Validation of reaction time as a measure of cognitive function and quality of life in healthy subjects and patients

Opium tincture has anti-propulsive effects in patients with chronic diarrhea: a randomized, placebo-controlled, and cross-over trial

OBJECTIVE

Chronic diarrhea affects approximately 5% of the population. Opioids inhibit gastrointestinal motility, and opium tincture has shown anti-propulsive effects in healthy, but no controlled studies of its clinical efficacy exist. We aimed to investigate the anti-propulsive and central nervous system (CNS) effects of opium tincture in patients with chronic diarrhea.

MATERIALS AND METHODS

The study was a randomized, double-blinded, placebo-controlled, cross-over trial in subjects with chronic diarrhea refractory to standard treatment. Participants received opium tincture or placebo during two intervention periods, each lasting seven days. Bowel movements were recorded daily, and gastrointestinal transit time was investigated with the wireless motility capsule system. Gastrointestinal symptoms, health-related quality of life, and CNS effects (pupil size, reaction time, memory, and general cognition) were also investigated, along with signs of addiction.

RESULTS

Eleven subjects (mean age: 45 ± 17 years, 46% males) with a median of 4.7 daily bowel movements were included. The number of daily bowel movements was reduced during opium tincture treatment to 2.3 (p = 0.045), but not placebo (3.0, p = 0.09). Opium tincture prolonged the colonic transit time compared to placebo (17 h vs. 12 h, p < 0.001). In both treatment arms, there were no changes in self-reported gastrointestinal symptoms, health-related quality of life, or CNS effects, and no indication of addiction was present.

CONCLUSION

Opium tincture induced anti-propulsive effects in patients with chronic diarrhea refractory to standard treatment. This indicates that opium tincture is a relevant treatment strategy for selected patients with chronic diarrhea. Moreover, no evidence of opioid-induced sedation or addiction was found.Trial Registration Number: NCT05690321 (registered 2023-01-10).

Relationship between Fear-Avoidance Beliefs and Reaction Time Changes Prior to and following Exercise-Induced Muscle Fatigue in Chronic Low Back Pain

Background

Reaction time is a reliable indicator of the velocity and efficiency of neuromuscular control and may be associated with fear-avoidance beliefs. However, the effect of exercise-induced muscle fatigue on reaction time in chronic low back pain (cLBP) and its relationship with fear-avoidance beliefs remains poorly understood.

Objectives

This study aimed to reveal the relationship between fear-avoidance beliefs and reaction time changes before and after exercise-induced muscle fatigue in cLBP.

Methods

Twenty-five patients with cLBP were tested by the Biering-Sorensen test (BST) to induce exhaustive muscle fatigue. Total reaction time (TRT), premotor time (PMT), and electromechanical delay (EMD) of dominated deltoid muscle were recorded by surface electromyography during the arm-raising task with visual cues before and after muscle fatigue. The mean difference (MD) of TRT (MDTRT), PMT (MDPMT), and EMD (MDEMD) was calculated from the changes before and after muscle fatigue. Fear-avoidance beliefs questionnaire (FABQ) was applied to evaluate fear-avoidance beliefs before muscle fatigue. In addition, the duration time of BST was recorded for each subject.

Results

TRT and PMT of dominated deltoid muscle were prolonged after exercise-induced muscle fatigue (Z = 3.511, p < 0.001; t = 3.431, p = 0.001), while there was no statistical difference in EMD (Z = 1.029, p = 0.304). Correlation analysis showed that both the MDTRT and MDPMT were positively correlated with FABQ (r = 0.418, p = 0.042; r = 0.422, p = 0.040).

Conclusions

These findings suggested that we should pay attention to both muscle fatigue-induced reaction time delay in cLBP management and the possible psychological mechanism involved in it. Furthermore, this study implied that FABQ-based psychotherapy might serve as a potential approach for cLBP treatment by improving reaction time delay. This trial is registered with ChiCTR2300074348.

The association between cardiovascular health and cognition in adults with Down syndrome

INTRODUCTION

Evidence in the general population suggests that predictors of cardiovascular health such as moderate to vigorous physical activity (MVPA), cardiorespiratory fitness, and systolic blood pressure are associated with cognitive function. Studies supporting these associations in adults with Down syndrome (DS) are limited. The purpose of this study was to examine the associations between systolic blood pressure, cardiorespiratory fitness, and MVPA on cognition in adults with DS.

METHODS

This is a cross-sectional analysis using baseline data from a trial in adults with DS. Participants attended a laboratory visit where resting blood pressure, cardiorespiratory fitness (VO2 Peak), and cognitive function (CANTAB® DS Battery) were obtained. The cognitive battery included tests measuring multitasking, episodic memory, and reaction time. Physical activity (accelerometer) was collected over the week following the laboratory visit. Pearson correlations and linear regressions were used to measure the impact of systolic blood pressure, cardiorespiratory fitness, and MVPA on cognitive outcomes.

