Executive functions include abilities of goal formation, planning, carrying out goal-directed plans, and effective performance. This article aims at reviewing some of the current knowledge surrounding executive functioning and presenting the contrasting views regarding this concept. The neural substrates of the executive system are examined as well as the evolution of executive functioning, from development to decline. There is clear evidence of the vulnerability of executive functions to the effects of age over lifespan. The first executive function to emerge in children is the ability to inhibit overlearned behavior and the last to appear is verbal fluency. Inhibition of irrelevant information seems to decline earlier than set shifting and verbal fluency during senescence. The sequential progression and decline of these functions has been paralleled with the anatomical changes of the frontal lobe and its connections with other brain areas. Generalization of the results presented here are limited due to methodological differences across studies. Analysis of these differences is presented and suggestions for future research are offered.

https://www.aecom.yu.edu/uploadedFiles/departments/neurology/Divisions/Child_Neurology/Child_Neurology_References/Executive_Fnc/Jurado.pdf

The Elusive Nature of Executive Functions: A Review of our Current Understanding

The aim of this study was to clarify which cognitive mechanisms underlie Trail Making Test (TMT) direct and derived scores. A comprehensive review of the literature on the topic was carried out to clarify which cognitive factors had been related to TMT performance. Following the review, we explored the relative contribution from working memory, inhibition/interference control, task-switching ability, and visuomotor speed to TMT performance. Forty-one healthy old subjects participated in the study and performed a battery of neuropsychological tests including the TMT, the Digit Symbol subtest [Wechsler Adult Intelligence Scale (Third Version) (WAIS-III)], a Finger Tapping Test, the Digits Forward and Backward subtests (WAIS-III), Stroop Test, and a task-switching paradigm inspired in the Wisconsin Card Sorting Test. Correlation and regression analyses were used in order to clarify the joint and unique contributions from different cognitive factors to the prediction of TMT scores. The results suggest that TMT-A requires mainly visuoperceptual abilities, TMT-B reflects primarily working memory and secondarily task-switching ability, while B-A minimizes visuoperceptual and working memory demands, providing a relatively pure indicator of executive control abilities.

/pdf/construct-validity-of-the-trail-making-test-role-of-task-3fvpq3zd3u.pdf

Construct validity of the Trail Making Test: Role of task-switching, working memory, inhibition/interference control, and visuomotor abilities

Background
Cognitive stimulation is an intervention for people with dementia which offers a range of enjoyable activities providing general stimulation for thinking, concentration and memory usually in a social setting, such as a small group. Its roots can be traced back to Reality Orientation (RO), which was developed in the late 1950s as a response to confusion and disorientation in older patients in hospital units in the USA. RO emphasised the engagement of nursing assistants in a hopeful, therapeutic process but became associated with a rigid, confrontational approach to people with dementia, leading to its use becoming less and less common.

Cognitive stimulation is often discussed in normal ageing as well as in dementia. This reflects a general view that lack of cognitive activity hastens cognitive decline. With people with dementia, cognitive stimulation attempts to make use of the positive aspects of RO whilst ensuring that the stimulation is implemented in a sensitive, respectful and person-centred manner.

There is often little consistency in the application and availability of psychological therapies in dementia services, so a systematic review of the available evidence regarding cognitive stimulation is important in order to identify its effectiveness and to place practice recommendations on a sound evidence base.

Objectives
To evaluate the effectiveness and impact of cognitive stimulation interventions aimed at improving cognition for people with dementia, including any negative effects.

Search methods
The trials were identified from a search of the Cochrane Dementia and Cognitive Improvement Group Specialized Register, called ALOIS (updated 6 December 2011). The search termsused were: cognitive stimulation, reality orientation, memory therapy, memory groups, memory support, memory stimulation, global stimulation, cognitive psychostimulation. Supplementary searches were performed in a number of major healthcare databases and trial registers to ensure that the search was up to date and comprehensive.

Selection criteria
All randomised controlled trials (RCTs) of cognitive stimulation for dementia which incorporated a measure of cognitive change were included.

Data collection and analysis
Data were extracted independently by two review authors using a previously tested data extraction form. Study authors were contacted for data not provided in the papers. Two review authors conducted independent assessments of the risk of bias in included studies.

Main results
Fifteen RCTs were included in the review. Six of these had been included in the previous review of RO. The studies included participants from a variety of settings, interventions that were of varying duration and intensity, and were from several different countries. The quality of the studies was generally low by current standards but most had taken steps to ensure assessors were blind to treatment allocation. Data were entered in the meta-analyses for 718 participants (407 receiving cognitive stimulation, 311 in control groups). The primary analysis was on changes that were evident immediately at the end of the treatment period. A few studies provided data allowing evaluation of whether any effects were subsequently maintained. A clear, consistent benefit on cognitive function was associated with cognitive stimulation (standardised mean difference (SMD) 0.41, 95% CI 0.25 to 0.57). This remained evident at follow-up one to three months after the end of treatment. In secondary analyses with smaller total sample sizes, benefits were also noted on self-reported quality of life and well-being (standardised mean difference: 0.38 [95% CI: 0.11, 0.65]); and on staff ratings of communication and social interaction (SMD 0.44, 95% CI 0.17 to 0.71). No differences in relation to mood (self-report or staff-rated), activities of daily living, general behavioural function or problem behaviour were noted. In the few studies reporting family caregiver outcomes, no differences were noted. Importantly, there was no indication of increased strain on family caregivers in the one study where they were trained to deliver the intervention.

Authors' conclusions
There was consistent evidence from multiple trials that cognitive stimulation programmes benefit cognition in people with mild to moderate dementia over and above any medication effects. However, the trials were of variable quality with small sample sizes and only limited details of the randomisation method were apparent in a number of the trials. Other outcomes need more exploration but improvements in self-reported quality of life and well-being were promising. Further research should look into the potential benefits of longer term cognitive stimulation programmes and their clinical significance.

Cognitive stimulation to improve cognitive functioning in people with dementia

Methodology of frontal and executive function

Speech and Language Impairments in Children: Causes, Characteristics, Intervention, and Outcome

Spatiotemporal brain dynamics during preparatory set shifting: MEG evidence

Introduccion. Distintos autores han propuesto que los ninos con trastorno por deficit de atencion con hiperactividad (TDAH) presentan una alteracion en el proceso de flexibilidad cognitiva (FC). El test de clasificacion de tarjetas de Wisconsin (WCST) es uno de los tests neuropsicologicos mas empleado para evaluar este proceso. Estudios previos han descrito la presencia de un subgrupo de ninos con TDAH que presentan una baja FC. Ademas, este subgrupo muestra una alta resistencia al tratamiento con farmacos estimulantes. Objetivos. El objetivo del presente estudio fue examinar si diferentes subgrupos de TDAH presentaban distintos patrones de actividad magnetica cerebral durante la ejecucion de una tarea de FC (WCST). Pacientes y metodos. La muestra consistio en 18 ninos, divididos en tres grupos de acuerdo con los criterios diagnosticos del DSM-IV-R. En este trabajo presentamos datos preliminares basados en una submuestra de nueve ninos. Se realizo un registro de la actividad magnetica cerebral mientras los ninos realizaban el WCST, por medio de la magnetoencefalografia (MEG). Esta es una tecnica de neuroimagen no invasiva y con una elevada resolucion espaciotemporal. Resultados. Los resultados preliminares mostraron que el grupo TDAH-combinado tuvo un mayor numero de respuestas perseverativas. Ademas, este grupo presento un patron diferente de actividad magnetica cerebral, y mostro una menor activacion en el cingulo anterior y la corteza prefrontal dorsolateral del hemisferio izquierdo durante los primeros 400 ms. Conclusiones. La MEG parece ser una herramienta util para describir cual es el circuito cerebral subyacente al proceso de FC en diferentes grupos de ninos. Esto podria tener importantes repercusiones en la clasificacion del TDAH, tanto desde un punto de vista neuropsicologico como farmacologico.

Sustrato neurofuncional de la rigidez cognitiva en el trastorno por déficit de atención con hiperactividad:: resultados preliminares

Lecciones de psicología médica

/pdf/propiedades-psicometricas-de-la-escala-de-satisfaccion-con-4dm9ziuzkh.pdf

Propiedades psicométricas de la escala de satisfacción con la vida en mujeres mayores activas

Introduccion y desarrollo. Las teorias vigentes sobre el trastorno por deficit de atencion con hiperactividad (TDAH) postulan que su deficit cognitivo primario consiste en una disfuncion ejecutiva. En los ultimos anos, los estudios realizados con tecnicas de neuroimagen han aportado evidencia, tanto anatomica como funcional, que apoya la hipotesis de una disfuncion frontoestriatal en este trastorno. Sin embargo, recientes estudios de neuroimagen han encontrado alteraciones a nivel anatomico y funcional en regiones corticales posteriores, como la corteza parietal inferior y la corteza temporal posterior, que se han relacionado con una disfuncion en la atencion selectiva. Los estudios realizados con potenciales relacionados con acontecimientos discretos (PRAD) muestran que los ninos con TDAH presentan alteraciones en componentes tempranos (durante los primeros 200 ms de procesamiento), como P1 o N1, que son sensibles al efecto de la atencion selectiva. Estos hallazgos introducen dudas sobre si la disfuncion frontoestriatal/ejecutiva es el deficit primario en el TDAH. Conclusiones. Uno de los objetivos principales de la investigacion sobre el TDAH deberia ser la busqueda de su deficit cognitivo primario y de los circuitos cerebrales que lo sustentan, por las importantes repercusiones que este hecho tiene sobre su diagnostico y tratamiento. Tecnicas con elevada resolucion temporal como los PRAD o la magnetoencefalografia pueden ser especialmente utiles para discriminar en que momento del procesamiento cognitivo la actividad cerebral de los ninos con TDAH empieza a presentar alteraciones, y como consecuencia, para ayudarnos a entender cual es su deficit cognitivo primario.

Nuevas aportaciones a la neurobiología del trastorno por déficit de atención con hiperactividad desde la magnetoencefalografía

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