1
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Godefroy O, Weaver NA, Roussel M, Dorchies F, Kassir R, Biesbroek JM, Lee KJ, Kim BJ, Bae HJ, Lim JS, Lee M, Yu KH, Aben HP, de Kort PLM, Bordet R, Lopes R, Dondaine T, Biessels GJ, Aarabi A. Architecture and anatomy of executive processes: evidence from verbal fluency and Trail Making Test in 2009 stroke patients. J Neurol 2024:10.1007/s00415-024-12541-8. [PMID: 39060618 DOI: 10.1007/s00415-024-12541-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/21/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES The few voxel-wise lesion-symptom mapping (VLSM) studies aimed at identifying the anatomy of executive function are limited by the absence of a model and by small populations. Using Trail Making Test (TMT) and verbal fluency and a model of their architectures, our objective was to identify the key structures underlying two major executive processes, set-shifting and strategic word search. METHODS We applied a validated VLSM analysis to harmonized cognitive and imaging data from 2009 ischemic stroke patients as a part of the Meta VCI Map consortium. All contrast analyses used an adjusted threshold with 2000 Freedman-Lane permutations (p ≤ 0.05). RESULTS The TMT parts A and B were associated with structures involved in visual-spatial processing, the motor system, the frontal lobes, and their subcortical connections. Set-shifting depended on the left dorsomedial frontal region. Both semantic and phonemic fluency tests depended on verbal output abilities and processing speed with similar slopes in different languages. The strategic search process depended on Broca's area, F2 and related tracts, temporal and deep regions. Lastly, the lesion map of set-shifting did not overlap with those of strategic word search processes. INTERPRETATION Our results identify the anatomical substrates of two main executive processes, revealing that they represent only a specific subpart of previously reported structures. Finally, our results indicate that executive functions depend on several specific, anatomically separable executive processes mainly operating in various parts of the frontal lobes.
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Affiliation(s)
- Olivier Godefroy
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France.
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Martine Roussel
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Flore Dorchies
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Rania Kassir
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hayllm University College of Medicine, Anyang, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hayllm University College of Medicine, Anyang, Republic of Korea
| | - Hugo P Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Paul L M de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Régis Bordet
- Department of Pharmacology, Lille University Hospital, Lille, France
| | - Renaud Lopes
- Department of Pharmacology, Lille University Hospital, Lille, France
| | - Thibaut Dondaine
- Department of Pharmacology, Lille University Hospital, Lille, France
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Ardalan Aarabi
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
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2
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Toba MN, Malkinson TS, Howells H, Mackie MA, Spagna A. Same, Same but Different? A Multi-Method Review of the Processes Underlying Executive Control. Neuropsychol Rev 2024; 34:418-454. [PMID: 36967445 DOI: 10.1007/s11065-023-09577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/26/2022] [Indexed: 03/29/2023]
Abstract
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.
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Affiliation(s)
- Monica N Toba
- Laboratory of Functional Neurosciences (UR UPJV 4559), University Hospital of Amiens and University of Picardie Jules Verne, Amiens, France.
- CHU Amiens Picardie - Site Sud, Centre Universitaire de Recherche en Santé, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
| | - Tal Seidel Malkinson
- Paris Brain Institute, ICM, Hôpital de La Pitié-Salpêtrière, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, 75013, Paris, France
- Université de Lorraine, CRAN, F-54000, Nancy, France
| | - Henrietta Howells
- Laboratory of Motor Control, Department of Medical Biotechnologies and Translational Medicine, Humanitas Research Hospital, IRCCS, Università Degli Studi Di Milano, Milan, Italy
| | - Melissa-Ann Mackie
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alfredo Spagna
- Department of Psychology, Columbia University, New York, NY, 10025, USA.
