Behavioural Assessment Of The Dysexecutive Syndrome Research Articles

The Relation Between Mini Mental State Examination and Multiple Measures of Executive Functioning

Given the necessity of executive functioning to perform day-to-day activities, the capacity of widely-used cognitive screening tools to detect potential executive dysfunctions could have important meanings for health care practices. Current research on this topic, however, is still scarce and controversial. The current study is the first of its kind to assess the association between a commonly used cognitive screening tool with multiple executive measures from two wildly used batteries of executive functioning tests. The Mini Mental State Examination (MMSE) along with the Delis Kaplan Executive Function System (DKEFS) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) were administered to 73 healthy adults aged 16-40 years (M=24.34, SD=6.53). Most of the relations between the MMSE total score and the executive measures were significant and in the moderate-to-strong range. The highest correlation of MMSE was with the BADS total profile score (r= .62, P< .01). In a secondary analysis, among the MMSE domains, the Attention and Calculation domain had the highest relations with the executive measures. As a measure of general cognitive ability, the MMSE taps on various basic- and higher-level cognitive processes interconnected with the multi-dimensional and multi-level executive processing. Thus, empirical separation of executive measures and general cognitive indices is difficult. Using multiple measures of the executive functioning could be an effective strategy to better understanding the interconnections.

Executive Function Evaluation System Based on Wiping Desk Behavior in Virtual Space

In this study, we report the development of a virtual reality (VR) system that evaluates executive function based on cleaning behaviors in real-time. It is known that patients with acquired brain injuries present adverse symptoms such as attention, memory, and functional disorders, as well as aphasia. Current methods to evaluate acquired brain injuries include tests such as the behavioral assessment of the dysexecutive syndrome (BADS) and digital clinical assessment for attention (D-CAT) tests; however, these tests require special/specific toolkits, and the methods are rigorous when applied for real-time dynamic evaluation. Moreover, patients are often burdened by the need to undergo paper tests as required by the evaluation methods. In this context, we propose and verify the efficacy of a method that offers real-time dynamic evaluation of acquired brain injury based on daily-living activities such as cooking, cleaning, and shopping. In this study, we focus on executive function relating to acquired brain injury, and we propose a real-time dynamic evaluation method for executive functioning using VR, which enables the automatic evaluation of subjects’ table-cleaning behavior. Our results indicate that our system can automatically assess subjects’ table cleaning behavior based on BADS test, while affording a cleaning behavior maximum average accuracy of 75.5%.

Association of daily physical activity with cognition and mood disorders in treatment-naive patients with early-stage Parkinson's disease.

To determine the association of daily physical activity with cognition, mood disorders, and olfactory function in treatment-naive patients with early-stage Parkinson's disease (PD). The study subjects were 52 treatment-naive patients with early-stage PD (< 80years). Daily physical activity was measured using a wearable sensor with a built-in triaxial accelerometer, and its association with cognition [mini-mental state examination (MMSE), clock-drawing test (CDT), frontal assessment battery (FAB), and behavioral assessment of the dysexecutive syndrome (BADS)], depressive symptoms [Beck Depression Inventory-Second Edition (BDI-II)], apathy [Starkstein Apathy Scale (AS)], and olfactory function [Odor Stick Identification Test for the Japanese (OSIT-J)] was analyzed using multiple linear regression after adjustment for age, sex, and education status. The daily physical activity (0.42 ± 0.11m/s2) of the PD group was significantly lower than that of healthy controls (p < 0.001). Moreover, the daily physical activity of the PD group was significantly associated with FAB (β = 0.337, p = 0.027) and BADS (β = 0.374, p = 0.017) scores, but not with MMSE, CDT, BDI-II, AS, and OSIT-J scores. The daily physical activity is significantly reduced in treatment-naive patients with early-stage PD, and the low activity correlates with frontal/executive function.

