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Suchy Y, DesRuisseaux LA, Gereau Mora M, Brothers SL, Niermeyer MA. Conceptualization of the term "ecological validity" in neuropsychological research on executive function assessment: a systematic review and call to action. J Int Neuropsychol Soc 2024; 30:499-522. [PMID: 38251679 DOI: 10.1017/s1355617723000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE "Ecological validity" (EV) is classically defined as test's ability to predict real-world functioning, either alone or together with test's similarity to real-world tasks. In neuropsychological literature on assessment of executive functions (EF), EV is conceptualized inconsistently, leading to misconceptions about the utility of tests. The goal of this systematic review was to examine how EV is conceptualized in studies of EF tests described as ecologically valid. METHOD MEDLINE and PsychINFO Databases were searched. PRISMA guidelines were observed. After applying inclusion and exclusion criteria, this search yielded 90 articles. Deductive content analysis was employed to determine how the term EV was used. RESULTS About 1/3 of the studies conceptualized EV as the test's ability to predict functional outcomes, 1/3 as both the ability to predict functional outcome and similarity to real-world tasks, and 1/3 were either unclear about the meaning of the term or relied on notions unrelated to classical definitions (e.g., similarity to real-world tasks alone, association with other tests, or the ability to discriminate between populations). CONCLUSIONS Conceptualizations of the term EV in literature on EF assessment vary grossly, subsuming the notions of criterion, construct, and face validity, as well as sensitivity/specificity. Such inconsistency makes it difficult to interpret clinical utility of tests that are described as ecologically valid. We call on the field to require that, at minimum, the term EV be clearly defined in all publications, or replaced with more concrete terminology (e.g., criterion validity).
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Madison A Niermeyer
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
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Suchy Y, Gereau Mora M, Brothers SL, DesRuisseaux LA. Six elements test vs D-KEFS: what does "Ecological Validity" tell us? J Int Neuropsychol Soc 2024; 30:350-359. [PMID: 38465734 DOI: 10.1017/s1355617723000723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities relative to traditional EF measures. METHOD Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. RESULTS The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS. CONCLUSIONS Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Bonnín CM, Sánchez-Moreno J, Lima F, Roca X, Segú X, Montejo L, Solé B, Hidalgo-Mazzei D, Martin-Parra S, Martínez-Arán A, Vieta E, Torrent C, Rosa AR. Factors associated with the discrepancy between objective and subjective cognitive impairment in bipolar disorder. J Affect Disord 2024; 349:210-216. [PMID: 38190862 DOI: 10.1016/j.jad.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The aim of this study is to evaluate the discrepancy between objective cognitive measures and cognitive subjective complaints in a sample of euthymic patients with bipolar disorder (BD). METHODS One hundred and sixteen participants (83 euthymic patients with BD and 33 healthy controls) were enrolled for this study. Patients were assessed with a comprehensive neuropsychological battery and they also reported their subjective cognitive complaints with the Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA). The discrepancy between objective and subjective data was calculated using a novel methodology proposed in a previous study (Miskowiak, 2016). Statistical analyses included Pearson correlations and multiple linear regression. RESULTS Higher number of previous depressive episodes was identified as one variable associated with the global sensitivity composite score (Beta = 0.25; t = 2.1; p = 0.04) and with the verbal learning and memory sensitivity score (Beta = 0.26; t = 2.16; p = 0.03). That is, patients with more previous depressive episodes tend to over-report cognitive complaints. In contrast, higher number of previous hospitalizations was associated with stoicism in the global total score (Beta = -0.27; t = -2.24: p = 0.029) and in the domain of attention/processing speed (Beta = -0.34; t = -2.52; p = 0.016), indicating patients with more hospitalizations tend to report less cognitive complaints. DISCUSSION Our study identified some factors that might help to explain the discrepancy between objective and subjective cognitive measures in BD, including number of previous depressive episodes and number of previous hospitalizations. This highlights the need of the combined use of both types of cognitive measures to make an accurate assessment of cognitive dysfunctions and their effective treatment.
