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BACKGROUND: Many cancer survivors experience cancer-related cognitive impairment (CRCI), often with significant negative consequences across various life domains. Emerging evidence suggests that allowing additional time to process information before acting may be a useful strategy for those with CRCI to mitigate some of its impacts. The Wisconsin Card Sorting Task (WCST), a measure of general cognition, has shown that for some cancer survivors, longer task completion time facilitates similar task performance outcomes to control populations concerning perseveration errors; a key performance metric of the WCST. However, assessing if this strategy may be useful, as well as determining for whom it may be useful, with regard to strengths and weaknesses among select cognitive domains, is challenging due to factors such as the problem of task impurity. Accordingly, this study provides an initial computational and experimental assessment of whether additional time to process information before acting is a useful strategy for those with CRCI. METHODS: We simulated individual cognitive differences observed in humans by varying contributions of executive functioning components (updating, shifting, inhibition) to yield 48 distinct computational models of the WCST. Our main manipulation was then to provide these models with more or less time (at three levels of 20, 40 and 60 cycles) before models executed an action to sort a given card. We compared the number of perseveration errors on the WCST produced by the computational models. Additionally, we determined models that simulated the performance of cancer survivors on the WCST by comparing the number of perseveration errors produced by the models to human data. RESULTS: Additional processing time resulted in the models producing significantly fewer perseveration errors, supporting our hypothesis. In addition, 8 unique models simulated the performance of cancer survivors on the WCST. Additional time appeared to have a positive influence on performance primarily by mitigating the impacts of severe inhibition impairments. For more severe global executive function impairments, a substantial amount of additional time was required to mitigate the impacts of the impairments. For the most severe impairments, additional time was unable to adequately mitigate the impact on performance. CONCLUSION: Additional processing time may be a useful strategy to rectify perseveration errors among cancer survivors with CRCI. Our findings have implications for the development of practical strategies, such as workload and deadline management in occupational settings, which may mitigate the negative effects of CRCI.
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Sobreviventes de Câncer , Disfunção Cognitiva , Função Executiva , Neoplasias , Teste de Classificação de Cartas de Wisconsin , Humanos , Neoplasias/complicações , Neoplasias/psicologia , Disfunção Cognitiva/etiologia , Função Executiva/fisiologia , Sobreviventes de Câncer/psicologia , Simulação por Computador , Masculino , FemininoRESUMO
It is not known why some novice gamblers eventually develop Gambling Disorder while most do not. This study tested predictions from two competing models of Gambling Disorder etiology: the Pathways Model of Problem and Pathological Gambling (Blaszczynski & Nower, 2002) and the Allostatic Model of addictions (Koob & Schulkin, 2019) applied to Gambling Disorder. Participants were drawn from introductory psychology courses and screened as non-gamblers (N = 91). They completed computerized versions of the Iowa Gambling Task (IGT-2), Wisconsin Sorting Task (WCST-64), and a Difficulties with Emotional Regulation Scale (DERS). Risk-taking tendencies were observed by having participants play a typical electronic slots game for up to 15 min. Higher betting on the slots game was correlated with the frequency of Deck A selections on the IGT-2 and lower total DERS scores. There were no significant correlations involving slots betting and the WCST-64. Greater risk-taking on the slots game was correlated with more frequent wins, partial losses that were disguised as wins, bonus game features, and the largest nominal amount won on a single spin. However, there were no significant correlations between betting behaviors and the 'payback percentage', defined as total winnings as a proportion of total wagers made throughout the session. Post-game ratings were positively correlated with frequency of reinforcing outcomes. These findings suggest that novice gamblers' likelihood of further gambling participation may be elevated by high sensitivity to immediate rewards and low difficulty self-regulating negative emotions. These findings are consistent with the Allostatic Model; they are not consistent with Pathways Model.
