Executive Dysfunction In Patients Research Articles

Can Intermittent Theta-Burst Stimulation of Dorsolateral Prefrontal Cortex Relieve Executive Dysfunction in Patients With Late-Life Depression?

Can Intermittent Theta-Burst Stimulation of Dorsolateral Prefrontal Cortex Relieve Executive Dysfunction in Patients With Late-Life Depression?

Can the proposed research criteria for prodromal behavioural variant FTD be a bridge between neurologists and psychiatrists for early diagnosis?

AbstractBackgroundThe early diagnosis of the behavioural variant of frontotemporal dementia (FTD) is very challenging to clinicians. This type of dementia has a wide range of clinical variability, and the psychiatric presentation adds to the complexity of the differential diagnosis. The need for early precise diagnosis of FTD in the prodromal phase is increasing for tailored interventional strategies, better guidance, early counselling, and enrolment in clinical trials. However, its application in clinical practice needs good collaboration between psychiatrists and neurologists. We aimed to review the literature for studies highlighting the need for such collaboration.MethodWe performed a scoping literature review on early diagnosis of FTD, including suggested new biomarkers and psychometric studies supporting the diagnosis.ResultThe search identified a recent publication on proposed research criteria for prodromal bvFTD. These criteria were developed and validated by the ALLFTD Consortium. For the early detection of FTD, the investigators stressed the need to refine the definitions of neuropsychiatric disorders in neurodegenerative diseases differentiating them from primary psychiatric disorders, to conduct psychometric assessment to detect executive dysfunctions in patients presented with psychiatric disorders, lowering the threshold of suspicion, applying some tests for social cognition, and to use plasma and CSF biomarkers to support the diagnosis. It was considered important to use culturally adapted psychometric batteries for assessment of executive function and social cognition.ConclusionCollaboration between neurologists and psychiatrists will be needed to translate research criteria into clinical practice for the early diagnosis of patients with FTD. The current search for feasible biomarkers to improve the diagnostic utility is important and should be encouraged among psychiatrists as well as neurologists.

Greater executive dysfunction in patients post-COVID-19 compared to those not infected

BackgroundA number of patients post-coronavirus disease-19 (COVID-19) report cognitive impairment (CI), even months after acute infection. We aimed to assess if COVID-19 is associated with increased incidence of CI in comparison to controls. MethodsWe analyzed data from the Mount Sinai Health System Post-COVID-19 Registry in New York City, a prospective cohort of patients post-COVID-19 ≥18 years of age and non-infected controls. CI was defined by scores ≥ 1.0 standard deviation below population norms, and was assessed using well-validated measures of attention, working memory, processing speed, executive functioning/cognitive flexibility, language, learning, and memory. Logistic regression models assessed odds for CI in each domain in patients post-COVID-19 vs. controls after adjusting for potential confounders. In exploratory analyses, we assessed odds for CI by site of acute COVID-19 care as a proxy for disease severity. Findings417 patients post-COVID-19 and 151 controls (mean age 49 years, 63% female, 21% Black, 17% Latinx) were included. In adjusted analyses, patients were significantly more likely than controls to have CI in executive functioning (odds ratio [OR]: 2.19; 95% confidence interval [CI]: 1.03 to 4.67), particularly those treated in outpatient (OR: 2.22; 95% CI: 1.02 to 4.82) and inpatient hospital (OR: 3.59; 95% CI: 1.27 to 10.16) settings. There were no significant associations between CI in other domains and history of COVID-19 or site of acute care. InterpretationPatients post-COVID-19 have greater odds of executive dysfunction, suggesting that focused cognitive screening may be prudent, even in those with mild to moderate disease. Studies should explore the pathophysiology and potential treatments for CI in this population. FundingThis work was funded by the Icahn School of Medicine at Mount Sinai.

