Precis of executive dyscontrol as a cause of problem behavior in dementia.

Frontal lobe executive control functions (ECF) are proposed as a source of problem behavior in dementia. The behavior and personality changes that follow frontal lobe brain damage overlap with those seen in dementia, and frontal lobe structural and metabolic lesions can be demonstrated across a variety of dementing illnesses. ECF help explain the importance of social and environmental cues in the production of disruptive behavior and suggest interpersonal strategies for their control. This model has considerable face validity and leads to several testable hypotheses.

[1]  E. Giller,et al.  MAOI treatment response: multiaxial assessment. , 1988, Journal of affective disorders.

[2]  D. Stuss,et al.  The Frontal Lobes , 1986 .

[3]  T. Barnes,et al.  Is the Concept of Frontal–Subcortical Dementia Relevant to Schizophrenia? , 1992, British Journal of Psychiatry.

[4]  D. Pickar,et al.  National Institute of Mental Health longitudinal study of chronic schizophrenia. Prognosis and predictors of outcome. , 1991, Archives of general psychiatry.

[5]  D. Royall,et al.  Bedside assessment of dementia type using the Qualitative Evaluation of Dementia , 1993 .

[6]  D. Benson,et al.  Dementia: A Clinical Approach , 1983 .

[7]  Muriel D. Lezak,et al.  The Problem of Assessing Executive Functions , 1982 .

[8]  K. Pribram,et al.  Psychophysiological basis of emotion , 1969 .

[9]  B. Pillon,et al.  Human autonomy and the frontal lobes. Part I: Imitation and utilization behavior: A neuropsychological study of 75 patients , 1986, Annals of neurology.

[10]  T. Powell,et al.  The Neuroanatomy of Alzheimer's Disease , 1989, Reviews in the neurosciences.

[11]  F. Lhermitte,et al.  Human autonomy and the frontal lobes. Part II: Patient behavior in complex and social situations: The “environmental dependency syndrome” , 1986, Annals of neurology.

[12]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[13]  D. Royall,et al.  EXIT, QED, and DSM-IV: very early Alzheimer's disease. , 1994, The Journal of neuropsychiatry and clinical neurosciences.

[14]  S. Kobayashi,et al.  Frontal white matter lesions and dementia in lacunar infarction. , 1990, Stroke.

[15]  S. Nadeau,et al.  Multi-infarct dementia, subcortical dementia, and hydrocephalus. , 1991, Southern medical journal.

[16]  J. Duncan.  Disorganisation of behaviour after frontal lobe damage , 1986 .

[17]  R. Marin,et al.  Apathy: a neuropsychiatric syndrome. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[18]  Bruce F. Pennington,et al.  Assessing frontal lobe functioning in children: Views from developmental psychology , 1988 .

[19]  F. Lhermitte.  'Utilization behaviour' and its relation to lesions of the frontal lobes. , 1983, Brain : a journal of neurology.

[20]  Bruce F. Pennington,et al.  A normative‐developmental study of executive function: A window on prefrontal function in children , 1991 .

[21]  R. Katzman.,et al.  Intrusions as a sign of Alzheimer dementia chemical and pathological verification , 1982, Annals of neurology.

[22]  J. Cummings.  Subcortical Dementia Neuropsychology, Neuropsychiatry, and Pathophysiology , 1986, British Journal of Psychiatry.

[23]  Karl H. Pribram,et al.  Psychophysiology of the frontal lobes , 1973 .

[24]  D. Royall,et al.  Bedside Assessment of Executive Cognitive Impairment: The Executive Interview , 1992, Journal of the American Geriatrics Society.

[25]  G. Paulson,et al.  The concept of subcortical dementia. , 1985, The American journal of psychiatry.

[26]  B. Fogel,et al.  Bedside Cognitive Screening Instruments: A Critical Assessment , 1986, The Journal of nervous and mental disease.

[27]  R. Robinson,et al.  Comparison of patients with and without poststroke major depression matched for size and location of lesion. , 1988, Archives of general psychiatry.

[28]  R. Marin,et al.  The sources of convergence between measures of apathy and depression. , 1993, Journal of affective disorders.

[29]  K. Ritchie.  The screening of cognitive impairment in the elderly: a critical review of current methods. , 1988, Journal of clinical epidemiology.

[30]  D. Meichenbaum.  Self-instructional strategy training: a cognitive prothesis for the aged. , 1974, Human development.

[31]  A crossover trial of bromocriptine in the treatment of vascular dementia , 1988, Annals of neurology.

[32]  Donald A. Norman,et al.  Attention to Action , 1986 .

[33]  A. Luria.  The Working Brain: An Introduction To Neuropsychology , 1976 .

[34]  R. Lévy,et al.  Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour , 1990, British Journal of Psychiatry.

[35]  G. E. Alexander,et al.  Parallel organization of functionally segregated circuits linking basal ganglia and cortex. , 1986, Annual review of neuroscience.

[36]  T. Shallice.  Specific impairments of planning. , 1982, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[37]  T. Shallice,et al.  The origins of utilization behaviour. , 1989, Brain : a journal of neurology.

[38]  R. Moos.  Conceptualizations of human environments. , 1973 .

[39]  D. Kaloupek,et al.  Poststroke depression and lesion location. An attempted replication. , 1986, Brain : a journal of neurology.

[40]  S. Kasper,et al.  The Diagnostic Specificity of Negative Symptoms and their Psychopathological Context , 1989, British Journal of Psychiatry.

[41]  J. Singer,et al.  Psychological consequences of brain lesions and ablations. , 1954, Psychological bulletin.

[42]  D. Benson,et al.  Subcortical Dementia: Review of an Emerging Concept , 1984 .

[43]  D. Stuss,et al.  Neuropsychological studies of the frontal lobes. , 1984, Psychological bulletin.

[44]  G. Fleming.  The Intellectual Functions of the Frontal Lobes , 1937 .

[45]  D. Neary,et al.  Dementia of frontal lobe type. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[46]  W. Penfield,et al.  THE FRONTAL LOBE IN MAN: A CLINICAL STUDY OF MAXIMUM REMOVALS , 1935 .

[47]  M. Mesulam.  Frontal cortex and behavior , 1986, Annals of neurology.

[48]  P. Goldman-Rakic.  Topography of cognition: parallel distributed networks in primate association cortex. , 1988, Annual review of neuroscience.

[49]  R. Robinson,et al.  Mood disorders in stroke patients. Importance of location of lesion. , 1984, Brain : a journal of neurology.

[50]  P. Liddle.  Schizophrenic syndromes, cognitive performance and neurological dysfunction , 1987, Psychological Medicine.

[51]  C. Marsden,et al.  'Frontal' cognitive function in patients with Parkinson's disease 'on' and 'off' levodopa. , 1988, Brain : a journal of neurology.

[52]  A. Brun.  Dementia of frontal type. , 1993, Dementia.

[53]  D. Royall,et al.  Bedside assessment of frontal degeneration: distinguishing Alzheimer's disease from non-Alzheimer's cortical dementia. , 1994, Experimental aging research.

[54]  P F Liddle,et al.  Schizophrenic Syndromes and Frontal Lobe Performance , 1991, British Journal of Psychiatry.

[55]  Alexander L. Miller,et al.  Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects. , 1993, The American journal of psychiatry.

[56]  A. Luria.  Higher Cortical Functions in Man , 1980, Springer US.

[57]  S. DeKosky,et al.  Synapse loss in frontal cortex biopsies in Alzheimer's disease: Correlation with cognitive severity , 1990, Annals of neurology.

[58]  R. Reitan,et al.  Clinical neuropsychology: Current status and applications. , 1974 .

[59]  M. Albert,et al.  The `subcortical dementia' of progressive supranuclear palsy , 1974, Journal of neurology, neurosurgery, and psychiatry.

[60]  Yasuo Nishihara,et al.  Why do frontal lobe symptoms predominate in vascular dementia with lacunes? , 1986, Neurology.

[61]  A. David.  Frontal Lobology – Psychiatry's New Pseudoscience , 1992, British Journal of Psychiatry.

[62]  P. McHugh,et al.  The Perspectives of Psychiatry , 1983 .

[63]  E. A. Berg,et al.  A simple objective technique for measuring flexibility in thinking. , 1948, The Journal of general psychology.

[64]  G. Klerman,et al.  Treatment effects on the social adjustment of depressed patients. , 1974, Archives of general psychiatry.

[65]  Anand R. Kumar,et al.  Frontotemporal Dementias: A New Clinical Syndrome? , 1993, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[66]  J. Stroop.  Studies of interference in serial verbal reactions. , 1992 .

[67]  E. Valenstein.  Brain control : a critical examination of brain stimulation and psychosurgery , 1974 .

[68]  J. Mazziotta,et al.  Reduction of prefrontal cortex glucose metabolism common to three types of depression. , 1989, Archives of general psychiatry.

[69]  M. Mesulam.  A cortical network for directed attention and unilateral neglect , 1981, Annals of neurology.

[70]  J. Mintz,et al.  Treatments of depression and the functional capacity to work. , 1992, Archives of general psychiatry.

[71]  C. Nemeroff,et al.  Alterations in Alzheimer's disease-associated protein in Alzheimer's disease frontal and temporal cortex. , 1991, Archives of general psychiatry.