Wisconsin Card Sorting Test performance in patients with focal frontal and posterior brain damage: effects of lesion location and test structure on separable cognitive processes

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.

Double dissociation between P300 components and task switch error type in healthy but not psychosis participants

Event-related potentials (ERPs) during oddball tasks and the behavioral performance on the Penn Conditional Exclusion Task (PCET) measure context-appropriate responding: P300 ERPs to oddball targets reflect detection of input changes and context updating in working memory, and PCET performance indexes detection, adherence, and maintenance of mental set changes. More specifically, PCET variables quantify cognitive functions including inductive reasoning (set 1 completion), mental flexibility (perseverative errors), and working memory maintenance (regressive errors). Past research showed that both P300 ERPs and PCET performance are disrupted in psychosis. This study probed the possible neural correlates of 3 PCET abnormalities that occur in participants with psychosis via the overlapping cognitive demands of the two study paradigms. In a two-tiered analysis, psychosis (n = 492) and healthy participants (n = 244) were first divided based on completion of set 1 - which measures subjects' ability to use inductive reasoning to arrive at the correct set. Results showed that participants who failed set 1 produced lower parietal P300, independent of clinical status. In the second tier of analysis, a double dissociation was found among healthy set 1 completers: frontal P300 amplitudes were negatively associated with perseverative errors, and parietal P300 was negatively associated with regressive errors. In contrast, psychosis participants showed global P300 reductions regardless of PCET performance. From this we conclude that in psychosis, overall activations evoked by the oddball task are reduced while the cognitive functions required by PCET are still somewhat supported, showing some level of independence or compensatory physiology in psychosis between neural activities underlying the two tasks.

Plasma Phospholipid Polyunsaturated Fatty Acid Associations with Neurocognition

Neurocognitive deficits are implicated in major depressive disorder (MDD) and suicidal behavior, and cognitive function may be affected by blood levels of polyunsaturated fatty acids (PUFAs). Neuroprotective functions have been described for omega-3 (n-3) PUFAs, while omega-6 (n-6) PUFAs exhibit broadly opposing activities. Both classes of PUFAs are linked to MDD and suicidal behavior. However, few studies have investigated the relationships between PUFAs and neurocognitive function with respect to MDD or suicidal behavior. Among participants with MDD (n = 45) and healthy volunteers (HV, n = 30) we assessed performance on tasks of attentional capacity and executive function and its relationship to plasma phospholipid PUFA levels, expressed as a percentage of total plasma phospholipids, for eicosapentaenoic acid (EPA%), docosahexaenoic acid (DHA%), and arachidonic acid (AA%). Regression models tested the correlations between PUFA levels and task performance in three groups: MDD with a history of suicide attempt (SA, n = 20), MDD with no attempts (NA, n = 25), and HV. Interaction testing indicated a significant positive correlation of EPA% with continuous performance test scores in the NA group (F = 4.883, df = 2,72, p = 0.01), a measure of sustained attention. The AA% correlated negatively with performance on two executive function tasks, object alternation (beta = -3.97, z-score = -2.67, p = 0.008) and the Wisconsin card sort (beta = 0.80, t-score = -2.16, df = 69, p = 0.035), after adjustment for group and age, with no group effects. Our findings suggest a role for PUFA imbalance in attentional functioning and executive performance; however, no MDD-specific effect was observed.

Investigating Ecological Momentary Assessed Physical Activity and Core Executive Functions in 18- to 24-Year-Old Undergraduate Students

Although evidence for young children (<10) and older adults (>64) highlights an association between physical activity (PA) and executive functions (EFs), there is a paucity of research on adolescents aged 18-24 years. Thus, this study examined the associations between PA and EF and the difference in EF between individuals who achieve the moderate-to-vigorous (MVPA) guidelines and those who do not. Forty-seven participants engaged in a Stroop task, a reverse Corsi-block test, and a task-switching test, to measure inhibition, working memory, and cognitive flexibility, respectively. An ecological momentary assessment (EMA) was used to determine the participant's MVPA and step count, through the "Pathverse" app. Multiple regressions were run to predict the task-switch cost, the Stroop effect, and the backward Corsi span from time spent in MVPA. A two-way ANCOVA examined the effects of achieving the MVPA guidelines on EF. MVPA and step count did not significantly predict EF. There were no significant differences in EF between participants achieving the MVPA guidelines and those that did not. Time spent in MVPA and step count were not significantly associated with working memory, cognitive flexibility, or inhibition in adolescents. Further research is warranted to understand other factors that may significantly affect EF, within and outside an individual's control.

Executive functions in non-suicidal self-injury comorbid first-episode and drug-naïve depression among adolescents

Executive functions(EFs) may be associated with the emergence of non-suicidal self-injury(NSSI) due to their role as behavior controllers. EFs includes three core cognitive processes: inhibitory control, working memory, and cognitive flexibility(i.e. the ability to selectively alter cognitive strategies to generate appropriate behavior in the changing environment). This study aimed to systematically explore the three core EFs in depressed adolescents with NSSI. The data was obtained from the baseline data of the Chinese adolescent depression Cohort. The adolescents underwent cognitive assessments to yield domain-specific scores in EFs using the Digit Span Backward test(DSB), the Stroop Color-word interference test- color-word condition(Stroop-CW), and the Wisconsin Card Sorting tests(WCST). The significant differences in WCST scores were found between the NSSI group and the non-NSSI group. NSSI frequency was moderately positively correlated with total errors and negatively correlated with the number of categories completed. The number of categories completed in the "≥200″ NSSI frequency group was significantly lower than that in the "≤10″ NSSI group. The current findings suggested that depressed adolescents who had engaged in NSSI have poorer cognitive flexibility performance compared to adolescents without NSSI. As the frequency of NSSI increased, cognitive flexibility might become worse. These results provide evidence of a connection between executive dysfunctions and NSSI in depressed adolescents.

A Verbal Card Sorting Task to Measure Executive Functions

PURPOSE

The Wisconsin Card Sorting Test (WCST) is commonly used to measure nonverbal executive functions (EFs) in a variety of clinical populations. However, in some clinical populations (e.g., people with aphasia), deficits may be present in more linguistic (or verbal) domains and less pronounced in nonverbal domains. Thus, when determining possible deficits in these individuals, it is critical to assess both verbal and nonverbal cognitive abilities. The purpose of this study was to create a verbal card sorting task (VCST) to complement the WCST.

METHOD

We created the VCST by modifying a computerized version of the WCST, the Berg Card Sorting Task (BCST). We then compared 35 individuals with mild traumatic brain injury (mTBI) and 33 matched controls' performance on each task. We tested the VCST in individuals with mTBI first because they demonstrate impaired EFs but unimpaired language. We therefore expected the mTBI group to perform similarly on the VCST and BCST, suggesting that the two tasks measure EFs similarly.

RESULTS

In line with our hypothesis, the mTBI group had unimpaired inhibition and sustained attention but impaired shifting on each task. Component loadings for both tasks were also similar, and participants' inhibition and shifting scores positively correlated across the two tasks.

CONCLUSIONS

Together, these findings suggest that the VCST is a potentially useful tool for measuring verbal EF deficits. Our results also provide important insights into the EF impairments experienced by individuals with mTBI.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23230475.