Neuromodulation of Executive Dysfunction in Patients with Acute Stroke Using Transcranial Direct Current Stimulation: Study Protocol for a Triple-Blind, Randomized Sham-Controlled Trial

Research on the benefits of non-invasive brain stimulation in stroke patients to improve executive functions is scarce. The objective of this study was to investigate the effectiveness of transcranial direct current stimulation (tDCS) in combination with cognitive training for the rehabilitation of executive functions in acute and subacute stroke patients as well as to explore the underlying physiological mechanisms. A triple-blinded, randomized-controlled clinical trial will be conducted involving 60 stroke patients with frontal or basal ganglia lesions and a Montreal Cognitive Assessment (MoCA) score less than 26. Participants will be randomly assigned to receive active tDCS (anode over the left dorsolateral prefrontal cortex, cathode at the right supraorbital region, 20 min at 2 mA) or sham tDCS in a 1:1 ratio for 10 sessions, followed by targeted executive function training. The primary efficacy outcome will be the MoCA score, while secondary outcomes will include the five-digit test (inhibitory control), the Digit Span Task (working memory), the abbreviated version of the Wisconsin Card Sorting test (cognitive flexibility), modified Rankin scale (functional state), Beck-II depression inventory, apathy evaluation scale, and the WHOQOL-BREF (quality of life), assessed immediately after the intervention and at 1, 3, 6, and 12 months post-intervention. Additionally, resting-state functional connectivity and blood biomarkers, such as neurotrophins, growth factors, and inflammatory molecules, will be evaluated before and after the intervention. This study will contribute to the investigation of the efficacy of tDCS in rehabilitating executive functions in acute and subacute stroke patients. The multidimensional approach utilized in this study, which includes analysis of resting-state connectivity and neuroplasticity-related blood biomarkers, is expected to provide insights into the underlying brain mechanisms involved in the rehabilitation of dysexecutive syndrome.

Cognitive decline in patients with essential tremor

Essential tremor (ET) is a heterogeneous disease with a high prevalence and disability. Traditionally, the disease was considered benign with the presence of tremor, the severity of which increases during the observation period. The severity of trembling varies widely from mild, not requiring therapy, to disabling. That is making difficulties to assess the prevalence of the disease. However, disability in patients with ET can occur not only due to the severity of tremor.The underestimated side of the disease, despite a long history of study, remains non-motor manifestations, including cognitive decline. Cognitive decline in essential tremor, compared with the general population, has a greater risk of transformation into dementia. In patients with ET, in comparison with other cognitive domains, executive functions are predominantly affected. Patients are also characterized by low awareness and concern about changes in intelligence. In the study of the brain using voxel morphometry, a heterogeneous group of changes that contradict each other was revealed. Most often, a change in the density of the cortex of different parts of the brain is detected in comparison with the control group. The most affected area of the brain is the precuneus. This may explain the executive dysfunction in patients and highlight the likely neurodegenerative nature of essential tremor. The absence of preventive therapy, the high incidence of changes in intelligence emphasizes the need for close monitoring of patients.

Higher education level as a protective factor against executive dysfunction in patients with epilepsy in Mataram, Indonesia

ObjectiveSince the concept of cognitive reserve is applicable in epilepsy-associated cognitive impairment, the role of cognitive reserve components as a protective factor against epilepsy-associated executive dysfunction needs further investigation. This study aimed at investigating the association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction in Mataram, Indonesia. MethodsThis case-control study involved both epilepsy outpatient and healthy participants recruited consecutively in 5 hospitals in Mataram, between October 2021 and September 2022. Data on sociodemographic, cognitive reserve components, and executive function status were collected from both groups, while data on seizure were collected only from epilepsy participants. The association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction was tested using logistic regression. ResultsA total of 119 epilepsy patients and 93 healthy participants were recruited. The frequency of epilepsy-associated executive dysfunction was 50.4%. Multivariate logistic regression analysis showed that higher education level was the only cognitive reserve component protective against epilepsy-associated executive dysfunction (odds ratio [OR]: 3.36; 95% confidence interval [CI]: 1.33 – 8.50). ConclusionA high frequency of epilepsy-associated executive dysfunction was observed in Mataram. Higher education level was a cognitive reserve component protective against executive dysfunction in these patients.