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Regulação Emocional , Jogo de Azar , Humanos , Jogo de Azar/psicologia , RecompensaRESUMO
The Wisconsin Card Sorting Test (WCST) is a popular neurocognitive task used to assess cognitive flexibility, and aspects of executive functioning more broadly, in research and clinical practice. Despite its widespread use and the development of an updated WCST manual in 1993, confusion remains in the literature about how to score the WCST, and importantly, how to interpret the outcome variables as indicators of cognitive flexibility. This critical review provides an overview of the changes in the WCST, how existing scoring methods of the task differ, the key terminology and how these relate to the assessment of cognitive flexibility, and issues with the use of the WCST across the literature. In particular, this review focuses on the confusion between the terms 'perseverative responses' and 'perseverative errors' and the inconsistent scoring of these variables. To our knowledge, this critical review is the first of its kind to focus on the inherent issues surrounding the WCST when used as an assessment of cognitive flexibility. We provide recommendations to overcome these and other issues when using the WCST in future research and clinical practice.
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Função Executiva , Teste de Classificação de Cartas de Wisconsin , Cognição , Humanos , Testes NeuropsicológicosRESUMO
Cognitive function is often impaired in early Parkinson's disease (PD). The Wisconsin Card Sorting Test (WCST) is a neuropsychological test of "set-shifting" ability. To see whether WCST is useful for detecting early changes of cognitive function in PD, we examined the correlations of WCST with the Montreal Cognitive Assessment (MoCA) and the Odor Stick Identification Test (OSIT). Subjects were 48 PD patients (age 66 ± 10 years; Hoehn & Yahr stage 2.3 ± 0.8; mean duration 3.1 ± 2.5 years). WCST sub-scores for categories achieved (CA), perseverative errors of Nelson type (PEN), and difficulties of maintaining set (DMS) were evaluated. MoCA-J (Japanese version) and OSIT-J (Japanese version) were done in that order, followed by the WCST. In PD patients, CA was 2.2 ± 2.0, PEN was 7.0 ± 6.4, and DMS was 2.3 ± 2.0, and all were worse than those of age-matched normal subjects. MoCA-J scores significantly correlated with PEN. OSIT-J scores were also significantly correlated with CA and DMS. As MoCA-J and OSIT-J show high sensitivity and specificity for detecting mild cognitive impairment in PD, WCST may also be a useful supplementary diagnostic tool for early and mild cognitive impairment in PD patients.
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Disfunção Cognitiva/diagnóstico , Técnicas de Diagnóstico Neurológico , Testes de Estado Mental e Demência , Percepção Olfatória , Doença de Parkinson/diagnóstico , Teste de Classificação de Cartas de Wisconsin , Idoso , Disfunção Cognitiva/etiologia , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicaçõesRESUMO
Although ASD (Autism Spectrum Disorder) diagnosis requires the co-occurrence of socio-emotional deficits and inflexible behaviors, the interaction between these two domains remains unexplored. We used an emotional Wisconsin Card Sorting Test adapted to fMRI to explore this question. ASD and control participants matched a central card (a face) with one of four surrounding cards according to one of three rules: frame color, facial identity or expression. Feedback informed participants on whether to change or maintain the current sorting rule. For each rule, we modeled feedback onsets to change, switch (confirming the newly found rule) and maintenance events. "Bias error", which measures participants' willingness to switch, was larger in ASD participants for the emotional sorting rule. Brain activity to change events showed no group differences. In response to switch events significantly larger activity was observed for ASD participants in bilateral Inferior Parietal Sulci. Inflexibility in ASD appears characterized by the unwillingness to switch toward processing socio-emotional information, rather than a major disruption in cognitive flexibility. However, a larger activity to switch events in ASD highlights the need for a higher level of certainty before setting into a stable processing stage, which may be particularly detrimental in the highly changeable socio-emotional environment.
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Transtorno do Espectro Autista/psicologia , Emoções/fisiologia , Incerteza , Adulto , Cognição/fisiologia , Expressão Facial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos , Adulto JovemRESUMO
Catechol-O-Methyltranferase (COMT) plays a crucial role in the removal of cortical dopamine and is strongly implicated in human executive function. Numerous studies have reported associations of the COMT Val158Met (rs4680) polymorphism with executive function in healthy subjects. However, little work has investigated this in the Thai population and the relationship of age and education with this association remains unclear. Therefore, this study was designed to investigate the association of this polymorphism of the COMT gene with executive cognitive brain function in healthy subjects and the relationship with age and education. The Wisconsin Card Sorting Test (WCST) was performed to assess executive function in 254 healthy Thai subjects (aged 20-72 years). The results showed a significant association of rs4680 with executive function, in which Val/Met heterozygotes demonstrated better cognitive set shifting performance. Moreover, Met allele carriers showed a significantly stronger effect in the categories completed score than did Val homozygotes. Furthermore, age and education also showed a significant association with COMT genotype and WCST. These results revealed that executive cognitive function is associated with COMT genotype and influenced by age and/or education level in a Thai sample.
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Catecol O-Metiltransferase/genética , Cognição , Função Executiva , Predisposição Genética para Doença , Adulto , Idoso , Alelos , Povo Asiático , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Catecóis/metabolismo , Dopamina/metabolismo , Feminino , Estudos de Associação Genética , Genótipo , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To determine whether the Short-Term Executive Plus (STEP) cognitive rehabilitation program improves executive dysfunction after traumatic brain injury (TBI). DESIGN: Randomized, waitlist controlled trial with minimization and blinded outcome assessment. SETTING: Community. PARTICIPANTS: Participants with TBI and executive dysfunction (N=98; TBI severity 50% moderate/severe; mean time since injury ± SD, 12±14y; mean age ± SD, 45±14y; 62% women; 76% white). INTERVENTION: STEP program: 12 weeks (9h/wk) of group training in problem solving and emotional regulation and individual sessions of attention and compensatory strategies training. MAIN OUTCOME MEASURES: Factor analysis was used to create a composite executive function measure using the Problem Solving Inventory, Frontal Systems Behavior Scale, Behavioral Assessment of the Dysexecutive Syndrome, and Self-Awareness of Deficits Interview. Emotional regulation was assessed with the Difficulties in Emotion Regulation Scale. The primary attention measure was the Attention Rating and Monitoring Scale. Secondary measures included neuropsychological measures of executive function, attention, and memory and measures of affective distress, self-efficacy, social participation, and quality of life. RESULTS: Intention-to-treat mixed-effects analyses revealed significant treatment effects for the composite executive function measure (P=.008) and the Frontal Systems Behavior Scale (P=.049) and Problem Solving Inventory (P=.016). We found no between-group differences on the neuropsychological measures or on measures of attention, emotional regulation, self-awareness, affective distress, self-efficacy, participation, or quality of life. CONCLUSIONS: The STEP program is efficacious in improving self-reported post-TBI executive function and problem solving. Further research is needed to identify the roles of the different components of the intervention and its effectiveness with different TBI populations.
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Lesões Encefálicas/reabilitação , Função Executiva , Adulto , Atenção , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/reabilitação , Resolução de Problemas , Qualidade de Vida , Autoeficácia , Autoavaliação (Psicologia) , Participação Social , Fatores Socioeconômicos , Índices de Gravidade do TraumaRESUMO
The prevalence of obesity is increasing worldwide. Previous research has shown a relationship between obesity and both executive functioning alterations and frontal cortex volume reductions. The Brain Derived Neurotrophic Factor val66met polymorphism, involved in eating behavior, has also been associated with executive functions and prefrontal cortex volume, but to date it has not been studied in relation to obesity. Our aim is to elucidate whether the interaction between the Brain Derived Neurotrophic Factor val66met polymorphism and obesity status influences executive performance and frontal-subcortical brain structure. Sixty-one volunteers, 34 obese and 27 controls, age range 12-40, participated in the study. Participants were assigned to one of two genotype groups (met allele carriers, n = 16, or non-carriers, n = 45). Neuropsychological assessment comprised the Trail Making Test, the Stroop Test and the Wisconsin Card Sorting Test, all tasks that require response inhibition and cognitive flexibility. Subjects underwent magnetic resonance imaging in a Siemens TIM TRIO 3T scanner and images were analyzed using the FreeSurfer software. Analyses of covariance controlling for age and intelligence showed an effect of the obesity-by-genotype interaction on perseverative responses on the Wisconsin Card Sorting Test as well as on precentral and caudal middle frontal cortical thickness: obese met allele carriers showed more perseverations on the Wisconsin Card Sorting Test and lower frontal thickness than obese non-carriers and controls. In conclusion, the Brain Derived Neurotrophic Factor may play an important role in executive functioning and frontal brain structure in obesity.
