J Neuropsychiatry Clin Neurosci 14:377-405, November 2002
© 2002 American Psychiatric Press, Inc.
Executive Control Function
A Review of Its Promise and Challenges for Clinical Research. A Report From the Committee on Research of the American Neuropsychiatric Association
Donald R. Royall, M.D.,
Edward C. Lauterbach, M.D.,
Jeffrey L. Cummings, M.D.,
Allison Reeve, M.D.,
Teresa A. Rummans, M.D.,
Daniel I. Kaufer, M.D.,
W. Curt LaFrance, Jr., M.D. and
C. Edward Coffey, M.D.
Received August 20, 2002. From the Committee on Research of the American Neuropsychiatric Association. Address correspondence to Dr. Royall, The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900. E-mail: royall{at}uthscsa.edu
This report reviews the state of the literature and opportunities for research related to "executive control function" (ECF). ECF has recently been separated from the specific cognitive domains (memory, language, and praxis) traditionally used to assess patients. ECF impairment has been associated with lesions to the frontal cortex and its basal ganglia–thalamic connections. No single putative ECF measure can yet serve as a "gold standard." This and other obstacles to assessment of ECF are reviewed. ECF impairment and related frontal system lesions and metabolic disturbances have been detected in many psychiatric and medical disorders and are strongly associated with functional outcomes, disability, and specific problem behaviors. The prevalence and severity of ECF deficits in many disorders remain to be determined, and treatment has been attempted in only a few disorders. Much more research in these areas is necessary.
Key Words: Executive Function • Frontal Lobe • American Neuropsychiatric Association • Neuropsychological Assessment
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