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Dysexecutive Functioning in Mild Cognitive Impairment: Derailment in Temporal Gradients

Published online by Cambridge University Press:  07 October 2011

Joel Eppig ,
Denene Wambach ,
Christine Nieves ,
Catherine C. Price ,
Melissa Lamar ,
Lisa Delano-Wood ,
Tania Giovannetti ,
Brianne M. Bettcher ,
Dana L. Penney  and
Rod Swenson
...Show all authors
Joel Eppig
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Denene Wambach
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Christine Nieves
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Catherine C. Price
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
Melissa Lamar
Affiliation:
Department of Psychiatry, University of Illinois, Chicago, Illinois
Lisa Delano-Wood
Affiliation:
Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, California and the Psychology Service, Veterans Administration San Diego Healthcare System, San Diego, California
Tania Giovannetti
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Brianne M. Bettcher
Affiliation:
Department of Neurology, The Lahey Clinic, Burlington, Massachusetts
Dana L. Penney
Affiliation:
Department of Neurology, The Lahey Clinic, Burlington, Massachusetts
Rod Swenson
Affiliation:
Department of Neuroscience, University of North Dakota Medical School, Fargo, North Dakota
Carol Lippa
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Anahid Kabasakalian
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Mark W. Bondi
Affiliation:
Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, California and the Psychology Service, Veterans Administration San Diego Healthcare System, San Diego, California
David J. Libon*
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
*
Correspondence and reprint requests to: David J. Libon, Drexel University, College of Medicine, 245 North 15th Street, 7th Floor, Philadelphia, PA 19102. E-mail: [email protected]
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Abstract

Libon et al. (2010) provided evidence for three statistically determined clusters of patients with mild cognitive impairment (MCI): amnesic (aMCI), dysexecutive (dMCI), and mixed (mxMCI). The current study further examined dysexecutive impairment in MCI using the framework of Fuster's (1997) derailed temporal gradients, that is, declining performance on executive tests over time or test epoch. Temporal gradients were operationally defined by calculating the slope of aggregate letter fluency output across 15-s epochs and accuracy indices for initial, middle, and latter triads from the Wechsler Memory Scale-Mental Control subtest (Boston Revision). For letter fluency, slope was steeper for dMCI compared to aMCI and NC groups. Between-group Mental Control analyses for triad 1 revealed worse dMCI performance than NC participants. On triad 2, dMCI scored lower than aMCI and NCs; on triad 3, mxMCI performed worse versus NCs. Within-group Mental Control analyses yielded equal performance across all triads for aMCI and NC participants. mxMCI scored lower on triad 1 compared to triads 2 and 3. dMCI participants also performed worse on triad 1 compared to triads 2 and 3, but scored higher on triad 3 versus triad 2. These data suggest impaired temporal gradients may provide a useful heuristic for understanding dysexecutive impairment in MCI. (JINS, 2012, 18, 20–28)

Keywords

Mild cognitive impairmentSingle domain mild cognitive impairmentMultiple domain mild cognitive impairmentAlzheimer's diseaseThe Titanic EffectExecutive control
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 1 , January 2012 , pp. 20 - 28
Copyright
Copyright © The International Neuropsychological Society 2011

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References

REFERENCES

Albert, M.S., DeKosky, S.T., Dickson, D., Dubois, B., Feldman, H.H., Fox, N.C., Phelps, C.H. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging and Alzheimer's Association workgroup. Alzheimer's and Dementia, 7, 1–10.CrossRefGoogle Scholar
Alexander, G.E., DeLong, M.R., Strick, P.L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357–381.CrossRefGoogle ScholarPubMed
Busse, A., Hensel, A., Gühne, U., Angermeyer, M.C., Riedel-Heller, S.G. (2006). Mild cognitive impairment: Long-term course of four clinical subtypes. Neurology, 67, 2176–2185.CrossRefGoogle ScholarPubMed
Carew, T.G., Cloud, B.S., Lamar, M., Grossman, M., Libon, D.J. (1997). Patterns of Impairment in category fluency in Alzheimer's disease and ischemic vascular dementia. Neuropsychology, 11, 400–412.CrossRefGoogle ScholarPubMed
Chao, L.L., Pa, J., Duarte, A., Schuff, N., Weiner, M.W., Kramer, J.H., Johnson, J.K. (2009). Patterns of cerebral hypoperfusion in amnestic and dysexecutive MCI. Alzheimer Disease Association and Related Disorders, 23, 245–252.CrossRefGoogle ScholarPubMed
Delano-Wood, L., Bondi, M.W., Sacco, J., Abeles, N., Jak, A.J., Libon, D.J., Bozoki, A. (2010). Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology. Journal of the International Neuropsychological Society, 15, 906–914.CrossRefGoogle Scholar
Delano-Wood, L., Libon, D.J., Cabrera, Y., Nation, D., Eppig, J., Dhanani, J., Bondi, M.W. (2011, July). Verbal fluency performance is associated with elevated stroke risk in nonamnestic MCI: A process and errors analytic approach. To be presented at the 2011 Alzheimer's Association International Conference on Alzheimer's Disease, Paris, France.Google Scholar
Fischer, P., Jungwirth, S., Zehetmayer, S., Weissgram, S., Hoenigschnabl, S., Gelpi, E., Kragl, K.H. (2007). Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Archives of Neurology, 68, 288–291.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E., McHugh, P.R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Fuster, J.M. (1997). The prefrontal cortex: Anatomy, physiology, and neuropsychology of the executive lobe (2nd ed.). New York, NY: Lippincott-Raven Press.Google Scholar
Kaplan, E. (1988). A process approach to neuropsychological assessment. In T. Boll & B.K. Bryant (Eds.), Clinical neuropsychology and brain function: Research, measurement, and practice (pp. 129–167). Washington, DC: American Psychological Association.Google Scholar
Kaplan, E., Fein, D., Morris, R.G., Delis, D.C. (1991). The Wechsler Adult Intelligence Scale—Revised as a neuropsychological instrument manual. San Antonio, TX: Psychological Corporation.Google Scholar
Kaplan, E., Goodglass, H., Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea and Febiger.Google Scholar
Kaufman, L., Ischebeck, A., Weiss, E., Koppelstaetter, F., Siedentopf, C., Vogel, S., Wood, G. (2008). An fMRI study of the numerical Stroop task in individuals with and without minimal cognitive impairment. Cortex, 44, 1248–1255.CrossRefGoogle Scholar
Lamar, M., Catani, M., Price, C.C., Heilman, K.M., Libon, D.J. (2008). The impact of region specific leukoaraiosis on working memory deficits in dementia. Neuropsychologia, 46, 2597–2601.CrossRefGoogle ScholarPubMed
Lamar, M., Podell, K., Carew, T.G., Cloud, B.S., Kennedy, C., Goldberg, E., Kaplan, E., Libon, D.J. (1997). Perseverative behavior in Alzheimer's disease and subcortical ischaemic vascular dementia. Neuropsychologia, 11, 523–534.CrossRefGoogle Scholar
Lamar, M., Price, C.C., Davis, K.L., Kaplan, E., Libon, D.J. (2002). Capacity to maintain mental set in dementia. Neuropsychologia, 40, 435–445.CrossRefGoogle ScholarPubMed
Lamar, M., Price, C.C., Giovannetti, T., Swenson, R., Libon, D.J. (2010). The dysexecutive syndrome associated with subcortical white matter disease and related white matter pathology. Behavioural Neurology, 22, 53–62.CrossRefGoogle Scholar
Lamar, M., Price, C.C., Libon, D.J., Penney, D.L., Kaplan, E., Grossman, M., Heilman, K.M. (2007). Alterations in working memory as a function of leukoaraiosis in dementia. Neuropsychologia, 45, 245–254.CrossRefGoogle ScholarPubMed
Lawton, M.P., Brody, E. (1968). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle Scholar
Leach, L., Kaplan, E., Rewilak, D., Richards, B., Proulx, G.B. (2000). The Kaplan Baycrest Neurocognitive Assessment. San Antonio, TX: The Psychological Corporation.Google Scholar
Libon, D.J., Bondi, M.W., Price, C.C., Lamar, M., Eppig, J., Wambach, D.M., Penney, D.L. (2011). Verbal serial list learning in mild cognitive impairment: A profile analysis of interference, forgetting, and errors. Journal of the International Neuropsychological Society, 2011, 17, 905–914.CrossRefGoogle Scholar
Libon, D.J., Eppig, J., Xie, X.S., Wicas, G., Lippa, C., Bettcher, B.M., Wambach, D. (2010). The heterogeneity of mild cognitive impairment: A neuropsychological analysis. Journal of the International Neuropsychological Association, 16, 84–93.CrossRefGoogle ScholarPubMed
Lopez, O.L., Jagust, W.J., DeKosky, S.T., Becker, J.T., Fitzpatrick, A., Dulberg, C., Kuller, L.H. (2003). Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study. Archives of Neurology, 60, 1385–1399.CrossRefGoogle ScholarPubMed
Monsch, A., Bondi, M., Butters, N., Salmon, D.P., Katzman, R., Thal, L.J. (1992). Comparison of verbal fluency tasks in the detection of dementia of the Alzheimer's type. Archives of Neurology, 49, 1253–1258.CrossRefGoogle Scholar
Pa, J., Boxer, A., Chao, L.L., Gazzaley, A., Freeman, K., Kramer, J., Johnson, J.K. (2009). Clinical-neuroimaging characteristics of dysexecutive mild cognitive impairment. Annuals of Neurology, 65, 414–423.CrossRefGoogle ScholarPubMed
Pare, D., Curro-Dossi, R., Steriade, M. (1991). Three types of inhibitory postsynaptic potentials generated by inter neurons in the anterior thalamic complex of the cat. Journal of Neurophysiology, 66, 1190–1204.CrossRefGoogle Scholar
Petersen, R.C., Morris, J.D. (2005). Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 1160–1163.CrossRefGoogle ScholarPubMed
Petersen, R.C., Roberts, R.O., Knopman, D.S., Boeve, B.F., Geda, Y.E., Ivnik, R.J., Jack, C.R. Jr. (2009). Mild cognitive impairment: Ten years later. Archives of Neurology, 66, 1447–1455.CrossRefGoogle ScholarPubMed
Price, C.C., Brumback, B., Towler, S., Mitchell, S., Tanner, J., Lamar, Libon, D.J. (2011, February). Re-examination of the 25% threshold for symptomatic leukoaraiosis. In D.J. Libon (Chair) The differential contribution of white and gray matter to the phenotypic expression of dementia. Symposium Presentation at the 39th annual meeting of The International Neuropsychological Society, Boston, MA.Google Scholar
Price, C.C., Garrett, K.D., Jefferson, A.L., Cosentino, S., Tanner, J., Penney, D.L., Libon, D.J. (2009). The role of leukoaraiosis severity on learning and memory in dementia: Performance differences on a 9-word list learning test. The Clinical Neuropsychologist, 23, 1–18.CrossRefGoogle Scholar
Solfrizzi, V., Panza, F., Colacicco, A.M., D'Introno, A., Capurso, C., Torres, F., Capurso, A. (2004). Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology, 63, 1882–1891.CrossRefGoogle ScholarPubMed
Steriade, M. (2004). Local gating of information processing through the thalamus. Neuron, 41, 493–494.CrossRefGoogle ScholarPubMed
Stuss, D.T., Shallice, T., Alexander, M.P., Picton, T.W. (1995). A multidisciplinary approach to anterior attentional functions. Annals of the New York Academy of Sciences, 769, 191–211.CrossRefGoogle ScholarPubMed
Wechsler, D. (1945). A standardized memory test for clinical use. Journal of Psychology, 19, 87–95.CrossRefGoogle Scholar
Wechsler, D. (1981). The Wechsler Adult Intelligence Scale-Revised. San Antonio, TX: Psychology Corporation.Google Scholar
Winblad, B., Palmer, K., Kivipelto, M., Jelic, V., Fratiglioni, L., Wahlund, L.O., Petersen, R.C. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
Yaffe, K., Petersen, R.C., Lindquist, K., Kramer, J., Miller, B. (2006). Subtype of mild cognitive impairment and progression to dementia and death. Dementia and Geriatric Cognitive Disorders, 22, 312–319.CrossRefGoogle ScholarPubMed
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M. (1983). Development and validation of a geriatric depression severity scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar