Dysexecutive Syndrome: Diagnostic Criteria and Validation Study
Identifieur interne : 000E91 ( PascalFrancis/Curation ); précédent : 000E90; suivant : 000E92Dysexecutive Syndrome: Diagnostic Criteria and Validation Study
Auteurs : Olivier Godefroy [France] ; Philippe Azouvi [France] ; Philippe Robert [France] ; Martine Roussel [France] ; Didier Legall [France] ; Thierry Meulemans [Belgique]Source :
- Annals of neurology [ 0364-5134 ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Réflexion sur l'Evaluation des Fonctions Exécutives (GREFEX) group has proposed criteria for behavioral and cognitive dysexecutive syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods: A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive dysexecutive disorders were examined using the GREFEX battery. Results: A dysexecutive syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive dysexecutive disorders discriminated (p = 0.001, all) patients from controls. The pattern of cognitive syndrome differed (p = 0.0001) according to the disease. Finally, behavioral (odds ratio [OR], 4.6; 95% confidence interval [CI], 2. 3-9.1; p = 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p = 0.001) dysexecutive syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p = 0.002) were independent predictors of loss of autonomy. Interpretation: This study provided criteria of dysexecutive syndrome and showed that both behavioral and cognitive syndromes contribute to loss of autonomy. Profiles vary across patients and diseases, and therefore systematic assessment of behavioral and cognitive disorders in reference to diagnostic criteria is needed.
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nerveux</term><term>Diagnostic</term><term>Validation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Réflexion sur l'Evaluation des Fonctions Exécutives (GREFEX) group has proposed criteria for behavioral and cognitive dysexecutive syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods: A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive dysexecutive disorders were examined using the GREFEX battery. Results: A dysexecutive syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive dysexecutive disorders discriminated (p = 0.001, all) patients from controls. The pattern of cognitive syndrome differed (p = 0.0001) according to the disease. Finally, behavioral (odds ratio [OR], 4.6; 95% confidence interval [CI], 2. 3-9.1; p = 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p = 0.001) dysexecutive syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p = 0.002) were independent predictors of loss of autonomy. Interpretation: This study provided criteria of dysexecutive syndrome and showed that both behavioral and cognitive syndromes contribute to loss of autonomy. Profiles vary across patients and diseases, and therefore systematic assessment of behavioral and cognitive disorders in reference to diagnostic criteria is needed.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0364-5134</s0></fA01><fA02 i1="01"><s0>ANNED3</s0></fA02><fA03 i2="1"><s0>Ann. neurol.</s0></fA03><fA05><s2>68</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Dysexecutive Syndrome: Diagnostic Criteria and Validation Study</s1></fA08><fA11 i1="01" i2="1"><s1>GODEFROY (Olivier)</s1></fA11><fA11 i1="02" i2="1"><s1>AZOUVI (Philippe)</s1></fA11><fA11 i1="03" i2="1"><s1>ROBERT (Philippe)</s1></fA11><fA11 i1="04" i2="1"><s1>ROUSSEL (Martine)</s1></fA11><fA11 i1="05" i2="1"><s1>LEGALL (Didier)</s1></fA11><fA11 i1="06" i2="1"><s1>MEULEMANS (Thierry)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Laboratory of Functional Neurosciences, University Hospital of Amiens</s1><s2>Amiens</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Rehabilitation, University Hospital of Garches</s1><s2>Garches</s2><s3>FRA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Academic Memory Clinic, University Hospital of Nice</s1><s2>Nice</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Departments of Neurology and Psychology, University of Angers</s1><s2>Angers</s2><s3>FRA</s3><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Psychology, University of Liège</s1><s2>Liege</s2><s3>BEL</s3><sZ>6 aut.</sZ></fA14><fA20><s1>855-864</s1></fA20><fA21><s1>2010</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>16555</s2><s5>354000193558180130</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>43 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0060410</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Annals of neurology</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Réflexion sur l'Evaluation des Fonctions Exécutives (GREFEX) group has proposed criteria for behavioral and cognitive dysexecutive syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods: A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive dysexecutive disorders were examined using the GREFEX battery. Results: A dysexecutive syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive dysexecutive disorders discriminated (p = 0.001, all) patients from controls. The pattern of cognitive syndrome differed (p = 0.0001) according to the disease. Finally, behavioral (odds ratio [OR], 4.6; 95% confidence interval [CI], 2. 3-9.1; p = 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p = 0.001) dysexecutive syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p = 0.002) were independent predictors of loss of autonomy. Interpretation: This study provided criteria of dysexecutive syndrome and showed that both behavioral and cognitive syndromes contribute to loss of autonomy. 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