Neurocognitive factorial structure of executive functions: Evidence from neurotypicals and frontotemporal dementia

• Main Authors: Fittipaldi, S. (Author), Gonzalez-Gomez, R. (Author), Huepe, D. (Author), Ibáñez, A. (Author), Rodríguez-Villagra, O.A (Author), Schulte, M. (Author), Torralva, T. (Author)
• Format: Article
• Language: English
• Published: Masson SpA 2021
• Subjects: abstract thinking; Addenbrooke cognitive examination III; adult; aged; amygdala; anterior insula; Article; backwards digit span; brain; Brain; brain mapping; brain size; bvFTD; clinical assessment; Clinical Dementia Rating; clinical evaluation; cognition; cognitive defect; comparative study; confirmatory factor analysis; Confirmatory factorial analysis; controlled study; executive function; Executive Function; Executive functions; female; frontal variant frontotemporal dementia; frontotemporal dementia; Frontotemporal Dementia; Go No Go task; gray matter; hayling test; human; Humans; Lesion model; Magnetic Resonance Imaging; major clinical study; male; nerve degeneration; neuroanatomy; neuropsychological test; Neuropsychological Tests; neurotypical frontotemporal dementia; nuclear magnetic resonance imaging; orbital cortex; posterior cingulate; proverb interpretation task; spatial working memory; task performance; trail making test; verbal working memory; very elderly; voxel based morphometry; Voxel-based morphometry; Wisconsin Card Sorting Test; working memory
• Online Access: View Fulltext in Publisher

 The latent structure of executive functions (EFs) remains controversial. Confirmatory factorial analysis (CFA) has provided support for both multidimensional (assumes EFs to be functionally separable but related components) and bifactor (proposes all components are nested within a common factor) models. However, these CFA models have never been compared in patient samples, nor regarding their neuroanatomical correlates. Here, we systematically contrast both approaches in neurotypicals and in a neurodegenerative lesion model (patients with the behavioral variant frontotemporal dementia, bvFTD), characterized by executive deficits associated with frontal neurodegeneration. First, CFA was used to test the models' fit in a sample of 341 neurotypicals and 29 bvFTD patients based on performance in an executive frontal screening battery which assesses working memory, motor inhibition, verbal inhibition, and abstraction capacity. Second, we compared EFs factor and observed scores between patients and matched controls. Finally, we used voxel-based morphometry (VBM) to compare the grey matter correlates of factor and observed scores. CFA results showed that both models fit the data well. The multidimensional model, however, was more sensitive than the bifactor model and the observed scores to detect EFs impairments in bvFTD patients. VBM results for the multidimensional model revealed common and unique grey matter correlates for EFs components across prefrontal-insular, posterior, and temporal cortices. Regarding the bifactor model, only the common factor was associated with prefrontal-insular hubs. Observed scores presented scant, non-frontal grey matter associations. Converging behavioral and neuroanatomical evidence from healthy populations and a neurodegenerative model of EFs supports an underlying multidimensional structure. © 2021 The Author(s)