Abstract
Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future prospects for research and interventions in the area will be outlined, with the intention of contributing scientific reference information that encompasses the knowledge and understanding of executive dysfunction and its relationship with these treated disorders.
Highlights
Studies using functional neuroimaging techniques with high spatial [single-photon emission computed tomography (SPECT), Positron emission tomography (PET), and functional magnetic resonance imaging (fMRI)] temporal [event-related brain potentials (ERPs)] and spatiotemporal [magnetoencephalography (MEG)] resolutions show functional differences in the prefrontal cortex (PFC) and striatum in patients with attention deficit hyperactivity disorder (ADHD) compared to controls, indicating the existence of dysfunction in the frontostriatal network, which could explain the changes observed in processes such as response inhibition
As a result of the review of literature associated with ADHD and post-traumatic stress disorder (PTSD), it can be said that these two clinical entities are characterized by a set of signs and symptoms that detail their particular neurobiology, allowing a better understanding for clinical management and behavioral aspects to be taken into account in the different diagnoses and future interventions
Inhibitory control is a cognitive process that plays an important role in ADHD and PTSD; giving rise to the possibility that research generates experimental approaches where inhibitory control is associated with emotional components
Summary
Executive functions (EFs), known as executive control or cognitive control, are a complex set of interrelated cognitive processes controlled by its top–down nature (Diamond, 2013) and mediated by dynamic behaviors in order to achieve goal-oriented behaviors that are essential for an individual to solve problems, resist interference, hold attention, learn, make decisions, plan, and regulate their behavior (including in new situations), among other skills necessary for everyday life (Diamond, 2013; Chung et al, 2014). It has been found that the term “EFs” was coined by Lezak, it was Luria – his direct predecessor – who first described it, even without mentioning it directly He proposed a brain functioning model based on clinical findings, which consists of three functional units: (1) motivation arousal (reticular and limbic systems); (2) acquisition, processing, and storage of information (post-rolandic cortical areas); and (3) programming, monitoring, and verification of behavior [dependent on the activity of the prefrontal cortex (PFC); Ardila, 2008]. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and psychopathological processes associated with ADHD and PTSD
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