Fifty Years of Prefrontal Cortex Research: Impact on Assessment

Abstract

Our knowledge of the functions of the prefrontal cortex, often called executive, supervisory, or control, has been transformed over the past 50 years. After operationally defining terms for clarification, we review the impact of advances in functional, structural, and theoretical levels of understanding upon neuropsychological assessment practice as a means of identifying 11 principles/challenges relating to assessment of executive function. Three of these were already known 50 years ago, and 8 have been confirmed or emerged since. Key themes over this period have been the emergence of the use of naturalistic tests to address issues of "ecological validity"; discovery of the complexity of the frontal lobe control system; invention of new tests for clinical use; development of key theoretical frameworks that address the issue of the role of prefrontal cortex systems in the organization of human cognition; the move toward considering brain systems rather than brain regions; the advent of functional neuroimaging, and its emerging integration into clinical practice. Despite these huge advances, however, practicing neuropsychologists are still desperately in need of new ways of measuring executive function. We discuss pathways by which this might happen, including decoupling the two levels of explanation (information processing; brain structure) and integrating very recent technological advances into the neuropsychologist's toolbox. (JINS, 2017, 23, 755-767)

Studying Executive Function Skills in Young Children in Low‐ and Middle‐Income Countries: Progress and Directions

“…We prioritize direct assessments because performance on EF tasks has been linked to specific neurobiological foundations (Diamond, ; Fiske & Holmboe, ), whereas adults’ reports of young children’s EFs often depend on cultural expectations. Performance‐based EF tasks engage cognitive processes that rely on the integrity, efficiency, and connectivity of the prefrontal cortex (Burgess & Stuss, ). Table summarizes recent studies that directly assess EFs of young children in low‐ and middle‐income countries.…”

“…Many EF tasks engage both EF and non‐EF skills (e.g., receptive language, fine motor control); this is known as the task impurity problem (Burgess & Stuss, ). This problem can be mitigated by designing or adopting EF tasks that partition performance into putatively EF and non‐EF skills, which is facilitated by including both EF and non‐EF control trials.…”

Exploring the Benefits of Doll Play Through Neuroscience

“…The neural correlates of executive function are relatively well established across paradigms and ages. fMRI, EEG, and fNIRS research all indicate that the prefrontal cortex (PFC) is activated during executive functioning tasks that include inhibition and working memory (Burgess and Stuss, 2017 ). In preschool-aged children, for whom executive functioning skills are still emerging, individual differences in executive functioning correlate with differences in brain activation of this region.…”

Executive function in high-functioning autism: Decision-making consistency as a characteristic gambling behaviour

“…Indeed, given what we know about the location of structures within the prefrontal cortex that support social competencies like mentalising and theory of mind, and also various executive functions, it is a possibility that any relation in performance is in effect merely epiphenomena. In neurological patients with acquired damage, there is no “executive (or “frontal lobe”) syndrome”: the various dysexecutive features show a high degree of dissociation (See Burgess and Stuss, 2017 for review), with, seemingly, each function having its own neuroanatomical substrates.…”