The DOI matches its Crossref record; 148 of the 150 references it cites were found in a registry or an index; 2 of the 107 sources its claims cite were checked for support.
Cognitive and behavioural flexibility: neural mechanisms and clinical considerations
Open accessAbstract
Cognitive and behavioural flexibility permit the appropriate adjustment of thoughts and behaviours in response to changing environmental demands. Brain mechanisms enabling flexibility have been examined using non-invasive neuroimaging and behavioural approaches in humans alongside pharmacological and lesion studies in animals. This work has identified large-scale functional brain networks encompassing lateral and orbital frontoparietal, midcingulo-insular and frontostriatal regions that support flexibility across the lifespan. Flexibility can be compromised in early-life neurodevelopmental disorders, clinical conditions that emerge during adolescence and late-life dementias. We critically evaluate evidence for the enhancement of flexibility through cognitive training, physical activity and bilingual experience. Flexibility is critical for the optimal adaptation of thoughts and actions under changing circumstances. In this Review, Uddin summarizes research that has identified cognitive processes and neural systems supporting flexibility and discusses ways to improve flexibility across the lifespan.
Overview
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Written from the paper’s full text.
TL;DR
This review synthesizes human neuroimaging and animal work on cognitive and behavioural flexibility, emphasizing distributed frontoparietal, midcingulo-insular, and frontostriatal systems across the lifespan. It argues that flexibility deficits cut across neurodevelopmental, adolescent-onset, and late-life disorders, while evidence for enhancing flexibility through training, exercise, and bilingualism remains mixed.
Key findings
- Flexibility is supported by large-scale functional networks: a lateral frontoparietal network (including dorsolateral prefrontal cortex, inferior frontal junction, and inferior parietal lobule), a midcingulo-insular network (including anterior insula and anterior midcingulate cortex), and frontostriatal circuits. The inferior frontal junction is engaged during updating of task representations and flexible item selection, with connectivity strength related to individual task performance.
- Flexibility follows an inverted U-shaped lifespan trajectory, peaking between the second and third decades and declining in later life. Brain signal variability generally decreases from ages 6 to 85 across most regions, except the anterior insula, which increases; higher variability has been linked to better performance in some older adults.
- Flexibility deficits appear transdiagnostically in autism spectrum disorder, ADHD, mood and anxiety disorders, obsessive–compulsive disorder, schizophrenia, Alzheimer disease, and Parkinson disease. The review’s table links manifestations such as restricted/repetitive behaviours, repetitive negative thinking, cognitive rigidity, and compulsions to putative substrates including frontostriatal, orbitofrontal, midcingulo-insular, and frontoparietal systems.
- Intervention evidence is mixed: cognitive training often produces narrow short-term transfer; a game-based flexibility training study reported reading comprehension gains only at 6-week follow-up; a randomized controlled trial of working memory and cognitive flexibility training in autism did not show differential improvement; “Unstuck and On Target” improved classroom behaviour, flexibility, and problem-solving in autism; exercise alone showed little or no executive function benefit; bilingual advantages were inconsistent but observed in lower socio-economic status children and as possible cognitive reserve.
Methods
- Narrative critical review, not a primary empirical study. It synthesizes non-invasive human neuroimaging and behavioural paradigms (including task-switching, set-shifting, Wisconsin Card Sorting Test, and reversal learning) alongside animal lesion, pharmacological, and behavioural studies.
- The review spans typical development, adulthood, ageing, and clinical conditions, and evaluates cognitive training, physical activity, and bilingualism as potential flexibility interventions.
- Main analysis is qualitative synthesis and critical evaluation; no systematic search strategy, meta-analysis, or primary sample is described.
Limitations
- The paper states measurement problems: laboratory/performance-based measures and self- or informant-report measures are only weakly correlated, and construct validity versus ecological validity remains a challenge. It calls for standardized, transdiagnostic, age-normed assessments.
- The paper states that intervention evidence is mixed, bilingualism findings lack consensus, and no interventional studies have yet shown that training changes brain network dynamics supporting flexibility. Cholinergic contributions are complicated by co-release of other neurotransmitters.
- Evident from the text: as a narrative review, it does not report a systematic search, formal effect sizes, or risk-of-bias assessment, and conclusions draw on heterogeneous paradigms, populations, and study designs.
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Claims the paper makes
94 Not checked yet · 10 No basis given · 6 Own interpretation · 2 Partly supported · accuracy not yet measured
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In the paper
“greater creativity was broadly predicted by grey matter of the inferior frontal gyrus and inferior parietal lobule as well as white matter integrity of the basal ganglia147.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Partly supportedcites [147] Sunavsky, A. & Poppenk, J. Neuroimaging predictors of creativity in healthy adults. Neuroimage 206, 116292 (2020). sourceExperimental — accuracy not yet measured
Section 4.2 reports a positive correlation between creativity and IFG grey matter density, along with IFG–IPL connectivity, but does not report grey matter in the IPL as a predictor. Section 3.3 identifies left basal-ganglia white-matter integrity as a creativity predictor that generalized to another creativity measure. The claim is therefore supported except for its attribution of a grey-matter predictor to the IPL; page numbers were not available in our copy. (LLM, conf=0.88)
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In the paper
“Entering the terms describing the latent variables comprising executive function into Neurosynth reveals that the brain maps associated with these interrelated cognitive constructs are highly overlapping7 (Fig. 1a).”
- Also stated in: § Cognitive flexibility in humans · plain
“Neurosynth reveals that brain imaging studies including the terms ‘shifting’, ‘updating’ and ‘inhibition’ report highly overlapping patterns of activation in lateral frontoparietal and midcingulo-insular brain regions”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [7] Miyake, A. et al. The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cogn. Psychol. 41, 49–100 (2000). source
- Not checked yetcites [29] Yarkoni, T., Poldrack, R. A., Nichols, T. E., Van Essen, D. C. & Wager, T. D. Large-scale automated synthesis of human functional neuroimaging data. Nat. Methods 8, 665–670 (2011). source
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- Also stated in: § Cognitive flexibility in humans · plain
None of the sources cited for this claim have been checked yet.
In the paper
“This work has identified large-scale functional brain networks encompassing lateral and orbital frontoparietal, midcingulo-insular and frontostriatal regions that support flexibility across the lifespan.”
- Also stated in: § Cognitive flexibility in humans · boosted
“A large body of literature on human functional neuroimaging studies using task-switching and set-shifting paradigms points to a central role for the lateral frontoparietal network (L-FPN) and the midcingulo-insular network (M-CIN) in supporting executive function and cognitive flexibility20,30.”
- Also stated in: § Behavioural flexibility in animals · hedged
“These findings have led to the proposal that the lateral PFC is necessary for shifting of responding between abstract perceptual dimensions, whereas the OFC and associated corticostriatal loops are necessary for shifting of responding between different stimuli with specific associations with reinforcement36.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Abstract
What the sources say
- Not checked yetcites [20] Dajani, D. R. & Uddin, L. Q. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends Neurosci. 38, 571–578 (2015). source
- Not checked yetcites [30] Seeley, W. W. et al. Dissociable intrinsic connectivity networks for salience processing and executive control. J. Neurosci. 27, 2349–2356 (2007). source
- Not checked yetcites [36] Robbins, T. W. Shifting and stopping: fronto-striatal substrates, neurochemical modulation and clinical implications. Philos. Trans. R. Soc. Lond. B Biol. Sci. 362, 917–932 (2007). source
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In the paper
“During a task requiring flexible selection of items based on different stimulus dimensions, participants initially directly engaged the IFJ, leading to recruitment of other L-FPN and M-CIN regions, including the dlPFC, IPL, anterior midcingulate cortex and AI via functional connections33.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [33] Dajani, D. R. et al. Measuring cognitive flexibility with the flexible item selection task: from MRI adaptation to individual connectome mapping. J. Cogn. Neurosci. 32, 1026–1045 (2020). This functional neuroimaging study in humans demonstrates that flexible item selection directly engages the left IFJ, which influences activity in other cortical and subcortical brain regions supporting cognitive flexibility. source
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overlap in lateral frontoparietal and striatal involvement for both flexibility and creativity points to potential shared neural substrates for these related constructs.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
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In the paper
“Performance on the WCST is strongly related to shifting (also referred to as ‘attention switching‘ or ‘task switching’), which involves the disengagement of an irrelevant task set and subsequent active engagement of a relevant task set7.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [7] Miyake, A. et al. The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cogn. Psychol. 41, 49–100 (2000). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Likewise, flexibility in later life can mitigate the effects of ageing on cognitive decline4.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Introduction
What the sources say
- Not checked yetcites [4] Burke, S. N. et al. What are the later life contributions to reserve, resilience, and compensation? Neurobiol. Aging 83, 140–144 (2019). source
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In the paper
“Developmental and lifespan research suggests that flexibility promotes academic achievement, employment success2, successful transitioning to adulthood3 and other optimal life outcomes.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Introduction
What the sources say
- Not checked yetcites [3] Burt, K. B. & Paysnick, A. A. Resilience in the transition to adulthood. Dev. Psychopathol. 24, 493–505 (2012). source
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In the paper
“one study found that the IFJ is engaged during the updating of task representations, a core aspect of flexibility32.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [32] Derrfuss, J., Brass, M., Neumann, J. & von Cramon, D. Y. Involvement of the inferior frontal junction in cognitive control: meta-analyses of switching and Stroop studies. Hum. Brain Mapp. 25, 22–34 (2005). source
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In the paper
“earlier work demonstrating domain-general task-switching activation in the IFJ34”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [34] Kim, C., Johnson, N. F., Cilles, S. E. & Gold, B. T. Common and distinct mechanisms of cognitive flexibility in prefrontal cortex. J. Neurosci. 31, 4771–4779 (2011). source
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None of the sources cited for this claim have been checked yet.
In the paper
“A large body of literature on human functional neuroimaging studies using task-switching and set-shifting paradigms points to a central role for the lateral frontoparietal network (L-FPN) and the midcingulo-insular network (M-CIN) in supporting executive function and cognitive flexibility20,30.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [20] Dajani, D. R. & Uddin, L. Q. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends Neurosci. 38, 571–578 (2015). source
- Not checked yetcites [30] Seeley, W. W. et al. Dissociable intrinsic connectivity networks for salience processing and executive control. J. Neurosci. 27, 2349–2356 (2007). source
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Flexible thinking is a critical component of creativity, or the ability to think of new ideas or make new things.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
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In the paper
“Cognitive flexibility is difficult to isolate, as it requires the confluence of several aspects of executive function20,28.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [20] Dajani, D. R. & Uddin, L. Q. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends Neurosci. 38, 571–578 (2015). source
- Not checked yetcites [28] Uddin, L. Q. Salience processing and insular cortical function and dysfunction. Nat. Rev. Neurosci. 16, 55–61 (2015). source
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In the paper
“A meta-analysis of neuroimaging studies of divergent thinking indicates that brain networks underlying creative idea generation are composed of lateral prefrontal, posterior parietal and anterior cingulate cortices, as well as the caudate146.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [146] Wu, X. et al. A meta-analysis of neuroimaging studies on divergent thinking using activation likelihood estimation. Hum. Brain Mapp. 36, 2703–2718 (2015). source
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In the paper
“What are referred to as ‘switch trials’ in cognitive flexibility studies are paralleled by ‘reversals’ in behavioural flexibility experiments.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
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In the paper
“a brain region that exhibits meta-analytic co-activation and resting state functional connectivity with the AI, dlPFC and IPL35.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [35] Sundermann, B. & Pfleiderer, B. Functional connectivity profile of the human inferior frontal junction: involvement in a cognitive control network. BMC Neurosci. 13, 119 (2012). source
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In the paper
“Neurons in the mouse OFC respond saliently and transiently to rule switches during reversal learning37.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [37] Banerjee, A. et al. Value-guided remapping of sensory cortex by lateral orbitofrontal cortex. Nature 585, 245–250 (2020). source
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In the paper
“Dynamics between the default mode or medial frontoparietal network (M-FPN) and the L-FPN have also been linked to cognitive flexibility46.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [46] Douw, L., Wakeman, D. G., Tanaka, N., Liu, H. & Stufflebeam, S. M. State-dependent variability of dynamic functional connectivity between frontoparietal and default networks relates to cognitive flexibility. Neuroscience 339, 12–21 (2016). source
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In the paper
“The dorsomedial striatum is thought to dynamically interact with multiple prefrontal subregions that generate new strategies to facilitate behavioural flexibility38.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [38] Ragozzino, M. E. The contribution of the medial prefrontal cortex, orbitofrontal cortex, and dorsomedial striatum to behavioral flexibility. Ann. NY Acad. Sci. 1121, 355–375 (2007). This review summarizes work in rodents delineating limbic, orbitofrontal and striatal contributions to behavioural flexibility. source
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In the paper
“Time-varying functional connectivity of the M-CIN predicts individual differences in cognitive flexibility45.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [45] Chen, T., Cai, W., Ryali, S., Supekar, K. & Menon, V. Distinct global brain dynamics and spatiotemporal organization of the salience network. PLoS Biol. 14, e1002469 (2016). source
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In the paper
