Executive Functions In Patients Research Articles

Association between BDNF Polymorphism (Val66Met) and Executive Function in Patients with Amnestic Mild Cognitive Impairment or Mild Alzheimer Disease

Background: In the present study, we examined whether brain-derived neurotrophic factor (BDNF) polymorphism (Val66Met) influenced the changeable executive dysfunction of patients with two separate disease stages: amnestic mild cognitive impairment (A-MCI) or mild Alzheimer disease (AD), which are comparatively similar demented conditions. Methods: Among 200 outpatients with dementia and MCI, 146 outpatients with mild AD or A-MCI were recruited and divided into two genotypic groups, valine homozygosity (Val/Val) and methionine (Met) carriers, based on the representative BDNF functional polymorphism Val66Met. Next, we compared the Frontal Assessment Battery (FAB) total and subtest scores between the two genotypic groups according to each of two different disease stages: A-MCI (n = 42) and mild AD (n = 104). Results: Among patients with only a mild stage of AD, the FAB total and go/no-go scores were significantly lower (p < 0.05) among the subjects with the Val/Val genotype than among the Met carriers. However, no significant differences in any other demographic variables were observed between the genotypes according to each of different disease stages. A significant interaction between Val66Met and age was not observed for the FAB scores. Conclusion: These results suggested that the BDNF gene may significantly influence executive dysfunction, including inhibition tasks, among patients with mild-stage AD.

Is the frontal dysexecutive syndrome due to a working memory deficit? Evidence from patients with stroke

Although frontal dysexecutive disorders are frequently considered to be due to working memory deficit, this has not been systematically examined and very little evidence is available for impairment of working memory in frontal damage. The objective of this study was to examine the components of working memory, their anatomy and the relations with executive functions in patients with stroke involving the frontal or posterior cortex. The study population consisted of 29 patients (frontal: n=17; posterior: n=12) and 29 matched controls. Phonological loop (letter and word spans, phonological store; rehearsal process), visuospatial sketchpad (visuospatial span) and the central executive (working memory span, dual task and updating process) were examined. The group comparison analysis showed impairment in the frontal group of: (i) verbal spans (P<0.03); (ii) with a deficit of the rehearsal process (P=0.006); (iii) visuospatial span (P=0.04); (iv) working memory span (P=0.001) that disappeared after controlling for verbal span and (v) running memory (P=0.05) unrelated to updating conditions. The clinical anatomical correlation study showed that impairment of the central executive depended on frontal and posterior lesion. Cognitive dysexecutive disorders were observed in 11/20 patients with central executive deficit and an inverse dissociation was observed in two patients. Receiver operating characteristic curve analysis indicated that cognitive dysexecutive disorders had the highest ability to discriminate frontal lesions (area under curve=0.844, 95% confidence interval: 0.74-0.95; P=0.0001; central executive impairment: area under curve=0.732, 95% confidence interval: 0.57-0.82; P=0.006). This study reveals that frontal lesions induce mild impairment of short-term memory associated with a deficit of the rehearsal process supporting the role of the frontal lobe in this process; the central executive depends on lesions in the frontal lobe and posterior regions accounting for its low frequency and the negative results of group studies. Finally, the frontal dysexecutive syndrome cannot be attributed to central executive impairment, although it may contribute to some dysexecutive disorders.

Executive functions in patients with frontal and temporal lobe epilepsy

Objective To investigate the executive functions of the frontal and temporal lobe epilepsy patients. Methods Fifty-five epilepsy patients (twenty-five frontal lobe epilepsy patients and thirty temporal lobe epilepsy patients) and fifty age, gender and education matched healthy controls were evaluated by means of Mini Mental State Examination (MMSE ). Executive function was assessed using Stroop color words test and trail making test. Results MMSE total score of frontal and temporal lobe epilepsy patients were (26.02±0.30) and (25.82±0.67), respectively. There was significant abnormality between epilepsy patients and the controls (P<0.05). Compared with normal control group, FLP group and TLP group took longer time and their score was lower in stroop color words test (P<0.05). There were significant difference between FLP and TLP on card B and C′s reading time, correct number and stroop interference effects (P<0.05). The epilepsy patients performed significantly worse than the controls in whole trail making test (P<0.05). The scores indicate that the TLE group outperformed the FLE group on all analysis values (P<0.05). Conclusion The frontal and temporal lobe epilepsy patients have executive function deficit. The FLE group has prominent deficits in executive functioning. Key words: Frontal lobe epilepsy; Temporal lobe epilepsy; Executive functions

Decision Making and Executive Functions in REM Sleep Behavior Disorder

This study was designed to assess decision making and executive functions in patients with idiopathic REM sleep behavior disorder (iRBD). IRBD is often seen as an early sign of later evolving neurodegenerative disease, most importantly Parkinson disease (PD) and Lewy body dementia (DLB). It has been proposed that iRBD patients show a cognitive profile similar to patients with PD. All participants performed an extensive test battery tapping executive functions as well as the IOWA gambling task, which measures decision making under ambiguity. University hospital sleep disorders center. 16 iRBD patients and 45 age- and education-matched controls. N.A. Compared with controls, iRBD patients showed disadvantageous decision making under ambiguity and did not learn by feedback over the task. IRBD patients' decision pattern was characterized by the lack of a consistent strategy, as indicated by frequent shifts between the single choices. A high proportion of iRBD patients (75%) showed random performance or worse even at the end of the task. No group differences were found in tasks assessing information sampling, flexibility and categorization, problem solving, and impulsivity. As suggested by the present investigation, iRBD patients may show difficulties in decision making under ambiguity in a stage when other cognitive functions are relatively well preserved. Whether this is driven by subgroups of patients prone to develop PD or DLB has to be assessed by follow-up investigations.

Anterior cingulate cortex activation is related to learning potential on the WCST in schizophrenia patients

The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient’s capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard test/training phase/standard test format of the WCST to classify 36 schizophrenia patients as high-achievers, learners or non-retainers. All healthy controls performed as high-achievers. An event-related fMRI design assessed neural activation patterns during post-training WCST performance. Patients showed a linear trend between set-shifting related activation in the anterior cingulate cortex and learning potential, i.e. increased activation in high-achievers, a trend for increased activation in learners, and no activation in non-retainers compared to controls. In addition, activation in the temporoparietal cortex was highest in patients classified as learners, whereas in non-retainers activation was increased in the inferior frontal gyrus compared to controls and high-achieving patients. These results emphasize the relevance of the ACC’s neural integrity in learning set-shifting strategies for patients with schizophrenia. Also, our results support the hypothesis that compensatory neural activation in patients with schizophrenia helps them to catch up with healthy controls on cognitive tasks.

The Utility of the INECO Frontal Screening (IFS) in the Detection of Executive Dysfunction in Patients with Traumatic Brain Injury (TBI) (P07.194)

Objective: The aim of our research was to investigate the sensitivity and specificity of this tool in the detection of executive dysfunction in patients with Traumatic Brain Injury (TBI). Background The INECO Frontal Screening (IFS) is a brief screening tool which has demonstrated high sensitivity and specificity in detecting executive dysfunction in patients with dementia. Design/Methods: A group of 23 patients with TBI and a group of 19 controls were evaluated with the IFS and a classic executive test battery. We analyzed the sensitivity and specificity of different cut-off scores for the IFS in detecting executive impairment in patients with TBI group. Patients were considered having executive impairment when they scored 1.5 SD below the mean of a matched control group in at least one executive test. Results: TBI patients with and without executive deficits differed significantly on the total score of the IFS. Of the total of patients evaluated, 20% showed executive dysfunction. With a cutoff score of 21/30, sensitivity of the tool was 91.7% while its specificity was 63.3%. Conclusions: The IFS is a tool able to detect deficits in executive functions in patients with head injury, showing a high sensitivity with moderate specificity. Disclosure: Dr. Marenco has nothing to disclose. Dr. Roca has nothing to disclose. Dr. Gleichgerrcht has nothing to disclose. Dr. Manes has nothing to disclose. Dr. Torralva has nothing to disclose.