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3
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Luo M, Duan Z, Song X, Liu C, Li R, Su K, Bai Y, Wang X, Fu W, Gao J, Feng X. Effects of Optimized Acupuncture and Moxibustion Treatment on Depressive Symptoms and Executive Functions in Patients With Post-Stroke Depression: Study Protocol for a Randomized Controlled Trial. Front Neurol 2022; 13:833696. [PMID: 35370914 PMCID: PMC8975266 DOI: 10.3389/fneur.2022.833696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/11/2022] Open
Abstract
Background Post-stroke depression (PSD), a common neuropsychiatric comorbidity after stroke, has a negative impact on the functional recovery and quality of life of survivors. It lacks effective therapeutic drugs with good curative effects and few adverse reactions. Preliminary experiments have shown that the optimized acupuncture and moxibustion treatment (OAMT), including acupuncture, moxibustion, and auricular intradermal acupuncture, improved depressive symptoms and neurological deficits in patients with PSD. However, the evidence for its effectiveness is still insufficient. Hence, we designed this study to evaluate the efficacy and safety of the OAMT in the treatment of PSD and to explore its possible mechanism from the perspective of executive functions. Methods/Design This is a randomized controlled trial, which comprises a total of 134 patients with PSD. Participants are randomized into intervention group and control group at a 1:1 ratio. All treatments are given five times per week for 4 weeks. The primary outcome is the severity of depression, which is evaluated by the Hamilton Depression Scale-17 (HAMD-17) and the Beck Depression Rating Scale (BDI). Secondary outcomes are executive abilities, which are measured by several neuropsychological tests, including the Stroop Color and Word Test (SCWT), the Trial Making Test (TMT), the Digit Symbol Substitution Test (DSST), and the Matrix Reasoning Test (MRT). All outcomes have been evaluated at baseline and weeks 4, 8, 12, and 20. At the same time, functional MRI (fMRI) is used to measure the functional connectivity in the cognitive control network (CCN) at baseline and 4 weeks after intervention. Discussion This study aims to provide high-quality evidence for the efficacy and safety of the OAMT for treating PSD. In addition, this trial is the first trial to explore if the improvement condition of depression in the OAMT group is related to the improvement of executive functions and the favorable changes in the structure. Clinical Trial Registration Chinese Clinical Trial Registry, identifier: ChiCTR2100048431.
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Affiliation(s)
- Meng Luo
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Zhaoyuan Duan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaolei Song
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chengmei Liu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ruiqing Li
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Kaiqi Su
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yanjie Bai
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaodan Wang
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenbin Fu
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Jing Gao
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- *Correspondence: Jing Gao
| | - Xiaodong Feng
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Xiaodong Feng
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4
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Yu Q, Huang X, Zhang B, Li Z, Zhang T, Hu Z, Ding M, Liang Z, Lo WLA. A Novel Perspective on the Proactive and Reactive Controls of Executive Function in Chronic Stroke Patients. Front Neurol 2022; 13:766622. [PMID: 35295836 PMCID: PMC8918511 DOI: 10.3389/fneur.2022.766622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives To investigate the proactive and reactive control process when executing a complex task in patients with stroke. Proactive control is the preparatory process before the target stimulus, whereas reactive control is an imperative resolution of interference after the target stimulus. Methods In total, 17 patients with chronic stroke and 17 healthy individuals were recruited. The proactive and reactive control of executive function was assessed by the task-switching paradigm and the AX version of the Continuous Performance Task (AX-CPT). The general executive function was assessed by Color Trial Test (CTT) and Stroop Test. The behavioral data of the task-switching paradigm were analyzed by a three-way repeated-measures ANOVA, and the AX-CPT data were analyzed by two-way repeated-measures ANOVA. Results For efficiency scores in the task-switching paradigm, trial (repeat vs. switch) × group (stroke or control group) interaction effect was significant. Post-hoc analysis on trial × group effect showed a significant between-trial difference in accuracy rates in the repeat trial in the control group regardless of 100 or 50% validity. For the AX-CPT, the main effects of condition and group on response time were statistically significant. The interaction effect of condition (AY or BX) × group (stroke or control group) was also significant. Post-hoc analysis for condition × group indicated that the stroke group had a significantly longer response time in the BX condition than the control group and longer completion time in CTT2 and larger word interference for completion time in the Stroop test than the control cohort. Conclusions Post-stroke survivors showed deficits in the performance of proactive control but not in the performance of reactive control. Deficits in proactive control may be related to the impairment of working memory. Interventions that focus on proactive control may result in improved clinical outcomes.
