Assessing Executive Dysfunction in Neurodegenerative Disorders: A Critical Review of Brief Neuropsychological Tools

Abstract

Executive function (EF) has been defined as a multifaceted construct that involves a variety of high-level cognitive abilities such as planning, working memory, mental flexibility, and inhibition. Being able to identify deficits in EF is important for the diagnosis and monitoring of several neurodegenerative disorders, and thus their assessment is a topic of much debate. In particular, there has been a growing interest in the development of neuropsychological screening tools that can potentially provide a reliable quick measure of EF. In this review, we critically discuss the four screening tools of EF currently available in the literature: Executive Interview-25 (EXIT 25), Frontal Assessment Battery (FAB), INECO Frontal Screening (IFS), and FRONTIER Executive Screen (FES). We first describe their features, and then evaluate their psychometric properties, the existing evidence on their neural correlates, and the empirical work that has been conducted in clinical populations. We conclude that the four screening tools generally present appropriate psychometric properties, and are sensitive to impairments in EF in several neurodegenerative conditions. However, more research will be needed mostly with respect to normative data and neural correlates, and to determine the extent to which these tools add specific information to the one provided by global cognition screening tests. More research directly comparing the available tools with each other will also be important to establish in which conditions each of them can be most useful.

Dopaminergic gene methylation is associated with cognitive performance in a childhood monozygotic twin study

“…They facilitate regulation of thoughts, emotions, and actions, which is required for effective interactions with our external world. This is clear when noting the overlap of cognitive dysfunction seen across neurodevelopmental, neurodegenerative, and psychiatric disorders that contribute to reduced quality of life and independence [1,2]. Cognitive functions involve dopaminergic neurocircuitry; dopamine is a catecholamine neuromodulator highly implicated in motivation, mood, and cognition [3].…”

Inhibitory Control, Task/Rule Switching, and Cognitive Planning in Vascular Dementia: Are There Any Differences From Vascular Aging?

“…‘Executive Functions (EF)’ (or otherwise ‘Cognitive control’) is an umbrella term for higher-order cognitive processes, which are supported by frontal regions and their distributed networks. They are considered as higher-order abilities because they coordinate other, cognitive, affective, and motor abilities during the execution of complex tasks ( Lippa and Davis, 2010 ; Moreira et al, 2017 ). At a theoretical level, they have been divided into cold or cool EF and hot EF ( Lippa and Davis, 2010 ; Moreira et al, 2017 ).…”

“…They are considered as higher-order abilities because they coordinate other, cognitive, affective, and motor abilities during the execution of complex tasks ( Lippa and Davis, 2010 ; Moreira et al, 2017 ). At a theoretical level, they have been divided into cold or cool EF and hot EF ( Lippa and Davis, 2010 ; Moreira et al, 2017 ). Cold or cool EF include ‘pure cognitive’ or logical, goal-directed abilities such as planning, inhibition, flexibility/switching, and working memory updating.…”

“…is involved. Nevertheless, this distinction might not be straightforward and it has been suggested that the two types of EF are rather interdependent ( Lippa and Davis, 2010 ; Moreira et al, 2017 ). Cognitive psychology and clinical neuropsychology approach EF -mainly but not only in terms of measurement- in different ways.…”

“…On the other hand, cognitive psychology ‘supports’ the development of ‘clear’ measures of EF. In other words, it stipulates that each task should be designed to measure a primary EF as well as component functions that contribute to performance on this task ( Lippa and Davis, 2010 ; Moreira et al, 2017 ).…”