Understanding the executive functioning heterogeneity in schizophrenia

Schizophrenia is characterized by heterogeneous brain abnormalities involving cerebral regions implied in the executive functioning. The dysexecutive syndrome is one of the most prominent and functionally cognitive features of schizophrenia. Nevertheless, it is not clear to what extend executive deficits are heterogeneous in schizophrenia patients. Furthermore, it is still unknown if the executive impairments observed in schizophrenia are better characterized as specific or as reflecting generalized cognitive factors. The four executive processes (i.e. updating, inhibition, shifting and divided attention) described in Miyake et al.’s (2000) theoretical model were examined in 62 individuals with schizophrenia and 49 healthy controls. At group level, impairments in all four executive processes confirmed the marked impairment in executive functioning in patients with schizophrenia. Statistical analysis indicated that executive performances in schizophrenia patients were more heterogeneous than in healthy controls. Compared with standardized norms, 94% of patients exhibited impairment in at least one of the executive tasks. Twenty-one percent of patients exhibited impairment in one executive task, 27% in two tasks, 23% in three executive tasks and 23% exhibited impairments in the four executive tasks. Six percent of patients had normal executive profile. Regression analysis indicated that only premorbid intellectual quotient and a general slowing in processing speed predicted the executive dysfunction severity. Executive functioning was not affected by age, duration of illness, psychotic status, or by antipsychotic dosage. Our results emphasize the heterogeneity of the dysexecutive syndrome in schizophrenia when individual profile analysis is considered, and extend the view that individual cognitive differences in schizophrenia are largely underlined by general cognitive factors such as intellectual level and general processing speed.

The role of executive function in posttraumatic stress disorder: A systematic review

Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results. A systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups. Across 18 studies, 1080 subjects were included. In comparison with 431 exposed controls and 227 healthy controls, 422 people with PTSD showed significantly impaired executive functioning. Subgroup analyses revealed more pronounced differences between PTSD patients and exposed controls than healthy controls. Male gender, higher age, war trauma, and higher severity of co-morbid depressive symptoms were related to poorer executive functioning in PTSD patients compared to exposed controls. Due to insufficient data and heterogeneity, not all subgroup differences or characteristics could be taken into account. Overall, PTSD patients were found to show impaired executive functioning. Future research should further elucidate the subgroup effects and focus on clinical implications with regard to daily functioning and treatment outcome.

Counting-backward test for executive function in idiopathic normal pressure hydrocephalus

The aim of this study was to develop and validate a bedside test for executive function in patients with idiopathic normal pressure hydrocephalus (INPH). Twenty consecutive patients with INPH and 20 patients with Alzheimer's disease (AD) were enrolled in this study. We developed the counting-backward test for evaluating executive function in patients with INPH. Two indices that are considered to be reflective of the attention deficits and response suppression underlying executive dysfunction in INPH were calculated: the first-error score and the reverse-effect index. Performance on both the counting-backward test and standard neuropsychological tests for executive function was assessed in INPH and AD patients. The first-error score, reverse-effect index and the scores from the standard neuropsychological tests for executive function were significantly lower for individuals in the INPH group than in the AD group. The two indices for the counting-backward test in the INPH group were strongly correlated with the total scores for Frontal Assessment Battery and Phonemic Verbal Fluency. The first-error score was also significantly correlated with the error rate of the Stroop colour-word test and the score of the go/no-go test. In addition, we found that the first-error score highly distinguished patients with INPH from those with AD using these tests. The counting-backward test is useful for evaluating executive dysfunction in INPH and for differentiating between INPH and AD patients. In particular, the first-error score may reflect deficits in the response suppression related to executive dysfunction in INPH.

A Prospective Functional MRI Study for Executive Function in Patients with Systemic Lupus Erythematosus Without Neuropsychiatric Symptoms

To study the functional brain activation signals before and after sufficient disease control in patients with systemic lupus erythematosus (SLE) without clinical neuropsychiatric symptoms. Blood-oxygen-level-dependent signals during event-related functional magnetic resonance imaging brain were recorded, while 14 new-onset SLE patients and 14 demographically and intelligence quotient matched healthy controls performed the computer-based Wisconsin card sorting test for assessing executive function, which probes strategic planning and goal-directed task performance during feedback evaluation (FE) and response selection (RS), respectively. Composite beta maps were constructed by a general linear model to identify regions of cortical activation. Blood-oxygen-level-dependent functional magnetic resonance imaging signals were compared between (1) new-onset SLE patients and healthy controls and (2) SLE patients before and after sufficient control of their disease activity. During RS, SLE patients demonstrated significantly higher activation than healthy controls in both caudate bodies and Brodmann area (BA) 9 to enhance event anticipation, attention, and working memory, respectively, to compensate for the reduced activation during FE in BA6, 13, 24, and 32, which serve complex motor planning and decision-making, sensory integration, error detection, and conflict processing, respectively. Despite significant reduction of SLE activity, BA32 was activated during RS to compensate for reduced activation during FE in BA6, 9, 37, and 23/32, which serve motor planning, response inhibition and attention, color processing and word recognition, error detection, and conflict evaluation, respectively. Even without clinically overt neuropsychiatric symptoms, SLE patients recruited additional pathways to execute goal-directed tasks to compensate for their reduced strategic planning skill despite clinically sufficient disease control.

P-806 - Executive functions deficit in obsessive-compulsive disorders patients

The purpose of this study is comparing executive functions in patients with obsessive - compulsive disorder (OCD) and matched healthy individual. In this cross - sectional study were evaluated 46 patients with obsessive-compulsive disorder are compared with 46 healthy individual by means of convenient sampling. In this retrospective, causal-comparative study, Stroop test, Wisconsin card sorting test (WCST) and continuous performance test (CPT) were used as the research tools. Data were analyzed through Student t-test. Finding show that reaction time significantly lower in OCD group ( p< 0.5). In continuous performance test omission error in OCD more than healthy group (p < 0.5); but to groups was similar in commission and reaction time. In WCST healthy group have better performance in preservation error and correct response (p < 0.5). OCD could be considered as dysfunction of executive functions.

99mTc-ECD SPECT at rest and activation in young patients with schizophrenia

Abstract The aim of the study was to localize brain parts involved in executive functions in patients with schizophrenia by means of 99mTc-ECD single photon emission computed tomography (SPECT) with 3-dimensional automatic software. We examined 12 men with schizophrenia (mean age 29±3.9 years). Brain perfusion SPECT was performed at rest and during Wisconsin Card Sorting Test (WCST). Two types of quantitative SPECT analysis were applied; voxel-based and volume of interest (VOI)-based. With voxel-based approach, rest and activation SPECT were compared. VOI-based analysis allowed for correlation of regional cerebral blood flow (rCBF) in 20 VOIs with WCST scores. In voxel-based analysis, the patterns of rCBF decrease and increase after activation varied between patients, with combinations of different brain regions involved. In VOI-based approach, the only statistically significant difference between activation and rest was rCBF decrease in the left basal ganglia (p=0.028). The thalami and right temporal cortex correlated with the greatest number of WCST scores, followed by left occipital cortex and left cerebellum. In conclusion, our results suggest that patterns of WCST activation and deactivation vary between patients with schizophrenia. Among the network of involved brain structures, right temporal cortex and thalami appear to play the major role.

ARVCFGenetic Influences on Neurocognitive and Neuroanatomical Intermediate Phenotypes in Chinese Patients With Schizophrenia

There are notable similarities between velocardiofacial syndrome and schizophrenia in terms of neurocognitive deficits and brain structural abnormalities. These similarities have supported the role of the armadillo repeat gene deleted in velocardiofacial syndrome (ARVCF) as a susceptibility gene in schizophrenia. This study investigated the relationships between haplotypes of the ARVCF gene and specific intermediate phenotypes in schizophrenia. We hypothesized that ARVCF gene haplotypes influence caudate nucleus volume, fractional anisotropy, and neurocognitive functioning in schizophrenia. Between May 2006 and November 2009, 200 Chinese participants (125 patients with DSM-IV diagnosis of schizophrenia and 75 controls) were genotyped using blood samples, and a subset of 166 participants (99 patients with DSM-IV diagnosis of schizophrenia and 67 controls) underwent structural magnetic resonance imaging, diffusion tensor imaging, and completed neuropsychological testing. The haplotype T-G-A-T-T-G-G-C-T-G-T (ARVCF-Hap1) was significantly associated with fractional anisotropy of the caudate nucleus and executive functioning in patients. Specifically, patients with more copies of ARVCF-Hap1 have lower white matter integrity in caudate nucleus (P = .0008) and greater perseverative errors (P = .00003) on the Wisconsin Card Sorting Test. A trend of lower caudate volume (P = .015) in patients with more copies of ARVCF-Hap1 was also observed. These findings are consistent with known ARVCF gene effects on neurodevelopment in terms of cellular arrangement, migration, and intracellular signaling involving the striatum and may involve interactions with other brain networks such as prefrontal cortex, and they underscore the importance of imaging-genetic studies to elucidate the genetic influences underlying intermediate phenotypes in complex neurobehavioral disorders.

Executive functions in patients with ADHD: An EEG-examination

Executive functions in patients with ADHD: An EEG-examination

Impairments in executive functioning in patients with remitted and non-remitted schizophrenia

Although deficits in executive functioning are prominent in schizophrenia, some patients in remission have shown significantly higher levels of neurocognitive functioning than patients not in remission. However, no consensus on the relationship between neurocognitive functioning and the severity of symptoms has been reached. Additionally, previous studies have mainly examined the primary symptom domains of schizophrenia without considering the influence of anxiety symptoms, which are likely to influence neuropsychological performance. The aim of the present study was to compare the executive functioning of normal controls and with that of patients with schizophrenia in acute and remitted states. We further examined associations between impaired executive functioning in patients and anxiety levels. Using a battery of tests assessing executive functioning including subtests of the Cambridge Neuropsychological Automated Test Battery (CANTAB) and the short form of the Korean Wechsler Adult Intelligence Scale (K-WAIS), we assessed 54 patients with schizophrenia and 33 normal controls. Our results showed that patients with non-remitted schizophrenia obtained significantly lower estimated IQ scores than did normal controls. They also exhibited longer reaction times on the Choice Reaction Time (CRT) test and the Stop Signal Test (SST) subtests of CANTAB and a greater number of total errors and errors that occurred before the extradimensional stage (i.e., pre-ED errors) on the Intradimensional/Extradimensional Shift (IED) subtest of CANTAB. Furthermore, those with schizophrenia in acute states showed significantly slower stop signal reaction times (SSRT) on the SST than did those with remitted schizophrenia and healthy controls. Finally, differences in the pre-ED errors and total adjusted errors on the IED became insignificant when scores on the Beck Anxiety Inventory (BAI) were entered as the covariate, whereas other significant differences remained when these scores were entered. Differences in executive functioning exist between patients with schizophrenia and healthy controls; these differences can be largely attributed to the relatively poor performance of patients in an active state.

Theory of mind tasks and executive functions: A systematic review of group studies in neurology

A growing number of studies have been addressing the relationship between theory of mind (TOM) and executive functions (EF) in patients with acquired neurological pathology. In order to provide a global overview on the main findings, we conducted a systematic review on group studies where we aimed to (1) evaluate the patterns of impaired and preserved abilities of both TOM and EF in groups of patients with acquired neurological pathology and (2) investigate the existence of particular relations between different EF domains and TOM tasks. The search was conducted in Pubmed/Medline. A total of 24 articles met the inclusion criteria. We considered for analysis classical clinically accepted TOM tasks (first- and second-order false belief stories, the Faux Pas test, Happe's stories, the Mind in the Eyes task, and Cartoon's tasks) and EF domains (updating, shifting, inhibition, and access). The review suggests that (1) EF and TOM appear tightly associated. However, the few dissociations observed suggest they cannot be reduced to a single function; (2) no executive subprocess could be specifically associated with TOM performances; (3) the first-order false belief task and the Happe's story task seem to be less sensitive to neurological pathologies and less associated to EF. Even though the analysis of the reviewed studies demonstrates a close relationship between TOM and EF in patients with acquired neurological pathology, the nature of this relationship must be further investigated. Studies investigating ecological consequences of TOM and EF deficits, and intervention researches may bring further contributions to this question.

P02-550 - Double dissociation of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral

IntroductionThe pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses.MethodDepressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and nonpsychiatric Controls (matched groups, n = 15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).ResultsECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p = 0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p &lt; 0.03 ; Control/NECT p &lt; 0.01) and the Spatial Recognition Memory (SRM) task (p &lt; 0.05 ; Controls/NECTs p &lt; 0.05) ; ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p &lt; 0.01 ; Controls/ECTs p &lt; 0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H = 11, p &lt; 0.01) but ECTs who completed SOC performed comparably to the other two groups.ConclusionsA double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT dépressives.

Executive Function in Patients with Obstructive Sleep Apnea Treated with Continuous Positive Airway Pressure—Erratum

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Executive dysfunction and influencing factors in convalescent patients with traumatic brain injury

Objective To explore and analyze the executive function of patients with traumatic brain injury in recovery phase and reveal its influential factors.Methods Behavioral Assessment of Dysexecutive Syndrome (BADS) was conducted in 104 patients with brain injury at 5 ～ 6 months after discharging and matched healthy comparison subjects in this study.Basic information in patients with the clinical data were collected by self-designed questionnaire to analyze the relevant factors.Results BADS findings showed that the individual scores and total standard scores of brain injury patients( 12.05 ± 2.54 ) were significantly lower than those of health population ( 19.02 ± 3.77 ) (P ＜ 0.05 ).Action program test, temporal judgment test, modified six elements test and total sub-standard scores ( 14.83 ±3.86)in junior high school education level and below group were significantly lower than that in high school and higher education group ( 17.67 ± 4.10 ).The individual scores and total standard scores ( 10.13 ± 3.86 )in heavier group were significantly lower than that in the lighter group ( 15.68 ± 4.10 ).The group without complication' action program test, key search test, zoo map test, modified six elements test were significantly lower than the group with complication.The BADS scores were related to education, illness condition,and complication (hypertension, hyperglykemia, hyperlipemia) (P＜0.05).Conclusion There is executive dysfunction in traumatic brain injury patients.The executive dysfunction is mainly correlated with education, illnesscondition and complication.Medical staff should provide pertinent intervention and treatment according to the above aspects, in order to obtain better effects of rehabilitation therapy . Key words: Traumatic brain injury; Recovery phase; Executive dysfunction; Factors

Attention Deficits and Frontal Executive Functions in Patients with Mild Cognitive Impairment and Sleep Apnea

본 연구는 경도인지장애(Mild Cognitive Impairment, MCI) 환자에서 수면무호흡증(Sleep Apnea Syndrome, SAS) 위험수준에 따른 인지기능 결함 특성을 알아보고자 하였다. 구체적으로, SAS 고/저 위험도에 따라 MCI 환자군과 정상노인 대조군을 나눈 뒤, 네 집단에 대해 전산화된 주의력 검사(시각 탐색 과제, 연속 수행 과제)와 전두엽 실행기능 검사(선추적 검사, 스트룹 검사, 단어유창성 검사)를 실시하였다. 연구 결과, MCI 환자군에서 SAS 위험도에 따른 주의력 검사의 수행 차이가 관찰된 반면, SAS 위험도에 따른 전두엽 실행기능 검사의 수행 차이는 통계적으로 유의하게 관찰되지 않았다. 특히, SAS가 주의력의 경우 MCI 환자군에서 정상노인 대조군보다 더욱 심한 결함을 초래한 반면, 전두엽 실행기능의 경우 정상노인 대조군에서 MCI 환자군보다 더욱 심한 결함을 초래하였다. 이 결과는 SAS가 MCI 환자와 정상노인에서 인지기능의 악화요인으로 작용할 수 있으므로, 이에 대한 평가와 치료적 개입이 중요함을 시사한다. MCI 환자의 SAS에 대한 국내 연구가 별로 없는 상황에서, MCI 환자를 대상으로 SAS 위험도에 따른 인지기능 결함 특성에 관한 실험적인 연구를 했다는 점에서 본 연구가 의의를 지닌다고 볼 수 있다. 마지막으로, 본 연구의 제한점과 추후 연구를 위한 방향에 대해 논의하였다.