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Affiliation(s)
- C M Bonnín
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIBSANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - J Sánchez-Moreno
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - F Lima
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - X Roca
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica- Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - X Segú
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain
| | - L Montejo
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - B Solé
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - D Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - S Martin-Parra
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - A Martínez-Arán
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - A R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Pharmacology, Health Basic Science Institute, Universidade Federal do Rio Grande do Sul (UFRGS), Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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BIPOLAR DISORDER, MOOD STABILIZERS AND COGNITIVE FLEXIBILITY: TRANSLATIONALLY DISSECTING ILLNESS FROM DRUG EFFECTS. Behav Brain Res 2022; 424:113799. [PMID: 35181389 DOI: 10.1016/j.bbr.2022.113799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 11/21/2022]
Abstract
Bipolar disorder (BD) effects on cognition are confounded by the putative cognitive impact of its major pharmacological treatments, given the neurotrophic potential of mood stabilizers, particularly lithium. We examined the area of cognitive flexibility (CF), aiming to disentangle BD from medication effects, using translational methodology. CF was assessed by CANTAB-IED (intra- extra-dimensional shift; Study 1, euthymic BD participants) and its animal analogue (Study 2, rats). Both studies included groups (1) control, (2) lithium, chronic, current treatment (LI-CHRON-C, A: >2 years, N=32; B: 2 months, N=11); (3) valproate, chronic, current treatment (VPA-CHRON-C, A: >2 years, N=30; B: 2 months, N=12). Study 2 included 2 additional groups; Group 4: LI-CHRON-PAST (2 months, stopped 1 month pretest, N=13); Group 5: LI-ACUTE (LI on test days only, N=13). In Study 1, neither total nor stage (discrimination: D; reversal R; intra- extra-dimensional shifts: IED) IED errors differed between groups [(Kruskal-Wallis: H(2, N= 94) 0.95 > p > 0.65]. Similarly in Study 2, errors did not differentiate the 5 pharmacological groups. Differences emerged only between LI-ACUTE and Controls in response latencies (D, R, IED ANOVAS: 0.002 > p > 0.0003; contrasts D, R: p = 0.002, 0.0001). In conclusion, LI and VPA BD patients were indistinguishable from Controls in IED errors, as were animals treated with LI-CHRON, current or past, or VPA-CHRON-C vs Controls. LI-ACUTE treatment produced significant latency deficits vs. Controls. Within the limitations of translational comparisons, our results suggest that the normal CF noted in euthymic BDs is not attributable to mood stabilizer effects.
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Measurement Properties of the Multiple Errands Test: A Systematic Review. Arch Phys Med Rehabil 2020; 101:1628-1642. [DOI: 10.1016/j.apmr.2020.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/22/2019] [Accepted: 01/01/2020] [Indexed: 01/13/2023]
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Neurocognitive impairment and evidence-based treatment options in Bipolar disorder. Ann Gen Psychiatry 2020; 19:54. [PMID: 32983247 PMCID: PMC7513501 DOI: 10.1186/s12991-020-00304-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients. METHODS The material was chosen on the basis of previous systematic reviews the author has taken part in. RESULTS The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate. CONCLUSIONS Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
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Seelye A, Thuras P, Doane B, Clason C, VanVoorst W, Urošević S. Steeper aging-related declines in cognitive control processes among adults with bipolar disorders. J Affect Disord 2019; 246:595-602. [PMID: 30605878 DOI: 10.1016/j.jad.2018.12.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/20/2018] [Accepted: 12/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging-cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. METHODS Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits-CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. RESULTS The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. LIMITATIONS This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. CONCLUSIONS Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility-select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.
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Affiliation(s)
- Adriana Seelye
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States; Oregon Health & Science University, Department of Neurology, Portland, OR, United States; Oregon Center for Aging & Technology, Portland, OR, United States.
| | - Paul Thuras
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
| | - Bridget Doane
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Christie Clason
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Wendy VanVoorst
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Snežana Urošević
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
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Ibáñez A, García AM, Esteves S, Yoris A, Muñoz E, Reynaldo L, Pietto ML, Adolfi F, Manes F. Social neuroscience: undoing the schism between neurology and psychiatry. Soc Neurosci 2018; 13:1-39. [PMID: 27707008 PMCID: PMC11177280 DOI: 10.1080/17470919.2016.1245214] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multiple disorders once jointly conceived as "nervous diseases" became segregated by the distinct institutional traditions forged in neurology and psychiatry. As a result, each field specialized in the study and treatment of a subset of such conditions. Here we propose new avenues for interdisciplinary interaction through a triangulation of both fields with social neuroscience. To this end, we review evidence from five relevant domains (facial emotion recognition, empathy, theory of mind, moral cognition, and social context assessment), highlighting their common disturbances across neurological and psychiatric conditions and discussing their multiple pathophysiological mechanisms. Our proposal is anchored in multidimensional evidence, including behavioral, neurocognitive, and genetic findings. From a clinical perspective, this work paves the way for dimensional and transdiagnostic approaches, new pharmacological treatments, and educational innovations rooted in a combined neuropsychiatric training. Research-wise, it fosters new models of the social brain and a novel platform to explore the interplay of cognitive and social functions. Finally, we identify new challenges for this synergistic framework.
