Assessment of Executive Function in Patients with Traumatic Brain Injury with the Wisconsin Card-Sorting Test

This review aimed at providing a brief and comprehensive summary of recent research regarding the use of the Wisconsin Card-Sorting Test (WCST) to assess executive function in patients with traumatic brain injury (TBI). A bibliographical search, performed in PubMed, Web of Science, Scopus, Cochrane Library, and PsycInfo, targeted publications from 2010 to 2020, in English or Spanish. Information regarding the studies’ designs, sample features and use of the WCST scores was recorded. An initial search eliciting 387 citations was reduced to 47 relevant papers. The highest proportion of publications came from the United States of America (34.0%) and included adult patients (95.7%). Observational designs were the most frequent (85.1%), the highest proportion being cross-sectional or case series studies. The average time after the occurrence of the TBI ranged from 4 to 62 years in single case studies, and from 6 weeks up to 23.5 years in the studies with more than one patient. Four studies compared groups of patients with TBI according to the severity (mild, moderate and/or severe), and in two cases, the studies compared TBI patients with healthy controls. Randomized control trials were seven in total. The noncomputerized WCST version including 128 cards was the most frequently used (78.7%). Characterization of the clinical profile of participants was the most frequent purpose (34.0%). The WCST is a common measure of executive function in patients with TBI. Although shorter and/or computerized versions are available, the original WCST with 128 cards is still used most often. The WCST is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies. Results might be useful to professionals in the clinical and research fields to guide them in assessment planning and proper interpretation of the WCST scores.

Does elevated peripheral benzodiazepine receptor gene expression relate to cognitive deficits in methamphetamine dependence?

BACKGROUND

Methamphetamine (METH) is a neurotoxin and psychostimulant drug with potent effects on the central nervous system. With chronic METH administration, an inflammatory glial response is observed as a result of METH-induced neurotoxicity. One inflammatory marker is the peripheral benzodiazepine receptor (PBR).

OBJECTIVE

The purpose of the present study was to determine whether PBR expression is changed in METH dependence and whether the changes relate to cognitive deficits.

METHODS

Reverse transcriptase-polymerase chain reaction was used to investigate PBR gene expression in blood samples taken from 14 male subjects with METH dependence and 14 controls.

RESULTS

The results showed a significant increase in PBR gene expression in METH dependence, suggestive of a systemic inflammatory response. The increase remained elevated for more than 1 year following abstinence from METH use, but eventually returned to normal. Subjects with elevated PBR also exhibited a deficit in one domain of the Wisconsin Card Sorting Test.

CONCLUSION

The results suggest that systemic inflammatory effects can be associated with chronic METH abuse, and this may relate to the cognitive deficits seen in METH dependence. Copyright © 2016 John Wiley & Sons, Ltd.

Intellectual ability as a predictor of performance on the Wisconsin Card-Sorting Test

The purpose of this study was to explore the relationship between intelligence and executive functioning in youth. More specifically, the authors hypothesized that there would be a positive correlation between scores on the Wechsler Intelligence Scale for Children-Fourth Edition General Ability Index (GAI) and understanding of sorting principles as measured by percent conceptual-level responses on the Wisconsin Card-Sorting Test (WCST). One hundred eighty-five children and adolescents completed neuropsychological evaluations. Results revealed a curvilinear regression with bright youth (GAI = 115-129) and gifted youth (GAI ≥130) performing better than average youth (GAI = 90-114) and no difference in performance between bright and gifted youth. Additionally, post-hoc analyses revealed intelligence in children 5 to 8 years of age and 12 to 16 years of age did not significantly predict percent conceptual-level responses, while intelligence predicted more than 19% of the variance in percent conceptual-level responses for children ages 9 to 11 years old. Findings revealed new evidence about the role of intellectual ability in executive functioning among different age ranges and have important implications for psychologists, caregivers, educators, and other professionals working with this population.