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Objective Apraxia is the inability to perform voluntary, skilled movements following brain lesions, in the absence of sensory integration deficits. Yet, patients with neurodegenerative diseases (ND) may have sensory integration deficits, so we tested the associations and dissociations between apraxia and sensory integration. Methods A total of 44 patients with ND and 20 healthy controls underwent extensive testing of sensory integration (i.e., localization of tactile, visual, and proprioceptive stimuli; agraphesthesia; astereognosis) and apraxia (i.e., finger dexterity, imitation, tool use). Results The results showed (i) that patients with Alzheimer’s disease, corticobasal syndrome, or posterior cortical atrophy were impaired on both dimensions; (ii) An association between both dimensions; (iii) that when sensory integration was controlled for, the frequency of apraxia decreased dramatically in some clinical subgroups. Conclusion In a non-negligible portion of patients, the hypothesis of a disruption of sensory integration can be more parsimonious than the hypothesis of apraxia in case of impaired skilled gestures. Clinicians and researchers are advised to integrate sensory integration measures along with their evaluation of apraxia.

BackgroundTheory of mind (ToM) refers to the ability to understand others’ states of mind, desires, emotions, beliefs, and intentions to predict the content of their mental representations. Two major dimensions within ToM have been studied. The first is the type of inferred mental state, which can be cognitive or affective. The second comprises the types of processes involved according to their degree of complexity (first- and second-order false belief and advanced ToM). ToM acquisition is fundamental—a key component in the development of everyday human social interactions. ToM deficits have been reported in various neurodevelopmental disorders through various tools assessing disparate facets of social cognition. Nevertheless, Tunisian practitioners and researchers lack a linguistically and culturally appropriate psychometric tool for ToM assessment among school-aged children.ObjectiveTo assess the construct validity of a translated and adapted French ToM Battery for Arabic-speaking Tunisian school-aged children.MethodsThe focal ToM Battery was designed with neuropsychological and neurodevelopmental theory and composed of 10 subtests distributed evenly in three parts: Pre-conceptual, cognitive, and affective ToM. Translated and adapted to the Tunisian sociocultural context, this ToM battery was individually administered to 179 neurotypical Tunisian children (90 girls and 89 boys) aged 7–12 years.ResultsAfter controlling for the age effect, construct validity was empirically confirmed on two dimensions (cognitive and affective) via structural equation modeling (SEM) analysis, demonstrating that this solution has a good fit. The results confirmed that the age affected differentially the performance obtained on ToM tasks based on the two components of the battery.ConclusionOur findings confirm that the Tunisian version of the ToM Battery has robust construct validity for the assessment of cognitive and affective ToM in Tunisian school-aged children; hence, it could be adopted in clinical and research settings.

Studies regarding executive functions (EFs) in children rarely focus on populations of North Africa countries. In this context, this research aimed to adapt EFs tests to the Moroccan context and provide preliminary normative data on the development of inhibitory control and working memory (WM). In addition, the executive performance of school-age Moroccan children was examined, as well as the effects of gender, parents' education level and multilingualism. The sample included 115 children at age 7 to 12 from Fes city. Results showed that the translation and adaptation steps were sufficient for the cross-cultural adaptation of the tasks. In addition, an overall effect of age on inhibition and WM performances was found, whereas gender and parents' education level showed non-significant effects. Multilingualism effects had a partial positive influence on EFs, with improved scores on a few executive tasks for multilingual children compared to their bilingual peers. Overall, results suggest that EFs in school-age Moroccan children operate on relatively homogeneous development trajectories, marked by improvements that differ according to tasks. As neuropsychological tools and normative data are still lacking in Morocco, this study helps better understand EFs development of children in this country.

