Differences in the neural correlates of frontal lobe tests

Abstract

Background: The Executive Interview (EXIT25), the executive clock-drawing task (CLOX1), and the Frontal Assessment Battery (FAB) are used to assess executive function at the bedside. These tests assess distinct psychometric properties. The aim of this study was to examine differences in the neural correlates of the EXIT25, CLOX1, and FAB based on magnetic resonance imaging. Methods: Fifty-eight subjects (30 with Alzheimer's disease, 10 with mild cognitive impairment, and 18 healthy controls) participated in this study. Multiple regression analyses were performed to examine the brain regions correlated with the EXIT25, CLOX1, and FAB scores. Age, gender, and years of education were included as covariates. Statistical thresholds were set to uncorrected P-values of 0.001 at the voxel level and 0.05 at the cluster level. Results: The EXIT25 score correlated inversely with the regional grey matter volume in the left lateral frontal lobe (Brodmann areas 6, 9, 44, and 45). The CLOX1 score correlated positively with the regional grey matter volume in the right orbitofrontal cortex (Brodmann area 11) and the left supramarginal gyrus (Brodmann area 40). The FAB score correlated positively with the regional grey matter volume in the right precentral gyrus (Brodmann area 6). The left lateral frontal lobe (Brodmann area 9) and the right lateral frontal lobe (Brodmann area 46) were identified as common brain regions that showed association with EXIT25, CLOX1, and FAB based only a voxel-level threshold. Conclusions: The results of this study suggest that the EXIT25, CLOX1, and FAB may be associated with the distinct neural correlates of the frontal cortex.

Clock drawing and neuroanatomical correlates: A systematic review

“…Of the 45 publications, which met inclusion criteria, one article was a review but not a systematic review, which is not included in the table, 30 articles proposed discrete lesion locations in the brain related to the CDT summarized in Table and Figure 2 . Nine articles examined the degree of white matter burden related to CDT (Table ) .…”

Diagnostic performance and neural basis of the combination of free‐ and pre‐drawn Clock Drawing Test

“…A previous systematic review reported the involvement of various brain regions in the performance of pre‐drawn CDT 18 . Some papers have highlighted the neurological correlation between CDT failure and the right inferior temporal gyrus, right superior temporal gyrus, and fusiform gyrus 13,15,16 . In severe AD, CDT performance depends on the function of the right hemisphere, especially the right inferior temporal gyrus, which is involved in the cortical processing of complex visual objects, including the face of a clock 31 .…”

“…Previous structural imaging studies linked CDT performance to a number of unilateral and bilateral brain areas, including the frontal, parietal, temporal, occipital, and subcortical lobes 13‐16 . Age is suggested to have a negative correlation with the functions of the occipital and parietal lobes, which could contribute to poor CDT performance 17 .…”

“…12 Previous structural imaging studies linked CDT performance to a number of unilateral and bilateral brain areas, including the frontal, parietal, temporal, occipital, and subcortical lobes. [13][14][15][16] Age is suggested to have a negative correlation with the functions of the occipital and parietal lobes, which could contribute to poor CDT performance. 17 However, a systematic review demonstrated that specific brain regions were not detected as neural correlates of CDT, and various brain regions were involved in CDT performance.…”

An update on magnetic resonance imaging markers in AD

“…80 Different studies are also targeting executive and frontal-lobe functioning in MCI, AD and healthy controls. [81][82][83] Authors of a multimodal MRI study in healthy adults showed that low deactivation of the DMN, high activation of the executive-control network and high WMH burden were the most accurate predictors of executive functioning at baseline. 82 In addition, greater AD pathology (assessed using CSF values), and poor WM structural connectivity within the DMN and the executive-control network predicted greater executive-dysfunction annual decline in asymptomatic subjects.…”