RESULTS

Complete data was available for 72 adults with DS (26.8 ± 9.3 years of age, 57% female). At baseline, VO2 Peak (21.1 ± 4.2 ml/kg/min) and MVPA were low (14.4 ± 14.4 min/day), and systolic blood pressure was 118.3 ± 13.3 mmHg. VO2 Peak was correlated with simple movement time (rho =  - 0.28, p = 0.03) but was not significant using a linear regression controlling for age and sex. Systolic blood pressure was significantly associated with episodic memory (first attempt memory score: β =  - 0.11, p = 0.002; total errors: β = 0.58, p = 0.001) and reaction time (five-choice movement time: β = 4.11, p = 0.03; simple movement time: β = 6.14, p = 0.005) using age- and sex-adjusted linear regressions. No associations were observed between MVPA and multitasking, episodic memory, or reaction time.

CONCLUSION

Predictors of cardiovascular health, including cardiorespiratory fitness and systolic blood pressure, were associated with some aspects of cognition in adults with DS. While future research should examine the role of improved cardiovascular health on delaying decreases in cognitive function and dementia in adults with DS, we recommend that health care providers convey the importance of exercise and cardiovascular health to their patients with DS.

TRIAL REGISTRATION

NCT04048759, registered on August 7, 2019.

Time-Course of Changes in Multidimensional Fatigue and Functional Exercise Capacity and Their Associations during a Short Inpatient Pulmonary Rehabilitation Program

This study aimed to assess the time-course of changes in multidimensional fatigue and functional exercise capacity and their associations during an inpatient pulmonary rehabilitation (PR) program. Seventy COPD patients from three centres were enrolled for a four-week PR program and were evaluated before (T0) and at the end of each week (T1, T2, T3, and T4). Weekly change in multidimensional fatigue was assessed by the multidimensional inventory questionnaire (MFI-20) and functional exercise capacity by the 6-minute walking distance (6MWD). Reaction time (RT) and heart rate variability (HRV) were also assessed as complementary markers of fatigue. HRV did not change during the study (all p > 0.05). MFI-20 score and RT decreased during the first part of the program (p < 0.001) and levelled off at T2 (all p > 0.05 compared with each preceding time). While 6MWD improved by almost 70% during the first part of the PR, it continued to increase, albeit at a greatly reduced pace, between T2 and T4 (p < 0.05). In parallel, a negative association was found between MFI-20 score and 6MWD at each evaluation time (r ranged from 0.43 to 0.71), with a significantly stronger T3 correlation compared with the other time periods (all p < 0.05). The strengthening of the association between fatigue and functional exercise capacity at T3, which occurred concomitantly with the slowdown of functional exercise capacity improvement, is consistent with a role for fatigue in the limitation of performance changes during PR. The limitation of fatigue during PR is thus an interesting aspect to improve the magnitude of performance changes.

Human energetic stress associated with upregulation of spatial cognition

OBJECTIVES

Evolutionary life history theory has a unique potential to shed light on human adaptive capabilities. Ultra-endurance challenges are a valuable experimental model allowing the direct testing of phenotypic plasticity via physiological trade-offs in resource allocation. This enhances our understanding of how the body prioritizes different functions when energetically stressed. However, despite the central role played by the brain in both hominin evolution and metabolic budgeting, cognitive plasticity during energetic deficit remains unstudied.

MATERIALS

We considered human cognitive plasticity under conditions of energetic deficit by evaluating variability in performance in three key cognitive domains. To achieve this, cognitive performance in a sample of 48 athletes (m = 29, f = 19) was assessed before and after competing in multiday ultramarathons.

RESULTS

We demonstrate that under conditions of energetic deficit, performance in tasks of spatial working memory (which assessed ability to store location information, promoting landscape navigation and facilitating resource location and calorie acquisition) increased. In contrast, psychomotor speed (reaction time) remained unchanged and episodic memory performance (ability to recall information about specific events) decreased.

DISCUSSION

We propose that prioritization of spatial working memory performance during conditions of negative energy balance represents an adaptive response due to its role in facilitating calorie acquisition. We discuss these results with reference to a human evolutionary trajectory centred around encephalisation. Encephalisation affords great plasticity, facilitating rapid responses tailored to specific environmental conditions, and allowing humans to increase their capabilities as a phenotypically plastic species.

Baseline Computerized Neurocognitive Testing and Oculomotor Measures are not Altered by Hormonal Contraceptive Use

OBJECTIVE

Neurocognitive testing and oculomotor assessment have been an integral component to provide objective measures for sport-related concussion (SRC) detection and management. Hormonal contraceptive (HC) use is common among collegiate female athletes and may modify baseline SRC performance. The purpose was to examine the effects of HC use on baseline computerized neurocognitive testing (CNT) and oculomotor testing in college-aged individuals.

