Memory encoding and retrieval in frontotemporal dementia and Alzheimer's disease.

Memory encoding and retrieval strategies were assessed in patients with behavior-executive variant frontotemporal dementia (FTD), language variant FTD, and Alzheimer's disease (AD) using verbal and visuospatial supraspan learning tests. FTD patients obtained higher free recall, cued recall, and recognition scores than AD patients. Comparison of free recall scores with cued recall and recognition scores was similar in the 3 dementia groups. Groups did not differ in semantic clustering strategies during learning, but serial-order recall was more common in FTD patients. These data do not support the idea that FTD patients' poor memory is due to a selective retrieval disorder, though FTD patients may fail to implement sophisticated organizational strategies during learning. FTD patients' retained capacity for encoding new information into long-term declarative memory is likely due to relatively spared medial temporal lobe involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visuospatial deficits predict rate of cognitive decline in autopsy-verified dementia with Lewy bodies.

Dementia with Lewy bodies (DLB) is often characterized by pronounced impairment in visuospatial skills, attention, and executive functions. However, the strength of the phenotypic expression of DLB varies and may be weaker in patients with extensive concomitant Alzheimer's disease (AD). To determine whether strength of the DLB clinical phenotype impacts cognitive decline, visuospatial and language tests were retrospectively used to predict 2-year rate of global cognitive decline in 22 autopsy-confirmed DLB patients (21 with concomitant AD) and 44 autopsy-confirmed "pure" AD patients. Generalized estimating equations (GEE) revealed a significant interaction such that poor baseline performances on tests of visuospatial skills were strongly associated with a rapid rate of cognitive decline in DLB but not AD (p     

Disparate letter and semantic category fluency deficits in autopsy-confirmed frontotemporal dementia and Alzheimer's disease.

Patients with autopsy-confirmed frontotemporal dementia (FTD; n = 16) and Alzheimer's disease (AD; n = 32) were compared on first-letter and semantic category fluency tasks. Despite being matched on age, education, and dementia severity, FTD patients performed worse overall and showed similar impairment in letter and semantic category fluency, whereas AD patients showed greater impairment in semantic category than letter fluency. A measure of the disparity between letter and semantic category fluency (the semantic index) was effective in differentiating FTD from AD patients, and this disparity increased with increasing severity of dementia. These unique patterns of letter and semantic category fluency deficits may be indicative of differences in the relative contribution of frontal-lobe-mediated retrieval deficits and temporal-lobe-mediated semantic deficits in FTD and AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Action and object naming in frontotemporal dementia, progressive supranuclear palsy, and corticobasal degeneration.

Action naming has been reported to be disproportionately impaired in comparison to object naming in patients with frontotemporal dementia (FTD). This finding has been attributed to the crucial role of frontal cortex in action naming. The investigation of object and action naming in the different subtypes of FTD, as well as in the related conditions of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), may thus contribute to the elucidation of the cerebral correlates of the action-object discrepancy as well as provide clues to the underlying cognitive mechanisms. The results indicated that, with the exception of semantic dementia, action naming was more impaired than object naming in all patient groups. The discrepancy was similar in frontal variant of FTD and Alzheimer's disease patients, whereas patients with nonfluent primary progressive aphasia, PSP, and CBD were significantly more impaired in the oral production of actions than of objects. These findings indicate that action naming impairment is not a general feature of FTD, but rather is associated with conditions that affect the frontoparietal-subcortical circuits involved in action knowledge and action representation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation deficits in frontotemporal lobar degeneration and Alzheimer’s disease.