후천성 뇌손상 환자의 집행기능 장애에 대한 메타인지중재 효과: 체계적 문헌연구

Objective: This study aimed to examine the latest evidence for the role of metacognitive intervention in improving executive dysfunction in patients with acquired brain injury(ABI). To this end, we conducted a systematic review of Korean and international randomized controlled trials (RCTs), extracted intervention details, and analyzed the results. Methods: This study used PubMed, EMBASE, CINAHL, KCI, KISS, and RISS to search for Korean and international literature published from January 2015 to November 2022. Seven studies were selected for the final analysis according to the PRISMA checklist, and the results were presented using the PICOS method. The PEDro scale was used to evaluate the quality of the selected studies. Results: Of the 611 retrieved studies, seven were selected (n = 347), which were all “good” in quality. In assessments of executive function, activities of daily living and participation, the interventions that showed significant differences between groups after the intervention were Cognitive Orientation to daily Occupational Performance and Error-Based Learning Conclusion: This study is clinically significant as we have improved the level of evidence power for metacognitive intervention in patients with ABI by selecting only well-designed RCTs. In summary, this study provides evidence to support the use of metacognitive intervention to treat executive dysfunction in patients with ABI.

Effects of Metacognitive Intervention on Executive Dysfunction in Patients With Acquired Brain Injury: A Systematic Reivew

Effects of Metacognitive Intervention on Executive Dysfunction in Patients With Acquired Brain Injury: A Systematic Reivew

EVALUATION OF FRONTAL LOBE FUNCTIONS IN PATIENTS WITH TEMPORAL LOBE EPILEPSY USING FAB (FRONTALASSESSMENT BATTERY) SCORE

Background: Several studies have demonstrated executive dysfunction in patients with frontal lobe epilepsy. The identication of frontal lobe dysfunction in TLE would have important clinical implications for prognosis and also for surgical management in refractory TLE. Aim: To assess frontal lobe functions in patients with temporal lobe epilepsy using FAB score. Methodology: 100 patients with Temporal lobe epilepsy were studied. Detailed history was taken with special attention to duration of epilepsy and time since last seizure. FAB score was assessed for all patients. Statistical analyses was done using SPSS 25.0 software for Windows. Chi-square and independent t test were applied to analyse categorical and numerical data, respectively. Result: The mean Total FAB score in TLE patients enrolled in our study was 10.47 ± 4.8, out of 18. On analysing the relation of duration of temporal lobe epilepsy with subsets of FAB and total FAB score, there was a statistically signicant correlation. There was also a signicant association between the last episode of seizures and total FAB scores. Conclusion: Impaired executive function is common in TLE patients, and FAB score is a clinically applicable test to monitor it. The longer the duration of epilepsy, the greater is the frontal dysfunction. Also, the time of the last seizure is a signicant predictor of executive functioning and patients with a recent seizure had a poorer performance.

White matter tract abnormalities are associated with executive dysfunction in temporal lobe epilepsy and hippocampal sclerosis (P12-1.010)

<h3>Objective:</h3> To evaluate the role of white-matter tract involvement in executive dysfunction in patients with temporal lobe epilepsy and unilateral hippocampal sclerosis (TLE-HS). <h3>Background:</h3> TLE-HS patients frequently display executive dysfunction (ED). The neuroanatomical substrate of ED in TLE-HS remains poorly understood. In this study, we investigated the role of white-matter tract involvement in ED in TLE-HS. <h3>Design/Methods:</h3> Patients with unilateral TLE-HS, aged 17–55, education&gt;=8 years, IQ&gt;=70, EEG findings of unilateral or bilateral temporal discharges were studied. Patients and healthy controls fulfilling the same inclusion criteria underwent the Stroop Color and Word Test (SCWT) and a 3T MRI with DTI sequences. DTI Fractional Anisotropy (FA) data was extracted and analyzed using FSL. FA maps were compared with Tract-Based Spatial Statistics (TBSS) voxel-wise analysis. Patients were classified as ED if performance in the SCWT was below minus 1.5 (−1.5) Standard Deviations of the mean performance of healthy controls. <h3>Results:</h3> 49 patients (30 left and 19 right HS) underwent the SCWT. Performance did not differ between right and left HS. Patients with normal and impaired executive function did not differ in disease duration, antiseizure medication load, and seizure frequency. Both patient groups showed diffuse FA decrease when compared to healthy controls. Compared to TLE-HS patients with normal SCWT performance, patients with ED had more pronounced FA alterations, showing statistically significant decreased FA in the superior longitudinal fasciculi, body of the corpus callosum, forceps major, corona radiata, inferior frontal-occipital fasciculus, uncinate fasciculus and corticospinal tract, and right thalamic radiations. <h3>Conclusions:</h3> In this TLE-HS patient population, executive dysfunction was associated with more pronounced widespread WM tract damage, in comparison with TLE-HS patients with preserved executive function. This finding underscores the role of microstructural WM damage in executive dysfunction in TLE-HS. <b>Disclosure:</b> Miss Solti has nothing to disclose. Mr. Mahler Ferreira Oliveira has nothing to disclose. Carla Adda has nothing to disclose. Rosa Valerio has nothing to disclose. Dr. Jorge has nothing to disclose. Katarina Lyra has nothing to disclose. Mr. Pastorello has nothing to disclose. Claudia Leite has nothing to disclose. Maria Otaduy has nothing to disclose. Dr. Castro has nothing to disclose.

Walking Ability Associated with Executive Dysfunction in Patients with Stroke: A Cross-Sectional Study

Previous studies have shown an association between executive dysfunction and walking ability. However, it remains unclear whether the degree of executive dysfunction is associated with differences in walking ability in patients with stroke. The aim of this study was to investigate whether there are differences in walking ability according to executive dysfunction in patients with stroke. A total of 51 patients with stroke were enrolled in this study. Executive function was measured using the Trail Making Test (TMT) Part B, and walking ability was assessed using the 10 m walk test and the Timed Up and Go Test (TUGT). Cluster analysis was performed using the TMT Part B and compared within each cluster. TMT Part B was categorized into three groups (cluster 1: n = 20, cluster 2: n = 24, and cluster 3: n = 7). Cluster 1 was significantly better than clusters 2 and 3, and cluster 2 was significantly better than cluster 3. The 10 m walk time and TUGT of cluster 1 were significantly better than those of cluster 3. However, the 10 m walk time and TUGT of clusters 1 and 2 did not differ significantly. In conclusion, these findings may indicate differences in walking ability according to executive dysfunction.

Evaluation of the executive dysfunction in patients with bipolar disorder

IntroductionBipolar disorders (BD) associate impairments in cognitive functioning not restricted to acute mood episodes. The functional impact of these cognitive dysfunctions is significant in many cases, therefore, an extensive evaluation is granted for BD patients from this perspective. Executive dysfunction in BD has been reported, especially during mania and was associated with formal thought disorder, but multiple cognitive deficits may reflect an underlying pathologic process related to the mood disorder itself.ObjectivesTo assess the level of executive dysfunction in a sample of patients with type I BD (BDI) using structured measurement methods.MethodsFive patients diagnosed with BDI (two patients during manic episodes, one during the euthymic phase, and 2 during depressive episodes) were evaluated for working memory (n-back test), verbal fluency (Controlled Oral Word Association Test, COWAT) and verbal learning (Verbal Learning and Memory test, VLMT). All patients were adults, mean age of 35.5 years, and all were undergoing psychotropic treatment with antipsychotics and/or mood stabilizers. Also, five normal healthy controls, matched for age, were evaluated using the same test battery.ResultsAll five BDI patients presented dysfunctions (three at a trend level, and one at a significant level, p&lt;0. 01) in at least one cognitive domain, with three patients presenting modifications in all three tests that were administered vs. normal controls. The most affected domain was verbal learning, followed by working memory and verbal fluency. No individual in the control group had significant cognitive deterioration, on any outcome assessed.ConclusionsCognitive domains are altered in BDI patients, therefore, a test battery destined to quantify executive dysfunctions, independent of the presence of an acute mood episode or during the euthymic phase, may be useful for case management.Disclosure of InterestNone Declared

Association of HTR3B gene polymorphisms with depression and its executive dysfunction: a case–control study

BackgroundPrevious studies have shown that depression was associated with HTR3B gene. The aim of this study was to investigate the relationship between polymorphisms of the HTR3B gene and depression and its executive dysfunction in Chinese Han population.MethodsA total of 229 patients with depressive disorder and 202 healthy controls were enrolled. Six Single nucleotide polymorphism sites (SNPs) including rs10789970, rs4938056, rs12421126, rs1176744, rs2276305 and rs12795805 were genotyped by Snapshot. Clinical features were collected using a general demographic questionnaire. The 24-item Hamilton Depression Scale (HAMD) was used to assess the symptoms’ severity of the patients. The patients' executive function was assessed using a series of cognitive tests including Maze Test, Symbolic Coding Test, Spatial Span Inverse Order Test, Linking Test, and Emotional Management Test.ResultsThe genotypic and allelic distributions of rs1176744 in HTR3B gene were significantly different (χ2 = 11.129, P = 0.004, χ2 = 9.288, P = 0.002, respectively) between patients and controls. The A allele was positively correlated with depression. The proportion of A carriers was significantly higher and that of C carriers was lower in patients than those in controls. Patients had significantly lower scores of Spatial Span Inverse Order Test in carriers of A allele at locus rs1176744 and higher scores in carriers of C alleles at locus rs1176744 and rs12795805.ConclusionsThe polymorphisms of HTR3B gene may be associated with depression in Chinese Han population. The A allele of rs1176744 may increase the risk of developing depression and executive dysfunction while C alleles of rs1176744 and rs12795805 may be the protective factors for executive dysfunction in patients with depression.

Executive dysfunctions in patients recovering from Covid-19

Background COVID-19 is recognized as a multi-organ disease that can affect many organs either during the acute stage of infection or even after recovery. These are part of the post COVID-19 syndrome. Neuropsychiatric symptoms such as cognitive impairments are part of them and include memory difficulties, executive functions impairments, and trouble focusing. However cognitive profile in these patients is still not precise and underlying mechanisms are still unclear. Besides, most studies were performed in western or Asian countries. Almost no studies were performed in African or Arab countries. The aim of our study was to assess neuropsychiatric and cognitive disorders in Tunisian patients who recovered from Covid-19. Method A cross-sectional survey was conducted during the months of May and June 2021, including patients one month after discharge from the pneumology ward in Mongi Slim Hospital in Marsa Tunisia. They all were hospitalized there for COVID-19 infection. Socio-demographic and clinical data were collected from medical records and through interviewing patients directly. To assess cognitive impairment, we used: Mini Mental State (MMS), Frontal Assessment Battery (FAB), Trail Making Test (TMT), and the maze task. Anxiety and depressive symptoms were also screened using the Hospital Anxiety and Depression. Results Twenty patients were included in the study, with 65% males. There were 14 patients with at least one cognitive dysfunction, which represents 70% of the sample. Three patients had less than the cut off score on the MMS and 8 patients on the FAB (showing respectively memory and executive impairment). On the TMT and the maze task, respectively 5 and 9 patients had abnormal timing scores. Conclusion Patients hospitalized with COVID-19 may show cognitive impairment shortly after discharge. Memory and executive functions are the most affected domains. For better management of these patients, screening for cognitive disorders in post COVID is vividly recommended. Long term studies are needed to check whether these impairments remain after the early phase.

Validity and Reliability of the Persian Version of the Frontal Assessment Battery (FAB) in Patients with Traumatic Brain Injury (TBI)

Objective: This study aimed to ascertain the validity and reliability of the Frontal Assessment Battery (FAB) in patients with traumatic brain injury (TBI). Methods: This study was conducted in a methodological, cross-sectional and prospective design. The study recruited 65 patients with TBI from the university rehabilitation centers in Tehran, Iran and matched them with 65 healthy participants in terms of age and sex. Concurrent validity was evaluated using Mini-Mental State Examination (MMSE), Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test (SCWT). The discriminant validity was evaluated through a comparison of the mean FAB scores between healthy participants and patients with TBI. The reliability was assessed with the analyses of internal consistency, test-retest reliability, and inter-judges reliability. Data was analyzed in SPSS V. 22 software. Results: FAB score in patients did not vary with age, sex and education. There was a significant correlation between the FAB score and MMSE (r=0.791, p&lt;0.001) and also various executive measures: the number of categories achieved (r=0.745, p&lt;0.001) and the number of perseveration errors (r=0.307, p&lt;0.05) in the WCST and all parts of the Stroop test (p&lt;0.001), except the interference score (p&gt;0.05). The FAB exhibited acceptable internal consistency (Cronbach’s α: 0.863) and also good test-retest (r=0.882, 95%CI = 0.77–0.95) and inter-judges reliability (r=0.994, 95%CI = 0.77–0.95). A cut-off of 15 for the total FAB score yielded the highest sensitivity (0.93) and specificity (0.90) to discriminate between patients with TBI and healthy participants. Conclusion: Our present study shows that the Persian version of the FAB is an easy, quick and confident tool for the screening of executive dysfunction in patients with TBI.

Improvement in disinhibition and executive dysfunctions in patients with MDD receiving TMS may be associated with astrocyte protein S100B whereas GFAP may have a role in non-cognitive depressive symptom improvement

Improvement in disinhibition and executive dysfunctions in patients with MDD receiving TMS may be associated with astrocyte protein S100B whereas GFAP may have a role in non-cognitive depressive symptom improvement

Lipid oxidation as a marker of apathy and executive dysfunction in patients at risk of vascular cognitive impairment

AbstractBackgroundApathy and executive function decline are hallmarks of vascular dysfunction in neurodegeneration and cognitive impairment. People with mild vascular cognitive impairment (mVCI) display a combined etiology of both cognitive impairment and vascular comorbidities; hence, patients with vascular risk factors are at risk for mVCI. The co‐occurrence of apathy and executive dysfunction is prevalent; however, the physiological pathway underlying these manifestations is yet to be investigated. Oxidative stress is often present in vascular dysfunction. This study investigated the relationship between oxidative stress, specifically markers of lipid oxidation, apathy, and executive dysfunction in patients at risk of mVCI.MethodPatients at risk of mVCI were recruited from a population of patients with coronary artery disease in a Cardiac Rehabilitation Program. Apathy was assessed using the Apathy Evaluation Scale and executive function with Trial Making Test B, phonemic fluency test and animal naming test. Fasting blood was collected and serum concentrations of early and late lipid oxidation markers, lipid hydroperoxides (LPH) and 8‐isoprostane (8‐ISO) respectively, were measured.ResultParticipants (n=206, Age= 63.0±7.5, 80% men, total years of education= 15.9±3.4, AES score= 28.3±8.8, composite z score for EF= 0±1) demonstrated significantly different ratios of late to early lipid oxidation markers (8‐ISO/LPH) between groups (F(3, 202) = 10.915, p &lt;0.001) with increasing levels in the following order: no apathy or executive dysfunction, only executive dysfunction, only apathy, and both apathy and executive dysfunction. A multivariate linear regression model adjusting for demographics found that lipid oxidation was significantly associated with apathy (B= 4.63, p &lt; 0.001) and executive function (B= ‐0.19, p= 0.018); however, when controlling for both demographics and vascular risk factors, lipid oxidation was significantly associated with apathy alone (B= 3.11, p= 0.002).ConclusionThe results highlight an important involvement of lipid oxidation in the co‐occurrence of apathy and executive dysfunction in patients at risk of mVCI. Our results show that increased oxidative stress may contribute to the development of apathy, which may relate to why apathy is a strong risk factor for progression to dementia in at‐risk populations.

Lipid Peroxidation as a Marker of Apathy and Executive Dysfunction in Patients at Risk for Vascular Cognitive Impairment.

The co-occurrence of apathy and executive dysfunction, a correlate of vascular cognitive impairment (VCI), is highly prevalent, yet facilitating factors are largely unknown. This study investigates the relationship between lipid peroxidation, apathy, and executive dysfunction in patients at risk for VCI. In participants with coronary artery disease, who are at a high risk of VCI, apathy (Apathy Evaluation Scale), and executive function (composite z-score based on age and education population norms from trails making test B, animal naming, and phonemic fluency tests) were assessed. Serum concentrations of an early (lipid hydroperoxide (LPH)) and late (8-isoprostane (8-ISO)) lipid peroxidation marker, were measured and the 8-ISO/LPH ratio was calculated. Participants (n = 206, age±SD = 63.0±7.5, 80% men, total years of education = 15.9±3.4, AES score = 28.3±8.8, executive function = 0±1) demonstrated significantly different 8-ISO/LPH ratios between groups (F(3, 202) = 10.915, p &lt; 0.001) with increasing levels in the following order: no apathy or executive dysfunction, only executive dysfunction (executive function composite score≤-1), only apathy (AES≥28), and both apathy and executive dysfunction. A model adjusting for demographics showed that lipid peroxidation was associated with both apathy (B(SE) = 4.63 (0.954), t = 4.852, p &lt; 0.001) and executive function (B(SE) = -0.19 (0.079), t = -2.377, p = 0.018). However, when controlling for both demographics and vascular risk factors, lipid peroxidation was associated with only apathy (B(SE) = 3.11 (0.987), t = 3.149, p = 0.002). The results highlight a potentially important involvement of lipid peroxidation in the co-occurrence of apathy and executive dysfunction in those at risk for VCI.

Computer-assisted training of executive functions in adult patients with non-progressive acquired brain damage – a pilot study on efficacy of a new therapeutic application

Executive dysfunction is most often caused by post-traumatic or post-stroke damage to the prefrontal regions of the brain. The aim of this study was to compare the efficacy of two computer-assisted therapy programs for executive dysfunctions in patients with acquired brain injury. Patients were trained using either a newly developed application ExeSystem (designed to help improve the ability to manage and control one’s own behavior by performing tasks imitating natural, everyday situations) or a combination of two commercial applications RehaCom and CogniPlus. Data collected after a three-week period of therapy conducted in two 15-person groups of participants indicated comparable efficacy of both therapy programs in improving quality of daily functioning, executive attention, as well as planning and problem-solving but not memory. The improvement in social competence (p = .028) was the only advantage of therapy with the ExeSystem. Therapeutic interactions using computer programs were shown to be positively evaluated by patients (p < .01). This study confirmed at least equal efficacy of computer-based executive function therapy using ExeSystem compared to RehaCom and CogniPlus. However, despite the implementation of a more ecological and comprehensive approach to the content of a new application, the benefits of this approach were limited.

Functional near-infrared spectroscopy as a potential objective evaluation technique in neurocognitive disorders after traumatic brain injury.

Most patients with neurocognitive disorders after traumatic brain injury (TBI) show executive dysfunction, in which the pre-frontal cortex (PFC) plays an important role. However, less objective evaluation technique could be used to assess the executive dysfunction in these patients. Functional near-infrared spectroscopy (fNIRS), which is a non-invasive technique, has been widely used in the study of psychiatric disorders, cognitive dysfunction, etc. The present study aimed to explore whether fNIRS could be a technique to assess the damage degree of executive function in patients with neurocognitive disorders after TBI by using the Stroop and N-back tasks in PFC areas. We enrolled 37 patients with neurocognitive disorders after TBI and 60 healthy controls. A 22-channel fNIRS device was used to record HbO during Stroop, 1-back and 2-back tasks. The results showed that patients made significantly more errors and had longer response times than healthy controls. There were statistically significant differences in HbO level variation in bilateral frontopolar, bilateral inferior frontal gyrus and left middle temporal gyrus during Stroop color word consistency tasks and in left frontopolar during Stroop color word inconsistency tasks. During 2-back tasks, there were also statistically significant differences in HbO level variation in bilateral frontopolar, bilateral inferior frontal gyrus, bilateral dorsolateral pre-frontal cortex. According to brain activation maps, the patients exhibited lower but more widespread activation during the 2-back and Stroop color word consistency tasks. The fNIRS could identify executive dysfunction in patients with neurocognitive disorders after TBI by detecting HbO levels, which suggested that fNIRS could be a potential objective evaluation technique in neurocognitive disorders after TBI.