title: Frontal MRI findings associated with impairment on the Executive Interview (EXIT25).
abstract: We examined the association between the Executive Interview (EXIT25), a bedside measure of executive control, and regional magnetic resonance imaging (MRI) pathology among 52 consecutive geriatric patients presenting to a university dementia assessment clinic. Left frontal (p < .002), left medial (p < .03), right frontal (p < .02), and right medial (p < .02) cortical lesions significantly worsened EXIT25 scores, even after adjusting for age, global cognitive impairment (on the Mini-Mental State Examination), and the severity of cortical dementia on the Qualitative Evaluation of Dementia [QED]. The EXIT25's associations with right hemisphere lesions did not persist after adjusting for left frontal lesions. Left posterior lesions did not significantly affect the EXIT25. Similarly, left frontal circuit pathology worsened EXIT25 scores (p < .05). Pathology in left anterior subcortical structures showed a trend (p = .052). EXIT25 scores were not affected by right subcortical pathology, nor by pathology in either hippocampus. We conclude that the EXIT25 is specifically affected by frontal system MRI lesions, particularly on the left. This conclusion is consistent with earlier functional neuroimaging studies associating EXIT25 performance with left mesiofrontal perfusion.
authors.affiliation: Departments of Psychiatry, Medicine, and Pharmacology, South Texas Veterans' Health System, Geriatric Research, Education and Clinical Center (GRECC), University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. royall@uthscsa.edu
authors.forename: D R
authors.initials: DR
authors.lastname: Royall
authors.forename: R
authors.initials: R
authors.lastname: Rauch
authors.forename: G C
authors.initials: GC
authors.lastname: Román
authors.forename: J A
authors.initials: JA
authors.lastname: Cordes
authors.forename: M J
authors.initials: MJ
authors.lastname: Polk
mesh_terms: D000368:Aged; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D003704:Dementia / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D005852:Geriatric Psychiatry; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008609:Mental Status Schedule; D019095:Point-of-Care Systems; D011859:Radiography