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Executive Functions in Health and Disease

By: , Posted on: September 18, 2017

Neuroscience used to be the monopoly of a few elite universities located in a handful of countries. Neuropsychology used to be a quaint niche discipline relatively unconnected to the larger world of neuroscience and content in its methods with paper-and-pencil tests. Neuroscience itself was relatively unconcerned with higher-order cognition, and the very term “cognitive neuroscience” was often met with rolled eyes by scientists working in more established areas of brain research (a personal observation made in the 1980s and even 1990s on more than one occasion). And the interest in executive functions was shared by a very small club of neuropsychologists and neuroscientists, a fact often noted in their times by the pioneers of “frontal-lobe” research Alexander Luria and a generation later Patricia Goldman-Rakic.

Chapter Download: Prefrontal Executive Functions Predict and Preadapt

None of this is true today. Important neuroscience research is conducted at numerous academic and biomedical centers worldwide. We are witnessing a substantial fusion, or at least blending, of cognitive neuroscience and neuropsychology. The terms “executive functions” and “frontal-lobe functions” are no longer used interchangeably, and a more refined understanding of both has emerged. Executive functions in health and disease have become the target of intense investigation by scores of researchers, arguably one of the most heavily populated territories of cognitive and clinical neuroscience (I recall a slide used in her lectures by the late Goldman-Rakic, with the number of stick-men drawn in each lobe reflecting the relative level of research interest in its functions. The slide, with its conspicuous near-absence of stick-men in the frontal lobe, would have to be re-drawn today). The range of research tools deployed for the understanding of executive function and dysfunction has also grown and continues to grow. Today it includes animal models, genetic studies, biochemical approaches, various forms of structural and functional neuroimaging, computational modeling involving neural nets and other methods, lesion and specific disorder studies, as well as a constantly expanding arsenal of sophisticated cognitive probes. In its clinical applications, the research into the nature of executive dysfunction is no longer limited to the traditional neuropsychological territory of focal lesions directly contained within the frontal lobes, and has expanded into a wide range of both focal and non-focal disorders whose impact is not restricted to the prefrontal cortex.

The vast expansion of interest in both healthy and impaired executive functions is reflected in the chapter composition of this book. Among the contributors are recognized authorities who played a pivotal role in shaping the modern understanding of executive functions, as well as young neuroscientists who joined the field relatively recently. The contributors employ a wide range of technologies and tools and conduct their research at universities in North America; Western, Central, and Eastern Europe; Asia; and Australia. Capturing the generational, geographic, and methodological expanse of the interest in executive functions has been the editor’s intent and is a distinguishing feature of the volume.

The book is divided into two sections: Executive Functions in Health and Executive Functions in Disease. In the first section, various aspects of healthy executive functions are examined. The topics include a broad general conceptualization of executive functions by a preeminent pioneer of the field (Joaquin Fuster); cellular mechanisms of executive functions and working memory (Taber Lightbourne and Amy Arnsten); gene expression in the frontal lobes (Zeljka Krznik and Goran Sedmak); large-scale networks and the frontal lobes (Adam Hampshire); computational neural net modeling of executive functions and decision making (Daniel Levine); frontal lobes and consciousness (Seth Lew and Hakwan Lau); neurodevelopmental aspects of executive functions (Layne Kalbfleisch); changes affecting executive functions in aging (Nathan Spreng, Leena Shoemaker, and Gary Turner); and a broad survey of neuropsychological assessment methods used in the neuropsychological research into executive functions (Yana Suchi, Rosemary Ziemnik, and Madison Niermeyer).

In the second sections, multiple forms of executive dysfunction are examined across a wide range of neurological, psychiatric, and medical conditions. Both broad categories of disorders and specific disorders are examined. The broad clinical categories examined include the mechanisms of cognitive, behavioral and emotional inflexibility, and perseveration across a number of neuropsychiatric disorders (Daniel Weisholtz, John Sullivan, Aaron Nelson, Kirk Daffner, and David Silbersweig); large-scale cognitive control network alteration in neuropsychiatric disorders, including autism, schizophrenia, and depression (Melissa-Ann Makie and Jin Fan); executive functions in neurodevelopmental disorders, including ADHD, focal frontal lesions, and epileptic foci (Masao Aihara); executive dysfunction in striatal disorders, including Parkinson’s disease, Huntington’s disease, and chronic stress (Joao Cergueira and Nuno Sousa); executive dysfunction in dementias, including Alzheimer’s disease, vascular dementia, frontotemporal dementia, progressive supranuclear palsy and corticobasal syndrome, motor neuron disease, Parkinson’s disease, Lewy body dementia, and Huntington’s disease (Michal Harciarek, Emilia Sitek, and Anna Barczak); executive dysfunction in medical conditions, including hypertension, diabetes mellitus, chronic kidney disease, HIV encephalopathy, hepatic encephalopathy, thyroid disease, and rheumatoid arthritis (Michal Harciarek and Aleksandra Wojtowicz); addictions to a number of substances, including cannabis, cocaine, methamphetamine, and opioids (Antonio Verdejo-Garcia); examination of the parallels between the effects of lateralized frontal lesions, hemiparkinsonian syndromes, and variants of Tourette’s syndrome (Kjell Hovik, Merete Oie, and Elkhonon Goldberg); as well as a broad survey of neuropsychological assessment methods used for the clinical assessment of executive functions (Yana Suchi). The specific disorders examined include executive dysfunction and efforts to rehabilitate it in traumatic brain injury (Irene Christofori and Jordan Grafman); frontal-lobe seizures (Sara Wildstein and Silvana Riggio); executive deficit in post-traumatic stress disorder (Jennifer Newman and Charles Marmar); and executive dysfunction in Tourette’s syndrome (Kjell Hovik).

From being a niche research enterprise, executive functions research has burgeoned into a vast area of neuroscience with its own niches and sub-niches, often with relatively little interaction between them. While probably unavoidable, such “Balkanization” of the field is unfortunate and self-defeating. Hopefully, combining in one volume chapters on basic and clinical executive functions research employing a variety of approaches and methodologies will help update the readers’ knowledge of the advances in their own niches as well as help familiarize them with the state of affairs in others; both update the readers about the more recent work by acknowledged leaders in the field, and introduce him to the new generation of neuroscientists advancing our understanding of executive function and dysfunction and representing the future of the field.

executive functions in heath and disease

The above is an excerpt from the Preface of Executive Functions in Health and Disease. We are pleased to share the first chapter of the book Prefrontal Executive Functions Predict and Preadaptby Joaquín M. Fuster.

If you found this chapter interesting, you can access additional chapters online via ScienceDirect. If you prefer to purchase your personal print or e-copy, visit the Elsevier store. Apply discount code STC317 at checkout and receive up to 30% off the list price and free global shipping.

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