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Fator Neurotrófico Derivado do Encéfalo/genética , Função Executiva/fisiologia , Obesidade/genética , Polimorfismo Genético , Córtex Pré-Frontal/patologia , Adolescente , Adulto , Alelos , Criança , Cognição/fisiologia , Feminino , Genótipo , Humanos , Masculino , Testes Neuropsicológicos , Polimorfismo Genético/genética , Adulto JovemRESUMO
Amnestic mild cognitive impairment (aMCI) is defined by memory impairment but executive function (EF) deficits could be also a common feature. This study examined the underlying neurocognitive processes associated with executive function (EF) deficits in patients with aMCI using the Wisconsin Card Sorting Test (WCST) and computational modeling. Forty-two patients with aMCI and thirty-eight matched Controls performed the WSCT and underwent neurocognitive assessment. The Attentional Learning Model was applied the WCST. Patients with aMCI demonstrated deficits in feedback-learning. More specifically, patients showed increased Reward-Sensitivity and reduced Punishment-Sensitivity. These alterations were associated with poor WSCT performance and deficits in EF and Memory. Goal-directed deficits in aMCI, as observed in the WCST, are associated with difficulties in updating attention after feedback as its changes too rapidly following positive feedback and too slowly following negative feedback. Consequently, memory and EF deficits interact and reinforce each other generating performance deficits in patients with aMCI.
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Amnésia , Disfunção Cognitiva , Função Executiva , Punição , Recompensa , Humanos , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/etiologia , Masculino , Feminino , Função Executiva/fisiologia , Idoso , Pessoa de Meia-Idade , Amnésia/fisiopatologia , Atenção/fisiologia , Testes Neuropsicológicos , Memória/fisiologia , Teste de Classificação de Cartas de WisconsinRESUMO
Objectives: This study aims to evaluate the efficacy of repeated transcranial magnetic stimulation (rTMS) combined with fluoxetine in enhancing the early antidepressant response in first-episode adolescent depression cases, providing insights for patient diagnosis and treatment. Methods: One hundred and thirty-five adolescents experiencing their first depressive episode were randomly assigned to either a sham group treated with fluoxetine or to low or high repetitive transcranial magnetic stimulation (rTMS) groups receiving both rTMS and fluoxetine. Therapeutic effects were assessed by comparing changes in Hamilton Depression Scale (HAMD-17) scores, cognitive function scores from the Wisconsin Card Sorting Test (WCST), and Clinical Global Impression-improvement (CGI-I) scores, along with recording adverse reactions. Results: The total effectiveness rate in the rTMS groups (Low, 95.56%; High, 97.78%) was significantly higher than in the Sham rTMS group (80%) (F = 11.15, P<0.0001). Post-treatment, not only the Low but also the High rTMS group exhibited more significant reductions in HAMD-17 (Low, 21.05; High, 21.45) and CGI-I scores (Low, 3.44; High, 3.60) compared to the Sham rTMS group (HAMD-17, 16.05; CGI-I, 2.57) (two weeks: F = 7.889, P = 0.0006; four weeks: F = 15.900, P<0.0001). Additionally, the two rTMS groups exhibited fewer erroneous responses and persistent errors in the WCST and completed more WCST categorizations than the Sham rTMS group. There was no significant difference in adverse reaction rates between the groups (F=4.421, P=0.0794). Conclusions: The combination of fluoxetine with rTMS demonstrates enhanced therapeutic effectiveness in treating adolescent depression, effectively controlling disease progression, reducing depressive symptoms, and improving cognitive function, making it a valuable clinical approach.
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(1) Background: Schizophrenia is a chronic and progressive neuropsychiatric illness. Apart from positive and negative symptoms, 98% of the population diagnosed with schizophrenia have impaired cognitive functioning, which significantly influences the quality of life. The correlation between lipids and cognitive functioning has been well established. Our study aimed to investigate correlations between cognitive functions, the severity of schizophrenia symptoms, and lipid profiles. (2) Methods: Fifty-two women diagnosed with schizophrenia participated in this study. Cognitive functioning was measured using the Wisconsin Card Sorting Test (WCST). The Positive and Negative Symptom Scale (PANSS) was used. The serum lipid profile, including low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), and triglycerides was measured. (3) Results: Better cognitive functions were associated with normal HDL levels, while low HDL levels correlated with worse WSCT scores. Only the PANSS negative subscale showed a correlation with HDL levels. Correlations with chronicity of schizophrenia and the patient's age with poorer cognitive functions, but not with symptom severity, were detected. Early/late age at onset did not influence WSCT scores. (4) Conclusions: Our results suggest high HDL levels might be a protective factor against cognitive impairment. The influences of age and illness duration also play a vital role in cognitive performance.
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Cognitive flexibility (CF) is the ability to shift between concepts or rules. Difficulty with CF is associated with autism (i.e., ASD) as it contributes to repetitive behaviours. However, little is known about CF skills of autistic adolescents with low intelligence. This study uses the Wisconsin Card Sorting Task (WCST) to assess the CF of 36 adolescents, all with a Weschler full-scale IQ between 50 and 85, 14 of whom had an ASD diagnosis. The results indicated no statistically significant differences in WCST performance between those with and without ASD. It was also found that performance IQ significantly contributed to the WCST performance in the ASD group only, suggesting an autism-specific role of non-verbal cognitive functioning in CF.
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Transtorno do Espectro Autista , Transtorno Autístico , Humanos , Adolescente , Transtorno Autístico/psicologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Cognição , Testes de Inteligência , Inteligência , Testes Neuropsicológicos , Função ExecutivaRESUMO
BACKGROUND: Computerized neuropsychological tests provide advantages to clinicians with cost, administration, and time. However, studies have pointed out performance differences between manual and computerized versions of some neuropsychological tests. One of these is the Wisconsin Card Sorting Test (WCST). Due to the performance difference, the normative data of manual tests cannot be used for their computerized versions. Therefore, normative data searches are needed for computerized versions. OBJECTIVE: This study aimed to determine the norm values of WCST-CV in a healthy sample. METHODS: 422 healthy adults aged 18-78 participated in this study. WCST-CVsub-scores are modeled by Regression Analysis based on Age and Education level to generate normative data. Among the 13 WCST scores, the regression models for WCST 2, WCST 3, WCST 4, WCST 10, and WCST 11 are significant. WCST 2, WCST 4, and WCST 11 scores are estimated with Ordinary Least Squares (OLS). However, WCST 3 and WCST 10 scores are estimated with Weighted Least Squares (WLS) due to the violation of the homoscedasticity assumption. RESULTS: The regression results show that p-values calculated from error increase as age and education level increase. CONCLUSION: As a result of our research, norm values between 18-78 years of age were produced using RA. It was determined that gender was not significant for any sub-score. Therefore, only age and education level from socio-demographic variables were included in the model.
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Teste de Classificação de Cartas de Wisconsin , Adulto , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Testes Neuropsicológicos , Valores de ReferênciaRESUMO
Children with developmental language disorder (DLD) demonstrate deficits in executive functioning; however, the specific components of executive functioning that are affected in this population are not well understood. This study evaluated set shifting and feedback processing in a Wisconsin Card Sorting Test (WCST) performed by 24 children with and without DLD. The behavioral results revealed poorer performance by the DLD group in measures of accuracy, proportion of correct rule shifts, perseverative errors on shift trials, and proportion of effective responses to feedback. Electrophysiological measures (event-related potentials, or ERPs) indicated different patterns of response to negative feedback that signaled the need for rule shifting, with the DLD group showing a trend toward processing shift cues as negative feedback. Group differences were found in the processing of the first and last positive feedback, with overall stronger responses to positive feedback by children with DLD. However, both groups showed a similar pattern of diminished attention to positive feedback when rule learning was established. Taken together, children with DLD demonstrated the inefficient processing of negative feedback in the context of rule-shifting and difficulty in establishing and maintaining a rule.
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Individuals with autism spectrum disorder (ASD) are characterized by impairments in flexibly acquiring and maintaining new information, as well as in applying learned information for problem solving. However, the neural mechanism underpinning such impairments remains unclear. This study investigated the flexibility in the acquisition and application of visual information in ASD (aged 14−21) when they performed the Wisconsin Card Sorting Test (WCST). Behavioral data including response accuracy and latency, and prefrontal hemodynamic data measured by functional near-infrared spectroscopy (fNIRS), were collected when individuals performed WCST. Canonical general linear model and functional connectivity analyses were performed to examine the prefrontal activation and synchronization patterns, respectively. Results showed that although ASD individuals (n = 29) achieved comparable accuracy rates when compared with age- and intelligence quotient (IQ)-matched typically developing (TD; n = 26) individuals (F1,53 = 3.15, p = 0.082), ASD individuals needed significantly more time to acquire and apply WCST card sorting rules (F1,53 = 17.92, p < 0.001). Moreover, ASD individuals showed significantly lower prefrontal functional connectivity than TD individuals during WCST (F1,42 = 9.99, p = 0.003). The hypoconnectivity in ASD individuals was highly significant in the right lateral PFC in the acquisition condition (p = 0.005) and in the bilateral lateral PFC in the application condition (ps = 0.006). Furthermore, slower WCST reaction time was correlated with lower bilateral lateral PFC functional connectivity only in the application condition (ps = 0.003) but not the acquisition condition. Impairment in information acquisition and application is evident in ASD individuals and is mediated by processing speed, which is associated with lower functional connectivity in the bilateral lateral PFC when these individuals apply learned rules to solve novel problems.
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BACKGROUND: The role of executive functions (EF) is to maintain particular behaviours in order to achieve intended goals. EF are crucial in management of pre-diabetes, diabetes and obesity which are grievous diseases and can lead to severe complications. The aims of our study were to: assess EF in group of obese subject with carbohydrate disorders, evaluate whether biochemical factors and comorbidities related to metabolic disorders have adverse effect on EF in this group of patients. METHODS: The study included 185 obese patients (146 women; 39 men) who were divided on three groups: pre-diabetic, diabetic and control subgroup. Patient underwent Wisconsin Card Sorting Test (WCST) to evaluate EF. Assessed biochemical factors included C-peptide, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c). RESULTS: Diabetic patients showed the worst WCST scores among the rest of groups. Pre-diabetic individuals did not differ in EF performance from control subgroup. We observed significant correlations between FPG and HbA1c and worse WCST scores in pre-diabetic subgroup. In diabetic patients C-peptide correlated with poorer EF. Depressive symptoms and hypertension significantly correlated with non-perseverative errors in WCST. CONCLUSIONS: The subgroup of diabetic patients were the most obese and had the worst glycemia parameters. They also showed the worst EF in WCST. According to obtained results, hyperglycemia positively correlated with poor EF in pre-diabetes. However, in diabetic subjects cognitive deterioration may results from insulin resistance rather than hyperglycemia. In obese individuals with carbohydrate disorders both hypertension and depressive symptoms significantly contributed to EF dysfunction.
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Diabetes Mellitus , Hiperglicemia , Hipertensão , Estado Pré-Diabético , Peptídeo C/metabolismo , Metabolismo dos Carboidratos , Diabetes Mellitus/metabolismo , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hiperglicemia/metabolismo , Hipertensão/metabolismo , Masculino , Obesidade/complicações , Obesidade/metabolismo , Córtex Pré-FrontalRESUMO
The Fist-Edge-Palm (FEP) task, a manual hand task, has been used to detect frontal dysfunctions in clinical situations: its performance failures are observed in various prefrontal cortex (PFC)-related disorders, including schizophrenia. However, previous imaging studies reported that the performance of the FEP task activated motor-related areas, but not the PFC. Here, we aimed to investigate the relationships between the performance of the FEP task and PFC functions. Hemodynamic activity in the PFC, including the dorsolateral PFC (area 46) and frontal pole (area 10), was recorded. Healthy young subjects performed the FEP task as well as a palm tapping (PT) task (control task) three times. The subjects also completed a Wisconsin Card Sorting Test (WCST) and Schizotypal Personality Scale (STA) questionnaire. We found that hemodynamic activity (Oxy-Hb) in the PFC increased in the first trial of the FEP task but decreased considerably in the second and third trials compared to the PT task. The number of performance errors in the FEP task also decreased in the second and third trials. Error reduction (i.e., learning) in the FEP task between the first and second trials was negatively correlated with schizotypal trait and the number of perseveration errors in the WCST. Furthermore, changes in the PFC hemodynamic activity between the first and second trials were positively correlated with error reduction in the FEP task between the first and second trials, and negatively correlated with the number of perseveration errors in the WCST. These results suggest that learning in the FEP task requires PFC activation, which is negatively associated with perseveration errors in the WCST. The results further suggest that the FEP task, in conjunction with near-infrared spectroscopy, may be useful as a diagnostic method for various disorders with PFC dysfunction.
