Frontal Disorders and Consciousness: A Review.

Adults with autism spectrum disorder (ASD) are frequently prescribed selective serotonin reuptake inhibitors (SSRIs). However, there is limited evidence to support this practice. Therefore, it is crucial to understand the impact of SSRIs on brain function abnormalities in ASD. It has been suggested that some core symptoms in ASD are underpinned by deficits in executive functioning (EF). Hence, we investigated the role of the SSRI citalopram on EF networks in 19 right-handed adult males with ASD and 19 controls who did not differ in gender, age, IQ or handedness. We performed pharmacological functional magnetic resonance imaging to compare brain activity during two EF tasks (of response inhibition and sustained attention) after an acute dose of 20 mg citalopram or placebo using a randomised, double-blind, crossover design. Under placebo condition, individuals with ASD had abnormal brain activation in response inhibition regions, including inferior frontal, precentral and postcentral cortices and cerebellum. During sustained attention, individuals with ASD had abnormal brain activation in middle temporal cortex and (pre)cuneus. After citalopram administration, abnormal brain activation in inferior frontal cortex was ‘normalised’ and most of the other brain functional differences were ‘abolished’. Also, within ASD, the degree of responsivity in inferior frontal and postcentral cortices to SSRI challenge was related to plasma serotonin levels. These findings suggest that citalopram can ‘normalise’ atypical brain activation during EF in ASD. Future trials should investigate whether this shift in the biology of ASD is maintained after prolonged citalopram treatment, and if peripheral measures of serotonin predict treatment response.

Executive Function and Adaptive Behavior in Muenke Syndrome

The transition to upper-elementary school marks an important shift when students are expected to independently manage their behaviors, attention, and engagement. The current study used a socioeconomically- and racially/ethnically-diverse sample of upper-elementary school students (N = 336, M age = 9.85 years). Results showed that teachers’ initial perceptions of students’ executive function (EF) behaviors as indexed by how well students adjusted to new situations, remembered multi-step activities, and stayed focused were related to their reports of conflict with students in the spring. Furthermore, teacher–student conflict was linked with teacher-reported EF behaviors in the spring, controlling for EF behaviors in the fall. Finally, teachers’ initial perceptions of students’ EF behaviors were associated with children’s performance on EF tasks in the spring, controlling for direct assessment of EF skills in the fall. Our findings emphasize the role of early teacher perceptions for the development of teacher–student relationships and children’s self-regulation skills during the school year.

Studies of deaf and hard-of-hearing (henceforth, deaf) children tend to make comparisons with typically hearing children for the purpose of either identifying deficits to be remediated or understanding the impact of auditory deprivation on visual or domain general processing. Here, we eschew these clinical and theoretical aims, seeking instead to understand factors that explain variability in cognitive function within deaf children. A total of 108 bilingual deaf children ages 7-13 years who use both English and American Sign Language (ASL) participated in a longitudinal study of executive function (EF) development. We report longitudinal data from a visual continuous performance task that measured sustained selective attention and response inhibition. Results show that the impact of deafness on these processes is negligible, but that language skills have a positive relationship with both: better English abilities were associated with better selective sustained attention, and better ASL abilities with better response inhibition. The relationship between sustained selective attention and English abilities may reflect the cognitive demands of spoken language acquisition for deaf children, whereas better ASL abilities may promote an "inner voice," associated with improved response inhibition. The current study cannot conclusively demonstrate causality or directionality of effects. However, these data highlight the importance of studies that focus on atypical individuals, for whom the relationships between language and cognition may be different from those observed in typically developing populations.

