Executive functions as a potential neurocognitive endophenotype in anxiety disorders: A systematic review considering DSM-IV and DSM-5 diagnostic criteria classification

Muller, Juliana de Lima; Torquato, Kamilla Irigaray; Manfro, Gisele Gus; Trentini, Clarissa Marceli

doi:10.1590/1980-57642015DN93000012

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Original Article • Dement. neuropsychol. 9 (3) • Jul-Sep 2015 • https://doi.org/10.1590/1980-57642015DN93000012 linkcopy

Executive functions as a potential neurocognitive endophenotype in anxiety disorders: A systematic review considering DSM-IV and DSM-5 diagnostic criteria classification

FUNÇÕES EXECUTIVAS COMO UM POTENCIAL ENDOFENÓTIPO NEUROCOGNITIVO NOS TRANSTORNOS DE ANSIEDADE: UMA REVISÃO SISTEMÁTICA DA LITERATURA CONSIDERANDO OS CRITÉRIOS DIAGNÓSTICOS DO DSM-IV E DO DSM-5

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Evidence in the literature indicates that neurocognitive impairments may represent endophenotypes in psychiatric disorders.

Objective: This study aimed to conduct a systematic review on executive functions as a potential neurocognitive endophenotype in anxiety disorder diagnosis according to the DSM-IV and DSM-5 classifications.

Methods: A literature search of the LILACS, Cochrane Library, Index Psi Periódicos Técnico-Científicos, PubMed and PsycInfo databases was conducted, with no time limits. Of the 259 studies found, 14 were included in this review.

Results: Only studies on obsessive-compulsive disorder (OCD) were found. The executive function components of decision-making, planning, response inhibition, behavioral reversal/alternation, reversal learning and set-shifting/cognitive flexibility were considered to be a neurocognitive endophenotypes in OCD.

Conclusion: Further studies on executive functions as a neurocognitive endophenotype in other anxiety disorders are needed since these may have different neurocognitive endophenotypes and require other prevention and treatment approaches.

endophenotypes; executive function; anxiety disorders; neuropsychology

Study	Country	Sample	Age (M)	Instruments	Results (deficits/impairments)*
Abramovitch et al., 2015⁵⁷	United States	27 SOC 27 LOC	24.2 24.1	Expanded Go/No-Go Task	Response inhibition and sustained attention (SOC)
Cavedini et al., 2010²³	Italy	35 OCD 35 UFDR 31 HC 31 HCR	35.6 45 34.7 43.2	Iowa Gambling Task, Tower of Hanoi, Wisconsin Card Sorting Test	Decision making and planning (OCD and UFDR)
Chamberlain et al., 2007⁵²	United Kingdom	20 OCD 20 UFDR 20 HC	32.1 34.2 33.1	Intradimensional/Extradimensional Shift Task, Stop Signal Task, Cambridge Gamble Task	Set-shifting/cognitive flexibility and response inhibition (OCD and UFDR)
Chamberlain et al., 2008⁶⁰	United Kingdom	14 OCD 12 UFDR 15 HC	31.7 39.5 34.8	A functional magnetic resonance imaging task capable of fractionating different components of cognitive flexibility	Reversal learning (OCD and UFDR)
Delorme et al., 2007⁵⁹	France	64 UFDR^** 47 HC	42.3 38	Tower of London Test, Trail Making Test, Design Fluency Task, Verbal Fluency Test (letter), Association Fluency task	Planning (UFDR^**)
da Rocha et al., 2008⁵⁴	Brazil	32 OCD S/Lg 17 OCD La/La	29.4 31.2	Iowa Gambling Task, CPT-II, Trail Making Test	Decision making (OCD S/Lg)
de Vries et al., 2014⁶¹	Netherlands	43 OCD 17 UFDR 37 HC	38.1 36.4 39.2	N-back Task	Spatial working memory (OCD and UFDR)
Lennertz et al., 2012⁵⁸	Germany	30 OCD 30 UFDR 30 HC	40.6 42.1 42.7	Verbal Fluency Test (letter), Tower of London, Trail Making Test, Saccadic tasks	Response inhibition (OCD and UFDR)
Menzies et al., 2007²⁰	United Kingdom	31 OCD 31 UFDR 31 HC	32.5 36.7 33.4	Stop Signal Task	Response inhibition (OCD and UFDR)
Rajender et al., 2011⁵³	India	30 OCD 30 UFDR 30 HC	25.6 26.4 26.9	Colour Trails Test, Digit Vigilance Test, The Triads Test, Tower of London Test, Wisconsin Card Sorting Test, Stroop Test- NIMHANS version	Set-shifting/cognitive flexibility and response inhibition (OCD and UFDR)
Rao et al., 2008⁵⁰	India	30 ROCD 30 HC	27.8 27.9	Digit span test, Continuous Performance Test, Trail Making Test, Stroop Color Word Interference Test, Wisconsin Card Sorting Test, Delayed Alternation Test, Tower of London, Controlled Oral Word Association Test, Letter Number Sequencing and Spatial Span	Set-shifting/cognitive flexibility, behavioral reversal/alternation and response inhibition (ROCD)
Viswanath et al., 2009 ⁵¹	India	25 UFDR^** 25 HC	27.5 27.4	Continuous Performance Test, Trail Making Test, Stroop Colour Word Interference Test, Delayed Alternation Test, Tower of London, Controlled Oral Word Association Test, Iowa Gambling Task, Wisconsin Card Sorting Test, Letter number sequencing, Spatial span	Decision making and behavioral reversal/alternation (UFDR^**)
Zhang et al., 2015⁵⁵	China	55 OCD 55 UFDR 55 HC	26.5 28.4 27.9	Stroop Color Word Test, Trail Making Test, Digit Span Test, Verbal Fluency Tests (letter and category), Wisconsin Card Sorting Test, Tower of London, Iowa Gambling Task, Game of Dice Task	Decision making and planning (OCD and UFDR)
Zhu et al., 2014⁵⁶	China	14 SOC 14 LOC	19.9 19.6	Iowa Gambling Task	Decision-making (SOC)

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[t01TFN01] OC: obsessive-compulsive; OCD: obsessive-compulsive disorder patients; UFDR: unaffected first-degree relatives of patients; SOC: subclinical obsessive- compulsive participants; LOC: low obsessive-compulsive symptoms control participants; HC: healthy controls; HCR: healthy controls relatives; ROCD: recovered obsessive-compulsive disorder patients; S/Lg: patients with S- and/or Lg-carriers; La/La: patients with the La/La genotype. * Participants with deficits/impairments given in parentheses). **Relatives of patients with obsessive-compulsive disorder.