A Computational Study of Executive Dysfunction in Amyotrophic Lateral Sclerosis.

Alexander Steinke,Florian Lange,Bruno Kopp,Caroline Seer,Susanne Petri

doi:10.3390/jcm9082605

Abstract

Executive dysfunction is a well-documented, yet nonspecific corollary of various neurological diseases and psychiatric disorders. Here, we applied computational modeling of latent cognition for executive control in amyotrophic lateral sclerosis (ALS) patients. We utilized a parallel reinforcement learning model of trial-by-trial Wisconsin Card Sorting Test (WCST) behavior. Eighteen ALS patients and 21 matched healthy control participants were assessed on a computerized variant of the WCST (cWCST). ALS patients showed latent cognitive symptoms, which can be characterized as bradyphrenia and haphazard responding. A comparison with results from a recent computational Parkinson’s disease (PD) study (Steinke et al., 2020, J Clin Med) suggests that bradyphrenia represents a disease-nonspecific latent cognitive symptom of ALS and PD patients alike. Haphazard responding seems to be a disease-specific latent cognitive symptom of ALS, whereas impaired stimulus-response learning seems to be a disease-specific latent cognitive symptom of PD. These data were obtained from the careful modeling of trial-by-trial behavior on the cWCST, and they suggest that computational cognitive neuropsychology provides nosologically specific indicators of latent facets of executive dysfunction in ALS (and PD) patients, which remain undiscoverable for traditional behavioral cognitive neuropsychology. We discuss implications for neuropsychological assessment, and we discuss opportunities for confirmatory computational brain imaging studies.

Highlights

The ability to maintain goal-directed behavior effectively is an important prerequisite for successful daily life, in particular in face of interfering information [1,2,3]
Haphazard responding seems to be a disease-specific latent cognitive symptom of amyotrophic lateral sclerosis (ALS), whereas impaired stimulus-response learning seems to be a disease-specific latent cognitive symptom of Parkinson’s disease (PD). These data were obtained from the careful modeling of trial-by-trial behavior on the computerized variant of the WCST (cWCST), and they suggest that computational cognitive neuropsychology provides nosologically specific indicators of latent facets of executive dysfunction in ALS patients, which remain undiscoverable for traditional behavioral cognitive neuropsychology
The present study examined the specificity of executive dysfunction in ALS through (1) a computational analysis of Wisconsin Card Sorting Test (WCST) behavior in patients with ALS and (2) a comparison between their latent cognitive profile and that of patients with PD from an earlier computational study [41]

Summary

Introduction

The ability to maintain goal-directed behavior effectively is an important prerequisite for successful daily life, in particular in face of interfering information [1,2,3]. This overarching cognitive ability is often referred to as executive control [4,5]. In order to identify the currently prevailing category, participants have to rely on the examiner’s positive and negative feedback on each trial. Negative feedback on a WCST-trial requests switching the previously applied category, whereas positive feedback indicates

Methods

Results

Discussion

Conclusion