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Affiliation(s)
- Agustín Ibáñez
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- c Center for Social and Cognitive Neuroscience (CSCN), School of Psychology , Universidad Adolfo Ibáñez , Santiago de Chile , Chile
- d Universidad Autónoma del Caribe , Barranquilla , Colombia
- e Centre of Excellence in Cognition and its Disorders , Australian Research Council (ACR) , Sydney , Australia
| | - Adolfo M García
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- f Faculty of Elementary and Special Education (FEEyE) , National University of Cuyo (UNCuyo) , Mendoza , Argentina
| | - Sol Esteves
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | - Adrián Yoris
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
| | - Edinson Muñoz
- g Departamento de Lingüística y Literatura, Facultad de Humanidades , Universidad de Santiago de Chile , Santiago , Chile
| | - Lucila Reynaldo
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | | | - Federico Adolfi
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | - Facundo Manes
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- e Centre of Excellence in Cognition and its Disorders , Australian Research Council (ACR) , Sydney , Australia
- i Department of Experimental Psychology , University of South Carolina , Columbia , SC , USA
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Filmer HL, Lyons M, Mattingley JB, Dux PE. Anodal tDCS applied during multitasking training leads to transferable performance gains. Sci Rep 2017; 7:12988. [PMID: 29021526 PMCID: PMC5636876 DOI: 10.1038/s41598-017-13075-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/19/2017] [Indexed: 01/08/2023] Open
Abstract
Cognitive training can lead to performance improvements that are specific to the tasks trained. Recent research has suggested that transcranial direct current stimulation (tDCS) applied during training of a simple response-selection paradigm can broaden performance benefits to an untrained task. Here we assessed the impact of combined tDCS and training on multitasking, stimulus-response mapping specificity, response-inhibition, and spatial attention performance in a cohort of healthy adults. Participants trained over four days with concurrent tDCS - anodal, cathodal, or sham - applied to the left prefrontal cortex. Immediately prior to, 1 day after, and 2 weeks after training, performance was assessed on the trained multitasking paradigm, an untrained multitasking paradigm, a go/no-go inhibition task, and a visual search task. Training combined with anodal tDCS, compared with training plus cathodal or sham stimulation, enhanced performance for the untrained multitasking paradigm and visual search tasks. By contrast, there were no training benefits for the go/no-go task. Our findings demonstrate that anodal tDCS combined with multitasking training can extend to untrained multitasking paradigms as well as spatial attention, but with no extension to the domain of response inhibition.
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Affiliation(s)
- Hannah L Filmer
- School of Psychology, The University of Queensland, 4072, St Lucia, Australia.
| | - Maxwell Lyons
- School of Psychology, The University of Queensland, 4072, St Lucia, Australia
| | - Jason B Mattingley
- School of Psychology, The University of Queensland, 4072, St Lucia, Australia
- Queensland Brain Institute, The University of Queensland, 4072, St Lucia, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, 4072, St Lucia, Australia
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Zimmermann N, Cardoso CDO, Kristensen CH, Fonseca RP. Brazilian norms and effects of age and education on the Hayling and Trail Making Tests. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:188-195. [DOI: 10.1590/2237-6089-2016-0082] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/20/2017] [Indexed: 11/22/2022]
Abstract
Abstract Objectives To describe normative data for the Hayling Test and the Trail Making Test (TMT) in a sample of Brazilian adults, and to investigate the effects of age and education on test performance. Method A total of 313 (TMT) and 364 (Hayling) individuals with age ranges of 19-39, 40-59, and 60-75 years, and with at least 5 years of formal education, participated in this study. The tests were administered as part of a large battery of a normative project. Individuals were evaluated individually in silent, ventilated rooms at a university clinic. Instrument protocols were scored by trained research assistants and double-checked to ensure data reliability. Results There were major effects of age on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Errors B/15, B/45), and major effects of education on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Time A, Errors B/15, B/45). Interaction effects were found in Time B and B-A for the Hayling Test and in Time A for the TMT. Conclusions Age and education were critical for performance on both verbal and non-verbal executive functions.
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Dickinson T, Becerra R, Coombes J. Executive functioning deficits among adults with Bipolar Disorder (types I and II): A systematic review and meta-analysis. J Affect Disord 2017; 218:407-427. [PMID: 28501741 DOI: 10.1016/j.jad.2017.04.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/04/2017] [Accepted: 04/07/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Executive functioning (EF) deficits contribute to a significant proportion of the burden of disease associated with bipolar disorder (BD). Yet, there is still debate in the literature regarding the exact profile of executive functioning in BD. The purpose of the present project was to assess whether EF deficits exist among adults suffering BD, and whether these deficits (if apparent) differ by BD subtype. METHODS A systematic search identified relevant literature. Randomised controlled trials that used neuropsychological assessment to investigate EF among adults 16-65 years) with a remitted DSM diagnosis of BD (type I or II) were included. Studies were published between 1994 and 2015. A systematic review and meta-analysis were undertaken. For individual studies, standardised mean differences (Cohen's d) and 95% confidence intervals were calculated and represented in forest plots to illustrate differences in executive performance between groups. Summary effects were produced and tests of heterogeneity employed to assess the dispersion and generalisability of results. RESULTS Thirty-six studies met criteria for inclusion. Six domains of EF were identified: Set-shifting (SS), inhibition (INH), planning (PLA), verbal fluency (VF), working memory (WM), and attention (ATT). BD1s performed worse than HCs in all domains. BD2s demonstrated impairment in VF, WM, SS, and ATT. The results were mixed for comparisons between BD1s and BD2s, but revealed that BD2s can experience similar (or sometimes greater) EF impairment. LIMITATIONS Only a limited number of studies that included BD2 samples were available for inclusion in the current study. Subgroup analysis to elucidate potential moderators of within-study variance was not undertaken. CONCLUSION This is the first systematic review and meta-analysis to have compared the EF of remitted BD1s, BD2s, and HCs. The results provided useful insight into the EF profile of patients with BD, and offered commentary as to some of the contradictory results reported in the literature. A standardised methodological protocol for assessment of EF in BD was proposed. The information in this review could enhance our understanding of EF impairment inherent in BD, and the methods and efficacy with which clinicians assess and treat this population.
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Affiliation(s)
- Tania Dickinson
- Clear Health Psychology, Edith Cowan University, 99 Central Avenue, Mount Lawley, Western Australia 6050, Australia.
| | - Rodrigo Becerra
- School of Psychology and Social Science, Edith Cowan Univeristy, Room 30.129, Building 30, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Jacqui Coombes
- Centre for Learning and Teaching, Edith Cowan University, Room 5.119, Building 5, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
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Zakzanis KK, Grimes KM, Uzzaman S, Schmuckler MA. Prospection and its relationship to instrumental activities of daily living in patients with mild traumatic brain injury with cognitive impairment. Brain Inj 2016; 30:986-92. [DOI: 10.3109/02699052.2016.1147077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial. J Int Neuropsychol Soc 2016; 22:436-52. [PMID: 26812574 DOI: 10.1017/s1355617715001344] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Executive dysfunction is a common consequence of acquired brain injury (ABI), causing significant disability in daily life. This randomized controlled trial investigated the efficacy of Goal Management Training (GMT) in improving executive functioning in patients with chronic ABI. Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT (n=33) or a psycho-educative active control condition, Brain Health Workshop (BHW) (n=37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months follow-up. Assessors were blinded to group allocation. Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findings show that executive dysfunction can be improved years after the ABI.