IntroductionFlow is a highly enjoyable, optimal psychological state people feel when they are so focused on a task that it amounts to complete absorption in an activity (Csikszentmihalyi, 1975). The essential component of flow is the centring of attention on a limited stimulus field with the exclusion of distractions from consciousness (Csikszentmihalyi, 1990). According to Csikszentmihalyi (1997), any activity can produce flow as long as there is a balance between the challenging task, which demands intense concentration and commitment, and one's skill level. Flow was found to be related to higher levels of well-being (Csikszentmihalyi, 1975, 1990; 1997; Hunter & Csikszentmihalyi, 2003) and higher achievement (e.g., Bakker, 2008; Jackson, Thomas, Marsh, & Smethurst, 2001). In the educational context, flow was found to be associated with higher levels of commitment to education and progress through the school curriculum (Carli, Delle Fave, & Massimini, 1988; Csikszentmihaly, Rathunde, & Whalen, 1993), and higher academic ach ievement a t coll ege (E ngeser & Rheinberg, 2008; En geser, Rheinberg, Vollmeyer, & Bischoff, 2005).Although there is a lot of research on psychological correlates, studies on biological and neuropsychological correlates of flow have been rare (for a review, see Peifer, 2012). Flow has been found to correlate with cardiovascular, respiratory and EMG measures (de Manzano, Theorell, Harmat, & Ullen, 2010; Gaggioli, Cipresso, Serino, & Riva, 2013), suggesting relative sympathetic enhancement during flow. Electromyography studies found that flow is associated with increased activity in zygomatic major muscle (indicator of positive affect, controls smiling, Larsen, Norris, & Cacioppo, 2003) (de Manzano et al., 2010) and decreased activity in corrugator supercilii (indicator of negative affect, controls frowns) (Kivikangas, 2006), suggesting a positive valence of emotion during flow, i.e. enjoyment. Neural correlates of experimentally induced flow during arithmetic calculation (as indexed by cerebral blood flow activity) includes both increased activity in the left putamen, the left inferior frontal gyrus (IFG) and posterior cortical regions, and decreased neural activity during flow in the medial prefrontal cortex (MPFC) and left amygdala (Ulrich, Keller, Hoenig, Waller, & Groen, 2014). Changes in neural activity in left IFG and left amygdala were correlated with subjectively experienced flow. The authors suggested that an increase of neural activity in the putamen possibly reflects increased outcome probability, and those in the left IFG might reflect a deeper sense of cognitive control. Decrease of neural activity in MPFC was attributed to decreased self-referential processing and decrease of neural activity in amygdala was considered to reflect positive emotionality during flow (Ulrich et al., 2014).Overall, studies have pointed to the importance of studying the biological correlates of flow. However, there is no published study investigating the association between flow and neuropsychological cognitive functions, which are considered to be measures of brain functions and may underlie flow experience. Especially interesting are cognitive control processes that regulate thought and behavior, known under the term executive functions (EF). Executive functions are considered to be a set of correlated but separable control processes that regulate lowerlevel cognitive processes in support of goaldirected behavior (Friedman et al., 2008). Although conceptualizations vary regarding what components of executive functions might be, most frequently EF include: inhibition of automatic, or prepotent response; updating working memory representations, shifting/switching between tasks or mental sets (Friedman et al., 2008); but also include sustained and selective attention (Alvarez & Emory, 2006), and dual-tasking (Logie, Cocchini, Della Sala, & Baddeley, 2004), among others. …

Event Abstract Back to Event Children born with very low birth weight show difficulties with sustained attention but not response inhibition. Katherine A. Johnson1*, Elaine Healy2, Barbara Dooley3, Simon P. Kelly4 and Fiona McNicholas2 1 University of Melbourne, School of Psychological Sciences, Australia 2 Lucena Clinic, Ireland 3 University College Dublin, School of Psychology, Ireland 4 City College of New York, Department of Biomedical Engineering, United States Children born with very low birth weight (VLBW) perform poorly on executive function batteries, showing difficulties on tasks measuring response inhibition, task switching, working memory, verbal fluency and concept generation. Impairments have also been shown on attention measures, including difficulties with selective, sustained, shifting and divided attention control. Previous sustained attention research on children with VLBW has used tasks that have methodological problems. Any difficulties with sustained attention may underpin problematic performances on tasks measuring higher-order cognitive control. The aim of this study was to compare the performance of VLBW and normal birth weight (NBW) children on a well-controlled task of sustained attention. The Fixed and Random versions of the Sustained Attention to Response Task (SART) were given to 17 VLBW and 18 NBW children. The response time data were analysed using the Fast Fourier Transform (FFT), to define fast- and slow-frequency contributions to overall response variability. The VLBW group performed the Fixed and Random SARTs in a similar manner as the NBW group on all measures except for the omission error and Slow Frequency Area under the Spectra (SFAUS) variables on the Fixed SART. These measures index lapses in sustained attention. The VLBW group showed no response inhibition deficits. Omission error and SFAUS measures are sensitive measures of behaviour associated with premature birth and low birth weight and may mark difficulties with sustained attention and arousal during a predictable, taxing task. Acknowledgements The authors acknowledge Dr Martin White, Dr Margaret Sheridan and Niamh O'Connor for their assistance with the study. Keywords: Attention, low birth weight, sustained attention, omission errors, response time variability Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Oral Topic: Attention Citation: Johnson KA, Healy E, Dooley B, Kelly SP and McNicholas F (2013). Children born with very low birth weight show difficulties with sustained attention but not response inhibition.. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00133 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 15 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Dr. Katherine A Johnson, University of Melbourne, School of Psychological Sciences, Melbourne, Australia, kajo@unimelb.edu.au Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Katherine A Johnson Elaine Healy Barbara Dooley Simon P Kelly Fiona McNicholas Google Katherine A Johnson Elaine Healy Barbara Dooley Simon P Kelly Fiona McNicholas Google Scholar Katherine A Johnson Elaine Healy Barbara Dooley Simon P Kelly Fiona McNicholas PubMed Katherine A Johnson Elaine Healy Barbara Dooley Simon P Kelly Fiona McNicholas Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Fetal alcohol spectrum disorder (FASD) is associated with widespread neurocognitive deficits, including impairments in executive function, attention, and inhibitory control. However, understanding of the neural mechanisms underlying these deficits in young children 6-8 years of age remains limited. This study investigated functional connectivity (FC) alterations in key brain networks related to inhibitory control and executive function in children with FASD compared to typically developing controls (TDC). Seed-based connectivity (SBC) analysis was conducted in 27 children with FASD and 30 TDC, focusing on the medial prefrontal cortex (MPFC) within the Default Mode Network (DMN) and Frontal Parietal Network (FPN). FC differences were assessed across resting-state conditions (eyes closed vs. eyes open) and correlated with Conners Continuous Performance Test (CPT). Children with FASD exhibited significantly reduced FC between MPFC and limbic regions, including the amygdala, hippocampus, and brainstem, suggesting impairments in emotion regulation and cognitive control. The FPN showed altered connectivity with the middle temporal gyrus and inferior lateral occipital cortex, regions crucial for higher order cognitive processing. Significant interactions between groups and resting-state condition were observed, with altered connectivity patterns in the MPFC and FPN suggesting sensory-motor and cognitive control disruptions. FC patterns in these networks were significantly correlated with CPT performance, including increased errors of omission and reaction time variability, indicating deficits in sustained attention and response inhibition. Our findings reveal early disruptions in FC within the DMN and FPN in young children with FASD, highlighting altered interactions between key brain regions implicated in inhibitory control and executive function. These neural alterations were associated with behavioral deficits in attention and cognitive control, suggesting that FC abnormalities may underlie core cognitive impairments in FASD. Findings underscore the importance of early identification and intervention strategies targeting neural network dysfunctions to improve cognitive outcomes in children with FASD.

Children with neurofibromatosis type 1 are at increased risk for the development of attention problems relative to their unaffected peers. Previous studies have reported deficits in sustained auditory attention, but other aspects of attention, including sustained visual attention, divided attention, response inhibition, and selective attention, have not been consistently documented. In the present study, we specifically investigated attention skills in children with neurofibromatosis type 1 using measures of visual and sustained auditory attention, divided attention, selective attention, and response inhibition. Consistent with previous reports, we confirmed the presence of deficits in sustained visual and auditory attention in children with neurofibromatosis type 1 but also identified deficits in divided attention and response inhibition. Based on the high frequency and wide spectrum of attention system impairments in this at-risk population, we advocate screening children with neurofibromatosis type 1 for attention problems and providing appropriate interventions that address all aspects of their executive functioning.

