Right frontal stroke: extra-frontal lesions, executive functioning and impulsive behaviour

Abstract

The aim of this study was to evaluate executive functioning (EF) and impulsiveness in three groups of people aged 30 to 79 years: post-frontal stroke (n = 13) and post-extra-frontal chronic stroke of the right hemisphere (n = 31) and control (n = 38). The years of education varied between the groups was as follows, frontal lesion group: M = 12 (SD = 6.11); extra-frontal lesion group: M = 9.06 (SD = 4.94); and control: M = 9.61 (SD = 4.24) years. The following instruments were used: Behavioural Assessment Dysexecutive Syndrome, Wisconsin Card Sorting Test (WSCT), Barratt Impulsivity Scale, Impulsivity Evaluation Scale, Delay Descounting Task and Go/No-Go Task. We found differences in EF between the extra-frontal lesion group and the control group with respect to cognitive flexibility (p = .018); number of WCST trials (p = .018); WCST perseverative errors (p = .014) and omission by impulsivity errors on the go/no-go task for 250 ms (p = .008) and 1750 ms trials (p = .006). The frontal lesion group made more errors of omission than the control group in the 1750 ms go/no-go trials (p = .006). These results suggest that extra-frontal lesions impair EF by influencing attentional impulsivity.

Executive Function Poststroke: Concepts, Recovery, and Interventions

“…Of note, while changes in executive function can be associated with lesions to the frontal lobes, they are also associated with lesions throughout the brain. 15,16 In fact, studies suggest that executive function impairments may be more strongly associated with distributed white matter hyperintensity volume rather than focal lesions within selected regions. 17,18 Thus, our review of executive function is defined by the behavior, rather than the assuming precise neuroanatomical associations.…”

Executive (dys)function after stroke: special considerations for behavioral pharmacology

“…In humans, multiple studies have documented that post-stroke individuals often struggle with impulsivity and decision making (Bechara et al, 2000b; Binder, 1984; Poulin et al, 2013). For example, Scheffer and colleagues (2016) used the Go/No-Go motor-impulsivity task to show that patients with right frontal-lobe stroke performed worse than the control group. In the Go/No-Go task, an individual is asked to perform a specific action in response to a specific stimulus (‘Go’) and to inhibit that same action in response to a different stimulus (‘No-Go’) (Gomez et al, 2007).…”

Preliminary validity evidence for the Executive Function Scale for Adults (EFSA).

“…The instrument also uses two versions, the first being the respondent’s self-report and the second an observer report, intended for the family member or caregiver who can evaluate the respondent (Wilson et al, 1996). This scale was selected because it has solid evidence of its reliability in previous studies in the literature for assessing EF in adults (Barker et al, 2011; Hellebrekers et al, 2017; Scheffer et al, 2015) and the version used in this research was the version adapted for Brazil by Macuglia et al (2016).…”