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Affiliation(s)
- Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaomin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Baofeng Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tao Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ziwei Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, China
| | - Minghui Ding
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenwen Liang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Zhenwen Liang
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering and Technology Research Centre for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Wai Leung Ambrose Lo
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5
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Jaywant A, DelPonte L, Kanellopoulos D, O'Dell MW, Gunning FM. The Structural and Functional Neuroanatomy of Post-Stroke Depression and Executive Dysfunction: A Review of Neuroimaging Findings and Implications for Treatment. J Geriatr Psychiatry Neurol 2022; 35:3-11. [PMID: 33073704 DOI: 10.1177/0891988720968270] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Post-stroke depression and executive dysfunction co-occur and are highly debilitating. Few treatments alleviate both depression and executive dysfunction after stroke. Understanding the brain network changes underlying post-stroke depression with executive dysfunction can inform the development of targeted and efficacious treatment. In this review, we synthesize neuroimaging findings in post-stroke depression and post-stroke executive dysfunction and highlight the network commonalities that may underlie this comorbidity. Structural and functional alterations in the cognitive control network, salience network, and default mode network are associated with depression and executive dysfunction after stroke. Specifically, post-stroke depression and executive dysfunction are both linked to changes in intrinsic functional connectivity within resting state networks, functional over-connectivity between the default mode and salience/cognitive control networks, and reduced cross-hemispheric frontoparietal functional connectivity. Cognitive training and noninvasive brain stimulation targeted at these brain network abnormalities and specific clinical phenotypes may help advance treatment for post-stroke depression with executive dysfunction.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - Larissa DelPonte
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Dora Kanellopoulos
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA.,Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA
| | - Michael W O'Dell
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA.,Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA
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6
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Segura IA, McGhee J, Della Sala S, Cowan N, Pompéia S. A reappraisal of acute doses of benzodiazepines as a model of anterograde amnesia. Hum Psychopharmacol 2021; 36:e2774. [PMID: 33368617 DOI: 10.1002/hup.2774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/28/2020] [Accepted: 12/11/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Acute administration of benzodiazepines is considered a pharmacological model of general organic anterograde amnesias (OAA). We sought to determine which type of amnesia these drugs best model by comparing the effects of diazepam with those reported in amnesiacs regarding working memory capacity (WMC), susceptibility to retroactive interference (RI), and accelerated forgetting. METHODS In this double-blind, parallel-group design study, 30 undergraduates were randomly allocated to acute oral treatments with 15 mg diazepam or placebo. WMC and story recall were assessed pre- and post-treatment. Story presentation was succeeded by 10 min of RI (spotting differences in pictures) or minimal RI (doing nothing in a darkened room). Delayed story recall was assessed under diazepam and 7 days later in a drug-free session to assess accelerated forgetting. RESULTS Recall of stories encoded under diazepam, whether reactivated or not, was severely impaired (anterograde amnesia). However, diazepam did not impair WMC, increase susceptibility to RI, or accelerate forgetting. CONCLUSIONS Diazepam's amnestic effects mirror those in patients with probable severe medial temporal damage, mostly restricted to initial consolidation and differ from other OAA (Korsakoff syndrome, frontal, transient epileptic, posttraumatic amnesia, and most progressive amnesias) in terms of WMC, susceptibility to RI and accelerated forgetting.
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Affiliation(s)
- Isis Angélica Segura
- Departamento de Psicobiologia, Universidade Federal de São Paulo- Escola Paulista de Medicina, Sao Paulo, Brazil
| | - Jamie McGhee
- Department of Psychology, Human Cognitive Neuroscience, University of Edinburgh, Edinburgh, UK.,Laboratory of Experimental Psychology, Suor Orsola Benincasa University, Naples, Italy
| | - Sergio Della Sala
- Department of Psychology, Human Cognitive Neuroscience, University of Edinburgh, Edinburgh, UK
| | - Nelson Cowan
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Sabine Pompéia
- Departamento de Psicobiologia, Universidade Federal de São Paulo- Escola Paulista de Medicina, Sao Paulo, Brazil
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7
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Balkaya M, Kim ID, Shakil F, Cho S. CD36 deficiency reduces chronic BBB dysfunction and scar formation and improves activity, hedonic and memory deficits in ischemic stroke. J Cereb Blood Flow Metab 2021; 41:486-501. [PMID: 32404022 PMCID: PMC7922745 DOI: 10.1177/0271678x20924099] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 01/06/2023]
Abstract
Ameliorating blood-brain barrier disruption and altering scar formation dynamics are potential strategies that may improve post-stroke recovery. CD36 is a class B scavenger receptor that plays a role in innate immunity, inflammation and vascular dysfunction and regulates post-stroke injury, neovascularization, reactive astrogliosis and scar formation. By subjecting WT and CD36KO mice to different MCAo occlusion durations to generate comparable acute lesion sizes, we addressed the role of CD36 in BBB dysfunction, scar formation and recovery. The majority of stroke recovery studies primarily focus on motor function. Here, we employed an extensive behavioral test arsenal to evaluate psychological and cognitive endpoints. While not evident during the acute phase, CD36 deficient mice displayed significantly attenuated BBB leakage and scar formation at three months after stroke compared to wild-type littermates. Assessment of motor (open field, rotarod), anxiety (plus maze, light-dark box), depression (forced swim, sucrose preference) and memory tests (water maze) revealed that CD36 deficiency ameliorated stroke-induced behavioral impairments in activity, hedonic responses and spatial learning and strategy switching. Our findings indicate that CD36 contributes to stroke-induced BBB dysfunction and scar formation in an injury-independent manner, as well as to the chronic motor and neurophysiological deficits in chronic stroke.
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Affiliation(s)
- Mustafa Balkaya
- Burke Neurological Research Institute, White Plains, NY,
USA
| | - Il-doo Kim
- Burke Neurological Research Institute, White Plains, NY,
USA
| | - Faariah Shakil
- Burke Neurological Research Institute, White Plains, NY,
USA
| | - Sunghee Cho
- Burke Neurological Research Institute, White Plains, NY,
USA
- Feil Family Brain and Mind Research Institute, Weill Cornell
Medicine at Burke Neurological Research Institute, White Plains, NY USA
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8
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Lugtmeijer S, Lammers NA, de Haan EHF, de Leeuw FE, Kessels RPC. Post-Stroke Working Memory Dysfunction: A Meta-Analysis and Systematic Review. Neuropsychol Rev 2020; 31:202-219. [PMID: 33230717 PMCID: PMC7889582 DOI: 10.1007/s11065-020-09462-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
This review investigates the severity and nature of post-stroke working memory deficits with reference to the multi-component model of working memory. We conducted a systematic search in PubMed up to March 2019 with search terms for stroke and memory. Studies on adult stroke patients, that included a control group, and assessed working memory function, were selected. Effect sizes (Hedges' g) were extracted from 50 studies (in total 3,084 stroke patients) based on the sample size, mean and standard deviation of patients and controls. Performance of stroke patients was compared to healthy controls on low-load (i.e. capacity) and high-load (executively demanding) working memory tasks, grouped by modality (verbal, non-verbal). A separate analysis compared patients in the sub-acute and the chronic stage. Longitudinal studies and effects of lesion location were systematically reviewed. Stroke patients demonstrated significant deficits in working memory with a moderate effect size for both low-load (Hedges' g = -.58 [-.82 to -.43]) and high-load (Hedges' g = -.59 [-.73 to -.45]) tasks. The effect sizes were comparable for verbal and non-verbal material. Systematically reviewing the literature showed that working memory deficits remain prominent in the chronic stage of stroke. Lesions in a widespread fronto-parietal network are associated with working memory deficits. Stroke patients show decrements of moderate magnitude in all subsystems of working memory. This review clearly demonstrates the global nature of the impairment in working memory post-stroke.
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Affiliation(s)
- Selma Lugtmeijer
- University of Amsterdam, Amsterdam, the Netherlands. .,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
| | | | | | - Frank-Erik de Leeuw
- Radboud University Medical Center, Department of Neurology, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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9
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Godefroy O, Martinaud O, Narme P, Joseph PA, Mosca C, Lhommée E, Meulemans T, Czernecki V, Bertola C, Labauge P, Verny M, Bellmann A, Azouvi P, Bindschaedler C, Bretault E, Boutoleau-Bretonniere C, Robert P, Lenoir H, Krier M, Roussel M. Dysexecutive disorders and their diagnosis: A position paper. Cortex 2018; 109:322-335. [PMID: 30415091 DOI: 10.1016/j.cortex.2018.09.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/01/2018] [Accepted: 09/30/2018] [Indexed: 11/19/2022]
Abstract
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).
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Affiliation(s)
- Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences (EA 4559), University Hospital of Amiens, France.
| | | | - Pauline Narme
- Department of Neurology and Laboratory of Functional Neurosciences (EA 4559), University Hospital of Amiens, France; Department of Psychology, Group of Neuropsychology of Aging (EA 4468), University Paris Descartes, France
| | | | - Chrystèle Mosca
- Department of Neurology, CMRR, University Hospital of Grenoble, France
| | - Eugénie Lhommée
- Department of Psychiatry Neurology and Neurological Rehabilitation, Movement Disorders Unit, University Hospital of Grenoble-Alpes, Institut des Neurosciences, GIN, Inserm, U1216, Grenoble, France
| | - Thierry Meulemans
- Department of Psychology, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Belgium
| | - Virginie Czernecki
- Department of Neurology Department, Salpetriere Hospital, Pierre & Marie Curie Paris 6 University, Brain & Spine Institut ICM-UMR, INSERM-UPMC 1127, Paris, France
| | - Céline Bertola
- Department of Rehabilitation, Fondation Hopale, Berck-sur-mer, France
| | - Pierre Labauge
- Department of Neurology, University Hospital of Nimes, France
| | - Marc Verny
- Department of Geriatry Université, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University Paris 6, Biological Adaptation and Aging, INSERM, UMR 8256, Hospital Department Fight Aging and Stress (DHU FAST), Paris, France
| | - Anne Bellmann
- Department of Neuropsychology, CRR-SUVA, Sion, Switzerland
| | - Philippe Azouvi
- Department of Medecine Physique et de Réadaptation, Université de Versailles Saint Quentin, France
| | - Claire Bindschaedler
- Department of of Neuropsychology and Neurorehabilitation, University Hospital of Lausanne, Psychology Faculty of Geneva University, Switzerland
| | - Eric Bretault
- Department of Neurology, General Hospital of Cholet, France
| | | | - Philippe Robert
- Department of CoBTeK Lab, IA, CMRR CHu, University Côte d'Azur, France
| | - Hermine Lenoir
- Department of Geriatry Broca Hospital and Université Paris Descartes, Paris, France
| | - Marianne Krier
- Department of Institut Régional de Médecine Physique et de Réadaptation, Nancy, France
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences (EA 4559), University Hospital of Amiens, France
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10
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Povroznik JM, Ozga JE, Haar CV, Engler-Chiurazzi EB. Executive (dys)function after stroke: special considerations for behavioral pharmacology. Behav Pharmacol 2018; 29:638-653. [PMID: 30215622 PMCID: PMC6152929 DOI: 10.1097/fbp.0000000000000432] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Stroke is a worldwide leading cause of death and long-term disability with concurrent secondary consequences that are largely comprised of mood dysfunction, as well as sensory, motor, and cognitive deficits. This review focuses on the cognitive deficits associated with stroke specific to executive dysfunction (including decision making, working memory, and cognitive flexibility) in humans, nonhuman primates, and additional animal models. Further, we review some of the cellular and molecular underpinnings of the individual components of executive dysfunction and their neuroanatomical substrates after stroke, with an emphasis on the changes that occur during biogenic monoamine neurotransmission. We concentrate primarily on changes in the catecholaminergic (dopaminergic and noradrenergic) and serotonergic systems at the levels of neurotransmitter synthesis, distribution, reuptake, and degradation. We also discuss potential secondary stroke-related behavioral deficits (specifically, poststroke depression as well as drug-abuse potential and addiction) and their relationship with stroke-induced deficits in executive function, an especially important consideration given that the average age of the human stroke population is decreasing. In the final sections, we address pharmacological considerations for the treatment of ischemia and the subsequent functional impairment, as well as current limitations in the field of stroke and executive function research.
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Affiliation(s)
- Jessica M. Povroznik
- Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, USA
- Department of Physiology, Pharmacology, and Neuroscience, West Virginia University, Morgantown, WV, USA
- Rodent Behavior Core, Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Jenny E. Ozga
- Injury and Recovery Laboratory, Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Cole Vonder Haar
- Injury and Recovery Laboratory, Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Elizabeth B. Engler-Chiurazzi
- Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, USA
- Department of Physiology, Pharmacology, and Neuroscience, West Virginia University, Morgantown, WV, USA
- Rodent Behavior Core, Health Sciences Center, West Virginia University, Morgantown, WV, USA
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11
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Poletti B, Carelli L, Faini A, Solca F, Meriggi P, Lafronza A, Ciringione L, Pedroli E, Ticozzi N, Ciammola A, Cipresso P, Riva G, Silani V. The Arrows and Colors Cognitive Test (ACCT): A new verbal-motor free cognitive measure for executive functions in ALS. PLoS One 2018; 13:e0200953. [PMID: 30091987 PMCID: PMC6084851 DOI: 10.1371/journal.pone.0200953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/04/2018] [Indexed: 11/18/2022] Open
Abstract
Background and objective The presence of executive deficits in patients with Amyotrophic Lateral Sclerosis is well established, even if standardized measures are difficult to obtain due to progressive physical disability of the patients. We present clinical data concerning a newly developed measure of cognitive flexibility, administered by means of Eye-Tracking (ET) technology in order to bypass verbal-motor limitations. Methods 21 ALS patients and 21 age-and education-matched healthy subjects participated in an ET-based cognitive assessment, including a newly developed test of cognitive flexibility (Arrows and Colors Cognitive Test–ACCT) and other oculomotor-driven measures of cognitive functions. A standard screening of frontal and working memory abilities and global cognitive efficiency was administered to all subjects, in addition to a psychological self-rated assessment. For ALS patients, a clinical examination was also performed. Results ACCT successfully discriminated between patients and healthy controls, mainly concerning execution times obtained at different subtests. A qualitative analysis performed on error distributions in patients highlighted a lower prevalence of perseverative errors, with respect to other type of errors. Correlations between ACCT and other ET-based frontal-executive measures were significant and involved different frontal sub-domains. Limited correlations were observed between ACCT and standard ‘paper and pencil’ cognitive tests. Conclusions The newly developed ET-based measure of cognitive flexibility could be a useful tool to detect slight frontal impairments in non-demented ALS patients by bypassing verbal-motor limitations through the oculomotor-driven administration. The findings reported in the present study represent the first contribution towards the development of a full verbal-motor free executive test for ALS patients.
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Affiliation(s)
- Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
- * E-mail:
| | - Laura Carelli
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Federica Solca
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Paolo Meriggi
- ICT & Biomedical Technology Integration Unit, Centre for Innovation and Technology Transfer (CITT), Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Annalisa Lafronza
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luciana Ciringione
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Andrea Ciammola
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
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Chiu EC, Wu WC, Hung JW, Tseng YH. Validity of the Wisconsin Card Sorting Test in patients with stroke. Disabil Rehabil 2017; 40:1967-1971. [DOI: 10.1080/09638288.2017.1323020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen-Chi Wu
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jen-Wen Hung
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsuan Tseng
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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13
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Roussel M, Lhommée E, Narme P, Czernecki V, Gall DL, Krystkowiak P, Diouf M, Godefroy O. Dysexecutive syndrome in Parkinson’s disease: the GREFEX study. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 24:496-507. [DOI: 10.1080/13825585.2016.1226248] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences EA 4559, SFR CAP-Santé (FED 4231), University Hospital of Amiens, Amiens, France
| | - Eugénie Lhommée
- Department of Neurology, Movement Disorder Unit, Inserm, U836, University Hospital of Grenoble, Grenoble, France
| | - Pauline Narme
- Department of Neurology and Laboratory of Functional Neurosciences EA 4559, SFR CAP-Santé (FED 4231), University Hospital of Amiens, Amiens, France
- Department of Psychology Descartes, University of Paris, Paris, France
| | - Virginie Czernecki
- Department of Neurology, University Hospital of Paris La Salpétrière, Paris, France
| | - Didier Le Gall
- Department of Psychology and Neurology, University Hospital of Angers, Angers, France
| | - Pierre Krystkowiak
- Department of Neurology and Laboratory of Functional Neurosciences EA 4559, SFR CAP-Santé (FED 4231), University Hospital of Amiens, Amiens, France
| | - Momar Diouf
- Department of Biostatistics, University Hospital of Amiens, Amiens, France
| | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences EA 4559, SFR CAP-Santé (FED 4231), University Hospital of Amiens, Amiens, France
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Conti J, Sterr A, Brucki SMD, Conforto AB. Diversity of approaches in assessment of executive functions in stroke: limited evidence? eNeurologicalSci 2015; 1:12-20. [PMID: 26623442 PMCID: PMC4662603 DOI: 10.1016/j.ensci.2015.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Stroke is a leading cause of disability worldwide. Cognitive functions and, in particular, executive function, are commonly affected after stroke, leading to impairments in performance of daily activities, decrease in social participation and in quality of life. Appropriate assessment and understanding of executive dysfunction are important, firstly to develop better rehabilitation strategies for executive functions per se and secondly to consider executive function abilities on rehabilitation strategies in general. The purpose of this review was to identify the most widely used assessment tools of executive dysfunction for patients with stroke, and their psychometric properties. We systematically reviewed manuscripts published in English in databases from 1999 to 2015. We identified 35 publications. The most frequently used instruments were the Stroop, Digit Span and Trail making tests. Psychometric properties were described for the Executive Function Performance Test, Executive Clock Drawing Task, Chinese Frontal Assessment Battery and Virtual Action Planning — Supermarket, and two subtests of the Cambridge Cognitive Examination — Revised. There is a paucity of tools to reliably measure executive dysfunction after stroke, despite the fact that executive dysfunction is frequent. Identification of the best tools for executive dysfunction assessment is necessary to address important gaps in research and in clinical practice.
