Executive Functions in Health and Disease: New book to help integrate Cognitive Neuroscience and Neuropsychology


Neu­ro­science used to be the monop­oly of a few elite uni­ver­si­ties locat­ed in a hand­ful of coun­tries. Neu­ropsy­chol­o­gy used to be a quaint niche dis­ci­pline rel­a­tive­ly uncon­nect­ed to the larg­er world of neu­ro­science and con­tent in its meth­ods with paper-and-pen­cil tests. Neu­ro­science itself was rel­a­tive­ly uncon­cerned with high­er-order cog­ni­tion, and the very term “cog­ni­tive neu­ro­science” was often met with rolled eyes by sci­en­tists work­ing in more estab­lished areas of brain research (a per­son­al obser­va­tion made in the 1980s and even 1990s on more than one occa­sion). And the inter­est in exec­u­tive func­tions was shared by a very small club of neu­ropsy­chol­o­gists and neu­ro­sci­en­tists, a fact often not­ed in their times by the pio­neers of “frontal-lobe” research Alexan­der Luria and a gen­er­a­tion lat­er Patri­cia Goldman-Rakic.

None of this is true today. Impor­tant neu­ro­science research is con­duct­ed at numer­ous aca­d­e­m­ic and bio­med­ical cen­ters world­wide. We are wit­ness­ing a sub­stan­tial fusion, or at least blend­ing, of cog­ni­tive neu­ro­science and neu­ropsy­chol­o­gy. The terms “exec­u­tive func­tions” and “frontal-lobe func­tions” are no longer used inter­change­ably, and a more refined under­stand­ing of both has emerged. Exec­u­tive func­tions in health and dis­ease have become the tar­get of intense inves­ti­ga­tion by scores of researchers, arguably one of the most heav­i­ly pop­u­lat­ed ter­ri­to­ries of cog­ni­tive and clin­i­cal neu­ro­science (I recall a slide used in her lec­tures by the late Gold­man-Rakic, with the num­ber of stick-men drawn in each lobe reflect­ing the rel­a­tive lev­el of research inter­est in its func­tions. The slide, with its con­spic­u­ous near-absence of stick-men in the frontal lobe, would have to be re-drawn today). The range of research tools deployed for the under­stand­ing of exec­u­tive func­tion and dys­func­tion has also grown and con­tin­ues to grow. Today it includes ani­mal mod­els, genet­ic stud­ies, bio­chem­i­cal approach­es, var­i­ous forms of struc­tur­al and func­tion­al neu­roimag­ing, com­pu­ta­tion­al mod­el­ing involv­ing neur­al nets and oth­er meth­ods, lesion and spe­cif­ic dis­or­der stud­ies, as well as a con­stant­ly expand­ing arse­nal of sophis­ti­cat­ed cog­ni­tive probes. In its clin­i­cal appli­ca­tions, the research into the nature of exec­u­tive dys­func­tion is no longer lim­it­ed to the tra­di­tion­al neu­ropsy­cho­log­i­cal ter­ri­to­ry of focal lesions direct­ly con­tained with­in the frontal lobes, and has expand­ed into a wide range of both focal and non-focal dis­or­ders whose impact is not restrict­ed to the pre­frontal cortex.

The vast expan­sion of inter­est in both healthy and impaired exec­u­tive func­tions is reflect­ed in the chap­ter com­po­si­tion of this book. Among the con­trib­u­tors are rec­og­nized author­i­ties who played a piv­otal role in shap­ing the mod­ern under­stand­ing of exec­u­tive func­tions, as well as young neu­ro­sci­en­tists who joined the field rel­a­tive­ly recent­ly. The con­trib­u­tors employ a wide range of tech­nolo­gies and tools and con­duct their research at uni­ver­si­ties in North Amer­i­ca; West­ern, Cen­tral, and East­ern Europe; Asia; and Aus­tralia. Cap­tur­ing the gen­er­a­tional, geo­graph­ic, and method­olog­i­cal expanse of the inter­est in exec­u­tive func­tions has been the editor’s intent and is a dis­tin­guish­ing fea­ture of the volume.

The book is divid­ed into two sec­tions: Exec­u­tive Func­tions in Health and Exec­u­tive Func­tions in Dis­ease. In the first sec­tion, var­i­ous aspects of healthy exec­u­tive func­tions are exam­ined. The top­ics include a broad gen­er­al con­cep­tu­al­iza­tion of exec­u­tive func­tions by a pre­em­i­nent pio­neer of the field (Joaquin Fuster); cel­lu­lar mech­a­nisms of exec­u­tive func­tions and work­ing mem­o­ry (Taber Light­bourne and Amy Arn­sten); gene expres­sion in the frontal lobes (Zelj­ka Krznik and Goran Sed­mak); large-scale net­works and the frontal lobes (Adam Hamp­shire); com­pu­ta­tion­al neur­al net mod­el­ing of exec­u­tive func­tions and deci­sion mak­ing (Daniel Levine); frontal lobes and con­scious­ness (Seth Lew and Hak­wan Lau); neu­rode­vel­op­men­tal aspects of exec­u­tive func­tions (Layne Kalbfleisch); changes affect­ing exec­u­tive func­tions in aging (Nathan Spreng, Leena Shoe­mak­er, and Gary Turn­er); and a broad sur­vey of neu­ropsy­cho­log­i­cal assess­ment meth­ods used in the neu­ropsy­cho­log­i­cal research into exec­u­tive func­tions (Yana Suchi, Rose­mary Ziem­nik, and Madi­son Niermeyer).

In the sec­ond sec­tions, mul­ti­ple forms of exec­u­tive dys­func­tion are exam­ined across a wide range of neu­ro­log­i­cal, psy­chi­atric, and med­ical con­di­tions. Both broad cat­e­gories of dis­or­ders and spe­cif­ic dis­or­ders are exam­ined. The broad clin­i­cal cat­e­gories exam­ined include the mech­a­nisms of cog­ni­tive, behav­ioral and emo­tion­al inflex­i­bil­i­ty, and per­se­ver­a­tion across a num­ber of neu­ropsy­chi­atric dis­or­ders (Daniel Weisholtz, John Sul­li­van, Aaron Nel­son, Kirk Daffn­er, and David Sil­ber­sweig); large-scale cog­ni­tive con­trol net­work alter­ation in neu­ropsy­chi­atric dis­or­ders, includ­ing autism, schiz­o­phre­nia, and depres­sion (Melis­sa-Ann Makie and Jin Fan); exec­u­tive func­tions in neu­rode­vel­op­men­tal dis­or­ders, includ­ing ADHD, focal frontal lesions, and epilep­tic foci (Masao Aihara); exec­u­tive dys­func­tion in stri­atal dis­or­ders, includ­ing Parkinson’s dis­ease, Huntington’s dis­ease, and chron­ic stress (Joao Cer­gueira and Nuno Sousa); exec­u­tive dys­func­tion in demen­tias, includ­ing Alzheimer’s dis­ease, vas­cu­lar demen­tia, fron­totem­po­ral demen­tia, pro­gres­sive supranu­clear pal­sy and cor­ti­cobasal syn­drome, motor neu­ron dis­ease, Parkinson’s dis­ease, Lewy body demen­tia, and Huntington’s dis­ease (Michal Har­cia­rek, Emil­ia Sitek, and Anna Bar­czak); exec­u­tive dys­func­tion in med­ical con­di­tions, includ­ing hyper­ten­sion, dia­betes mel­li­tus, chron­ic kid­ney dis­ease, HIV encephalopa­thy, hepat­ic encephalopa­thy, thy­roid dis­ease, and rheuma­toid arthri­tis (Michal Har­cia­rek and Alek­san­dra Woj­tow­icz); addic­tions to a num­ber of sub­stances, includ­ing cannabis, cocaine, metham­phet­a­mine, and opi­oids (Anto­nio Verde­jo-Gar­cia); exam­i­na­tion of the par­al­lels between the effects of lat­er­al­ized frontal lesions, hemi­parkin­son­ian syn­dromes, and vari­ants of Tourette’s syn­drome (Kjell Hov­ik, Merete Oie, and Elkhonon Gold­berg); as well as a broad sur­vey of neu­ropsy­cho­log­i­cal assess­ment meth­ods used for the clin­i­cal assess­ment of exec­u­tive func­tions (Yana Suchi). The spe­cif­ic dis­or­ders exam­ined include exec­u­tive dys­func­tion and efforts to reha­bil­i­tate it in trau­mat­ic brain injury (Irene Christo­fori and Jor­dan Graf­man); frontal-lobe seizures (Sara Wild­stein and Sil­vana Rig­gio); exec­u­tive deficit in post-trau­mat­ic stress dis­or­der (Jen­nifer New­man and Charles Mar­mar); and exec­u­tive dys­func­tion in Tourette’s syn­drome (Kjell Hovik).

From being a niche research enter­prise, exec­u­tive func­tions research has bur­geoned into a vast area of neu­ro­science with its own nich­es and sub-nich­es, often with rel­a­tive­ly lit­tle inter­ac­tion between them. While prob­a­bly unavoid­able, such “Balka­niza­tion” of the field is unfor­tu­nate and self-defeat­ing. Hope­ful­ly, com­bin­ing in one vol­ume chap­ters on basic and clin­i­cal exec­u­tive func­tions research employ­ing a vari­ety of approach­es and
method­olo­gies will help update the read­ers’ knowl­edge of the advances in their own nich­es as well as help famil­iar­ize them with the state of affairs in oth­ers; both update the read­ers about the more recent work by acknowl­edged lead­ers in the field, and intro­duce him to the new gen­er­a­tion of neu­ro­sci­en­tists advanc­ing our under­stand­ing of exec­u­tive func­tion and dys­func­tion and rep­re­sent­ing the future of the field.

Elkhonon Gold­berg
Decem­ber 2016
New York City

— The above is the Pref­ace from the new book Exec­u­tive Func­tions in Health and Dis­easeedit­ed by Dr. Elkhonon Goldberg.

  • Descrip­tion: Exec­u­tive Func­tions in Health and Dis­ease pro­vides a com­pre­hen­sive review of both healthy and dis­or­dered exec­u­tive func­tion. It dis­cuss­es what exec­u­tive func­tions are, what parts of the brain are involved, what hap­pens when they go awry in cas­es of demen­tia, ADHD, psy­chi­atric dis­or­ders, trau­mat­ic injury, devel­op­men­tal dis­or­ders, cut­ting edge meth­ods for study­ing exec­u­tive func­tions and ther­a­pies for treat­ing exec­u­tive func­tion dis­or­ders. It will appeal to neu­ropsy­chol­o­gists, clin­i­cal psy­chol­o­gists, neu­ro­sci­en­tists and researchers in cog­ni­tive psychology.
  • Intend­ed read­ers: Neu­ropsy­chol­o­gists, cog­ni­tive psy­chol­o­gists, clin­i­cal psy­chol­o­gists, neu­ro­sci­en­tist, neu­rol­o­gists, psychiatrists

To learn more about the book and to buy it:

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SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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