Clinical utility of neuropsychological tests for employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury

ABSTRACTObjective: To retrospectively examine the clinical utility of neuropsychological tests (NPTs) for predicting employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury (TBI).Methods: 132 individuals of working age with cognitive impairment after moderate to severe TBI were classified into three groups by employment status: competitive employment (CE); supported employment (SE); and unemployed (UE). NPT scores were compared among groups. Using multinomial logistic regression with group allocation as the dependent variable, significant variables were identified, and receiver operating characteristic (ROC) curves were calculated.Results: Comparison of NPT results among the three groups showed significant differences for all NPTs (all items, p < 0.01). Using multinomial logistic regression analysis, Rivermead Behavioral Memory Test (RBMT) and Behavioral Assessment of the Dysexecutive Syndrome from CE versus SE and Trail Making Test-B and RBMT from SE versus UE were identified. ROC curve analysis indicated small to moderate accuracy (area under the curve, 0.63–0.84).Conclusion: NPT scores can predict future employment status in patients with cognitive impairment after TBI. These findings may lead to improved clinical assessments when providing work support. Future research should consider occupational categories, managerial categories, and types of re-employment.

Neuropsychological correlates of instrumental activities of daily living in neurocognitive disorders: a possible role for executive dysfunction and mood changes.

ABSTRACTSince baseline executive dysfunction predicts worsening Instrumental Activities of Daily Living (i-ADL) over time and progression to Alzheimer's Disease (AD), we aimed to analyze the role of neuropsychological variables to outline which factors can contribute to functional impairment. Specific attention to executive functions (EFs) has been given.A total of 144 subjects complaining of different cognitive deficits - ranging from "MCI likely due to AD" to "mild AD patients" - underwent an overall neuropsychological assessment. The Behavioral Assessment of the Dysexecutive Syndrome was used to analyze EFs. We conducted multiple linear regression analyses to study whether the level of independent living skills - assessed with the Lawton-scale - could be associated with cognitive and behavioral measurements.We found a significant association between i-ADL and specific EFs measured by Rule Shift Cards (p = 0.04) and Modified Six Elements (p = 0.02). Moreover, considering i-ADL scores, we observed an involvement of mood changes and a reduced awareness of deficits in terms of Hamilton Depression Rating Scale (p = 0.02) and Awareness of Deficit Questionnaire - Dementia scale (p &lt; 0.0001), respectively.Our results suggest the importance of considering the association between a reduction in i-ADL and executive dysfunction in patients who have AD etiopathology, for which the ability to inhibit a response, self-monitoring, set-shifting and mood deflection play a key role. Besides, no straightforward associations between i-ADL scores and global cognition, memory, language comprehension, attention, and perspective taking abilities were found.

Assessment of executive functions and inhibitory control in alcohol and crack use disorders

This study assessed executive functions and inhibitory control in alcohol and crack users, as previous research suggests an association between substance-related disorders and impaired self-regulation and impulse control. In this study, 67 men aged 18-65 years completed the following instruments: sociodemographic questionnaire, Vocabulary and Matrix Reasoning (Wechsler Abbreviated Scale of Intelligence), Five Digit Test, and Behavioral Assessment of the Dysexecutive Syndrome. Alcohol and crack users showed deficits involving processing speed, response inhibition, flexibility, abstraction, planning, and monitoring. Analysis per type of drug revealed poorer cognitive performance among alcohol users. Years of drug use were associated with planning deficits. These findings are consistent with the hypothesis of an association between drug abuse and cognitive changes. In conclusion, impairments in executive functioning and inhibitory control were found in the study samples.***Avaliação das funções executivas e controle inibitório nos transtornos por uso de álcool e crack***Este estudo investigou as funções executivas e o controle inibitório em usuários de álcool e crack, pois pesquisas prévias sugerem associação entre os transtornos relacionados a substâncias e o comprometimento das capacidades de autorregulação e de controle dos impulsos. Neste estudo, 67 homens com idades entre 18-65 anos responderam aos seguintes instrumentos: questionário sociodemográfico, Vocabulário e Raciocínio Matricial (Wechsler Abbreviated Scale of Intelligence), Five Digit Test e Behavioural Assessment of the Dysexecutive Syndrome. Os usuários de álcool e crack apresentaram déficits envolvendo velocidade de processamento, inibição de respostas, flexibilidade, abstração, planejamento e monitoramento. A análise por droga de abuso revelou desempenho cognitivo inferior entre os alcoolistas. O tempo de abuso de drogas foi associado a déficits de planejamento. Esses achados são consistentes com a hipótese de associação do abuso de drogas com alterações cognitivas. Em conclusão, foram observadas alterações do funcionamento executivo e do controle inibitório nas amostras de usuários avaliadas.

