The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Olivier Godefroy - One of the best experts on this subject based on the ideXlab platform.
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Dysexecutive Syndrome in parkinson s disease the grefex study
Aging Neuropsychology and Cognition, 2017Co-Authors: Martine F Roussel, Eugenie Lhommee, Pauline Narme, Virginie Czernecki, Didier Le Gall, Pierre Krystkowiak, Momar Diouf, Olivier GodefroyAbstract:ABSTRACTThe objectives of this study were to characterize the frequencies and profiles of behavioral and cognitive Dysexecutive Syndromes in PD (based on validated battery and diagnostic criteria) and to develop a shortened diagnostic battery. Eighty-eight non-demented patients with a diagnosis of PD were examined with an executive validated battery. Using a validated framework, the patients’ test results were interpreted with respect to normative data from 780 controls. A Dysexecutive Syndrome was observed in 80.6% of the patients [95% confidence interval: 71.1–90.1]. The Dysexecutive profile was characterized by prominent impairments in deduction, flexibility, inhibition and initiation in the cognitive domain, and by global hypoactivity with apathy and hyperactivity in the behavioral domain. This finding implies that patients with PD should be assessed with cognitive tests and a validated inventory for behavioral Dysexecutive Syndromes. A shortened battery (based on three cognitive tests and three behav...
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the Dysexecutive Syndrome of alzheimer s disease the grefex study
Journal of Alzheimer's Disease, 2014Co-Authors: Olivier Godefroy, Olivier Martinaud, Marc Verny, Chrystele Mosca, H Lenoir, Eric Bretault, Martine F RousselAbstract:Background Dysexecutive disorders are common in early-stage Alzheimer's disease (AD) but have yet to be characterized in detail. Objective The objectives of the present study based on validated diagnostic criteria were to determine the frequency and characterize the profile of behavioral and cognitive Dysexecutive disorders in AD. Methods 102 patients with AD (mild: n = 92; moderate: n = 10; mean MMSE score: 23.2) were examined with the GREFEX battery. Neuropsychological data were interpreted within a validated framework based on the performance levels of 780 control participants from the GREFEX study. Results Dysexecutive Syndrome was observed in 87.5% (95%CI: 79-96) of the AD patients (p = 0.0001). The Dysexecutive disorder profile was characterized by prominent impairments of planning, inhibition flexibility and generation in the cognitive domain (p = 0.0001 as compared to controls for all) and global hypoactivity in the behavioral domain (p = 0.0001 as compared to controls). Conclusions Dysexecutive Syndrome is observed in over 80% of AD patients and has a distinct profile.
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Dysexecutive Syndrome after stroke
2014Co-Authors: Olivier Godefroy, Pierre Yves Garcia, Jean Marc Bugnicourt, Claire Leclercq, Martine F RousselAbstract:Disorders of executive functions represent a leading form of post-stroke cognitive impairment, regardless of stroke mechanism, and are important contributors to post-stroke disability. This chapter reviews executive functions and impairment of these functions and then discusses the main disorders observed in stroke and their assessment.
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is the frontal Dysexecutive Syndrome due to a working memory deficit evidence from patients with stroke
Brain, 2012Co-Authors: Martine F Roussel, Kathy Dujardin, Hilde Henon, Olivier GodefroyAbstract:Although frontal Dysexecutive disorders are frequently considered to be due to working memory deficit, this has not been systematically examined and very little evidence is available for impairment of working memory in frontal damage. The objective of this study was to examine the components of working memory, their anatomy and the relations with executive functions in patients with stroke involving the frontal or posterior cortex. The study population consisted of 29 patients (frontal: n=17; posterior: n=12) and 29 matched controls. Phonological loop (letter and word spans, phonological store; rehearsal process), visuospatial sketchpad (visuospatial span) and the central executive (working memory span, dual task and updating process) were examined. The group comparison analysis showed impairment in the frontal group of: (i) verbal spans (P<0.03); (ii) with a deficit of the rehearsal process (P=0.006); (iii) visuospatial span (P=0.04); (iv) working memory span (P=0.001) that disappeared after controlling for verbal span and (v) running memory (P=0.05) unrelated to updating conditions. The clinical anatomical correlation study showed that impairment of the central executive depended on frontal and posterior lesion. Cognitive Dysexecutive disorders were observed in 11/20 patients with central executive deficit and an inverse dissociation was observed in two patients. Receiver operating characteristic curve analysis indicated that cognitive Dysexecutive disorders had the highest ability to discriminate frontal lesions (area under curve=0.844, 95% confidence interval: 0.74-0.95; P=0.0001; central executive impairment: area under curve=0.732, 95% confidence interval: 0.57-0.82; P=0.006). This study reveals that frontal lesions induce mild impairment of short-term memory associated with a deficit of the rehearsal process supporting the role of the frontal lobe in this process; the central executive depends on lesions in the frontal lobe and posterior regions accounting for its low frequency and the negative results of group studies. Finally, the frontal Dysexecutive Syndrome cannot be attributed to central executive impairment, although it may contribute to some Dysexecutive disorders.
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Dysexecutive Syndrome diagnostic criteria and validation study
Annals of Neurology, 2010Co-Authors: Olivier Godefroy, Martine F Roussel, Philippe Azouvi, Philippe Robert, Didier Legall, Thierry MeulemansAbstract:Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Reflexion sur l'Evaluation des Fonctions Executives (GREFEX) group has proposed criteria for behavioral and cognitive Dysexecutive Syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive Dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods: A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive Dysexecutive disorders were examined using the GREFEX battery. Results: A Dysexecutive Syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive Dysexecutive disorders discriminated (p ¼ 0.001, all) patients from controls. The pattern of cognitive Syndrome differed (p ¼ 0.0001) according to the disease. Finally, behavioral (odds ratio (OR), 4.6; 95% confidence interval (CI), 2. 3-9.1; p ¼ 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p ¼ 0.001) Dysexecutive Syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p ¼ 0.002) were independent predictors of loss of autonomy. Interpretation: This study provided criteria of Dysexecutive Syndrome and showed that both behavioral and cognitive Syndromes contribute to loss of autonomy. Profiles vary across patients and diseases, and therefore systematic assessment of behavioral and cognitive disorders in reference to diagnostic criteria is needed. ANN NEUROL 2010;68:855-864
Nick Alderman - One of the best experts on this subject based on the ideXlab platform.
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the ecological validity of tests of executive function
Journal of The International Neuropsychological Society, 1998Co-Authors: Paul W Burgess, Nick Alderman, Hazel Emslie, Jon Evans, Barbara A WilsonAbstract:Ninety-two mixed etiology neurological patients and 216 control participants were assessed on a range of neuropsychological tests, including 10 neuropsychological measures of executive function derived from 6 different tests. People who knew the patients well (relatives or carers) completed a questionnaire about the patient's Dysexecutive problems in everyday life, and this paper reports the extent to which the tests predicted the patients' everyday life problems. All of the tests were significantly predictive of at least some of the behavioral and cognitive deficits reported by patients' carers. However, factor analysis of the patients' Dysexecutive symptoms suggested a fractionation of the Dysexecutive Syndrome, with neuropsychological tests loading differentially on 3 underlying cognitive factors (Inhibition, Intentionality, and Executive Memory), supporting the conclusions that different tests measure different cognitive processes, and that there may be limits to the fractionation of the executive system.
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the development of an ecologically valid test for assessing patients with a Dysexecutive Syndrome
Neuropsychological Rehabilitation, 1998Co-Authors: Barbara A Wilson, Jonathan Evans, Hazel Emslie, Nick Alderman, Paul W BurgessAbstract:(1998). The Development of an Ecologically Valid Test for Assessing Patients with a Dysexecutive Syndrome. Neuropsychological Rehabilitation: Vol. 8, Assessment of Attention and Executive Function. Guest Editor: J. Crawford, pp. 213-228.
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improvement of self monitoring skills reduction of behaviour disturbance and the Dysexecutive Syndrome comparison of response cost and a new programme of self monitoring training
Neuropsychological Rehabilitation, 1995Co-Authors: Nick Alderman, Roberta K Fry, Heather A YoungsonAbstract:Abstract Impairment of executive functioning may impose particular neuropsychological constraints on the ability to learn. Some categories of behaviour disorder are secondary to the presence of the “Dysexecutive Syndrome”, particularly impairment in the ability for accurate self-monitoring. In these cases behaviour modification interventions using reinforcement and extinction methods may be unsuccessful. Response cost has been reported previously as one method which facilitates learning in such cases. However, there are practical difficulties that limit its use, or make practitioners reluctant to employ it. In this paper a case is described in which behaviour incompatible with rehabilitation was attributable to inaccuracies in self-monitoring. Two treatment methods were utilised. Whilst response cost was used successfully the results did not generalise to a second environment. A new programme of self-monitoring training was implemented to: teach inhibitory control in this environment; evolve an alternativ...
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Behavioural treatment of the Dysexecutive Syndrome: Reduction of repetitive speech using response cost and cognitive overlearning
Neuropsychological Rehabilitation, 1991Co-Authors: Nick Alderman, Antony WardAbstract:Abstract Damage to the frontal lobes frequently precedes the development of behavioural disorders that may prevent an individual gaining access to rehabilitation services. In recent years the use of behaviour modification, particularly programmes based on the use of positive reinforcement and time-out, has been increasingly reported in the literature as a means of remediating behaviour disturbance. However, it is becoming clear that there is a subgroup of brain-injured individuals who do not respond to the use of such methods and who present with the “Dysexecutive Syndrome”, which imposes neuropsychological constraints on their ability to learn using these techniques. This study describes the use of two behavioural methods—response cost and cognitive overlearning—in the treatment of a behaviourally disturbed, herpes simplex encephalitis survivor who presented with a Dysexecutive Syndrome. Treatment resulted in significant statistical and clinical change within sessions. This change was found to have gener...
Cesar Gonzalezgonzalez - One of the best experts on this subject based on the ideXlab platform.
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original a rticle e pidemiology clinical p ractice a nd h ealth caregiver burden of mexican dementia patients the role of Dysexecutive Syndrome sleep disorders schooling and caregiver depression
2014Co-Authors: Oscar Rosascarrasco, Maria De Guadalupe Guerrasilla, Laura Del Pilar Torresarreola, Carmen Garciapena, Cristopher Isaac Escamillajimenez, Cesar GonzalezgonzalezAbstract:Results: The results showed that patient variables have a greater impact on caregiver burden than caregiverassociated variables. Dysexecutive Syndrome, sleep disorders, schooling and caregiver depression are associated with a higher level of caregiver burden. Conclusions: Caregiver burden is a complex phenomenon. The results of the present study showed the need to implement multifactorial interventions targeting the caregiver to reduce the burden, strengthen the skills for patient management to avoid depression, improve patient health, and diminish functional dependence and future hospitalization. Geriatr Gerontol Int 2014; 14: 146–152.
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caregiver burden of mexican dementia patients the role of Dysexecutive Syndrome sleep disorders schooling and caregiver depression
Geriatrics & Gerontology International, 2014Co-Authors: Oscar Rosascarrasco, Maria De Guadalupe Guerrasilla, Laura Del Pilar Torresarreola, Carmen Garciapena, Cristopher Isaac Escamillajimenez, Cesar GonzalezgonzalezAbstract:Aims As a result of the accelerated growth of the elderly population, reconfiguration of families and member roles, and the increase of mental disorders, it is necessary to investigate the effects of this set of factors on the caregivers of patients with dementia in Mexico. Mental disorders of individuals have a negative impact on their physical and emotional quality of life, leading to greater dependence and making the caring experience a heavy burden. Several studies (none in Mexico) have used either the characteristics of the patient or caregiver to determine the burden, but few studies have included both profiles within a single study. The objective of the present study was to analyze the characteristics of the patients and caregivers associated with caregiver burden. Methods A multicenter study was carried out in six health institutions located in Mexico City, including 175 patients (and their caregivers) diagnosed with different types of dementia. We used the Spanish Caregiver Burden Screen. Descriptive analysis and logistic regressions were used to estimate the effect of the covariates on the caregiver burden. Results The results showed that patient variables have a greater impact on caregiver burden than caregiver-associated variables. Dysexecutive Syndrome, sleep disorders, schooling and caregiver depression are associated with a higher level of caregiver burden. Conclusions Caregiver burden is a complex phenomenon. The results of the present study showed the need to implement multifactorial interventions targeting the caregiver to reduce the burden, strengthen the skills for patient management to avoid depression, improve patient health, and diminish functional dependence and future hospitalization. Geriatr Gerontol Int 2014; 14: 146–152.
Martine F Roussel - One of the best experts on this subject based on the ideXlab platform.
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Dysexecutive Syndrome in parkinson s disease the grefex study
Aging Neuropsychology and Cognition, 2017Co-Authors: Martine F Roussel, Eugenie Lhommee, Pauline Narme, Virginie Czernecki, Didier Le Gall, Pierre Krystkowiak, Momar Diouf, Olivier GodefroyAbstract:ABSTRACTThe objectives of this study were to characterize the frequencies and profiles of behavioral and cognitive Dysexecutive Syndromes in PD (based on validated battery and diagnostic criteria) and to develop a shortened diagnostic battery. Eighty-eight non-demented patients with a diagnosis of PD were examined with an executive validated battery. Using a validated framework, the patients’ test results were interpreted with respect to normative data from 780 controls. A Dysexecutive Syndrome was observed in 80.6% of the patients [95% confidence interval: 71.1–90.1]. The Dysexecutive profile was characterized by prominent impairments in deduction, flexibility, inhibition and initiation in the cognitive domain, and by global hypoactivity with apathy and hyperactivity in the behavioral domain. This finding implies that patients with PD should be assessed with cognitive tests and a validated inventory for behavioral Dysexecutive Syndromes. A shortened battery (based on three cognitive tests and three behav...
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the Dysexecutive Syndrome of alzheimer s disease the grefex study
Journal of Alzheimer's Disease, 2014Co-Authors: Olivier Godefroy, Olivier Martinaud, Marc Verny, Chrystele Mosca, H Lenoir, Eric Bretault, Martine F RousselAbstract:Background Dysexecutive disorders are common in early-stage Alzheimer's disease (AD) but have yet to be characterized in detail. Objective The objectives of the present study based on validated diagnostic criteria were to determine the frequency and characterize the profile of behavioral and cognitive Dysexecutive disorders in AD. Methods 102 patients with AD (mild: n = 92; moderate: n = 10; mean MMSE score: 23.2) were examined with the GREFEX battery. Neuropsychological data were interpreted within a validated framework based on the performance levels of 780 control participants from the GREFEX study. Results Dysexecutive Syndrome was observed in 87.5% (95%CI: 79-96) of the AD patients (p = 0.0001). The Dysexecutive disorder profile was characterized by prominent impairments of planning, inhibition flexibility and generation in the cognitive domain (p = 0.0001 as compared to controls for all) and global hypoactivity in the behavioral domain (p = 0.0001 as compared to controls). Conclusions Dysexecutive Syndrome is observed in over 80% of AD patients and has a distinct profile.
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Dysexecutive Syndrome after stroke
2014Co-Authors: Olivier Godefroy, Pierre Yves Garcia, Jean Marc Bugnicourt, Claire Leclercq, Martine F RousselAbstract:Disorders of executive functions represent a leading form of post-stroke cognitive impairment, regardless of stroke mechanism, and are important contributors to post-stroke disability. This chapter reviews executive functions and impairment of these functions and then discusses the main disorders observed in stroke and their assessment.
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is the frontal Dysexecutive Syndrome due to a working memory deficit evidence from patients with stroke
Brain, 2012Co-Authors: Martine F Roussel, Kathy Dujardin, Hilde Henon, Olivier GodefroyAbstract:Although frontal Dysexecutive disorders are frequently considered to be due to working memory deficit, this has not been systematically examined and very little evidence is available for impairment of working memory in frontal damage. The objective of this study was to examine the components of working memory, their anatomy and the relations with executive functions in patients with stroke involving the frontal or posterior cortex. The study population consisted of 29 patients (frontal: n=17; posterior: n=12) and 29 matched controls. Phonological loop (letter and word spans, phonological store; rehearsal process), visuospatial sketchpad (visuospatial span) and the central executive (working memory span, dual task and updating process) were examined. The group comparison analysis showed impairment in the frontal group of: (i) verbal spans (P<0.03); (ii) with a deficit of the rehearsal process (P=0.006); (iii) visuospatial span (P=0.04); (iv) working memory span (P=0.001) that disappeared after controlling for verbal span and (v) running memory (P=0.05) unrelated to updating conditions. The clinical anatomical correlation study showed that impairment of the central executive depended on frontal and posterior lesion. Cognitive Dysexecutive disorders were observed in 11/20 patients with central executive deficit and an inverse dissociation was observed in two patients. Receiver operating characteristic curve analysis indicated that cognitive Dysexecutive disorders had the highest ability to discriminate frontal lesions (area under curve=0.844, 95% confidence interval: 0.74-0.95; P=0.0001; central executive impairment: area under curve=0.732, 95% confidence interval: 0.57-0.82; P=0.006). This study reveals that frontal lesions induce mild impairment of short-term memory associated with a deficit of the rehearsal process supporting the role of the frontal lobe in this process; the central executive depends on lesions in the frontal lobe and posterior regions accounting for its low frequency and the negative results of group studies. Finally, the frontal Dysexecutive Syndrome cannot be attributed to central executive impairment, although it may contribute to some Dysexecutive disorders.
-
Dysexecutive Syndrome diagnostic criteria and validation study
Annals of Neurology, 2010Co-Authors: Olivier Godefroy, Martine F Roussel, Philippe Azouvi, Philippe Robert, Didier Legall, Thierry MeulemansAbstract:Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Reflexion sur l'Evaluation des Fonctions Executives (GREFEX) group has proposed criteria for behavioral and cognitive Dysexecutive Syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive Dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods: A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive Dysexecutive disorders were examined using the GREFEX battery. Results: A Dysexecutive Syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive Dysexecutive disorders discriminated (p ¼ 0.001, all) patients from controls. The pattern of cognitive Syndrome differed (p ¼ 0.0001) according to the disease. Finally, behavioral (odds ratio (OR), 4.6; 95% confidence interval (CI), 2. 3-9.1; p ¼ 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p ¼ 0.001) Dysexecutive Syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p ¼ 0.002) were independent predictors of loss of autonomy. Interpretation: This study provided criteria of Dysexecutive Syndrome and showed that both behavioral and cognitive Syndromes contribute to loss of autonomy. Profiles vary across patients and diseases, and therefore systematic assessment of behavioral and cognitive disorders in reference to diagnostic criteria is needed. ANN NEUROL 2010;68:855-864
Christina Liossi - One of the best experts on this subject based on the ideXlab platform.
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the relationship between general intellectual ability and performance on ecologically valid executive tests in a severe brain injury sample
Journal of The International Neuropsychological Society, 2007Co-Authors: Rodger Ll Wood, Christina LiossiAbstract:Recent studies of brain injured and healthy individuals have provided empirical support for the theoretical proposition that executive function and general intelligence are closely associated by demonstrating that performance on tests of executive function is correlated with general intellectual ability (g). In the present investigation, the relationship between performance on the Wechsler Adult Intelligence Scale-III (WAIS-III), as a measure of g, and performance on recently developed ecological tests of executive function [i.e., Hayling and Brixton, Zoo Map and Key Search sub-tests from the Behavioral Assessment of the Dysexecutive Syndrome (BADS) battery], was examined in a sample of 118 severely brain injured individuals. The results indicated that (a) performance on tests of executive function share significant variance, and (b) a proportion of that shared variance is associated with performance on the WAIS-III. Correlations between conventional measures of executive function (i.e. Trails B and Controlled Oral Word Association) and WAIS-III were of comparable magnitude to the correlations between new, ecologically valid executive tests and WAIS-III. The results provide some support to the notion that tests of executive function measure non-specific intellectual functions, reminiscent of g.
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the ecological validity of executive tests in a severely brain injured sample
Archives of Clinical Neuropsychology, 2006Co-Authors: Rodger Ll Wood, Christina LiossiAbstract:It is unclear how well performance on recently developed, specialized executive tests, reflects problems that patients and their relatives complain of in real life. The ecological validity of four specialised tests of executive function: the Hayling and Brixton Tests, and the Zoo Map and Key Search sub-tests from the Behavioural Assessment of Dysexecutive Syndrome (BADS) battery, was assessed against the Dysexecutive Questionnaire from the BADS in a sample of 59 severely brain injured individuals. Results indicated that only the Hayling C was significantly negatively correlated (r=-.26, P<.05) with the informant version of the Dysexecutive Questionnaire. An index of insight was not correlated with any of the executive tests. It is concluded that these tests have limited ecological validity when used to assess patients following severe head trauma.