Diversity of approaches in assessment of executive functions in stroke: Limited evidence?

Conti, Juliana; Sterr, Annette; Brucki, Sônia Maria Dozzi; Conforto, Adriana Bastos

doi:10.1016/j.ensci.2015.08.002

Cited by 24 publications

(13 citation statements)

References 78 publications

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“…The Mini Mental-State Examination (MMSE) is the most widely used cognitive screening instrument, measuring mainly verbal and memory functions. The Trail Making Tests A and B (TMT-A, TMT-B) examine executive functions, including the ability to maintain attention, speed of processing and set-shifting/mental flexibility, mainly reflecting subcortico-frontal functions and cerebrovascular lesions (Conti et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests

Nylander

Kilander

Åhlström

et al. 2018

Front. Aging Neurosci.

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Background and Purpose: Signs of small vessel disease (SVD) are commonly seen on magnetic resonance imaging (MRI) of the brain in cognitively healthy elderly individuals, and the clinical relevance of these are often unclear. We have previously described three different MRI manifestations of SVD as well as cerebral perfusion in a longitudinal study of non-demented 75-year-old subjects. The purpose of the present study was to evaluate the relationship of these findings to cognition and executive function at age 75 and changes after 5 years.Methods: In all, 406 subjects from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study were examined with MRI of the brain at age 75 years. Two-hundred and fifty of the subjects were re-examined 5 years later. White matter hyperintensities (WMHs) and lacunar infarcts (LIs) were assessed on both occasions, but microbleeds (MBs) and perfusion only at age 75. Cognitive function was screened by the Mini Mental State Examination (MMSE). Trail Making Test A and B (TMT-A and TMT-B) were performed at baseline and at follow-up at age 80.Results: At baseline, 93% performed >27 points in the MMSE. The TMT-B at age 75 was significantly related to WMH visual scoring after adjustment for sex, education and cerebrovascular disease risk factors (+80 s (95% CI 0.3–161 s), P < 0.05 for grade 2–3 vs. grade 0). Neither MMSE nor TMT-A was significantly related to WMH scoring. There was no relation between any test performance and WMH volume, white matter volume, number of MBs or brain perfusion at age 75. Subjects who had sustained a new LI (n = 26) showed a greater increase of the time to perform TMT-A at the 5-year follow-up (+25 s vs. +4 s in LI-free subjects, P = 0.003). Changes in MMSE or TMT-A and -B test performance between ages 75 and 80 were not related to changes in WMH scoring or volume during the 5 years follow-up, or to brain perfusion at age 75.Conclusion: In this cognitively healthy community-based population, moderate-severe WMHs and incident LIs on brain MRI in individuals aged 75–80 years were associated with a mild impairment of processing speed and executive function.

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Section: Introductionmentioning

confidence: 99%

Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests

Nylander

Kilander

Åhlström

et al. 2018

Front. Aging Neurosci.

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“…When the health professional decides to use an instrument to evaluate a patient it is essential that the tool is validated for the population target, not only for a given language and culture, but also for the specific disease/injury. 8 …”

Section: Discussionmentioning

confidence: 99%

Cognitive assessment: A challenge for occupational therapists in Brazil

Conti

2017

Dement. neuropsychol.

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Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life.ObjectiveThe aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice.MethodsThe instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed.ResultsThe search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment).ConclusionThere are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice.

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“…Some patients constantly make mistakes carrying out particular tasks, even when they detect and verbalise the principle behind it. Such difficulties are a manifestation of the dissociation between thinking and action [22]. The prevalence of executive dysfunction after stroke ranges from 18.5% to 39%, depending on definitions and instruments used for its evaluation [23,24].…”

Section: Characteristics Of Executive Functionsmentioning

confidence: 99%

“…To date, there have been a number of reports on various specific executive symptoms resulting from lesions to different brain areas in stroke patients [22]. Assessment of such disorders is no easy task, considering the complexity of cerebral vascularisation and disassociation in severity of different deficits.…”

Section: Executive Dysfunction and Location Of Strokementioning

confidence: 99%

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Zaburzenia funkcji wykonawczych po udarze mózgu – możliwości i ograniczenia diagnozy

Tyburski¹,

Mak²,

Kurpisz³

et al. 2018

ppn

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Purpose: A variety of neuropsychological symptoms, including executive dysfunction, are common consequences of a stroke. However, as demonstrated in literature reviews, there are still several unclear issues in this area. This article, therefore, provides description of specific components of executive dysfunction in stroke patients together with principles of their diagnosis. Views: Cerebral stroke is one of the most common causes of disability, with a devastating impact on the daily functioning of patients. Some of its common consequences are cognitive and behavioural disorders. Comorbid symptoms include premorbid personality changes and emotional disorders. A relatively new diagnostic category of post-stroke symptoms is the dysexecutive syndrome. It involves a variety of symptoms, such as ineffective performance, perseveration, rigidity of thought or impaired planning and predicting the consequences of one's actions. The dysexecutive syndrome is not a homogenous syndrome, and many researchers postulate its division into subunits, depending on the predominant symptoms. Conclusions: Executive dysfunction after stroke is an important clinical and social problem. Impaired performance of complex tasks or deficits within planning or reasoning have a marked effect on patients' social and professional functioning. The theoretical notion of dysexecutive syndrome may allow to better understand the scope and nature of patients' problems and implementation of more effective forms of neuropsychological rehabilitation.

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Diversity of approaches in assessment of executive functions in stroke: Limited evidence?

Cited by 24 publications

References 78 publications

Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests

Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests

Cognitive assessment: A challenge for occupational therapists in Brazil

Zaburzenia funkcji wykonawczych po udarze mózgu – możliwości i ograniczenia diagnozy

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