We examined instructed and spontaneous emotion regulation in patients with frontotemporal lobar degeneration (FTLD, N = 32), which presents with profound emotional and personality changes; patients with Alzheimer’s disease (AD, N = 17), which presents with profound memory impairment; and neurologically normal controls (N = 25). Participants were exposed to an aversive acoustic startle stimulus (115 dB) under 3 different conditions: (a) unwarned without instructions to down-regulate, (b) warned without instructions to down-regulate, and (c) warned with instructions to down-regulate. In the last 2 conditions, the warning took the form of a 20-s countdown. In all conditions, visible aspects of the startle response were assessed by measuring overall somatic activity and coding emotional facial expressions. FTLD patients, AD patients, and control participants showed similar patterns of down-regulation in somatic activity across the 3 startle trials. However, differences between the 3 groups emerged in the amount of emotional facial behavior expressed in the startle trials. There were no group differences in response in the unwarned condition, indicating that the startle response was intact in the patients. In the warned with instructions condition, both FTLD and AD patients were moderately impaired in down-regulatory ability compared with controls. In the warned without instructions condition, AD patients and normal controls spontaneously down-regulated their emotional responses, but FTLD patients did not. These findings illuminate specific problems that these patients have in the emotional realm. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological decline in frontotemporal lobar degeneration: A longitudinal analysis.

Few studies have assessed whether the patterns of neuropsychological impairment in patients with different frontotemporal lobar degeneration (FTLD) subtypes remain distinct over the duration of their illness or devolve into a common, undifferentiated neuropsychological state. A longitudinal neuropsychological analysis was obtained over 100 months assessing executive control, language/naming, and visuoconstruction in 441 patients diagnosed with Alzheimer’s disease (AD) and four FTLD subtypes, i.e., a social comportment/dysexecutive (SOC/EXEC) disorder; progressive non-fluent aphasia (PNFA); semantic dementia (SemD); and corticobasal degeneration (CBD). Initial group differences on each measure were maintained over the duration of illness, including several double dissociations. For example, AD patients exhibited a decline in 'animal' fluency; PNFA patients had difficulty on tests of executive control, SemD maintained their impairment on tests of naming, and CBD had presented with performance on visuoconstructional tests. None of the group by neuropsychological task interactions evaluating longitudinal decline was significant, suggesting that performance does not converge onto a common subtype over time. These data indicate that distinct patterns of neuropsychological impairment are maintained longitudinally, reflecting the unique anatomic distribution of relative disease burden in AD and FTLD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frontotemporal dementia selectively impairs transitive reasoning about familiar spatial environments.

Although patients with frontotemporal dementia (FTD) are known to exhibit a wide range of cognitive and personality difficulties, some evidence suggests that there may be a degree of selectivity in their reasoning impairments. Based on a recent review of the neuroimaging literature on reasoning, the authors hypothesized that the presence or absence of familiar content may have a selective impact on the reasoning abilities of patients with FTD. Specifically, the authors predicted that patients with frontal-variant FTD would be more impaired when reasoning about transitive arguments involving familiar spatial environments than when reasoning about identical logical arguments involving unfamiliar spatial environments. As predicted, patients with FTD were less accurate than normal controls only when the content of arguments involved familiar spatial environments. These results indicate a degree of selectivity in the cognitive deficits of this patient population and suggest that the frontal-temporal lobe system may play a necessary role in reasoning about familiar material. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Double dissociation in the anatomy of socioemotional disinhibition and executive functioning in dementia.

Objective: To determine whether socioemotional disinhibition and executive dysfunction are related to dissociable patterns of brain atrophy in neurodegenerative disease. Previous studies have indicated that behavioral and cognitive dysfunction in neurodegenerative disease are linked to atrophy in different parts of the frontal lobes, but these prior studies did not establish that these relationships were specific, which would best be demonstrated by a double dissociation. Method: Subjects included 157 patients with neurodegenerative disease. A semiautomated parcellation program (Freesurfer) was used to generate regional cortical volumes from structural MRI scans. Regions of interest (ROIs) included anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG). Socioemotional disinhibition was measured using the Neuropsychiatric Inventory. Principal component analysis including 3 tasks of executive function (EF; verbal fluency, Stroop Interference, modified Trails) was used to generate a single-factor score to represent EF. Results: Partial correlations between ROIs, disinhibition, and EF were computed after controlling for total intracranial volume, Mini-Mental State Examination, diagnosis, age, and education. Brain regions significantly correlated with disinhibition (ACC, OFC, IFG, and temporal lobes) and EF (MFG) were entered into separate hierarchical regressions to determine which brain regions predicted disinhibition and EF. OFC was the only brain region to significantly predict disinhibition, and MFG significantly predicted EF performance. A multivariate general linear model demonstrated a significant interaction between ROIs and cognitive–behavioral functions. Conclusions: These results support a specific association between orbitofrontal areas and behavioral management as compared with dorsolateral areas and EF. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Executive Functioning and Alcohol-Related Aggression.

The primary goal of this investigation was to determine whether executive functioning (EF) would moderate the alcohol-aggression relation. Participants were 310 (152 men and 158 women) healthy social drinkers between 21 and 35 years of age. EF as well as non-EF skills were measured with 13 validated neuropsychological tests. Following the consumption of either an alcoholic or a placebo beverage, participants were tested on a modified version of the Taylor Aggression Paradigm (S. Taylor, 1967), in which mild electric shocks were received from, and administered to, a fictitious opponent. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent. EF was negatively related to aggressive behavior for men, regardless of beverage group, even when controlling for non-EF skills. Furthermore, alcohol increased aggression only for men with lower EF scores. Finally, the mere belief that alcohol was consumed suppressed aggression for women but not for men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functions and adhd in adults: Evidence for selective effects on ADHD symptom domains.

Dual-process models of attention-deficit/hyperactivity disorder (ADHD) suggest that both executive functioning and regulatory functions (e.g., processing speed) are involved and that executive function weaknesses may be associated specifically with symptoms of inattention-disorganization but not hyperactivity-impulsivity. Adults aged 18-37 (105 with ADHD, 90 controls) completed a neuropsychological battery. The ADHD group had weaker performance than did the control group (p = .01) on both executive and speed measures. Symptoms of inattention-disorganization were uniquely related to executive functioning with hyperactivity-impulsivity controlled. Inattention was associated with slower response speed, and hyperactivity-impulsivity with faster output speed. Results were not accounted for by IQ, age, gender, education level, or comorbid disorders. Findings are discussed in terms of developmental and dual-process models of ADHD leading into adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive control in a modified antisaccade task: Effects of aging and bilingualism.

Two studies are reported that assess differences associated with aging and bilingualism in an executive control task. Previous work has suggested that bilinguals have an advantage over monolinguals in nonlinguistic tasks involving executive control; the major purpose of the present article is to ascertain which aspects of control are sensitive to the bilingual experience. Study 1 used an antisaccade task and found no effects of aging or bilingualism. Study 2 used the identical visual display but coupled to keypress responses. The results showed that bilinguals resolved various types of response conflict faster than monolinguals and that this bilingual advantage generally increased with age. A speculative interpretation of this pattern of results is offered in conclusion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functioning, irritability, and alcohol-related aggression.

The purpose of this investigation was to examine (a) whether irritability mediates the relation between executive functioning (EF) and alcohol-related aggression and (b) whether the alcohol-aggression relation is better explained by the interactive effects of EF and irritability above and beyond the effects of either variable alone. EF was measured using seven well-established neuropsychological tests. Irritability was assessed with the Caprara Irritability Scale. Participants were 313 male and female social drinkers between 21 and 35 years of age. Following the consumption of an alcohol or a placebo beverage, participants were tested on a laboratory aggression task in which electric shocks were given to and received from a fictitious opponent under the guise of a competitive reaction-time task. Aggression was operationalized as the shock intensities administered to the fictitious opponent. Results indicated that irritability successfully mediated the relation between EF and intoxicated aggression for men only. Despite the fact that irritability and EF both independently moderated the alcohol-aggression relation in previous studies, no significant interaction for their combined effect was detected here. The findings are discussed, in part, within a cognitive neoassociationistic framework for aggressive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tacrine efficacy in Lewy body dementia

BACKGROUND: Response to tacrine varies among patients with Alzheimer's disease (AD). Lewy body dementia (LBD) could be a high responder subtype of AD. The aim of the study was to compare the effects of tacrine in LBD and AD. METHODS: Seventy-five consecutive outpatients with mild or moderate AD were screened. Tacrine was given at a dose of 40 mg/day during 6 weeks. During the next 6 weeks, the patients were treated with 80 mg/day and afterwards with 120 mg/day. Patients were assessed at baseline and treated with a dose of 120 mg/day tacrine for 2 weeks. RESULTS: Analysis was performed on 39 patients (AD, N = 20; LBD, N = 19). Eight patients were lost to follow-up, eight patients manifested with side-effects, six suffered from an intercurrent somatic disease during the study and 14 patients had poor compliance or were treated with incompatible drugs. Twenty-two patients (11 AD/11 LBD) increased their cognitive performances with tacrine. Among the 22 patients, the improvement differed between the AD and the LBD groups. In AD, conceptualization improved; in LBD, the improvements occurred in verbal initiation and digit span. CONCLUSION: This study emphasizes the importance of using appropriate tests to determine the positive effects of pharmacological treatments.     

Visual impairments in dementia with Lewy bodies and posterior cortical atrophy.

Dementia with Lewy bodies (DLB) and Posterior Cortical Atrophy (PCA), the visual variant of Alzheimer’s disease, are neurodegenerative diseases that present with progressive deterioration in visual perception. However, little is known about the precise nature underlying the complex visual deficits associated with both conditions. The present study compared DLB, PCA, and healthy control participants, in four visual tasks designed to measure the efficiency of the visual system at different levels of processing. In ascending order of complexity there were tasks of visual acuity, line orientation, contour integration, and rotated object comparison. DLB patients did not differ from controls in low level visual functions of visual acuity and line orientation, suggesting that early visual processing areas including V1 were relatively preserved, consistent with pathology evidence (Yamamoto et al., 2006). However, higher level visual functions of contour integration, mediated by extrastriatal areas, and the most complex task of object rotation, relying on processing within inferior temporal (IT), parietal, and frontal cortices, were impaired in DLB. In contrast, PCA patients were impaired in all tasks, consistent with evidence of widespread pathology within occipital and parietal areas in PCA. The latter suggests that both lower and higher level visual impairments contribute to the complex visual symptoms associated with PCA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive Growth Along the Adult Development Curve.

This article describes how principles of adult psychological development can inform executive coaching. An adult developmental perspective is used to identify key transformational tasks of adulthood that help shape executive role functioning. The correlation of psychological competencies with leadership competencies is outlined in more detail for the roles of senior vice president and executive vice president. Coaching case material is used to further illustrate how consultants can use an adult developmental framework to better align organizational life with personal strivings for meaning and growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations Between Cognitive Abilities and Measures of Executive Functioning.

Although frequently mentioned in contemporary neuropsychology, the term executive functioning has been a source of considerable confusion. One way in which the meaning of a variable can be investigated involves examining its pattern of relations with established cognitive abilities. This method was applied to a variety of variables hypothesized to assess executive functioning in 2 data sets, 1 consisting of 328 adults between 18 and 93 years of age and a 2nd composite data set based on nearly 7,000 healthy adults between 18 and 95 years of age. Most of the hypothesized executive functioning variables were strongly related to reasoning and perceptual speed abilities, and very few had any unique relations with age after taking into consideration the relations of age through the cognitive abilities. These results raise questions about the extent to which neuropsychological tests of executive functioning measure a distinct dimension of variation in normal adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive Functioning as a Potential Mediator of Age-Related Cognitive Decline in Normal Adults.

Critical requirements for the hypothesis that executive functioning is a potential mediator of age-related effects on cognitive functioning are that variables assumed to reflect executive functioning represent a distinct construct and that age-related effects on other types of cognitive functioning are reduced when measures of executive functioning are statistically controlled. These issues were investigated in a study involving 261 adults between 18 and 84 years of age. Although age-related effects on various cognitive abilities were substantially reduced after statistical control of the variance in measures hypothesized to represent executive functioning, there was only weak evidence for the existence of distinct constructs corresponding to executive functioning or to aspects of executive control concerned with inhibition, updating, or time sharing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive Function and Theory of Mind: Stability and Prediction From Ages 2 to 3.

Several studies have demonstrated a relation between executive functioning (EF) and theory of mind (ToM) in preschoolers, yet the developmental course of this relation remains unknown. Longitudinal stability and EF-ToM relations were examined in 81 children at 24 and 39 months. At Time 1, EF was unrelated to behavioral measures of ToM but was significantly related to parent report of children's internal-state language, independent of vocabulary size. At Time 2, behavioral batteries of EF and ToM were significantly related (r=.50, p