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BACKGROUND: Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are commonly observed and typically assessed using tests like the Wisconsin Card Sorting Test (WCST). However, the structure of executive deficits remains unclear, and the underlying processes may be different. This study aimed to explore and compare the network structure of WCST measures in patients with psychosis and their unaffected siblings and to empirically validate the resulting network structure of the patients. METHODS: The subjects were 298 patients with a DSM 5 diagnosis of a psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the WCST were examined by means of exploratory graph analysis (EGA) and network centrality parameters. RESULTS: The WCST network structure comprised 4 dimensions: perseveration (PER), inefficient sorting (IS), failure to maintain set (FMS) and learning (LNG). The patient and sibling groups showed a similar network structure, which was reliably estimated. PER and IS showed common and strong associations with antecedent, concurrent and outcome validators. The LNG dimension was also moderately associated with these validators, but FMS did not show significant associations. CONCLUSIONS: Four cognitive processes underlying WCST performance were identified by the network analysis. PER, IS and LNG were associated with and shared common antecedent, concurrent and outcome validators, while FMS was not associated with external validators. These four underlying dysfunctions might help disentangle the neurofunctional basis of executive deficits in psychosis.
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Disfunção Cognitiva , Transtornos Psicóticos , Disfunção Cognitiva/etiologia , Função Executiva , Humanos , Testes Neuropsicológicos , Transtornos Psicóticos/complicações , Irmãos/psicologiaRESUMO
The aims of Study 1 (S1) were (a) to compare the task performance of 361 typically developing (TD) children aged 7 to 12 years, according to the mode of Wisconsin Card Sorting Test (WCST) administration (manual vs. computerized) and b) to examine the contributions of executive functions (EFs) (i.e., working memory [WM], shifting and inhibition) to each WCST version. The objectives of Study 2 (S2) were (a) to study the comparability of the results obtained from the manual version to the results from the computer version in 43 children with Attention Deficit/Hyperactivity Disorder (ADHD) and (b) to compare task performance on both versions between children with ADHD and TD children. The effect of age was only significant for the manual WCST. Regression analyses revealed that WM and shifting contributed to manual WCST performance, whereas WM and inhibition contributed to the performance on the computer version. We observed differences depending on the WCST mode of administration, as better scores for the manual version were recorded for both TD children and children with ADHD, despite similar performance on tasks involving other EFs. Additionally, children with ADHD performed worse than TD children on both versions. Our findings suggest that verbal face-to-face interactions would play a significant role in supporting children's abilities to solve novel situations characterized by uncertainty.
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Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Desenvolvimento Infantil/fisiologia , Função Executiva/fisiologia , Inibição Psicológica , Memória de Curto Prazo/fisiologia , Desempenho Psicomotor/fisiologia , Teste de Classificação de Cartas de Wisconsin/normas , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Diagnóstico por Computador/normas , Feminino , Humanos , MasculinoRESUMO
Positive or negative feedback is usually used to maintain or shift a sorting rule in the Wisconsin Card Sorting Test (WCST). Previous studies have demonstrated that negative feedback evokes a larger P3 than positive feedback. However, it is unclear whether the neural response is different for negative feedback appearing at different stages of the WCST. We compared ERPs evoked by the negative feedback appearing at the rule-switching stage (switch-NF) with those appearing at the rule-learning stage (learn-NF) in a modified WCST. Results indicated that: 1) switch-NF evoked a longer N1 latency than learn-NF, 2) switch-NF evoked a delayed and larger N2 component than learn-NF, particularly at the frontal and central electrodes, 3) P3 latency was shorter and the P3 amplitude was larger in learn-NF than in switch-NF. These findings suggest that in the different stages of the WCST, negative feedback implied different involvement of attention, inhibition control, and context updating.