Neurodevelopmental Follow-Up of Children Born to Mothers with Graves' Disease and Neonatal Hyperthyroidism.

INTRODUCTION: Neonatal hyperthyroidism, often caused by maternal Graves' disease (GD), carries potential neurodevelopmental risks for children. Excessive thyroid hormones during fetal development are linked to neurological issues like ADHD and epilepsy. However, the impact of transient neonatal hyperthyroidism is not well understood. METHODS: In a retrospective study at the Royal Children's Hospital in Melbourne, 21 neonates with hyperthyroidism from mothers with GD were examined. Of these, the parents of 10 children consented to participate; thus, questionnaires assessing executive functions, behavior, and social communication were completed. The outcomes were compared to those of control subjects recruited from the community using standardized tools (BRIEF, SDQ, SCQ). The results were analyzed against socio-demographic factors, maternal, and neonatal health. RESULTS: No significant demographic or clinical differences were found between study participants (n = 10) and non-participants (n = 11). Participants, compared to controls, showed similar family demographics but a higher proportion of control parents had university-level education (p = 0.003). Patients displayed more social (SCQ scores: 12.1 ± 2.5 vs. 6 ± 1.07, p = 0.008) and behavioral difficulties (SDQ scores: 10.2 ± 2.17 vs. 6.14 ± 1.03, p = 0.03), with increased executive function challenges (BRIEF scores indicating problem-solving and self-regulation difficulties). Significant effects of family living situation and partner education level on neurodevelopmental measures were noted, underscoring the influence of socio-demographic factors. CONCLUSIONS: These findings suggest neonatal hyperthyroidism might lead to subtle neurodevelopmental variations, with socio-economic elements and family dynamics possibly intensifying these effects. While most children did not show severe impairments, early detection and intervention are recommended. The research emphasizes the necessity for inclusive care approaches that consider socio-economic factors for children affected by neonatal hyperthyroidism.

Socioeconomic position and executive functioning from childhood to young adulthood: Evidence from Santiago, Chile.

BACKGROUND: Optimizing cognitive development through early adulthood has implications for population health. This study aims to understand how socioeconomic position (SEP) across development relates to executive functioning. We evaluate three frameworks in life-course epidemiology - the sensitive period, accumulation, and social mobility hypotheses. METHODS: Participants were young adults from Santiago, Chile who were studied from 6 months to 21 years. Family SEP was measured at ages 1 y, 10 y, and 16 y with the modified Graffar Index. Executive functioning was assessed at ages 16 y and 21 y by the Trail Making Test Part B (Trails B). Analyses estimating 16 y and 21 y executive function involved 581 and 469 participants, respectively. Trails B scores were modeled as a function of SEP at 1 y, 10 y, and 16 y, as the total accumulation of disadvantage, and as change in SEP between 1 y and 10 y and between 10 y and 16 y. RESULTS: Participants were low- to middle-income in infancy and, on average, experienced upwards mobility across childhood. Half of participants (58%) improved Trails B scores from 16 y and 21 y. Most (68%) experienced upward social mobility between infancy and 16 y. When examined independently, worse SEP measured at 10 y and 16 y related to worse (longer time to complete) Trails B scores at Age 21 but did not relate to the other outcomes. After mutual adjustment as a test of the sensitivity hypothesis, no SEP measure was independently related to any outcome. Testing the accumulation hypothesis, cumulative low SEP was associated with worse cognitive performance at 21 y (ß = 3.6, p = 0.04). Results for the social mobility hypothesis showed no relation to cognitive scores or to change in cognitive scores. Comparing all hypotheses, SEP at 16 y explained the most variability in executive functioning at 21 y, providing support for the sensitive period hypothesis. CONCLUSIONS: Results indicate that experiencing cumulatively low socioeconomic position from infancy to adolescence can have a negative impact on cognitive functioning in young adulthood. Findings also provide evidence in support of adolescence as a key developmental period during which SEP can most strongly impact cognitive functioning.

Social cognition across bipolar disorder and behavioral-variant frontotemporal dementia: an exploratory study

Objectives: Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD. Methods: We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing. Results: Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and bvFTD did not differ regarding FER or mFP total scores, although patients with bvFTD had significantly higher difficulties than those in the BD1 group to detect social faux-pas (p < 0.001, d = 1.35). Conclusion: BD1 and bvFTD share deficits in the core SC functions. These findings should be considered in the development of tasks aiming to improve clinical differentiation between the two disorders.

Social cognition across bipolar disorder and behavioral variant frontotemporal dementia: an exploratory study.

OBJECTIVES: Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD. METHODS: We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing. RESULTS: Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and bvFTD did not differ regarding FER or mFP total scores, although patients with bvFTD had significantly higher difficulties than those in the BD1 group to detect social faux-pas (p < 0.001, d = 1.35). CONCLUSION: BD1 and bvFTD share deficits in the core SC functions. These findings should be considered in the development of tasks aiming to improve clinical differentiation between the two disorders.

Emotion Regulation and Executive Function: Associations with Depression and Anxiety in Autism.

Background: Adolescents and young adults with autism spectrum disorder (ASD) are prone to experience co-occurring mental health conditions such as mood or anxiety disorders, as well as impairments in emotion regulation and executive functioning. However, little research has examined inter-relationships among these constructs, despite evidence of additional stressors and increased risk of internalizing disorders at this age, relative to non-autistic individuals. If either emotion regulation or executive functioning are shown to have patterns of association with mental health, this can inform mechanism-based intervention. Method: Fifty-seven autistic adolescents and adults (16-25 years) with ASD in a transition intervention completed questionnaires and clinician-administered measures at baseline. Analyses assessed whether executive functioning impairment, above and beyond emotion regulation impairment, were associated with depression and anxiety symptoms. Results: ASD characteristics, emotion regulation, anxiety, and depression were significantly correlated. ASD characteristics was a significant contributor to depression and emotion regulation impairments were significant contributors to anxiety and depression. Findings indicated that inhibition difficulties did not uniquely contribute to depression or anxiety above emotion regulation impairment. Difficulties in cognitive flexibility were associated with depression above and beyond ASD characteristics, IQ, and emotion regulation, but not associated with anxiety. Conclusions: Although preliminary, findings suggest that inflexibility and regulatory impairment should be considered in depression remediation approaches. Improving ER, on the other hand, may have broader transdiagnostic impact across both mood and anxiety symptoms in ASD.

Executive Functions Contribute to the Differences Between ADHD and Sluggish Cognitive Tempo (SCT) in Adults.

OBJECTIVES: This paper analyses the relationship between sociodemographic variables, executive dysfunctions, Sluggish Cognitive Tempo (SCT) and the mainly dimensions of ADHD: hyperactivity-impulsivity (ADHD-H/I) and inattention (ADHD-IN) in Brazilian adults. METHOD: A cross-sectional, exploratory, and comparative design was used. A total of 446 participants (295 women) aging from 18 to 63 years old (M = 3,499 years, SD = 10.7) were recruited on the internet. Correlations, t independent tests and regressions were conducted. RESULTS: Higher scores in ADHD dimensions were associated to more executive functioning problems and time perception distortions in comparison to those participants without significant ADHD symptoms. However, ADHD-IN dimension as well as SCT were higher associated with these dysfunctions than ADHD-H/I. The regression results showed that ADHD-IN was more related to Self-Management to time while ADHD-H/I to Self-Restraint and SCT to Self-Organization/Problem Solving. CONCLUSION: This paper contributed to the distinction between SCT and ADHD in adults in important psychological dimensions.

Cognitive Processes and Legal Capacity in Patients With Bipolar Disorder: A Brief Research Report.

The current study verified the association between cognitive process such as attention, executive functioning, and legal capacity in patients with bipolar disorder (BD). The sample consisted of 72 participants, assorted to episodic patients (n = 21), euthymic patients (n = 22), and healthy controls (HCs) (n = 29). We used the following neuropsychological measures: subtests of the Wechsler Abbreviated Intelligence Scale (WASI): vocabulary and matrix reasoning; Continuous Performance Test (CPT); Five Digit Test (FDT); and Rey-Osterrieth Complex Figure (ROCF). Euthymic patients expressed slower processing speed (FDT) compared to HC. They tended to make more errors with slightly worse discrimination, suggesting more impulsiveness (CPT, p < 0.01). On the contrary, episodic patients showed worse discrimination, committed more omissions, were more inconsistent with regard to response speed (CPT-3, p < 0.01), showed more difficulties in organizing their actions (ROCF: copy, p = 0.03), and were more rigid (FDT: flexibility, p = 0.03). The results suggest that bipolar patients in episode express more cognitive impairments that can compromise the quality of legal capacity. These results highlight the need for more protective support for episodic BD patients regarding legal capacity.

Relación entre funciones ejecutivas y la competencia social, en menores que se desvinculan del conflicto armado en Colombia / Relationship between executive functions and social competence, in minors who disassociate themselves from the armed conflict in Colombia

Resumen. El presente estudio tuvo por objetivo determinar el perfil del funcionamiento ejecutivo (Dorsal y orbital) y el tipo de relación con la competencia social que tiene que ver con lo que es socialmente correcto, en una población de menores que se desvinculan del conflicto armado en Colombia. El alcance de la propuesta fue descriptivo-correlacional. El diseno cuasi experimental, de orden longitudinal para la recolección de los datos relacionados con la evaluación neuropsicológica y la evaluación de la competencia social. De carácter cuantitativo, se evaluaron las variables a través de instrumentos estandarizados y sus puntuaciones son de tipo numérico. Se encontró un coeficiente de correlación mùltiple de R=0.759, entre las FE, y la criterio (competencia social) por lo tanto el 57.6% de la variabilidad de lo que se considera Socialmente Correcto, puede explicarse por las variables predictoras contempladas en el modelo. El ajuste del modelo puede considerarse alto. Así mismo, el valor de significancia permite comprobar que la regresión entre las variables independientes y la variable dependiente es significativa. Con ello se rechaza la hipótesis nula (p=0,001). Y se acepta la existencia de relaciones directas/inversas entre el funcionamiento ejecutivo y la competencia social que hace referencia a lo que es socialmente correcto.

Abstract. The objective of the present study was to establish the relationship between the profile of executive functioning and social competence that has to do with what is socially correct, in a population of 70 minors who disassociate themselves from the armed conflict in Colombia. The scope of the proposal was descriptive-correlational. The design we used was quasi-experimental, longitudinal in order to collect the data related to the neuropsychological evaluation and the evaluation of social competence. It is quantitative in nature; the variables were evaluated through standardized and valid instruments. We find positive and negative relationships between executive functions and social competence; that is, the alternative hypothesis of the research is accepted, in which we propose the existence of direct relationships between executive functioning and social competence.

The impact of preterm birth on the executive functioning of preschool children: A systematic review.

This paper presents a systematic review of the impact of preterm childbirth on the later executive functioning of preschool-aged children. A systematic search for studies published between 2014 and 2019 was performed using the following keywords: executive funct* AND preterm AND child. The methodological quality of the reports was examined using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Thirty-two studies were reviewed and scored at least 67% on the methodological quality assessment. In comparison to children born full-term, preschool children born preterm exhibit executive functioning deficits in the dimensions of the global index, inhibitory control, cognitive flexibility, working memory, and planning/executive functioning. These findings are independent of the degree of prematurity at birth. Since executive functioning has many complex components, future studies should assess the dimensions of executive functioning separately in preschool-aged children born preterm, rather than as a single measure.

Culturally relevant stressors as moderators of intergenerational transmission of mother-adolescent executive function in Mexican immigrant families.

The intergenerational transmission of executive function may be enhanced or interrupted by culturally salient environmental stressors that shape the practice of executive function in the family. Building upon past research, the current study tests whether culturally relevant stressors such as economic stress and foreigner stress have a direct effect on adolescent executive function, as well as whether they modify the intergenerational transmission of mother-child executive function (i.e., working memory, inhibitory control, and shifting) in low-income Mexican immigrant families. The sample consists of 179 Mexican American adolescents (Mage = 17.03 years; SDage = 0.83; 58% females) and their Mexico-born mothers (Mage = 43.25 years; SDage = 5.90). Results show that mothers' perceived economic stress is associated with poor inhibitory control in adolescents. Low levels of mothers' perceived foreigner stress related to a stronger association between mothers' and adolescents' working memory, while high levels of mothers' perceived foreigner stress related to enhanced intergenerational transmission of poor shifting ability. Study findings demonstrate the prominence of perceived foreigner stress as a contextually relevant factor moderating the intergenerational transmission of mother-child executive function in low-income Mexican immigrant families.

