It is increasingly recognised that chronic exposure to opioids has been associated with neuropsychological impairment during both active use and following a period of abstinence. The overall objective of this thesis was to review the relevant prior literature in a systematic manner and subsequently to describe the effects of chronic exposure to prescribed and illicit opioids using an ambispective cohort study design. A systematic literature review was conducted to identify if chronic (defined as a period for more than 3 months) exposure to opioids (prescribed and/or illicit) was associated with measurable neuropsychological deficits. This review was conducted accordingly to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The results were subsequently described within three cognitive domains of intelligence, executive function and memory and learning. Out of a total of 905 articles extracted between 1964 and 2009, 49 articles were considered appropriate for selection and review. Studies of current and abstinent chronic opioid users (illicit heroin users, patients prescribed methadone for illicit opioid dependence and patients taking opioids as part of the management of chronic pain) have identified performance deficits in measures of executive functioning and memory. These have included impairments within the domains of cognitive and motor impulsivity, strategic planning, cognitive flexibility, attention and memory. However other studies found no clear deficits when comparing the performance of healthy controls. The literature suggested that these neuropsychological deficits may be subject to at least partial recovery following initiation of methadone or total withdrawal from any opioids.This review also highlighted several methodological issues that affect the reliability, validity and clinical relevance of the results obtained. Subsequently a two year ambispective cohort design study was conducted which tested representative opioid exposed participants and healthy controls. Cohorts of participants with validated histories of illicit heroin use (HEROIN, n=24), stabilised methadone maintenance (METHADONE, n=29), chronic opioid prescriptions for pain (CHRONIC PAIN, n=28) and controls (HEALTHY CONTROL, n=28) were recruited. The study was designed to test neuropsychological performance in the HEALTHY CONTROL and CHRONIC PAIN groups on one occasion; and for the HEROIN and METHADONE groups on three and two occasions respectively. The intention was to describe neuropsychological performance in the HEROIN group under conditions of stable illicit heroin use, in controlled opioid withdrawal and when subsequently stabilised on methadone. For the METHADONE group, participants were tested twice, six months apart, to test for changes induced by chronic exposure to methadone. Eligible, screened and consented individuals were tested on nine tests from the CANTAB test battery. Data were analysed using univariate or repeated measures ANCOVA with a between subjects factor of GROUP. Further a priori subgroup analyses were conducted using (1) a two-group factor reflecting DEPENDENCE status and (2) a two-group factor reflecting INJECTING status separately as between subject factors. The homogeneity of variance across groups in repeated-measures design ANCOVAs was assessed by the Mauchly Sphericity Test. NART, age in years, SIMD, total Fagerström score, years in education and past alcohol use in years were used as covariates. A significance level of p<0.01 was applied due to multiple testing, in addition to the post-hoc Bonferroni correction procedure. On the Cambridge Gambling Task (CGT), HEROIN users placed higher bets earlier and risked more. They also showed increased motor impulsivity, impaired strategic planning and visuospatial memory on the Affective Go-NoGo (AGN), Stockings of Cambridge (SOC), and Delayed Matching to Sample(DMS) respectively. METHADONE users deliberated longer and placed higher bets earlier on the CGT, but did not show a tendency to risk more. METHADONE users were also more inattentive and demonstrated poor strategic planning and visuospatial memory on the Spatial Span (SSP) task. The CHRONIC PAIN participants did not exhibit significant impairment in neuropsychological performance on all the CANTAB tasks. Participants from the HEROIN, METHADONE and CHRONIC PAIN groups did not present with impaired cognitive flexibility. Chronic opioid dependence is associated with neuropsychological impairment reflected in altered performance on measures of risk taking and strategic planning. These data support the hypothesis that these neuropsychological impairments reflect an underlying trait vulnerability to drug taking and/or dependence rather than an effect of chronic exposure to opioids. Notably, motor impulsivity and visuo-spatial memory in HEROIN users improved after three weeks stability with methadone. Methadone use seems to confer improvement in some aspects of neuropsychological performance following cessation of heroin and sustains other deficits during long term stable methadone treatment. Dependence and injecting status do not contribute to the causation or deterioration of the identified neuropsychological impairments. Further long term longitudinal studies to help elucidate cognitive endophenotypes responsible for the components in the initiation, continuation and deterioration of neuropsychological deficits present in an opioid dependent population is necessary.

