Executive Function of Brain

Psychiatry, Seminar, brain, Neurology

1. Executive Function Presenter Dr. Anusa A M First year MD PG Prepared by Prof. Rooban T, Oral & Maxillofacial Pathologist

2. Introduction

3. What is Executive Function Unified term for cognitive processes that regulate, control, manage other cognitive processes such as planning, working memory, attention, problem solving, verbal reasoning, inhibition, mental flexibility, task switching and initiation and monitoring of actions.

4. What is Executive Function ? Is a theorized cognitive system in psychology  that controls and manages other cognitive processes. Responsible for processes that are also referred to as executive functions, executive skills, supervisory attentional system, or cognitive control.

5. Definition

6. “The CEO of the Brain” Saltus , 2003 This description focus attention on the increase in frontal lobe synaptic connectivity that begins to occur during adolescence, eventually leading to developmental improvements in self-direction and self-control - Stuss & Alexander, 2000 Directive capacities of the human brain – Goldberg, 2001

7. Definition

8. Definition “There are specific processes related to different brain regions within the frontal lobes. There is no frontal homunculus, no unitary executive function” Stuss and Alexander (2000) “Multiple executive functions that govern human conscious perceptions, feelings, thoughts, and actions as constituting a collection of “co-conductors” of an orchestra in a highly collaborative manner with the others”

9. Definition The ability to Shift from one concept to another Modify behavior, particularly in response to new or modified information about task demands Synthesize and integrate isolated details into a coherent whole Manage multiple resources of information Make use of relevant acquired knowledge Stuss , 1992

10. Definition Ability to plan ahead and organize behavior across time and space in order to fulfill goals and intentions The ability to shift strategies and adapt to changing circumstances Planning, decision making, directed goal selection, and monitoring of ongoing behavior Also involved in self-awareness, empathy, and social sensitivity Temple, 1997

11. Definition Gioia , Isquith , Guy, & Kenworthy (1996) on defining Executive Functions: A collection of processes or interrelated functions responsible for Guiding, directing, managing cognition, emotion and behavior, particularly in novel problem-solving situations Purposeful, goal-directed problem-solving behavior

12. Definition Denckla (2001) “Clinical Descriptors—EF Terms from Cognitive Psychology:” Supra-ordinate (Higher Order) Processes Meta-cognitive or Metamodal Capacities Control Processes (Initiate, Sustain, Inhibit, Shift) Set Maintenance Self-Monitoring and Flexibility Inhibitory Processes Integrative Processes Sequencing/Organizing Processes

13. Models of Executive functions

14. EF Models Top-Down inhibitory control Model Supervisory Attentional Model system – Norman & Shallice , 1986 and further expansions Working memory Model- Baddley , 1996, 2002 Self regulatory Model Problem solving Model

15. EF Models Conceptual Model, Lezak Neurophysiological Model, Barkley, 1997 Miller and Cohen Model, 2001 Holarchical Model – McCloskey, 2004 Miyake and Friedman’s Model Cascade of control Model , Banich , 2009

16. Supervisory Attentional Model System Norman & Shallice , 1986 –

17. Contention Scheduling (3) Trigger Data Base Special-purpose Cognitive Subsystems (1) Perceptual System Supervisory Attentional System (4) Schema Control Units (Action) (2) Supervisory Attentional System Shallice (1981) Supervisory Attentional System

18. Supervisory Attentional Model System Shallice and Burgess, 1996 – expanded further

19. Working Memory Model Baddley , 1996 and 2002 Visual Semantics Episodic LTM Language

20. Neurophysiological model of Self regulation Barkley, 1997

21. The McClosky Holarchical Model, 2004

22. Self Activation Initiation and “ramping up” of basic executive functions related to an awakened state of mind and to overcoming sleep inertia.

23. Self Regulation A set of control capacities that cue and direct functioning across the domains of sensation/ perception, emotion, cognition, and action

24. Self Realization Directs cognitive processes that engage in self-awareness, self-reflection and self-analysis. Cues cognitive processes to access accumulated information about self and apply it in specific situations to initiate, sustain, or alter behavior.

25. Self Determination Foresight/Long-Term Planning and Goal Generation Directs the use of cognitive processes to construct visions of the future and plans for action over longer periods of time. Directs reflection on the past for purposes of improving or altering behavior and thinking in future.

26. Self Generation Pose speculative questions related to the meaning and purpose of life and/or the ultimate source(s) of reality and physical existence, mind-body relationships, spirit, and soul; contemplates existence beyond the physical plane. Directs the generation of a philosophy of life used to guide self-awareness, self-realization and the other levels of executive function processes; serves as a basis for an ultimate source of intentional behavior direction.

27. Trans-Self Integration Directs the engagement of mental processes that enable realization and experiencing of a trans-self state of ultimate or unity consciousness. In most spiritual traditions, this state is considered the highest achievement of human consciousness and therefore very different from the maladaptive states characteristic of clinical diagnoses of dissociative states.

28. IV. Self Generation III. Self Control: Self Determination Goal Generation II. Self Control: Self Regulation Initiate Modulate Execute (Behavior Syntax) Focus Attn Sustain Attn Monitor Check Interrupt/Stop Inhibit Perceive Organize Manipulate Store Retrieve I. Self Control: Self Activation Mind-Body Integration, Sense of Spirit Awaken, Attend Anticipate Hold Balance Correct Generate Time Sense Pace V. Trans-self Integration Sense of source, Cosmic consciousness Sensation/Perception Cognition Emotion Action Self Realization Self Awareness Self Analysis Long-Term Foresight/Planning Gauge Shift Associate Choose Focus Effort Sustain Effort Flexible Plan Time Mgt

29. Cascade of Control Model Unified concept of all existing models Bannich et al., 2009 Three levels Neurobiological Psychological Computational

30. Cascade of Control Model

31. Executive Function Development - Lines and Levels

32. EF development

33. Brain and EF

34. Arenas of Involvement for EF Variations in types of activities affected by EF is a key concept in understanding what we refer to as the arenas of involvement in which the effects of executive functions are manifested. 4 key arenas

35. Arena Implication Intrapersonal Control one’s own internal states Interpersonal Interactions with others Environment Interactions with the environment around them Symbol system Engagement with the tools of the culturally derived symbol systems used to process and share information Arena of interaction and EF

36. Internal command vs External demand Internal command Executive control can stem from a person’s own internal desires, drives, aspirations, plans, and proclivities Easier and Less effort External demand Executive control summoned by sources outside of the person, executive control is being initially cued. Tough, more effort

37. Domain Implication Perception Executive control of modes of input including perception of external (sensory) and internal (representational) stimuli Cognition Executive control of thoughts & thought processes Emotion Executive control of feelings & emotional processes Action Executive control of modes of output including behavior in external world and storage & retrieval of internal representations Domains of functioning

38. Other Executive Function Assessment dimensions

39. Contextual factors Factor Explanation Mental Stance Consciously directed vs. non consciously convected Locus of Intention Internally commanded vs. externally demanded Maturation Chronological age and degree of neural development Biological Constraint Medical conditions

40. Contextual factors Factor Explanation Multi-Cueing Capacity Simultaneous vs. sequential ordering of multiple EF capacities, multitasking, EF “syntax ” Task Constraints Constraints on how information is processed when performing a task Generalization Setting specific vs. setting nonspecific Energy Executive control stamina fluctuations Temporality Temporal nature of any observed stamina fluctuations

41. Information processing capacities

42. Time frames for reference Factor Explanation Immediate Initial registration Extended Immediate Active working memory Remote and recent past Retrieval from long term store

43. Areas of Academic skill

44. Tests for EF Wisconsin Card Sorting Test WCST; Heaton, Chelune , Talley, Kay, & Curtiss, 1993 Delis-Kaplan Executive Function System D-KEFS; Delis, Kaplan & Kramer, 2001 NEPSY: A Developmental Neuropsychological Assessment Korkman , Kirk, & Kemp, 1998 Behavioral Assessment of the Dysexecutive Syndrome BADS; Wilson, Alderman, Burgess, Emslie , & Evans, 1996 Behavior Rating Inventory of Executive Function BRIEF, BRIEF-2, BRIEF-SR; Gioia , Isquith , Guy, & Kenworthy , 2000 Frontal Systems Behavior Scale FrSBE ; Grace & Malloy, 2001.

45. Conditions with Executive Dysfunction ADHD Conduct disorder Depression Bipolar disorder OCD Tourette syndrome Huntington's disease Wilson's disease Schizophrenia Autism Asperger's syndrome Nonverbal learning disorders Turner's syndrome Fragile X syndrome Phenylketonuria Frontal brain tumors Traumatic brain injury Acquired brain injury, via toxins, anoxia, infections, etc Complex partial epilepsy of frontal origin Williams syndrome Velocardiofacial syndrome Hydrocephalus Fetal alcohol syndrome Metachromatic leukodystrophy Cerebellar tumors

46. EF in AD/HD Difficulties with the self- regulation cues of Inhibit, Focus/Select, and Sustain. Self-realization difficulties involving delayed development of self-awareness, self-analysis, long-term goal setting, and long term foresight/planning

47. EF in Autism Spectrum disorder Include deficiencies related to interpersonal arena. Involve perception, emotion, cognition, action, difficulties with self-analysis and self-awareness Severe deficits in self-determination Decreased Fluency, Impaired Planning, Altered Flexibility

48. EF in ODD, CD Multiple self-regulation and self realization deficits. Deficits are expressed in one arena of involvement—the interpersonal arena—and involve primarily the emotion and cognition domains of functioning. These difficulties are often accompanied by difficulties with self-analysis and self-awareness

49. EF in Schizoprenia Deficits include impairment in attention, working memory and EF Loss of verbal and visual learning and memory, working memory, immediate, selective and sustained attention, perceptual/motor processing and motor skills

50. EF in Schizoprenia Amnesia, Loss of episodic memory only Working memory and multi-tasking impairments typically characterize the disorder. Deficits in response inhibition and cognitive flexibility

51. EF in Parkinson’s disease Problems with memory and thought processes. Increased distractibility Problems in set formation and maintaining and shifting attentional sets Deficits in self-directed planning, problems solving

52. EF in Parkinson’s disease Working memory show deficits in the areas of: a) spatial working memory b) central executive aspects of working memory c) loss of episodic memories d) locating events in time

53. EF in Fetal Alcohol Spectrum disorder Decreased measures of planning ability, selective inhibition, concept formation and reasoning. Decreased set-shifting, planning and strategy use, attention and spatial working memory, longer reaction and decision time

54. EF in Bipolar disorder Problems of attentional processing, EF and verbal memory Impairment in visual memory, working memory and risk taking behavior, selective attention, attentional shifting, verbal planning, verbal memory, perseveration Loss of processing speed, inhibitory control, response inhibition and strategic thinking

55. Executive Functions Plan actions towards a goal Use information flexibly Realize consequences Draw inferences Independent of IQ

56. EF and Brain Function Capacity Implicated Brain area Self-Activation Reticular activating system, epithalamus, caudate nucleus, anterior cingulate, dorsolateral cortex Self-Regulation Perceive Prefrontal cortex, ventromedial prefrontal, paracingulate Initiate Orbitofrontal cortex, anterior cingulate ; dorsolateral prefrontal cortex; superior medial

57. EF and Brain Function Capacity Implicated Brain area Focus/Select Anterior cingulate; dorsolateral prefrontal cortex Gauge Anterior cingulate, dorsolateral prefrontal cortex Modulate Cingulate gyrus, orbitofrontal cortex, basal ganglia Interrupt/Stop Orbital prefrontal cortex, anterior cingulate , amygdale; right inferior frontal gyrus