Manic morbidity and executive function impairment as determinants of long-term psychosocial dysfunction in bipolar disorder.

OBJECTIVE: In this study, we aimed to evaluate the role of cognitive performance and measures of clinical course-including both syndromal and subsyndromal symptomatology-as determinants of the functional outcome of patients with Bipolar Disorder (BD) during a mean follow-up period of more than 4 years. METHODS: Seventy patients with euthymic BD completed a neurocognitive battery at study entry. Clinical course was assessed prospectively for a period longer than 48 months by two measures: time spent ill (documented using a modified life charting technique) and density of affective episodes (defined as the number of depressive and hypo/manic episodes per year of follow-up). Psychosocial functioning was assessed during euthymia using the Functioning Assessment Short Test (FAST) total score at the end of follow-up period. RESULTS: Baseline deficits in phonological fluency, a measure of executive functions (ß = -2.49; 95% CI = -3.98, -0.99), and density of hypo/manic episodes during follow-up (ß = 6.54; 95% CI = 0.43, 12.65) were independently associated with FAST total score at the end of study. CONCLUSIONS: Although interrelated, manic morbidity and executive function impairments independently contribute to long-term psychosocial dysfunction in BD and could be potential targets of intervention.

Hydroxyurea Use Associated with Nonverbal and Executive Skills in Sickle Cell Anemia.

OBJECTIVE: Hydroxyurea (HU) is used in children with sickle cell disease (SCD) to increase fetal hemoglobin (HF), contributing to a decrease in physical symptoms and potential protection against cerebral microvasculopathy. There has been minimal investigation into the association between HU use and cognition in this population. This study examined the relationship between HU status and cognition in children with SCD. METHODS: Thirty-seven children with SCD HbSS or HbS/ß0 thalassaemia (sickle cell anemia; SCA) ages 4:0-11 years with no history of overt stroke or chronic transfusion completed a neuropsychological test battery. Other medical, laboratory, and demographic data were obtained. Neuropsychological function across 3 domains (verbal, nonverbal, and attention/executive) was compared for children on HU (n = 9) to those not taking HU (n = 28). RESULTS: Children on HU performed significantly better than children not taking HU on standardized measures of attention/executive functioning and nonverbal skills. Performance on verbal measures was similar between groups. CONCLUSIONS: These results suggest that treatment with HU may not only reduce physical symptoms, but may also provide potential benefit to cognition in children with SCA, particularly in regard to attention/executive functioning and nonverbal skills. Replication with larger samples and longitudinal studies are warranted.

Desenvolvimento e propriedades psicométricas do Teste Informatizado de Avaliação das Funções Executivas / Development and psychometric properties of the Computerized Executive Functions Assessment Test / Desarrollo y propiedades psicométricas del Test Informatizado de Evaluación de las Funciones Ejecutivas

Funções executivas (FE) são habilidades que permitem o autocontrole comportamental e cognitivo e estão relacionadas a diversos desfechos ao longo da vida. O uso de testes informatizados para avaliar as FE pode facilitar a precisão dos registros, a padronização e a análise dos dados. Este estudo objetivou desenvolver um instrumento informatizado para avaliar FE em crianças de 4 a 10 anos e analisar características psicométricas. Foram conduzidas cinco etapas: 1) Definição teórica e metodológica; 2) Construção dos itens; 3) Estudo piloto; 4) Análise de juízes; e 5) Estudos psicométricos de validade e fidedignidade. As tarefas informatizadas mostraram-se adequadas para o público-alvo, conforme avaliação dos juízes. As diferentes tarefas de memória de trabalho, inibição e flexibilidade cognitiva apresentaram correlações significativas entre si e a maioria das medidas no teste-reteste evidenciou estabilidade na mensuração. Portanto, os resultados sugerem viabilidade para uso do instrumento no contexto brasileiro. (AU)

Executive functions (EF) are skills linked to behavioral and cognitive self-control and are related to various outcomes throughout life. The use of computerized tests to evaluate EFs can facilitate the accuracy of records, standardization and data analysis. This study aimed to develop a computerized instrument for the EF assessment of children aged 4 to 10 years, and to seek psychometric evidence. Five steps were carried out: 1) Theoretical and methodological definition; 2) Construction of the items; 3) Pilot study; 4) Analysis of experts; and 5) Psychometric studies of validity and reliability. The computerized tasks proved to be suitable for the target audience according to the expert's evaluation. The results between the different tasks of working memory, inhibition and cognitive flexibility showed significant correlations and most test-retest measures showed stability in the measurement. Therefore, the results indicate the feasibility of using the instrument in the Brazilian context. (AU)

Funciones ejecutivas (FE) son habilidades que permiten el autocontrol conductual y cognitivo y están relacionadas con diversos resultados a lo largo de la vida. El uso de tests informatizados para evaluar las FE puede facilitar la precisión de los registros, la estandarización y el análisis de datos. Este estudio tuvo como objetivo desarrollar un instrumento informatizado para la FE para niños de 4 a 10 años, y analizar evidencias psicométricas. Fueron ejecutados cinco pasos: 1) Definición teórica y metodológica; 2) Construcción de los ítems; 3) Estudio piloto; 4) Análisis de jueces; y 5) Estudios psicométricos de validez y fiabilidad. Las tareas informatizadas demostraron ser adecuadas para el público objetivo según la evaluación de los jueces. Las diferentes tareas de memoria de trabajo, inhibición y flexibilidad cognitiva mostraron correlaciones significativas entre sí y la mayoría de las medidas test-retest presentaron estabilidad en la medición. Por lo tanto, los resultados sugieren la viabilidad del instrumento para el contexto brasileño. AU)

Domains of awareness in Alzheimer's disease: The influence of executive function.

OBJECTIVE: Awareness is a developing area in dementia research and the evaluation of its domains has been increasingly included as part of care for people with Alzheimer's disease (PwAD). Our aim is to examine whether executive dysfunction is associated with awareness domains. METHODS: A consecutive series of 75 people with mild-to-moderate Alzheimer's disease completed assessments about global cognitive function, executive functioning, and their awareness of disease. Their primary caregivers' dyad provided information about demographics, awareness of disease, dementia severity, neuropsychiatric symptoms, and functional status. RESULTS: Different types of executive dysfunction were presented as a predictor for awareness of disease (cognitive flexibility, inhibitory control, and working memory), of emotional state (short-term memory and attention) and of social functioning and relationships (visuospatial organization, integrative functions, and abstract thinking). Awareness of cognitive functioning and health condition and of functional activity impairments exhibit only global cognitive function as a predictor. CONCLUSIONS: Findings confirm some degree of independence between awareness domains. The importance of identifying differences in domains of awareness relies in the understanding of awareness as a clinical phenomenon in order to guide the management and support of PwAD and their caregivers.

Funciones ejecutivas y bienestar subjetivo en alumnos que presentan trastorno del espectro autista e inteligencia sobre el rango promedio / Executive functions and subjective well-being of students that presents both above-average intelligence and autism spectrum disorder

Los estudiantes con doble excepcionalidad son alumnos que presentan dos condiciones fuera de lo común, típicamente una condición asociada a talento y otra condición a discapacidad. Este estudio buscó determinar un perfil de funcionamiento ejecutivo (FE) y bienestar subjetivo (BS) de alumnos con doble excepcionalidad (DE) que presentan trastorno del espectro autista (TEA) e inteligencia sobre el rango promedio, para compararlo con estudiantes con desarrollo normativo e inteligencia Promedio de la comuna de Concepción. Los alumnos fueron pareados por sexo, edad y nivel socio económico. Mediante un método cuantitativo, descriptivo, comparativo y transversal, se evaluaron a 10 varones; cinco alumnos DE (M= 12,65 [4,18]) y cinco del grupo comparativo (M=12,48 [4,10]). Al comparar funcionamiento ejecutivo entre grupos, se observó que los alumnos con DE presentan mejor desempeño en Razonamiento Fluido (p=0,04) y, según la percepción de los docentes, un mejor control Inhibitorio (p=0,04). A pesar de que no se encontraron otras diferencias significativas entre grupos, el perfil de alumnos DE si mostró un déficit en funciones ejecutivas, pero únicamente en la manifestación conductual de las mismas. Los resultados asociados al bienestar subjetivo, indican que no existen diferencias significativas entre grupos. El perfil de alumnos DE refleja que mantienen "moderada" satisfacción con la vida y mayor Afecto Positivo que Negativo.

Students with double exceptionality are those who present two out of the ordinary conditions: one associated with outstanding skill and the other associated with a disability. This study sought to determine a profile of executive functioning and subjective well-being of students with double exceptionality (DE) which presented both above-average intelligence and Autism Spectrum Disorder (ASD). The results were compared with a control group of equally numbered students. The students were paired by sex, age, and socio-economic level. Through a quantitative, descriptive, comparative and cross-cutting method, 10 males were evaluated: five DE students (M=12.65 [4.18]) and five control group Students (M=12.48 [4.10]). The results of executive functioning show that DE Students present higher performance in Fluid Reasoning (p=0.04) and, according to teachers' perception, a better Inhibitory Control (p=0.04). Although no other significative differences were found between groups, DE students' profile did show a deficiency in executive functioning, but only in its behavioral manifestation. Results associated with subjective well-being didn't show any significative differences between groups. DE students' profile reflects that they maintain moderate satisfaction with life and higher positive affect than negative.

Funciones ejecutivas y ajuste clínico en adolescentes colombianos policonsumidores / Executive functions and clinical adjustment in Colombian adolescents polydrug

Resumen El estudio tuvo como objetivo analizar el funcionamiento ejecutivo y el ajuste clínico en una muestra de adolescentes colombianos policonsumidores. Se efectuó un estudio ex post facto con 204 participantes entre 12 y 17 años (M = 14,50, DT = 1,71). Se aplicó la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales BANFE-2 y para la evaluación clínica se utilizó la Escala de Autoestima de Rosenberg, Cuestionario de Afrontamiento COPE, Escala de Impulsividad de Dickman y Cuestionario de 90 Síntomas SCL-90-R. Se identificó un rendimiento significativamente inferior del grupo policonsumidor en las funciones ejecutivas, bajos niveles de autoestima, altos niveles de impulsividad disfuncional y de diversidad psicopatológica, así como estilo de afrontamiento a través del consumo de sustancias. Así mismo, se detectó un efecto predictor de la interacción edad x tiempo de consumo en el funcionamiento ejecutivo, observándose un menor rendimiento de los policonsumidores más jóvenes a medida que se incrementaba el tiempo de consumo.

Abstract The research aim was to analyze the executive functioning and the clinical adjustment in a sample of Colombian teen polydrug users. An ex post facto study was carried out with 204 participants, 12-17 years old (M= 14,50, SD = 1,71). The neuropsychological test BANFE-2 was applied for analyzing frontal lobes and executive functioning and the Rosenberg self esteem scale, a COPE questionnaire, the Dickman impulsivity scale and the SCL-90-R questionnaire were used for clinical adjustment respectively. A lower executive functioning throughput were observed in polydrug users. Low self-esteem, high dysfunctional impulsivity, high diverse psychopathologies and coping strategies for drug use were also observed. A predictor effect between age and consumption time on the executive functioning were also determined. A lower throughput in younger polydrug users increase through consumption time.

Subjective and physiological stress measurement in a multiple sclerosis sample and the relation with executive functions performance.

In multiple sclerosis (MS), hypothalamic-pituitary-adrenal (HPA) axis functioning may be dysregulated due to the high cortisol levels involved in the disease activity. HPA axis dysregulation can affect cognitive performance, including executive functions. This study aimed to evaluate hair cortisol concentration and perceived stress as well as verify the association with the performance of executive function in both individuals diagnosed with MS and control individuals. Hair cortisol concentration and perceived stress were evaluated and their association with the performance of healthy individuals (n = 33) and those with MS (n = 64), most of them with remitting-relapsing multiple sclerosis (RRMS) assessed using the Expanded Disability Status Scale (EDSS). Instruments that were employed to measure perceived stress and health aspects included the Behavioral Assessment Dysexecutive Syndrome, Wisconsin Card Sorting Test, Stroop Test, and Perceived Stress Scale. No significant statistical difference was found in the comparison of means among the groups; however, an association was found when using statistical correlation tests between cortisol and cognitive performance in the clinical group (r = 0.31, p = 0.10). Further, an absence of correlations with perceived stress measure was noted. It was possible to observe interaction between group factors and low level of cortisol and problem-solving/cognitive flexibility in the MS group. The results indicated that stress measures used in the present study seem to influence the performance of inhibitory control and problem-solving/cognitive flexibility, the latter with low levels of cortisol in individuals with MS. We suggest studies that examine different measures of physiological stress and characteristics of the disease such as more time of stress.

The comparison of risky and ambiguity decision making and cool executive functions between patients with obsessive compulsive disorder and healthy controls

Abstract Background: Executive functioning has been evaluated in obsessive compulsive disorder (OCD). Cool and hot executive functioning discrimination provided a different way of conceptualising executive functions. Objectives: The aim of this study was to compare ambiguity and risky decision-making and cool executive functions in an OCD and a healthy control group. The relationship between decision-making and cool executive functioning was investigated. Methods: Sixty-two OCD patients and 48 healthy control participants were compared. Decision-making was measured using the Iowa Gambling Task. The cool executive functioning was assessed using the Stroop Test and the Wisconsin Card Sorting Task (WCST). Results: The OCD group completed the WCST and the Stroop Test statistically significantly with a lower score than that of the control group. The OCD group had impaired response inhibition and set-shifting that indicate impaired cool executive functioning. In contrast to a lack of a statistically significant difference, the risky decision-making performance was worse in the OCD group than in the healthy control group and in the unmedicated OCD patients than in the medicated OCD patients. Discussion: The OCD patients had a poorer performance in risky decision-making and cool executive functioning. There was a link between risky decision-making performance and impaired cool executive functions.

Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure.

OBJECTIVE: To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). STUDY DESIGN: A longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive functioning for ages 2-16 years. At 12 months, patients 3-16 years of age completed neurocognitive testing. HRQoL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; executive functioning scores were examined categorically. RESULTS: A total of 52 parent-report HRQoL surveys were completed at 6 months, 48 at 12 months; 25 patients completed neurocognitive testing. The median age at 6 months was 7.9 years (range 3.5-15.0), and final diagnosis was indeterminate for 46.2% (n = 24). Self and parent-report on Pediatric Quality of Life Inventory Generic and Multidimensional Fatigue scales fell below the healthy sample at 6 months and 12 months (almost all P < .001). Children reported lower mean scores on cognitive fatigue at 12 months (60.91 ± 22.99) compared with 6 months (73.61 ± 27.49, P = .006) . The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6 months (n = 14, P ≤ .003); Global Executive Composite and Emergent Metacognition at 12 months (n = 10, P = .03). Visual Motor Integration (VMI-6) Copying (mean = 90.3 ± 13.8, P = .0002) and VMI-6 Motor Coordination (mean = 85.1 ± 15.2 P = .0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners' Continuous Performance Test) did not. CONCLUSIONS: Survivors of PALF appear to show deficits in motor skills, executive functioning, HRQoL, and evidence for worsening cognitive fatigue from 6 to 12 months following PALF presentation.

Girl With Tyrosinemia Type 1 and Executive Dysfunctions Treated With Methylphenidate: A Case Report

Abstract Hereditary tyrosinemia type 1 (HT1; OMIM 27670) is an inborn error of tyrosine metabolism, caused by a deficiency of the enzyme fumarylacetoacetate hydrolase. This defect leads to accumulation of toxic products, which cause liver and kidney dysfunction. In patients with HT1, IQ, executive functioning, and social cognition are also affected. We report here a case report of a Belgian 11-year-old girl of Moroccan ethnicity with HT1. She had attention problems, which had a significant impact on her school functioning. Neuropsychological tests showed very low scores for processing speed and executive functioning. Therapies such as adaptations in the school and private tutoring were not sufficient to improve this. Treatment with methylphenidate showed a significant improvement in the neuropsychological test and school functioning. This case shows the importance of being alert for problems with executive functions in patients with HT1 and to consider psychopharmacological treatment.