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 Dysex… Show more
“…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.…”
Section: Executive Function Concepts and Definitionsmentioning
Executive function is frequently impaired among people who have sustained stroke. This review provides an overview of definitions, concepts, and measures. The review also summarizes current best evidence examining executive function impairment and recovery trajectories after stroke, correlates of change over time, and emerging intervention research. Finally, this review provides recommendations for research and clinical practices, as well as priorities for future executive function research.
“…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.…”
Section: Executive Function Concepts and Definitionsmentioning
Executive function is frequently impaired among people who have sustained stroke. This review provides an overview of definitions, concepts, and measures. The review also summarizes current best evidence examining executive function impairment and recovery trajectories after stroke, correlates of change over time, and emerging intervention research. Finally, this review provides recommendations for research and clinical practices, as well as priorities for future executive function research.
“…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).…”
Section: Stroke and Executive Dysfunctionmentioning
Stroke is a worldwide leading cause of death and long-term disability with concurrent secondary consequences that are largely comprised of mood dysfunction, as well as sensory, motor, and cognitive deficits. This review focuses on the cognitive deficits associated with stroke specific to executive dysfunction (including decision making, working memory, and cognitive flexibility) in humans, nonhuman primates, and additional animal models. Further, we review some of the cellular and molecular underpinnings of the individual components of executive dysfunction and their neuroanatomical substrates after stroke, with an emphasis on the changes that occur during biogenic monoamine neurotransmission. We concentrate primarily on changes in the catecholaminergic (dopaminergic and noradrenergic) and serotonergic systems at the levels of neurotransmitter synthesis, distribution, reuptake, and degradation. We also discuss potential secondary stroke-related behavioral deficits (specifically, poststroke depression as well as drug-abuse potential and addiction) and their relationship with stroke-induced deficits in executive function, an especially important consideration given that the average age of the human stroke population is decreasing. In the final sections, we address pharmacological considerations for the treatment of ischemia and the subsequent functional impairment, as well as current limitations in the field of stroke and executive function research.
“…Essentially, the predominant distribution of regional engagement in the delta band could indicate changes in cognitive demands for signal detection and decision making (Dolce and Waldeier, 1974 ; Başar-Eroglu et al, 1992 ). Moreover, there is growing evidence that stroke patients often have deficits in decision-making (Poulin et al, 2013 ; Scheffer et al, 2016 ). In the oddball tasks, at the behavioral level, task performance is associated with signal detection and decision-making.…”
Although consistent evidence has revealed that cognitive impairment is a common sequela in patients with mild stroke, few studies have focused on it, nor the impact of lesion location on cognitive function. Evidence on the neural mechanisms underlying the effects of mild stroke and lesion location on cognitive function is limited. This prompted us to conduct a comprehensive and quantitative study of functional brain network properties in mild stroke patients with different lesion locations. Specifically, an empirical approach was introduced in the present work to explore the impact of mild stroke-induced cognitive alterations on functional brain network reorganization during cognitive tasks (i.e., visual and auditory oddball). Electroencephalogram functional connectivity was estimated from three groups (i.e., 40 patients with cortical infarctions, 48 patients with subcortical infarctions, and 50 healthy controls). Using graph theoretical analysis, we quantitatively investigated the topological reorganization of functional brain networks at both global and nodal levels. Results showed that both patient groups had significantly worse behavioral performance on both tasks, with significantly longer reaction times and reduced response accuracy. Furthermore, decreased global and local efficiency were found in both patient groups, indicating a mild stroke-related disruption in information processing efficiency that is independent of lesion location. Regarding the nodal level, both divergent and convergent node strength distribution patterns were revealed between both patient groups, implying that mild stroke with different lesion locations would lead to complex regional alterations during visual and auditory information processing, while certain robust cognitive processes were independent of lesion location. These findings provide some of the first quantitative insights into the complex neural mechanisms of mild stroke-induced cognitive impairment and extend our understanding of underlying alterations in cognition-related brain networks induced by different lesion locations, which may help to promote post-stroke management and rehabilitation.
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