title: Executive dysfunction in subcortical ischaemic vascular disease.
abstract: BACKGROUND
  Executive dysfunction has been reported in patients with subcortical-frontal pathology, even in the absence of dementia.
  
  
  OBJECTIVE
  This study was undertaken to determine if impairments in executive functioning could be found in non-demented patients with subcortical lacunes.
  
  
  METHODS
  Cross sectional comparison between older control subjects (n=27) and non-demented patients with one or more subcortical lacunes (n=12). All participants were administered a neuropsychological test battery incorporating three measures of executive functioning, the Stroop interference test, California card sorting test, and the initiation-perseveration subtest of the Mattis dementia rating scale.
  
  
  RESULTS
  No group differences were found on measures of recent verbal memory, language, or spatial ability. Normal controls performed better than patients with lacunes in visual memory. On the Stroop interference test, patients with lacunes performed as well as controls on the colour naming condition but slower on the interference condition. Patients with lacunes also generated fewer correct sorts on the California card sort test and achieved lower scores on the initiation-perseveration subtest. Executive measures were correlated with extent of white matter signal hyperintensity but not number of lacunes.
  
  
  CONCLUSIONS
  Subcortical ischaemic vascular disease is associated with subtle declines in executive functioning and visual memory, even in non-demented patients. The pattern of cognitive impairment after subcortical lacunes is consistent with models of subcortical-frontal circuits.
authors.affiliation: San Francisco Medical Center, University of California, 401 Parnassus Avenue, San Francisco, CA 94143, USA. kramer@itsa.ucsf.edu
authors.forename: J H
authors.initials: JH
authors.lastname: Kramer
authors.forename: B R
authors.initials: BR
authors.lastname: Reed
authors.forename: D
authors.initials: D
authors.lastname: Mungas
authors.forename: M W
authors.initials: MW
authors.lastname: Weiner
authors.forename: H C
authors.initials: HC
authors.lastname: Chui
mesh_terms: D000368:Aged; D001288:Attention / Q000502:physiology*; D001931:Brain Mapping; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology; D004193:Discrimination Learning / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000503:physiopathology; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology*