Neuropsychologic assessment of frontal lobe dysfunction

Given the pervasive nature of executive deficit, assessment of executive functions is of crucial importance in neuropsychiatry, child and adolescent psychiatry, geriatric psychiatry, and other related areas. A number of neuropsychologic tests of executive function commonly are used in assessing several clinical disorders, including but not limited to traumatic brain injury, schizophrenia, depression, attention deficit disorder/attention deficit hyperactivity disorder, and dementia. Because the concept of executive control in its current form constitutes an over arching construct, a construct that is based on the cognitive symptoms of the frontal lobe disorder caused by many disparate underlying conditions, no single measure of executive function can adequately tap the construct in its entirety.Therefore, it is necessary to administer several tests of executive function,each assessing a particular aspect of the executive function. An appropriate combination of such neuropsychologic tests and batteries, including the Wisconsin Card Sorting Test, Tower test, Stroop test, the D-KEFS, and the ECB, provides an adequate but relatively crude mechanism for assessing executive systems dysfunction. Neuroscientists continue to refine their understanding of the nature of executive control, and additional innovative procedures that reflect state-of-the-art insights of cognitive neuroscience have been introduced recently. Among a few first steps in that direction are nonveridical, actor-centered procedures such as the CBT and the Iowa Gambling Test.