Conflicting evidence has arisen from the few correlational studies that have examined the relationship between the ability to decode social emotional cues through the eyes and executive functions in individuals with prefrontal cortex damage. The objective of the current study was (1) to investigate the impact of both focal prefrontal and parietal cortex damage on both of these domains; (2) to examine whether impaired ability to decode social emotion cues through the eyes was predicted by executive function deficits and; (3) to explore the neural correlates of both of these components.Thirty individuals with prefrontal cortex damage, 15 individuals with parietal cortex damage and 30 matched healthy comparison subjects were subjected to a battery of executive tasks assessing inhibition, flexibility, and planning processes and the Reading the Mind in the Eyes Task (RMET) assessing ability to decode social emotion cues through the eyes.Compared to both comparison groups, individuals with prefrontal cortex damage were impaired in performing RMET and almost all executive tasks. Regression analysis showed that for individuals with prefrontal cortex damage, performance on the Stroop and Hayling tasks predicted scores on the RMET, while for the healthy comparison group, only the verbal fluency performance predicted scores on the RMET. The Voxel lesions-symptom mapping technique showed that both components rely partly on the same neural substrates, reflecting beyond the neural network of RMET per se that of the cognitive processes elicited by this multi-determinant task.These findings suggest that the ability to read mental states of mind depends on the inhibition and flexibility executive mechanisms.

Visuo-imitative apraxia has been consistently reported in patients with dementia, yet there have been substantial methodological differences between studies, while multiple, sometimes competing hypotheses have been put forward to explain this syndrome. Our goals were to study specific imitation deficits in groups of patients who have been selected and assigned to a group solely based on clinical criteria. We tested the effects of body part, bimanual imitation, asymmetry of the model, and body midline crossing, in patients with cortical atrophy of the temporal lobes (semantic dementia, SD), frontal-parietal networks (FPN, i.e., posterior cortical atrophy and corticobasal syndrome) or both (Alzheimer's disease, AD). Sixty-three patients and 32 healthy controls were asked to imitate 45 meaningless finger/hand, uni-/bimanual, asymmetrical/symmetrical, and crossed/uncrossed postures. SD patients had subnormal imitation scores. FPN patients showed frequent and marked deficits in most conditions, better performance with hand than finger postures (probably because of visuo-constructive deficits), and better performance with uncrossed than crossed configurations (probably because of body schema disorganization). Bimanual configurations were difficult for AD patients, not because of bimanual activity in itself, but rather because of the complexity of the model. The finding of dissociations in 34/63 cases (54%) suggests that some patients, even within the same clinical category, can have variable performance in imitation tests as a function of the abovementioned factors. Clinicians are advised to use tests with a large array of items to properly capture patients' imitation skills. This provides a new basis for future research to unpack which neurocognitive mechanisms are disrupted to cause specific patterns of impaired imitation.

Few studies have considered health-related quality of life (HRQOL) as a primary outcome measure in adult survivors of primary brain tumor (PBT), and fewer still have studied the cognitive factors that may influence it. Research suggests that executive functions (EFs) are associated with HRQOL, but there is scant evidence to support this. The present study was conducted to (1) extend prior findings about HRQOL limitations in a sample of stable, long-term adult survivors of PBT, (2) investigate the associations between objective/reported EFs and HRQOL, and (3) identify the EFs that contribute most to HRQOL.We recruited 40 survivors of PBT (2 years post-treatment) and 40 matched healthy controls. Participants completed an objective EF assessment (inhibition, working memory, shifting, and rule detection) and two self-report questionnaires probing EFs (Behavior Rating Inventory of Executive Function-Adult) and HRQOL (Medical Outcomes Study Short-Form 36). Participants' relatives completed observer-rated versions of these questionnaires.Patients' objective EF performances were relatively intact. However, patients and caregivers reported significantly more problems than healthy controls and their relatives, for both EFs and HRQOL. There were only negligible links between objective EFs and HRQOL, whereas numerous associations were found between reported EFs and HRQOL components. ANCOVA models revealed that specific reported EF processes contributed to both the physical and mental components of HRQOL, regardless of group.From a clinical point of view, this study demonstrates that even several years after end of treatment, adult PBT survivors experience substantial problems across different HRQOL domains. HRQOL assessment should therefore be part of the long-term follow-up of PBT survivors, and clinicians should consider EF limitations when designing appropriate survivorship care plans. These findings indicate that cognitive interventions targeting EFs could improve HRQOL.

ObjectivePatients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior.MethodWe examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the “Faux-Pas” task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test.ResultsThe group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the “Faux-Pas”, Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the “Faux-Pas” task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.

