Assessing the dysexecutive syndrome in dementia

David A. Gansler*, Edward D. Huey, Jessica J. Pan, Eric Wasserman, Jordan Henry Grafman

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: We compared performance on tests of dysexecutive behaviour (DB) and executive function (EF) in patients with behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and corticobasal syndrome (CBS). Methods: Patients diagnosed with bvFTD (n=124), PPA (n=34) and CBS (n=85) were recruited. EF was measured with the Delis-Kaplan Executive Function System (DKEFS: performance based), and DB was measured with the Frontal Systems Behavior Scale (FrSBe: caregiver-report based). Confirmatory factor analysis characterised the relationship between EF and DB, binary logistic regression evaluated the incremental diagnostic utility of the measures and neuroimaging data from 110 patients identified neural correlates. Results: EF was lowest and DB was highest in bvFTD participants. EF and DB were distinct but related (r= -0.48). Measures correctly classified 89% of bvFTD from CBS patients and 93% of bvFTD from PPA patients -30% and 13% above base rates (59%, 80%), respectively. All modalities were useful in identifying CBS and PPA, whereas DB alone was useful for identifying bvFTD. EF was uniquely associated with caudal left dorsolateral prefrontal and lateral temporo-parietal cortices. DB was uniquely associated with the cingulate (R>L), right subcallosal and right anterior frontal cortex. EF and DB were associated with the rostral dorsolateral prefrontal cortex bilaterally. Conclusions: EF and DB measures displayed criterion and construct validity, had incremental utility at low DB levels (CBS and PPA) and were associated with overlapping and distinct neural correlates. EF and DB procedures can conjointly provide useful diagnostic and descriptive information in identifying and ruling out the dysexecutive syndrome.

Original languageEnglish (US)
Pages (from-to)254-261
Number of pages8
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume88
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Executive Function
Dementia
Primary Progressive Aphasia
Frontotemporal Dementia
Parietal Lobe
Frontal Lobe
Prefrontal Cortex
Neuroimaging
Caregivers
Statistical Factor Analysis
Logistic Models

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Gansler, David A. ; Huey, Edward D. ; Pan, Jessica J. ; Wasserman, Eric ; Grafman, Jordan Henry. / Assessing the dysexecutive syndrome in dementia. In: Journal of Neurology, Neurosurgery and Psychiatry. 2017 ; Vol. 88, No. 3. pp. 254-261.
@article{0d8c0fd235d444348054ef8e5d09fdd5,
title = "Assessing the dysexecutive syndrome in dementia",
abstract = "Objective: We compared performance on tests of dysexecutive behaviour (DB) and executive function (EF) in patients with behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and corticobasal syndrome (CBS). Methods: Patients diagnosed with bvFTD (n=124), PPA (n=34) and CBS (n=85) were recruited. EF was measured with the Delis-Kaplan Executive Function System (DKEFS: performance based), and DB was measured with the Frontal Systems Behavior Scale (FrSBe: caregiver-report based). Confirmatory factor analysis characterised the relationship between EF and DB, binary logistic regression evaluated the incremental diagnostic utility of the measures and neuroimaging data from 110 patients identified neural correlates. Results: EF was lowest and DB was highest in bvFTD participants. EF and DB were distinct but related (r= -0.48). Measures correctly classified 89{\%} of bvFTD from CBS patients and 93{\%} of bvFTD from PPA patients -30{\%} and 13{\%} above base rates (59{\%}, 80{\%}), respectively. All modalities were useful in identifying CBS and PPA, whereas DB alone was useful for identifying bvFTD. EF was uniquely associated with caudal left dorsolateral prefrontal and lateral temporo-parietal cortices. DB was uniquely associated with the cingulate (R>L), right subcallosal and right anterior frontal cortex. EF and DB were associated with the rostral dorsolateral prefrontal cortex bilaterally. Conclusions: EF and DB measures displayed criterion and construct validity, had incremental utility at low DB levels (CBS and PPA) and were associated with overlapping and distinct neural correlates. EF and DB procedures can conjointly provide useful diagnostic and descriptive information in identifying and ruling out the dysexecutive syndrome.",
author = "Gansler, {David A.} and Huey, {Edward D.} and Pan, {Jessica J.} and Eric Wasserman and Grafman, {Jordan Henry}",
year = "2017",
month = "3",
day = "1",
doi = "10.1136/jnnp-2016-313576",
language = "English (US)",
volume = "88",
pages = "254--261",
journal = "Journal of Neurology, Neurosurgery and Psychiatry",
issn = "0022-3050",
publisher = "BMJ Publishing Group",
number = "3",

}

Assessing the dysexecutive syndrome in dementia. / Gansler, David A.; Huey, Edward D.; Pan, Jessica J.; Wasserman, Eric; Grafman, Jordan Henry.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 88, No. 3, 01.03.2017, p. 254-261.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Assessing the dysexecutive syndrome in dementia

AU - Gansler, David A.

AU - Huey, Edward D.

AU - Pan, Jessica J.

AU - Wasserman, Eric

AU - Grafman, Jordan Henry

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective: We compared performance on tests of dysexecutive behaviour (DB) and executive function (EF) in patients with behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and corticobasal syndrome (CBS). Methods: Patients diagnosed with bvFTD (n=124), PPA (n=34) and CBS (n=85) were recruited. EF was measured with the Delis-Kaplan Executive Function System (DKEFS: performance based), and DB was measured with the Frontal Systems Behavior Scale (FrSBe: caregiver-report based). Confirmatory factor analysis characterised the relationship between EF and DB, binary logistic regression evaluated the incremental diagnostic utility of the measures and neuroimaging data from 110 patients identified neural correlates. Results: EF was lowest and DB was highest in bvFTD participants. EF and DB were distinct but related (r= -0.48). Measures correctly classified 89% of bvFTD from CBS patients and 93% of bvFTD from PPA patients -30% and 13% above base rates (59%, 80%), respectively. All modalities were useful in identifying CBS and PPA, whereas DB alone was useful for identifying bvFTD. EF was uniquely associated with caudal left dorsolateral prefrontal and lateral temporo-parietal cortices. DB was uniquely associated with the cingulate (R>L), right subcallosal and right anterior frontal cortex. EF and DB were associated with the rostral dorsolateral prefrontal cortex bilaterally. Conclusions: EF and DB measures displayed criterion and construct validity, had incremental utility at low DB levels (CBS and PPA) and were associated with overlapping and distinct neural correlates. EF and DB procedures can conjointly provide useful diagnostic and descriptive information in identifying and ruling out the dysexecutive syndrome.

AB - Objective: We compared performance on tests of dysexecutive behaviour (DB) and executive function (EF) in patients with behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and corticobasal syndrome (CBS). Methods: Patients diagnosed with bvFTD (n=124), PPA (n=34) and CBS (n=85) were recruited. EF was measured with the Delis-Kaplan Executive Function System (DKEFS: performance based), and DB was measured with the Frontal Systems Behavior Scale (FrSBe: caregiver-report based). Confirmatory factor analysis characterised the relationship between EF and DB, binary logistic regression evaluated the incremental diagnostic utility of the measures and neuroimaging data from 110 patients identified neural correlates. Results: EF was lowest and DB was highest in bvFTD participants. EF and DB were distinct but related (r= -0.48). Measures correctly classified 89% of bvFTD from CBS patients and 93% of bvFTD from PPA patients -30% and 13% above base rates (59%, 80%), respectively. All modalities were useful in identifying CBS and PPA, whereas DB alone was useful for identifying bvFTD. EF was uniquely associated with caudal left dorsolateral prefrontal and lateral temporo-parietal cortices. DB was uniquely associated with the cingulate (R>L), right subcallosal and right anterior frontal cortex. EF and DB were associated with the rostral dorsolateral prefrontal cortex bilaterally. Conclusions: EF and DB measures displayed criterion and construct validity, had incremental utility at low DB levels (CBS and PPA) and were associated with overlapping and distinct neural correlates. EF and DB procedures can conjointly provide useful diagnostic and descriptive information in identifying and ruling out the dysexecutive syndrome.

UR - http://www.scopus.com/inward/record.url?scp=84979747331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84979747331&partnerID=8YFLogxK

U2 - 10.1136/jnnp-2016-313576

DO - 10.1136/jnnp-2016-313576

M3 - Article

VL - 88

SP - 254

EP - 261

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

IS - 3

ER -