INTRODUÇÃO: A apatia constitui o transtorno neuropsiquiátrico mais prevalente na doença de Alzheimer (DA) e se relaciona com uma série de desfechos deletérios. Sua neurobiologia ainda é pouco compreendida, e alguns autores postulam sua associação com disfunção de circuitos fronto-estriatais. A maior parte da evidência disponível sobre essa relação provém de estudos em que foram avaliados pacientes com DA leve a moderada. OBJETIVO: Investigar a associação entre apatia e disfunção executiva em estágios bastante iniciais do processo de declínio cognitivo no contexto da DA. MÉTODOS: Foram avaliados 87 indivíduos, sendo 28 deles com DA leve, 26 com Comprometimento Cognitivo Leve de subtipo amnéstico (CCLa) e 33 controles. Os participantes foram submetidos a uma bateria de avaliações da qual constavam a Bateria Breve de Rastreio Cognitivo (BBRC-Edu), o Mini-Exame do Estado Mental (MEEM), a Entrevisa Executiva (EXIT-25), a Bateria de Avaliação Frontal (BAF), a Escala de Avaliação de Demência (DRS), o Teste de Aprendizagem Auditivo Verbal de Rey (RAVLT), a Escala de Avaliação de Incapacidade na Demência (DAD) e a Escala de Apatia (EA). Explorou-se correlações entre o desempenho nos testes empregados e os escores aferidos pela EA, nos grupos com comprometimento cognitivo (DA ou CCLa), e em grupos constituídos a partir da combinação deles, considerando os pacientes com CCLa conversores à DA no seguimento. RESULTADOS: O grupo de pacientes com DA apresentava média de idade de 81,9 ± 4,8 anos e escolaridade média de 2,5 ± 2,0 anos. O grupo com CCLa apresentava média de idade de 80,8 ± 3,7 anos e escolaridade média de 3,7 ± 2,8 anos. O grupo dos controles apresentava média de idade de 79,5 ± 3,5 anos e escolaridade média de 3,7 ± 3,3 anos. Os três grupos não se distinguiam significativamente quanto às suas características sociodemográficas. Não foram observadas correlações entre o desempenho em quaisquer dos testes de função executiva empregados e os escores obtidos por meio da EA. Observou-se correlação forte entre o desempenho funcional auferido através da DAD e os escores na EA (rho= -0,7; p<0,001) no grupo DA. Documentou-se correlação moderada entre a sintomatologia apática e o desempenho na subescala Atenção da DRS (rho= -0,59; p<0,01) e em tarefas de evocação tardia nos testes de memória episódica da BBRC (rho=-0,37; p<0,05) e do RAVLT (rho= -0,47; p< 0,001), quando analisados em conjunto os pacientes com DA e aqueles com CCLa que converteram para DA. CONCLUSÃO: Nesta amostra de indivíduos com baixa escolaridade, composta por pacientes com DA leve e CCLa, não se observou associação entre o desempenho em testes de função executiva e a sintomatologia apática medida pela EA / INTRODUCTION: Apathy is the most prevalent neuropsychiatric disorder in Alzheimer disease (AD), and has been related to several deleterious outcomes. Its neurobiology is still poorly understood, and some studies have suggested an association with frontostriatal circuits dysfunction. Most of this evidence comes from studies with mild to moderate AD patients. OBJECTIVE: To investigate the association between apathy and executive dysfunction in the very early stages of cognitive impairment in the context of AD. METHODS: 87 subjects were evaluated, being 28 with mild AD, 26 with amnestic Mild Cognitive Impairment (aMCI) and 33 controls. The participants were submitted to a comprehensively evaluation consisting on the Brief Cognitive Screening Battery (BCSC), the Mini-Mental State Examination (MMSE), the Executive Interview (EXIT-25), the Frontal Assessment Battery (FAB), the Mattis Dementia Rating Scale (DRS), the Rey Auditory Verbal Learning Test (RAVLT), the Disability Assessment in Dementia (DAD), and the Apathy Scale (AS). Correlations were investigated between AS scores and the performance in the cognitive measures within the two cognitively impaired groups (AD or aMCI) and also within combinations of them, considering aMCI convertion to AD. RESULTS: The AD group had mean age of 81.9 ± 4.8 years, and 2.5 ± 2.0 mean years of formal education, while the aMCI group had mean age of 80.8 ± 3.7 years and a mean of 3.7 ± 2.8 years of schooling. Controls were aged 79.5 ± 3.5 years, with 3.7 ± 3.3 years of education. The three groups did not differ statistically from each other regarding the main sociodemographic features. There was no correlation between any executive measure and AS scores. We found strong correlations between AS scores and functional performance evaluated with the DAD (rho= -0.70; p <0.001) in the AD group. There were also modest to moderate correlations between AS scores and DRS Attention subscale (rho= -0.59; p<0.01), and with delayed recall tasks of episodic memory tests from the BCSB (rho=-0.37; p<0.05) and the RAVLT (rho= -0.47 ; p< 0.05), when AD and aMCI converters were analysed toghether as a group. CONCLUSION: In this sample consisting of mild AD and aMCI subjects, with very low educational level, we failed to find any association between executive function tests performance and apathy symptoms measured with the AS

