Absence of reinforcing, mood and psychomotor performance effects of caffeine in habitual non-consumers of caffeine

The Neurophysiology of Caffeine as a Central Nervous System Stimulant and the Resultant Effects on Cognitive Function

Caffeine is one of the world’s most consumed drugs. According to the Washington Post (2015), two billion cups of coffee are consumed per day worldwide. Caffeine is classified as a central nervous system (CNS) stimulant and an organic molecule called methylxanthine. Caffeine has three notable mechanisms of action on the CNS that produce a psychostimulant effect. These effects are responsible for the effect that caffeine has on cognitive function. The effects of caffeine consumption on cognitive function have been demonstrated across several studies involving humans and animals. With the immense number of people consuming caffeine around the world, it is of vital importance to study the effects that this drug has on people’s cognitive function. This literature review provides useful insights on this question through the analysis of caffeine’s effects on cognitive function, along with information on caffeine’s three modes of action. The findings of recent studies show mixed results regarding the effects of caffeine on mood, attention, processing speed, and memory. Current research suggests that if caffeine does have an effect on mood, the most significant changes may be anxiety. Studies did not support caffeine as having any significant effect on attention, but that it did play a role in enhancing processing speed. The majority of the studies reviewed suggest caffeine as having a significant positive effect on both short and long-term memory in adults and the elderly. Current findings warrant continued research on the association of caffeine and the resultant effects on cognitive function.

Natural Odor Inhalers (AromaStick®) Outperform Red Bull® for Enhancing Cognitive Vigilance: Results From a Four-Armed, Randomized Controlled Study

Two recent publications demonstrated that specifically designed essential odor inhalers can enhance performance through (a) better selective attention and scanning speed and (b) physiological changes of increased heart rate variability and blood oxygenation. In this study, we compared two natural odor inhalers with a popular energy drink (Red Bull®) with regard to their ability to improve vigilance on a computerized attention test. We employed a four-armed, randomized controlled experimental design and used a modified version of the CompACT-Vi test module to investigate whether deep inhalations of essential oil scents improved vigilance. Both inhalers markedly improved the number of correctly identified targets and participants' reaction time when compared to a control condition and consumption of Red Bull® (0.9 < d < 1.3). Additionally, the number of correctly solved mathematical sums during the second half of the vigilance test was substantially higher (d = 1.3) with the use of inhalers than for the control and Red Bull participants. Inhaler use was also associated with relatively increased heart rate variability (d = 1.0) as a mechanism of adapting to the experimental demands. Thus, short and deep inhalations of essential oil scents delivered directly to the nose improved vigilance, while a popular energy drink failed to show an effect beyond that of a control group receiving no stimulant.

The enhancing effect of 200 mg caffeine on mnemonic discrimination is at best small

Mnemonic discrimination is the ability to discriminate among similar memories, which requires separable representations of similar information. The neurocomputational process that assumedly decorrelates representations during encoding and consolidation is referred to as pattern separation. Deficits in pattern separation contribute to age-related declines in mnemonic functioning, which has motivated the development of targeted interventions. We followed-up a recent report that one 200 mg-dose of caffeine administered post-study enhances mnemonic discrimination [Borota, D., Murray, E., Keceli, G., Chang, A., Watabe, J. M., Ly, M., Toscano, J. P., & Yassa, M. A. (2014). Post-study caffeine administration enhances memory consolidation in humans. Nature Neuroscience, 17(2), 201-203. https://doi.org/10.1038/nn.3623]. To test whether the reported enhancements are an artifact of performance-impairing withdrawal symptoms in the control group, we did not restrict preexperimental caffeine intake and statistically adjusted treatment effects for habitual caffeine consumption. We detected no effects of caffeine and nonsuperiority testing ruled out medium and large enhancements in both average (1200 mg per week) and low-consumers (50 mg per week). Our results raise doubts about a caffeine-mediated enhancement of mnemonic discrimination on two counts: If the effect exists, it (1) is substantially smaller than originally reported and (2) may reflect an offset of performance-impairing withdrawal symptoms rather than genuinely enhanced consolidation. We recommend that future studies employ an alternating exposure-abstinence protocol, use an active control group, and verify posttreatment caffeine abstinence via saliva or blood samples.

Effects of Caffeine and Acute Aerobic Exercise on Working Memory and Caffeine Withdrawal

Studies show that a single bout of exercise confers cognitive benefits. However, many individuals use psychoactive substances such as caffeine to enhance cognitive performance. The effects of acute exercise in comparison to caffeine on cognition remain unknown. Furthermore, caffeine use is associated with withdrawal symptoms upon cessation. Whether acute exercise can reduce withdrawal symptoms also remains unknown. The objectives of this study were to compare the effects of acute moderate intensity aerobic exercise to caffeine on working memory (WM) and caffeine withdrawal symptoms (CWS). In Phase I, non-caffeine (n = 29) and caffeine consumers (n = 30) completed a WM assessment, followed by acute exercise and caffeine. In Phase II, caffeine consumers (n = 25) from Phase I underwent the WM assessment and reported CWS following a 12-hour deprivation period. Acute moderate intensity aerobic exercise and caffeine (1.2 mg/kg) significantly improved WM accuracy and reduced CWS comparably. WM performance was not reduced following caffeine deprivation.

The Acute Effects of Caffeinated Black Coffee on Cognition and Mood in Healthy Young and Older Adults

Cognitive and mood benefits of coffee are often attributed to caffeine. However, emerging evidence indicates behavioural effects of non-caffeine components within coffee, suggesting the potential for direct or synergistic effects of these compounds when consumed with caffeine in regular brewed coffee. The current randomised, placebo-controlled, double-blind, counterbalanced-crossover study compared the effects of regular coffee, decaffeinated coffee, and placebo on measures of cognition and mood. Age and sex effects were explored by comparing responses of older (61–80 years, N = 30) and young (20–34 years, N = 29) males and females. Computerised measures of episodic memory, working memory, attention, and subjective state were completed at baseline and 30 min post-drink. Regular coffee produced the expected effects of decreased reaction time and increased alertness when compared to placebo. When compared to decaffeinated coffee, increased digit vigilance accuracy and decreased tiredness and headache ratings were observed. Decaffeinated coffee also increased alertness when compared to placebo. Higher jittery ratings following regular coffee in young females and older males represented the only interaction of sex and age with treatment. These findings suggest behavioural activity of coffee beyond its caffeine content, raising issues with the use of decaffeinated coffee as a placebo and highlighting the need for further research into its psychoactive effects.

Comparative effect of coffee robusta and coffee arabica (Qahwa) on memory and attention

The comparative effects of coffee robusta and coffee arabica (Qahwa) on different attention and memory related assignments were measured in a double-blind study of 300 healthy young adult women who were randomly assigned to one of three different drinks: Group I (coffee robusta sachet dissolved in 100 ml of hot water): Group II (coffee arabica): and group III (100 ml water only). Cognitive function was assessed by standardized tests. Several monitoring cognitive tests and tasks were specifically chosen and performed to investigate the comparative effects of coffee robusta (CR) and coffee arabica (Qahwa; AC) on sleepiness (sleep and clear headed scale), attention (trail A & B, symbol digit, letter cancellation), general cognitive ability (stroop test) and memory (card test). Data was interpreted by analysis of variance (ANOVA). The present study revealed that coffee robusta has beneficial effects on attention, general cognitive ability and memory. Higher though non-significant cognitive scores were associated with coffee robusta consumption. Although, consumption of coffee arabica (Qahwa) has significant effects (P < 0.05) on sleepiness, attention, general cognitive ability and memory and it significantly improve reaction time and correct responses. Since different tasks were related to the sustained attention and working memory processes, results would suggest that coffee arabica (qahwa) could increase the memory and efficiency of the attentional system might be due to the presence of chlorogenic acids (CGA) which are found in less quantity in coffee robusta. However, more studies using larger samples and different tasks are necessary to better understand the effects of coffee robusta and arabica (Qahwa) on attention and memory.

Flavour Liking and Preference Conditioned by Caffeine in Humans

When caffeine consumers repeatedly experience a novel flavoured drink containing caffeine, the rated pleasantness of the drink flavour increases progressively. These results could be interpreted in terms of the flavour acting as a Pavlovian conditioned stimulus (CS) predicting the consequences of caffeine ingestion. However, all studies of this phenomenon to date have used between-subjects designs, and one criticism of this is that changes in pleasantness might have arisen from nonspecific effects. A more rigorous test is to examine changes in pleasantness for two drinks, a CS+ flavour paired with caffeine and CS− paired with placebo. Accordingly, 20 moderate caffeine consumers consumed both CS+ and CS− drinks in counterbalanced order over eight conditioning trials at breakfast, with hedonic and sensory characteristics evaluated on each trial. As predicted, the rated pleasantness of the CS+ drink increased whereas pleasantness of the CS− drink did not change. Despite this, participants did not have an overall preference for the CS+ flavour posttraining. However, both those who chose the CS+ and those who chose the CS− at the end showed the same direction and rate of change in pleasantness for the two drinks during training, but spurious differences in baseline preference obscured this effect in terms of an overall change in preference. Overall these data suggest that changes in pleasantness of drinks paired with caffeine delivery are best explained in terms of Pavlovian associations between drink flavour and the postingestive effects of caffeine.

Acute caffeine ingestion affects surround suppression of perceived contrast

Caffeine is a widely used psychostimulant that is associated with increased acetylcholine levels in mammalian brain and acetycholinesterase antagonism. Acetylcholine, a neuromodulator, plays an important role in the processing of visual information. One key example in human vision, thought to at least partly involve cholinergic neuromodulation, is perceptual surround suppression of contrast, whereby the perceived contrast of a pattern is altered by the presence of a neighbouring pattern. Perceptual surround suppression is weaker with pharmacological administration of donepezil (a centrally-acting acetylcholine enzyme inhibitor) in healthy human observers. Here, we test whether temporarily manipulating caffeine levels (from complete washout to a controlled dose of caffeine) has a similar effect on perceptual surround suppression in 21 healthy young adults (aged 20-24 years, 11 females). Neither ingestion of a caffeine pill nor placebo altered contrast judgments when the target pattern was presented on a uniform grey background ( p=0.54). With caffeine ingestion, perceptual surround suppression strength was reduced relative to baseline (prior to pill ingestion, p=0.003) and placebo ( p=0.029), irrespective of whether the surround was oriented parallel or orthogonal to the central target. While daily habitual caffeine consumption of low-to-moderate doses (<400 mg/day, estimated from a written questionnaire) is not predictive of performance, our study indicates that acute consumption of caffeine on the day of testing influences perceptual surround suppression strength. Perceptual surround suppression is predominantly attributed to inhibitory processes involving the major cortical inhibitory neurotransmitter, gamma-aminobutyric acid. Our results point to the involvement of other neuromodulators, possibly cholinergic, in perceptual surround suppression.

Caffeine Deprivation State Modulates Expression of Acquired Liking for Caffeine-Paired Flavours

Previous studies found that caffeine consumers acquired a liking for the flavour of novel caffeinated drinks when these drinks were consumed repeatedly in a caffeine-deprived, but not nondeprived, state. Expression of this acquired liking appeared acutely sensitive to current caffeine deprivation state, but the use of between-subjects designs confounded interpretation of those studies. The present study evaluated these findings further using a within-subject design, with one flavour paired with caffeine (CS +) and the second with the absence of caffeine (CS–). During four CS + and four CS– training days, 32 moderate caffeine consumers alternatively consumed a novel flavoured drink a CS + paired with caffeine and a CS– flavour paired with placebo. Participants evaluated both drinks before and after training in two motivational states: caffeine deprived and nondeprived. As predicted, pleasantness ratings for the caffeine-paired flavour increased overall. However, this acquired liking was only significant when tested in a caffeine-deprived state. These data are consistent with a conditioned-flavour preference model and imply that expression of acquired liking for a novel caffeinated flavour depends on the need for the effects of caffeine at the time when the drink is evaluated.

Comparison of caffeine disposition following administration by oral solution (energy drink) and inspired powder (AeroShot) in human subjects

AIMS

To determine the disposition and effects of caffeine after administration using a new dosage form (AeroShot) that delivers caffeine by inspiration of a fine powder into the oral cavity and compare it to an equivalent dose of an oral solution (energy drink) as the reference standard.

METHODS

Healthy human subjects (n = 17) inspired a 100 mg caffeine dose using the AeroShot device or consumed an energy drink on separate study days. Heart rate, blood pressure and subject assessments of effects were measured over an 8-h period. Plasma concentrations of caffeine and its major metabolites were determined by liquid chromatography-mass spectrometry. Pharmacokinetic, cardiovascular and perceived stimulant effects were compared between AeroShot and energy drink phases using a paired t test and standard bioequivalency analysis.

RESULTS

Caffeine disposition was similar after caffeine administration by the AeroShot device and energy drink: peak plasma concentration 1790 and 1939 ng ml-1 , and area under the concentration-time curve (AUC) 15 579 and 17 569 ng ml-1 × h, respectively, but they were not bioequivalent: AeroShot AUC of 80.3% (confidence interval 71.2-104.7%) and peak plasma concentration of 86.3% (confidence interval 62.8-102.8%) compared to the energy drink. Female subjects did have a significantly larger AUC compared to males after consumption of the energy drink. The heart rate and blood pressure were not significantly affected by the 100 mg caffeine dose, and there were no consistently perceived stimulant effects by the subjects using visual analogue scales.

CONCLUSION

Inspiration of caffeine as a fine powder using the AeroShot device produces a similar caffeine profile and effects compared to administration of an oral solution (energy drink).

Effects of a single, oral 60 mg caffeine dose on attention in healthy adult subjects

Caffeine induces positive effects on sustained attention, although studies assessing the acute effects of low caffeine dose (<75 mg) on sustained attention are limited and use short-term tests. Therefore, we investigated the acute effects of a 60 mg dose of caffeine on sustained attention in tests lasting up to 45 minutes using 82 low or non-caffeine-consuming healthy male ( n=41) and female ( n=41) adults aged between 40 and 60 years. Vigilance was measured using Mackworth Clock test, Rapid Visual Information Processing Test, adaptive tracking test, saccadic eye movement and attention switch test. Effects on mood and fatigue were analysed using Bond and Lader and Caffeine Research visual analogue scales, and Samn-Perelli questionnaire. Saliva sampling was performed for both compliance and caffeine pharmacokinetic analysis. Administration of a 60 mg caffeine dose resulted in a significant improvement in sustained attention compared with the placebo. Also a significantly improved peak saccadic velocity and reaction time performance was found, and decreased error rate. Significantly increased feelings of alertness, contentment and overall mood after caffeine treatment compared with placebo were observed. This study demonstrated that in healthy adult subjects oral administration of a single 60 mg caffeine dose elicited a clear enhancement of sustained attention and alertness, measured both in multiple objective performances and in subjective scales.

Effects of the Red Bull energy drink on cognitive function and mood in healthy young volunteers

The present study compared the cognitive and mood effects of two commercially available products, Red Bull energy drink 250 mL and Red Bull Sugarfree energy drink 250 mL, together with a matching placebo 250 mL. Twenty-four healthy young volunteers took part in a randomised, placebo controlled, double-blind, three-way cross-over study. Cognitive function was assessed using an integrated set of nine computerised tests of attention, working and episodic memory. On each study day the volunteers received a standardised breakfast prior to completing a baseline performance on cognitive tests and mood scales, followed by the consumption of the study drink. The cognitive tests and scales were then re-administered at 30, 60 and 90 min post-dose. Red Bull was found to produce significant improvements over both the Sugarfree version and the placebo drink on two composite scores from the six working and episodic memory tests; one combining the 12 accuracy measures from the six tasks and the other the average speed of correct responses from the working memory and episodic recognition memory tasks. These improvements were in the range of a medium effect size, which reflects a substantial enhancement to memory in young volunteers.

The Effect of Breakfast Prior to Morning Exercise on Cognitive Performance, Mood and Appetite Later in the Day in Habitually Active Women

Pre-exercise nutritional practices for active females exercising for mood, cognitive and appetite benefits are not well established. Results from an initial field pilot study showed that higher energy intake at breakfast was associated with lower fatigue and higher overall mood and alertness post-exercise (all p < 0.05). In a follow-up, randomised, controlled trial, 24 active women completed three trials in a balanced, cross-over design. At 0815 h participants completed baseline cognitive tasks, mood and appetite visual analogue scales (VAS) and were administered a cereal breakfast (providing 118 or 236 kcal) or no breakfast. After 45 min, they completed a 30 min run at 65% heart rate reserve (HRR). Parameters were re-assessed immediately after exercise, then hourly until lunch (~1240 h), immediately post-lunch and at 1500 and 1900 h via a mobile phone. Breakfast enhanced feelings of relaxation before lunch (p < 0.05, d > 0.40), though breakfast was detrimental for working memory mid-afternoon (p = 0.019, d = 0.37) and mental fatigue and tension later in the day (all p < 0.05, d > 0.038). Breakfast was also beneficial for appetite control before lunch irrespective of size (all p < 0.05, d > 0.43). These data provide information on pre-exercise nutritional practices for active females and suggest that a small breakfast eaten prior to exercise can benefit post-exercise mood and subjective appetite ratings.

Increase in cocaine- and amphetamine-regulated transcript (CART) in specific areas of the mouse brain by acute caffeine administration

Caffeine produces a variety of behavioral effects including increased alertness, reduced food intake, anxiogenic effects, and dependence upon repeated exposure. Although many of the effects of caffeine are mediated by its ability to block adenosine receptors, it is possible that other neural substrates, such as cocaine- and amphetamine-regulated transcript (CART), may be involved in the effects of caffeine. Indeed, a recent study demonstrated that repeated caffeine administration increases CART in the mouse striatum. However, it is not clear whether acute caffeine administration alters CART in other areas of the brain. To explore this possibility, we investigated the dose- and time-dependent changes in CART immunoreactivity (CART-IR) after a single dose of caffeine in mice. We found that a high dose of caffeine (100 mg/kg) significantly increased CART-IR 2 h after administration in the nucleus accumbens shell (AcbSh), dorsal bed nucleus of the stria terminalis (dBNST), central nucleus of the amygdala (CeA), paraventricular hypothalamic nucleus (PVN), arcuate hypothalamic nucleus (Arc), and locus coeruleus (LC), and returned to control levels after 8 h. But this increase was not observed in other brain areas. In addition, caffeine administration at doses of 25 and 50 mg/kg appears to produce dose-dependent increases in CART-IR in these brain areas; however, the magnitude of increase in CART-IR observed at a dose of 50 mg/kg was similar or greater than that observed at a dose of 100 mg/kg. This result suggests that CART-IR in AcbSh, dBNST, CeA, PVN, Arc, and LC is selectively affected by caffeine administration.

A double-blind, placebo-controlled study evaluating the effects of caffeine and L-theanine both alone and in combination on cerebral blood flow, cognition and mood

RATIONALE

Evidence suggests interactive effects of the tea components caffeine and L-theanine on behaviour, yet no data exists exploring the impact of the two on cerebral blood flow (CBF).

OBJECTIVES

The current placebo-controlled, double-blind, counterbalanced, crossover study examined the effects of caffeine and L-theanine on CBF and extended previous cognitive and mood findings by using lower doses than previous studies of a similar methodology, which more closely reflect the ratios present in tea.

METHODS

Twelve habitual consumers and 12 non-habitual consumers of caffeine each received 75 mg caffeine, 50 mg L-theanine, 75 mg caffeine plus 50 mg L-theanine, and placebo in a counterbalanced order across four separate visits. CBF was measured via near-infrared spectroscopy with cognition and mood assessed at baseline and 30 min post-dose. Salivary caffeine and peripheral haemodynamics were co-monitored.

RESULTS

Caffeine reduced oxygenated haemoglobin (oxy-Hb), increased deoxygenated haemoglobin (deoxy-Hb), improved performance on attention tasks and increased overall mood ratings. Increases in deoxy-Hb following caffeine were more pronounced in non-consumers. Some evidence for increased deoxy-Hb remained when caffeine was combined with L-theanine, but this effect was attenuated and the effects of caffeine on oxy-Hb, cognition and mood were eradicated.

CONCLUSIONS

Combining L-theanine with caffeine, at levels and ratios equivalent to one to two cups of tea, eliminated the vasoconstrictive effect and behavioural effects of caffeine. This supports previous findings of an interaction between these substances, despite a lack of effects of L-theanine in isolation. However, at the levels tested here, this did not lead to a positive impact on behaviour.

Cortical substrates of the effects of caffeine and time-on-task on perception of effort

Caffeine intake results in a decrease in perception of effort, but the cortical substrates of this perceptual effect of caffeine are unknown. The aim of this randomized counterbalanced double-blind crossover study was to investigate the effect of caffeine on the motor-related cortical potential (MRCP) and its relationship with rating of perceived effort (RPE). We also investigated whether MRCP is associated with the increase in RPE occurring over time during submaximal exercise. Twelve healthy female volunteers performed 100 intermittent isometric knee extensions at 61 ± 5% of their maximal torque 1.5 h after either caffeine (6 mg/kg) or placebo ingestion, while RPE, vastus lateralis electromyogram (EMG), and MRCP were recorded. RPE and MRCP amplitude at the vertex during the first contraction epoch (0–1 s) were significantly lower after caffeine ingestion compared with placebo ( P < 0.05) and were significantly higher during the second half of the submaximal intermittent isometric knee-extension protocol compared with the first half ( P < 0.05). No significant effects of caffeine and time-on-task were found for EMG amplitude and submaximal force output variables. The covariation between MRCP and RPE across both caffeine and time-on-task ( r10 = −0.335, P < 0.05) provides evidence in favor of the theory that perception of effort arises from neurocognitive processing of corollary discharges from premotor and motor areas of the cortex. Caffeine seems to reduce perception of effort through a reduction in the activity of cortical premotor and motor areas necessary to produce a submaximal force, and time-on-task has the opposite effect.

Caffeine and cognitive performance: persistent methodological challenges in caffeine research

Human cognitive performance is widely perceived to be enhanced by caffeine at usual dietary doses. However, the evidence for and against this belief continues to be vigorously contested. Controversy has centred on caffeine withdrawal and withdrawal reversal as potential sources of experimental confounding. In response, some researchers have enlisted "caffeine-naïve" experimental participants (persons alleged to consume little or no caffeine) assuming that they are not subject to withdrawal. This mini-review examines relevant research to illustrate general methodological challenges that have been the cause of enduring confusion in caffeine research. At issue are the processes of caffeine withdrawal and withdrawal reversal, the definition of caffeine-naïve, the population representativeness of participants deemed to be caffeine-naïve, and confounding due to caffeine tolerance. Attention to these processes is necessary if premature conclusions are to be avoided, and if caffeine's complex effects and the mechanisms responsible for those effects are to be illuminated. Strategies are described for future caffeine research aimed at minimising confounding from withdrawal and withdrawal reversal.

Naturalistic Effects of Five Days of Bedtime Caffeine Use on Sleep, Next-Day Cognitive Performance, and Mood

Background: Disruptive effects of caffeine on sleep have previously been reported, although measures of next-day mood and performance have rarely been included. The present study aims to evaluate the effects of caffeine on sleep and associated next-day effects in a naturalistic field setting. Methods: Nineteen participants (daily caffeine intake 0-141 mg), assessed as good sleepers, took part in a randomized, placebo-controlled, double-blind, 2-week crossover study to assess the effects of bedtime caffeine use (250 mg) on sleep and next-day cognitive performance and mood, which were assessed on a mobile phone in the morning and afternoon. Sleep was assessed objectively (actiwatch) and subjectively (sleep diary). Results: Caffeine's effects on sleep were largely restricted to the first day of administration, with actigraphically measured reduced sleep efficiency, increased activity score and fragmentation index, decreased self-rated sleep quality, and an increased occurrence of participants waking early; only decreased sleep efficiency remained over the week. Effects on next-day performance and mood were evident over the whole week, although despite disrupting sleep, accuracy on a working memory task was higher after caffeine than placebo administration. Conclusions: Caffeine disrupted sleep, although when assessing next-day performance, which may have been affected by the presence of residual caffeine, performance appeared better after caffeine compared to placebo, although this was most likely due to prevention of the effects of overnight withdrawal from caffeine rather than representing a net benefit. Furthermore, partial tolerance developed to the effects of caffeine on sleep.

Psychostimulants and cognition: a continuum of behavioral and cognitive activation

Psychostimulants such as cocaine have been used as performance enhancers throughout recorded history. Although psychostimulants are commonly prescribed to improve attention and cognition, a great deal of literature has described their ability to induce cognitive deficits, as well as addiction. How can a single drug class be known to produce both cognitive enhancement and impairment? Properties of the particular stimulant drug itself and individual differences between users have both been suggested to dictate the outcome of stimulant use. A more parsimonious alternative, which we endorse, is that dose is the critical determining factor in cognitive effects of stimulant drugs. Herein, we review several popular stimulants (cocaine, amphetamine, methylphenidate, modafinil, and caffeine), outlining their history of use, mechanism of action, and use and abuse today. One common graphic depiction of the cognitive effects of psychostimulants is an inverted U-shaped dose-effect curve. Moderate arousal is beneficial to cognition, whereas too much activation leads to cognitive impairment. In parallel to this schematic, we propose a continuum of psychostimulant activation that covers the transition from one drug effect to another as stimulant intake is increased. Low doses of stimulants effect increased arousal, attention, and cognitive enhancement; moderate doses can lead to feelings of euphoria and power, as well as addiction and cognitive impairment; and very high doses lead to psychosis and circulatory collapse. This continuum helps account for the seemingly disparate effects of stimulant drugs, with the same drug being associated with cognitive enhancement and impairment.

The Janus face of caffeine

Caffeine is certainly the psychostimulant substance most consumed worldwide. Over the past years, chronic consumption of caffeine has been associated with prevention of cognitive decline associated to aging and mnemonic deficits of brain disorders. While its preventive effects have been reported extensively, the cognitive enhancer properties of caffeine are relatively under debate. Surprisingly, there are scarce detailed ontogenetic studies focusing on neurochemical parameters related to the effects of caffeine during prenatal and earlier postnatal periods. Furthermore, despite the large number of epidemiological studies, it remains unclear how safe is caffeine consumption during pregnancy and brain development. Thus, the purpose of this article is to review what is currently known about the actions of caffeine intake on neurobehavioral and adenosinergic system during brain development. We also reviewed other neurochemical systems affected by caffeine, but not only during brain development. Besides, some recent epidemiological studies were also outlined with the control of "pregnancy signal" as confounding variable. The idea is to tease out how studies on the impact of caffeine consumption during brain development deserve more attention and further investigation.

Effects of caffeine in overnight-withdrawn consumers and non-consumers

RATIONALE

A number of recent studies have suggested that caffeine only improves mood and cognitive performance in regular caffeine consumers who are caffeine withdrawn at test (the "withdrawal hypothesis"). This can be tested by investigating the effects of caffeine in non-consumers of caffeine.

OBJECTIVES

To compare the effects of 2 mg/kg caffeine on mood and cognitive performance in overnight-withdrawn consumers and non-consumers of caffeine.

METHODS

Twenty-five overnight-withdrawn consumers and twenty-five non-consumers of caffeine were tested in a within-subjects design where they were given a drink containing 2 mg/kg caffeine on one test day and placebo on another test day. The order of conditions (caffeine/placebo) was counterbalanced. Mood and performance measures were taken before and after each drink, and pre-drink measures were used as covariates in the analysis of post-drink measures.

RESULTS

Analysis of baseline scores revealed no significant effects of caffeine withdrawal. Caffeine generally improved mood and cognitive performance, relative to placebo, in both subjects groups. These effects did not differ significantly between groups apart from three measures (fewer lapses of attention and ratings of alertness and anxiety) where the effects of caffeine were larger in the non-consumers.

CONCLUSIONS

The present study revealed no negative effects of caffeine withdrawal. Beneficial effects of caffeine were observed in both withdrawn consumers and in non-consumers. Therefore, the withdrawal hypothesis is not an adequate explanation for the effects of caffeine.

Acute and chronic caffeine administration increases physical activity in sedentary adults

Caffeine is a commonly used stimulant thought to have ergogenic properties. Most studies on the ergogenic effects of caffeine have been conducted in athletes. The purpose of this study was to test the hypothesis that caffeine reduces ratings of perceived exertion and increases liking of physical activity in sedentary adults. Participants completed treadmill walking at 60% to 70% of their maximal heart rate at baseline and for 6 subsequent visits, during which half of the participants were given caffeine (3 mg/kg) and half given placebo in a sports drink vehicle. To investigate the potential synergistic effects of acute and chronic caffeine on self-determined exercise duration, participants were rerandomized to either the same or different condition for the last visit, creating 4 chronic/acute treatment groups (placebo/placebo, placebo/caffeine, caffeine/placebo, caffeine/caffeine). Participants rated how much they liked the activity and perceived exertion at each visit. There was a main effect of time on liking of physical activity, with liking increasing over time and an interaction of sex and caffeine treatment on liking, with liking of activity increasing in female participants treated with caffeine, but not with placebo. There was no effect of caffeine on ratings of perceived exertion. Individuals who received caffeine on the final test day exercised for significantly longer than those who received placebo. These data suggest that repeated exposure to physical activity significantly increases liking of exercise and reduces ratings of perceived exertion and that caffeine does little to further modify these effects.

Behavioural effects of compounds co-consumed in dietary forms of caffeinated plants

Research into the cognitive and mood effects of caffeine in human subjects has highlighted some fairly robust and well-accepted effects. However, the majority of these studies have focused on caffeine in isolation; whilst caffeine is normally consumed in the form of plant-derived products and extracts that invariably contain other potentially bioactive phytochemicals. The aim of the present review is to consider the possible mechanisms of action of co-occurring phytochemicals, and any epidemiological evidence suggesting that they contribute to potential health benefits ascribed to caffeine. Intervention studies to date that have been conducted to explore the effects on brain function of the non-caffeine components in caffeine-bearing plants (coffee, tea, cocoa, guaraná), either alone or in combination with caffeine, will also be summarised. Research is beginning to accumulate showing independent effects for several of the phytochemicals that co-occur with caffeine, and/or a modulation of the effects of caffeine when it is co-consumed with these naturally concomitant phytochemicals. The present review highlights that more research aimed at understanding the effects of these compounds is needed and, more importantly, the synergistic relationship that they may have with caffeine.

Faster but not smarter: effects of caffeine and caffeine withdrawal on alertness and performance

RATIONALE

Despite 100 years of psychopharmacological research, the extent to which caffeine consumption benefits human functioning remains unclear.

OBJECTIVES

To measure the effects of overnight caffeine abstinence and caffeine administration as a function of level of habitual caffeine consumption.

METHODS

Medium-high (n = 212) and non-low (n = 157) caffeine consumers completed self-report measures and computer-based tasks before (starting at 10:30 AM) and after double-blind treatment with either caffeine (100 mg, then 150 mg) or placebo. The first treatment was given at 11:15 AM and the second at 12:45 PM, with post-treatment measures repeated twice between 1:45 PM and 3:30 PM.

RESULTS

Caffeine withdrawal was associated with some detrimental effects at 10:30 AM, and more severe effects, including greater sleepiness, lower mental alertness, and poorer performance on simple reaction time, choice reaction time and recognition memory tasks, later in the afternoon. Caffeine improved these measures in medium-high consumers but, apart from decreasing sleepiness, had little effect on them in non-low consumers. The failure of caffeine to increase mental alertness and improve mental performance in non-low consumers was related to a substantial caffeine-induced increase in anxiety/jitteriness that offset the benefit of decreased sleepiness. Caffeine enhanced physical performance (faster tapping speed and faster simple and choice reaction times) in both medium-high and non-low consumers.

CONCLUSIONS

While caffeine benefits motor performance and tolerance develops to its tendency to increase anxiety/jitteriness, tolerance to its effects on sleepiness means that frequent consumption fails to enhance mental alertness and mental performance.

Dynamics of the General Factor of Personality in Response to a Single Dose of Caffeine

General Factor of Personality (GFP) research is an emergent field in personality research. This paper uses a theoretical mathematical model to predict the short-term effects of a dose of a stimulant drug on GFP and reports the results of an experiment showing how caffeine achieves this. This study considers the General Factor of Personality Questionnaire (GFPQ) a good psychometric approach to assess GFP. The GFP dynamic mechanism of change is based on the Unique Trait Personality Theory (UTPT). This theory proposes the existence of GFP which occupies the apex of the hierarchy of personality, and extends from an impulsiveness-and-aggressiveness pole (approach tendency) to an anxiety-andintroversion pole (avoidance tendency). An experiment with 25 volunteers was performed. All the participants completed the GFPQ and the Sensation-Seeking Scale list of adjectives from the trait version of MAACL-R (Multiple Affect Adjective Checklist Revised) on an empty stomach. The participants in the experimental group (20) received 330 mg of caffeine. All the participants filled in a state version form with the sensation-seeking adjectives every 4.5 minutes. This study considers that the Sensation-Seeking Scale list of adjectives from the MAACL-R, available in both trait and state versions, is a good psychometric approach to assess GFP. The results show that GFP is modified by a single dose of caffeine in the direction predicted by the UTPT.

Effects of caffeine on alcohol-related changes in behavioural control and perceived intoxication in light caffeine consumers

RATIONALE

Caffeinated alcoholic beverages have been associated with increased risk of alcohol-related harms. However, few studies have examined these combined effects on behavioural control, which is believed to underlie many of the negative effects of alcohol consumption. In addition, studies have often omitted subjective measures, and none have directly assessed the role of caffeine consumer history.

OBJECTIVES

To examine the combined effects of alcohol and caffeine on measures of behavioural control and perceived intoxication in abstinent, light caffeine consumers.

METHODS

Participants (n = 28; 50% male) attended four sessions at which they consumed one of the following beverages in a randomised order: placebo, alcohol alone (0.6 g/kg), caffeine alone (2.0 mg/kg), and alcohol/caffeine. They completed measures of mood, intoxication, anxiety and alcohol craving before and after a task battery comprising measures of behavioural control and reaction time performance.

RESULTS

Caffeine attenuated alcohol-related performance deficits on stop-signal accuracy, had no effect on go-no-go performance deficits, and worsened accuracy on the Stroop task. Caffeine did not influence absolute changes in perceived intoxication but there was suggestion that caffeine may have changed the nature of intoxication with increases in stimulation.

CONCLUSIONS

Caffeine appears to have mixed effects on alcohol intoxication that are task-dependent. We found increased stimulation in the alcohol/caffeine condition, supporting the contention that caffeinated alcoholic beverages enable an individual to drink for longer. Future research should model real world drinking behaviour by examining how these effects change across multiple drink administrations.

Does coffee enriched with chlorogenic acids improve mood and cognition after acute administration in healthy elderly? A pilot study

RATIONALE

Caffeine exerts positive effects on cognitive and behavioral processes, especially in sub-optimal conditions when arousal is low. Apart from caffeine, coffee contains other compounds including the phenolic compounds ferulic acid, caffeic acid, and the chlorogenic acids, which have purported antioxidant properties. The chlorogenic acids are the most abundant family of compounds found in coffee, yet their effects on cognition and mood have not been investigated.

OBJECTIVES

This study aims to ascertain whether a coffee rich in chlorogenic acid modulates brain function.

METHODS

The present pilot study examined the acute effects of decaffeinated coffee with regular chlorogenic acid content and decaffeinated coffee with high chlorogenic acid content on mood and cognitive processes, as measured by behavioral tasks and event-related potentials (ERPs). Performance and ERP responses to a battery of cognitive tasks were recorded at baseline and following the equivalent of three cups of coffee in a randomized, double-blind, crossover study of 39 healthy older participants.

RESULTS

Compared with the decaffeinated coffee with regular chlorogenic acid and placebo, caffeinated coffee showed a robust positive effect on higher-level mood and attention processes. To a lesser extent, the decaffeinated coffee high in chlorogenic acid also improved some mood and behavioral measures, relative to regular decaffeinated coffee.

CONCLUSIONS

Our pilot results suggest that non-caffeine compounds in coffee such as the chlorogenic acids may be capable of exerting some acute behavioral effects, thus warranting further investigation.

Glucose and caffeine effects on sustained attention: an exploratory fMRI study

OBJECTIVE

Caffeine and glucose can have beneficial effects on cognitive performance. However, neural basis of these effects remain unknown. Our objective was to evaluate the effects of caffeine and glucose on sustained attention, using functional magnetic resonance imaging (fMRI).

METHODS

Forty young right-handed, healthy, low caffeine-consuming subjects participated in the study. In a double-blind, randomised design, subjects received one of the following beverages: vehicle (water, 150 ml); vehicle plus 75 g of glucose; vehicle plus 75 mg of caffeine; vehicle plus 75 g of glucose and 75 mg of caffeine. Participants underwent two scanning fMRI sessions (before and 30 min after of the administration of the beverage). A continuous performance test was used to assess sustained attention.

RESULTS

Participants who received combined caffeine and glucose had similar performance to the others but had a decrease in activation in the bilateral parietal and left prefrontal cortex.

CONCLUSIONS

Since these areas have been related to the sustained attention and working memory processes, results would suggest that combined caffeine and glucose could increase the efficiency of the attentional system. However, more studies using larger samples and different levels of caffeine and glucose are necessary to better understand the combined effects of both substances.

Interrelations between plasma caffeine concentrations and neurobehavioural effects in healthy volunteers: model analysis using NONMEM

The objective was to develop a population pharmacokinetic-pharmacodynamic model of caffeine's psychomotor effects in healthy, non-habitual users of caffeine. Twenty Chinese males each received a single dose of 250 mg of caffeine orally. Plasma concentrations of caffeine were determined at various times within 24 h after dosing. The subjects' psychomotor performance was evaluated before and at various times after dosing by a test battery consisting of oculomotor assessment (saccadic velocity) as well as the computerised Swedish Performance Evaluation System. Nonlinear mixed-effects modelling to analyse the pharmacokinetic-pharmacodynamic relationships was performed using NONMEM. Model robustness was assessed by a nonparametric bootstrap. The results showed that caffeine caused significant improvements in psychomotor functioning. The time course of these effects was best described by pharmacokinetic/pharmacodynamic models involving an effect compartment. The transfer half-lives between plasma and effect site for different domains of psychomotor functioning were in the range 24.8-49.5 min. Evaluation of the final models showed close agreement between pairs of bootstrapped and final model parameter estimates (all differences<10%). These results provided the first suggestive evidence that caffeine effects on psychomotor performance occur after some time delay relative to changes in plasma caffeine concentration. The models for the neurobehavioural tests provided similar transfer half-lives between plasma and effect site.

Association of the anxiogenic and alerting effects of caffeine with ADORA2A and ADORA1 polymorphisms and habitual level of caffeine consumption

Caffeine, a widely consumed adenosine A(1) and A(2A) receptor antagonist, is valued as a psychostimulant, but it is also anxiogenic. An association between a variant within the ADORA2A gene (rs5751876) and caffeine-induced anxiety has been reported for individuals who habitually consume little caffeine. This study investigated whether this single nucleotide polymorphism (SNP) might also affect habitual caffeine intake, and whether habitual intake might moderate the anxiogenic effect of caffeine. Participants were 162 non-/low (NL) and 217 medium/high (MH) caffeine consumers. In a randomized, double-blind, parallel groups design they rated anxiety, alertness, and headache before and after 100 mg caffeine and again after another 150 mg caffeine given 90 min later, or after placebo on both occasions. Caffeine intake was prohibited for 16 h before the first dose of caffeine/placebo. Results showed greater susceptibility to caffeine-induced anxiety, but not lower habitual caffeine intake (indeed coffee intake was higher), in the rs5751876 TT genotype group, and a reduced anxiety response in MH vs NL participants irrespective of genotype. Apart from the almost completely linked ADORA2A SNP rs3761422, no other of eight ADORA2A and seven ADORA1 SNPs studied were found to be clearly associated with effects of caffeine on anxiety, alertness, or headache. Placebo administration in MH participants decreased alertness and increased headache. Caffeine did not increase alertness in NL participants. With frequent consumption, substantial tolerance develops to the anxiogenic effect of caffeine, even in genetically susceptible individuals, but no net benefit for alertness is gained, as caffeine abstinence reduces alertness and consumption merely returns it to baseline.

Effects of caffeine and glucose, alone and combined, on cognitive performance

OBJECTIVE

To study the effects of consuming caffeine and glucose, alone and combined, on cognitive performance.

METHODS

Seventy-two healthy subjects (36 women; age range 18-25) were tested early in the morning, having fasted overnight. Using a double-blind, randomised design, subjects received one of the following beverages: water (150 ml); water plus 75 mg of caffeine; water plus 75 g of glucose; water plus and 75 mg of caffeine and 75 g of glucose. Attention, manual dexterity, visuo-spatial and frontal functions, memory (immediate, consolidation and working) and subjective state were all assessed.

RESULTS

The combination of caffeine and glucose had beneficial effects on attention (sequential reaction time tasks) and on learning and consolidation of verbal memory, effects not being observed when either substance was administered alone. Caffeine only showed improvement in simple reaction time and glucose in simple and one sequential reaction time tasks and in the manual dexterity assembly task.

CONCLUSIONS

The results indicate that the synergistic effects of caffeine and glucose can benefit sustained attention and verbal memory, even with adequate levels of activation of the subjects. However, further studies are required, controlling for different levels of cognitive effort and also considering measurements of neural activity.

A comparison of the effects of caffeine following abstinence and normal caffeine use

RATIONALE

Caffeine typically produces positive effects on mood and performance. However, tolerance may develop following habitual use, and abrupt cessation can result in withdrawal symptoms, such as fatigue. This study investigated whether caffeine has a greater stimulant effect in a withdrawn state compared to a normal caffeinated state, among moderate daily caffeine consumers.

MATERIALS AND METHODS

Using a within-subjects design, 17 caffeine consumers (mean +/- sd = 375 +/- 101 mg/day) ingested placebo or caffeine (250 mg) following 30-h of caffeine abstention or normal dietary caffeine use on four separate days. Self-reported mood and performance on choice reaction time, selective attention, and memory tasks were measured.

RESULTS

Caffeine had a greater effect on mood and choice reaction time in the abstained state than in the normal caffeinated state, but caffeine improved selective attention and memory in both states.

CONCLUSIONS

Although improvements in mood and reaction time may best explained as relief from withdrawal symptoms, other performance measures showed no evidence of withdrawal and were equally sensitive to an acute dose of caffeine in the normal caffeinated state.

The effect of a carbohydrate-caffeine sports drink on simulated golf performance

A round of golf lasts approximately 4 h, during which time homeostasis could be challenged through either hypoglycemia or hypohydration. This might result in impaired motor skill or cognitive performance. Given the high cognitive demand of putting and the potential fatiguing effects from prolonged walking, the combination of a caffeine and carbohydrate drink could be beneficial in offsetting hypoglycemia and hypohydration. This study used a laboratory-simulated round of golf to examine the effect of an isotonic carbohydrate and caffeine sports drink on putting performance during a round of golf. After institutional ethics approval, 20 male golfers (mean +/- standard deviation: age 23 +/- 4 years, stature 176.4 +/- 5.6 cm, mass 72.8 +/- 17.4 kg, handicap 15 +/- 4, daily caffeine consumption 157.3 +/- 47.2 mg) consumed either an isotonic sports drink containing caffeine (6.4 g carbohydrate and 16 mg caffeine per 100 mL) or a no-energy, flavour-matched placebo drink in a double-blind, randomized, counter-balanced crossover design . Drinks were consumed preround (5 mL.kg-1 body mass (BM)) and at holes 6 and 12 (2.5 mL.kg-1 BM). Participants therefore consumed 1.6 mg.kg-1 BM of caffeine and 0.64 g.kg-1 BM of carbohydrate throughout the trial. Five and 2 m putting performance were assessed at each hole. Self-rated mood assessments were carried out every third hole. Putting performance over 5 m and 2 m and self-rated scores for alertness and relaxation showed a main effect for drink (p < 0.05). Ratings of mental fatigue and tiredness significantly increased during the round (p < 0.001). In experienced golfers, the consumption of an isotonic carbohydrate sports drink containing caffeine prior to and during a round of golf improved putting performance and increased feelings of alertness.

Caffeine use in children: what we know, what we have left to learn, and why we should worry

Caffeine is a widely used psychoactive substance in both adults and children that is legal, easy to obtain, and socially acceptable to consume. Although once relatively restricted to use among adults, caffeine-containing drinks are now consumed regularly by children. In addition, some caffeine-containing beverages are specifically marketed to children as young as 4 years of age. Unfortunately, our knowledge of the effects of caffeine use on behavior and physiology of children remains understudied and poorly understood. The purpose of this article is to review what is known about caffeine use in children and adolescents, to discuss why children and adolescents may be particularly vulnerable to the negative effects of caffeine, and to propose how caffeine consumption within this population may potentiate the rewarding properties of other substances. The following topics are reviewed: (1) tolerance and addiction to caffeine, (2) sensitization and cross-sensitization to the effects of caffeine, (3) caffeine self-administration and reinforcing value, and (4) conditioning of preferences for caffeine-containing beverages in both adults and children.

Methodological considerations for the quantification of self-reported caffeine use

RATIONALE

The field of research regarding the effects of habitual caffeine use is immense and frequently utilizes self-report measures of caffeine use. However, various self-report measures have different methodologies, and the accuracy of these different methods has not been compared.

MATERIALS AND METHODS

Self-reported caffeine use was estimated from two methods (a retrospective interview of weekly caffeine use and a 7-day prospective diary; n = 79). These estimates were then tested against salivary caffeine concentrations in a subset of participants (n = 55).

RESULTS

The estimates of caffeine use (mg/day) from the interview- and diary-based methods correlated with one another (r = 0.77) and with salivary caffeine concentrations (r = 0.61 and 0.68, respectively). However, almost half of the subjects who reported more than 600 mg/day in the interview reported significantly less caffeine use in the diary.

CONCLUSIONS

Self-report measures of caffeine use are a valid method of predicting actual caffeine levels. Estimates of high caffeine use levels may need to be corroborated by more than one method.

Caffeinated energy drinks--a growing problem

Since the introduction of Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle. Regulation of energy drinks, including content labeling and health warnings differs across countries, with some of the most lax regulatory requirements in the U.S. The absence of regulatory oversight has resulted in aggressive marketing of energy drinks, targeted primarily toward young males, for psychoactive, performance-enhancing and stimulant drug effects. There are increasing reports of caffeine intoxication from energy drinks, and it seems likely that problems with caffeine dependence and withdrawal will also increase. In children and adolescents who are not habitual caffeine users, vulnerability to caffeine intoxication may be markedly increased due to an absence of pharmacological tolerance. Genetic factors may also contribute to an individual's vulnerability to caffeine-related disorders including caffeine intoxication, dependence, and withdrawal. The combined use of caffeine and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury. Several studies suggest that energy drinks may serve as a gateway to other forms of drug dependence. Regulatory implications concerning labeling and advertising, and the clinical implications for children and adolescents are discussed.

Caffeine and headaches

Caffeine is the most widely consumed psychostimulant drug in the world. With intermittent exposures, caffeine may act as a mild analgesic for headache or as an adjuvant for the actions of other analgesics. Chronic repetitive exposures to caffeine increase the risks for development of analgesic-overuse headache, chronic daily headache, and physical dependency. Cessation of caffeine use after chronic exposures leads to a withdrawal syndrome with headache as a dominant symptom. At dosages achieved by common dietary intake, caffeine acts as a potent antagonist of central and peripheral nervous system adenosine receptors. The complex effects of caffeine on headache disorders suggest important roles for adenosine in these disorders and in the induction of caffeine dependency.

Genetics of coffee consumption and its stability

BACKGROUND

Coffee is a highly popular drink associated with the pathogenesis of several diseases and the use of tobacco and alcohol. Considering the worldwide consumption, coffee has a substantial effect on individual wellbeing and public health. The role of genetic factors contributing to interindividual differences and their stability in coffee use is not well known.

AIMS

We analysed the heritability of coffee consumption and its stability in a large population-based sample of Finnish twins.

DESIGN

In 1975 and 1981 a postal questionnaire on coffee consumption was sent to all Finnish same-sex twin pairs born before 1958. Responses were obtained from 10 716 complete twin pairs in 1975 (3409 monozygotic and 7307 dizygotic), of whom 8124 also responded in 1981. The data were analysed using classical twin modelling based on linear structural equations.

FINDINGS

Additive genetic and unique environmental factors affected coffee drinking, whereas shared environmental factors did not show any effect. Heritability of coffee consumption, adjusted for age and sex, was estimated as 0.56 in 1975 and 0.45 in 1981. Coffee consumption showed a moderate correlation between these two time-points (r = 0.58 in men and 0.55 in women). Genetic factors affecting coffee consumption were stable: additive genetic correlations were 0.84 in men and 0.83 in women, whereas unique environmental correlations were moderate (0.45 and 0.36). Additive genetic factors had the highest contribution in young adults.

CONCLUSIONS

Coffee consumption is affected by both additive genetic and unique environmental factors, each of which plays an almost equally important role. The long-term stability of coffee consumption is affected mainly by a stable set of additive genetic factors.

Cognitive and mood effects in healthy children during 12 weeks' supplementation with multi-vitamin/minerals

Adequate levels of vitamins and minerals are essential for optimal neural functioning. A high proportion of individuals, including children, suffer from deficiencies in one or more vitamins or minerals. This study investigated whether daily supplementation with vitamins/minerals could modulate cognitive performance and mood in healthy children. In this randomised, double-blind, placebo-controlled, parallel groups investigation, eighty-one healthy children aged from 8 to 14 years underwent laboratory assessments of their cognitive performance and mood pre-dose and at 1 and 3 h post-dose on the first and last days of 12 weeks' supplementation with a commercially available vitamins/mineral product (Pharmaton Kiddi). Interim assessments were also completed at home after 4 and 8 weeks at 3 h post-dose. Each assessment comprised completion of a cognitive battery, delivered over the Internet, which included tasks assessing mood and the speed and accuracy of attention and aspects of memory (secondary, semantic and spatial working memory). The vitamin/mineral group performed more accurately on two attention tasks: 'Arrows' choice reaction time task at 4 and 8 weeks; 'Arrow Flankers' choice reaction time task at 4, 8 and 12 weeks. A single task outcome (Picture Recognition errors) evinced significant decrements at 12 weeks. Mood was not modulated in any interpretable manner. Whilst it is possible that the significant improvements following treatment were due to non-significant numerical differences in performance at baseline, these results would seem to suggest that vitamin/mineral supplementation has the potential to improve brain function in healthy children. This proposition requires further investigation.