58. EF and Brain Function Capacity Implicated Brain area Inhibit Middle and interior frontal gyrus, orbitofrontal cortex, caudate, nucleus, basal ganglia, striatum; left superior frontal cortex Sustain Dorsolateral prefrontal cortex, orbitofrontal cortex, thalamus, anterior cingulate Hold Dorsolateral prefrontal cortex, anterior cingulate gyrus , left frontal cortex, anterior insula , frontal gyrus , cerebellum, hippocampus

59. EF and Brain Function Capacity Implicated Brain area Manipulate Dorsolateral prefrontal cortex Organize Dorsolateral prefrontal cortex Store Left prefrontal cortex, basal ganglia Retrieve Hippocampus, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex Foresight/Plan Dorsolateral prefrontal cortex, orbitofrontal cortex, striatum, hippocampus, cerebellum Generate Left inferior frontal gyrus , bilateral frontal cortex and superior parietal lobes; dorsolateral prefrontal cortex; anterior cingulated

60. EF and Brain Function Capacity Implicated Brain area Associate Left dorsolateral prefrontal cortex Balance Cerebellar-frontal pathway, anterior cingulated Time Orbitofrontal cortex Pace Basal ganglia, dorsolateral prefrontal cortex; anterior cingulated Execute Dorsolateral prefrontal cortex, interior parietal, striatum,basal ganglia Monitor Dorsolateral prefrontal cortex, anterior cingulate ; right lateral prefrontal cortex

61. EF and Brain Function Capacity Implicated Brain area Correct Dorsolateral prefrontal cortex, orbitofrontal cortex Self-Realization Self-Awareness Posterior cingulate or paracingulate sulcus , anterior medial and ventromedial prefrontal cortex, parietal region, left and right basal temporal regions, left orbitofrontal cortex, frontal gyrus , limbic and insula regions

62. EF and Brain Function Capacity Implicated Brain area Self-Determination Orbitofrontal cortex, ventromedialprefrontal cortex Self- Generation Medial frontal gyrus, posterior cingulate, angular gyrus, dorsolateral prefrontal cortex, anterior cingulated Trans- Generation Prefrontal cortex, anterior cingulate , reticular and middle thalamic region, basal ganglia, dorsolateral prefrontal cortex

63. Prefrontal Cortex and EF PFC is a major area for EF to occur though other areas are involved 4 important functions involved Selective attention Working memory Preparatory set Monitoring

64. Perpetual Memory Acquired through sensory organs. @ basic level- memory of elementary sense perceptions, in sensory and parasensory cortices. @ higher levels, multimodal sensory memories, in "trans-modal" cortex @ higher cortex - includes episodic and semantic memories to form declarative memory. The highest level is conceptual memory , f orm of perceptual knowledge.

65. Fuster J., 2003

66. Thank You

67. Declarative Memory Declarative memory is conscious memory. Knowledge of facts and events episodic (time-related data of past experiences) semantic (fact-related) data. Declarative memory stores information about facts (who, what, when, where) and the relationship between them. “explicit memory” or “cognitive memory.”

68. Nondeclarative Memory: That cannot be accessed consciously. Motor learning, habits, and conditioning. Includes skills achieved through repetitious exposure Involves multiple senses , systems Utilizes multiple motor and cognitive pathways in its execution. Other names “implicit memory,” “dispositional memory,” or “ nonconscious memory.”

69. Types of memory Short term or Working Memory Long term memory - stored, permanent information Semantic Memory - general information involving who, what, why Episodic Memory- information associated with time and place where memory was formed Procedural Memory - stores information on how to do something Perceptual Memory - serves to identify objects and structure of language; memory through senses

70. Short term or Working Memory Short lived; unprocessed;   3 phase - central executive, the visuo -spatial sketchpad, and the phonological loop

71. Phyletic memory is a basic form of memory from primary sensory and motor cortices and foundation of individual memory Executive memory is the representation of motor acts and behaviors