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Ecological Validity and Neuroanatomical Correlates of the NIH EXAMINER Executive Composite Score

Published online by Cambridge University Press:  14 June 2013

Katherine L. Possin ,
Amanda K. LaMarre ,
Kristie A. Wood ,
Dan M. Mungas  and
Joel H. Kramer
Katherine L. Possin*
Affiliation:
Department of Neurology, University of California – San Francisco, San Francisco, California
Amanda K. LaMarre
Affiliation:
Department of Neurology, University of California – San Francisco, San Francisco, California
Kristie A. Wood
Affiliation:
Department of Neurology, University of California – San Francisco, San Francisco, California
Dan M. Mungas
Affiliation:
Department of Neurology, University of California – Davis, Davis, California
Joel H. Kramer
Affiliation:
Department of Neurology, University of California – San Francisco, San Francisco, California
*
Correspondence and reprint requests to: Katherine L. Possin, 675 Nelson Rising Lane, Ste 190, MC 1207, San Francisco, CA 94158. E-mail: kpossin@memory.ucsf.edu
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Abstract

Executive functions refer to a constellation of higher-level cognitive abilities that enable goal-oriented behavior. The NIH EXAMINER battery was designed to assess executive functions comprehensively and efficiently. Performance can be summarized by a single score, the “Executive Composite,” which combines measures of inhibition, set-shifting, fluency, and working memory. We evaluated the ecological validity of the Executive Composite in a sample of 225 mixed neurological patients and controls using the Frontal Systems Behavior Scale (FrSBe), an informant-based measure of real-world executive behavior. In addition, we investigated the neuroanatomical correlates of the Executive Composite using voxel-based morphometry in a sample of 37 participants diagnosed with dementia, mild cognitive impairment, or as neurologically healthy. The Executive Composite accounted for 28% of the variance in Frontal Systems Behavior Scale scores beyond age. Even after including two widely used executive function tests (Trails B and Stroop) as covariates, the Executive Composite remained a significant predictor of real-world behavior. Anatomically, poorer scores on the Executive Composite were associated with smaller right and left dorsolateral prefrontal volumes, brain regions critical for good executive control. Taken together, these results suggest that the Executive Composite measures important aspects of executive function not captured by standard measures and reflects the integrity of frontal systems. (JINS, 2013, 19, 1–9)

Keywords

Executive functionMagnetic resonance imagingValidity of resultsNeurological disordersPrefrontal cortexNeurodegenerative disorders
Type
Special Series
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 1 , January 2014 , pp. 20 - 28
Copyright
Copyright © The International Neuropsychological Society 2013 

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