BackgroundAutism spectrum disorder (ASD) is associated with deficits in executive functioning (EF), and these have been suggested to contribute to core as well as co-occurring psychiatric symptoms. The biological basis of these deficits is unknown but may include the serotonergic system, which is involved both in regulating EF in neurotypical populations and in the pathophysiology of ASD. We previously demonstrated that reducing serotonin by acute tryptophan depletion (ATD) shifts differences in brain function during performance of EF tasks towards control levels. However, ATD cannot be easily used in the clinic, and we therefore need to adopt alternative approaches to challenge the serotonin system. Hence, we investigated the role of the serotonergic modulator tianeptine on EF networks in ASD.MethodWe conducted a pharmacological magnetic resonance imaging study, using a randomized double-blind crossover design, to compare the effect of an acute dosage of 12.5 mg tianeptine and placebo on brain activation during two EF tasks (of response inhibition and sustained attention) in 38 adult males: 19 with ASD and 19 matched controls.ResultsUnder placebo, compared to controls, individuals with ASD had atypical brain activation in response inhibition regions including the inferior frontal cortex, premotor regions and cerebellum. During sustained attention, individuals with ASD had decreased brain activation in the right middle temporal cortex, right cuneus and left precuneus. Most of the case–control differences in brain function observed under placebo conditions were abolished by tianeptine administration. Also, within ASD individuals, brain functional differences were shifted significantly towards control levels during response inhibition in the inferior frontal and premotor cortices.LimitationsWe conducted a pilot study using a single dose of tianeptine, and therefore, we cannot comment on long-term outcome.ConclusionsOur findings provide the first evidence that tianeptine can shift atypical brain activation during EF in adults with ASD towards control levels. Future studies should investigate whether this shift in the biology of ASD is maintained after prolonged treatment with tianeptine and whether it improves clinical symptoms.

The authors reviewed 35 open-label sertraline trials for executive impairment in ischemic cerebrovascular disease. Outcomes included clock-drawing, the Executive Interview (EXIT25), the Geriatric Depression Scale, and the Mini-Mental State Examination. Clinically "meaningful" improvement was defined as a >3.0 EXIT25 point decline from baseline. "Remission" was defined as the achievement of an EXIT25 score <15/50. Only EXIT25 scores improved significantly. Twenty patients (57.1%) experienced a clinically meaningful improvement in executive control function. Twelve (34.3%) achieved remission. Our findings suggest that sertraline may have both statistical and clinically meaningful effects on executive control function in ischemic cerebrovascular disease. The authors discuss the implications for future clinical trials.

Executive Function consists of self-regulation processes which underlie our ability to plan, coordinate, and complete goal-directed actions in our daily lives. While attention is widely considered to be central to the emergence and development of executive function during early childhood, it is not clear if it is integral or separable from other executive function processes. Previous studies have not addressed this question satisfactorily because executive function and attention are multidimensional constructs, but they are often studied without differentiating the specific processes that are tested. Moreover, some studies consist of only one task per process, making it difficult to ascertain if the pattern of results is attributable to different processes or more simply to task variance. The main aim of this study was to more fully investigate how attention factored into the underlying structure of executive function in preschool children. Preschool children (n = 137) completed a battery of tasks which included executive function (i.e., response inhibition, working memory) and attentional control (i.e., sustained attention, selective attention) processes; there were two tasks per process. Confirmatory factor analyses (CFA) were conducted to test which of three models fit the data best: (1) a unitary one-factor model with attention loading onto the same factor as other executive function processes, (2) a two-factor model with attention loading onto a separate factor than other executive function processes, or (3) a three-factor model with attention, response inhibition, and working memory as separate factors. Fit indices and model comparisons indicated that the two-factor model fit the data best, suggesting that attentional control and executive function were related, but separable. Although this study is not the first to advocate for a two-factor model during the preschool years, it is the first to suggest that the two factors are attentional control and executive function, not working memory and response inhibition. One important implication of these findings is that a complete assessment of executive function during the preschool years necessitates measuring not only response inhibition and working memory, but attentional control as well.

