Executive functions in the context of "Coma"

The human brain is the central organ of the nervous system, and with the spinal cord, comprises the central nervous system. It consists of the cerebrum, the brainstem and the cerebellum. The brain controls most of the activities of the body, processing, integrating, and coordinating the information it receives from the sensory nervous system. The brain integrates sensory information and coordinates instructions sent to the rest of the body.

The cerebrum, the largest part of the human brain, consists of two cerebral hemispheres. Each hemisphere has an inner core composed of white matter, and an outer surface – the cerebral cortex – composed of grey matter. The cortex has an outer layer, the neocortex, and an inner allocortex. The neocortex is made up of six neuronal layers, while the allocortex has three or four. Each hemisphere is divided into four lobes – the frontal, parietal, temporal, and occipital lobes. The frontal lobe is associated with executive functions including self-control, planning, reasoning, and abstract thought, while the occipital lobe is dedicated to vision. Within each lobe, cortical areas are associated with specific functions, such as the sensory, motor, and association regions. Although the left and right hemispheres are broadly similar in shape and function, some functions are associated with one side, such as language in the left and visual-spatial ability in the right. The hemispheres are connected by commissural nerve tracts, the largest being the corpus callosum.

Self-control is an aspect of inhibitory control, one of the core executive functions. Executive functions are cognitive processes that are necessary for regulating one's behavior in order to achieve specific goals.

Defined more independently, self-control is the ability to regulate one's emotions, thoughts, and behavior in the face of temptations and impulses. Thought to be like a muscle, acts of self-control expend a limited resource. In the short term, use of self-control can lead to the depletion of that resource. However, in the long term, the use of self-control can strengthen and improve the ability to control oneself over time.

Developmental psychology is the scientific study of how and why humans grow, change, and adapt across the course of their lives. Originally concerned with infants and children, the field has expanded to include adolescence, adult development, aging, and the entire lifespan. Developmental psychologists aim to explain how thinking, feeling, and behaviors change throughout life. This field examines change across three major dimensions, which are physical development, cognitive development, and social emotional development. Within these three dimensions are a broad range of topics including motor skills, executive functions, moral understanding, language acquisition, social change, personality, emotional development, self-concept, and identity formation.

Developmental psychology explores the influence of both nature and nurture on human development, as well as the processes of change that occur across different contexts over time. Many researchers are interested in the interactions among personal characteristics, the individual's behavior, and environmental factors, including the social context and the built environment. Ongoing debates in regards to developmental psychology include biological essentialism vs. neuroplasticity and stages of development vs. dynamic systems of development. While research in developmental psychology has certain limitations, ongoing studies aim to understand how life stage transitions and biological factors influence human behavior and development.

Attentional control, commonly referred to as concentration, refers to an individual's capacity to choose what they pay attention to and what they ignore. It is also known as endogenous attention or executive attention. In lay terms, attentional control can be described as an individual's ability to concentrate. Primarily mediated by the frontal areas of the brain including the anterior cingulate cortex, attentional control and attentional shifting are thought to be closely related to other executive functions such as working memory.

Cognitive flexibility is an intrinsic property of a cognitive system often associated with the mental ability to adjust its activity and content, switch between different task rules and corresponding behavioral responses, maintain multiple concepts simultaneously and shift internal attention between them. The term cognitive flexibility is traditionally used to refer to one of the executive functions. In this sense, it can be seen as neural underpinnings of adaptive and flexible behavior. Most flexibility tests were developed under this assumption several decades ago. Nowadays, cognitive flexibility can also be referred to as a set of properties of the brain that facilitate flexible yet relevant switching between functional brain states.

Cognitive flexibility varies during the lifespan of an individual. In addition, certain conditions such as obsessive–compulsive disorder are associated with reduced cognitive flexibility. Since cognitive flexibility is a vital component of learning, deficits in this area might have other implications.

Cognitive impairment is an inclusive term to describe any characteristic that acts as a barrier to the cognition process or different areas of cognition. Cognition, also known as cognitive function, refers to the mental processes of how a person gains knowledge, uses existing knowledge, and understands things that are happening around them using their thoughts and senses. Cognitive impairment can be in different domains or aspects of a person's cognitive function including memory, attention span, planning, reasoning, decision-making, language (comprehension, writing, speech), executive functioning, and visuospatial functioning. The term cognitive impairment covers many different diseases and conditions and may also be symptom or manifestation of a different underlying condition. Examples include impairments in overall intelligence (as with intellectual disabilities), specific and restricted impairments in cognitive abilities (such as in learning disorders like dyslexia), neuropsychological impairments (such as in attention, working memory or executive function), or it may describe drug-induced impairment in cognition and memory (such as that seen with alcohol, glucocorticoids, and the benzodiazepines.). Cognitive impairments may be short-term, progressive (gets worse over time), or permanent.

There are different approaches to assessing or diagnosing a cognitive impairment including neuropsychological testing using various different tests that consider the different domains of cognition. Examples of shorter assessment clinical tools include the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). There are many different syndromes and pathologies that cause cognitive impairment including dementia, mild neurocognitive disorder, and Alzheimer's disease.

Methylphenidate, sold under the brand name Ritalin and Concerta, among others, is a central nervous system (CNS) stimulant used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It may be taken by mouth or applied to the skin, and different formulations have varying durations of effect. For ADHD, the effectiveness of methylphenidate is comparable to atomoxetine but modestly lower than amphetamine. Methylphenidate reduces core ADHD symptoms and may do so in part by enhancing cognitive control of behavior (i.e., working memory and inhibitory control).

At therapeutic doses, methylphenidate increases alertness and concentration and reduces hyperactivity and impulsive behavior in individuals with ADHD. Common side effects include loss of appetite, weight loss, trouble sleeping, and small increases in heart rate and blood pressure. Long-term treatment in children has been associated with slightly slower growth. Methylphenidate can be misused; dependence and withdrawal are mainly reported with high-dose or non-medical use and are uncommon at therapeutic doses.

The Council of Judges and Prosecutors (Turkish: Hâkimler ve Savcılar Kurulu), HSK; previously named as Supreme Board of Judges and Prosecutors (Turkish: Hâkimler ve Savcılar Yüksek Kurulu) is the disciplinary body of the legal system of the Republic of Turkey and the national council of the judiciary of Turkey. It was established under the 1982 Constitution of Turkey and significantly amended by the Turkish constitutional referendum, 2010 (including an expansion from 7 members to 22). After 2017 constitutional referendum, members are reduced to 13.

The Council currently consists of the thirteen members: seven appointed by the Parliament from high courts and lawyers, and four by the President from civil and administrative judges and prosecutors, the Minister of Justice, and the Ministry Undersecretary. The three branches —the legislative, executive, and judicial— of state as well as practicing lawyers are represented in the Council. Thus, the shaping of the judicial body, through the appointments, is carried out by all the authorities together.