Executive functioning in TBI from rehabilitation to social reintegration: COMPASS^(goal), a randomized controlled trial(grant: 1I01RX000637-01A3 by the VA ORD RR&D, 2013–2016)

Background: Traumatic brain injury is a major health problem that frequently leads to deficits in executive function. Self-regulation processes, such as goal-setting, may become disordered after traumatic brain injury, particularly when the frontal regions of the brain and their connections are involved. Such impairments reduce injured veterans' ability to return to work or school and to regain satisfactory personal lives. Understanding the neurologically disabling effects of brain injury on executive function is necessary for both the accurate diagnosis of impairment and the individual tailoring of rehabilitation processes to help returning service members recover independent function.Methods/design: The COMPASSgoal(Community Participation through Self-Efficacy Skills Development) program develops and tests a novel patient-centered intervention framework for community reintegration psychosocial research in veterans with mild traumatic brain injury. COMPASSgoal integrates the principles and best practices of goal self-management. Goal setting is a core skill in self-management training by which persons with chronic health conditions learn to improve their status and decrease symptom effects. Over a three-year period, COMPASSgoal will recruit 110 participants with residual executive dysfunction three months or more post-injury. Inclusion criteria combine both clinical diagnosis and standardized scores that are >1 SD from the normative score on the Frontal Systems Rating Scale. Participants are randomized into two groups: goal-management(intervention) and supported discharge(control). The intervention is administered in eight consecutive, weekly sessions. Assessments occur at enrollment, post-intervention/supported discharge, and three months post-treatment follow-up.Discussion: Goal management is part of the "natural language" of rehabilitation. However, collaborative goal-setting between clinicians/case managers and clients can be hindered by the cognitive deficits that follow brain injury. Re-training returning veterans with brain injury in goal management, with appropriate help and support, would essentially treat deficits in executive function. A structured approach to goal self-management may foster greater independence and self-efficacy, help veterans gain insight into goals that are realistic for them at a given time, and help clinicians and veterans to work more effectively as true collaborators.

Bibliographical Review on Rehabilitation of Executive Functions in Patients With Developmental Coordination Disorder(DCD)

The present study aims to establish a literature review on intervention programs for executive functions(EFs)through the use of fundamental motor skills,from a neuropsychopedagogical perspective in subjects with Developmental Coordination Disorder(DCD).An exploratory study was carried out through an integrative literature review.The research was carried out in the Scientific databases Electronic Library Online(SciELO),Latin American and Caribbean Literature in Health Sciences(LILACS),Virtual Health Library-Psychology Brazil(BVSPSI),Electronic Journals of Psychology(PePSIC),in the periodicals available in the Brazilian Digital Library of Theses and Dissertations(BDTD)and on the website of the Coordination for the Improvement of Higher Education Personnel(CAPES).The covering publications took place from 2018 to 2023,14 articles were selected for analysis.This literature review made it possible to create strategies for stimulating EF and Visuomotor Functions so that educators and other professionals can better deal with students with DCD.It was perceived the need to carry out and develop more empirical research regarding the intervention of EFs and Visuomotor Functions by educators and professionals,with a greater sampling amplitude,to increase the number of studies that enable interventions both in children and in teenagers with DCD.

Acute exercise is associated with specific executive functions in college students with ADHD:A preliminary study

Purpose： The relationship between acute exercise and executive functions in college students with attention deficit hyperactivity disorder （ADHD） has not been clearly established. The purpose of this preliminary study was to examine the difference in cognitive performance between college students with and without ADHD and to explore the effects of acute exercise on multiple aspects of executive functions and on serum brain derived neurotrophic factor （BDNF）. Methods： College students （normal： n = 10; ADHD： n = 10） performed the Stroop Test, Trail Making Test, and Digit Span Test prior to and after an acute exercise intervention. Blood samples were obtained prior to the pre-test cognitive test performance and then again after exercise and prior to the post-test cognitive test performance. Results： Students with ADHD exhibited impaired executive functions, particularly on inhibition. Additionally, while acute exercise improved all aspects of executive functions in those without ADHD, acute exercise only improved inhibitory performance for those with ADHD. Further, BDNF was not influenced by acute exercise regardless of the subjects＇ ADHD status. Conclusion： These results provide preliminary evidence for exercise as a potential adjunct treatment for benefitting inhibition in college students with ADHD.

Processing Environmental Stimuli in Paranoid Schizophrenia:Recognizing Facial Emotions and Performing Executive Functions

Objective To study the contribution of executive function to abnormal recognition of facia expressions of emotion in schizophrenia patients. Methods Abnormal recognition of facial expressions of emotion was assayed according to Japanese and Caucasian facial expressions of emotion （JACFEE）, Wisconsin card sorting test {WCST）, positive and negative symptom scale, and Hamilton anxiety and depression scale, respectively, in 88 paranoid schizophrenia patients and 75 healthy volunteers. Results Patients scored higher on the Positive and Negative Symptom Scale and the Hamilton Anxiety and Depression Scales, displayed lower JACFEE recognition accuracies and poorer WCST performances. The JACFEE recognition accuracy of contempt and disgust was negatively correlated with the negative symptom scale score while the recognition accuracy of fear was positively with the positive symptom scale score and the recognition accuracy of surprise was negatively with the general psychopathology score in patients. Moreover, the WCST could predict the JACFEE recognition accuracy of contempt, disgust, and sadness in patients, and the perseverative errors negatively predicted the recognition accuracy of sadness in healthy volunteers. The JACFEE recognition accuracy of sadness could predict the WCST categories in paranoid schizophrenia patients. Conclusion Recognition accuracy of social-/moral emotions, such as contempt, disgust and sadness is related to the executive function in paranoid schizophrenia patients, especially when regarding sadness.

Association between central obesity and executive function as assessed by stroop task performance:A functional near-infrared spectroscopy study

Recent studies have suggested a link between executive function(EF)and obesity.Studies oftenadopt body mass index(BM),which reflects the distribution of subcutaneous fat,as the solemarker of obesity;however,BMI is inappropriate to distinguish central obesity,which indicatesthe centralized distribution of visceral fat.Visceral fat compared with subcutaneous fat repre-sents greater relative lipid turnover and may increase the risk of cognitive decline in older adults.However,the relationship between EF and central obesity is largely unknown,particularly inyoung adults.Therefore,we used waist circumference(WC)as a marker of central obesity andinvestigated diferent sensitivities between BMI and WC in the brain function.A total of 26healthy young adults(aged 18-25 years;42%female)underwent functional near-infrared spec-troscopy assessments.EF was assessed using the Stroop task,which is a classical measurementof EF.A significant Stroop effect was observed in the behavioral and hemodynamic data.Inaddition,we observed that behavioral interference on the Stroop task varied much more insubjects with higher BMI and WC than those subjects with lower.Elevated BMI and WC wereassociated with a decreased hemodynamic response during the Stroop task specifically in the pre-frontal cortex(PFC).Compared to BMI,WC was more closely connected with inhibitory controland revealed right lateralized PFC activation.Our findings suggest that WC is a reliable indicatorof brain function in young adults and propose a relationship bet ween EF and central obesity.

Impact of Auditory-Verbal Therapy on executive functions in children with Cochlear Implants

Objective: Auditory-Verbal Therapy(AVT) can be considered one of the best practices for children with Cochlear Implants(CIs) who show impairments in cognitive skills such as executive functions. Hence,this research examined the impact of AVT on the executive functions in children with CIs.Methods: This was a randomized case control study with pre-and post-intervention assessments. The participants were 36 children with CIs and their mothers. They were randomly selected from rehabilitation centers and deaf pre-schools, and randomly allocated to a control(n = 18) and a study(n = 18)group. The mean age of the children in the study and control groups was 3.11 ± 0.31 years and 3.20 ± 0.29years, respectively. Participants in the study group received 20 sessions of AVT over 10 weeks at twice a week, while those in the control group did not. All mothers completed the Behavior Rating Inventory of Executive Function Pre-school Version(BRIEF-P) before and after children in the study group completed their AVT intervention. Data were analyzed by MANCOVA.Results: The results suggest that AVT significantly influenced executive functions and all subscales including shifting, inhibition, emotional control, working memory and organization/planning in children with CIs.Conclusions: These findings suggest that AVT may be effective in resulting in positive outcomes and may play an important role in improving executive functions in children with CIs.

Effectiveness of Mindfulness Training in Enhancing Executive Function and Decreasing Symptoms of Depression and Anxiety in Patients with Multiple Sclerosis (MS)

The purpose of the present study was to evaluate the effectiveness of mindfulness training in enhancing executive function and decreasing symptoms of depression and anxiety in multiple sclerosis patients. The population in this study consisted of people with MS who referred to Karaj city MS society in 1394. These people didn’t experience medicinal changes during the study period and their expanded disability status score (EDSS) was between 0 and 5.5. 40 of them were randomly selected and placed into two experimental and control groups (20 for the experimental and the other for the control group). The treatment of mindfulness training was held in 8 sessions of group training, once a week and for 2 hours. The statistical method of multivariate analysis of covariance was used. The measurement tools were the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II) and the Wisconsin Card Sorting Test (WCST). After all, the results in both groups were compared and evaluated by the use of analysis of covariance. The results showed significant differences in symptoms of anxiety and depression between the two groups (p 0.05). Generally, the results of this research showed positive effects of mindfulness training on reducing anxiety and depression among patients with MS and ineffectiveness of mindfulness training on their executive function. Therefore, considering that there is no certain treatment for MS plus results of this study, the application of mindfulness training can be quite useful to reduce levels of anxiety and depression in patients with MS.

Assessment of Stress Cognitive Control and Executive Function with Stress Control Rating Scale (ECOSTRESS) and Low Resolution Brain Electromagnetic Tomography (LORETA) (In Portuguese People in Situations of Unemployment and Economic Insufficiency)

This article reviews the constructs of stress, appraisal, coping, according to a transactional perspective, and executive function, and presents a stress control rating scale (ECOSTRESS), which design is founded in these constructs. This psychometric tool is useful in the assessment of cognitive control of stress, correlated with the function of dorsolateral prefrontal cortex. It has been validated for its use in the assessment of Portuguese people in situations of stress related to unemployment and economic insufficiency. Also, within the context of the cognitive control of stress, it is highlighted the usefulness of low resolution brain electromagnetic tomography (LORETA).

Failure to identify an acute exercise effect on executive function assessed by the Wisconsin Card Sorting Test

Purpose： Acute exercise has been linked to the facilitation of executive function, but little is known regarding executive function assessed by the Wisconsin Card Sorting Test （WCST）. The present research consisted of two experiments aimed to determine whether acute aerobic exercise influences successive WCST performance. Methods： In Study 1, 27 young adults were randomly assigned to the exercise or reading control group and then instiucted to perform the WCST before and after assigned treatment. In exercise group, participants completed a single bout aerobic exercise with moderate intensity for 20 min on a stationary bike. A similar experimental protocol was replicated in Study 2 with 24 late middle-aged adults to look for age differences during adulthood and control for a potential ceiling effect at young adult age. Results： Although a significant time effect was observed in young adults, both studies revealed that there was no main effect for treatment or an interaction between treatment and time on any of the WCST indices. Conclusion： Acute aerobic exercise failed to influence executive function as assessed by the WCST, revealing that this classical neuropsy- chological test tapping executive function may not be sensitive to acute exercise. Our findings suggest that acute exercise does not broadly affect the entire family of executive functions, or its effect on a specific aspect of executive function may be task-dependent, as proposed by Etnier and Chanj~ （2009）.

Optical neuroimaging of executive function impairments in food addiction

This study investigated the neural mechanisms located in the prefrontal cortex(PFC)involved in maintaining addictive-like eating behavior.Therefore,we aimed toll a gap in the existing literature and help clarify the food addiction(FA)cycle by inspecting the relationship between the executive control and psychopathology involved in the FA cycle.Twenty-three students recruited from the University of Macao participated in this study.We investigated a hemodynamic response captured by NIRS recordings,activated during n-back,set-shifting,and go/nogo paradigms.Moreover,we investigated the FA symptoms through the YFAS clinical inventory to better understand the relationship between hemodynamic response and clinical symptomatology in college students.First,the hemodynamicndings conrm that altered cognitive control in executive function performance appears to be linked to addictive-like eating behaviors,which in turn conrms a circuit similarity between FA and the substance abuse population(SUD)as reported in previous fMRI studies.Secondly,the psychologicalndings conrm the signicant association between the working memory decits and symptoms severity which suggest the role of self-control and regulation in limiting the storage resources as a potential trigger to develop overconsumption episodes in the FA cycle.Ourndings highlight how disrupted self-control and regulation of craving and negative a®ect induced by mental imagery might shape and overload the working memory storage as a potential trigger to develop binge eating episodes to maintain the FA cycle.In conclusion,the use of fNIRS in the context of eating disorders studies represents a valuable application,noninvasive,and patientfriendly tool,providing new insights into understanding the addiction cycle and treatment guidelines.

Topographical Analysis of Frontal Lobe Executive Functions in Patients Following a Stroke

Objective: This study aimed to carry out a topographical analysis of frontal lobe executive function components in post-stroke patients. Methods: A descriptive, cross-sectional study. The assessment using the WCST (Wisconsin Card Sorting Test) included sixteen patients with a clinical diagnosis of CVA and frontal lobe impairment. Results from the two groups were compared (patients with right frontal lobe impairment and patients with left frontal lobe impairment). Statistical analysis was performed using the program “Statistical Package for Social Sciences” (SPSS) Version 20.0. For comparison between groups was used Mann-Whitney test and considered the alpha level of 0.05 on the statistically significant results. Results: There was no statistically significant difference between the groups, thus showing that executive functions are symmetrically distributed across the frontal lobes. Conclusion: Executive functions are symmetrically organized across the two frontal lobes, since the comparison between the groups did not demonstrate a statistically significant difference for any of the variables of WSCT.

Basic Study Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder

BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly prescribed for children with ADHD and are considered effective in 70%of the cases.Furthermore,only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.AIM To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.METHODS Thirty-seven children with ADHD completed a stimulant medication trial to study the short-and long-term impact of medication.Children with ADHD completed three neuropsychological assessments[Continuous Performance Test(CPT)-II,Digit Span Backwards and Spatial Span Backwards].Parents of children with ADHD completed behaviour rating scales[Behaviour Rating Inventory of Executive Functioning(BRIEF)and Behaviour Assessment System for Children-Second Edition(BASC-2)].Participants were evaluated at:(1)Baseline(no medication);and(2)Best-dose(BD;following four-week MPH treatment).Additionally,18 participants returned for a long-term naturalistic follow up(FU;up to two years following BD).RESULTS Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2.Neuropsychological assessments showed some improvement,but not on all tasks following the medication trial.These improvements did not sustain at FU,with increases in EF and behaviour challenges,and a decline in performance on the CPT-II task being observed.CONCLUSION Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU.Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.