Cumulative mild partial sleep deprivation negatively impacts working memory capacity but not sustained attention, response inhibition, or decision making: a randomized controlled trial

Sustained attention and response inhibition were examined in boys with full mutation fragile X syndrome (FXS) using adapted visual and auditory continuous performance tests (CPTs). Only 61% of 56 boys with visual CPT data and 54% of 52 boys with auditory data were able to demonstrate sufficient understanding to complete the visual and auditory CPTs, respectively. Mental age (MA) predicted whether boys with FXS were able to demonstrate understanding of the CPTs. The performance of boys with FXS who were able to complete the CPTs was compared to a sample of boys without disabilities matched on MA. Boys with FXS demonstrated similar or smaller declines in sustained attention over task time than their MA-matched peers on the visual and auditory CPTs, respectively, but consistently demonstrated greater declines in response inhibition over task time than their MA-matched peers. There were no differences between groups for response time of hits. Higher MAs consistently predicted better sustained attention and response inhibition over task time on the visual and auditory CPTs. Furthermore, boys taking psychotropic medication performed better at the beginning of most tasks, although their performance deteriorated at a faster rate over time, and boys rated as meeting diagnostic criteria for ADHD-hyperactive type had more difficulty over task time with response inhibition on the auditory CPT. For both boys with FXS and their MA matches, performance was better on the visual CPT than on the auditory CPT though this effect may be attributable to a number of factors other than the modality.

The prominent cognitive-behavioral model of hoarding posits that information processing deficits contribute to hoarding disorder. Although individuals with hoarding symptoms consistently self-report attentional and impulsivity difficulties, neuropsychological tests have inconsistently identified impairments. These mixed findings may be the result of using different neuropsychological tests, tests with poor psychometric properties, and/or testing individuals in a context thatdrastically differs from their own homes. One hundred twenty-three participants (hoarding = 63; control = 60) completed neuropsychological tests of sustained attention, focused attention, and response inhibition in cluttered and tidy environments in a counterbalanced order. Hoarding participants demonstrated poorer sustained attention and response inhibition than the control group (CPT-3 Omission and VST scores) and poorer response inhibition in the cluttered environment than when in the tidy environment (VST scores). CPT-3 Detectability and Commission scores also indicated that hoarding participants had greater difficulty sustaining attention and inhibiting responses than the control group; however, these effect sizes were just below the lowest practically meaningful magnitude. Posthoc exploratory analyses demonstrated that fewer than one-third of hoarding participants demonstrated sustained attention and response inhibition difficulties and thatthese participants reported greater hoarding severity and greater distress in the cluttered room. Given these findings and other studies showing that attentional difficulties may be a transdiagnostic factor for psychopathology, future studies will want to explore whether greater sustained attention and response inhibition difficulties in real life contexts contribute to comorbidity and functional impairment in hoarding disorder.

Previous studies demonstrated the influential role of sustained attention in the reading comprehension of alphabetic writing systems. However, there is limited understanding of how these cognitive functions contribute to reading comprehension in non-alphabetic systems, such as Japanese. This study seeks to explore this gap, focusing on how sustained attention and response inhibition function in a writing system where some of the characters represent meanings rather than sounds, introducing another layer of difficulty in the complex process of reading; Methods: Seventy-five Japanese 9th grade students performed a task to assess sustained attention and response inhibition. The cognitive test was carried out using tablets to enable feasible parallel group administration while maintaining high comparability with ecological classroom settings. Reading comprehension was measured using an exam that the participants took as part of their educational routine; Results: Our results indicate that both sustained attention and response inhibition significantly contributed to the reading comprehension of Japanese 9th grade students; Conclusions: These results replicate and expand previous studies documenting the contribution of sustained attention on the reading comprehension of alphabetic writing systems to a non-alphabetic system. Moreover, our findings unravel another important cognitive factor, namely response inhibition in reading comprehension. We suggest that response inhibition may play a crucial role in reading non-alphabetic writing systems that pose high cognitive demands, such as Japanese.