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD. METHODS Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis. CONCLUSION The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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Kievit RA, Davis SW, Mitchell DJ, Taylor JR, Duncan J, Henson RNA. Distinct aspects of frontal lobe structure mediate age-related differences in fluid intelligence and multitasking. Nat Commun 2014; 5:5658. [PMID: 25519467 PMCID: PMC4284640 DOI: 10.1038/ncomms6658] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/24/2014] [Indexed: 12/25/2022] Open
Abstract
Ageing is characterized by declines on a variety of cognitive measures. These declines are often attributed to a general, unitary underlying cause, such as a reduction in executive function owing to atrophy of the prefrontal cortex. However, age-related changes are likely multifactorial, and the relationship between neural changes and cognitive measures is not well-understood. Here we address this in a large (N=567), population-based sample drawn from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) data. We relate fluid intelligence and multitasking to multiple brain measures, including grey matter in various prefrontal regions and white matter integrity connecting those regions. We show that multitasking and fluid intelligence are separable cognitive abilities, with differential sensitivities to age, which are mediated by distinct neural subsystems that show different prediction in older versus younger individuals. These results suggest that prefrontal ageing is a manifold process demanding multifaceted models of neurocognitive ageing.
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Affiliation(s)
- Rogier A Kievit
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Simon W Davis
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK
| | - Daniel J Mitchell
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Jason R Taylor
- 1] MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK [2] School of Psychological Sciences, The University of Manchester, Brunswick Street, Manchester M13 9PL, UK
| | - John Duncan
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | | | - Richard N A Henson
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK
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Barttfeld P, Petroni A, Báez S, Urquina H, Sigman M, Cetkovich M, Torralva T, Torrente F, Lischinsky A, Castellanos X, Manes F, Ibañez A. Functional connectivity and temporal variability of brain connections in adults with attention deficit/hyperactivity disorder and bipolar disorder. Neuropsychobiology 2014; 69:65-75. [PMID: 24576926 DOI: 10.1159/000356964] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess brain functional connectivity and variability in adults with attention deficit/hyperactivity disorder (ADHD) or euthymic bipolar disorder (BD) relative to a control (CT) group. METHODS Electroencephalography (EEG) was measured in 35 participants (BD = 11; ADHD = 9; CT = 15) during an eyes-closed 10-min rest period, and connectivity and graph theory metrics were computed. A coefficient of variation (CV) computed also the connectivity's temporal variability of EEG. Multivariate associations between functional connectivity and clinical and neuropsychological profiles were evaluated. RESULTS An enhancement of functional connectivity was observed in the ADHD (fronto-occipital connections) and BD (diffuse connections) groups. However, compared with CTs, intrinsic variability (CV) was enhanced in the ADHD group and reduced in the BD group. Graph theory metrics confirmed the existence of several abnormal network features in both affected groups. Significant associations of connectivity with symptoms were also observed. In the ADHD group, temporal variability of functional connections was associated with executive function and memory deficits. Depression, hyperactivity and impulsivity levels in the ADHD group were associated with abnormal intrinsic connectivity. In the BD group, levels of anxiety and depression were related to abnormal frontotemporal connectivity. CONCLUSIONS In the ADHD group, we found that intrinsic variability was associated with deficits in cognitive performance and that connectivity abnormalities were related to ADHD symptomatology. The BD group exhibited less intrinsic variability and more diffuse long-range brain connections, and those abnormalities were related to interindividual differences in depression and anxiety. These preliminary results are relevant for neurocognitive models of abnormal brain connectivity in both disorders.
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Affiliation(s)
- Pablo Barttfeld
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University, Buenos Aires, Argentina
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Civil Arslan F, Tiryaki A, Ozkorumak E. A comparison of euthymic bipolar patients with unaffected first-degree relatives and healthy controls in terms of neuropsychological functions. Int J Psychiatry Clin Pract 2014; 18:208-14. [PMID: 24164495 DOI: 10.3109/13651501.2013.859706] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Cognitive dysfunction in bipolar disorder (BD) is well established in the literature. The neurocognitive deficits have been considered to be endophenotypic markers of BD, and studies have examined whether neurocognitive deficits exist in first-degree relatives of individuals with BD I. We hypothesized that performance in tests of neurocognitive function would be impaired in euthymic BD I patients and their unaffected first-degree relatives compared to that of healthy controls. METHODS We compared the performance of bipolar patients, their first-degree relatives, and healthy controls in a battery of neurocognitive tests to reveal possible endophenotypes of BD. A diagnostic interview and neuropsychological test battery were administered to 30 BD I patients, 55 of their unaffected first-degree relatives and 32 healthy controls. RESULTS The patients and their first-degree relatives were significantly impaired in executive function assessed using the Wisconsin Card Sorting Test (WCST) and Trail Making Test-B (TMT-B) relative to the controls (WCST; perseverative errors: p < 0.0005, categories completed: p = 0.002, TMT-B; p = 0.002). There were no significant differences between the groups in terms of attention, psychomotor speed, verbal memory, or learning. CONCLUSION Our study suggests that the deficits in executive function may be endophenotypic markers of genetic vulnerability to BD I.
