Frontal and executive functions

The term executive function derives from the theory that there is a supervisory system exerting executive control of attention. (3! Deficits of this system cause broad patterns of cognitive and behavioural change called the dysexecutive syndrome,(32) which includes changes in volition, poor planning, a disruption of purposive action, and reduced efficacy of performance. One of the most frequent causes of this syndrome is damage to the frontal lobes (frontal-lobe syndrome is a dysexecutive syndrome) but it may also be caused by other patterns of lesion. T§bie,8 lists some of the features of the dysexecutive syndrome, and examples of tests that are sensitive to such features.

Table B Features and tests of the dysexecutive syndrome

Some clinical issues Sources of tests and test data

A good summary of the principles of test theory is given by Kline.(1..) Information about tests and where to order them from can be found in Lezak's Neuropsychological Assessment42 and Spreen and Strauss's Compendium of Neuropsychological Tests.ty Slightly older, but still useful, is the Handbook of Neuropsychological Assessment by Crawford et al.(43> Many tests are 'closed', i.e. they can only be ordered by appropriately qualified people who are registered as test users within specified domains.

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