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Affiliation(s)
- Juliana Conti
- Neurostimulation Laboratory, Neurology Clinical Division. Hospital das Clínicas/Sao Paulo University
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, UK and Visiting Professor, Neurostimulation Laboratory
| | | | - Adriana B Conforto
- Neurostimulation Laboratory, Neurology Clinical Division. Hospital das Clínicas/Sao Paulo University ; Hospital Israelita Albert Einstein, São Paulo, Brazil
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Posttraumatic stress disorder is associated with limited executive resources in a working memory task. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2015; 14:792-804. [PMID: 24165904 DOI: 10.3758/s13415-013-0219-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) can show declines in working memory. A dual-task design was used to determine whether these impairments are linked to executive control limitations. Participants performed a Sternberg memory task with either one or four letters. In the dual-task condition, the maintenance period was filled with an arrow flanker task. PTSD patients were less accurate on the working memory task than were controls, especially in the dual-task condition. In the single-task condition, both groups showed similar patterns of brain potentials from 300 to 500 ms when discriminating old and new probes. However, when taxed with an additional task, the event-related potentials (ERPs) of the PTSD group no longer differentiated old and new probes. In contrast, interference resolution processes in both the single- and dual-task conditions of the flanker task were intact. The lack of differentiation in the ERPs reflects impaired working memory performance under more difficult, dual-task conditions. Exacerbated difficulty in performing a working memory task with concurrent task demands suggests a specific limitation in executive control resources in PTSD.
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Al-Adawi S, Braidy N, Essa M, Al-Azri F, Hussain S, Al-Sibani N, Al-Khabouri J, Al-Asmi A, Al-Mashani A. Cognitive profiles in patients with multi-infarct dementia: an omani study. Dement Geriatr Cogn Dis Extra 2014; 4:271-82. [PMID: 25202321 PMCID: PMC4154192 DOI: 10.1159/000363621] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Studies on neurocognitive impairment among patients presenting with multi-infarct dementia (MID) have received little attention from non-Western societies, and the Arab world is no exception. To our knowledge, this is the first study to characterize neurocognitive, affective and vegetative functioning in patients with MID in Oman. Methods In this study, we recruited 20 Omani patients presenting with MID and age- and gender-matched controls at the outpatient clinic of the Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman. In addition to the collection of clinical and demographic information, various cognitive batteries were administered to the consenting participants, including those indexing nonverbal reasoning abilities, working memory (attention, concentration and recall) and executive functioning. Questionnaires that elicit the affective range and the quality of sleep were also administered. Results Compared with the matched healthy subjects, the patients diagnosed with MID significantly differed in the presently operationalized indices of visuospatial function, semantic memory and affective and vegetative functioning. In contrast, episodic memory and some attentional capacities were not significantly different compared with the control subjects. Conclusions The present study was explorative and clinically designed to describe neurocognitive functioning in patients with MID seeking consultation at a tertiary care center in Oman. Our data are necessary for planning and setting up community services and health care programs for demented patients in a society where dementia is a growing silent epidemic.
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Affiliation(s)
- Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Muscat, Oman
| | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, N.S.W., Australia
| | - Musthafa Essa
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
| | - Faisal Al-Azri
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | - Samir Hussain
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | - Nasser Al-Sibani
- Al-Masara Hospital, Ministry of Health, Ministry of Health, Muscat, Oman
| | - Jabar Al-Khabouri
- Department of Neurology, Royal Hospital, Ministry of Health, Muscat, Oman
| | - Abdullah Al-Asmi
- Department of Neurology, Royal Hospital, Ministry of Health, Muscat, Oman
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Godefroy O, Gibbons L, Diouf M, Nyenhuis D, Roussel M, Black S, Bugnicourt JM. Validation of an integrated method for determining cognitive ability: Implications for routine assessments and clinical trials. Cortex 2014; 54:51-62. [PMID: 24632464 PMCID: PMC4737650 DOI: 10.1016/j.cortex.2014.01.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/25/2013] [Accepted: 01/27/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Although accurate diagnosis of deficit of mild intensity is critical, various methods are used to assess, dichotomize and integrate performance, with no validated gold standard. This study described and validated a framework for the analysis of cognitive performance. METHODS This study was performed by using the Groupe de Réflexion sur L'Evaluation des Fonctions EXécutives (GREFEX) database (724 controls and 461 patients) examined by 7 tests assessing executive functions. The first phase determined the criteria for the cutoff scores, the second phase, the effect of test number on diagnostic accuracy and the third phase, the best methods for combining test scores into an overall summary score. Four validation criteria were used: determination of impaired performance as compared to expected one, false-positive rate ≤5%, detection of both single and multiple impairments with optimal sensitivity. RESULTS The procedure based on 5th percentile cutoffs determined from standardized residuals was the most appropriate procedure. Although area under the curve (AUC) increased with the number of scores (p = .0001), the false-positive rate also increased (p = .0001), resulting in suboptimal sensitivity for detecting selective impairment. Two overall summary scores, the average of the seven process scores and the Item Response Theory (IRT) score, had significantly (p = .0001) higher AUCs, even for patients with a selective impairment, and provided higher resulting prevalence of dysexecutive disorders (p = .0001). CONCLUSIONS The present study provides and validates a generative framework for the interpretation of cognitive data. Two overall summary score met all 4 validation criteria. A practical consequence is the need to profoundly modify the analysis and interpretation of cognitive assessments for both routine use and clinical research.
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Affiliation(s)
- Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, France.
| | - Laura Gibbons
- Department of General Internal Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Momar Diouf
- Department of Biostatistics, University Hospital of Amiens, France
| | - David Nyenhuis
- Hauenstein Neuroscience Center, Saint Mary's Health Care, Grand Rapids, MI, USA
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, France
| | - Sandra Black
- Brill Chair in Neurology, Dept of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jean Marc Bugnicourt
- Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, France
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Volle E, Levy R. [Role of the prefrontal cortex in human behavioral adaptation]. Med Sci (Paris) 2014; 30:179-85. [PMID: 24572117 DOI: 10.1051/medsci/20143002016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Emmanuelle Volle
- Université Pierre et Marie Curie-Paris 6, Centre de recherche de l'institut du cerveau et de la moelle épinière (Cricm), UMRS 975, hôpital Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France - Inserm U1127, Paris, France - CNRS, UMR 7225, Paris, France
| | - Richard Levy
- Université Pierre et Marie Curie-Paris 6, Centre de recherche de l'institut du cerveau et de la moelle épinière (Cricm), UMRS 975, hôpital Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France - Inserm U1127, Paris, France - CNRS, UMR 7225, Paris, France - AP-HP, hôpital Saint-Antoine, service de neurologie, 184, rue du faubourg Saint-Antoine, 75012 Paris, France
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Besnard J, Allain P, Aubin G, Chauviré V, Etcharry-Bouyx F, Le Gall D. An integrative view of Luria's perspective on arithmetic problem solving: the two sides of environmental dependency. J Clin Exp Neuropsychol 2014; 36:88-109. [PMID: 24392726 DOI: 10.1080/13803395.2013.870135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION A. R. Luria was the first author to hypothesize that executive dysfunction can lead to specific deficits in arithmetic problem solving, showing that patients' performance depends on the structure of the tasks. Cummings (1995. Anatomic and behavioral aspects of frontal-subcortical circuits. Annals of the New York Academy of Sciences, 15, 1-13) proposed the term "environmental dependency" to define such behavioral disorders triggered by the characteristics of the test and pointed out also the role of executive impairments. Few studies compare executive functioning and problem solving in brain-damaged patients, and none have examined the question from this point of view. Thus, the main aim of the present paper was to study the relationship between environmental dependency and executive functions. METHOD Fifty neurological patients with frontal, subcortical, and posterior brain lesions were compared to 45 matched healthy controls and were divided into two groups (dysexecutive/nondysexecutive) according to their performances on executive tasks. Then, we confronted the results of the two groups on an experimental protocol designed in accordance with Luria's proposals. We made also comparisons between groups on the basis of lesion location. RESULTS Our findings indicate a high association between executive functions and environmental dependency, showing that dysexecutive patients' performances were dependent on task demands. In addition, a specific frontal behavior not associated with executive functions and characterized by the solving of insoluble problems was highlighted. CONCLUSION The discussion focused on the interest to take into account the methodological and clinical contributions of environmental dependency. Based on our findings and theoretical arguments, we highlight the need to fractionate this concept.
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Affiliation(s)
- Jérémy Besnard
- a LUNAM Université, Laboratoire de Psychologie des Pays de la Loire (UPRES EA 4638), University of Angers , France
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