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Affiliation(s)
- Filiz Civil Arslan
- Department of Psychiatry, Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey
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Cognitive functions in euthymic patients with bipolar II disorder and their correlation with the clinical profile. MIDDLE EAST CURRENT PSYCHIATRY 2014. [DOI: 10.1097/01.xme.0000449844.48496.f1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Baez S, Ibanez A, Gleichgerrcht E, Perez A, Roca M, Manes F, Torralva T. The utility of IFS (INECO Frontal Screening) for the detection of executive dysfunction in adults with bipolar disorder and ADHD. Psychiatry Res 2014; 216:269-76. [PMID: 24582774 DOI: 10.1016/j.psychres.2014.01.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 10/25/2022]
Abstract
Bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) in adults share clinical symptoms. Both disorders present with executive functioning impairment. The detection of executive dysfunction usually requires the administration of an extensive neuropsychological battery. The Institute of Cognitive Neurology (INECO) Frontal Screening (IFS) is an efficient tool, which has been demonstrated to be useful for the detection of executive deficits in other diseases involving the prefrontal cortex. This study assessed the usefulness of the IFS in detecting the executive dysfunction of BD and ADHD adults, by means of a receiver-operating characteristic curve analysis and a multigroup discriminant function analysis. Twenty-four BD, 25 ADHD patients and 25 controls were assessed with a battery that included the IFS and other measures of executive functioning. Our results showed that both patient groups performed significantly lower than controls on the IFS total score. Using a 27.5 point cut-off score, the IFS showed good sensitivity and acceptable specificity to detect executive impairments in BD and ADHD patients. The IFS discriminated between controls and each patient group more reliably than other executive functions measures. Our results suggest that this tool could be a useful instrument to assess executive functions in BD and ADHD patients.
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Affiliation(s)
- Sandra Baez
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile
| | - Agustin Ibanez
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Ezequiel Gleichgerrcht
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile
| | - Ana Perez
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
| | - María Roca
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile
| | - Facundo Manes
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Australian Research Council (ACR) Centre of Excellence in Cognition and its Disorders, Australia
| | - Teresa Torralva
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina; Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile.
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Keogh E, Moore DJ, Duggan GB, Payne SJ, Eccleston C. The disruptive effects of pain on complex cognitive performance and executive control. PLoS One 2013; 8:e83272. [PMID: 24386168 PMCID: PMC3875458 DOI: 10.1371/journal.pone.0083272] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 11/08/2013] [Indexed: 01/21/2023] Open
Abstract
Pain interferes and disrupts attention. What is less clear is how pain affects performance on complex tasks, and the strategies used to ensure optimal outcomes. The aim of the current study was to examine the effect of pain on higher-order executive control processes involved in managing complex tasks. Sixty-two adult volunteers (40 female) completed two computer-based tasks: a breakfast making task and a word generation puzzle. Both were complex, involving executive control functions, including goal-directed planning and switching. Half of those recruited performed the tasks under conditions of thermal heat pain, and half with no accompanying pain. Whilst pain did not affect central performance on either task, it did have indirect effects. For the breakfast task, pain resulted in a decreased ability to multitask, with performance decrements found on the secondary task. However, no effects of pain were found on the processes thought to underpin this task. For the word generation puzzle, pain did not affect task performance, but did alter subjective accounts of the processes used to complete the task; pain affected the perceived allocation of time to the task, as well as switching perceptions. Sex differences were also found. When studying higher-order cognitive processes, pain-related interference effects are varied, and may result in subtle or indirect changes in cognition.