Despite the key role that decoding of social-perceptual cues from faces plays in interpersonal communication, it is only recently that the potential of prefrontal cortex damage to disrupt this ability has been recognized. In fact, few studies to date had assessed whether the ability to identify the state of mind of others from the whole or part of the face is disrupted after prefrontal cortex damage and whether these two abilities are associated and share overlapped neural systems. In the present study, 30 patients with focal prefrontal lesions and 30 matched control subjects were assessed on their ability to recognize six basic emotions from facial expressions of the whole face and to identify states of mind of others from photographs of only the eyes using the "Reading the Mind in the Eyes Task". Results showed that frontal patients were significantly impaired compared with control subjects on both tasks. Moreover, regression analyses showed that these two abilities are associated and reciprocally predictive of one another. Finally, using voxel-based lesion analysis; we identified a partially common bilaterally distributed prefrontal network in the decoding of both emotional cues from both the whole face and eyes centered within the dorsomedial and ventral regions with extension to the lateral frontal pole.

Imitation of meaningless gestures is a frequently used task to assess praxis skills in Alzheimer’s disease (AD). The visuospatial analysis is considered to be one of the cognitive mechanisms most involved in perceiving the gestures of the other (i.e. model to imitate) in the imitation of meaningless gestures. However, in order to perform a classic gesture imitation task (i.e. face model), it is also necessary to transpose the representation of the other’s gestures to better represent one’s own gestures. This transposition can be superimposed on the dichotomy of egocentric spatial reference frames (i.e. self-gestures) and allocentric spatial reference frames (i.e. gestures of the other). Given previous researches on the relation between hippocampus and allocentric performance, we predicted that AD patients could have imitation difficulties specifically for the allocentric imitation. We thus propose a specific methodology to evaluate the imitation of meaningless gestures in both egocentric and allocentric conditions using unimanual ( i.e. one hand gestures) as well bimanual (i.e. two hand gestures) gest modalities for each condition. Our results show significant differences between the AD group and control group, except under the bimanualallocentric condition. Moreover, correlation analyses with visuospatial assessments do not validate the essential role of visuospatial abilities in our gestural imitation tasks. The comparison of the within-group results shows a significant difference between egocentric and allocentric conditions only for the elderly control group suggesting that the impact of spatial reference frames in gestural imitation would not be specific to AD. However, one should also be alert to within-pathological variability in AD, which would require a future study with several subgroups of AD patients.L'imitation de gestes non significatifs est une tâche fréquemment utilisée pour évaluer les aptitudes praxiques de la maladie d'Alzheimer (MA). L'analyse visuospatiale est considérée comme un des mécanismes cognitifs les plus impliqués dans l'imitation de gestes non significatifs pour percevoir les gestes de l'autre (i.e., modèle à imiter). Cependant pour réaliser une tâche d'imitation de gestes en forme classique (i.e., modèle situé de face), il est également nécessaire de transposer la représentation des gestes de l'autre pour mieux se représenter ses propres gestes. Cette transposition peut être superposée à la dichotomie de l'espace égocentrique (cf. gestes de soi) et l'espace allocentrique (cf. gestes de l'autre). Nous proposons ainsi une méthodologie spécifique afin d'évaluer l'imitation de gestes à la fois en condition égocentrique et en condition allocentrique. Nos résultats montrent des différences significatives entre le groupe MA et le groupe contrôle dans toutes les conditions sauf en condition allocentrique de la modalité bimanuelle (i.e., en deux mains). De plus, les analyses de corrélation avec des évaluations visuo-spatiales ne valident pas le rôle essentiel des capacités visuo-spatiales dans nos tâches d'imitation de gestes non significatifs. La comparaison des résultats en intragroupe montrent une différence significative entre les conditions égocentrique et allocentrique uniquement pour le groupe contrôle âgé, laissant supposer que l'impact des cadres de référence spatiale dans l'imitation de gestes ne serait pas spécifique à la MA. Toutefois, il faudrait également être attentif à une variabilité intrapathologique de la MA, ce qui requerrait une future étude avec plusieurs sous-groupes des patients MA.

Previous studies have shown inconsistent findings regarding the contribution of the different prefrontal regions in emotion recognition. Moreover, the hemispheric lateralization hypothesis posits that the right hemisphere is dominant for processing all emotions regardless of affective valence, whereas the valence specificity hypothesis posits that the left hemisphere is specialized for processing positive emotions while the right hemisphere is specialized for negative emotions. However, recent findings suggest that the evidence for such lateralization has been less consistent. In this study, we investigated emotion recognition of fear, surprise, happiness, sadness, disgust, and anger in 30 patients with focal prefrontal cortex lesions and 30 control subjects. We also examined the impact of lesion laterality on recognition of the six basic emotions. The results showed that compared to control subjects, the frontal subgroups were impaired in recognition of three negative basic emotions of fear, sadness, and anger - regardless of the lesion laterality. Therefore, our findings did not establish that each hemisphere is specialized for processing specific emotions. Moreover, the voxel-based lesion symptom mapping analysis showed that recognition of fear, sadness, and anger draws on a partially common bilaterally distributed prefrontal network.

The current study focused on adapting EF tests for children to the Arabic language and examine the developmental trajectories of a sample of school-aged Lebanese children in four domains of EF (inhibition, flexibility, working memory, and planning). It also focused on examining the effects of gender and parental education level on EF performance. The study population included 100 Lebanese children aged from 6 to 12-years old who were grouped and comparable for age, gender, and parental level of education. Results revealed a main effect of age and level of education of parents while the effect of gender was non-significant.

Executive dysfunctions are central symptoms in different neurological, developmental, and context-related conditions. The assessment of these functions is then essential in neuropsychological pediatric clinical practice. Given the need for reliable and valid evaluation batteries for clinical practice in Brazil, this study aimed to present the pieces of evidences of reliability of the Child Executive Functions Battery (CEF-B). A total of 230 Brazilian children with typical development aged between 7 and 12 years participated in the study. Internal consistency was determined by the split-half method, Cronbach’s α, and Ω. In addition, measurements of test-retest reliability and intraclass coefficient were also performed. Retest indicators were mostly weak and moderate (between .43 and .75). Overvall, coefficients show a satisfactory internal consistency reliability for planning and inhibition measures (between .72 and .92). Considering the measures of WM, results were also satisfactory for both α and Ω indexes. This study revealed that the CEF-B has satisfactory internal consistency reliability coefficients. However, several tests have shown low reliability assessed through the test-retest method. In general, findings reveal interesting pieces of initial evidence of reliability of the Brazilian version. The methodological approach could be improved in future studies by including children with executive disorders.

International audience; Purpose:The main objective of this study was to provide further information concerning the validity of patient-reported executive function (EF) in survivors of primary brain tumor (PBT) compared with a report provided by each patient’s caregiver.Methods: Forty survivors of PBT, 40 non-cancer controls and their proxies completed an assessment of functional executive disorders (e.g., planning, inhibition, shifting, action initiation). Comparisons of self and informant EF reports were examined, for both patients and non-cancer controls. The extent of the concordance between patients’ reports and their caregivers’ reports was also determined.Results: PBT survivors and their caregivers reported more problems related to EF in contrast with the non-cancer comparison group (significant differences). There was a high level of agreement between patients’ and caregivers’ ratings within the patient group.Conclusions: This study provides evidence suggesting that at an average of 3.67 (SD = 2.31) years following treatment for a PBT, EF difficulties are reported by patients and their caregivers. This study establishes a consistency between what is reported by survivors and what is reported by those who frequently interact with them. Further research investigating the link between these ratings and quality of life as well as other functions is encouraged.Implications for Cancer Survivors: This study’s results demonstrate the importance of listening to PBT survivors’ perception of EF difficulties. While not confirmed by neuropsychological evaluations, the functional executive challenges reported by these survivors’ close relatives reflect what PBT survivors themselves report. Specialists should pay close attention to these difficulties to guarantee optimal post-cancer care.

