In general, executive functions are attributed to the frontal lobes, in particular to the prefrontal cortex. Thus it is evident that, for patients and their loved ones, the functional consequences of executive dysfunction are far-reaching and devastating.
Many report memory loss, as forgetfulness can result from inattention, perseveration, and poorly planned information retrieval. They may not grasp jokes or puns because of limited capacity for abstract thinking.
Their stories and conversations may be poorly organized and difficult to follow. Because the ability to appreciate the larger picture, manage multiple options, and assess consequences may be compromised, patients show impaired judgment in daily decision making and problem solving. They may become distressed when the day’s plan changes and exhibit difficulty switching situations, behaviors, or thoughts. They may have trouble keeping up with demands at work. 2 Patients may have difficulty grocery shopping or preparing a meal. Individuals with executive dysfunction can exhibit a broad range of manifestations in their daily lives. Indeed, executive resources are fundamental to success in the wide range of cognition domains covered in this issue of CONTINUUM. 1 In short, executive resources allow for flexible, adaptive, goal-directed behavioral responses to environmental circumstances. Examples of executive functions include initiation of goal-directed behavior, planning and sequencing of complex tasks, performing more than one task simultaneously (multitasking), shifting attention to salient items or events, strategic decision making, extracting the gist of a scenario, sustaining behavior despite distraction or interference, overriding automatic responses with more appropriate behaviors, and terminating behavior at an opportune time. Intact executive functioning supports a multitude of behaviors, underscoring the ubiquitous involvement of executive resources in human behavior and cognition. Executive function is a fundamental aspect of human cognition that is compromised in patients with a wide range of medical conditions.Įxecutive resources are defined as higher-order processes involved in the control of cognition and goal-directed behavior.
These aspects of executive function appear to depend in part on large-scale neural networks that are centered in distinct areas of prefrontal cortex, working in concert with other brain regions, such as parietal cortex and the basal ganglia. Inhibitory control allows an individual to inhibit inappropriate responses and to shift responses when necessary. Planning and organizing of behavior involves the way in which individuals optimize the execution of multistep tasks to achieve a goal. Working memory is the system by which information is maintained in an active mental state so that it can be used for other purposes. This article will highlight three essential aspects of executive function: (1) working memory, (2) planning and organizing, and (3) inhibitory control. Executive function is composed of related, but separable, components. Executive resources allow for flexible, adaptive, goal-directed responses to environmental circumstances in essentially all facets of daily living.
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