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Affiliation(s)
- Edmund Keogh
- Department of Psychology, University of Bath, Bath, United Kingdom
- Centre for Pain Research, University of Bath, Bath, United Kingdom
- * E-mail:
| | - David J. Moore
- Centre for Pain Research, University of Bath, Bath, United Kingdom
| | | | - Stephen J. Payne
- Department of Computer Science, University of Bath, Bath, United Kingdom
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Laloyaux J, Pellegrini N, Mourad H, Bertrand H, Domken MA, Van der Linden M, Larøi F. Performance on a computerized shopping task significantly predicts real world functioning in persons diagnosed with bipolar disorder. Psychiatry Res 2013; 210:465-71. [PMID: 23870492 DOI: 10.1016/j.psychres.2013.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 06/17/2013] [Accepted: 06/23/2013] [Indexed: 10/26/2022]
Abstract
Persons diagnosed with bipolar disorder often suffer from cognitive impairments. However, little is known concerning how these cognitive deficits impact their real world functioning. We developed a computerized real-life activity task, where participants are required to shop for a list of grocery store items. Twenty one individuals diagnosed with bipolar disorder and 21 matched healthy controls were administered the computerized shopping task. Moreover, the patient group was assessed with a battery of cognitive tests and clinical scales. Performance on the shopping task significantly differentiated patients and healthy controls for two variables: Total time to complete the shopping task and Mean time spent to consult the shopping list. Moreover, in the patient group, performance on these variables from the shopping task correlated significantly with cognitive functioning (i.e. processing speed, verbal episodic memory, planning, cognitive flexibility, and inhibition) and with clinical variables including duration of illness and real world functioning. Finally, variables from the shopping task were found to significantly explain 41% of real world functioning of patients diagnosed with bipolar disorder. These findings suggest that the shopping task provides a good indication of real world functioning and cognitive functioning of persons diagnosed with bipolar disorder.
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Affiliation(s)
- Julien Laloyaux
- Department of Psychology, University of Liège, Liège, Belgium.
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Caletti E, Paoli RA, Fiorentini A, Cigliobianco M, Zugno E, Serati M, Orsenigo G, Grillo P, Zago S, Caldiroli A, Prunas C, Giusti F, Consonni D, Altamura AC. Neuropsychology, social cognition and global functioning among bipolar, schizophrenic patients and healthy controls: preliminary data. Front Hum Neurosci 2013; 7:661. [PMID: 24146642 PMCID: PMC3797996 DOI: 10.3389/fnhum.2013.00661] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 09/23/2013] [Indexed: 12/19/2022] Open
Abstract
This study aimed to determine the extent of impairment in social and non-social cognitive domains in an ecological context comparing bipolar (BD), schizophrenic (SKZ) patients and healthy controls (HC). The sample was enrolled at the Department of Psychiatry of Policlinico Hospital, University of Milan; it includes stabilized SKZ patients (n = 30), euthymic bipolar patients (n = 18) and HC (n = 18). Patients and controls completed psychiatric assessment rating scales, the Brief Assessment of Cognition in Schizophrenia (BACS) and the Executive and Social Cognition Battery (ESCB) that contains both ecological tests of executive function and social cognition, in order to better detect cognitive deficits in patients with normal results in standard executive batteries. The three groups differed significantly for gender and substance abuse, however, the differences did not influence the results. BD patients showed less impairment on cognitive performance compared to SKZ patients, even in “ecological” tests that mimic real life scenarios. In particular, BD performed better than SKZ in verbal memory (p < 0.0038) and BACS symbol coding (p < 0.0043). Regarding the ESCB tests, in the Hotel task SKZ patients completed significantly less tasks (p < 0.001), showed a greater number of errors in Multiple Errands Test (MET-HV) (p < 0.0248) and a worse performance in Theory of Mind (ToM) tests (p < 0.001 for the Eyes test and Faux pas test). Both patients' groups performed significantly worse than HC. Finally, significant differences were found between the two groups in GAF scores, being greater among BD subjects (p < 0.001). GAF was correlated with BACS and ESCB scores showing the crucial role of cognitive and ecological performances in patients' global functioning.
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Affiliation(s)
- Elisabetta Caletti
- Department of Neuroscience and Mental Health, Psychiatric Clinic, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milan, Italy
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Cognitive impairment in Egyptian euthymic patients with bipolar I disorder compared with controls. MIDDLE EAST CURRENT PSYCHIATRY 2013. [DOI: 10.1097/01.xme.0000433325.69290.c9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pose M, Cetkovich M, Gleichgerrcht E, Ibáñez A, Torralva T, Manes F. The overlap of symptomatic dimensions between frontotemporal dementia and several psychiatric disorders that appear in late adulthood. Int Rev Psychiatry 2013; 25:159-67. [PMID: 23611346 DOI: 10.3109/09540261.2013.769939] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Several factors make diagnosis of a possible behavioural variant of frontotemporal dementia (bvFTD) particularly challenging, especially the overlap of certain symptomatic dimensions such as apathy, disinhibition, depression, anhedonia, stereotyped behaviour, and psychosis between bvFTD and several psychiatric disorders that appear in late adulthood. We discuss the most frequent psychiatric conditions that can simulate early bvFTD symptoms, including late onset bipolar disorder, late onset schizophrenia-like psychosis, late onset depression, and attention deficit hyperactivity disorder in middle and older age.
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Baez S, Herrera E, Villarin L, Theil D, Gonzalez-Gadea ML, Gomez P, Mosquera M, Huepe D, Strejilevich S, Vigliecca NS, Matthäus F, Decety J, Manes F, Ibañez AM. Contextual social cognition impairments in schizophrenia and bipolar disorder. PLoS One 2013; 8:e57664. [PMID: 23520477 PMCID: PMC3592887 DOI: 10.1371/journal.pone.0057664] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/23/2013] [Indexed: 01/09/2023] Open
Abstract
Background The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. Methodology/Principal Findings This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients’ depression levels were negatively correlated with performance on empathy tasks. Conclusions/Significance Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.
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Affiliation(s)
- Sandra Baez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Pontifical Catholic University of Argentina, Buenos Aires, Argentina
| | - Eduar Herrera
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Lilian Villarin
- Interdisciplinary Center for Scientific Computing, University of Heidelberg, Heidelberg, Germany
| | | | - María Luz Gonzalez-Gadea
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Pedro Gomez
- CARI University Hospital, Barranquilla, Colombia
| | | | - David Huepe
- Laboratory of Cognitive and Social Neuroscience, Universidad Diego Portales, Santiago, Chile
| | - Sergio Strejilevich
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
| | - Nora Silvana Vigliecca
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Instituto de Humanidades (IDH) de la Facultad de Filosofía y Humanidades, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Franziska Matthäus
- Interdisciplinary Center for Scientific Computing, University of Heidelberg, Heidelberg, Germany
| | - Jean Decety
- Departments of Psychology and Psychiatry, and Center for Cognitive and Social Neuroscience, University of Chicago, Chicago, Illinois, United States of America
| | - Facundo Manes
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
| | - Agustín M. Ibañez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Laboratory of Cognitive and Social Neuroscience, Universidad Diego Portales, Santiago, Chile
- * E-mail:
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Drysdale E, Knight HM, McIntosh AM, Blackwood DHR. Cognitive endophenotypes in a family with bipolar disorder with a risk locus on chromosome 4. Bipolar Disord 2013; 15:215-22. [PMID: 23320647 DOI: 10.1111/bdi.12040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES We studied cognitive function in high-risk relatives belonging to a single extended family showing linkage of bipolar disorder to a locus on chromosome 4. High-risk relatives were defined as those that carried the risk haplotype of polymorphic markers, identified in a previous linkage study. This family provided a rare opportunity to characterize a neuropsychological endophenotype in a homogeneous sample of relatives with a common genetic risk factor. METHODS Fifteen family members carrying the risk haplotype (eight diagnosed with bipolar disorder or depression and seven with no psychiatric diagnosis), unrelated patients with bipolar disorder (n = 36) and major depressive disorder (n = 40), and healthy control subjects (n = 33) were administered the California Verbal Learning Test, Verbal Fluency Test, Hayling Sentence Completion Test, and Brixton Spatial Anticipation Test to assess verbal memory, verbal fluency, and executive function. RESULTS Compared with healthy controls, family members carrying the risk haplotype were impaired in indices of memory and executive function. There were no significant differences between unaffected and affected haplotype-carrying family members in any cognitive measure. Pronounced deficits in the encoding stage of verbal memory and category verbal fluency were evident in individuals with the risk haplotype. CONCLUSIONS Verbal learning and semantic verbal fluency impairments may represent a cognitive endophenotype for both bipolar disorder and major depression in relatives of bipolar disorder patients, as impairment was also present in high-risk relatives who had not developed any affective disorder symptoms. These findings suggest that impairment in semantic organization may be linked to the genetic aetiology of bipolar disorder.
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Affiliation(s)
- Emma Drysdale
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
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