T80. CALCIUM AND POTASSIUM VOLTAGE-GATED CHANNELS GENES ASSOCIATION ANALYSIS: EVIDENCE ON THEIR ROLE IN COGNITIVE PERFORMANCE OF SCHIZOPHRENIA PATIENTS AND HEALTHY SUBJECTS

BackgroundCognitive deficits are considered core features of schizophrenia (SZ) (Green & Harvey 2014). Subtle variations in the perfectly coupled mechanism that maintains the potential of membrane in neurons may have repercussion on neuronal processing. Therefore, genetic variability related to the functioning of excitable cells and linked to pathways essential for neuronal survival and plasticity may underlie the observed differences in cognitive abilities (Carr et al 2016). CACNA1C and KCNH2 genes encode for calcium and potassium voltage-gated channels, ultimately related to neuronal functioning (Dolmetsch et al 2001, Schwarz et al 2004). These two genes have been previously related with SZ (Atalar et al 2010, Ripke et al 2014). The aim of this study was to evaluate whether the genetic variability of CACNA1C and KCNH2 is associated with: i) the risk for schizophrenia, ii) the cognitive performance of SZ patients and healthy subjects.MethodsOur sample consisted of 348 SZ patients and 387 unrelated healthy controls (HC). DNA was extracted from blood/saliva samples using standard procedures and two Single Nucleotide Polymorphisms (SNPs) were genotyped: rs1006737 (G/A) in CACNA1C gene, rs3800779 (G/A) in KCNH2. A subsample (296 SZ/157 HC) underwent neurocognitive assessment, which included: i) premorbid IQ (Word Accentuation Test - Test de Acentuación de Palabras (TAP)); ii) memory (Wechsler Memory Scale (WMS-III)) and, iii) executive function (Behavioural Assessment of the Dysexecutive Syndrome (BADS)). The association between the SNPs and neurocognitive performance was explored (adjusted by sex and age) separately in patients and in controls groups.ResultsIn our sample, we did not detect an association of CACNA1C and KCNH2 with the risk for SZ. Patients performed significantly worse than controls in all cognitive measures (p<0.005). SZ patients homozygous for the risk allele (A) of the CACNA1C polymorphism showed lower premorbid IQ (TAP scores) than patients carriers of the C allele (rs1006737: B=-1.39 p=0.027). Within HC, the minor allele (A) of KCNH2 was associated with WMS global score (rs3800779: B=3.01 p=0.010): subjects carrying the AA genotype presented better memory performance.DiscussionOur findings add evidence on the role of CACNA1C and KCNH2 on modulating cognitive performance in SZ patients and HC (Huffaker et al 2009, Krug et al 2010, Zhang et al 2012, Hashimoto et al 2013). Our results in patients are in line with previous studies that suggest an association of CACNA1C risk allele on different cognitive domains. As regards to KCNH2, our results are opposite in terms of the direction of the effect observed in previous studies, probably as a consequence of the sample size and heterogeneity in methods used to assess memory. The different direction of the genetic effects among patients and controls reflects the complex relationship between genetic factors and cognitive performance variability. It is suggested that genes that enhance cognitive abilities under normal circumstances turn to be pernicious under the modulation effect of a disease (Crespi et al 2007). Further research is needed and we expect to extend the present results with neuroimaging genetics approaches.AcknowledegmentsSpanish Ministry of Economy and Competitivity, Instituto de Salud Carlos III (PI15/01420 and PI15/00299), Ayuda cofinanciada por el Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa”.

Ecological Assessment of Executive Dysfunction in Anxiety

Introduction: The specialized literature states that anxiety can interfere with cognition, particularly in complex cognitive processes such as those related to executive functioning. Neuropsychological studies in anxiety disorders have confirmed the presence of deficits in executive functions, with significant changes in its components. The main aim of this study was to compare the executive performance of a sample with anxiety disorder to a control group, using an instrument that differs from the others by high ecological validity, revealing a higher predictive evidence on daily tasks. Methods: This study included 60 participants aged between 18 and 53 years that were allocated to an experimental group (n=30; mean = 31.93; standard deviation [SD] =10.99) and a control group (n=30; mean = 29.63; SD=9.07). Anxiety symptoms and the executive functioning were assessed using the Beck Anxiety Inventory (BAI) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS), respectively. Results: Participants with anxiety disorders presented a significant impairment on executive functioning in general. However, we found a significant impact in tasks that involve control inhibition, design of action strategies according to the functionality and probability of success, the ability to predict or estimate and the ability to plan the action. In addition, the EG required significantly more time to execute all the tests (mean = 440.33, SD = 97.17), compared to the CG (mean = 320.90; SD = 51.27). Conclusions: Individuals with anxiety disorders have a significant impairment in their executive functioning in general, which is reflected in activities of daily living. Keywords : Anxiety disorders; executive functions; BADS; cognitive and affective evaluation

Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C©)

ABSTRACTObjectives: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI).Methods: Twenty-nine patients with ABI aged 10–18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire.Results: The JEF-C© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach’s alpha = 0.62 and significant intercorrelations between individual JEF-C© constructs). Patients performed significantly worse than controls on most of the JEF-C© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables.Conclusion: JEF-C© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.

Theory of mind and schizophrenia in young and middle-aged patients: Influence of executive functions

Theory of Mind (ToM) is compromised in schizophrenia, and responsible for social disability. We aim to study the correlation between ToM deficits and Executive Functions (EF), using the Faux Pas Test (FPT) for ToM evaluation, Behavioral Assessment of the Dysexecutive Syndrome (BADS) and Wisconsin Card Sorting Test (WCST) for EF assessment. Two groups of patients with schizophrenia were included: 22 young (18–35 years-old) and 18 middle-aged (>50 years-old) Patients, compared to age-matched Controls.We found worst FPT performances in both groups of patients, but with a more generalized pattern of dysfunction in the middle-aged patient group. This group had worse EF scores than both controls and younger patients. The association of EF with FPT items was uneven. In young patients only empathy (Q6) remained significant after controlling for EF and level of education, while in middle-aged patients faux pas explanation (Q4), false belief (Q5) and total scores remained significant. In young patients only affective TOM was impaired. No correlation was found with clinical symptoms, nor age at onset of the disease.We conclude that ToM deficit arises early during the course of the illness (already present in young patients), increases in middle-aged patients, and relates only partially with EF.

Effects of dopaminergic drug adjustment on executive function in different clinical stages of Parkinson's disease.

BackgroundEffects of dopaminergic medication on executive function in patients with Parkinson’s disease (PD) are inconsistent.ObjectiveWe examined the effect of dopaminergic medication on executive function in 24 drug-naïve PD patients (de novo group) and in 21 PD patients on chronic dopaminergic medication (chronic medication group).MethodsPD patients without dementia were included in this study. For the de novo group patients, dopaminergic medication was initiated, and the dose was increased to improve motor symptoms. For the chronic medication group patients, dopaminergic medication was adjusted to relieve clinical problems. All participants were tested prior to and at 4–7 months after the drug initiation/adjustment. Executive function was assessed by using the Behavioral Assessment of the Dysexecutive Syndrome (BADS). Motor function was assessed by using the Unified Parkinson’s Disease Rating Scale (UPDRS; part III). Improvement in executive function was compared with a simultaneous change in levodopa equivalent doses (LED) of dopaminergic medication and with improvement in motor functions.ResultsThe mean standardized BADS scores showed no significant improvement in both the groups. In the de novo group, percent improvement in the standardized BADS scores showed a significant positive correlation with the LED, but not with percent improvement in UPDRS part III. In the chronic medication group, percent improvement in the standardized BADS scores was negatively correlated with change in the LED, but not with percent improvement in UPDRS part III. Multiple regression analysis using improvement in the standardized BADS score as a dependent variable and patient’s background factors (ie, age, education, disease duration, and motor and executive assessments at baseline) as independent variable showed that improvement in the executive assessment is significantly correlated with the LED only in the de novo group.ConclusionEffects of dopaminergic drug adjustment on executive function differ according to the patient’s clinical stage and depend on LED in de novo stage.

The Key Search Subtest of the Behavioural Assessment of the Dysexecutive Syndrome in Children (BADS-C) Instrument Reveals Impaired Planning Without External Constraints in Children With Neurofibromatosis Type 1

Studies of executive function and its relationship with brain T2-weighted hyperintensities in children with neurofibromatosis type 1 (NF1) have yielded inconsistent results. We examined 16 children with NF1 aged 8 to 15 years, of normal intelligence, and compared their findings to those of 16 siblings and 16 typically developing children using the Behavioural Assessment of the Dysexecutive Syndrome in Children (BADS-C). NF1 patients had an adequate overall score at BADS-C, but showed significantly lower performance than typical peers in the Key Search subtest. This is a task that must be solved without any given rules, in which subjects must devise a strategy and an efficient search pattern transferable to other similar real situations. The Key Search scores were not correlated with number and signal characteristics of T2-weighted hyperintensities. Planning without external indications is impaired in children with NF1 because they have to rely entirely on self-organization and monitoring; this study provides information for remediation programs designed to improve functioning in daily life.

A pilot randomized controlled trial of the Occupational Goal Intervention method for the improvement of executive functioning in patients with treatment-resistant schizophrenia.

Schizophrenia is a chronic disabling mental disorder that involves impairments in several cognitive domains, especially in executive functions (EF), as well as impairments in functional performance. This is particularly true in patients with Treatment-Resistant Schizophrenia (TRS). The aim of this study was to test the efficacy of the Occupational Goal Intervention (OGI) method for the improvement of EF in patients with TRS. In this randomized, controlled, single-blind pilot study, 25 TRS patients were randomly assigned to attend 30 sessions of either OGI or craft activities (control) over a 15-week period and evaluated by the Behavioural Assessment of the Dysexecutive Syndrome (BADS) as the primary outcome and the Direct Assessment of Functional Status (DAFS-BR) as well as the Independent Living Skills Survey (ILSS-BR) as secondary outcomes, all adapted for the Brazilian population. The Positive and Negative Syndrome Scale (PANSS) was used for monitoring symptom severity. Results showed significant statistical differences, favoring the OGI group in terms of improvement on the BADS, both in subtests (Action Program and Key Search) and the total score. Improvements in EFs were observed by families in various dimensions as measured by different subtests of the ILSS-BR inventory. The OGI group showed no significant results in secondary outcomes (DAFS-BR) except in terms of improvement of communication skills. Although preliminary, our results indicate that the OGI method is efficacious and effective for patients with TRS.

Structural and Functional Brain Correlates of Cognitive Impairment in Euthymic Patients with Bipolar Disorder.

IntroductionCognitive impairment in the euthymic phase is a well-established finding in bipolar disorder. However, its brain structural and/or functional correlates are uncertain.MethodsThirty-three euthymic bipolar patients with preserved memory and executive function and 28 euthymic bipolar patients with significant memory and/or executive impairment, as defined using two test batteries, the Rivermead Behavioural Memory Test (RBMT) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS), plus 28 healthy controls underwent structural MRI using voxel-based morphometry (VBM). Twenty-seven of the cognitively preserved patients, 23 of the cognitively impaired patients and 28 controls also underwent fMRI during performance of the n-back working memory task.ResultsNo clusters of grey or white matter volume difference were found between the two patient groups. During n-back performance, the cognitively impaired patients showed hypoactivation compared to the cognitively preserved patients in a circumscribed region in the right dorsolateral prefrontal cortex. Both patient groups showed failure of de-activation in the medial frontal cortex compared to the healthy controls.ConclusionsCognitive impairment in euthymic bipolar patients appears from this study to be unrelated to structural brain abnormality, but there was some evidence for an association with altered prefrontal function.

Severe Infections are Common in Thiamine Deficiency and May be Related to Cognitive Outcomes: A Cohort Study of 68 Patients With Wernicke-Korsakoff Syndrome

Wernicke encephalopathy can have different clinical outcomes. Although infections may precipitate the encephalopathy itself, it is unknown whether infections also modify the long-term outcome in patients developing Korsakoff syndrome. To determine whether markers of infection, such as white blood cell (WBC) counts and absolute neutrophil counts in the Wernicke phase, are associated with cognitive outcomes in the end-stage Korsakoff syndrome. Retrospective, descriptive study of patients admitted to Slingedael Korsakoff Center, Rotterdam, The Netherlands. Hospital discharge letters of patients with Wernicke encephalopathy were searched for relevant data on infections present upon hospital admission. Patients were selected for further analysis if data were available on WBC counts in the Wernicke phase and at least 1 of 6 predefined neuropsychological tests on follow-up. Infections were reported in 35 of 68 patients during the acute phase of Wernicke-Korsakoff syndrome-meningitis (1), pneumonia (14), urinary tract infections (9), acute abdominal infections (4), sepsis (5) empyema, (1) and infection "of unknown origin" (4). The neuropsychological test results showed significant lower scores on the Cambridge Cognitive Examination nonmemory section with increasing white blood cell counts (Spearman rank correlation, ρ = -0.34; 95% CI: -0.57 to -0.06; 44 patients) and on the "key search test" of the behavioral assessment of the dysexecutive syndrome with increasing absolute neutrophil counts (ρ= -0.85; 95% CI: -0.97 to -0.42; 9 patients). Infections may be the presenting manifestation of thiamine deficiency. Patients with Wernicke-Korsakoff syndrome who suffered from an infection during the acute phase are at risk of worse neuropsychological outcomes on follow-up.

Executive functioning of complicated-mild to moderate traumatic brain injury patients with frontal contusions

ABSTRACTExecutive dysfunctions are among the most prevalent neurobehavioral sequelae of traumatic brain injuries (TBIs). Using culturally validated tests from the Delis-Kaplan Executive Function System (D-KEFS: Trail Making, Verbal Fluency, Design Fluency, Sorting, Twenty Questions, and Tower) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS: Rule Shift Cards, Key Search, and Modified Six Elements), the current study was the first to examine executive functioning in a group of Iranian TBI patients with focal frontal contusions. Compared with a demographically matched normative sample, the frontal contusion patients showed substantial impairments, with very large effect sizes (p ≤ .003, 1.56 < d < 3.12), on all the executive measures. Controlling for respective lower-level/fundamental conditions, the differences on the highest-level executive (cognitive switching) conditions were still significant. The frontal patients also committed more errors. Patients with lateral prefrontal (LPFC) contusions were qualitatively worst. For example, only the LPFC patients committed perseverative repetition errors. Altogether, our results support the notion that the frontal lobes, specifically the lateral prefrontal regions, play a critical role in cognitive executive functioning, over and above the contributions of respective lower-level cognitive abilities. The results provide clinical evidence for validity of the cross-culturally adapted versions of the tests.

A Serious Game to Improve Cognitive Functions in Schizophrenia: A Pilot Study.

Cognitive deficits in schizophrenia impair everyday functioning and instrumental daily living activities. These disabilities can be partly responsible for chronicity and institutionalization. We present here a virtual reality (VR) tool in which patients with schizophrenia performed a virtual game in an imaginary town during a 3-month program. In a pilot study, seven patients with schizophrenia (DSM-5), institutionalized for many years, attended weekly 1-h-and-a-half sessions organized by two clinicians. During the first sessions, they listed together the difficulties they experienced in everyday organization and planning. After being familiarized with the joystick and the VR environment, they navigated in the town, and planned actions that were difficult for them to carry out in their usual life (e.g., shopping, memorizing the way to the supermarket or being on time at a meeting point). They had to look for alternative routes and practice a switch from a 2D Map to the 3D Map. They also gathered their efforts to share strategies for each action, or discussed the action plan they could generate to solve concrete problems. The pre/post-neuropsychological evaluations showed attention, working memory, prospective, and retrospective memory benefits, but no improvement in planning as assessed by the Zoo map test and the action program subtest of Behavioral Assessment of the Dysexecutive Syndrome. Patients also clinically and functionally improved, gaining autonomy. Pragmatically, they reported a strong energy to elaborate concrete plans to search for jobs, or return to activities in the community. Qualitative assessments showed a benefit in sparing time, planning better, enriched relatedness, and better management of their housework. This VR game opens avenue to rehabilitation for patients with schizophrenia experiencing chronicity in their life, less attendance in daycare units, and a better community living. This program might reduce neurocognitive difficulties and might evolve into a true method for cognitive remediation (trial n° 2011-A00988-33).

Children's planning performance in the Zoo Map task (BADS-C): Is it driven by general cognitive ability, executive functioning, or prospection?

ABSTRACTA minimal amount of research has examined the cognitive predictors of children's performance in naturalistic, errand-type planning tasks such as the Zoo Map task of the Behavioral Assessment of the Dysexecutive Syndrome for Children (BADS-C). Thus, the current study examined prospection (i.e., the ability to remember to carry out a future intention), executive functioning, and intelligence markers as predictors of performance in this widely used naturalistic planning task in 56 children aged 7- to 12-years-old. Measures of planning, prospection, inhibition, crystallized intelligence, and fluid intelligence were collected in an individual differences study. Regression analyses showed that prospection (rather than traditional measures of intelligence or inhibition) predicted planning, suggesting that naturalistic planning tasks such as the Zoo Map task may rely on future-oriented cognitive processes rather than executive problem solving or general knowledge.

Relation between Resting State Front-Parietal EEG Coherence and Executive Function in Parkinson's Disease.

Objective. To assess the relation between executive dysfunction (ED) in Parkinson's disease (PD) and resting state functional connectivity evaluated using electroencephalography (EEG) coherence. Methods. Sixty-eight nondemented sporadic PD patients were assessed using the Behavioural Assessment of the Dysexecutive Syndrome (BADS) to evaluate executive function. EEG coherence in the left frontoparietal electrode pair (F3-P3) and the right frontoparietal electrode pair (F4-P4) was analyzed in the alpha and theta range. The BADS scores were compared across the coherence groups, and the multiple logistic regression analysis was performed to assess the contribution of confounders. Results. The standardized BADS score was significantly lower in the low F3-P3 coherence group in the alpha range (Mann-Whitney U test, p = 0.032), though there was no difference between F4-P4 coherence group in the alpha range, F3-P3, and F4-P4 coherence groups in the theta range and the standardized BADS score. The multiple logistic regression analysis revealed the significant relation between the F3-P3 coherence group in alpha range and age-controlled standardized BADS score (p = 0.039, 95% CI = 1.002–1.062). Conclusion. The decrease in resting state functional connectivity between the frontal and parietal cortices especially in the left side is related to ED in PD.

Patients with idiopathic normal pressure hydrocephalus improved executive dysfunction after shunt operation

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by cognitive decline, gait disturbance and impairment in bladder control. We evaluate changes in cognitive function before and after medical treatment for patients with iNPH. Objective: To report the changes of frontal dysfunctions. Patients and methods: We have diagnosed clinical inspection using Japanese NPH Grading Scale-revised to them. First of all, patients took mini-mental state test (MMSE) for memory decline, then took frontal assessment battery (FAB) and Behavioural Assessment of the Dysexecutive Syndrome (BADS). Only the cases that improved by tap tests were performed lumboperioneal (LP) shunt operations. We examined neuropsychological tests once before tap test and same tests in a half year after surgery. Results: Twenty six patients with iNPH were operated. Significant improvement between before and after operation was found in profile scores of FAB (9.6 ± 3.0 to 11.2 ± 2.9) and BADS (7.6 ± 3.8 to 9.6 ± 3.8). At the Conflicting Instructions and Go/No-Go of FAB item showed significant improvement after the operation. And the categorized item of Action Program in BADS was also improved, although no changeable of MMSE score. Conclusion: It was controversial that the executive dysfunction was recovered by LP shunted taking FAB and BADS. The executive dysfunction is related to the prefrontal area. Especially, Go/No-Go and Conflicting Instructions item showed activity in the posterior part of the inferior frontal sulcus. Memory disturbance is not the main affected impairment by iNPH. We think that the obstacle in iNPH is related with frontal lobe functions such as the executive dysfunction.