Cognitive flexibility (CF) is the ability to adapt cognitive strategies according to the changing environment. The deficit in CF has often been linked to various neurological and psychiatric disorders including schizophrenia. However, the operationalization and assessment of CF have not been unified and the current research suggests that the available instruments measure different aspects of CF. The main objective of the present study was to compare three frequently used neuropsychological measures of CF-Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Stroop Color and Word Test (SCWT) in a population of patients (N = 220) with first-episode schizophrenia spectrum disorders in order to evaluate their convergent validity. The hypothesis of an underlying latent construct was tested via a confirmatory factor analysis. We used a one-factor CF model with scores from WCST, SCWT and TMT as observed variables. The established model showed a good fit to the data (χ2 = 1.67, p = 0.43, SRMR = 0.02, RMSEA = 0.0, CFI = 1.00). The highest factor loading was found in WCST as CF explained most of the variance in this neuropsychological measure compared to the other instruments. On the other hand, a TMT ratio index and a SCWT interference demonstrated lowest loadings in the model. The findings suggest that not all the frequently used measures share an underlying factor of CF or may capture different aspects of this construct.

• MeSH
• Adult MeSH
• Executive Function * physiology   MeSH
• Factor Analysis, Statistical MeSH
• Cognitive Dysfunction * etiology   diagnosis   physiopathology   MeSH
• Cognitive Flexibility MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Neuropsychological Tests * standards   MeSH
• Psychometrics MeSH
• Schizophrenic Psychology * MeSH
• Schizophrenia * complications   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Cognitive Behavioral Therapy methods   MeSH
• Cognition Disorders epidemiology   complications   MeSH
• Feeding and Eating Disorders etiology   MeSH
• Publication type
• Congress MeSH

Úvod: Obsedantně-kompulzivní porucha (OCD) je chronické neuropsychiatrické onemocnění s heterogenními symptomy v podobě obsesivních myšlenek a kompulzivního jednání. Kompulzivní chování charakterizované maladaptivními opakujícími se, nepružnými vzorci myšlení a jednání, poukazuje na nedostatek kognitivní flexibility u pacientů s OCD. V souladu s tímto klinickým pozorováním poukazuje mnoho studií na abnormality v kognitivní flexibilitě u pacientů s OCD v behaviorální i neurobiologické rovině. Kognitivní flexibilita je schopnost měnit své chování na základě vnějších podmínek, a uzpůsobovat ho tak potřebám svým i okolí. Cílem tohoto přehledu je zmapovat studie, které se zabývají efektivitou intervencí zaměřených na kognitivní flexibilitu u pacientů s OCD. Metoda: Pro účely přehledu literatury byla provedena systematická rešerše v databázi PubMed dle předem zvolených klíčových slov. Použity byly klinické a randomizované klinické studie zaměřující se se na intervenci cílenou na kognitivní flexibilitu. výsledky: Nálezy sledovaných studií se shodují ve smyslu oslabené kognitivní flexibility u OCD pacientů, jsou však rozporuplné s ohledem na efektivitu použitých intervencí. Zatímco některé studie reportují zlepšení kognitivní flexibility u pacientů s OCD po aplikované intervenci (zejména v případě metod využívajících postupy zaměřené přímo na kognitivní funkce), jiné očekávanou změnu v měřené kognitivní flexibilitě nenachází. Srovnatelnost nálezů je navíc značně limitovaná zejména s ohledem na variabilitu použitých metod při posuzování kognitivní flexibility, ale také s ohledem na mnohdy nízký počet testovaných participantů. Závěr: Kognitivní flexibilita je u pacientů s OCD oslabena. Její zlepšení by mohlo vést ke zvýšení kvality života, nicméně se zdá být vhodnější využití intervencí přímo cílících na kognitivní flexibilitu. Při hodnocení efektivity těchto terapeutických intervencí je však nutné v budoucnu využívat validované metody přímo hodnotící tuto kognitivní schopnost.

Introduction: Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder with heterogeneous symptoms of obsessive thoughts and compulsive behaviour. Compulsive behaviour, which is characterised by maladaptive patterns of repetitive, inflexible cognition and behaviour, indicates a lack of cognitive flexibility in OCD patients. Consistent with this clinical observation, many studies show abnormalities in cognitive flexibility in OCD patients at both behavioral and neurobiological levels. Cognitive flexibility, in brief, is the ability to change one’s behavior based on external conditions and thus adapt it to one’s needs and those of the environment. The aim of this review is to map studies that address the effectiveness of interventions targeting cognitive flexibility in patients with OCD. Method: A systematic search of the PubMed database was performed according to pre-selected keywords for the literature review. Clinical and randomized clinical trials focusing on an intervention targeting cognitive flexibility were used. Results: The findings of the reviewed studies are consistent in terms of impaired cognitive flexibility in OCD patients, but inconsistent with regard to the effectiveness of the interventions used. While some studies report an improvement in cognitive flexibility in OCD patients after the applied intervention (especially in the case of methods using procedures directly targeting cognitive functions), other studies do not find the expected change in measured cognitive flexibility. Moreover, the comparability of findings is severely limited, particularly with regard to the variability of the methods used to assess cognitive flexibility, but also with regard to the often small number of participants tested. Conclusion: Cognitive flexibility is impaired in OCD patients. Its improvement could lead to increased quality of life, but interventions directly targeting cognitive flexibility seem to be more preferable. However, validated methods directly assessing this cognitive ability should be used to evaluate the effectiveness of these therapeutic interventions in future studies.

• Keywords
• kognitivní flexibilita,
• MeSH
• Antidepressive Agents administration & dosage   therapeutic use   MeSH
• Coping Skills methods   MeSH
• Outcome Assessment, Health Care MeSH
• Cognitive Training methods   MeSH
• Humans MeSH
• Neuropsychological Tests MeSH
• Obsessive-Compulsive Disorder * diagnosis   drug therapy   therapy   MeSH
• Randomized Controlled Trials as Topic MeSH
• Transcranial Magnetic Stimulation methods   instrumentation   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Poruchy kognitivních funkcí jsou považovány za klíčový příznak schizofrenie a předpovídají terapeutický výsledek. Velmi významně narušují denní fungování pacientů se schizofrenií, a přesto dosud neexistuje cílená léčba kognitivního deficitu u schizofrenie. V tomto translačním projektu plánujeme objasnit kauzální roli hipokampálně-prefrontálních projekcí v kognitivní koordinace a flexibilitě. Rovněž ukážeme na příčinnou roli frontotemporální theta koherence a synchronie pomocí optogenetické kontroly aktivity PV+ interneuronů u volně pohyblivých potkanů. V klinické části otestujeme vliv frontotemporální synchronizace na kognitivní koordinaci a flexibilitu ve skupině 35 pacientů v remisi a u 35 zdravých kontrol s využitím hrEEG/fMRI měření a testů virtuální reality. Hlavním cílem je objasnění neurobiologického substrátu kognitivního deficitu u schizofrenie, které umožní inteligentní design nových léčebných postupů. Výsledky projektu jednoznačně ukážou složky frontotemporální dysfunkce u schizofrenie a otevřou cestu pro budoucí specifickou terapii kognitivního deficitu.; Disturbances of cognitive functions have been recognized as hallmarks of schizophrenia and predictors of therapeutic outcome. They significantly limit patient ́s functioning, yet there are no specific treatments for cognitive deficits in this disease. In this translational project, we seek to determine the causal role of hippocampal-prefrontal projections in cognitive coordination and flexibility. Moreover, causative role of frontotemporal theta coherence and synchrony will be revealed by controlling PV+ interneuron activity in freely-moving rats. The human part will test relations of frontotemporal synchrony to coordination and flexibility in 35 remitted schizophrenia patients and 35 matched healthy controls using a hrEEG/fMRI measurements and tests of the virtual reality. The overall aim is to elucidate a neuronal substrate for cognitive deficits in schizophrenia for an intelligent design of new treatments. Results of this project will unequivocally show the constituents of frontotemporal dysfunction in schizophrenia and open way for future treatment of cognitive deficits.

• MeSH
• Electroencephalography MeSH
• Hippocampus MeSH
• Cognitive Dysfunction etiology   physiopathology   MeSH
• Rats MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Disease Models, Animal MeSH
• Synaptic Transmission MeSH
• Neuroimaging MeSH
• Optogenetics MeSH
• Prefrontal Cortex MeSH
• Schizophrenia diagnosis   MeSH
• Translational Research, Biomedical MeSH
• Virtual Reality MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Animals MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurologie
• psychiatrie
• NML Publication type
• závěrečné zprávy o řešení grantu AZV MZ ČR

OBJECTIVES: Autism spectrum disorder (ASD) is associated with repetitive and stereotyped behaviour, suggesting that cognitive flexibility may be deficient in ASD. A central, yet not examined aspect to understand possible deficits in flexible behaviour in ASD relates (i) to the role of working memory and (ii) to neurophysiological mechanisms underlying behavioural modulations. METHODS: We analysed behavioural and neurophysiological (EEG) correlates of cognitive flexibility using a task-switching paradigm with and without working memory load in adolescents with ASD and typically developing controls (TD). RESULTS: Adolescents with ASD versus TD show similar performance in task switching with no memory load, indicating that 'pure' cognitive flexibility is not in deficit in adolescent ASD. However performance during task repetition decreases with increasing memory load. Neurophysiological data reflect the pattern of behavioural effects, showing modulations in P2 and P3 event-related potentials. CONCLUSIONS: Working memory demands affect repetitive behaviour while processes of cognitive flexibility are unaffected. Effects emerge due to deficits in preparatory attentional processes and deficits in task rule activation, organisation and implementation of task sets when repetitive behaviour is concerned. It may be speculated that the habitual response mode in ASD (i.e. repetitive behaviour) is particularly vulnerable to additional demands on executive control processes.

• MeSH
• Child MeSH
• Electroencephalography MeSH
• Executive Function MeSH
• Cognition * MeSH
• Memory, Short-Term * MeSH
• Humans MeSH
• Adolescent MeSH
• Neuropsychological Tests MeSH
• Autism Spectrum Disorder physiopathology   psychology   MeSH
• Attention MeSH
• Psychomotor Performance MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Executive functions, like the capacity to control and organize thoughts and behavior, develop from childhood to young adulthood. Although task switching and working memory processes are known to undergo strong developmental changes from childhood to adulthood, it is currently unknown how task switching processes are modulated between childhood and adulthood given that working memory processes are central to task switching. The aim of the current study is therefore to examine this question using a combined cue- and memory-based task switching paradigm in children (N = 25) and young adults (N = 25) in combination with neurophysiological (EEG) methods. We obtained an unexpected paradoxical effect suggesting that memory-based task switching is better in late childhood than in young adulthood. No group differences were observed in cue-based task switching. The neurophysiological data suggest that this effect is not due to altered attentional selection (P1, N1) or processes related to the updating, organization, and implementation of the new task-set (P3). Instead, alterations were found in the resolution of task-set conflict and the selection of an appropriate response (N2) when a task has to be switched. Our observation contrasts findings showing that cognitive control mechanisms reach their optimal functioning in early adulthood.

• MeSH
• Executive Function * MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Neuropsychological Tests MeSH
• Memory MeSH
• Attention MeSH
• Human Development * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

The effects of high-dose ethanol intoxication on cognitive flexibility processes are not well understood, and processes related to hangover after intoxication have remained even more elusive. Similarly, it is unknown in how far the complexity of cognitive flexibility processes is affected by intoxication and hangover effects. We performed a neurophysiological study applying high density electroencephalography (EEG) recording to analyze event-related potentials (ERPs) and perform source localization in a task switching paradigm which varied the complexity of task switching by means of memory demands. The results show that high-dose ethanol intoxication only affects task switching (i.e. cognitive flexibility processes) when memory processes are required to control task switching mechanisms, suggesting that even high doses of ethanol compromise cognitive processes when they are highly demanding. The EEG and source localization data show that these effects unfold by modulating response selection processes in the anterior cingulate cortex. Perceptual and attentional selection processes as well as working memory processes were only unspecifically modulated. In all subprocesses examined, there were no differences between the sober and hangover states, thus suggesting a fast recovery of cognitive flexibility after high-dose ethanol intoxication. We assume that the gamma-aminobutyric acid (GABAergic) system accounts for the observed effects, while they can hardly be explained by the dopaminergic system.