“this emerging literature is in line with the notion that the ability of the brain to flexibly reconfigure itself in response to changing demands may underlie individual differences in flexible behaviours.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
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In the paper
“Late life onset dementias, including Parkinson disease and Alzheimer disease, are also marked by rigidity and cognitive inflexibility.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions
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In the paper
“Neural flexibility, or the frequency with which brain regions change allegiance between functional modules, has recently been shown to increase with age during the first 2 years of life50.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [50] Yin, W. et al. The emergence of a functionally flexible brain during early infancy. Proc. Natl Acad. Sci. USA 117, 23904–23913 (2020). source
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In the paper
“Flexibility deficits are observed in neurodevelopmental conditions with early life onset, such as ASD and ADHD, as well as psychiatric conditions that emerge in adolescence, including mood disorders, obsessive–compulsive disorder (OCD) and schizophrenia.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions
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In the paper
“it has been shown that certain patterns of whole-brain dynamics are associated with elevated levels of cognitive flexibility.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [44] Nomi, J. S. et al. Chronnectomic patterns and neural flexibility underlie executive function. Neuroimage 147, 861–871 (2017). This dynamic functional connectivity analysis demonstrates that individuals with the propensity to exhibit whole-brain dynamics characterized by attenuated correlations between brain regions and greater functional connectivity variability perform better on the WCST, a test of cognitive flexibility. source
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In the paper
“Flexibility deficits are observed in neurodevelopmental conditions with early life onset, such as ASD and ADHD, as well as psychiatric conditions that emerge in adolescence, including mood disorders, obsessive–compulsive disorder (OCD) and schizophrenia.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions
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In the paper
“Older adults aged 59–73 years who exhibit upregulated brain signal variability show higher levels of task performance62.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [62] Garrett, D. D., Epp, S. M., Kleemeyer, M., Lindenberger, U. & Polk, T. A. Higher performers upregulate brain signal variability in response to more feature-rich visual input. Neuroimage 217, 116836 (2020). source
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In the paper
“In children with ASD or ADHD, executive function and flexibility deficits are often observed in laboratory settings and in day-to-day activities64,65.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [64] Lai, C. L. E. et al. Meta-analysis of neuropsychological measures of executive functioning in children and adolescents with high-functioning autism spectrum disorder. Autism Res. 10, 911–939 (2017). source
- Not checked yetcites [65] Dajani, D. R., Llabre, M. M., Nebel, M. B., Mostofsky, S. H. & Uddin, L. Q. Heterogeneity of executive functions among comorbid neurodevelopmental disorders. Sci. Rep. 6, 36566 (2016). source
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In the paper
“blood oxygen level-dependent (BOLD) variability is a better predictor of age than BOLD mean59.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [59] Garrett, D. D., Kovacevic, N., McIntosh, A. R. & Grady, C. L. Blood oxygen level-dependent signal variability is more than just noise. J. Neurosci. 30, 4914–4921 (2010). source
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In the paper
“Neuroimaging additionally reveals the role of the dorsal anterior cingulate cortex and the inferior frontal gyrus in suppression of prior learned responses and response inhibition during reversal learning40.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [40] Ghahremani, D. G., Monterosso, J., Jentsch, J. D., Bilder, R. M. & Poldrack, R. A. Neural components underlying behavioral flexibility in human reversal learning. Cereb. Cortex 20, 1843–1852. This functional neuroimaging study reveals how human reversal learning and guidance of actions consistent with current reward contingencies engages the lateral OFC, dorsal anterior cingulate cortex and right inferior frontal cortex. source
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In the paper
“OFC inactivation in rats impairs reversal learning owing to perseverance of previously learned choices15.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [15] Izquierdo, A., Brigman, J. L., Radke, A. K., Rudebeck, P. H. & Holmes, A. The neural basis of reversal learning: an updated perspective. Neuroscience 345, 12–26 (2017). source
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In the paper
“Multimodal investigations considering both anatomical connectivity and activation dynamics find that greater alignment between white matter networks and functional signals is associated with greater cognitive flexibility48.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [48] Medaglia, J. D. et al. Functional alignment with anatomical networks is associated with cognitive flexibility. Nat. Hum. Behav. 2, 156–164 (2018). This multimodal neuroimaging study demonstrates how alignment between functional activation and underlying white matter networks is associated with greater cognitive flexibility across individuals. source
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In the paper
“Several recent studies have further shown how individual differences in task performance are related to patterns of dynamic brain organization54,55.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [54] Allegra, M. et al. Brain network dynamics during spontaneous strategy shifts and incremental task optimization. NeuroImage 217, 116854 (2020). source
- Not checked yetcites [55] Saggar, M. et al. Towards a new approach to reveal dynamical organization of the brain using topological data analysis. Nat. Commun. 9, 1399 (2018). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“increased IFJ variability is linked to better performance on a cognitive flexibility task61.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [61] Armbruster-Genç, D. J. N., Ueltzhöffer, K. & Fiebach, C. J. Brain signal variability differentially affects cognitive flexibility and cognitive stability. J. Neurosci. 36, 3978–3987 (2016). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Flexibility deficits in OCD manifest themselves as maladaptive patterns of recurrent and persistent thoughts, urges and impulses that are intrusive, as well as compulsions, including repetitive behaviours that an individual feels driven to perform69.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [69] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). (American Psychiatric Association Publishing, 2013). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Other work examining ASD, ADHD and co-morbid ASD and ADHD using latent profile analysis also provides evidence for transdiagnostic executive function classes65.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [65] Dajani, D. R., Llabre, M. M., Nebel, M. B., Mostofsky, S. H. & Uddin, L. Q. Heterogeneity of executive functions among comorbid neurodevelopmental disorders. Sci. Rep. 6, 36566 (2016). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“While ASD is characterized by difficulty in flexibly adapting to changes in routines, children with ADHD have difficulty with attentional focus and exhibit high levels of variability in moment-to-moment behaviours73.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [73] Kuntsi, J. & Klein, C. Intraindividual variability in ADHD and its implications for research of causal links. Curr. Top. Behav. Neurosci. 9, 67–91 (2012). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Still, the story is not as simple as ‘impaired flexibility in ASD’ versus ‘heightened flexibility in ADHD’, as there is a very high degree of co-morbidity between these two disorders74 such that the combination of impaired flexibility and inattention can manifest itself in the same individual.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [74] Leitner, Y. The co-occurrence of autism and attention deficit hyperactivity disorder in children - what do we know? Front. Hum. Neurosci. 8, 268 (2014). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Just as in the general population, frontostriatal circuitry appears to be linked with variability of cognitive flexibility performance in schizophrenia96.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [96] Waltz, J. A. The neural underpinnings of cognitive flexibility and their disruption in psychotic illness. Neuroscience 345, 203–217 (2017). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“For example, intrinsic dynamics of the M-CIN (but not the L-FPN) have been shown to relate to individual differences in distractibility in neurotypical adults84.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [84] Steimke, R. et al. Salience network dynamics underlying successful resistance of temptation. Soc. Cogn. Affect. Neurosci. 12, 1928–1939 (2017). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Studies of the neural circuitry underlying RRBs transdiagostically point to a critical role for frontostriatal systems in mediating these behaviours71.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [71] Wilkes, B. J. & Lewis, M. H. The neural circuitry of restricted repetitive behavior: Magnetic resonance imaging in neurodevelopmental disorders and animal models. Neurosci. Biobehav. Rev. 92, 152–171 (2018). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Neuroimaging investigations across OCD and ASD provide evidence that increased functional connectivity within frontostriatal circuitry relates to more severe symptoms of repetitive behaviour91.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [91] Akkermans, S. E. A. et al. Frontostriatal functional connectivity correlates with repetitive behaviour across autism spectrum disorder and obsessive–compulsive disorder. Psychol. Med. 49, 2247–2255 (2019). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Measurement issues complicate the assessment of flexibility deficits and their neural bases in ASD and ADHD, as different combinations of laboratory-based measures, neuropsychological tests and informant-report questionnaires have been used across studies72.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [72] Uddin, L. Q. Brain mechanisms supporting flexible cognition and behavior in adolescents with autism spectrum disorder. Biol. Psychiatry 89, 172–183 (2021). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The severity of RRBs is associated with measures of cognitive inflexibility in ASD70.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [70] Lopez, B. R., Lincoln, A. J., Ozonoff, S. & Lai, Z. Examining the relationship between executive functions and restricted, repetitive symptoms of autistic disorder. J. Autism Dev. Disord. 35, 445–460 (2005). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“It is important to note that well-documented inflexible everyday behaviours in ASD are not necessarily directly related to cognitive flexibility deficits assessed experimentally85.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [85] Geurts, H. M., Corbett, B. & Solomon, M. The paradox of cognitive flexibility in autism. Trends Cognit. Sci. 13, 74–82 (2009). source
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Age-related improvements in executive function are more clearly observed in ASD than in ADHD77.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [77] Happe, F., Booth, R., Charlton, R. & Hughes, C. Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: examining profiles across domains and ages. Brain Cogn. 61, 25–39 (2006). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Another reported no evidence for group differences in functional network connectivity across diagnostic groups80.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [80] Dajani, D. R. et al. Investigating functional brain network integrity using a traditional and novel categorical scheme for neurodevelopmental disorders. Neuroimage Clin. 21, 101678 (2019). source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“In OCD, reduced activation of the OFC and frontostriatal regions during cognitive flexibility task performance is regularly reported92,93.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [92] Gu, B.-M. et al. Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder. Brain 131, 155–164 (2008). source
- Not checked yetcites [93] Gruner, P. & Pittenger, C. Cognitive inflexibility in obsessive-compulsive disorder. Neuroscience 345, 243–255 (2017). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Still, these types of nuanced measure of flexibility are not yet routinely used in transdiagnostic assessment settings, leaving several open questions as to the specific profile of executive function and flexibility deficits that characterize neurodevelopmental disorders.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Some reports claim that executive dysfunction is more pervasive and more severe in ADHD than in ASD75, yet studies targeting flexibility document that children with ASD perform poorer on the WCST than do children with ADHD76.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [76] Sergeant, J. A., Geurts, H. & Oosterlaan, J. How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behav. Brain Res. 130, 3–28 (2002). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent review of neural mechanisms underlying cognitive and behavioural flexibility in autism additionally points to atypical patterns of L-FPN and M-CIN activation in response to task switching and set-shifting72.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [72] Uddin, L. Q. Brain mechanisms supporting flexible cognition and behavior in adolescents with autism spectrum disorder. Biol. Psychiatry 89, 172–183 (2021). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“One found evidence for shared and distinct patterns of intrinsic functional connectivity centrality in children with these disorders79.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [79] Di Martino, A. et al. Shared and distinct intrinsic functional network centrality in autism and attention-deficit/hyperactivity disorder. Biol. Psychiatry 74, 623–632 (2013). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Data-driven techniques are now being used to identify key dimensions of functioning that overlap across diagnostic categories and also present heterogeneously within diagnostic categories81.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [81] Cordova, M. et al. Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD. Neuroimage Clin. 26, 102245 (2020). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“l-DOPA withdrawal studies demonstrate that patients with Parkinson disease not receiving medication show inflexibility in the form of increased switch costs when switching between tasks108.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Drugs and training of flexibility > Pharmacology supporting flexibility
What the sources say
- Not checked yetcites [108] Cools, R., Barker, R. A., Sahakian, B. J. & Robbins, T. W. L-Dopa medication remediates cognitive inflexibility, but increases impulsivity in patients with Parkinson’s disease. Neuropsychologia 41, 1431–1441 (2003). This study examining patients with Parkinson disease receiving and not receiving dopaminergic medication shows how dopamine influences cognitive flexibility performance. source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Cognitive stability — the opposite of cognitive flexibility — can likewise be beneficial during tasks requiring focused attention and distractor inhibition105.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [105] Ueltzhöffer, K., Armbruster-Genç, D. J. N. & Fiebach, C. J. Stochastic dynamics underlying cognitive stability and flexibility. PLoS Comput. Biol. 11, e1004331 (2015). source
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“A burgeoning functional neuroimaging literature including task-switching and set-shifting tasks adapted from neuropsychological assessments (most notably the WCST) investigates cognitive flexibility deficits in ageing and dementia, confirming the critical role of PFC recruitment in maintaining these functions101.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [101] McDonald, A. P., D’Arcy, R. C. N. & Song, X. Functional MRI on executive functioning in aging and dementia: a scoping review of cognitive tasks. Aging Med. 1, 209–219 (2018). source
boosteddirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“One of the signs of dementia is heightened executive function impairment compared with that from normal ageing, including a deterioration of mental flexibility and the onset of cognitive rigidity.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Flexibility deficits observed in Parkinson disease may result from dysfunction of frontostriatal loops resulting from dopamine depletion102.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [102] Robbins, T. W. & Cools, R. Cognitive deficits in Parkinson’s disease: a cognitive neuroscience perspective. Mov. Disord. 29, 597–607 (2014). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Such models can help clarify how dedifferentiation observed at the network level, such as that proposed by the default–executive coupling hypothesis of ageing, can be seen as compensation for the decline of structural integrity in the ageing brain100.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [100] Naik, S., Banerjee, A., Bapi, R. S., Deco, G. & Roy, D. Metastability in senescence. Trends Cogn. Sci. 21, 509–521 (2017). source
plainconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Taken together, the literature on flexibility in ageing and dementia points to frontoparietal and frontostriatal dysfunction, as might be predicted from the human and animal research.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Serotonin and striatal dopamine neurotransmitter systems have a modulatory role in reversal learning, as evidenced by human and animal lesion, stimulation and neuroimaging studies106.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Drugs and training of flexibility > Pharmacology supporting flexibility
What the sources say
- Not checked yetcites [106] Clark, L., Cools, R. & Robbins, T. W. The neuropsychology of ventral prefrontal cortex: decision-making and reversal learning. Brain Cognition 55, 41–53 (2004). source
plainconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, reduced flexibility may paradoxically be optimal under specific conditions.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Whole-brain computational models permit quantification of metastability and recalibration processes underlying changes in cognitive performance over the lifespan.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“In humans, transient cerebral serotonin depletion affects processing of negative feedback during reversal learning107.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Drugs and training of flexibility > Pharmacology supporting flexibility
What the sources say
- Not checked yetcites [107] Evers, E. A. T. et al. Serotonergic modulation of prefrontal cortex during negative feedback in probabilistic reversal learning. Neuropsychopharmacology 30, 1138–1147 (2005). source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, alterations in flexibility might in some cases represent normative adaptations to the perceived characteristics of the environment.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- It may state two separate claims as one. 42
- Probably not a substantial claim. 6
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“laboratory-based measures and neuropsychological tests have high construct validity but may not always converge with real-world flexible behaviours as indexed using self-report or informant-report questionnaires, which typically have greater ecological validity21.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Partly supportedcites [21] Dang, J., King, K. M. & Inzlicht, M. Why are self-report and behavioral measures weakly correlated? Trends Cogn. Sci. 24, 267–269 (2020). sourceExperimental — accuracy not yet measured
The Introduction (page unavailable) reports weak correlations between behavioral and self-report measures of several presumed constructs, and Divergent Response Processes explains that the two assess structured task performance versus reported behavior across real-life situations. The paper does not establish that laboratory or neuropsychological measures of flexibility have high construct validity, or compare them specifically with informant-report questionnaires. It also does not explicitly establish the questionnaires’ greater ecological validity. (LLM, conf=0.86)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
In the paper
“These paradigms assess the ability to respond adaptively in the face of changing stimulus–outcome or response–outcome contingencies15.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [15] Izquierdo, A., Brigman, J. L., Radke, A. K., Rudebeck, P. H. & Holmes, A. The neural basis of reversal learning: an updated perspective. Neuroscience 345, 12–26 (2017). source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Assessment of behavioural flexibility in marmoset monkeys reveals that animals with lateral PFC lesions are not impaired in reversal learning or in shifting behavioural responses to a previously rewarded alternative. These monkeys are, however, impaired with regard to extradimensional shifts.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [36] Robbins, T. W. Shifting and stopping: fronto-striatal substrates, neurochemical modulation and clinical implications. Philos. Trans. R. Soc. Lond. B Biol. Sci. 362, 917–932 (2007). source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Cognitive and behavioural flexibility fall under the broader category of executive functions, or processes necessary for the control of goal-directed behaviour7.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [7] Miyake, A. et al. The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cogn. Psychol. 41, 49–100 (2000). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“This framework may lead to a revised diagnostic nosology that is more firmly grounded in biology17.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [17] Saggar, M. & Uddin, L. Q. Pushing the boundaries of psychiatric neuroimaging to ground diagnosis in biology. eNeuro https://doi.org/10.1523/ENEURO.0384-19.2019 (2019). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Developmental and lifespan research suggests that flexibility promotes academic achievement, employment success2, successful transitioning to adulthood3 and other optimal life outcomes.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Introduction
What the sources say
- Not checked yetcites [2] Diamond, A. & Lee, K. Interventions shown to aid executive function development in children 4 to 12 years old. Science 333, 959–964 (2011). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“executive functions are postulated to comprise three latent variables, described as mental set-shifting (‘shifting’), information updating and monitoring in working memory (‘updating’) and inhibition of prepotent responses (‘inhibition’), that are moderately correlated with one another, yet clearly separable7.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [7] Miyake, A. et al. The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cogn. Psychol. 41, 49–100 (2000). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Individuals with frontal lobe damage and children younger than 4 years tend to persist in sorting cards according to previously learned rules and have difficulty flexibly switching to new sorting rules143.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Components of flexibility
What the sources say
- Not checked yetcites [143] Grant, D. A. & Berg, E. A. Wisconsin Card Sorting Test. PsycTESTS Dataset https://doi.org/10.1037/t31298-000 (2014). source
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In the paper
“Cognitive flexibility follows a protracted, inverted U-shaped developmental trajectory from early childhood through adolescence and adulthood, peaking between the second and third decades of life, and declining in late life19.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility
What the sources say
- Not checked yetcites [19] Cepeda, N. J., Kramer, A. F. & Gonzalez de Sather, J. C. M. Changes in executive control across the life span: examination of task-switching performance. Dev. Psychol. 37, 715–730 (2001). source
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In the paper
“Considerable individual variability in functional network topography supporting cognitive flexibility was observed, and the strength of functional connectivity between selected brain regions was related to individual differences in task performance (Fig. 1b).”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Cognitive flexibility in humans
What the sources say
- Not checked yetcites [33] Dajani, D. R. et al. Measuring cognitive flexibility with the flexible item selection task: from MRI adaptation to individual connectome mapping. J. Cogn. Neurosci. 32, 1026–1045 (2020). This functional neuroimaging study in humans demonstrates that flexible item selection directly engages the left IFJ, which influences activity in other cortical and subcortical brain regions supporting cognitive flexibility. source
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In the paper
“Individuals who score higher on the WCST exhibit more episodes of more frequently occurring brain states, and fewer episodes of less frequently occurring brain states that have previously been associated with low vigilance and arousal44 (Fig. 2c).”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [44] Nomi, J. S. et al. Chronnectomic patterns and neural flexibility underlie executive function. Neuroimage 147, 861–871 (2017). This dynamic functional connectivity analysis demonstrates that individuals with the propensity to exhibit whole-brain dynamics characterized by attenuated correlations between brain regions and greater functional connectivity variability perform better on the WCST, a test of cognitive flexibility. source
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In the paper
“In younger adults, executive function ability is correlated with efficiency in brain dynamics of the M-CIN, whereas for older adults this ability is associated with efficiency in the M-FPN52.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [52] Ezaki, T., Sakaki, M., Watanabe, T. & Masuda, N. Age-related changes in the ease of dynamical transitions in human brain activity. Hum. Brain Mapp. 39, 2673–2688 (2018). source
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In the paper
“Between childhood and mid-adulthood, brain signal variability increases with age, shows negative correlations with reaction time variability and positive correlations with accuracy57.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [57] McIntosh, A. R., Kovacevic, N. & Itier, R. J. Increased brain signal variability accompanies lower behavioral variability in development. PLoS Comput. Biol. 4, e1000106 (2008). source
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In the paper
“Brain variability appears to increase during task performance compared with rest in younger and faster-performing adults, whereas older and slower-performing adults exhibit less differentiation in brain variability across experimental conditions58.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [58] Garrett, D. D., Kovacevic, N., McIntosh, A. R. & Grady, C. L. The modulation of BOLD variability between cognitive states varies by age and processing speed. Cereb. Cortex 23, 684–693 (2013). This study illustrates how variability of fMRI signals differs in normal ageing, and specifically highlights the fact that older and slower-performing individuals exhibit reduced variability. source
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In the paper
“older adults performing well on a cognitive test battery were found to exhibit brain states characterized by global coherence, whereas those performing poorly exhibited greater frequency of switching between dynamic brain states51.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [51] Cabral, J. et al. Cognitive performance in healthy older adults relates to spontaneous switching between states of functional connectivity during rest. Sci. Rep. 7, 5135 (2017). source
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In the paper
“Dorsomedial striatal inactivation impairs both reversal learning and strategy switching, resulting in an inability to maintain new choice patterns once they are selected.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [38] Ragozzino, M. E. The contribution of the medial prefrontal cortex, orbitofrontal cortex, and dorsomedial striatum to behavioral flexibility. Ann. NY Acad. Sci. 1121, 355–375 (2007). This review summarizes work in rodents delineating limbic, orbitofrontal and striatal contributions to behavioural flexibility. source
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In the paper
“Monkeys with orbitofrontal cortex (OFC) lesions show the opposite behaviour: impairment in reversal learning but no deficits in extradimensional shifts.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [36] Robbins, T. W. Shifting and stopping: fronto-striatal substrates, neurochemical modulation and clinical implications. Philos. Trans. R. Soc. Lond. B Biol. Sci. 362, 917–932 (2007). source
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In the paper
“These findings have led to the proposal that the lateral PFC is necessary for shifting of responding between abstract perceptual dimensions, whereas the OFC and associated corticostriatal loops are necessary for shifting of responding between different stimuli with specific associations with reinforcement36.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [36] Robbins, T. W. Shifting and stopping: fronto-striatal substrates, neurochemical modulation and clinical implications. Philos. Trans. R. Soc. Lond. B Biol. Sci. 362, 917–932 (2007). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“For humans, reversal learning is much easier to perform than extradimensional shifts, but similar neuroanatomy to that seen in animals has been observed using fMRI39.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Behavioural flexibility in animals
What the sources say
- Not checked yetcites [39] Hampshire, A. & Owen, A. M. Fractionating attentional control using event-related fMRI. Cereb. Cortex 16, 1679–1689 (2006). source
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In the paper
“The suggestion is that higher variability might reflect a broader repertoire of metastable brain states and transitions between them to enable optimal responses57.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [57] McIntosh, A. R., Kovacevic, N. & Itier, R. J. Increased brain signal variability accompanies lower behavioral variability in development. PLoS Comput. Biol. 4, e1000106 (2008). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although children with ASD, ADHD or co-morbid ASD and ADHD may all exhibit flexibility deficits, the nature and severity of these issues can differ across and even within these disorders.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
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In the paper
“Ease of transitions between brain states distinguishes younger from older individuals, and is further linked with executive function indexed by the D-KEFS.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [51] Cabral, J. et al. Cognitive performance in healthy older adults relates to spontaneous switching between states of functional connectivity during rest. Sci. Rep. 7, 5135 (2017). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Across the age range from 6 to 85 years, BOLD signal variability decreases linearly across most of the brain, with the exception of the AI, a critical M-CIN node involved in flexibility, which shows the opposite pattern60 (Fig. 3).”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain variability and flexibility
What the sources say
- Not checked yetcites [60] Nomi, J. S., Bolt, T. S., Ezie, C., Uddin, L. Q. & Heller, A. S. Moment-to-moment BOLD Signal variability reflects regional changes in neural flexibility across the lifespan. J. Neurosci. https://doi.org/10.1523/JNEUROSCI.3408-16.2017 (2017). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Brain regions in higher-order association cortices exhibit high levels of functional flexibility, with dissociable age-related changes observed in frontal and parietal regions across the lifespan53.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Neural substrates of flexibility > Brain dynamics supporting flexibility
What the sources say
- Not checked yetcites [53] Yin, D. et al. Dissociable changes of frontal and parietal cortices in inherent functional flexibility across the human life span. J. Neurosci. 36, 10060–10074 (2016). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Executive function impairments broadly, and flexibility impairments specifically, are observed across many forms of psychopathology and may serve as transdiagnostic intermediate phenotypes63.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions
What the sources say
- Not checked yetcites [63] Snyder, H. R., Miyake, A. & Hankin, B. L. Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches. Front. Psychol. 6, 328 (2015). source
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In the paper
“Even though not all children with a primary diagnosis of ASD exhibit executive dysfunction78, the vast majority of children with co-morbid ASD and ADHD do exhibit executive function impairments65.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [78] Baez, A. C. et al. Parsing heterogeneity of executive function in typically and atypically developing children: a conceptual replication and exploration of social function. J. Autism Dev. Disord. https://doi.org/10.1007/s10803-019-04290-9 (2019). source
- Not checked yetcites [65] Dajani, D. R., Llabre, M. M., Nebel, M. B., Mostofsky, S. H. & Uddin, L. Q. Heterogeneity of executive functions among comorbid neurodevelopmental disorders. Sci. Rep. 6, 36566 (2016). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Diagnostic criteria for ADHD include inattention, hyperactivity and impulsivity69, which can be thought of as manifestations of distractibility or too much flexibility.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [69] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). (American Psychiatric Association Publishing, 2013). source
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In the paper
“Brain circuitry supporting cognitive control is still undergoing development during adolescence87, in part owing to differential development of limbic and executive control systems88.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [87] Luna, B., Paulsen, D. J., Padmanabhan, A. & Geier, C. The teenage brain: cognitive control and motivation. Curr. Dir. Psychol. Sci. 22, 94–100 (2013). source
- Not checked yetcites [88] Casey, B. J., Jones, R. & Hare, T. The adolescent brain. The year in cognitive neuroscience. Ann. NY Acad. Sci. 11, 84–94 (2008).
plainconditional- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While executive function and flexibility deficits are observed in normal ageing, these issues can be further exacerbated in neurological disorders that affect later life.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Older adults exhibit reduced efficiency of lateral prefrontal control regions, and compensate for age-related declines in task-switching performance by relying on enhanced frontotemporal connectivity compared with younger adults97.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [97] Hakun, J. G., Zhu, Z., Johnson, N. F. & Gold, B. T. Evidence for reduced efficiency and successful compensation in older adults during task switching. Cortex 64, 352–362 (2015). source
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In the paper
“A recent meta-analysis of fMRI studies of executive function in ageing reveals that the IFJ is recruited to a different degree in younger versus older adults. Furthermore, decreased functional connectivity between the IFJ and other executive function-related brain regions is observed with increasing age99.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [99] Heckner, M. K. et al. The aging brain and executive functions revisited: implications from meta-analytic and functional connectivity evidence. J. Cogn. Neurosci. 1–36 (2020). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Restricted and repetitive behaviours (RRBs), considered core deficits in ASD, can include stereotyped movements, insistence on sameness, and circumscribed or perseverative interests69.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [69] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). (American Psychiatric Association Publishing, 2013). source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“For example, transdiagnostic executive function subtypes have been identified with use of community detection algorithms, and children within the subtype characterized by inflexibility showed a failure to modulate parietal lobe activation in response to increasing executive task demands82.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [82] Vaidya, C. J. et al. Data-driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders. J. Child. Psychol. Psychiatry 61, 51–61 (2020). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“These asymmetries are evident in studies demonstrating that adolescents learn faster from negative reward prediction errors than adults, and recruit the right AI to a greater degree during probabilistic reversal learning89.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [89] Hauser, T. U., Iannaccone, R., Walitza, S., Brandeis, D. & Brem, S. Cognitive flexibility in adolescence: neural and behavioral mechanisms of reward prediction error processing in adaptive decision making during development. Neuroimage 104, 347–354 (2015). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Another adolescent-onset disorder characterized by severe flexibility impairments is OCD.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Schizophrenia is another condition emerging during late adolescence that is associated with reduced cognitive flexibility, often accompanied by frontal lobe hypometabolism94.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [94] Weinberger, D. R. Schizophrenia and the frontal lobe. Trends Neurosci. 11, 367–370 (1988). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Standardized informant-report assessments specifically targeting flexible behaviours in autism have been developed, such as the Flexibility Scale, which reveals factors related to routines/rituals, transitions/change, special interests, social flexibility and generativity86.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [86] Strang, J. F. et al. The Flexibility Scale: development and preliminary validation of a cognitive flexibility measure in children with autism spectrum disorders. J. Autism Dev. Disord. 47, 2502–2518 (2017). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Early work in developmental psychopathology66 and recent meta-analyses confirm broad executive dysfunction in ASD across domains67 as well as more specific impairments in flexibility, typically assessed with the WCST64,68.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [66] Pennington, B. F. & Ozonoff, S. Executive functions and developmental psychopathology. J. Child. Psychol. Psychiatry 37, 51–87 (1996). source
- Not checked yetcites [67] Demetriou, E. A. et al. Autism spectrum disorders: a meta-analysis of executive function. Mol. Psychiatry 23, 1198–1204 (2018). source
- Not checked yetcites [64] Lai, C. L. E. et al. Meta-analysis of neuropsychological measures of executive functioning in children and adolescents with high-functioning autism spectrum disorder. Autism Res. 10, 911–939 (2017). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“While ASD is characterized by difficulty in flexibly adapting to changes in routines, children with ADHD have difficulty with attentional focus and exhibit high levels of variability in moment-to-moment behaviours73.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in developmental disorders
What the sources say
- Not checked yetcites [73] Kuntsi, J. & Klein, C. Intraindividual variability in ADHD and its implications for research of causal links. Curr. Top. Behav. Neurosci. 9, 67–91 (2012). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Worry and rumination may reflect the same underlying construct of repetitive negative thinking, which is likely a product of inflexible thinking and difficulty engaging the L-FPN executive control systems in the service of emotion regulation90.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [90] Burrows, C. A., Timpano, K. R. & Uddin, L. Q. Putative brain networks underlying repetitive negative thinking and comorbid internalizing problems in autism. Clin. Psychol. Sci. 5, 522–536 (2017). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Individuals with schizophrenia perform worse than individuals with OCD on the WCST, suggesting the involvement of different subsystems within basal–corticofrontal circuits in these two disorders95.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in adolescence and midlife
What the sources say
- Not checked yetcites [95] Cavallaro, R. et al. Basal-corticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controlled, double dissociation study. Biol. Psychiatry 54, 437–443 (2003). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Methylphenidate, a psychostimulant influencing dopamine and noradrenaline activity, has long been used to treat ADHD and other developmental disorders109.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Drugs and training of flexibility > Pharmacology supporting flexibility
What the sources say
- Not checked yetcites [109] Martino, A. D., Di Martino, A., Melis, G., Cianchetti, C. & Zuddas, A. Methylphenidate for pervasive developmental disorders: safety and efficacy of acute single dose test and ongoing therapy: an open-pilot study. J. Child. Adolesc. Psychopharmacol. 14, 207–218 (2004). source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Dysexecuitve syndrome, which involves impairment of working memory, cognitive flexibility and inhibitory control, is seen in progressive dementia syndrome due to Alzheimer disease. This syndrome is accompanied by frontoparietal hypometabolism as demonstrated by positron emission tomography104.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [104] Townley, R. A. et al. Progressive dysexecutive syndrome due to Alzheimer’s disease: a description of 55 cases and comparison to other phenotypes. Brain Commun. https://doi.org/10.1093/braincomms/fcaa068 (2020). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While we focus on maladaptive outcomes associated with flexibility deficits here, flexibility reductions can also be associated with adaptive or healthy traits, and the level of flexibility required can fluctuate depending on the context.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In Parkinson disease, cognitive impairments such as slowed thinking and cognitive inflexibility parallel motor impairments102, suggesting that reduced flexibility might be an appropriate reaction to a world that is experienced as more stationary.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [102] Robbins, T. W. & Cools, R. Cognitive deficits in Parkinson’s disease: a cognitive neuroscience perspective. Mov. Disord. 29, 597–607 (2014). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There is some evidence from studies of rhesus monkeys given therapeutic doses of methylphenidate that the drug can impair task-switching performance. This indicates that the improved ability to focus attention may come at the expense of hindering flexibility110.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Drugs and training of flexibility > Pharmacology supporting flexibility
What the sources say
- Not checked yetcites [110] Rajala, A. Z., Populin, L. C. & Jenison, R. L. Methylphenidate affects task-switching and neural signaling in non-human primates. Psychopharmacology 237, 1533–1543 (2020). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Across neurological disorders, different aspects of cognitive flexibility may be impaired. For example, frontoparietal changes affecting set-shifting ability characterize patients with amyotrophic lateral sclerosis, whereas frontostriatal changes affecting rule inference are seen in primary dystonia and Parkinson disease103.”
§ Cognitive and behavioural flexibility: neural mechanisms and clinical considerations > Flexibility in clinical conditions > Flexibility in neurological disorders
What the sources say
- Not checked yetcites [103] Lange, F., Seer, C. & Kopp, B. Cognitive flexibility in neurological disorders: cognitive components and event-related potentials. Neurosci. Biobehav. Rev. 83, 496–507 (2017). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Cognitive and behavioural flexibility are impaired in autism spectrum disorder, attention-deficit/hyperactivity disorder, schizophrenia, mood disorders, and dementias.
“Cognitive and behavioural flexibility are compromised in clinical conditions affecting early life such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD); those that emerge in adolescence, including schizophrenia and mood disorders; and dementias with later-life onset.”
The paper relies on this without support.
Many of these clinical conditions share flexibility deficits.
