive models, as well as recent data from lesion studies, invasive and non-invasive multimodal neuroimaging and brain stimulation. We emphasize the benefits of considering converging evidence from multiple methodologies centred on the identification of brain mechanisms supporting goal-driven behaviour. We propose that expanding on this approach should enable the construction of a comprehensive anatomo-functional framework with testable new hypotheses, and aid clinical neuroscience to intervene on impairments of executive functions.

Impact of corpus callosum integrity on functional interhemispheric connectivity and cognition in healthy subjects

To examine the corpus callosum's (CC) integrity in terms of fractional anisotropy (FA) and how it affects resting-state hemispheric connectivity (rs-IHC) and cognitive function in healthy individuals. Sixty-eight healthy individuals were recruited for the study. The global FA (gFA) and FA values of each CC tract (forceps minor, body, tapetum, and forceps major) were evaluated using diffusion-weighted imaging (DWI) sequences. The homotopic functional connectivity technique was used to quantify the effects of FA in the CC tracts on bilateral functional connectivity, including the confounding effect of gFA. Brain regions with higher or lower rs-IHC were identified using the threshold-free cluster enhancement family-wise error-corrected p-value of 0.05. The null hypothesis was rejected if the p-value was ≤ 0.05 for the nonparametric partial correlation technique. Several clusters of increased rs-IHC were identified in relation to the FA of individual CC tracts, each with a unique topographic distribution and extension. Only forceps minor FA values correlated with cognitive scores. The integrity of CC influences rs-IHC differently in healthy subjects. Specifically, forceps minor anisotropy impacts rs-IHC and cognition more than other CC tracts do.

Executive Function in Deaf Native Signing Children

The aim of this study is twofold: To examine if deafness is invariably associated with deficits in executive function (EF) and to investigate the relationship between sign language proficiency and EF in deaf children of deaf parents with early exposure to a sign language. It is also the first study of EF in children acquiring Polish Sign Language. Even though the mothers of the deaf children (N = 20) had lower levels of education compared with the mothers of a hearing control group, the children performed similarly to their hearing peers (N = 20) on a variety of EF task-based assessments. Only in the Go/No-go task were weaker inhibition skills observed in younger deaf children (6-9 years) compared with hearing peers, and this difference was not seen in older children (10-12 years). Hence, deafness does not necessarily impair EF; however, attentional and inhibition abilities may be acquired via a different route in deaf children. Sign language receptive skills predicted EF in deaf children. In conclusion, we highlight the importance of deaf parenting building the scaffolding for EF in deaf children.

A Neuroscience Primer for Integrating Geroscience With the Neurobiology of Aging

Neuroscience has a rich history of studies focusing on neurobiology of aging. However, much of the aging studies in neuroscience occur outside of the gerosciences. The goal of this primer is 2-fold: first, to briefly highlight some of the history of aging neurobiology and second, to introduce to geroscientists the broad spectrum of methodological approaches neuroscientists use to study the neurobiology of aging. This primer is accompanied by a corresponding geroscience primer, as well as a perspective on the current challenges and triumphs of the current divide across these 2 fields. This series of manuscripts is intended to foster enhanced collaborations between neuroscientists and geroscientists with the intent of strengthening the field of cognitive aging through inclusion of parameters from both areas of expertise.

Neurocognitive factorial structure of executive functions: Evidence from neurotypicals and frontotemporal dementia

The latent structure of executive functions (EFs) remains controversial. Confirmatory factorial analysis (CFA) has provided support for both multidimensional (assumes EFs to be functionally separable but related components) and bifactor (proposes all components are nested within a common factor) models. However, these CFA models have never been compared in patient samples, nor regarding their neuroanatomical correlates. Here, we systematically contrast both approaches in neurotypicals and in a neurodegenerative lesion model (patients with the behavioral variant frontotemporal dementia, bvFTD), characterized by executive deficits associated with frontal neurodegeneration. First, CFA was used to test the models' fit in a sample of 341 neurotypicals and 29 bvFTD patients based on performance in an executive frontal screening battery which assesses working memory, motor inhibition, verbal inhibition, and abstraction capacity. Second, we compared EFs factor and observed scores between patients and matched controls. Finally, we used voxel-based morphometry (VBM) to compare the grey matter correlates of factor and observed scores. CFA results showed that both models fit the data well. The multidimensional model, however, was more sensitive than the bifactor model and the observed scores to detect EFs impairments in bvFTD patients. VBM results for the multidimensional model revealed common and unique grey matter correlates for EFs components across prefrontal-insular, posterior, and temporal cortices. Regarding the bifactor model, only the common factor was associated with prefrontal-insular hubs. Observed scores presented scant, non-frontal grey matter associations. Converging behavioral and neuroanatomical evidence from healthy populations and a neurodegenerative model of EFs supports an underlying multidimensional structure.

A Dissociation of Attention, Executive Function and Reaction to Difficulty: Development of the MindPulse Test, a Novel Digital Neuropsychological Test for Precise Quantification of Perceptual-Motor Decision-Making Processes

Traditionally, neuropsychological testing has assessed processing speed and precision, closely related to the ability to perform high-order cognitive tasks. An individual making a decision under time pressure must constantly rebalance its speed to action in order to account for possible errors. A deficit in processing speed appears to be afrequent disorder caused by cerebral damage — but it can be hard to pinpoint the exact cause of the slowdown. It is therefore important to separate the perceptual-motor component of processing speed from the decision-time component. We present a technique to isolate Reaction Times (RTs): a short digital test to assess the decision-making abilities of individuals by gauging their ability to balance between speed and precision. Our hypothesis is that some subjects willaccelerate, and others slow down in the face of the difficulty. This pilot study, conducted on 83 neurotypical adult volunteers, used images stimuli. The test was designed to measure RTs and correctness. After learning release gesture, the subjects were presented with three tasks: a simple Reaction Time task, a Go/No-Go, and a complex Go/No-Go with 2 simultaneous Choices. All three tasks have in common a perceptual component and a motor response. By measuring the 3 reference points requiring attentional and executive processing, while progressively increasing the conceptual complexity of the task, we were able to compare the processing times for different tasks — thus calculating the deceleration specific to the reaction time linked to difficulty. We defined the difficulty coefficient of a task as being the ratio of the group average time of this task minus the base time/average time of the unit task minus the base time. We found that RTs can be broken down into three elementary, uncorrelated components: Reaction Time, Executive Speed, and Reaction to Difficulty (RD). We hypothesized that RD reflects how the subject reacts to difficulty by accelerating (RD < 0) or decelerating (RD > 0). Thus we provide here a first proof of concept: the ability to measure four axes of the speed-precision trade-off inherent in a subject’s fundamental decision making: perceptual-motor speed, executive speed, subject accuracy, and reaction to difficulty.

Executive Functions in panic disorder: A mini-review

BACKGROUND

Panic disorder (PD) is an anxiety disorder characterized by recurrent panic attacks whose aetiology might be associated with alterations of the prefrontal-amygdala circuitry. The prefrontal cortex is a key region involved in executive functioning (EF) whose disturbance may imply harsh consequences over personal, social, and working aspects of PD patients. Indeed, defining the real involvement of EF in PD could lead to early assessment, better treatment, and rehabilitation options. These could have a substantial impact on the quality of life of these patients and their caregivers, thus reducing long-term health care needs.

METHODS

We reviewed findings from different studies that investigated executive functioning in PD patients using standardized neuropsychological measures. The review was conducted with the Preferred Reported Items for Systematic Reviews and Meta-Analysis (PRISMA). In addition, peer-reviewed human-based research articles were selected and twelve studies were retrieved through a search on PubMed. Four uniquely focused on PD patients, two also included a sample of first-degree relatives, while six included a mixed sample of different psychiatric illnesses, including PD.

RESULTS

The majority of the studies found no alterations in PD patients, suggesting that EF might not be a core deficit in this disorder. However, some studies (N = 4) found EF deficits in selective domains, which included attention and set-shifting processes, cognitive flexibility, decision-making abilities, and working memory in PD patients and/or in their first-degree relatives.

LIMITATIONS

Unbalanced and small samples, unmonitored therapies, and the heterogeneity of cognitive and diagnostic assessment measures might have limited the generalizability of the results.

CONCLUSIONS

Overall, the results point towards the hypothesis that PD patients had preserved EF. However, future studies with standardized methodological procedures and with a gold standard assessment of EF will be required to finally exclude its involvement in the disease.

Sex and region-specific effects of high fat diet on PNNs in obesity susceptible rats

Perineuronal nets (PNNs) are specialized extracellular matrix structures that primarily surround fast-spiking parvalbumin (PV)-containing interneurons within the PFC. They regulate PV neuron function and plasticity to maintain cortical excitatory/inhibitory balance. For example, reductions in PNN intensity are associated with reduced local inhibition and enhanced pyramidal neuron firing. We previously found that exposure to dietary high fat reduced PNN intensity within the PFC of male Sprague-Dawley (SD) rats. However, how high fat affects PNNs in the PFC of females or in obesity-vulnerable vs. -resistant models is unknown. Therefore, we gave male and female SD, selectively bred obesity-prone (OP), and obesity-resistant rats (OR) free access to standard lab chow or 60% high fat for 21 days. We then measured the number of PNN positive cells and PNN intensity (determined by Wisteria floribunda agglutinin [WFA] staining) as well as the number of PV positive neurons using immunohistochemistry. We found sex and region-specific effects of dietary high fat on PNN intensity, in the absence of robust changes in cell number. Effects were comparable in SD and OP but differed in OR rats. Specifically, high fat reduced PNN intensities in male SD and OP rats but increased PNN intensities in female SD and OP rats. In contrast, effects in ORs were opposite, with males showing increases in PNN intensity and females showing a reduction in intensity. Finally, these effects were also region specific, with diet-induced reductions in PNN intensity found in the prelimbic PFC (PL-PFC) and ventral medial orbital frontal cortex (vmOFC) of SD and OP males in the absence of changes in the infralimbic PFC (IL-PFC), and increases in PNN intensity in the IL-PFC of SD and OP females in the absence of changes in other regions. These results are discussed in light of roles PNNs may play in influencing PFC neuronal activity and the differential role of these sub-regions in food-seeking and motivation.

Preservation of Interference Effects in Working Memory After Orbitofrontal Damage

Orbitofrontal cortex (OFC) is implicated in multiple cognitive processes, including inhibitory control, context memory, recency judgment, and choice behavior. Despite an emerging understanding of the role of OFC in memory and executive control, its necessity for core working memory (WM) operations remains undefined. Here, we assessed the impact of OFC damage on interference effects in WM using a Recent Probes task based on the Sternberg item-recognition task (1966). Subjects were asked to memorize a set of letters and then indicate whether a probe letter was presented in a particular set. Four conditions were created according to the forthcoming response (“yes”/“no”) and the recency of the probe (presented in the previous trial set or not). We compared behavioral and electroencephalography (EEG) responses between healthy subjects (n = 14) and patients with bilateral OFC damage (n = 14). Both groups had the same recency pattern of slower reaction time (RT) when the probe was presented in the previous trial but not in the current one, reflecting the proactive interference (PI). The within-group electrophysiological results showed no condition difference during letter encoding and maintenance. In contrast, event-related potentials (ERPs) to probes showed distinct within-group condition effects, and condition by group effects. The response and recency effects for controls occurred within the same time window (300–500 ms after probe onset) and were observed in two distinct spatial groups including right centro-posterior and left frontal electrodes. Both clusters showed ERP differences elicited by the response effect, and one cluster was also sensitive to the recency manipulation. Condition differences for the OFC group involved two different clusters, encompassing only left hemisphere electrodes and occurring during two consecutive time windows (345–463 ms and 565–710 ms). Both clusters were sensitive to the response effect, but no recency effect was found despite the behavioral recency effect. Although the groups had different electrophysiological responses, the maintenance of letters in WM, the evaluation of the context of the probe, and the decision to accept or reject a probed letter were preserved in OFC patients. The results suggest that neural reorganization may contribute to intact recency judgment and response after OFC damage.

Executive functions and intelligence from the CHC theory perspective: Investigating the correspondence between the WAIS-IV and the NAB Executive Functions Module

Substantial overlap between executive functions (EFs) and intelligence has been reported. Yet further research is required with respect to how the specific components of the two constructs are interrelated. The present study was aimed at exploring the relationship between EFs and intelligence by examining the latent structure of the Wechsler Adult Intelligence Scale (WAIS-IV) and the Executive Functions Module from the Neuropsychological Assessment Battery (NAB). The aim was also to test the correspondence of the two measures to the Cattell-Horn-Carroll (CHC) theory. 205 healthy participants, aged 18-89 years, were administered the NAB and WAIS-IV. Confirmatory factor analysis (CFA) was employed to explore the latent constructs underlying the two test batteries. Models based on the current WAIS-IV index structure showed worse model fit than models based on the CHC theory. In particular, factors representing broad CHC abilities comprehension knowledge (Gc), fluid reasoning (Gf), visual processing (Gv), processing speed (Gs), and working memory capacity (Gwm) proved model fit improvement. The best model fit, however, provided a five-factor model combining the Gf and Gwm abilities into one factor and additionally including a retrieval fluency (Gr) factor. The results demonstrate strong relationships between the WAIS-IV and the NAB Executive Functions Module and suggest substantial overlap between EFs and intelligence within the CHC framework. Nevertheless, according to the recent update of the CHC theory, the NAB fluency tasks may represent a distinct EF factor comprising Gr abilities independent from the WAIS-IV.

Multimodal neuroimaging analysis reveals age-associated common and discrete cognitive control constructs

The aims of this study were to determine which cognitive control functions are most sensitive to cross-sectional age differences and to identify neural features in different neuroimaging modalities that associated cognitive control function across the adult lifespan. We employed a joint independent component analysis (jICA) approach to obtain common networks among three different brain-imaging modalities (i.e., structural MRI, resting-state functional MRI, and diffusion tensor imaging) in relation to the cognitive control function. We differentiated three distinct cognitive constructs: one common (across inhibition, shifting, and updating) and two specific (shifting, updating) factors. These common/specific constructs were transformed from three original performance indexes: (a) stop-signal reaction time, (b) switch-cost, and (c) performance sensitivity collected from 156 individuals aged 20 to 78 years old. The current results show that the cross-sectional age difference is associated with a wide spread of brain degeneration that is not limited to the frontal region. Crucially, these findings suggest there are some common and distinct joined multimodal components that correlate with the psychological constructs of common and discrete cognitive control functions, respectively. To support current findings, other fusion ICA models were also analyzed including, parallel ICA (para-ICA) and multiset canonical correlation analysis with jICA (mCCA + jICA). Dynamic interactions among these brain features across different brain modalities could serve as possible developmental mechanisms associated with these age effects.

Frontal Lobe Functions in Normal Aging: Metacognition, Autonomy, and Quality of Life

BACKGROUND

Starting from the "frontal lobe hypothesis of cognitive aging", we aim to study the metacognitive functions (deception, reciprocity, cognitive and affective theory of mind), autonomy and quality of life in normal aging.

METHODS

Eighty healthy subjects (30 young adults [YA] aged 20-40, 30 old adults [OA] aged 65-79 and 20 very old adults [VOA] aged 80 and over) participated in our study. Standard and novel neuropsychological tasks have been used, assessing abilities to understand others' mental and affective states, deceptive and cooperative situations.

RESULTS

OA and VOA's performances are significantly poorer than those of YA on first-/second-order false beliefs, deception, reciprocity and emotion recognition tasks. VOA have made more errors than other participants on control false beliefs, general cognition, and memory tasks. Normal aging seems also to be characterized by a reduction in processing speed. The level of instrumental activities of daily living decreases with aging. Theory of mind is associated with individual general cognitive state and executive functions, but not with OA and VOA's levels of autonomy and quality of life.

CONCLUSION

In this study, we have shown an age-related deterioration of metacognitive functions, which does not seem to be associated with old adults' autonomy and satisfaction of life. A good level of mental activity could be necessary to maintain satisfactory interpersonal relationships.

A Review of Acute Aerobic Exercise and Transcranial Direct Current Stimulation Effects on Cognitive Functions and Their Potential Synergies

Today, several pharmaceutic and non-pharmaceutic approaches exist to treat psychiatric and neurological diseases. Because of the lack of treatment procedures that are medication free and without severe side effects, transcranial direct current stimulation (tDCS) and aerobic exercise (AE) have been tested to explore the potential for initiating and modulating neuroplasticity in the human brain. Both tDCS and AE could support cognition and behavior in the clinical and non-clinical context to improve the recovery process within neurological or psychiatric conditions or to increase performance. As these techniques still lack meaningful effects, although they provide multiple beneficial opportunities within disease and health applications, there is emerging interest to find improved tDCS and AE protocols. Since multimodal approaches could provoke synergetic effects, a few recent studies have begun to combine tDCS and AE within different settings such as in cognitive training in health or for treatment purposes within clinical settings, all of which show superior effects compared to single technique applications. The beneficial outcomes of both techniques depend on several parameters and the understanding of neural mechanisms that are not yet fully understood. Recent studies have begun to directly combine tDCS and AE within one session, although their interactions on the behavioral, neurophysiological and neurochemical levels are entirely unclear. Therefore, this review: (a) provides an overview of acute behavioral, neurophysiological, and neurochemical effects that both techniques provoke within only one single application in isolation; (b) gives an overview regarding the mechanistic pathways; and (c) discusses potential interactions and synergies between tDCS and AE that might be provoked when directly combining both techniques. From this literature review focusing primarily on the cognitive domain in term of specific executive functions (EFs; inhibition, updating, and switching), it is concluded that a direct combination of tDCS and AE provides multiple beneficial opportunities for synergistic effects. A combination could be useful within non-clinical settings in health and for treating several psychiatric and neurologic conditions. However, there is a lack of research and there are several possibly interacting moderating parameters that must be considered and more importantly must be systematically investigated in the future.

Dysexecutive disorders and their diagnosis: A position paper

Although executive function disorders are among the most prevalent cognitive impairments a consensus on diagnostic criteria has yet to be reached. With a view to harmonizing these criteria, the present position paper (i) focuses on the main dysexecutive disorders, (ii) examines recent approaches in both the behavioral and cognitive domains, (iii) defines diagnostic boundaries for frontal syndrome, (iv) reports on the frequency and profile of the executive function disorders observed in the main brain diseases, and (v) proposes an operationalization of diagnostic criteria. Future work must define the executive processes involved in human adaptive behavior, characterize their impairment in brain diseases, and improve the management of these conditions (including remediation strategies and rehabilitation).

Behavioral and Neural Correlates of Executive Function: Interplay between Inhibition and Updating Processes

This study investigated the interaction between two executive function processes, inhibition and updating, through analyses of behavioral, neurophysiological, and effective connectivity metrics. Although, many studies have focused on behavioral effects of executive function processes individually, few studies have examined the dynamic causal interactions between these two functions. A total of twenty participants from a local university performed a dual task combing flanker and n-back experimental paradigms, and completed the Operation Span Task designed to measure working memory capacity. We found that both behavioral (accuracy and reaction time) and neurophysiological (P300 amplitude and alpha band power) metrics on the inhibition task (i.e., flanker task) were influenced by the updating load (n-back level) and modulated by working memory capacity. Using independent component analysis, source localization (DIPFIT), and Granger Causality analysis of the EEG time-series data, the present study demonstrated that manipulation of cognitive demand in a dual executive function task influenced the causal neural network. We compared connectivity across three updating loads (n-back levels) and found that experimental manipulation of working memory load enhanced causal connectivity of a large-scale neurocognitive network. This network contains the prefrontal and parietal cortices, which are associated with inhibition and updating executive function processes. This study has potential applications in human performance modeling and assessment of mental workload, such as the design of training materials and interfaces for those performing complex multitasking under stress.

Chronnectomic patterns and neural flexibility underlie executive function

Despite extensive research into executive function (EF), the precise relationship between brain dynamics and flexible cognition remains unknown. Using a large, publicly available dataset (189 participants), we find that functional connections measured throughout 56min of resting state fMRI data comprise five distinct connectivity states. Elevated EF performance as measured outside of the scanner was associated with greater episodes of more frequently occurring connectivity states, and fewer episodes of less frequently occurring connectivity states. Frequently occurring states displayed metastable properties, where cognitive flexibility may be facilitated by attenuated correlations and greater functional connection variability. Less frequently occurring states displayed properties consistent with low arousal and low vigilance. These findings suggest that elevated EF performance may be associated with the propensity to occupy more frequently occurring brain configurations that enable cognitive flexibility, while avoiding less frequently occurring brain configurations related to low arousal/vigilance states. The current findings offer a novel framework for identifying neural processes related to individual differences in executive function.

Attentional updating and monitoring and affective shifting are impacted independently by aging in macaque monkeys

One hallmark of the normal cognitive aging process involves alterations in executive function. Executive function can be divided into at least three separable components, including set shifting, attentional updating and monitoring, and inhibition of prepotent responses. The ability to study the neural basis of cognitive aging has been enriched by the use of animal models such as the macaque monkey. In aged macaques, changes in attentional updating and monitoring systems are poorly understood compared to changes in shifting and inhibition. A partial explanation for this is the fact that the tasks designed to study executive function in aged monkeys, to date, primarily have probed shifting and inhibition processes. Here we examine how aging impacts attentional updating and monitoring processes in monkeys using an interference task designed after a paradigm used to examine multi-tasking in older humans. Young and aged macaque monkeys were tested on this interference task as well as on an object reversal learning task to study these processes in the same animals. Relative to the young monkeys, aged animals were impaired on both tasks. Proactive and retroactive interference did not differ between age groups on an array of 40 object pairs presented each day in the object reversal learning task. The levels of performance on the interference task were not correlated with levels of performance in the object reversal task. These results suggest that attentional updating and monitoring and affective shifting are separable functions in the macaque, and that normal aging affects these mental operations independently.

Unity and diversity of executive functions: Individual differences as a window on cognitive structure

Executive functions (EFs) are high-level cognitive processes, often associated with the frontal lobes, that control lower level processes in the service of goal-directed behavior. They include abilities such as response inhibition, interference control, working memory updating, and set shifting. EFs show a general pattern of shared but distinct functions, a pattern described as "unity and diversity". We review studies of EF unity and diversity at the behavioral and genetic levels, focusing on studies of normal individual differences and what they reveal about the functional organization of these cognitive abilities. In particular, we review evidence that across multiple ages and populations, commonly studied EFs (a) are robustly correlated but separable when measured with latent variables; (b) are not the same as general intelligence or g; (c) are highly heritable at the latent level and seemingly also highly polygenic; and (d) activate both common and specific neural areas and can be linked to individual differences in neural activation, volume, and connectivity. We highlight how considering individual differences at the behavioral and neural levels can add considerable insight to the investigation of the functional organization of the brain, and conclude with some key points about individual differences to consider when interpreting neuropsychological patterns of dissociation.

Vagal Recovery From Cognitive Challenge Moderates Age-Related Deficits in Executive Functioning

Decline in executive functioning (EF) is a hallmark of cognitive aging. We have previously reported that faster vagal recovery from cognitive challenge is associated with better EF. This study examined the association between vagal recovery from cognitive challenge and age-related differences in EF among 817 participants in the Midlife in the U.S. study (aged 35-86). Cardiac vagal control was measured as high-frequency heart rate variability. Vagal recovery moderated the association between age and EF (β = .811, p = .004). Secondary analyses revealed that older participants (aged 65-86) with faster vagal recovery had superior EF compared to their peers who had slower vagal recovery. In contrast, among younger (aged 35-54) and middle-aged (aged 55-64) participants, vagal recovery was not associated with EF. We conclude that faster vagal recovery from cognitive challenge is associated with reduced deficits in EF among older, but not younger individuals.

Effects of Acute Laboratory Stress on Executive Functions

Recent research indicates that stress can affect executive functioning. However, previous results are mixed with respect to the direction and size of effects, especially when considering different subcomponents of executive functions. The current study systematically investigates the effects of stress on the five components of executive functions proposed by Smith and Jonides (1999): attention and inhibition; task management; planning; monitoring; and coding. Healthy participants (N = 40) were either exposed to the computerized version of the Paced Auditory Serial Addition Test as a stressor (N = 20), or to a rest condition (N = 20). Stress reactions were assessed with heart rate and subjective measures. After the experimental manipulation, all participants performed tasks that measure the different executive functions. The manipulation check indicates that stress induction was successful (i.e., the stress group showed a higher heart rate and higher subjective responses than the control group). The main results demonstrate that stressed participants show a poorer performance compared with unstressed participants in all executive subcomponents, with the exception of monitoring. Effect sizes for the tasks that reveal differences between stressed and unstressed participants are high. We conclude that the laboratory stressor used here overall reduced executive functioning.

Aerobic training as a means to enhance inhibition: what's yet to be studied?

Some of the neurodegenerative processes in healthy aging, including changes in structural and biochemical properties of the brain, are argued to affect cortical inhibitory functions. Age-related deficits in the ability to control cerebral inhibition may explain wide range of motor and cognitive deficits that healthy older adults experience in daily life such as impaired coordination skills and declines in attention, concentration, and learning abilities. Importantly, evidence from many studies suggests that impaired inhibitory control in advancing age can be delayed or even alleviated by aerobic exercise training. Findings from a recent study by Duchesne and colleagues (2015) may provide insights into this process. First, observations from Duchesne et al. indicated that aerobic exercise training program improved cognitive inhibitory functioning in both patients with Parkinson’s disease (PD) and matched older controls. Second, Duchesne et al. showed that cognitive inhibition and motor skills were highly correlated both pre- and post-exercise in PD but not in controls. Based on the aforementioned findings we highlight possible mechanisms that may play a role in the interactions between cognitive and motor inhibitory functions in healthy elderly that could benefit from aerobic exercise training: specifically, the brain neurotransmission systems and the frontal-basal ganglia network. In conclusion, we raise two fundamental questions which are yet to be addressed: (1) the extent to which different brain neurotransmitter systems are affected by aerobic exercise training; (2) the extent to which neurotransmitter levels prior to the onset of intervention may facilitate (or impede) training-induced neuroplasticity in the aging brain.

[Role of the prefrontal cortex in human behavioral adaptation]

Behavioral adaptation to complex or new situations depends on the anatomical, physiological and functional properties of the prefrontal cortex, and on its interaction with other regions. These properties allow distinguishing two main prefrontal regions: the lateral part involved in cognitive aspects of goal-directed behaviors, and the ventral part involved in its affective aspects. Damage to these two regions is associated with two distinct clinical syndromes. Cognitive deficits in planning dominate in the lateral syndrome, behavioral regulation and motivation disorders in the ventral syndrome. Beyond this distinction, the question of how the systems that enable cognitive and behavioral aspects of adaptation are organized in prefrontal subregions, and can be best assessed, is not fully understood. This question is an essential issue in cognitive neuroscience and is crucial to improve clinical practice.

Structure and Invariance of Executive Functioning Tasks across Socioeconomic Status: Evidence from Spanish-Speaking Children

The aim of the present study was to analyze the latent structure of executive functions (EFs) in Spanish-speaking children and to test measurement invariance across socioeconomic status (SES). We sampled 248 children, aged 8 to 12, who were divided into two groups: 124 children from a medium socioeconomic status (MSS) and 124 children from a low socioeconomic status (LSS). We applied a neuropsychological battery consisting of various EF tasks and performed confirmatory factor analysis (CFA) and multi-group CFA (MGCFA). CFA showed best fit for the three factor solution: (a) Working memory, (b) Cognitive flexibility, and (c) Inhibition. Moreover, the MGCFA revealed that the three-factor solution was invariant (configural, metric, and structural) across SES, allowing valid comparison between the groups (MSS and LSS) of factors. Finally, bifactorial MANOVA revealed a significant effect of SES and group age but not for the interaction between the two in the three EF dimensions indicative of quantitative group differences. Results are discussed in terms of the dimensional nature of the EF construct and the effects of SES on executive functioning.

Development Patterns of Executive Functions in Children

Executive Functions (EF) exercise control over an individual’s conduct and thinking through a set of functionally independent processes, among which are cognitive flexibility (reactive and spontaneous), working memory and planning. The development patterns of these components appear to have stages of acceleration and deceleration during childhood. Studies analyzing their development in Spanish-speaking children were not found in our area. Therefore, this study will analyze the development patterns of the cited executive functions with the objective of establishing relationships and comparisons, and identifying the stages of acceleration and stagnation for each component. The study’s sample consists of 274 schoolchildren between the ages of 6 and 8 (119 in first grade, 61 in second grade and 94 in third grade). Participants were evaluated using the following instruments from the Neuropsychological Assessment of Children test battery (known by the acronym ENI in Spanish): Verbal Fluency (semantic and phonemic); Cognitive Flexibility; Mexican Pyramid; and Backward Digit Span. Three different development patterns were detected, as well as different interactions between the executive components. Additionally, three empirical types were established based on the patterns and relationships between components.

Confirmatory factor analysis of the Behavior Rating Inventory of Executive Function-Adult version in healthy adults and application to attention-deficit/hyperactivity disorder

The Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) is a questionnaire measure designed to assess executive functioning in everyday life. Analysis of data from the BRIEF-A standardization sample yielded a two-factor solution (labeled Behavioral Regulation and Metacognition). The present investigation employed confirmatory factor analysis (CFA) to evaluate four alternative models of the factor structure of the BRIEF-A self-report form in a sample of 524 healthy young adults. Results indicated that a three-factor model best fits the data: a Metacognition factor, a Behavioral Regulation factor consisting of the Inhibit and Self-Monitor scales, and an Emotional Regulation factor composed of the Emotional Control and Shift scales. The three factors contributed 14%, 19%, and 24% of unique variance to the model, respectively, and a second-order general factor accounted for 41% of variance overall. This three-factor solution is consistent with recent CFAs of the Parent report form of the BRIEF. Furthermore, although the Behavioral Regulation factor score in the two-factor model did not differ between adults with attention-deficit/hyperactivity disorder and a matched healthy comparison group, greater impairment on the Behavioral Regulation factor but not the Emotional Regulation factor was found using the three-factor model. Together, these findings support the multidimensional nature of executive function and the clinical relevance of a three-factor model of the BRIEF-A.

Additive scales in degenerative disease--calculation of effect sizes and clinical judgment

Background

The therapeutic efficacy of an intervention is often assessed in clinical trials by scales measuring multiple diverse activities that are added to produce a cumulative global score. Medical communities and health care systems subsequently use these data to calculate pooled effect sizes to compare treatments. This is done because major doubt has been cast over the clinical relevance of statistically significant findings relying on p values with the potential to report chance findings. Hence in an aim to overcome this pooling the results of clinical studies into a meta-analyses with a statistical calculus has been assumed to be a more definitive way of deciding of efficacy.

Methods

We simulate the therapeutic effects as measured with additive scales in patient cohorts with different disease severity and assess the limitations of an effect size calculation of additive scales which are proven mathematically.

Results

We demonstrate that the major problem, which cannot be overcome by current numerical methods, is the complex nature and neurobiological foundation of clinical psychiatric endpoints in particular and additive scales in general. This is particularly relevant for endpoints used in dementia research. 'Cognition' is composed of functions such as memory, attention, orientation and many more. These individual functions decline in varied and non-linear ways. Here we demonstrate that with progressive diseases cumulative values from multidimensional scales are subject to distortion by the limitations of the additive scale. The non-linearity of the decline of function impedes the calculation of effect sizes based on cumulative values from these multidimensional scales.

Conclusions

Statistical analysis needs to be guided by boundaries of the biological condition. Alternatively, we suggest a different approach avoiding the error imposed by over-analysis of cumulative global scores from additive scales.

The future of Alzheimer's disease: the next 10 years

Alzheimer's disease (AD) is a fast growing world-wide epidemic. AD is a genetically complex, slowly progressive, and irreversible neurodegenerative disease of the brain. During decades of asymptomatic progression multiple interactive systems, pathways and molecular mechanisms (e.g. protein processing, aberrant signaling, inflammation and immune system, lipid transport, endocytosis, apoptosis, oxidative damage and response to stress, tau pathology, neuron and synapse loss, energy metabolism), contribute to the development of the early clinical prodromal stage with episodic memory deficits and to further decline and loss of general cognitive functioning during the final syndromal dementia stage. The non-mendelian genetically complex "sporadic" AD type is the most common form of dementia affecting people usually over the age of 65. Despite considerable progress of AD research in recent years and evolving paradigm shifts in both pathophysiological concepts as well as in diagnostic criteria fundamental challenges have not yet been resolved. The strong age-related incidence, the recent failure and complete lack of disease-modifying or preventive therapy that may delay onset or substantially affect the pathophysiology of AD, result in an enormous burden posed both on individuals, their families and care givers, and the societies at large, and these call for urgent concerted worldwide measures. Based on the meeting of the German Task Force on Alzheimer's Disease (GTF-AD) in Paris on July 19th 2011, the present position paper provides an overview on the current state and future developments in epidemiology, pathophysiology, disease conceptualization, diagnostic criteria and their use in research and clinical practice, as well as preventive and symptomatic therapeutic approaches. Particular emphasis is placed on a discussion of the different approaches to diagnostics and therapy taken by preventive/public health medicine, methodologically advanced academic research propagating the use of sophisticated biomarkers, and everyday clinical practice focusing on patient-centered care. During the next 10 years, major advances both in early detection as well as in therapy and comprehensive AD care seem mandatory. These still unmet needs call for ever more concerted and focused efforts in research across the world to combat the erupting and as yet uncontrolled epidemic of AD.

The future of cognitive neurorehabilitation

Cognitive neurorehabilitation is rooted both in the cognitive function being treated and the neural substrates underlying that ability. Recent progress in understanding both brain (in particular brain plasticity) and the complexities of behaviour imply a promising future for cognitive neurorehabilitation. The manuscripts in this issue focuse on advances in the use of non-invasive brain stimulation (NIBS) as a tool for cognitive neurorehabilitation. This paper presents a broader context in which to understand the importance and potential of this specific approach. Achieving the promise requires theoretical and experimental rigour including selection of relevant outcome measures, and understanding of the complexities of individual patients. Success will depend on our ability to integrate knowledge and approaches.

Measuring therapeutic efficacy in patients with Alzheimer's disease: role of instruments

BACKGROUND/AIMS

Global cognitive scales and meta-analyses thereof are used to appraise therapeutic efficacy over a broad range of disease severity. Clinically, however, different aspects of cognition change in different stages of disease.

METHODS

Calculation of effect sizes for single cognitive functions on treatment as assessed by the Alzheimer's Disease Assessment Scale (ADAS-cog), the Mini-Mental-Status Examination (MMSE), and the Severe Impairment Battery (SIB). In these scales, subdomains of 'cognition', e.g. memory and language, are represented in different proportions. To exemplify the analysis of 'cognition', we used original data of previously published clinical studies with memantine.

RESULTS

Depending on dementia severity and on the scale used, the effect size for memory varies between -0.44 and +0.34 and for language between -0.40 and +0.26.

CONCLUSION

Beyond interstudy variance, effect sizes for treatment with antidementia drugs are subject to disease stage, instruments used, and interaction thereof. Therefore, clinical interpretation is necessary to appraise therapeutic efficacy in clinical studies and meta-analyses thereof when patients with different severity are included or different instruments are used. Alternatively, severity-adapted endpoints should be used for appraisal and meta-analysis of therapeutic efficacy.

Functions of the frontal lobes: relation to executive functions

Proceeding from the assumptions that specific frontal regions control discrete functions and that very basic cognitive processes can be systematically manipulated to reveal those functions, recent reports have demonstrated consistent anatomical/functional relationships: dorsomedial for energization, left dorsolateral for task setting, and right dorsolateral for monitoring. There is no central executive. There are, instead, numerous domain general processes discretely distributed across several frontal regions that act in concert to accomplish control. Beyond these functions, there are two additional "frontal" anatomical/functional relationships: ventral-medial/orbital for emotional and behavioral regulation, and frontopolar for integrative-even meta-cognitive-functions.

Challenging the supremacy of the frontal lobe: early views (1906-1909) of Christfried Jakob on the human cerebral cortex

This article focuses on a series of six studies that address functional localization in the frontal lobe; they were published in Argentina between 1906 and 1909 by Christfried Jakob (1866-1956), one of the great thinkers in early 20th century neuropathology and neurophilosophy. At that time, the localization-holism controversy was at a peak, having been triggered by the historic Marie-Déjerine aphasiology debate. Jakob held the view that constitutive physiological elements of cognition are localized. Nonetheless, he cast doubt on phrenological approaches that considered the frontal lobe as 'superior' to the other cortical regions. Jakob studied the human frontal lobe from fetal life through senility, in normality and pathology, including tumors, injuries, softening, general paralysis and dementia. Based on those finds, he considered strict localization theories a dead-end. Taking a critical look at Flechsig's ideas on the parallel ontogenies of frontal association centers and intellect, Jakob argued that the frontal lobe does not carry any selective advantage over the remaining human cerebral lobes or even over the frontal lobe in non-human primates. Regarding lesion experiments in laboratory animals, he pointed to methodological caveats, such as insufficient recovery time, that may lead to disorientating conclusions, and rejected élite brain research, calling it superficial and inexact. Jakob was convinced that the verification of the anatomical connections of the frontal lobe would elucidate its functions. Thus, he viewed the frontal lobe as a central station receiving input via olfactory pathways and thalamic radiations, pertinent to muscular and cutaneous senses, and attributed a perceptive character to a brain region traditionally associated with productive functions. Modern neuroscience seems to support Jakob's rejection of distinguishable motor and sensory regions and to adopt a cautious stance concerning oversimplified localization views.

Executive resources

Executive resources allow for flexible, adaptive, goal-directed responses to environmental circumstances in essentially all facets of daily living. Executive function is composed of related, but separable, components. This article will highlight three essential aspects of executive function: (1) working memory, (2) planning and organizing, and (3) inhibitory control. Working memory is the system by which information is maintained in an active mental state so that it can be used for other purposes. Planning and organizing of behavior involves the way in which individuals optimize the execution of multistep tasks to achieve a goal. Inhibitory control allows an individual to inhibit inappropriate responses and to shift responses when necessary. These aspects of executive function appear to depend in part on large-scale neural networks that are centered in distinct areas of prefrontal cortex, working in concert with other brain regions, such as parietal cortex and the basal ganglia. Executive function is a fundamental aspect of human cognition that is compromised in patients with a wide range of medical conditions.

Developmental outcome of isolated fetal microcephaly

OBJECTIVE

To assess the neurodevelopmental outcome of children with prenatally diagnosed isolated microcephaly defined as head circumference more than 2 SD below the gestational mean.

METHODS

Children aged 2-6 years who had been diagnosed in utero as having head circumference measurements more than 2 SD below the gestational mean were compared with normocephalic children, utilizing a standard neuropsychological battery. Comparisons were also made within the study group.

RESULTS

HCs were between -2 and -4.8 SD, only one fetus having a HC below -3 SD. Children with a prenatal head circumference between 2 SD and 3 SD below the gestational mean did not differ significantly from the control group regarding cognitive, language and motor functioning. However, they exhibited more behavioral-emotional problems. There were no significant differences between children who had suffered from intrauterine growth restriction and those who had not, or between those with familial and those with non-familial microcephaly. Nevertheless, linear regression analysis showed that head circumference in utero helps predict cognitive functioning later in life.

CONCLUSIONS

Prenatally diagnosed head circumference between 2 SD and 3 SD below the gestational mean is not a risk factor for later abnormal neuropsychological development.

Cognitive correlates of anti-saccade task performance

The anti-saccade task (AST) is widely used in experimental, clinical, and neuroscience research as a pronounced test of executive functions. AST research includes to some extent also the investigation into its cognitive correlates. In the present study, we have examined cognitive correlates of the AST in the short-term/working memory, executive functions, and intelligence domains in healthy adults. We have obtained the following results. In line with previous research, the global percentage of direction errors PDE comprised of two only negligibly correlated components, direction errors with express or regular latencies. Substantial correlations with the other cognitive measures were obtained only for regular direction errors and, less so, for the global PDE. Results add to the evidence that distinguishes express and regular direction errors and underline that the complex requirements of the AST are reflected in a comparatively rich set of non-redundant parameters.

Executive function in adolescents with Down Syndrome

BACKGROUND

The present work is aimed at analysing executive function (EF) in adolescents with Down Syndrome (DS). So far, EF has been analysed mainly in adults with DS, showing a pattern of impairment. However, less is known about children and adolescents with this syndrome. Studying adolescents with DS might help us better understand whether performances on EF tasks of individuals with DS are determined by age or by Alzheimer disease, as some studies suggest, or whether their performances are directly related to DS cognitive profile.

METHOD

A battery of EF tasks assessing set shifting, planning/problem-solving, working memory, inhibition/perseveration and fluency, as well as a tasks assessing sustained attention has been administered to a group of 15 adolescents with DS and 15 typically developing children matched for mental age. All EF tasks were selected from previous studies with individuals with intellectual disabilities or from developmental literature and are thought to be useful for the samples considered.

RESULTS

The present results revealed that the group of individuals with DS performed at a significantly lower level on tasks assessing set shifting, planning/problem-solving, working memory and inhibition/perseveration, but not on the tasks assessing fluency. In addition, individuals with DS demonstrated a greater number of errors and less strategy use for the sustained attention task.

CONCLUSIONS

The results suggest a broad impairment in EF in adolescents with DS, and are consistent with several similar studies conducted with adults with DS. We assume that EF deficit is a characteristic of DS.

Increased dorsolateral prefrontal cortex activation in obese children during observation of food stimuli

OBJECTIVE

Food cues yield different patterns of brain activation in obese compared with normal-weight adults in prefrontal and limbic/paralimbic areas. For children, no mapping studies comparing representation sites for food and other stimuli between obese and normal-weight subjects are available.

DESIGN

We used a cross-sectional design of two age-matched subject groups to investigate differences in brain activation in response to visually presented food, pleasant, and neutral pictures between obese/overweight and normal children.

SUBJECTS

22 overweight/obese children were compared with 22 normal-weight children.

MEASUREMENTS

Functional magnetic resonance imaging (of the whole head during perception of visually presented stimuli), psychological testing, and psychophysical measures of heart rate deceleration were assessed.

RESULTS

Obese children showed higher activation of the dorsolateral prefrontal cortex (DLPFC) in response to food pictures. In addition, DLPFC activation was negatively correlated with self-esteem. In contrast, normal-weight children showed higher activation of the caudate and hippocampus specific to food pictures, and of the anterior cingulate cortex and thalamus to visual cues in general. In response to food stimuli, obese children showed a heart rate deceleration correlating positively with activation of the ventrolateral prefrontal cortex.

CONCLUSION

Obese children react to food stimuli with increased prefrontal activation, which might be associated with increased inhibitory control.

Quality of life as an outcome in Alzheimer's disease and other dementias--obstacles and goals

Background

The number of individuals at risk for dementia will probably increase in ageing societies as will the array of preventive and therapeutic options, both however within limited economic resources. For economic and medical purposes valid instruments are required to assess disease processes and the efficacy of therapeutic interventions for different forms and stages of illness. In principal, the impact of illness and success of an intervention can be assessed with biomedical variables, e.g. severity of symptoms or frequency of complications of a disease. However, this does not allow clear judgement on clinical relevance or comparison across different diseases.

Discussion

Outcome model variables such as quality of life (QoL) or health care resource utilization require the patient to appraise their own well-being or third parties to set preferences. In Alzheimer's disease and other dementias the evaluation process performed by the patient is subject to the disease process itself because over progress of the disease neuroanatomical structures are affected that mediate evaluation processes.

Summary

Published research and methodological considerations thus lead to the conclusion that current QoL-instruments, which have been useful in other contexts, are ill-suited and insufficiently validated to play a major role in dementia research, decision making and resource allocation. New models integrating biomedical and outcome variables need to be developed in order to meet the upcoming medical and economic challenges.

Is our brain hardwired to produce God, or is our brain hardwired to perceive God? A systematic review on the role of the brain in mediating religious experience

To figure out whether the main empirical question "Is our brain hardwired to believe in and produce God, or is our brain hardwired to perceive and experience God?" is answered, this paper presents systematic critical review of the positions, arguments and controversies of each side of the neuroscientific-theological debate and puts forward an integral view where the human is seen as a psycho-somatic entity consisting of the multiple levels and dimensions of human existence (physical, biological, psychological, and spiritual reality), allowing consciousness/mind/spirit and brain/body/matter to be seen as different sides of the same phenomenon, neither reducible to each other. The emergence of a form of causation distinctive from physics where mental/conscious agency (a) is neither identical with nor reducible to brain processes and (b) does exert "downward" causal influence on brain plasticity and the various levels of brain functioning is discussed. This manuscript also discusses the role of cognitive processes in religious experience and outlines what can neuroscience offer for study of religious experience and what is the significance of this study for neuroscience, clinicians, theology and philosophy. A methodological shift from "explanation" to "description" of religious experience is suggested. This paper contributes to the ongoing discussion between theologians, cognitive psychologists and neuroscientists.