This study's objectives were to characterize the frequency and profile of behavioral and cognitive dysexecutive syndromes in patients with focal prefrontal cortex damage and how these syndromes overlap. We also examined the contribution of the prefrontal brain regions to these syndromes. Therefore, thirty patients with prefrontal cortex damage and thirty control subjects were compared on their performances using the GREFEX battery assessing the dysexecutive syndromes. The results showed that combined behavioral and cognitive dysexecutive syndrome was observed in 53.33%, while pure cognitive dysexecutive syndrome was observed in 20% and behavioral in 26.67%. Also, almost all behavioral and cognitive dysexecutive disorders discriminated frontal patients from controls. Moreover, correlations and regression analyses between task scores in both domains of dysexecutive syndromes showed that the spectrum of behavioral disorders was differentially associated with cognitive impairment of initiation, inhibition, generation, deduction, coordination, flexibility and the planning process. Furthermore, the patterns of cognitive and behavioral dysexecutive syndrome were both predictors of impairment in daily living activities and loss of autonomy. Finally, frontal regions contributing to different dysexecutive syndromes assessed by MRI voxel lesion symptom analysis indicate several overlapping regions centered on the ventromedial and dorsomedial prefrontal cortex for both domains of dysexecutive syndrome. This study concludes that damage to the frontal structures may lead to a diverse set of changes in both cognitive and behavioral domains which both contribute to loss of autonomy. The association of the ventromedial and dorsomedial prefrontal regions to both domains of dysexecutive syndrome suggests a higher integrative role of these regions in processing cognition and behavior.

International audience; Objective: Childhood brain tumors (BTs) and their treatment often negatively affect development of executive functions. Previous studies have reported executive functions deficits, particularly through questionnaires of daily life. This study aimed to assess executive functioning in everyday life following pediatric BT, in a larger and more histologically diverse sample than previously, and to study clinical and demographic factors influencing outcome. Methods: Assessment of executive functioning using parent ratings of the Behavior Rating Inventory of Executive Function (BRIEF), in a large sample of children treated for various BT (n = 153). Clinical and demographic factors were: age at diagnostic, age at assessment, parental education level, radiation therapy. Results: Significant difficulties were found in the 3 composite indices and in the majority of the BRIEF subscales. The highest level of difficulties was observed in the Working Memory subscale. Older age at assessment and younger age at diagnosis were significantly associated with higher levels of parent-reported difficulties, particularly for metacognition. Conclusions: Parents of children treated for BT report widespread and persistent deficits in executive functions that negatively affect their everyday functioning. Including analysis of all clinical scales and composite indices allows a more comprehensive approach and enables to specify the patients’ executive profile.

This study aimed to describe the processes of translation and cross-cultural adaptation to Brazilian Portuguese of the Childhood Executive Functions Battery (CEF-B), designed to evaluate executive functions in children and adolescents from 6 to 16 years of age. Six steps were carried out to ensure the quality of the processes: 1) instrument translation into the new language; 2) synthesis of the translated versions; 3) evaluation of the synthesized version by experts; 4) evaluation by the target population; 5) back-translation and 6) pilot study. We sought to ensure the translation and adaptation properties of the CEF-B in terms of semantic, idiomatic, experiential and cultural equivalence between the instructions in the original language and the target language. Results showed preliminary evidence of cultural adequacy and a satisfactory comprehension of the instrument instructions by the target population.

Objective:To provide a comprehensive systematic review of the literature by examining studies published on all cognitive aspects of children with early and continuously treated phenylketonuria (ECT-PKU) included in the databases Medline, PsycINFO, and PsycARTICLE.Method:In addition to a classical approach, we summarized methodology and results of each study in order to discuss current theoretical and methodological issues. We also examined recent advances in biochemical markers and treatments of PKU, with implications for future research on metabolic control and its role as a determinant of neuropsychological outcome.Results:Consistent with previous reviews, the hypothesis of a specific and central executive impairment in children with ECT-PKU was suggested. However, findings are inconclusive regarding the nature of executive impairments as well as their specificity, impact on everyday life, persistence over time, and etiology.Conclusion:Given the current state of the science, we suggest future directions for research that utilizes a developmental and integrative approach to examine the effects of recent advances in biochemical markers and treatment of PKU. (JINS, 2019,25, 624–643)

North African countries such as Morocco are scarcely the focus of neuropsychological studies, although the role of culture in cognition processes is widely recognized. Currently, studies on flexibility and planning skills in the Moroccan context are still lacking and there are no adapted tools to assess these functions in the country. In this scenario, this study aimed to adapt the Child Executive Functions Battery (CEF-B) tasks and the playing cards task of the Behavioral Assessment of the Dysexecutive Syndrome for Children (BADS-C) to Morocco and provide preliminary normative data on the development of flexibility and planning. In addition, this study proposed to examine the effects of gender, parents' education level and multilingualism on executive development. To this end, six tasks of the CEF-B were adapted through a translation and back-translation process and administered to 115 children aged 7-12 years. Results showed that the adopted procedure was sufficient for the cross-cultural adaptation of the tasks. Analyses showed a continuous increase with age on executive performance in most of the variables. However, gender and parents' level of education showed mostly non-significant effects. On the other hand, a significant effect of multilingualism was found on the two analyzed functions, with better results for multilingual children if compared to their bilingual peers. In general, results suggest that the identified pattern of development is consistent with international studies. Although normative data on executive functions are still lacking in Morocco, this unprecedented study will help better understand their development in this context.

The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.

espanolEste estudio objetiva describir los procedimientos de traduccion y adaptacion transcultural del protocolo Funciones Ejecutivas en Ninos (FEN) para el portugues brasileno, dirigido a la evaluacion de las funciones ejecutivas de los ninos y adolescentes de 6 a 16 anos. Para garantizar la calidad del proceso, se realizaron 6 etapas: 1. traduccion del instrumento del idioma de origen al idioma de destino; 2. sintesis de las versiones traducidas; 3. evaluacion por expertos; 4. evaluacion por el publico objetivo; 5. traduccion inversa y 6. estudio piloto. Se busco garantizar las propiedades de la traduccion y adaptacion del protocolo FEN, en terminos de equivalencia semantica, idiomatica, experiencial y cultural entre las instrucciones en el idioma original y en el idioma de destino. Los resultados apuntaron evidencias iniciales de adecuacion cultural y buena comprension de las instrucciones del instrumento por el publico objetivo. EnglishThis study aimed to describe the processes of translation and cross-cultural adaptation to Brazilian Portuguese of the Childhood Executive Functions Battery (CEF-B), designed to evaluate executive functions in children and adolescents from 6 to 16 years of age. Six steps were carried out to ensure the quality of the processes: 1. instrument translation into the new language; 2. synthesis of the translated versions; 3. evaluation of the synthesized version by experts; 4. evaluation by the target population; 5. back-translation and 6. pilot study. We sought to ensure the translation and adaptation properties of the CEF-B in terms of semantic, idiomatic, experiential and cultural equivalence between the instructions in the original language and the target language. Results showed preliminary evidence of cultural adequacy and a satisfactory comprehension of the instrument instructions by the target population. portuguesEste estudo objetiva descrever os procedimentos de traducao e adaptacao transcultural para o portugues brasileiro do Protocolo Funcoes Executivas em Criancas (FEC), voltado para a avaliacao das funcoes executivas de criancas e adolescentes de 6 a 16 anos. Para garantir a qualidade do processo, foram realizadas seis etapas: 1. traducao do instrumento do idioma de origem para o idiomaalvo; 2. sintese das versoes traduzidas; 3. avaliacao por experts; 4. avaliacao pelo publico-alvo; 5. traducao reversa e 6. estudo piloto. Buscou-se assegurar as propriedades da traducao e adaptacao do protocolo FEC, em termos de equivalencia semântica, idiomatica, experiencial e cultural entre as instrucoes no idioma original e no idioma-alvo. Os resultados apontaram evidencias iniciais de adequacao cultural e boa compreensao das instrucoes do instrumento pelo publico-alvo.

