Journal of the International Neuropsychological Society

Table of Contents - January 2012 - Volume 18, Issue 01  

Research Articles

Dysexecutive Functioning in Mild Cognitive Impairment: Derailment in Temporal Gradients

Joel Eppiga1, Denene Wambacha1, Christine Nievesa1, Catherine C. Pricea2, Melissa Lamara3, Lisa Delano-Wooda4, Tania Giovannettia5, Brianne M. Bettchera6, Dana L. Penneya6, Rod Swensona7, Carol Lippaa1, Anahid Kabasakaliana1, Mark W. Bondia4 and David J. Libona1 c1

a1 Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania

a2 Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida

a3 Department of Psychiatry, University of Illinois, Chicago, Illinois

a4 Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, California and the Psychology Service, Veterans Administration San Diego Healthcare System, San Diego, California

a5 Department of Psychology, Temple University, Philadelphia, Pennsylvania

a6 Department of Neurology, The Lahey Clinic, Burlington, Massachusetts

a7 Department of Neuroscience, University of North Dakota Medical School, Fargo, North Dakota

Abstract

Libon et al. (2010) provided evidence for three statistically determined clusters of patients with mild cognitive impairment (MCI): amnesic (aMCI), dysexecutive (dMCI), and mixed (mxMCI). The current study further examined dysexecutive impairment in MCI using the framework of Fuster's (1997) derailed temporal gradients, that is, declining performance on executive tests over time or test epoch. Temporal gradients were operationally defined by calculating the slope of aggregate letter fluency output across 15-s epochs and accuracy indices for initial, middle, and latter triads from the Wechsler Memory Scale-Mental Control subtest (Boston Revision). For letter fluency, slope was steeper for dMCI compared to aMCI and NC groups. Between-group Mental Control analyses for triad 1 revealed worse dMCI performance than NC participants. On triad 2, dMCI scored lower than aMCI and NCs; on triad 3, mxMCI performed worse versus NCs. Within-group Mental Control analyses yielded equal performance across all triads for aMCI and NC participants. mxMCI scored lower on triad 1 compared to triads 2 and 3. dMCI participants also performed worse on triad 1 compared to triads 2 and 3, but scored higher on triad 3 versus triad 2. These data suggest impaired temporal gradients may provide a useful heuristic for understanding dysexecutive impairment in MCI. (JINS, 2012, 18, 20–28)

(Received November 14 2010)

(Revised August 15 2011)

(Accepted August 15 2011)

Keywords

Correspondence:

c1 Correspondence and reprint requests to: David J. Libon, Drexel University, College of Medicine, 245 North 15th Street, 7th Floor, Philadelphia, PA 19102. E-mail: dlibon@drexelmed.edu

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