Executive Dysfunction Across Anxiety Severity Level: Evidence for Cognitive Plateau.

Background: Alcohol Use Disorder (AUD) is associated with significant cognitive impairments, particularly in executive functioning, yet evidence for cognitive rehabilitation therapy (CRT) in low-resource settings remains limited. This study evaluated the efficacy of CRT for mild executive dysfunction among male AUD patients in Zambia. Methods: A randomized controlled trial was conducted with 56 participants (aged 18-40 years) recruited from a residential rehabilitation center in Lusaka. Participants were randomized to either an 8-week CRT program (Brain Wave-R, n=28) or active control (painting sessions, n=28), both delivered alongside standard treatment. Executive function was assessed pre- and post-intervention using the Zambian Neurobehavioral Test Battery, including the Wisconsin Card Sorting Test (WCST), Colour Trails Test 2 (CTT), and Stroop Test. Results: The CRT group demonstrated significant improvements in response inhibition (Stroop Test: fewer errors, p=0.01; more words completed, p<0.01) compared to controls. However, no significant between-group differences emerged for cognitive flexibility (WCST: correct responses p=0.87; categories completed p=0.06) or task-switching (CTT: errors p=0.12; time p=0.56). Secondary analyses revealed government-employed participants showed better outcomes on WCST (p=0.04) and CTT (p=0.03), while those with chronic medical conditions performed worse on WCST (p<0.001). The control group showed unexpected but significant Stroop Test improvements (p<0.001), suggesting non-specific benefits of structured activities. Conclusion: CRT shows selective efficacy for improving response inhibition in Zambian AUD patients, with employment status and health conditions moderating treatment effects. These findings support targeted implementation of CRT in low-resource settings, particularly for patients without significant comorbidities. Future research should investigate optimal intervention duration and strategies to enhance effects on complex executive functions.

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.

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 < 0.0001). On WCST, cases completed fewer categories and demonstrated more total errors, perseverative errors, and perseverative responses (all p < 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

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

Sedentary behavior and physical inactivity are widespread among university students, negatively impacting physical and neurocognitive health. Executive functions and insulin-like growth factor 1 (IGF-1) are adversely affected by inactivity. Moreover, physical activity increases IGF-1 concentrations, which may mediate beneficial effects on brain health and cognitive performance. The effect of HIIT exercise combined with increased physical activity on these variables is not well understood. This study evaluated the chronic effects of HIIT, with or without increased physical activity, over 12 weeks of training and a 12-week follow-up period, on executive functions and IGF-1 concentrations in sedentary young university students. This randomized controlled trial included 77 sedentary female university students, assigned to three groups: HIIT (n = 25), HIIT plus increased daily physical activity (HIIT + PA, n = 25), and control group (CG, n = 27). The intervention involved assessments at baseline (T1), post-intervention (T2), and after a 12-week follow-up (T3). Salivary IGF-1 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Executive functions were evaluated with the Stroop Test, Wisconsin Card Sorting Test, and Digit Span Test. The HIIT protocol consisted of 40-min sessions, three times per week, delivered online. The HIIT + PA group also aimed to complete 10,000 steps per day. No statistically significant changes in IGF-1 concentrations were found over time or between groups, although descriptive increases were observed in both HIIT and HIIT + PA groups at follow-up. For executive functions, improvements over time were found in cognitive flexibility (WCST) and working memory (DST-B and DST-T), but without significant group × time interactions. Only WCST-E-P showed a significant group effect (p = 0.028), indicating possible differences between groups in cognitive rigidity. The HIIT + PA group showed a tendency toward improved inhibitory control (Stroop accuracy), although this was not supported by significant interaction effects. Working memory improvements (DST-B) were significant over time, especially in the HIIT group, but again without significant differences between groups. A 12-week HIIT program, with or without increased daily physical activity, can lead to improvements in executive functions in sedentary young women, particularly in working memory and cognitive flexibility. However, these changes were not exclusive to the intervention groups, suggesting possible contributions from repeated testing or other external factors. While IGF-1 levels showed upward trends, no significant group-level effects were confirmed. These findings highlight the potential cognitive benefits of HIIT but emphasize the need for further research with tighter controls and objective neurobiological measures to clarify the mechanisms involved. Incorporating HIIT into student routines may support cognitive health, but broader lifestyle interventions may be needed to sustain long-term benefits.

Objective: To examine if first-degree relatives (FDRS) of individuals diagnosed with Bipolar I Affective Disorder (BPAD) exhibit cognitive deficits and to assess whether such deficits may indicate a hereditary vulnerability to the disorder.Methods: This cross-sectional comparative study was conducted at Index Medical College, Hospital & Research Centre, Indore, comprising 90 participants divided equally into three groups: 30 patients diagnosed with Bipolar I Disorder (BPAD), 30 first-degree relatives (FDRs) of these patients, and 30 healthy control subjects.The groups were matched for age, gender, and educational background.All participants underwent comprehensive neuropsychological evaluations using standardised instruments, including the Wisconsin Card Sorting Test (WCST), PGI Memory Scale, Trail Making Test (TMT), Stroop Colour and Word Test (Golden Version), and Letter Cancellation Test (LCT).Psychiatric conditions were systematically excluded in FDRs and control subjects through structured clinical interviews and administration of the General Health Questionnaire (GHQ-12).Quantitative scores from cognitive tests were statistically analysed using One-way ANOVA was used for normally distributed variables, and the Kruskal-Wallis H test for non-parametric comparisons among the three groups.for normally distributed data and Mann-Whitney U tests for non-parametric data, with significance set at p < 0.05.Results: First-degree relatives (FDRs) of bipolar patients exhibited statistically significant cognitive deficits compared to the healthy control group.Specifically, the FDRs demonstrated pronounced impairments in executive functions, including categorisation and conceptual-level responses on the Wisconsin Card Sorting Test (WCST; p < 0.001), which highlights challenges in cognitive flexibility and strategic planning.Additionally, they exhibited significant deficits in attentional processing speed on the Trail Making Test (TMT; p < 0.01) and memory functions, as measured by the PGI Memory Scale (p < 0.01). Conclusions:The cognitive deficits identified in asymptomatic first-degree relatives of patients with bipolar disorder potentially reflect an underlying familial or genetic vulnerability to the disorder.These findings emphasise the value of routine neuropsychological assessments among family members, enabling the identification of at-risk individuals and guiding the implementation of early preventative and intervention strategies for bipolar disorder.

Executive dysfunction in euthymic bipolar disorder patients and its association with plasma biomarkers

P03-250 - Is executive function distinguishing schizophrenia from bipolar disorder?

ObjectivePrevious studies have suggested a positive association between physical activity (PA) and executive function in older adults. However, they did not adequately consider the compositional nature of daily time use and accumulated PA patterns. Therefore, this study aimed to examine the association between intensity or accumulated PA patterns and executive functions (inhibitory control, working memory, and cognitive flexibility) in community-dwelling older adults, considering the interaction of daily time spent in PA, sedentary behavior (SB), and sleep.MethodThis cross-sectional study used baseline data from a randomized controlled trial on the effect of exercise on cognitive function conducted between 2021 and 2022. Data from 76 community-dwelling older adults were used in the analysis. The time spent in PA and SB was assessed using an accelerometer, and sleep duration was self-reported. The Stroop task (inhibitory control), N-back task (working memory), and task-switching task (cognitive flexibility) were conducted to evaluate the subcomponents of executive function. Considering various potential confounders, compositional multiple linear regression analysis and compositional isotemporal substitution were performed to examine the association of PA with executive function and to estimate predicted changes in executive function in response to the hypothetical time-reallocation of movement behaviors, respectively.ResultsA longer time spent in light-intensity PA (LPA), relative to remaining behaviors, was associated with better Stroop task performance. Moreover, this association was stronger in LPA lasting longer than 10 min than in sporadic LPA. Additionally, theoretical 30 min/day time reallocation from SB or sleep to LPA was associated with better Stroop task performance (corresponding to approximately a 5%−10% increase). On the other hand, no significant associations of time spent in moderate- to vigorous-intensity PA with any subcomponents of executive function were observed.ConclusionLPA was positively associated with inhibitory control, and this association was stronger in bouts of LPA than in sporadic LPA. Moreover, reducing the time spent in SB or sleep and increasing the time spent in LPA, especially long-bout LPA, could be important measures for managing inhibitory control in late life. Future large longitudinal and intervention studies are needed to confirm these associations and reveal the causality and underlying mechanisms.

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.

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.

Phonemic and semantic fluency tasks are frequently used to differentiate executive control roles and the integrity of lexical-semantic representation. The main goal of this study is to determine the influence of basic executive components on phonemic and semantic productivity in children with mild intellectual disability. The sample consisted of 95 children with unspecified mild intellectual disability (MID), ages 10-13.11. Phonemic fluency was assessed by the Controlled Oral Word Association Test (COWAT), while semantic fluency was assessed by the Category Naming Test (CNT). Cognitive flexibility was assessed by Wisconsin Card Sorting Test (WCST) and Trail Making Test (TMT). Number Manipulation Task (NMT) was used for the verbal working memory assessment, while Day/Night Stroop Task was used for the assessment of inhibitory control. The results analysis showed that all of the assessed EF components significantly affect phonemic productivity. Semantic productivity significantly depends on WCST and TMT performance. Verbal working memory and inhibitory control do not significantly contribute to semantic productivity. The results of our study indicate that the discrepancy between phonemic and semantic productivity in children with MID could be directly associated with the basic executive functions components.

Executive Function and Decision-Making in Women with Fibromyalgia

Systematic review of executive functions in children with self-limited epilepsy with centrotemporal spikes