Executive Functioning, Memory, and Learning in Phenylketonuria.

The executive deficit hypothesis of treated phenylketonuria (PKU) suggests that dopaminergic depletion in the lateral prefrontal cortex leads to selective executive impairment. This was examined by comparing adults with PKU on a lifelong diet with a matched healthy control group. Those with PKU were impaired on selective and sustained attention, working memory (Self-Ordered Pointing), and letter fluency. However, they failed to show differential sensitivity to increased cognitive load on the attentional and working memory tasks, and they did not differ significantly on the remaining executive tasks (rule finding, inhibition, and multitasking). Nor did they differ significantly on recall or recognition memory. Overall, the findings provided little support for the executive deficit hypothesis. A possible explanation in terms of slowed information processing speed is explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological aspects of multiple sclerosis

Twenty-six persons (five males and 21 females) with the neurological diagnosis of multiple sclerosis, and an equal number of control subjects matched on age, sex, and education were given a battery of tests designed to assess motor and intellectual functioning. Subjects in the multiple sclerosis group displayed marked deficits on all tests of motor skill except grip strength. Although verbal intelligence was not impaired in subjects with multiple sclerosis, these subjects performed more poorly than control subjects on two different tests of memory even though these tasks required minimal motor responsivity. Correlational analyses on the several motor and cognitive tasks revealed that correlations between motor and memory performance were consistently higher in persons with multiple sclerosis than in controls. These results suggest that whereas multiple sclerosis may not have mch effect on the utilization of stored verbal information, the processing and storage of new verbal material are disrupted by the disease to a degree that is paralleled by the extent of motor impairment. This finding is consistent with the view that the memory impairments observed are secondary to the primary motor deficit, but the alternative explanation that memory functions, like motor functions, are especially vulnerable to the demylination process of multiple sclerosis is equally viable at present.     

Neuropsychological correlates of ADHD symptoms in preschoolers.

The authors examined the neuropsychological status of 22 preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD) and 50 matched control children, using measures of nonverbal working memory, perceptual and motor inhibition, and memory for relative time. All tasks included paired control conditions, which allowed for the isolation of discrete executive function constructs. Group differences were evident on several measures of neuropsychological functioning; however, after accounting for nonexecutive abilities, no deficits could be attributed to specific functions targeted by the tasks. Performance on executive measures was not related to objective indices of activity level or ratings of ADHD symptoms. Yet, the fact that at-risk preschoolers were highly symptomatic casts doubt on whether executive function deficits and/or frontostriatal networks contribute etiologically to early behavioral manifestations of ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of Verbal Working Memory in Patients With Parkinson's Disease.

The authors examined the nature of the working memory deficit in persons with Parkinson's disease (PD). Three hypotheses were tested: a limited storage capacity, an impaired executive component, and a reduction of psychomotor speed. Verbal working memory was assessed in 14 PD patients without dementia and 14 matched control participants. Participants were administered a classical verbal span test, working memory tasks that required either updating or manipulation capacities, and motor and psychomotor speed tasks. Patients' performance was comparable to that of control participants on the verbal span test. However, results on the working memory tasks indicated a deficit in manipulation with normal updating capacities. Motor and psychomotor slowing were found in the patient group, but slowing could not fully account for the impairment observed in the manipulation task. Results indicated that there is a genuine but selective working memory impairment in patients with PD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological correlates of early symptoms of autism

Both the medial temporal lobe and dorsolateral prefrontal cortex have been implicated in autism. In the present study, performance on two neuropsychological tasks--one tapping the medial temporal lobe and related limbic structures, and another tapping the dorsolateral prefrontal cortex--was examined in relation to performance on tasks assessing autistic symptoms in young children with autism, and developmentally matched groups of children with Down syndrome or typical development. Autistic symptoms included orienting to social stimuli, immediate and deferred motor imitation, shared attention, responses to emotional stimuli, and symbolic play. Compared with children with Down syndrome and typically developing children, children with autism performed significantly worse on both the medial temporal lobe and dorsolateral prefrontal tasks, and on tasks assessing symptoms domains. For children with autism, the severity of autistic symptoms was strongly and consistently correlated with performance on the medial temporal lobe task, but not the dorsolateral prefrontal task. The hypothesis that autism is related to dysfunction of the medial temporal lobe and related limbic structures, such as the orbital prefrontal cortex, is discussed.     

Differential deficit in executive control in euthymic bipolar disorder.

Patients with remitted bipolar disorder (BD) have persistent cognitive deficits, but the nature and specificity of this deficit remain unclear. The authors evaluated the executive hypothesis of BD by determining whether (a) patients' executive deficits qualify as differential deficits, that is, that these significantly exceed deficits in other cognitive domains; (b) deficits in particular executive functions are evident, and (c) executive difficulties mediate declarative memory deficits in BD. The cognitive performance of 63 prospectively verified euthymic bipolar patients was compared with controls, using J. Baron and R. Trieman's (1980) method of testing for differences in nonindependent correlations. There were no differential deficits within the executive domain. Patients' generic executive performance was differentially impaired relative to primary verbal memory and retention in declarative memory, but not relative to their declarative recall, recognition, or their psychomotor performance. However, patients' executive deficit was not an artifact of their poor psychomotor performance. Executive performance accounted for all but a trivial portion of the between-group variance in declarative memory. Persistent cognitive difficulties in euthymic bipolar disorder (EBD) are thus usefully characterized as a generic dysexecutive syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of comorbid depressive symptoms on neuropsychological performance in obsessive-compulsive disorder.

There is indirect evidence from previous research that several executive disturbances in obsessive-compulsive disorder (OCD) are mediated by comorbid depressive symptoms. For the present study, the authors investigated whether OCD patients with elevated Hamilton Rating Scale for Depression (HRSD; M. Hamilton, 1967) scores would exhibit deficits in tasks sensitive to the medial and dorsolateral frontal cortex as well as other executive tasks. The 36 OCD patients were split along the median according to their HRSD scores and compared with matched control subjects. Patients with high HRSD scores performed significantly worse than control subjects and patients with low HRSD scores on the Wisconsin Card Sorting Test (J. Loong, 1990), the Trail-Making Test (TMT, Part B; R. M. Reitan, 1992), and the TMT difference score. Moreover, patients with high HRSD scores exhibited deficits on a (creative) verbal fluency task. It is suggested that comorbid depressive symptoms may have artificially inflated some executive deficit scores in previous studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometrically matched visual-processing tasks in schizophrenia spectrum disorders.

Patients with schizophrenia show deficits in visual perception and working memory, but the relationship between these deficits has not been characterized with psychometrically matched tasks. The authors administered 2 visual discrimination and 6 recognition tasks to 43 schizophrenia spectrum patients and 22 nonpsychiatric subjects. When performing difficulty-matched tasks, spectrum subjects showed more severe impairments for motion compared with form processing. When tasks were matched on true score variance, spectrum subjects exhibited worse performance on both form and motion discrimination, and a differential deficit in motion recognition with a short display duration and long interstimulus interval. These results provide evidence of differential deficits in visual processing in schizophrenia that appear to be dependent on the temporal characteristics of the tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A dissociation between simple and complex span impairment in alcoholics

We investigated whether the surprisingly good memory performance of alcoholics may result from simple memory performance being spared while performance in complex memory tasks is impaired. Simple word span was contrasted with a complex word span task involving concurrent monitoring and re-organisation of items for recall. To control for disruption of rehearsal in the complex word span task, performance on two additional tasks with disrupted rehearsal but no additional processing components was studied. As hypothesised, the alcoholics showed a deficit in the complex but not the simple word span task. They were also impaired, compared to controls, on both tasks with disrupted rehearsal. The difference between groups remained in the complex span task when scores in simple span and either of the two other tasks were used as covariates. Thus, both executive processes necessary for coping with disrupted rehearsal and additional processes scheduling processing and storage in a complex task may play a role in accounting for working memory deficits found in alcoholics.     

Sex differences in olfactory identification and Wisconsin Card Sorting performance in schizophrenia: relationship to attention and verbal ability

We investigated the hypothesis that different prefrontal brain systems (i.e., dorsal vs. ventral) and sex contribute differentially to cognitive deficit in schizophrenia. Performance was assessed among clinically stable, chronic schizophrenic outpatients and matched normal control subjects on olfactory identification [on the University of Pennsylvania Smell Identification Test (UPSIT)] and on executive functions [using the Wisconsin Card Sorting Test (WCST)]. Patients were impaired on both tests compared to controls, and male schizophrenics were impaired on the WCST compared to female schizophrenics. The pattern of results suggests that gender differences on the UPSIT are mildly accentuated in schizophrenia. The data support our previous study indicating that UPSIT performance is largely independent of the executive or attentional deficits typically associated with schizophrenia, with the exception of verbal ability. Further research with larger samples is required to test the hypothesis that there is a severely impaired subgroup of male patients with diffuse prefrontal dysfunctions.     

Executive function in parents of children with autism

BACKGROUND: Previous studies have shown that individuals with autism show impaired performance on tests of executive function (Ozonoff et al. 1991, 1993; Hughes & Russell, 1993; Hughes et al. 1994). There is also strong evidence for genetic involvement in autism (see Rutter, 1991 for review). If executive dysfunction is a core impairment in autism, then similar impairments are hypothesized to exist in a subtler form among the parents of autistic children. METHODS: Forty parents of autistic children were compared with 40 parents of learning disabled children and 36 adults from unaffected families on three computerized tests of executive function. These tasks tapped attentional-shifting skills, visuospatial planning and working memory. Participants also received a computerized control test of spatial memory-span. In addition, the interviewer's initial impressions of family members were coded using a new 33-item questionnaire. RESULTS: A significant proportion of parents of autistic children (especially fathers) showed impaired executive function. By contrast, parents did as well as both comparison groups on a control test of spatial span, and on other 'non-executive' measures from the tasks, indicating that the autism group were as able and motivated as comparison groups. Interestingly, impairment of executive function was significantly correlated with the interviewer's pre-test impression of social abnormality among parents of autistic children. CONCLUSIONS: The hypothesis that a significant proportion of parents of autistic children show impaired executive function was supported. Parents showed good memory ability, but relatively poor planning skills and attentional flexibility. The extent to which this is an inherent trait in family members, rather than a reflection of the difficulties involved in caring for an autistic child, remains to be examined.     

Working Memory, Task Switching, and Executive Control in the Task Span Procedure.

Four experiments explored the task span procedure: Subjects received lists of 1-10 task names to remember and then lists of 1-10 stimuli on which to perform the tasks. Task span is the number of tasks performed in order perfectly. Experiment 1 compared the task span with the traditional memory span in 6 practiced subjects and found little difference. Experiment 2 compared the task span and the memory span in 64 unpracticed subjects and also found little difference. Experiment 3 compared practice with consistent and varied lists to address retrieval from long-term memory. Experiment 4 manipulated the number of task switches and found that it had little effect on task spans. The results suggest there is no trade-off between storage and task switching, which supports some theories of executive control and challenges others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functions in young males with fragile X syndrome in comparison to mental age-matched controls: Baseline findings from a longitudinal study.

The performance of 54 boys with fragile X syndrome (FXS), ages 7 to 13 years, was compared to that of a group of typically developing boys who were matched on mental age (MA) and ethnicity across multiple measures of executive function (EF). Boys with FXS varied in their ability to complete EF measures, with only 25.9% being able to complete a set-shifting task and 94.4% being able to complete a memory for word span task. When compared to the control group, and controlling for MA and maternal education, boys with FXS showed significant deficits in inhibition, working memory, cognitive flexibility/set-shifting, and planning. No group differences were observed in processing speed. Mental age significantly impacted performance on working memory, set-shifting, planning, and processing speed tasks for both groups. In boys with FXS, MA significantly predicted performance on working memory and set-shifting tasks. Our findings suggest that deficits in EF in boys with FXS are not solely attributable to developmental delays but, rather, present as a true array of neurocognitive deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rate and timing precision of motor coordination in developmental dyslexia.

Temporal characteristics of interlimb coordination were examined in adolescents and young adults with developmental dyslexia, matched normal control subjects, and matched learning disabled adolescent students without reading difficulties. Subjects were asked to tap in time to an entraining metronome at each of 3 prescribed rates by moving the index fingers of both hands in unison, in rhythmical alternation, or in more complex bimanual patterns. Dyslexic subjects showed significant deficits of timing precision on bimanual tasks that required the integration of asynchronous responses, but not when they moved the fingers in unison. Findings are discussed in terms of both the hypothesis that impaired temporal resolution in dyslexia reflects an underlying deficit of left-hemisphere function and an alternative hypothesis that functional deficits in developmental dyslexia are associated with impaired interhemispheric communication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inhibitory processes in adults with persistent childhood onset ADHD.

The theory that attention-deficit/hyperactivity disorder (ADHD) stems from a deficit in an executive behavioral inhibition process has been little studied in adults, where the validity of ADHD is in debate. This study examined, in high-functioning young adults with persistent ADHD and a control group, 2 leading measures of inhibitory control: the antisaccade task and the negative priming task. ADHD adults showed weakened ability to effortfully stop a reflexive or anticipated oculomotor response but had normal ability to automatically suppress irrelevant information. Results suggest that an inhibitory deficit in ADHD is confined to effortful inhibition of motor response, that antisaccade and negative priming tasks index distinct inhibition systems, and that persistence of ADHD symptoms into adulthood is associated with persistence of executive motor inhibition deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working memory constraints on linear reasoning with spatial and temporal contents

The present article reports two experiments testing the use of working memory components during reasoning with temporal and spatial relations in four-term series problems. In the first experiment four groups of subjects performed reasoning tasks with temporal and with spatial contents either without (control) or with a secondary task (articulatory suppression, visuo-spatial suppression or central executive suppression). The second experiment tested the secondary task effects in a within-subjects design either on problems with a spatial content or on problems with a temporal content, and within each content domain either under conditions of self-paced or of fixed presentation of the premises. Both experiments found effects of all three secondary tasks on reasoning accuracy. This supports the hypothesis that the subjects construct spatial representations of the premise information with the support of visuo-spatial resources of working memory. The second experiment also showed that during premise intake, only visuo-spatial and central executive secondary tasks had an effect. The implications of the data for the working memory requirements of reasoning and for theories of linear reasoning are discussed.     

A test of motor (not executive) planning in developmental coordination disorder and autism.

Grip selection tasks have been used to test “planning” in both autism and developmental coordination disorder (DCD). We differentiate between motor and executive planning and present a modified motor planning task. Participants grasped a cylinder in 1 of 2 orientations before turning it clockwise or anticlockwise. The rotation resulted in a comfortable final posture at the cost of a harder initial reaching action on 50% of trials. We hypothesized that grip selection would be dominated by motoric developmental status. Adults were always biased towards a comfortable end-state with their dominant hand, but occasionally ended uncomfortably with their nondominant hand. Most 9- to 14-year-olds with and without autism also showed this “end-state comfort” bias but only 50% of 5- to 8-year-olds. In contrast, children with DCD were biased towards selecting the simplest initial movement. Our results are best understood in terms of motor planning, with selection of an easier initial grip resulting from poor reach-to-grasp control rather than an executive planning deficit. The absence of differences between autism and controls may reflect the low demand this particular task places on executive planning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition by familiarity is preserved in Parkinson's without dementia and Lewy-Body disease.

Objective: The retrieval deficit hypothesis states that the lack of deficit in recognition often observed in patients with Parkinson's disease is because of the low retrieval requirements of the task, given that these patients have retrieval and not encoding deficits. To test this hypothesis we investigated recognition memory by familiarity in Parkinson's patients and in patients with Lewy Bodies disease and Parkinson with dementia. Method: We analyzed to what extent the experimental groups were able to recognize by familiarity in a typical yes/no recognition memory task. The experimental groups were patients with early nondemented Parkinson's disease, advanced nondemented Parkinson's disease, demented Parkinson's patients, and patients with dementia with Lewy Bodies. We compared their performance with a group of young and another group of old healthy participants. The estimation of familiarity was made by analyzing recognition of word targets and distractors consisting of combinations of different letters in comparison with a condition in which targets and distractors were composed of similar letters, even though subjects were unaware of the independent variable. Results: The results indicate that familiarity was used at the same level by controls, patients with early Parkinson's disease and patients with dementia with Lewy Bodies. Although late Parkinson patients also used familiarity, its effect was only marginally significant. Patients with Parkinson's disease and dementia were not capable of using familiarity in recognition memory. Conclusions: Our results support the retrieval deficit hypothesis as Parkinson's patients without dementia show no deficit in a situation in which the retrieval requirements are minimal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive efficiency modes in old age: Performance on sequential and coordinative verbal and visuospatial tasks.

In an experiment using a large set of verbal and spatial tasks requiring low or high degrees of executive control, 3 distinct age-related effects were found. The smallest effect (no slowing was tied to lexical tasks with low executive involvement, the largest deficit (age-related slowing factor of 2.2) was tied to visuospatial tasks with high executive involvement, an intermediate level of deficit (slowing factor of 1.7) was found for visuospatial tasks with low executive load and verbal tasks with high executive load. These age-related dissociations were incompatible with any "common cause" formulation. The mechanism responsible for the dissociation between verbal and visual tasks, and between low and high executive load remains to be determined. The latter may reflect capacity limits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Abstract reasoning in autism: A disassociation between concept formation and concept identification.

The concept identification and concept formation aspects of abstract reasoning were examined in 90 nonmentally retarded individuals with autism and 107 normal controls. It was hypothesized that pronounced deficits would be found on concept formation tests, whereas performance on concept identification tests would be relatively intact. There was a significant difference between individuals with autism and individuals from a matched control group on all abstract reasoning tasks, but, with the exception of the Wisconsin Card Sorting Test (R. K. Heaton et al., 1993), differences on concept identification tests were not clinically significant. Factor analyses showed that concept formation and concept identification tasks loaded on separate factors in the autism group but not in the control group. Stepwise discriminant function analyses revealed that 2 tests of concept formation correctly classified 78.4% of cases, whereas concept identification tasks did not pass the tolerance test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)