Cognitive flexibility in neurodevelopmental disorders: insights from neuroimaging and neuropsychology

Abstract

Recurrent and problematic thoughts or behaviors are characteristic of many neurodevelopmental disorders. Thus, altered development of cognitive flexibility may contribute to the progression of these disorders. This review describes recent neuroimaging and neuropsychology findings related to cognitive flexibility in several neurodevelopmental disorders: autism spectrum disorder, obsessive–compulsive disorder, and attention–deficit hyperactivity disorder. Functional magnetic resonance imaging (fMRI) studies suggest that across disorders, brain activity is altered during set-shifting and probabilistic reversal learning tasks in regions of large-scale cognitive and attention networks, including the frontoparietal, cingulo-opercular/action-mode, and default-mode networks. Yet, the lack of convergence in fMRI results suggests such alterations may be the product of cascading effects of deficits in lower-level cognitive mechanisms rather than a higher-order, cognitive flexibility-specific system. Future work investigating potential mediating effects of deficits in sensorimotor and lower-level cognitive processes may provide insight into the factors leading to altered cognitive flexibility, as well as targets for intervention.