The diagnosis of limb apraxia relies mainly on exclusion criteria (e.g., elementary motor or sensory deficits, aphasia). Due to the diversity of apraxia definitions and assessment methods, patients may or may not show apraxia depending on the chosen assessment method or theory, making the definition of apraxia somewhat arbitrary. As a result, "apraxia" may be diagnosed in patients with different cognitive impairments. Based on a quantitative and critical review of the literature, it is argued that this situation has its roots in the evolution from a task-based approach (i.e., the use of gold standard tests to detect apraxia) toward a process-based approach, namely, the deconstruction of the conceptual or production systems of action into multiple cognitive processes: language, executive functions, working memory, semantic memory, body schema, body image, visual-spatial skills, social cognition, visual-kinesthetic engrams, manipulation knowledge, technical reasoning, structural inference, and categorical apprehension. The coexistence of both approaches in the current literature is a major challenge that stands in the way of a scientific definition of apraxia. As a step toward a solution, we suggest to focus on symptoms, and on two complementary definition criteria (in addition with traditional exclusion criteria): Specificity (i.e., is apraxia explained by the alteration of cognitive processes specifically dedicated to gesture production?), and consistency (i.e., is the gesture production impairment consistent across tasks?). Two categories of limb apraxia are proposed: symptomatic apraxia (i.e., gesture production deficits that are secondary to more general cognitive impairments) and idiopathic apraxia (i.e., gesture production deficits that can be observed in isolation). It turns out that the only apraxia subtype that fulfills exclusion, specificity, and consistency criteria is limb-kinetic apraxia. A century after Liepmann's demonstration of the autonomy of apraxia toward language, the autonomy of this syndrome toward the rest of cognition remains an open question, while it poses new challenges to apraxia studies.

The goal of this review is to perform a critical analysis of the instruments used to assess executive functions (EFs) in preschool and school-age children in Brazil. We identified 37 assessment measures through a systematic review. Some performance-based tests for assessing working memory and inhibition were identified. However, there is a lack of rating measures and instruments to assess flexibility and planning in clinical practice. We observed regional differences in the performance of EFs measures. One possible explanation may be the use of normative samples from more highly-developed regions to characterize performance in less-developed regions. However, there may be alternative explanations, such as variations in the exposure to testing and the adequacy of test materials in different regions. Joint efforts among research groups should be encouraged in order to obtain normative references that are more representative of the socio-cultural diversity of the country. This improvement is essential to better understand the typical and atypical development of EFs and how the peculiarities of each country's context and culture can impact its trajectory.

Les troubles d’utilisation d’outils constituent une plainte frequente en clinique pediatrique, notamment en cas de trouble developpemental de la coordination (TDC), et peuvent limiter la participation de l’enfant aux activites de vie quotidienne. Pourtant, l’absence de theorie explicative consensuelle dans le TDC induit des strategies d’examen peu structurees, voire affranchies de cadrage theorique, qui n’integrent pas automatiquement l’evaluation du retentissement des difficultes dans la vie quotidienne. Cet article propose d’interroger, dans une premiere partie, la nature des troubles gestuels et de coordination motrice chez l’enfant TDC ainsi que leur role eventuel dans l’utilisation d’outils. La pertinence des concepts theoriques et des evaluations cliniques mises en œuvre est egalement questionnee au regard de l’analyse des difficultes d’utilisation. La seconde partie expose les modelisations theoriques formulees dans le developpement typique et en neuropsychologie adulte, susceptibles d’eclairer la comprehension de ces symptomes chez l’enfant TDC. Enfin, les perspectives d’un examen differentiel et theoriquement guide de l’utilisation d’outils chez l’enfant sont abordees a l’issue de cette revue.

Resume Les fonctions executives (FE) jouent un role determinant dans le developpement psychologique de l’enfant. Ces dernieres annees, leur etude a suscite un interet majeur dans le champ de la neuropsychologie de l’enfant, plus particulierement depuis l’accumulation d’arguments empiriques suggerant un lien potentiel entre les perturbations executives et les difficultes d’ordre cognitif, scolaire et psychosocial. Aujourd’hui, nombreuses sont les donnees qui montrent que les habiletes executives se developpent precocement et de facon prolongee. Cette idee est reprise dans une proposition theorique recente formulee par Diamond (2013), qui detaille les principales FE a travers un modele integratif a composantes multiples. Neanmoins, ce type de modele ne prevoit pas l’effet de l’environnement et de la culture sur le developpement des FE, alors que plusieurs arguments existent desormais et sont en faveur d’une influence potentielle de ces dimensions. Dans cet article, une synthese des principales donnees empiriques accumulees dans ce domaine est proposee, ainsi qu’une reflexion sur les enjeux cliniques lies a la prise en compte indispensable de la culture en cas de perturbation du developpement cerebral. Plusieurs elements de prospective sont proposes, en particulier d’ordre methodologique, afin de favoriser l’emergence d’outils d’evaluation neuropsychologique des FE adaptes a l’enfant, qui prennent en compte a minima l’effet de l’environnement et du contexte culturel.

International audience; While imitation of meaningless gestures is a gold standard in the assessment of apraxia in patients with either stroke or neurodegen- erative diseases, little is known about potential age-related effects on this measure. A significant body of literature has indicated that different mechanisms (i.e., executive functioning, visuospatial skills, sensory integration, body knowledge, categorical apprehension) may underlie the performance depending on imitation conditions (i.e., finger/hand, uni-/bimanual, symmetric/asymmetric, crossed/ uncrossed configurations). However, neither the effects of these conditions on performance, nor the contribution of the abovemen- tioned mechanisms to imitation have been explored in normal aging. The aim of the present study was to fill this gap. To do so, healthy adults (n = 103) aged 50 to 89 were asked to imitate 45 meaningless gestures. The authors controlled for general cognitive function, motor function, visual-spatial skills, executive function, sensory inte- gration, body knowledge, and mechanical problem-solving skills. The results showed that asymmetry, body-midline crossing and, to a lesser extent, bimanual activity added an additional layer of diffi- culty to imitation tasks. After controlling for motor speed and cogni- tive function, age had an effect on imitation skills after 70 years old. This may reflect a decline in body knowledge, sensory integration, and executive functions. In contrast, the visuospatial and mechanical problem-solving hypotheses were ruled out. An additional motor simulation hypothesis is proposed. These findings may prove useful for clinicians working inmemory clinics by providing insights on how to interpret imitation deficits. Lower performance after 70 years old should not be considered abnormal in a systematic manner.

Alexithymia has been extensively reported in studies of psychiatric patients. However, little attention has been paid regarding its occurrence in the context of patients with circumscribed prefrontal cortex lesions. Moreover, the neuro-cognitive impairments that lead to alexithymia remain unclear and limited numbers of studies have addressed these issues. The authors investigated the impact of prefrontal cortex lesions on alexithymia and its neuro-cognitive correlates in a population of 20 patients with focal frontal lesions, 10 patients with parietal lesions and 34 matched control participants. Alexithymia was screened using the Toronto Alexithymia Scale (TAS-20) and executive functions were assessed using a large battery of executive tasks that address inhibition, flexibility and the planning process. Results showed that patients with prefrontal cortex damage showed significantly increased difficulty in facets of identifying feelings (DIF) and externally oriented thinking (EOT) on TAS-20, compared to parietal patients and control participants. Moreover, both correlation and regression analysis revealed that higher alexithymia levels on the three facets of TAS-20 were consistently but differentially associated with impairment in inhibition, flexibility and planning tasks for frontal patients and both control groups. These findings provide clinical evidence of the implication of prefrontal cortex damage and executive control in alexithymia. Our results were also discussed in the light of the cognitive appraisal concept as a mechanism involved in emotion episode processing. This study suggests that increased neuropsychological attention should be directed to the relation between the neuro-cognitive model of executive functions and cognitive appraisal theory in processing emotion.

International audience; We report the case of M.B. who demonstrated severe optic ataxia with the right hand following stroke in the left hemisphere. The clinical picture may shed light on both the pathological characteristics of reaching and grasping actions, and potential rehabilitation strategies for optic ataxia. First, M.B. demonstrated a dissociation between severely impaired reaching and relatively spared grasping and tool use skills and knowledge, which confirms that grasping may be more intermingled with non-motoric cognitive mechanisms than reaching. Besides, M.B.’s reaching performance was sensitive to movement repetition. We observed a substitution effect: Reaching time decreased if M.B. repeatedly reached toward the same object but increased when object identity changed. This may imply that not only object localization but also object identity, is integrated into movement programming in reach-to-grasp tasks. Second, studying M.B.’s spontaneous compensation strategies ascertained that the mere repetition of reaching movements had a positive effect, to the point M.B. almost recovered to normal level after an intensive one-day repetitive training session. This case study seems to provide one of the first examples of optic ataxia rehabilitation. Reaching skills can be trained by repetitive training even two years post-stroke and despite the presence of visuo-imitative apraxia.