Stress, Executive Function, Resilience and Quality of Life in Portuguese Subjects in Situations of Economic Insufficiency and Unemployment

The aim of this study is the investigation of the impact of stress of Portuguese subjects in situations of economic insufficiency and unemployment on executive function and quality of life and the coping strategies and resilience skills used. The sample consists of 41 participants. The psychometric instruments used are validated for Portuguese population, measure (perceived) stress, coping, material deprivation, resilience and quality of life, defined by World Health Organization. Executive function has been evaluated through performances at Stroop and Berg tasks. It has been concluded that, in this population, resilience skills and active coping strategies are positively correlated with quality of life. Quality of life is negatively correlated with material deprivation. Active coping strategies are supported by adequate executive function, which neurobiological substrate is dorso-lateral prefrontal cortex. Not active coping strategies correlate negatively with cognitive flexibility, suggesting the presence of a deficit at infero-lateral prefrontal cortex.

Differential Impact of an Executive-Function and a Social Cognition Training on Preschoolers with Externalizing Behavior Problems

In preschoolers, externalizing behavior problems are a primary cause of consultation. It is known that externalizing behavior (EB) could result from individual and environmental risk factors. Individual risk factors included notably social cognition (SC) and executive functions (EF). A high level of EB has usually been related to dysfunction in SC and to poor skills in EF. The aim of the present experimental study is to compare the impact of two very targeted child-oriented trainings in the increasing of social competence and decreasing of EB in preschoolers. One training targeted SC abilities while the second one targeted EF capacities. These two trainings were compared on 48 preschoolers presenting clinically relevant levels of EB. The comparison of those results highlighted how each training could help preschoolers with EB in their behavior, emotion regulation and social adjustment. In comparison to a waiting-list control-group, the two trainings were effective in decreasing EB and differentiated impacts of the two trainings were obtained on different dimensions of profiles of social competence and emotion regulation. Results are discussed for their research and clinical implications.

Neuropsychological Rehabilitation of Executive Functions: Challenges and Perspectives

Introduction: Executive Dysfunction (ED) is associated with difficulties in daily life and poor treatment adherence in individuals with neurological and psychiatric disorders. The aim of this paper is to present an update of Executive Function (EF) Rehabilitation Techniques. Methods: We performed a comprehensive literature review using the following keywords: executive function, mental disorders and rehabilitation in the PubMed, specific journals and books. Results: There is evidence of improvement of EF using some rehabilitation techniques, such as goal planning, goal management training, problem solving training, verbalization, drill and practice approach, metacognitive strategy instruction, computer-assisted training and neurofeedback. However, impact of rehabilitation on daily life remains poorly understood. Conclusion: Executive Dysfunction (ED) may be remediated and/or compensated at a certain degree by neuropsychological rehabilitation, but there is still a great challenge in this area based on how to measure effectiveness of EF interventions on daily life. There is a need for the development of new and/or combined techniques (i.e., pharmacological treatment, deep-brain stimulation) for a broader impact on quality of life for patients.

Cognitive and Emotional Factors Related to Obstructive Sleep Apnea Diagnoses: A Brief Review

Sleep apnea is a clinical condition characterized by cessation of breathing in the sleeper due to pharyngeal airway closure. The reduction in air exchange results in decreased cerebral blood circulation with consequential behavioral deficits cognitively and emotionally. Untreated sleep apnea is associated with chronic illnesses of depression, cardiovascular disorder, obesity and diabetes mellitus. Measured cognitive behavior before and following CPAP treatment demonstrates the cognitive deficit as the effectiveness of CPAP treatment. Emotional factors related to sleep apnea diagnosis and adherence to treatment are facilitated in patients with cognitive behavior therapy (CBT) interventions by sleep specialists. This is a brief review paper that presents findings about cognition and emotional factors related to sleep apnea. This is a brief review paper.

Exercise and children's cognition:The role of exercise characteristics and a place for metacognition

Definitive conclusions concerning the impact of exercise interventions on children＇s mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was conducted to evaluate the role of two types of exercise interventions on children＇s cognition. Acute and chronic exercise interventions were classified as quantitative or qualitative on the basis of manipulations of task complexity and, by inference, mental engagement. Both types of interventions enhance aspects of children＇s cognition; however, their effects on metacognitive processes are unknown. The role of metacognitive processes and their regulation of children＇s behavior and academic performance are highlighted.

Does exercise have a protective effect on cognitive function under hypoxia? A systematic review with meta-analysis

Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data sources:PubMed,Scopus,Web of Science,PsychInfo,and SPORTDiscus were searched.Eligibility criteria for selecting studies:randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered(Aim 2),as were studies investigating the effects of hypoxia on cognition(Aim 1).Results:In total,18 studies met our inclusionary criteria for the systematic review,and 12 studies were meta-analyzed.Exposure to hypoxia impaired attentional ability(standardized mean difference(SMD)=-0.4),executive function(SMD=-0.18),and memory function(SMD=-0.26),but not information processing(SMD=0.27).Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement(SMD=0.3,95%confidence interval:0.14-0.45,I^2=54%,p<0.001).Various characteristics(e.g.,age,cognitive task type,exercise type,exercise intensity,training type,and hypoxia level)moderated the effects of hypoxia and exercise on cognitive function.Conclusion:Exercise during exposure to hypoxia improves cognitive function.This association appears to be moderated by individual and exercise/hypoxia-related characteristics.

The effect of acute exercise on cognitive performance in children with and without ADHD

Background： Attention deficit hyperactivity disorder （ADHD） is a common childhood disorder that affects approximately 11% of children in the United States. Research supports that a single session of exercise benefits cognitive performance by children, and a limited number of studies have demonstrated that these effects can also be realized by children with ADHD. The purpose of this study was to examine the effect of acute exercise on cognitive performance by children with and without ADHD. Methods： Children with and without ADHD were asked to perform cognitive tasks on 2 days following treatment conditions that were assigned in a random, counterbalanced order. The treatment conditions consisted of a 30-min control condition on 1 day and a moderate intensity exercise condition on the other day. Results： Exercise significantly benefited performance on all three conditions of the Stroop Task, but did not significantly affect performance on the Tower of London or the Trail Making Test. Conclusion： children with and without ADHD realize benefits in speed of processing and inhibitory control in response to a session of acute exercise, but do not experience benefits in planning or set shifting.

Differential effects of physical activity and sleep duration on cognitive function in young adults

Purpose: Although exercise and sleep duration habits are associated with cognitive function, their beneficial effects on cognitive function remain unclear. We aimed to examine the effect of sleep duration and daily physical activity on cognitive function, elucidating the neural mechanisms using near-infrared spectroscopy(NIRS).Methods: A total of 23 healthy young adults(age 22.0 ± 2.2 years) participated in this study. Exercise amount was assessed using a uniaxial accelerometer. We evaluated total sleep time(TST) and sleep efficiency by actigraphy. Cognitive function was tested using the N-back task, the Wisconsin Card Sorting Test(WCST), and the Continuous Performance Test—Identical Pairs(CPT-IP), and the cortical oxygenated hemoglobin levels during a word fluency task were measured with NIRS.Results: Exercise amount was significantly correlated with reaction time on 0- and 1-back tasks(r = —0.602, p = 0.002; r = —0.446, p = 0.033,respectively), whereas TST was significantly correlated with % corrects on the 2-back task(r = 0.486, p = 0.019). Multiple regression analysis,including exercise amount, TST, and sleep efficiency, revealed that exercise amount was the most significant factor for reaction time on 0- and 1-back tasks(b = —0.634, p = 0.002; b = —0.454, p = 0.031, respectively), and TST was the most significant factor for % corrects on the 2-back task(b = 0.542, p = 0.014). The parameter measured by WCST and CPT-IP was not significantly correlated with TST or exercise amount. Exercise amount, but not TST, was significantly correlated with the mean area under the NIRS curve in the prefrontal area(r = 0.492, p = 0.017).Conclusion: Exercise amount and TST had differential effects on working memory and cortical activation in the prefrontal area. Daily physical activity and appropriate sleep duration may play an important role in working memory.