Dysexecutive syndrome: Diagnostic criteria and validation study

ANNALS of NeurologyOur approach provides separate criteria in the behavioraland cognitive domains. This was based on previousreports of dissociated disorders, usually presentingwith behavioral disorders unaccompanied by cognitivedisorders. 5,7 The present results, obtained in a largegroup of unselected patients with multiple diseases, supportthis position, and even revealed that a dissociateddisorder was more frequent than the combined behavioraland cognitive syndrome. This is consistent with experimentalneuropsychological studies showing prominentimpairment of working memory in dorsolaterallesions and prominent impairment of behavioral processesin mediofrontal lesions. 5,7,30 On clinical grounds,the prominence of behavioral impairment has already beenreported in mediofrontal damage, 5,7,30 but the reverse patternremains rarely documented to our knowledge. 31 Thisindicates that both behavioral and cognitive domains mustbe examined in clinical practice whenever possible.The present criteria were strictly defined and operationalizedusing definite performance indices that havebeen previously normalized. In addition, the cutoff scoresof dysexecutive syndrome were adjusted for the number ofindices, and this provides a good specificity (

Godefroy et al: Dysexecutive SyndromeAuthorshipO.G. and M.R. designed the study and prepared thestatistical analysis plan. O.G. wrote the manuscript withassistance from P.A., P.R., M.R., T.M., and D.L.G. M.R.contributed to data analysis. O.G., M.R., P.A., P.R., M.R.,T.M., and D.L.G. identified patients or controls. All authorsreviewed the manuscript and approved the final draft.Potential Conflicts of InterestNothing to report.AppendixThe following centers and investigators participated inthe GREFEX cooperative study (n number of patientsincluded at each center; investigators): Amiens UniversityHospital (France) (n 183; O. Godefroy and M. Roussel),Angers University Hospital (France) (n 19; D. LeGall), Heliomarin Rehabilitation Center Berck (France)(n 15; C. Bertola), Bordeaux University Hospital(France) (n 28; J. M. Giroire and P. A. Joseph), SaintLuc University Hospital Brussels (Belgium) (n 6; X.Seron, F. Coyette), Cholet General Hospital (France) (n8; E. Bretault and I. Bernard), Ottignies William LennoxCenter (Belgium) (n 3; M. Leclercq), Garches UniversityHospital (France) (n 9; P. Azouvi and C. Vallat-Azouvi), Grenoble University Hospital (France) (n 24; P.Pollack and C. Mosca), Lausanne University Hospital(Switzerland) (n 9; C. Bindschadler), Lay St. ChristopheRehabilitation Center (France) (n 3; M. Krier), LiègeDepartment of Cognitive Sciences (Belgium) (n 19; T.Meulemans and V. Marquet), Lille Stroke Center UniversityHospital (France) (n 26; D. Leys and M. Roussel),Nantes University Hospital (France) (n 8; P. Renou andM. Vercelletto), Nice University Hospital (France) (n 6;E. Michel and P. Robert ), Nîmes University Hospital(France) (n 15; P. Labauge and C. Franconie), Paris-LaSalpétrière University Hospital Neurology Department(France) (n 18; B. Pillon and B. Dubois), Paris-La SalpétrièreUniversity Hospital Geriatrics Department(France) (n 13; B. Dieudonnée and M. Verny), Paris-Broca University Hospital (France) (n 5; H. Lenoir andJ. 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