• MeSH
• Gyrus Cinguli physiology   physiopathology   MeSH
• Breath Tests MeSH
• Adult MeSH
• Electroencephalography MeSH
• Evoked Potentials physiology   MeSH
• gamma-Aminobutyric Acid MeSH
• Cognition physiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain physiology   physiopathology   MeSH
• Synaptic Transmission physiology   MeSH
• Alcoholic Intoxication physiopathology   psychology   MeSH
• Task Performance and Analysis MeSH
• Attention MeSH
• Reaction Time MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Cognitive flexibility is a major requirement for successful behavior. nNeural oscillations in the alpha frequency band were repeatedly associated with cognitive flexibility in task-switching paradigms. Alpha frequencies are modulated by working memory load and are used to process information during task switching, however we do not know how this oscillatory network communication is modulated. In order to understand the mechanisms that drive cognitive flexibility, ERPs, oscillatory power and how the communication within these networks is organized are of importance. The EEG data show that during phases reflecting preparatory processes to pre-activate task sets, alpha oscillatory power but not the small world properties of the alpha network architecture was modulated. During the switching only the N2 ERP component showed clear modulations. After the response, alpha oscillatory power reinstates and therefore seems to be important to deactivate or maintain the previous task set. For these reactive control processes the network architecture in terms of small-world properties is modulated. Effects of memory load on small-world aspects were seen in repetition trials, where small-world properties were higher when memory processes were relevant. These results suggest that the alpha oscillatory network becomes more small-world-like when reactive control processes during task switching are less complex.

• MeSH
• Adult MeSH
• Electroencephalography * MeSH
• Evoked Potentials MeSH
• Cognition physiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Brain Mapping MeSH
• Adolescent MeSH
• Young Adult MeSH
• Memory physiology   MeSH
• Reaction Time MeSH
• Healthy Volunteers MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• Publication type
• Meeting Abstract MeSH

BACKGROUND: Despite cognitive inflexibility is trait like in obsessive compulsive disorder (OCD) patients and underlies clinical symptomatology, it is elusive at what stage of information processing deficits, leading to cognitive inflexibility, emerges. We hypothesize that inhibitory control mechanisms during early stimulus categorization and integration into a knowledge system underlie these deficits. METHODS: We examined N = 25 adolescent OCD patients and matched healthy controls (HC) in a paradigm manipulating the importance of the knowledge system to perform task switching. This was done using a paradigm in which task switches were signaled either by visual stimuli or by working memory processes. This was combined with event-related potential recordings and source localization. RESULTS: Obsessive compulsive disorder patients showed increased switch costs in the memory as compared with the cue-based block, while HC showed similar switch costs in both blocks. At the neurophysiological level, these changes in OCD were not reflected by the N2 and P3 reflecting response-associated processes but by the P1 reflecting inhibitory control during sensory categorization processes. Activation differences in the right inferior frontal gyrus and superior temporal gyrus are associated with the P1 effect. CONCLUSIONS: Cognitive flexibility in adolescent OCD patients is strongly modulated by working memory load. Contrary to common sense, not response-associated processes, but inhibitory control mechanisms during early stimulus categorization processes are likely to underlie cognitive inflexibility in OCD. These processes are associated with right inferior frontal and superior temporal gyrus mechanisms.

• MeSH
• Child MeSH
• Electroencephalography MeSH
• Evoked Potentials physiology   MeSH
• Executive Function physiology   MeSH
• Inhibition, Psychological * MeSH
• Memory, Short-Term physiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Cerebral Cortex physiopathology   MeSH
• Obsessive-Compulsive Disorder physiopathology   MeSH
• Concept Formation physiology   MeSH
• Visual Perception physiology   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH