Executive Functioning
In Psychiatric Disorders, Developmental Disabilities, Substance Issues & Brain Injury
[Under construction]
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Abstract
Many psychiatric disorders are associated with impaired executive functioning (EF). The associated EF component varies by psychiatric disorders, and this variation might be due to genetic liability. We explored the genetic association between five psychiatric disorders and EF in clinically-recruited attention deficit hyperactivity disorder (ADHD) children using polygenic risk score (PRS) methodology. Genome-wide association study (GWAS) summary data for ADHD, major depressive disorder (MDD), schizophrenia (SZ), bipolar disorder (BIP) and autism were used to calculate the PRSs. EF was evaluated by the Stroop test for inhibitory control, the trail-making test for cognitive flexibility, and the digital span test for working memory in a Chinese ADHD cohort (n = 1147). Exploratory factor analysis of the three measures identified one principal component for EF (EF-PC). Linear regression models were used to analyze the association between each PRS and the EF measures. The role of EF measures in mediating the effects of the PRSs on ADHD symptoms was also analyzed. The result showed the PRSs for MDD, ADHD and BIP were all significantly associated with the EF-PC. For each EF component, the association results were different for the PRSs of the five psychiatric disorders: the PRSs for ADHD and MDD were associated with inhibitory control (adjusted P = 0.0183 and 0.0313, respectively), the PRS for BIP was associated with working memory (adjusted P = 0.0416), and the PRS for SZ was associated with cognitive flexibility (adjusted P = 0.0335). All three EF measures were significantly correlated with ADHD symptoms. In mediation analyses, the ADHD and MDD PRSs, which were associated with inhibitory control, had significant indirect effects on ADHD symptoms through the mediation of inhibitory control. These findings indicate that the polygenic risks for several psychiatric disorders influence specific executive dysfunction in children with ADHD. The results helped to clarify the relationship between risk genes of each mental disorder and the intermediate cognitive domain, which may further help elucidate the risk genes and motivate efforts to develop EF measures as a diagnostic marker and future treatment target. |
Metabolism and Psychiatric Disorders
The Elephant in the room -- is it executive functioning? is it not? something different?
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Val's Take
Some people with psychiatric disorders struggle with their weight and some don't --- some are athletic. If you have seen these EXTREMES play out among yourself and family members ---- it sure seems like weight is more complicated than what we've been led to believe. THAT MATTERS. Are the problems some people with psychiatric disorders having with weight an "EXECUTIVE FUNCTIONING" Problem? It depends on how one defines EXECUTIVE FUNCTIONING, but it is perhaps more accurately seen as problem in METABOLISIM. I also think that is why a number of women (and men) with psychiatric disorders are also ultimately diagnosed with a THYROID DISORDER. Now every person with a psychiatric disorder and a thyroid disorder is not struggling with their weight --- but a significant percentage are. International Bipolar Foundation Dr. Tanya T. Nguyen is an Assistant Professor of Psychiatry at the University of California San Diego (UCSD). She is a clinical neuropsychologist with expertise is in the assessment and treatment of older adults with neuropsychiatric disorders. Dr. Nguyen is research faculty within the Stein Institute for Research on Aging at UCSD, where she is actively involved in clinical research. She has been the Principal Investigator on several National Institutes of Health as well as national and local foundation grants. Broadly, her research aims to identify mechanisms cognitive and biological aging in mental illnesses. Her current work is focused on the gut-brain axis and understanding the relationship between the gut microbiome and brain/behavior, particularly as it pertains to mental illness and aging. Dr. Nguyen is the principal investigator of National Institute of Mental Health Career Development Award to investigate the role of the gut microbiome in accelerated aging in schizophrenia and how imbalance of the gut ecosystem can alter immune responses, leading to alterations to brain and behavioral function. |
University of North Carolina School of Medicine Study Finds Anorexia Nervosa is Both Metabolic and Psychiatric (2019)
Stockholm Psychiatry Lectures, Nov 4, 2019 at Karolinska Institutet. "The Psychiatric-Metabolic Syndrome: How Stress and Trauma Program the Body and Brain" Professor Audrey Tyrka Dr. Tyrka's (Brown University, United States) research program is focused on the biological mechanisms of risk resulting from early stress and trauma in maltreated children and adults with a history of childhood adversity. She has made important contributions to understanding the metabolic, genetic, and epigenetic mechanisms of risk. Dr. Tyrka's research is focused on understanding the link between childhood trauma and physical and psychiatric illnesses. In addition to psychiatric disorders, including major depression and post-traumatic stress disorder (PTSD), stress and trauma increase risk for medical conditions such as obesity, diabetes and heart disease. Dr. Tyrka studies maltreated children and adults with early adversity to understand the metabolic, neuroendocrine, neuroimmune, and cellular aging pathways of risk for mood and anxiety disorders and related health conditions. The goal of this work is to elucidate the biology of risk and protection in order to inform prevention and treatment efforts. A second line of research involves efforts to advance the treatment of major depression. Our group has investigated several new treatments for depression, including novel pharmacologic and neurostimulation approaches to the treatment of major depression and treatment resistant depression. |