Efficacy of Cognitive Rehabilitation Therapy for Alcohol-Induced Executive Dysfunction: A Zambia RCT

Anxiety disorders are increasingly recognized as involving neurocognitive impairments in executive functioning, including working memory, inhibitory control, and cognitive flexibility. However, Indian research has predominantly emphasized emotional and behavioural manifestations, leaving the neuropsychological correlates of anxiety severity underexplored. To investigate the relationship and differences in executive functioning among individuals with varying levels of anxiety. A cross-sectional study was conducted with 60 patients, classified into mild, moderate, or severe anxiety using the PROMIS Anxiety-Adult Short Form. Neuropsychological assessment included the Wechsler Memory Scale (WMI), Stroop Test (inhibitory control), and Wisconsin Card Sorting Test (conceptual processing). Data were analysed using ANOVA, post hoc comparisons, chi-square tests, Pearson's correlations, and linear regression. Ethical approval and informed consent were obtained. Significant group differences emerged across all domains (WMI: F = 6.87, p = .002; Stroop: F = 13.09, p < .001; WCST: F = 17.72, p < .001). Post hoc tests showed superior performance in the mild group relative to moderate and severe groups, with no significant differences between the latter two. Anxiety severity correlated negatively with executive functioning (r = -0.45 to -0.61, p < .01). Regression analyses confirmed severity as a significant predictor, explaining 20%-37% of variance in executive performance. Executive dysfunction worsens with increasing anxiety severity, with cognitive decline plateauing between moderate and severe levels. Strong correlations highlight severity as a critical determinant of working memory, inhibitory control, and conceptual processing. Findings underscore the need to integrate neuropsychological assessment and cognitive rehabilitation into anxiety management in Indian clinical settings.

Interaction of oxidative stress and BDNF on executive dysfunction in patients with chronic schizophrenia

To investigate attention, memory, verbal-linguistic ability, and executive functions in symptom-free young offspring having a parent with bipolar I disorder (BD1O) in comparison with healthy controls (CO). Materials and methods: Thirty symptom-free BD1O and 37 CO were recruited. The groups (both all participants and those &amp;amp;gt;=11 years of age) were well-matched for age, sex, IQ, and years of education. The neurocognitive battery included the Rey Auditory Verbal Learning and Memory Test, Controlled Word Association Test, Digit Span Test, Trail Making Test, Auditory Consonant Trigram Test, Wisconsin Card Sorting Test, Stroop Test, and Test of Variables of Attention. Results: The BD1O group demonstrated impairments in psychomotor speed, focused attention, verbal attention, phonemic verbal fluency, short-term memory, and learning functions and performed marginally worse in divided attention, information processing, and working memory. No group difference was found in sustained attention, executive functions, or alternating attention. Conclusion: Divided attention, information processing, and working memory seem to be important in evaluating the cognitive pathology before the onset of affective psychopathology.

To explore the magnetic resonance spectroscopy characteristics of lenticular nucleus in Bipolar II disorder and its relation with cognitive function. Thirty Bipolar II disorder patients in hospital from 2012 September to 2013 April and twenty healthy controls were evaluated with Multi-Voxel 1H-MRS scans on lenticular nucleus to assess the NAA, Cho, Cr and MI. All subjects were assessed for attention using the Stroop Test and executive function by Wisconsin card sorting test. NAA, Cho, Cr in right lenticular nucleus and Cr in left lenticular nucleus were lower than healthy controls (P < 0.05). The patients showed significant cognitive impairment in all aspects of Stroop Test and Wisconsin card sorting test (P < 0.05). NAA in right lenticular nucleus was positively correlated with correct number of Stroop-CW. Neural dysfunction in right lenticular nucleus of Bipolar II disorder may influence attention function. Cellular energy metabolism rate was reduced in bilateral lenticular nucleus.

Executive dysfunctions are part of the clinical symptoms of a stroke and can inhibit the process of rehabilitation. Patients with impaired executive functions may manifest aggression, impulsiveness, impaired thinking and planning. The aim of this study was to assess the effect of the ischemic focus location on the effectiveness of physiotherapy in improving the executive functions in patients after stroke. Ninety patients after unilateral ischemic cerebral stroke were studied. We studied 45 patients treated at the Department of Rehabilitation and Physical Medicine of the WAM University Hospital of Lodz for 5 weeks. The rehabilitation program included: kinesitherapy, physiotherapy, speech therapy, psychological consultations and psychotherapy. The control group consisted of patients who were waiting for admission to the Department of Rehabilitation. The patients in both groups were divided into three subgroups with different locations of stroke: front, back and subcortical. Executive functions were measured by the Wisconsin Card Sorting Test (WCST), the trail making test (TMT - A, TMT - B), the verbal fluency test (VFT). Patients rehabilitated in the hospital with the front and subcortical lesion location reported improvement in executive functions in terms of a greater number of the analyzed indicators of the Wisconsin Card Sorting Test (WCST) than those with the back lesion location. Patients rehabilitated at home with the subcortical lesion location did not experience a significant improvement in executive functions in any of the analyzed indicators of the Wisconsin Card Sorting Test (WCST). Most of the indicators, with the exception of the total errors of Wisconsin Card Sorting Test (WCST) and TMT B, have not been modified by the location of stroke. Executive dysfunction occurs not only in patients with an anterior location of the stroke, but also in the posterior and subcortical locations. Patients with a subcortical location of the stroke require more treatment to mitigate the dysfunction.

Background: The aim of this study was to investigate the executive functions in patients with sporadic schizophrenia (SS) and familial schizophrenia (FS), and the executive functions in their parents. Methods: The study included 30 patients with FS and their 37 parents with a positive family history of schizophrenia; 30 patients with SS and their 44 parents; 30 controls matched with the patients for gender, age and education, and 40 controls matched with the parents for gender, age and education (211 subjects in total). All the subjects were interviewed with the Structured Clinical Interview for DSM-IV-Axis I (SCID-I). The executive functions were assessed using the Verbal Fluency Test (VFT), the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and the Stroop Test. Results: Patients with FS and their parents, and patients with SS performed significantly worse than their controls on the VFT, TMT, WCST and the Stroop test. There were no statistically significant differences between parents of patients with SS and their controls on any of the tests except for the Stroop color score. FS parents performed significantly worse than SS parents on all tests. FS patients performed significantly worse than SS patients on the VFT, TMT, Stroop test. Conclusion: Previous studies that investigated the cognitive functions of relatives of patients with schizophrenia brought out inconsistent results. The present study investigated relatives with and without a family history of schizophrenia separately and found that executive functions were impaired only in parents with a positive family history of schizophrenia. These findings suggest that impairment in executive functions may represent a genetic endophenotype for schizophrenia.

Readers Discuss: the Business of Nursing

The aim of this study was to assess executive functions of obese individuals with binge eating disorder. Thirty-eight obese individuals with binge eating disorder were compared to thirty-eight obese controls without binge eating disorder in terms of their executive functions. All individuals were assessed using the following instruments: Digit Span, Trail Making Tests A and B, Stroop Test and the Wisconsin Card Sorting Test. In addition, four subtests from the Behavioral Assessment of the Dysexecutive Syndrome Battery were also used, namely the Zoo Map Test, the Modified Six Elements Test, the Action Program Test and the Rule Shift Cards Test. When compared to obese controls, obese individuals with binge eating disorder presented significant impairment in the following tests: Digit Span backward, Zoo Map Test, Modified Six Elements Test, and Action Program Test. Subjects with binge eating disorder also showed significant more set shifting and perseverative errors in the Wisconsin Card Sorting Test. In other measures such as the Digit Span Forward, the Trail Making Test, the Stroop Test and the Rule Shift Cards Test, obese subjects with binge eating disorder did not differ significantly from obese subjects without binge eating disorder. These results suggest that, in the present sample, obese individuals with binge eating disorder presented executive deficits, especially impairments relating to problem-solving, cognitive flexibility and working memory.

Objective: The aim of this study is to examine the relationship between executive functions such as selective atten-tion, response inhibition and cognitive flexibility and social-cognitive and social-perceptual theory of mind (ToM) functions in obsessive-compulsive disorder (OCD) patients. Methods: The Demographic Information Form, Beck Anxiety Scale, Beck Depression Scale, Wisconsin Card Sorting Test (WCST), Stroop Test, Eyes Test, Hinting Test were applied to 48 patients with OCD diagnosis and 39 healthy subjects. The Yale Brown Obsessive Compulsive Scale was administered to the OCD group. Results: While there was no difference in selective attention and re-sponse inhibition between the groups, it was found that the OCD group performed poorly in terms of cognitive flexi-bility. Compared to groups ToM tests, The OCD group was found to score significantly lower than the control group in the Eyes Test. In the OCD group, there was no significant correlation between ToM tests and other continuous numerical variables. In the control group, there was a moderate negative correlation between the Hinting Test score and Stroop 5 duration. Conclusion: To our knowledge, our study is the second study in the literature to show that impairment in social-perceptual ToM functions that may be specific to OCD and that this condition is independent of impairment in cognitive functions. Further studies with greater samples are needed.

Introduction: Substance use during adolescence and young adulthood is a major public health concern, particularly for alcohol and opioids. Neurocognitive impairments related to substance use can adversely affect executive functioning and decision-making. This study compared cognitive functioning and demographic profiles of adolescents and young adults using alcohol or opioids with healthy controls.Method: A comparative cross-sectional study was conducted with alcohol users (n = 36) and opioid users (n = 36), each matched with 36 healthy controls. Sociodemographic data including age, gender, education, socioeconomic status, marital status, and parental education were recorded. Cognitive performance was assessed using the Trail Making Test (Parts A and B) and the Wisconsin Card Sorting Test (WCST). Independent t-tests and chi-square tests were applied for analysis.Results: Cases and controls did not differ significantly in age, gender, marital status, residency, or socioeconomic status. Substance users showed marked cognitive deficits compared to controls. Both alcohol and opioid users had significantly longer completion times on Trail Making Tests A and B (p &lt; 0.0001). On WCST, cases completed fewer categories and demonstrated more total errors, perseverative errors, and perseverative responses (all p &lt; 0.0001). Alcohol users additionally had significantly higher failures to maintain set, unlike opioid users.Conclusion: Adolescents and young adults with alcohol and opioid use exhibited significant impairments in executive function, attention, and cognitive flexibility. Early detection and cognitive rehabilitation are essential to limit long-term neurocognitive consequences. How to cite this article:Shankar V, Roopalatha M. A Study on the Spectrum of Fungal Pathogens Isolated in ICU patient: A Study from Tertiary Care Centre. J Commun Dis. 2025;57(3):1-5. DOI: https://doi.org/10.24321/0019.5138.202561

Meta-analytical and electrophysiological evidence for executive dysfunction in primary dystonia

Catechol-O-Methyltranferase (COMT) plays a crucial role in the removal of cortical dopamine and is strongly implicated in human executive function. Numerous studies have reported associations of the COMT Val158Met (rs4680) polymorphism with executive function in healthy subjects. However, little work has investigated this in the Thai population and the relationship of age and education with this association remains unclear. Therefore, this study was designed to investigate the association of this polymorphism of the COMT gene with executive cognitive brain function in healthy subjects and the relationship with age and education. The Wisconsin Card Sorting Test (WCST) was performed to assess executive function in 254 healthy Thai subjects (aged 20-72 years). The results showed a significant association of rs4680 with executive function, in which Val/Met heterozygotes demonstrated better cognitive set shifting performance. Moreover, Met allele carriers showed a significantly stronger effect in the categories completed score than did Val homozygotes. Furthermore, age and education also showed a significant association with COMT genotype and WCST. These results revealed that executive cognitive function is associated with COMT genotype and influenced by age and/or education level in a Thai sample.

The questionnaire DEX was designed by Wilson et al. in 1996 to explore the disturbances of executive functions (EF) in activities of daily living (ADL). This study was performed to explore the specificity of the DEX to evaluate executive dysfunction in ADL, and its contribution to the distinction between Alzheimer's disease (AD) and frontotemporal dementia (FTD). 13 patients with the frontal variant of FTD, 19 patients with FTD associated with amyotrophic lateral sclerosis, FTD/SLA, 18 patients with Alzheimer's disease, AD, and 24 controlled subjects. The scores on the DEX completed by a proxy as well as those on two scales assessing ADL (the Cognitive Difficulties Scale by McNair & Kahn, and a composite scale (NADL) including the evaluation of basic (BADL) and instrumental (IADL) by the Lawton & Brody scales, and of social activities (SADL) from Katz & Lyerly) were compared to neuropsychological tests assessing EF (Behavioural Assessment of Dysexecutive Syndrome (BADS), Wisconsin Card Sorting Test, Stroop test, Trail Making Test B, lexical and categorical verbal fluencies, WAIS-III similarities). No correlation was found between the scores on the DEX or the other ADL scales, and the BADS scores. Scores on DEX showed some weak correlations with some executive tasks, but no stronger than those found with the other ADL scales. Analysis of the most frequently perturbed DEX items failed to show a characteristic profile for EF dysfunction. No significant difference was found between patients with AD and DFT on the scores on the DEX as well as on other ADL scales, when adjusted for dementia severity (assessed by the Mattis Dementia Rating Scale (MDRS)). No difference was found between MA and DFT patients neither in the profile of the most frequently perturbed DEX items, nor in decreased awareness of the disorders assessed by comparison of the scores on the DEX completed by patients and familiars. In this study, DEX does not appear as a specific tool for assessing EF dysfunction in ADL compared to other ADL scales. It was more related to global cognitive difficulties as assessed by the CDS and the MDRS. Scores on the DEX as well as on other ADL scales do not contribute to the distinction between AD and FTD.

ObjectiveAlthough the executive function subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) have been used to assess cognitive function in diverse psychiatric illnesses, few studies have verified the validity of this battery for Korean psychiatric patients. Therefore, this preliminary study evaluated the construct and concurrent validity of the executive function subtests of the CANTAB for Korean psychiatric patients by comparing it with subtests of the Computerized Neuropsychological Test (CNT).MethodsThree subtests of the CANTAB and three subtests of the CNT were administered to 36 patients diagnosed with either schizophrenia or bipolar disorder. Subtests of the CANTAB included the Intra/Extra-Dimensional Set Shift (IED), Stockings of Cambridge (SOC), and Spatial Working Memory (SWM). Differences between groups on each subtest as well as correlations between the subtests of the CANTAB and the CNT were assessed.ResultsThe schizophrenia group performed significantly more poorly on the IED and the Wisconsin Card Sorting Test (WCST) compared with the bipolar disorder group. Additionally, correlation analyses revealed a significant correlation between the IED and the WCST; a positive correlation between the SOC and the Trail Making Test, Part B and the Stroop test; and a significant correlation between the SWM and the Stroop test.ConclusionThis study verified the construct and concurrent validity of the executive function subtests of the CANTAB for Korean psychiatric patients and suggests that the subtests of this battery would be useful and appropriate for assessing deficits in executive function in Korean clinical settings.

Studies of adults who have been diagnosed with, and treated for, bipolar disorder have shown that these patients exhibit impairment on measures of executive functioning. However, it is unclear whether executive dysfunction precedes the diagnosis of bipolar illness, or develops subsequent to its onset. Moreover, investigators have failed to control for the effects of premorbid attentional problems on cognitive performance in these patients. The present authors explored these questions using data from a longitudinal prospective study of individuals at risk for major mood disorder. Results revealed that 67% of participants who met criteria for bipolar disorder in young adulthood showed impairment on the Wisconsin Card Sorting Test (WCST) when they were assessed during adolescence, as compared with 17% of individuals with no major mood diagnosis, and 19% with unipolar depression. This association between performance on the WCST and bipolar illness was not accounted for by high rates of premorbid attentional disturbance. In fact, among participants with early attentional problems, only those who ultimately developed bipolar disorder exhibited impairment on the WCST. Early attentional problems that preceded unipolar depression or no mood disorder were not associated with executive dysfunction.