Research on physical activity has revealed that physical activity may be beneficial for not only physical health, but also mental functioning (Center for Disease Control, 2014; Alexander, Allen, & Bindoff, 2013). For instance, physical activity has been shown to alleviate symptoms of stress responses, has shown promise in alcohol and substance abuse treatments, and has been shown to improve executive functioning in adult and adolescent populations (Taylor, Sallis, & Needle, 1985; Best, 2010). While little research on relations between physical activity and executive functioning in infancy and early childhood exist, the limited results have surprisingly revealed a negative relation between the two (Rothbart, 2001). To investigate these diverging patterns, we aimed to investigate a possible moderator of the physical activity-executive function association, namely, maternal encouragement of physical activity. Fifty-six children (26 boys) visited the lab at M = 18.3 months (SD = 0.43 months). The Early Childhood Behavior Questionnaire (ECBQ; Putnam et al., 2006) superdimension of effortful control was used as a surrogate measure of early executive function. To measure child activity level, we used the mother-reported activity level subdimension from the ECBQ, and also coded mother-child free play periods to quantify children’s predilection to use physical activity in the service of social or cognitive objectives, such as grasping a spoon and extending the arm outwards to feed a baby doll, which we termed sociocognitive activity. To measure sociocognitive activity we used a modified version of Tamis-LeMonda and Bornstein’s (1990) play competence scale wherein each instance of sociocognitive activity was noted and summed for a total score of sociocognitive activity level (See Table 1). Finally, to gauge maternal encouragement, a modified version of the Dyadic Parent Child Interaction Coding System (DPICS; Eyeberg, Nelson, Duke, & Boggs, 2005) was used to identify maternal commands, praise, questions, physical involvement, talking, touching, and scaffolding behaviors during mother-child free play sessions. Zero-order correlations revealed a significant negative relationship between mother-reported activity level and child executive function (r = -.42, p < 0.01), replicating previous findings. However, correlations between sociocognitive activity and executive function, while positive, was not significant. We conducted moderation analyses separately for each maternal encouragement variable, and found that a higher amount of maternal questioning during play corresponded to a positive association between sociocognitive activity and executive functioning (moderator = 1.00, p < 0.05). These findings partially support our hypotheses and suggest that the ways in which caregivers direct and train activity during play through questioning strategies may also direct and train cognitive functioning. However, further research is needed to support these claims. These results also point toward issues with the measurement of activity level, as our two measures of activity produced significantly different correlations with executive functioning (z = -3.4, p < 0.01). Future research in the area of motor development as it pertains to cognitive functioning should investigate and develop a standard measure of motor activity that is capable of capturing not only simple milestone achievement and intensity levels, but also the amount of sociocognitive engagement during physical activity.

Sleep is a fundamental and essential component of vertebrate life, although its exact function remains unknown. Animals that are deprived of sleep typically show reduced neurobiological performance, health, and in some cases, survival. However, a number of animals exhibit adaptations that permit them to carry out normal activities even when sleep is restricted or deprived. Lapland longspurs (Calcarius lapponicus), arctic-breeding passerine birds, exhibit around-the-clock activity during their short breeding season, with an inactive period of only 3–4 h/day (71°N). Whether these birds suffer behavioral and physiological costs associated with acute sleep loss (SL) is unknown. To assess the effects of SL, wild-caught male longspurs were placed in captivity (12L:12D) and trained for 2 months using a series of memory tests, including color association and spatial learning to assess executive function. Birds were then placed in automated sleep fragmentation cages that utilize a moving wire to force movement every 1 min (60 arousals/h) during 12D (inactive period) or control conditions (during 12L; active period). After a single round of SL (or control) treatment, color association and spatial learning tests were conducted. Baseline plasma corticosterone concentration, body mass, and satiety were also assessed. SL significantly elevated corticosterone levels and increased accuracy during the color association test, but not the overall time required to complete the test. SL had no effect upon spatial learning, body mass, or satiety. Taken together, these results suggest that Lapland longspurs exhibit a behavioral, but not a physiological, resilience to acute SL.

Only one third of older breast cancer survivors (BCS) meet national physical activity (PA) guidelines. Theories of self-regulation and research with older adults suggest that executive function (EF) plays an important role in PA, yet the impact of lower EF on older survivors’ PA is unknown. My project addressed this gap using secondary data from the Thinking and Living with Cancer (TLC) cohort study, which examined cognitive function among older BCS pre-treatment, followed every 12 months, and contemporaneously assessed matched controls. My first aim was to test two hypotheses regarding EF change and PA and determine if these relationships differ between BCS and controls. My hypotheses were: 1) EF decline from baseline to 12 months will predict lower PA at 24 months, and 2) lower PA at 12 months will predict EF decline from 12 to 24 months. My second aim was to explore whether the effects of EF change on PA in BCS differed based on risk factors for accelerated cognitive decline (i.e., older age, more advanced cancer stage, comorbidity, and <i>APOE</i> ε4 genotype). The TLC study measured EF with neuropsychological tests and PA with the International Physical Activity Questionnaire-Short Form. For aims 1 and 2, I used multiple regression with multiple imputation. Primary results showed no significant effect of EF change from baseline to 12 months on PA at 24 months (β=-0.01, p=0.88) and no significant group (BCS vs. controls) by EF interaction (β=-0.05, p=0.33). Separate models in BCS and controls showed similar findings. In the entire sample, PA at 12 months significantly predicted EF change from 12 to 24 months (β=0.17, p=0.01), but there was no significant group by PA interaction (β=-0.06, p=0.54). Separate analyses by group found a significant effect of PA for controls (β=0.07, p=0.02), but not for BCS (β=0.05, p=0.27). Regarding the second aim, there were no significant interactions between EF change and the proposed risk factors on PA. Findings were largely inconsistent with theory and prior research. Continued research in this area will inform future exercise interventions to improve physical and cognitive health for the growing population of older cancer survivors.

The effects of age/maturation, grade, amount of school exposure, and early or late entry into school, on mathematics and executive function skills of pre-kindergarten and kindergarten students was examined. The sample consists of four-and five-year olds from low-income ethnic minority families enrolled in pre-kindergarten (pre-K) (n = 42) and kindergarten (n = 40). Assessments of mathematics competency and executive function were conducted by trained researchers in the fall of the school year. Regression analyses were conducted to test the effects of age/maturation and amount of schooling, while independent samples t-test were used to examine late versus early entry into school, the value of pre-K attendance, and if grade level matters. The findings revealed that there is a maturation effect to an extent in the beginning of the preschool year. The importance of school exposure (pre-K attendance) and early entry was also confirmed. A future longitudinal study needs to be conducted that follows the same cohort from pre-K to adulthood in order to find the long term effects underlying this debate. / acase@tulane.edu

Decision-making in the context of leadership, has received scant attention in the management literature, which has traditionally centered on general mental ability and personality as predictors of effectiveness. This research effort bridges the neuroscientific and management literatures to offer an alternative, neuropsychological profile of effective leadership by proposing prefrontal brain processes (executive function) as a key component and predictor of complex decision-making and leadership effectiveness. While the management literature has largely viewed decision-making as a cognitive ability, neuroscience informs us that this complex function emerges from the integration of affective and cognitive signals in the prefrontal cortex. In an attempt to identify the neural predictors of effective leadership decision-making, 105 corporate leaders were assessed on a robust array of neuropsychological indices of prefrontal brain function. These were in turn correlated with their leadership and decision-making abilities after controlling for general mental ability and personality, utilizing structural equation modeling. Executive function incrementally predicts complex decision-making and transformational leadership effectiveness, above and beyond general mental ability. Complex decision-making does not appear to be central to leadership effectiveness, while extraversion emerges as the strongest predictor of transformational leadership followed by executive function. Executive function, extraversion and general mental ability do not predict transactional leadership. These results would need replication in a larger dataset to establish their validity, especially in the case of executive function. While the heritability of leadership ability has emerged as fairly significant, this opens the field to unearthing the biological variables and predictors of leadership ability. Neuroscience thus has the potential to offer biomarkers and metrics of leadership that can further not only our foundational knowledge of organizational behavior, but can also find useful applications in recruitment, training and development practice, though this cross-disciplinary initiative is in its infancy. Based on the preliminary results from this study, executive function (which has so far remained in the domain of neurology) has the potential to inform and measure leadership effectiveness.

Children from non-English-speaking homes often lag behind their English speaking peers academically. However, people who speak two languages often have better executive functioning skills than people who speak only one language. Executive functions are neurologically-based skills related to managing oneself to achieve a goal. The relation between bilingualism and executive function may be due to how two languages are processed in the brain. However, it is unclear if more balanced bilinguals experience larger gains in executive function than people who are less balanced. Children from low-income homes are at a disadvantage as compared to children from homes with higher incomes. A quarter of children in the Head Start program, which serves children from low-income homes, come from homes that speak a language other than English which puts them at a double disadvantage. Longitudinal data from 3-year-old children enrolled in Head Start who were from Spanish-speaking households were used to investigate whether there were different patterns of dual language development and if those patterns related differently to executive function. Results revealed three groups of dual language development. Groups were compared in terms of children’s performance on a nonverbal executive functioning task. Results showed that children in the group that had the most similar proficiency between English and Spanish had the highest average executive functioning scores, even after controlling for child age and gender. This indicates balanced bilingualism may enjoy additional benefits to executive functioning development as compared to individuals with relative imbalance between languages.

Individuals with Asperger syndrome (AS), an autism spectrum disorder, are characterized by average to superior intelligence while at the same time experiencing severe and pervasive deficits in social interaction. While many individuals with AS report that they keenly desire social relationships, the combination of repeated social failures and intelligence sufficient to appreciate these difficulties increases the risk for developing depression, anxiety, and other mental health concerns (Tantam, 1998; 2000). <p>Emotional intelligence (EI) is a construct that offers potential to understand individual emotional and social characteristics. The broad purpose of the two studies in this project was to examine ability and trait approaches to EI to understand if EI offers enriched understanding of social outcomes in AS. Further, this study explored EI, executive functions (EF), and theory of mind (ToM) to understand whether EI singularly or in combination with other theoretical explanations best accounts for social outcomes in individuals with AS. <p>The participants in this study were 25 young adults (aged 16-21) diagnosed with AS in Alberta and Manitoba. In study 1, trends and differences between AS and normative groups were examined. Further, correlation and multiple regression were employed to explore relationships amongst variables. Results indicated that trait EI was impaired for individuals with AS; however ability EI was intact. Regression analyses revealed that trait and ability EI together predicted 57% the variance for self-reported interpersonal skills and 31% of the variance for parent-reported social skills. Trait EI alone predicted 19% of the variance for self-reported social stress. <p>In study 2, EI, EF, and ToM were explored as predictors of social outcomes. Low correlations between EF and outcome variables precluded further analysis with this particular set of variables. Multiple regression procedures revealed that together ToM and trait EI predicted 33 % of the variance for self-reported Social Stress. The findings suggest that including ToM and EI measures in assessment protocols for individuals with AS provides important information to inform interventions.

Background: The current study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR) intervention to improve contextual processing of objects in children with autism. Contextual processing is a cognitive ability thought to underlie the social and communication deficits of autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its basic component abilities: abstraction and cognitive flexibility. Methods: Four children with autism participated in a multiple baseline single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information. One-on-one teaching sessions occurred three times per week for approximately two weeks. Results: All children demonstrated significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test. Changes in context-related behaviours were reported. Conclusions: Further studies using virtual reality to target specific cognitive impairments in children with autism are warranted.