“While many of these conditions share flexibility deficits, the heterogeneous nature, severity and patterns of co-morbid symptoms complicate efforts to develop treatment strategies for enhancing flexibility.”
The paper relies on this without support.
The heterogeneity, severity, and co-morbidity of these conditions make it difficult to develop treatments to enhance flexibility.
“While many of these conditions share flexibility deficits, the heterogeneous nature, severity and patterns of co-morbid symptoms complicate efforts to develop treatment strategies for enhancing flexibility.”
The paper relies on this without support.
All DSM-V categories, possibly except sleep-wake disorders, include clinical conditions with compromised executive function domains.
“All of the DSM-V categories (with the possible exception of sleep–wake disorders) include clinical conditions in which domains of executive function are compromised; this raises the question of the extent to which the construct of flexibility has discriminative value.”
The paper relies on this without support.
In several disorders with documented flexibility deficits, these impairments can be observed while basic perceptual and motor performance remains unchanged.
“In several of the disorders in which flexibility deficits have been documented, these impairments can be observed even while performance on basic perceptual and motor tasks remains unaltered.”
The authors state this as an assumption.
The common behavioural manifestations of cognitive inflexibility across ASD and ADHD should be reflected in shared neural substrates.
“Although it is hypothesized that the common behavioural manifestations of cognitive inflexibility across ASD and ADHD should be reflected in shared neural substrates, few assessments of brain circuitry supporting flexibility across these disorders have been conducted.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Thus, mechanisms underlying cognitive flexibility overlap anatomically with those of updating working memory to some extent, but likely also depend on some specialized circuitry [90].”
From The role of prefrontal cortex in cognitive control and executive function (2022) · cites this paper as [90]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Recent neuroimaging studies support this view, emphasizing dynamic functional connectivity alterations in CSTC loops that extend to associated subcortical and cortical regions, contributing to cognitive inflexibility (158).”
From Neural mechanisms underlying cognitive inflexibility in obsessive-compulsive disorder: a review (2026) · cites this paper as [158]
Experimental — accuracy not yet measured
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000) · Cognitive Psychology · doi:10.1006/cogp.1999.0734 · Cited by 15,798
Dissociable intrinsic connectivity networks for salience processing and executive control
Seeley, W. W., Menon, V., Schatzberg, A. F., Keller, J., Glover, G. H., Kenna, H., Reiss, A. L., & Greicius, M. D. (2007) · The Journal of Neuroscience · doi:10.1523/jneurosci.5587-06.2007 · Cited by 7,426
Large-scale automated synthesis of human functional neuroimaging data.
Yarkoni, T., Poldrack, R. A., Nichols, T. E., Van Essen, D. C., & Wager, T. D. (2011) · Nature Methods · doi:10.1038/nmeth.1635 · Cited by 3,686
Executive functions and developmental psychopathology.
Pennington, B. F., & Ozonoff, S. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01380.x · Cited by 3,150
Tracking whole-brain connectivity dynamics in the resting state
Allen, E. A., Damaraju, E., Plis, S. M., Erhardt, E. B., Eichele, T., & Calhoun, V. D. (2014) · Cerebral Cortex · doi:10.1093/cercor/bhs352 · Cited by 2,992
Dynamic functional connectivity: Promise, issues, and interpretations
Hutchison, R. M., Womelsdorf, T., Allen, E. A., Bandettini, P. A., Calhoun, V. D., Corbetta, M., Della Penna, S., Duyn, J. H., Glover, G. H., Gonzalez-Castillo, J., et al. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.05.079 · Cited by 2,962
Interventions shown to aid executive function development in children 4 to 12 years old
Diamond, A., & Lee, K. (2011) · Science · doi:10.1126/science.1204529 · Cited by 2,901
Delis-Kaplan Executive Function System
Delis, D. C., Kaplan, E., & Kramer, J. H. (2012) · PsycTESTS Dataset · doi:10.1037/t15082-000 · Cited by 2,683
A simple objective technique for measuring flexibility in thinking
Berg, E. A. (1948) · The Journal of General Psychology · doi:10.1080/00221309.1948.9918159 · Cited by 2,255
Research works printed but not linked: 2
- Cambridge Cognition. Intra-Extra Dimensional Set Shift (IED). https://www.cambridgecognition.com/cantab/cognitive-tests/executive-function/intra-extra-dimensional-set-shift-ied/ (2021).
- Casey, B. J., Jones, R. & Hare, T. The adolescent brain. The year in cognitive neuroscience. Ann. NY Acad. Sci. 11, 84–94 (2008).
Cited by
Sorted by citations
The role of prefrontal cortex in cognitive control and executive function
Friedman, N. P., & Robbins, T. W. (2022) · Neuropsychopharmacology · doi:10.1038/s41386-021-01132-0 · Cited by 1,737
“Thus, mechanisms underlying cognitive flexibility overlap anatomically with those of updating working memory to some extent, but likely also depend on some specialized circuitry [90].”
BackgroundDoss, M. K., Považan, M., Rosenberg, M. D., Sepeda, N. D., Davis, A. K., Finan, P. H., Smith, G. S., Pekar, J. J., Barker, P. B., Griffiths, R. R., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01706-y · Cited by 356
Pharmacological, neural, and psychological mechanisms underlying psychedelics: A critical review
van Elk, M., & Yaden, D. B. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104793 · Cited by 221
The effects of early life adversity on children’s mental health and cognitive functioning
Wade, M., Wright, L., & Finegold, K. E. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02001-0 · Cited by 184
Principles of cognitive control over task focus and task switching
Egner, T. (2023) · Nature Reviews Psychology · doi:10.1038/s44159-023-00234-4 · Cited by 161
Metadata
- Authors
- Uddin, L. Q.
- Affiliations
- University of Miami (US)
- Corresponding author
- Uddin, Lucina Q.
- ORCID
- Uddin, Lucina Q.
- Venue
- Nature Reviews Neuroscience
- Published
- 2021-02-03
- Volume
- 22
- Issue
- 3
- Pages
- 167-179
- ISSN
- 1471-003X (ISSN-L)
- 1471-0048
- PMC
- PMC7856857
- OpenAlex
- W3128518091
- Cited by
- 698
- References
- 150
- Citations by year
- 2026: 151 · 2025: 175 · 2024: 146 · 2023: 111 · 2022: 79 · 2021: 36
- FWCI
- 13.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nature reviews. Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Miami
- Canadian Institute for Advanced Research
- National Institute of Mental Health (R01MH107549)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- cognitive flexibility, behavioral flexibility, neural mechanisms, frontoparietal network, frontostriatal circuits, neurodevelopmental disorders, dementia, cognitive training, physical activity, bilingualism
- MeSH terms
- Animals, Behavior, Behavioral Symptoms, Cognition, Cognition Disorders, Humans, Nerve Net, Nervous System Physiological Phenomena, Neural Pathways
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
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