Sustained attention performance deficits in the three-choice serial reaction time task in male and female rats after experimental brain trauma

Impaired attention is central to the cognitive deficits associated with long-term sequelae for many traumatic brain injury (TBI) survivors. Assessing complex sustained attention post-TBI is clinically-relevant and may provide reliable avenues towards developing therapeutic and rehabilitation targets in both males and females. We hypothesized that rats subjected to a moderate TBI will exhibit attentional deficits seen as reduced accuracy and increased distractibility in an operant 3-choice serial reaction time task (3-CSRT), designed as an analogue of the clinical continuous performance test. Upon reaching baseline of 70% accuracy at the 300 ms cue, adult male and female Sprague-Dawley rats were subjected to a controlled cortical impact (2.8 mm deformation at 4 m/s) or sham injury over the right parietal cortex. After two weeks of recovery, they were retested on the 3-CSRT for ten days. Dependent measures include percent accuracy (overall and for each of the three cue ports), percent omissions, as well as latency to instrumental poke and retrieve reward. Results demonstrate that both males and females displayed reduced percent accuracy and increased omissions when re-tested post-TBI on 3-CSRT compared to Sham rats and to their own pre-insult baseline (p's < 0.05). Performance accuracy was impaired consistently throughout the ten days of post-surgery re-testing, suggesting pronounced and long-lasting dysfunction in sustained attention processes. Deficits were specifically more pronounced when the cue was pseudorandomly presented in the left-side cue port (p < 0.05), mirroring clinical hemispatial neglect. These data demonstrate significant and persistent complex attention impairments in both sexes after TBI, rendering identifying efficient therapies for cognitive recovery as pivotal.

Evaluating the Distinction between Cool and Hot Executive Function during Childhood

This article assesses the cool-hot executive function (EF) framework during childhood. First, conceptual analyses suggest that cool EF (cEF) is generally distinguished from hot EF (hEF). Second, both EFs can be loaded into different factors using confirmatory factor analyses. Third, the cognitive complexity of EF is similar across cEF tasks, and the cognitive complexity of cEF is similar to hEF tasks. Finally, neuroimaging analysis suggests that children activate the lateral prefrontal regions during all EF tasks. Taken together, we propose that the cool-hot framework is a useful, though not definitive way of characterizing differences in EF.

Effects of transcranial direct current stimulation on improving performance of delayed- reinforcement attentional set-shifting tasks in attention-deficit/hyperactivity disorder rat model

Behavioral flexibility (or set-shifting), which is regulated by the prefrontal cortex (PFC), is often impaired in patients with attention-deficit/hyperactivity disorder (ADHD), which is characterized by poor inhibitory control and reinforcement learning. Transcranial direct current stimulation (tDCS) has been proposed as a means of noninvasive brain stimulation and a potential therapeutic tool for modulating behavioral flexibility. Animal studies can pave the way to know if tDCS application can potentially benefit rule- and goal-based activities in ADHD. Spontaneously hypertensive rats (SHRs) and inbred Wistar-Kyoto (WKY) rats were used as an animal model of ADHD and controls, respectively, and their strategy set-shifting abilities, including initial discrimination, set-shifting, and reversal learning tasks under 0-s or 15-s reinforcer delivery delay conditions, were evaluated. The tDCS treatment had a limited effect on the performance of the SHRs and WKY rats in initial discrimination task under 0-s delay condition. Under the 15-s delay condition, the SHRs had longer lever-press reaction times and/or more trial omissions than the WKY rats did when completing set-shifting and reversal-learning tasks. Among the SHRs, tDCS treatment improved the rats' reaction times and/or reduced their trial omissions in the set-shifting and reversal-learning tasks. Although tDCS may improve delayed reinforcement learning set-shifting performance in SHRs, further studies are required to clarify the responsible mechanism.

The Role of Cognitive Deficits in Borderline Personality Disorder with Early Traumas: A Mediation Analysis

(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition. In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms. The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology. (2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls. BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET). Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls. A mediation analysis was conducted with the Sobel Test in the BPD patients group. The significance level was p ≤ 0.05. (3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET. Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score. (4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls. Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition.

Iron supplementation given to nonanemic infants: neurocognitive functioning at 16 years

OBJECTIVE

There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation.

METHODS

We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed.

RESULTS

Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb ≥ 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition.

CONCLUSION

The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-à-vis the risks associated with supplementing nonanemic infants with high levels of iron.Clinical Trials number: NCT01166451.

Assessing cognitive flexibility in humans and rhesus macaques with visual motion and neutral distractors

Introduction

Cognitive flexibility is the ability of an individual to make behavioral adjustments in response to internal and/or external changes. While it has been reported in a wide variety of species, established paradigms to assess cognitive flexibility vary between humans and non-human animals, making systematic comparisons difficult to interpret.

Methods

We developed a computer-based paradigm to assess cognitive flexibility in humans and non-human primates. Our paradigm (1) uses a classical reversal learning structure in combination with a set-shifting approach (4 stimuli and 3 rules) to assess flexibility at various levels; (2) it employs the use of motion as one of three possible contextual rules; (3) it comprises elements that allow a foraging-like and random interaction, i.e., instances where the animals operate the task without following a strategy, to potentially minimize frustration in favor of a more positive engagement.

Results and Discussion

We show that motion can be used as a feature dimension (in addition to commonly used shape and color) to assess cognitive flexibility. Due to the way motion is processed in the primate brain, we argue that this dimension is an ideal candidate in situations where a non-binary rule set is needed and where participants might not be able to fully grasp other visual information of the stimulus (e.g., quantity in Wisconsin Card Sorting Test). All participants in our experiment flexibly shifted to and from motion-based rules as well as color- and shape-based rules, but did so with different proficiencies. Overall, we believe that with such approach it is possible to better characterize the evolution of cognitive flexibility in primates, as well as to develop more efficient tools to diagnose and treat various executive function deficits.

Neural substrates underlying effortful control deficit in autism spectrum disorder: a meta-analysis of fMRI studies

Effortful control comprises attentional control, inhibitory control, and cognitive flexibility subprocesses. Effortful control is impaired in individuals with autism spectrum disorder, yet its neural underpinnings remain elusive. By conducting a coordinate-based meta-analysis, this study compared the brain activation patterns between autism and typically developing individuals and examined the effect of age on brain activation in each effortful control subprocesses. Meta-analytic results from 22 studies revealed that, individuals with autism showed hypoactivation in the default mode network for tasks tapping inhibitory control functioning (threshold-free cluster enhancement p < 0.001). When these individuals perform tasks tapping attentional control and cognitive flexibility, they exhibited aberrant activation in various brain networks including default mode network, dorsal attention, frontoparietal, visual and somatomotor networks (uncorrected ps < 0.005). Meta-regression analyses revealed that brain regions within the default mode network showed a significant decreasing trend in activation with increasing age (uncorrected p < 0.05). In summary, individuals with autism showed aberrant activation patterns across multiple brain functional networks during all cognitive tasks supporting effortful control, with some regions showing a decrease in activation with increasing age.

Evaluation of Compensation Strategies for Gait Impairment in Patients With Parkinson Disease

BACKGROUND AND OBJECTIVES

Compensation strategies are essential in Parkinson disease (PD) gait rehabilitation. However, besides external cueing, these strategies have rarely been investigated systematically. We aimed to perform the following: (1) establish the patients' perspective on the efficacy and usability of 5 different compensation strategies; (2) quantify the efficacy of these strategies on spatiotemporal gait parameters; and (3) explore associations between the effects of specific strategies and patient characteristics.

METHODS

We recruited persons with PD and self-reported disabling gait impairments for this laboratory-based, within-subject study. Clinimetrics included the following: questionnaires (New Freezing of Gait Questionnaire, Vividness of Movement Imagery Questionnaire, Goldsmiths Musical Sophistication Index), cognitive assessments (Attentional Network Test and Montreal Cognitive Assessment [MoCA], Brixton), and physical examinations (Movement Disorders Society Unified Parkinson's Disease Rating Scale [MDS-UPDRS III], Mini-Balance Evaluation Systems Test, tandem gait, and rapid turns test). Gait assessment consisted of six 3-minute trials of continuous walking around a 6-m walkway. Trials comprised the following: (1) baseline gait; (2) external cueing; (3) internal cueing; (4) action observation; (5) motor imagery; and (6) adopting a new walking pattern. Spatiotemporal gait parameters were acquired using 3-dimensional motion capture analysis. Strategy efficacy was determined by the change in gait variability compared with baseline gait. Associated patient characteristics were explored using regression analyses.

RESULTS

A total of 101 participants (50 men; median [range] age: 66 [47-91] years) were included. The effects of the different strategies varied greatly among participants. While participants with higher baseline variability showed larger improvements using compensation strategies, participants without freezing of gait, with lower MDS-UPDRS III scores, higher balance capacity, and better performance in orienting attention also showed greater improvements in gait variability. Higher MoCA scores were associated with greater efficacy of external cueing.

DISCUSSION

Our findings support the use of compensation strategies in gait rehabilitation for PD but highlight the importance of a personalized approach. Even patients with high gait variability are able to improve through the application of compensation strategies, but certain levels of cognitive and functional reserve seem necessary to optimally benefit from them.

How Can Animal Models Inform the Understanding of Cognitive Inflexibility in Patients with Anorexia Nervosa?

Deficits in cognitive flexibility are consistently seen in patients with anorexia nervosa (AN). This type of cognitive impairment is thought to be associated with the persistence of AN because it leads to deeply ingrained patterns of thought and behaviour that are highly resistant to change. Neurobiological drivers of cognitive inflexibility have some commonalities with the abnormal brain functional outcomes described in patients with AN, including disrupted prefrontal cortical function, and dysregulated dopamine and serotonin neurotransmitter systems. The activity-based anorexia (ABA) model recapitulates the key features of AN in human patients, including rapid weight loss caused by self-starvation and hyperactivity, supporting its application in investigating the cognitive and neurobiological causes of pathological weight loss. The aim of this review is to describe the relationship between AN, neural function and cognitive flexibility in human patients, and to highlight how new techniques in behavioural neuroscience can improve the utility of animal models of AN to inform the development of novel therapeutics.

Neuroanatomical changes associated with conduct disorder in boys: influence of childhood maltreatment

Childhood maltreatment (CM) poses a serious risk to the physical, emotional and psychological well-being of children, and can advance the development of maladaptive behaviors, including conduct disorder (CD). CD involves repetitive, persistent violations of others' basic rights and societal norms. Little is known about whether and how CM influences the neural mechanisms underlying CD, and CD-characteristic neuroanatomical changes have not yet been defined in a structural magnetic resonance imaging (sMRI) study. Here, we used voxel-based morphometry (VBM) and surface-based morphometry (SBM) to investigate the influence of the CD diagnosis and CM on the brain in 96 boys diagnosed with CD (62 with CM) and 86 typically developing (TD) boys (46 with CM). The participants were 12-17 years of age. Compared to the CM- CD group, the CM+ CD group had structural gray matter (GM) alterations in the fronto-limbic regions, including the left amygdala, right posterior cingulate cortex (PCC), right putamen, right dorsolateral prefrontal cortex (dlPFC) and right anterior cingulate cortex (ACC). We also found boys with CD exhibited increased GM volume in bilateral dorsomedial prefrontal cortex (dmPFC), as well as decreased GM volume and decreased gyrification in the left superior temporal gyrus (STG) relative to TD boys. Regional GM volume correlated with aggression and conduct problem severity in the CD group, suggesting that the GM changes may contribute to increased aggression and conduct problems in boys with CD who have suffered CM. In conclusion, these results demonstrate previously unreported CM-associated distinct brain structural changes among CD-diagnosed boys.

Executive Functions in Aging: An Experimental and Computational Study of the Wisconsin Card Sorting and Brixton Spatial Anticipation Tests

In order to explore the effect of normal aging on executive function, we tested 25 younger adults and 25 neurologically healthy older adults on the Wisconsin Card Sorting Test (WCST) and the Brixton Spatial Anticipation Test (BRXT), two classic tests of executive function. We found that older participants were more likely than younger participants to err on both tasks, but the additional errors of older participants tended to be related to task set maintenance and rule inference rather than perseveration. We further found that the tendency to perseverate (across all participants) on the WCST was related to the tendency to produce stimulus or response perseverations on the BRXT, rather than any tendency to perseverate on BRXT rule application. Finally, on both tasks, older participants were also slower, particularly on trials following an error, than younger participants. To explore the neurocomputational basis for the observed behaviours we then extended an existing model of schema-modulated action selection on the WCST to the BRXT. We argue on the basis of the model that the performance of older participants on both tasks reflects a slower update of schema thresholds within the basal ganglia, coupled with a decrease in sensitivity to feedback.

The neural substrate and underlying mechanisms of executive control fluctuations in primates

Trial-by-trial alterations in response time have been linked to fluctuations of executive control and transient lapses of attention. Here, we report remarkable homologies in performance-dependent fluctuations of response time between humans and monkeys. We examined the effects of selective bilateral lesions in four frontal regions on control fluctuations in the context of a rule-shifting task. Lesions within orbitofrontal cortex (OFC), but not within superior-lateral prefrontal cortex, significantly exaggerated the performance-dependent fluctuations of control and prevented its restoration following feedback. Lesions within dorsolateral prefrontal cortex (DLPFC) or within anterior-cingulate cortex (ACC) led to instability of control and disruption of its link with monkeys' upcoming decisions. Examining the activity of DLPFC and OFC cells shed more lights on the underlying neuronal mechanisms by showing that before the start of each trial, OFC cell activity conveyed detailed information regarding the current state of executive control and the likelihood of success or failure in the future decisions. This further emphasizes the crucial role of OFC in the trial-by-trial allocation (setting) of control to the ongoing task. These findings bring insights to the neural architecture of executive control in primates and suggest that DLPFC and ACC support sustained executive control, but OFC is more involved in setting and restoring the control.

What do neuropsychological tests assess?

Background. Contemporary neuroimaging techniques, particularly fMRI and PET, have demonstrated that cognitive abilities do not strictly depend on specific brain areas, but rather on complex brain circuits or systems.Methods. Using PubMed and Google Scholar databases, a search for functional studies (fMRI and PET) during the performance of several neuropsychological tests was done. The pattern of brain activity found during the solution of some executive functions, language, memory, calculation, and visuospatial/visuoconstructive abilities is reviewed.Results. Brain activity supporting the performance in these tests is usually quite extended, and involves not only those brain areas traditionally assumed in neuropsychology, but also other cortical and sometimes subcortical regions.Conclusions. Most neuropsychological tests are simultaneously evaluating different cognitive abilities associated with the activity of diverse brain areas. "Cognitive/anatomical" correlations could only be established for some relatively simple functions. This change in the understanding about the brain organization of cognition has not been reflected in the interpretation of the neuropsychological tests yet. The interpretation of neuropsychological tests should be based not only in clinical observations but also in functional studies. This is a necessary further step in clinical neuropsychology.

Fluency test generation and errors in focal frontal and posterior lesions

The number produced on fluency tasks is widely used to measure voluntary response generation. To further evaluate the relationship between generation, errors, and the area of anatomical damage we administered eight fluency tasks (word, design, gesture, ideational) to a large group of focal frontal (n = 69) and posterior (n = 43) patients and controls (n = 150). Lesions were analysed by a finer-grained frontal localisation method, and traditional subdivisions (anterior/posterior, left/right frontal). Thus, we compared patients with Lateral lesions to patients with Medial lesions. Our results show that all fluency tasks are sensitive to frontal lobe damage for the number of correct responses and, for the first time, we provide evidence that seven fluency tasks show frontal sensitivity in terms of errors (perseverations, rule-breaks). Lateral (not Medial) patients produced the highest error rates, indicative of task-setting or monitoring difficulties. There was a right frontal effect for perseverative errors when retrieving known or stored items and rule-break errors when creating novel responses. Left lateral effects were specific to phonemic word fluency rule-breaks and perseverations for meaningless gesture fluency. In addition, our generation output and error findings support a frontal role in novelty processes. Finally, we confirm our previous generation findings suggesting critical roles of the superior medial region in energization and the left inferior frontal region in selection (Robinson et al., 2012). Overall, these results support the notion that frontal functions comprise a set of highly specialised cognitive processes, supported by distinct frontal regions.

Towards an expanded neuroscientific understanding of social play

Play has been recognized as a complex and diverse set of behaviors that has been difficult to define. Play can range from rough and tumble play among rats to a human child playing a computer game. Play has been understood to exist in multiple forms such as social, object, and locomotor (Burghardt, 2005). In this article we review the literatures on the neural basis of social play, on heart rate variability, on behavioral switching and set-shifting, on prepulse inhibition of the acoustic startle reflex, and on learning at the level of the basal ganglia. Each of these neuronal pathways, aside from heart rate variability, is rooted in the parafascicular nucleus of the thalamus, an important neural substrate for social play. We argue that social play optimally balances a number of opposing neural pathways by engaging systems involved in safety versus danger (heart rate variability), automatized reactions versus learned reactions to new stimuli (behavioral switching and set-shifting), and gating relevant versus less relevant stimuli (prepulse inhibition of the acoustic startle reflex). The idea that play, in addition to its role in interpersonal adaptation to social life, may have a central role in optimizing flexibility and creativity in individual response to novelty has been explored by previous authors (Huizinga, 1955; Spinka et al., 2001; Pellegrini et al., 2007; Pellis and Pellis, 2017). In this paper we explore the possible underlying neural basis for this function of play, having to do with balancing various neural networks, and in doing so propose an expanded understanding of the nature and function of social play.

A network analysis and empirical validation of executive deficits in patients with psychosis and their healthy siblings

BACKGROUND

Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are commonly observed and typically assessed using tests like the Wisconsin Card Sorting Test (WCST). However, the structure of executive deficits remains unclear, and the underlying processes may be different. This study aimed to explore and compare the network structure of WCST measures in patients with psychosis and their unaffected siblings and to empirically validate the resulting network structure of the patients.

METHODS

The subjects were 298 patients with a DSM 5 diagnosis of a psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the WCST were examined by means of exploratory graph analysis (EGA) and network centrality parameters.

RESULTS

The WCST network structure comprised 4 dimensions: perseveration (PER), inefficient sorting (IS), failure to maintain set (FMS) and learning (LNG). The patient and sibling groups showed a similar network structure, which was reliably estimated. PER and IS showed common and strong associations with antecedent, concurrent and outcome validators. The LNG dimension was also moderately associated with these validators, but FMS did not show significant associations.

CONCLUSIONS

Four cognitive processes underlying WCST performance were identified by the network analysis. PER, IS and LNG were associated with and shared common antecedent, concurrent and outcome validators, while FMS was not associated with external validators. These four underlying dysfunctions might help disentangle the neurofunctional basis of executive deficits in psychosis.

A combined therapeutic regimen of citalopram and environmental enrichment ameliorates attentional set-shifting performance after brain trauma

Traumatic brain injuries (TBI) have led to lasting deficits for an estimated 5.3 million American patients. Effective therapies for these patients remain scarce and each of the clinical trials stemming from success in experimental models has failed. We believe that the failures may be, in part, due to the lack of preclinical assessment of cognitive domains that widely affect clinical TBI. Specifically, the behavioral tasks in the TBI literature often do not focus on common executive impairments related to the frontal lobe such as cognitive flexibility. In previous work, we have demonstrated that the attentional set-shifting test (AST), a task analogous to the clinically-employed Wisconsin Card Sorting Test (WCST), could be used to identify cognitive flexibility impairments following controlled cortical impact (CCI) injury. In this study, we hypothesized that both the administration of the antidepressant drug citalopram (CIT) and exposure to a preclinical model of neurorehabilitation, environmental enrichment (EE), would attenuate cognitive performance deficits on AST when provided alone and lead to greater benefits when administered in combination. Adult male rats were subjected to a moderate-severe CCI or sham injury. Rats were randomly divided into experimental groups that included surgical injury, drug therapy, and housing condition. We observed that both CIT and EE provided significant cognitive recovery when administered alone and reversal learning performance recovery increased the most when the therapies were combined (p < 0.05). Ongoing studies continue to evaluate novel ways of assessing more clinically relevant measurements of high order cognitive TBI-related impairments in the rat model.

A Predictive Processing Account of Card Sorting: Fast Proactive and Reactive Frontoparietal Cortical Dynamics during Inference and Learning of Perceptual Categories

For decades, a common assumption in cognitive neuroscience has been that prefrontal executive control is mainly engaged during target detection [Posner, M. I., & Petersen, S. E. The attention system of the human brain. Annual Review of Neuroscience, 13, 25-42, 1990]. More recently, predictive processing theories of frontal function under the Bayesian brain hypothesis emphasize a key role of proactive control for anticipatory action selection (i.e., planning as active inference). Here, we review evidence of fast and widespread EEG and magnetoencephalographic fronto-temporo-parietal cortical activations elicited by feedback cues and target cards in the Wisconsin Card Sorting Test. This evidence is best interpreted when considering negative and positive feedback as predictive cues (i.e., sensory outcomes) for proactively updating beliefs about unknown perceptual categories. Such predictive cues inform posterior beliefs about high-level hidden categories governing subsequent response selection at target onset. Quite remarkably, these new views concur with Don Stuss' early findings concerning two broad classes of P300 cortical responses evoked by feedback cues and target cards in a computerized Wisconsin Card Sorting Test analogue. Stuss' discussion of those P300 responses-in terms of the resolution of uncertainty about response (policy) selection as well as the participants' expectancies for future perceptual or motor activities and their timing-was prescient of current predictive processing and active (Bayesian) inference theories. From these new premises, a domain-general frontoparietal cortical network is rapidly engaged during two temporarily distinct stages of inference and learning of perceptual categories that underwrite goal-directed card sorting behavior, and they each engage prefrontal executive functions in fundamentally distinct ways.

A Frontal Account of False Alarms

Prior research has demonstrated that the frontal lobes play a critical role in the top-down control of behavior, and damage to the frontal cortex impairs performance on tasks that require executive control [Burgess, P. W., & Stuss, D. T. Fifty years of prefrontal cortex research: Impact on assessment. Journal of the International Neuropsychological Society, 23, 755-767, 2017; Stuss, D. T., & Levine, B. Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual Review of Psychology, 53, 401-433, 2002]. Across executive functioning tasks, performance deficits are often quantified as the number of false alarms per total number of nontarget trials. However, most studies of frontal lobe function focus on individual task performance and do not discuss commonalities of errors committed across different tasks. Here, we describe a neurocognitive account that explores the link between deficient frontal lobe function and increased false alarms across an array of experimental tasks from a variety of task domains. We review evidence for heightened false alarms following frontal deficits in episodic long-term memory tests, working memory tasks (e.g., n-back), attentional tasks (e.g., continuous performance tasks), interference control tasks (e.g., recent probes), and inhibitory control tasks (e.g., go/no-go). We examine this relationship via neuroimaging studies, lesion studies, and across age groups and pathologies that impact the pFC, and we propose 11 issues in cognitive processing that can result in false alarms. In our review, some overlapping neural regions were implicated in the regulation of false alarms. Ultimately, however, we find evidence for the fractionation and localization of certain frontal processes related to the commission of specific types of false alarms. We outline avenues for additional research that will enable further delineation of the fractionation of the frontal lobes' regulation of false alarms.

Rule Perseveration during Task-Switching in Brain Tumor: A Severe Form of Task-Setting Impairment

It has been proposed that at least two distinct processes are engaged during task-switching: reconfiguration of the currently relevant task-set and interference resolution arising from the competing task-set. Whereas in healthy individuals the two are difficult to disentangle, their disruption is thought to cause different impairments in brain-damaged patients. Yet, the observed deficits are inconsistent across studies and do not allow drawing conclusions regarding their independence. Forty-one brain tumor patients were tested on a task-switching paradigm. We compared their performance between switch and repeat trials (switch cost) to assess rule reconfiguration, and between trials requiring the same response (congruent) and a different response for the two tasks (incongruent) to assess interference control. In line with previous studies, we found the greatest proportion of errors on incongruent trials, suggesting an interference control impairment. However, a closer look at the distribution of errors between two task rules revealed a rule perseveration impairment: Patients with high error rate on incongruent trials often applied only one task rule throughout the task and less frequently switched to the alternative one. Multivariate lesion-symptom mapping analysis unveiled the relationship between lesions localized in left orbitofrontal and posterior subcortical regions and perseveration scores, measured as absolute difference in accuracy between two task rules. This finding points to a more severe task-setting impairment, not reflected as a mere switching deficit, but instead as a difficulty in creating multiple stable task representations, in line with recent accounts of OFC functions suggesting its critical role in representing task states.

Intact Proactive Motor Inhibition after Unilateral Prefrontal Cortex or Basal Ganglia Lesions

Previous research provided evidence for the critical importance of the PFC and BG for reactive motor inhibition, that is, when actions are cancelled in response to external signals. Less is known about the role of the PFC and BG in proactive motor inhibition, referring to preparation for an upcoming stop signal. In this study, patients with unilateral lesions to the BG or lateral PFC performed in a cued go/no-go task, whereas their EEG was recorded. The paradigm called for cue-based preparation for upcoming, lateralized no-go signals. Based on previous findings, we focused on EEG indices of cognitive control (prefrontal beta), motor preparation (sensorimotor mu/beta, contingent negative variation [CNV]), and preparatory attention (occipital alpha, CNV). On a behavioral level, no differences between patients and controls were found, suggesting an intact ability to proactively prepare for motor inhibition. Patients showed an altered preparatory CNV effect, but no other differences in electrophysiological activity related to proactive and reactive motor inhibition. Our results suggest a context-dependent role of BG and PFC structures in motor inhibition, being critical in reactive, unpredictable contexts, but less so in situations where one can prepare for stopping on a short timescale.

Cognitive Impairments in Spinocerebellar Ataxia Type 10 and Their Relation to Cortical Thickness

BACKGROUND

Spinocerebellar ataxia type 10 is a neurodegenerative disorder caused by the expansion of an ATTCT pentanucleotide repeat. Its clinical features include ataxia and, in some cases, epileptic seizures. There is, however, a dearth of information about its cognitive deficits and the neural bases underpinning them.

OBJECTIVES

The objectives of this study were to characterize the performance of spinocerebellar ataxia type 10 patients in 2 cognitive domains typically affected in spinocerebellar ataxias, memory and executive function, and to correlate the identified cognitive impairments with ataxia severity and cerebral/cerebellar cortical thickness, as quantified by MRI.

METHODS

Memory and executive function tests were administered to 17 genetically confirmed Mexican spinocerebellar ataxia type 10 patients, and their results were compared with 17 healthy matched volunteers. MRI was performed in 16 patients.

RESULTS

Patients showed deficits in visual and visuospatial short-term memory, reduced storage capacity for verbal memory, and impaired monitoring, planning, and cognitive flexibility, which were ataxia independent. Patients with seizures (n = 9) and without seizures (n = 8) did not differ significantly in cognitive performance. There were significant correlations between short-term visuospatial memory impairment and posterior cerebellar lobe cortical thickness (bilateral lobule VI, IX, and right X). Cognitive flexibility deficiencies correlated with cerebral cortical thickness in the left middle frontal, cingulate, opercular, and temporal gyri. Cerebellar cortical thickness in several bilateral regions was correlated with motor impairment.

CONCLUSIONS

Patients with spinocerebellar ataxia type 10 show significant memory and executive dysfunction that can be correlated with deterioration in the posterior lobe of the cerebellum and prefrontal, cingulate, and middle temporal cortices.

Relationship between cool and hot executive function in young children: A near-infrared spectroscopy study

A theoretical distinction exists between the cool and hot aspects of executive function (EF). At the neural level, cool EF may be associated with activation in the lateral prefrontal cortex and the anterior cingulate cortex, whereas the orbitofrontal cortex may play a key role in hot EF. However, some recent studies have shown that young children show activity in the lateral prefrontal regions during hot EF tasks, suggesting that the distinction between hot and cool EF may not be as marked. Nevertheless, few neuroimaging studies have directly examined the relationship between cool and hot EF. In this study, preschool children (N = 46, mean age = 66.1 months) were given both cool (Dimensional Change Card Sort (DCCS) and Stroop-like tasks) and hot (delay of gratification) EF tasks, and neural activation during these tasks was measured using functional near-infrared spectroscopy (fNIRS). Correlational analyses and analysis of variance (ANOVA) were conducted to assess the relationship between cool and hot EF. At the behavioral level, a moderate correlation was found between DCCS and Stroop-like tasks, but no correlation emerged between cool and hot EF tasks. At the neural level, prefrontal activations during the cool EF tasks did not correlate with those during the hot EF task. Further, children showed stronger prefrontal activations during the DCCS tasks compared to the delay of gratification tasks. The results suggest that the neural basis of hot and cool EF may differ during early childhood.

Internal manipulation of perceptual representations in human flexible cognition: A computational model

Executive functions represent a set of processes in goal-directed cognition that depend on integrated cortical-basal ganglia brain systems and form the basis of flexible human behaviour. Several computational models have been proposed for studying cognitive flexibility as a key executive function and the Wisconsin card sorting test (WCST) that represents an important neuropsychological tool to investigate it. These models clarify important aspects that underlie cognitive flexibility, particularly decision-making, motor response, and feedback-dependent learning processes. However, several studies suggest that the categorisation processes involved in the solution of the WCST include an additional computational stage of category representation that supports the other processes. Surprisingly, all models of the WCST ignore this fundamental stage and they assume that decision making directly triggers actions. Thus, we propose a novel hypothesis where the key mechanisms of cognitive flexibility and goal-directed behaviour rely on the acquisition of suitable representations of percepts and their top-down internal manipulation. Moreover, we propose a neuro-inspired computational model to operationalise this hypothesis. The capacity of the model to support cognitive flexibility was validated by systematically reproducing and interpreting the behaviour exhibited in the WCST by young and old healthy adults, and by frontal and Parkinson patients. The results corroborate and further articulate the hypothesis that the internal manipulation of representations is a core process in goal-directed flexible cognition.

The role of the medial prefrontal cortex in cognition, ageing and dementia

Humans require a plethora of higher cognitive skills to perform executive functions, such as reasoning, planning, language and social interactions, which are regulated predominantly by the prefrontal cortex. The prefrontal cortex comprises the lateral, medial and orbitofrontal regions. In higher primates, the lateral prefrontal cortex is further separated into the respective dorsal and ventral subregions. However, all these regions have variably been implicated in several fronto-subcortical circuits. Dysfunction of these circuits has been highlighted in vascular and other neurocognitive disorders. Recent advances suggest the medial prefrontal cortex plays an important regulatory role in numerous cognitive functions, including attention, inhibitory control, habit formation and working, spatial or long-term memory. The medial prefrontal cortex appears highly interconnected with subcortical regions (thalamus, amygdala and hippocampus) and exerts top-down executive control over various cognitive domains and stimuli. Much of our knowledge comes from rodent models using precise lesions and electrophysiology readouts from specific medial prefrontal cortex locations. Although, anatomical disparities of the rodent medial prefrontal cortex compared to the primate homologue are apparent, current rodent models have effectively implicated the medial prefrontal cortex as a neural substrate of cognitive decline within ageing and dementia. Human brain connectivity-based neuroimaging has demonstrated that large-scale medial prefrontal cortex networks, such as the default mode network, are equally important for cognition. However, there is little consensus on how medial prefrontal cortex functional connectivity specifically changes during brain pathological states. In context with previous work in rodents and non-human primates, we attempt to convey a consensus on the current understanding of the role of predominantly the medial prefrontal cortex and its functional connectivity measured by resting-state functional MRI in ageing associated disorders, including prodromal dementia states, Alzheimer's disease, post-ischaemic stroke, Parkinsonism and frontotemporal dementia. Previous cross-sectional studies suggest that medial prefrontal cortex functional connectivity abnormalities are consistently found in the default mode network across both ageing and neurocognitive disorders such as Alzheimer's disease and vascular cognitive impairment. Distinct disease-specific patterns of medial prefrontal cortex functional connectivity alterations within specific large-scale networks appear to consistently feature in the default mode network, whilst detrimental connectivity alterations are associated with cognitive impairments independently from structural pathological aberrations, such as grey matter atrophy. These disease-specific patterns of medial prefrontal cortex functional connectivity also precede structural pathological changes and may be driven by ageing-related vascular mechanisms. The default mode network supports utility as a potential biomarker and therapeutic target for dementia-associated conditions. Yet, these associations still require validation in longitudinal studies using larger sample sizes.

Cannabinoid Modulation of Dopamine Release During Motivation, Periodic Reinforcement, Exploratory Behavior, Habit Formation, and Attention

Motivational and attentional processes energize action sequences to facilitate evolutionary competition and promote behavioral fitness. Decades of neuropharmacology, electrophysiology and electrochemistry research indicate that the mesocorticolimbic DA pathway modulates both motivation and attention. More recently, it was realized that mesocorticolimbic DA function is tightly regulated by the brain's endocannabinoid system and greatly influenced by exogenous cannabinoids-which have been harnessed by humanity for medicinal, ritualistic, and recreational uses for 12,000 years. Exogenous cannabinoids, like the primary psychoactive component of cannabis, delta-9-tetrahydrocannabinol, produce their effects by acting at binding sites for naturally occurring endocannabinoids. The brain's endocannabinoid system consists of two G-protein coupled receptors, endogenous lipid ligands for these receptor targets, and several synthetic and metabolic enzymes involved in their production and degradation. Emerging evidence indicates that the endocannabinoid 2-arachidonoylglycerol is necessary to observe concurrent increases in DA release and motivated behavior. And the historical pharmacology literature indicates a role for cannabinoid signaling in both motivational and attentional processes. While both types of behaviors have been scrutinized under manipulation by either DA or cannabinoid agents, there is considerably less insight into prospective interactions between these two important signaling systems. This review attempts to summate the relevance of cannabinoid modulation of DA release during operant tasks designed to investigate either motivational or attentional control of behavior. We first describe how cannabinoids influence DA release and goal-directed action under a variety of reinforcement contingencies. Then we consider the role that endocannabinoids might play in switching an animal's motivation from a goal-directed action to the search for an alternative outcome, in addition to the formation of long-term habits. Finally, dissociable features of attentional behavior using both the 5-choice serial reaction time task and the attentional set-shifting task are discussed along with their distinct influences by DA and cannabinoids. We end with discussing potential targets for further research regarding DA-cannabinoid interactions within key substrates involved in motivation and attention.

Social cognition and executive functioning in multiple sclerosis: A cluster-analytic approach

Multiple sclerosis (MS) is associated with deficits in social cognition, the process underlying social interaction and cognitive function. However, the relationships between executive impairment and social cognition remain unclear in MS. Previous studies exclusively focused on group comparisons between healthy controls and patients with MS, treating the latter as a homogeneous population. The variability of socio- and neurocognitive profiles in this pathology therefore remains underexplored. In the present study, we used a cluster analytic approach to explore the heterogeneity of executive and social cognition skills in MS. A total of 106 patients with MS were compared with 53 healthy matched controls on executive (e.g., working memory) and social cognition (facial emotion recognition and theory of mind) performances. A cluster analysis was then performed, focusing on the MS sample, to explore the presence of differential patterns of interaction between executive and social cognition difficulties and their links to sociodemographic, clinical and cognitive variables. We identified three distinct functional profiles: patients with no executive or social cognition deficits (Cluster 1); patients with difficulties in facial emotion recognition and theory of mind and, to a lesser extent, executive functioning (Cluster 2); and patients with executive functioning difficulties only (Cluster 3). Clinical characteristics (disease duration, disability, fatigue) did not differ between clusters. CONCLUSIONS: These results suggest that there are qualitative differences in the social cognition and executive difficulties that are commonly found among patients with MS. If replicated, the identification of these profiles in clinical practice could allow for more individualized rehabilitation.

Cognitive and Motor Perseveration Are Associated in Older Adults

Aging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4 ± 3.7 y/o) and older participants (76.5 ± 2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.

The Role of Primate Prefrontal Cortex in Bias and Shift Between Visual Dimensions

Imaging and neural activity recording studies have shown activation in the primate prefrontal cortex when shifting attention between visual dimensions is necessary to achieve goals. A fundamental unanswered question is whether representations of these dimensions emerge from top-down attentional processes mediated by prefrontal regions or from bottom-up processes within visual cortical regions. We hypothesized a causative link between prefrontal cortical regions and dimension-based behavior. In large cohorts of humans and macaque monkeys, performing the same attention shifting task, we found that both species successfully shifted between visual dimensions, but both species also showed a significant behavioral advantage/bias to a particular dimension; however, these biases were in opposite directions in humans (bias to color) versus monkeys (bias to shape). Monkeys' bias remained after selective bilateral lesions within the anterior cingulate cortex (ACC), frontopolar cortex, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), or superior, lateral prefrontal cortex. However, lesions within certain regions (ACC, DLPFC, or OFC) impaired monkeys' ability to shift between these dimensions. We conclude that goal-directed processing of a particular dimension for the executive control of behavior depends on the integrity of prefrontal cortex; however, representation of competing dimensions and bias toward them does not depend on top-down prefrontal-mediated processes.

The Influence of Slow-Paced Breathing on Executive Function

Abstract. The aim of this experiment was to test the immediate effects of slow-paced breathing on executive function. Slow-paced breathing is suggested to increase cardiac vagal activity, and the neurovisceral integration model predicts that higher cardiac vagal activity leads to better executive functioning. In total, 78 participants (41 men, 37 women; Mage = 23.22 years) took part in two counterbalanced experimental conditions: a 3 × 5 min slow-paced breathing condition and a television viewing control condition. After each condition, heart rate variability was measured and participants performed three executive function tasks: the color-word match Stroop (inhibition), the automated operation span task (working memory), and the modified card sorting task (cognitive flexibility). Results showed that performance on executive function tasks was better after slow-paced breathing compared to control, with higher scores observed for Stroop interference accuracy, automated operation span score, and perseverative errors, but not Stroop interference reaction times. This difference in executive function between experimental conditions was not mediated by cardiac vagal activity. Therefore, findings only partially align with predictions of the neurovisceral integration model. Slow-paced breathing appears a promising technique to improve immediate executive function performance. Further studies are recommended that address possible alternative underlying mechanisms and long-term effects.

Toward a neuropsychology of political orientation: exploring ideology in patients with frontal and midbrain lesions

How do people form their political beliefs? In an effort to address this question, we adopt a neuropsychological approach. In a natural experiment, we explored links between neuroanatomy and ideological preferences in two samples of brain lesion patients in New York City. Specifically, we compared the political orientations of patients with frontal lobe lesions, patients with amygdala lesions and healthy control subjects. Lesion type classification analyses revealed that people with frontal lesions held more conservative (or less liberal) beliefs than those with anterior temporal lobe lesions or no lesions. Additional analyses predicting ideology by extent of damage provided convergent evidence that greater damage in the dorsolateral prefrontal cortex-but not the amygdala-was associated with greater conservatism. These findings were robust to model specifications that adjusted for demographic, mood, and affect-related variables. Although measures of executive function failed to mediate the relationship between frontal lesions and ideology, our findings suggest that the prefrontal cortex may play a role in promoting the development of liberal ideology. Our approach suggests useful directions for future work to address the issue of whether biological developments precede political attitudes or vice versa-or both. This article is part of the theme issue 'The political brain: neurocognitive and computational mechanisms'.

The Mediated Moderation Model of Depressive Symptoms, Alcohol Use, and Consequences: The Protective Role of Executive Function

Heavy episodic drinking (HED) and negative drinking consequences represent prevalent and serious health concerns for college students. Depressive symptoms may elevate students' risk for engaging in HED and experiencing negative consequences, but levels of risk may vary by executive function (EF) capabilities. Growing evidence suggests that EF deficits are associated with comorbid depressive symptoms and alcohol misuse. Nevertheless, little is known about unique and shared risks that depressive symptoms and EF may interactively pose for HED and negative drinking consequences. Methods: To address these gaps, the study assessed depressive symptoms, multiple domains of EF via multimethod approach, HED, and negative drinking consequences in a sample of 446 undergraduate students. Mediated moderation models were conducted to examine associations between depressive symptoms and alcohol use behaviors and modulating roles of EF. Results: Depressive symptoms, poor planning, and self-reported executive dysfunction were significantly associated with HED and negative drinking consequences. HED mediated the effect of depressive symptoms and executive dysfunction on negative consequences. A significant interaction indicated that better EF (i.e. low or average self-reported executive dysfunction) may buffer the risk depressive symptoms present for negative drinking consequences. Conclusions: The current findings suggest that among college students, risk and resilience factors for HED and negative drinking consequences may vary. Effective EF capabilities may be especially helpful for reducing students' risk for more serious drinking consequences.

Early Life Stress Preceding Mild Pediatric Traumatic Brain Injury Increases Neuroinflammation but Does Not Exacerbate Impairment of Cognitive Flexibility during Adolescence

Early life stress (ELS) followed by pediatric mild traumatic brain injury (mTBI) negatively impacts spatial learning and memory and increases microglial activation in adolescent rats, but whether the same paradigm negatively affects higher order executive function is not known. Hence, we utilized the attentional set-shifting test (AST) to evaluate executive function (cognitive flexibility) and to determine its relationship with neuroinflammation and hypothalamic-pituitary-adrenal (HPA) axis activity after pediatric mTBI in male rats. ELS was induced via maternal separation for 180 min per day (MS180) during the first 21 post-natal (P) days, while controls (CONT) were undisturbed. At P21, fully anesthetized rats received a mild controlled cortical impact (2.2 mm tissue deformation at 4 m/sec) or sham injury. AST was evaluated during adolescence on P35-P40 and cytokine expression and HPA activity were analyzed on P42. The data indicate that pediatric mTBI produced a significant reversal learning deficit on the AST versus sham (p < 0.05), but that the impairment was not exacerbated further by MS180. Additionally, ELS produced an overall elevation in set-loss errors on the AST, and increased hippocampal interleukin (IL)-1β expression after TBI. A significant correlation was observed in executive dysfunction and IL-1β expression in the ipsilateral pre-frontal cortex and hippocampus. Although the combination of ELS and pediatric mTBI did not worsen executive function beyond that of mTBI alone (p > 0.05), it did result in increased hippocampal neuroinflammation relative to mTBI (p < 0.05). These findings provide important insight into the susceptibility to incur alterations in cognitive and neuroimmune functioning after stress exposure and TBI during early life.

Cognition in Vascular Aging and Mild Cognitive Impairment

Cardiovascular health declines with age, due to vascular risk factors, and this leads to an increasing risk of cognitive decline. Mild cognitive impairment (MCI) is defined as the negative cognitive changes beyond what is expected in normal aging. The purpose of the study was to compare older adults with vascular risk factors (VRF), MCI patients, and healthy controls (HC) in main dimensions of cognitive control. The sample comprised a total of 109 adults, aged 50 to 85 (M = 66.09, S.D. = 9.02). They were divided into three groups: 1) older adults with VRF, 2) MCI patients, and 3) healthy controls (HC). VRF and MCI did not differ significantly in age, educational level, or gender as was the case with HC. The tests used mainly examine inhibition, cognitive flexibility, and working memory processing. Results showed that the VRF group had more Set Loss Errors in drawing designs indicating deficits in establishing cognitive set and in cognitive shifting. MCI patients displayed lower performance in processing. Hence, different types of specific impairments emerge in vascular aging and MCI, and this may imply that discrete underlying pathologies may play a role in the development of somewhat different profiles of cognitive decline.

Distinct performance profiles on the Brixton test in frontotemporal dementia

The Brixton Spatial Anticipation Test is a well-established test of executive function that evaluates the capacity to abstract, follow, and switch rules. There has been remarkably little systematic analysis of Brixton test performance in the prototypical neurodegenerative disorder of the frontal lobes: behavioural variant frontotemporal dementia (bvFTD) or evaluation of the test's ability to distinguish frontal from temporal lobe degenerative disease. We carried out a quantitative and qualitative analysis of Brixton performance in 76 patients with bvFTD and 34 with semantic dementia (SD) associated with temporal lobe degeneration. The groups were matched for demographic variables and illness duration. The bvFTD group performed significantly more poorly (U = 348, p < .0001, r = .58), 53% of patients scoring in the poor-impaired range compared with 6% of SD patients. Whereas bvFTD patients showed problems in rule acquisition and switching, SD patients did not, despite their impaired conceptual knowledge. Error analysis revealed more frequent perseverative errors in bvFTD, particularly responses unconnected to the stimulus, as well as random responses. Stimulus-bound errors were rare. Within the bvFTD group, there was variation in performance profile, which could not be explained by demographic, neurological, or genetic factors. The findings demonstrate sensitivity and specificity of the Brixton test in identifying frontal lobe degenerative disease and highlight the clinical value of qualitative analysis of test performance. From a theoretical perspective, the findings provide evidence that semantic knowledge and the capacity to acquire rules are dissociable. Moreover, they exemplify the separable functional contributions to executive performance.

Frontoparietal Network in Executive Functioning in Autism Spectrum Disorder

Higher cognitive functions in autism spectrum disorder (ASD) are characterized by impairments in executive functions (EF). While some research attributes this to an overreliance of the prefrontal cortex (PFC), others demonstrate poor recruitment of the PFC in individuals with ASD. In order to assess the emerging consensus across neuroimaging studies of EF in ASD, the current study used a coordinate-based activation likelihood estimation (ALE) analysis of 16 functional magnetic resonance imaging (fMRI) studies, resulting in a meta-analysis of data from 739 participants (356 ASD, 383 typically developing [TD] individuals) ranging from 7 to 52 years of age. Within-group analysis of EF tasks revealed that both TD and ASD participants had significant activity in PFC regions. Analysis of group differences indicated greater activation in ASD, relative to TD participants, in the right middle frontal gyrus and the anterior cingulate cortex, and lesser activation in the bilateral middle frontal, left inferior frontal gyrus, right inferior parietal lobule, and precuneus. Although both ASD and TD participants showed similar PFC activation, there was differential recruitment of wider network of EF regions such as the IPL in ASD participants. The under-recruitment of parietal regions may be due to poor connectivity of the frontoparietal networks with other regions during EF tasks or a restricted executive network in ASD participants which is limited primarily to the PFC. These results support the executive dysfunction hypothesis of ASD and suggests that poor frontoparietal recruitment may underlie some of the EF difficulties individuals with ASD experience. LAY SUMMARY: This study reports a meta-analysis of 16 brain imaging studies of executive functions (EF) in individuals with autism spectrum disorder (ASD). While parts of the brain's EF network is activated in both ASD and control participants, the ASD group does not activate a wider network of EF regions such as the parietal cortex. This may be due to poor EF network connectivity, or a constrained EF network in ASD participants. These results may underlie some of the EF difficulties individuals with ASD experience. Autism Res 2020, 13: 1762-1777. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Context-dependency in the Cognitive Bias Task and Resting-state Functional Connectivity of the Dorsolateral Prefrontal Cortex

OBJECTIVE

Goldberg, the author of the "novelty-routinization" framework, suggested a new pair of cognitive styles for agent-centered decision-making (DM), context-dependency/independency (CD/CI), quantified by the Cognitive Bias Task (CBT) and supposedly reflecting functional brain hemispheric specialization. To date, there are only three lesion and activation neuroimaging studies on the CBT with the largest sample of 12 participants. The present study is the first to analyze whole-brain functional connectivity (FC) of the dorsolateral prefrontal cortex (DLPFC), involved in contextual agent-centered DM.

METHOD

We compared whole-brain resting-state FC of the DLPFC between CD (n = 24) and CI (n = 22) healthy participants. Additionally, we investigated associations between CD/CI and different aspects of executive functions.

RESULTS

CD participants had stronger positive FC of the DLPFC with motor and visual regions; FC of the left DLPFC was more extensive. CI participants had stronger positive FC of the left DLPFC with right prefrontal and parietal-occipital areas and of the left and right DLPFC with ipsilateral cerebellar hemispheres. No sex differences were found. CD/CI had nonlinear associations with working memory.

CONCLUSIONS

The findings suggest that CD and CI are associated with different patterns of DLPFC FC. While CD is associated with FC between DLPFC and areas presumably involved in storing representations of current situation, CI is more likely to be associated with FC between DLPFC and right-lateralized associative regions, probably involved in the inhibition of the CD response and switching from processing of incoming perceptual information to creation of original response strategies.

Is the Brixton Spatial Anticipation Test sensitive to frontal dysfunction? Evidence from patients with frontal and posterior lesions

INTRODUCTION

The Brixton Spatial Anticipation Test is a widely used neuropsychological test, thought to assess executive functions and to be sensitive to frontal lobe lesions. Our aim was to investigate Brixton performance in patients with focal frontal or posterior lesions and healthy controls.

METHOD

We compared performance on the Brixton in a sample of 24 frontal patients, 18 posterior patients and 22 healthy controls. Both overall performance (total number of errors) and error types were analyzed.

RESULTS

We found no significant differences between frontal and posterior patients and healthy controls in overall Brixton performance. Moreover, our error analysis showed no difference between frontal patients, posterior patients and healthy controls. The only exception was that posterior patients had a greater tendency to guess and make more errors when following specific rules than healthy controls but this was no longer significant once fluid intelligence was controlled for. We also found no significant difference between the performance of patients with left lateral (n = 11), right lateral (n = 10) or superior medial (n = 18) frontal lesions and healthy controls.

CONCLUSIONS

The Brixton test is not sensitive to frontal lobe dysfunction. It is likely that the test draws on a range of cognitive abilities not specific to frontal lobe lesions. Hence, caution should be taken when drawing conclusions about its neural substrates.

Stimulation of the dorsolateral prefrontal cortex impacts conflict resolution in Level-1 visual perspective taking

Theory of mind is the ability to understand others' beliefs, mental states, and knowledge. Perspective-taking is a key part of this capacity, and while previous research has suggested that calculating another's perspective is relatively straightforward, executive function is required to resolve the conflict between the self and that other perspective. Previous studies have shown that theory of mind is selectively impaired by transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC). However, it has been hitherto unclear as to which specific aspect of perspective-taking is impacted. The current study administered rTMS (N = 31 adult participants) to the DLPFC (active condition) and vertex (control condition) in a within-subjects design. Participants completed a L1 VPT task after each stimulation session, and focus (relative performance on self-perspective trials compared with other perspective trials) and conflict indices (relative ability to resolve competing self/other perspectives) were calculated. Results showed that stimulation of the DLPFC selectively impaired the conflict index, suggesting that the DLPFC may be causally related with the resolution of conflict between self and other perspectives, and that self-other interference may rely on domain-general processes.