METHOD

A total of 63 participants (22 HC using females, 22 non-HC using females, 19 males) completed a baseline SRC battery consisting of CNT, near point of convergence (NPC), and the King-Devick (KD) test. CNT measures were composite scores of verbal and visual memory, visual motor processing speed and reaction time, impulse control, and cognitive efficiency index (CEI). NPC was measured as the average convergence distance across three trials. KD time was recorded as total time for each of the two trials and best trial marked as baseline.

RESULTS

There were no group differences between HC, non-HC, and male control groups on all baseline CNT composite scores (p = .13-.98), impulse control (p = .47), and CEI (p = .49). NPC distance was similar between groups (p = .41), as well as KD time by trial (Trial 1 p = .65; 2 p = .48) and best time (p = .49).

CONCLUSIONS

HC use does not appear to influence baseline SRC measures of neurocognition and oculomotor assessment. Clinicians should continue to consider the effects of modifying factors at baseline and post-concussion. Additional research is needed to better understand sex hormone levels and SRC performance measures.

Optimizing Fine Motor Coordination, Selective Attention and Reaction Time in Children: Effect of Combined Accuracy Exercises and Visual Art Activities

Optimizing fine motor coordination and cognitive abilities in middle childhood through new intervention programs remains one of the most essential orientations in motor development and skills proficiency. The present study aims to identify the effect of a structure-based program intervention, combining motor accuracy exercises with visual art activities (ceramics, pottery, and creations using raw materials), on fine motor coordination, selective attention, and reaction time in middle childhood. Sixty, right-handed typically developed male schoolchildren (age = 8.29 ± 0.74 years; body height = 130.25 ± 0.05 cm and body mass = 29.83 ± 4.68 kg; mean ± SD) volunteered to participate in the study. They were randomly assigned to a combined group intervention (MG) receiving a mixed program integrating visual art activities and motor accuracy exercises; an accuracy group intervention (AG) receiving oriented motor accuracy exercises; and a control group (CG). Selective attention, reaction time, and fine motor coordination skills (accuracy: darts throw; manual dexterity: grooved pegboard test) were measured. Repeated measure ANOVA, one-way ANOVA, and Kruskal-Wallis ANOVA were performed for analysis. The results showed higher changes in MG compared to AG in manual dexterity (p < 0.001), in motor accuracy (p < 0.001), and in reaction time (p < 0.01), but not in selective attention (p = 0.379). In addition, higher changes were recorded in AG compared to CG in motor accuracy (p < 0.05), reaction time (p < 0.05), and in selective attention (p < 0.01), but not in manual dexterity (p = 0.082). The structured combined program best assists accuracy, manual dexterity, reaction time, and selective attention. Therefore, instructors in sports academies and teachers at schools are advised to use the combined program in the training sessions and in the non-curricular activities, respectively, to improve fine motor coordination, selective attention, and reaction time in middle childhood.

Effects of opium tincture on the enteric and central nervous systems: A randomized controlled trial

Opioids change gut motility, and opium tincture has been used for treatment of chronic diarrhoea for centuries. However, the effects have never been documented in controlled trials. We aimed to investigate the effects of opium tincture on gastrointestinal transit and motility, frequency of bowel movements, stool consistency, gastrointestinal symptoms and sedation. Twenty healthy subjects were included in this randomized controlled trial. Opium tincture or placebo was each applied for 9 days. Gastrointestinal transit and motility were investigated with the 3D-transit system. Bowel movements and gastrointestinal symptoms were recorded daily. General cognition, reaction time, memory and electroencephalography were used to assess effects on the central nervous system. Opium tincture doubled colonic transit (49 vs. 23 h, p < 0.001), decreased antegrade colonic movements (p < 0.05), reduced daily bowel movements (0.7 vs. 1.2, p < 0.001) and increased stool consistency (Type 3 vs. Type 4, p < 0.001). No changes in general cognition, reaction time or memory were observed, and minor changes of power observed by electroencephalography did not indicate sedation. This study is the first to show that opium tincture has anti-propulsive properties in the healthy gut, while no sedative effects were seen. This indicates that opium tincture is a relevant and safe treatment option in chronic diarrhoea.

Relationship between Reaction Times and Post-COVID-19 Symptoms Assessed by a Web-Based Visual Detection Task

Long-COVID is a clinical condition in which patients affected by SARS-CoV-2 usually report a wide range of physical and cognitive symptoms from 3 to 6 months after the infection recovery. The aim of the current study was to assess the link between self-reported long-COVID symptoms and reaction times (RTs) in a self-administered Visual Detection Task (VDT) in order to identify the predictor symptoms of the slowing in reaction times to determine attention impairment. In total, 362 participants (age (mean ± S.D.: 38.56 ± 13.14); sex (female-male: 73.76-26.24%)) responded to a web-based self-report questionnaire consisting of four sections: demographics, disease-related characteristics, and medical history questions. The final section consisted of a 23 item 5-point Likert-scale questionnaire related to long-term COVID-19 symptoms. After completing the questionnaire, subjects performed a VDT on a tablet screen to assess reaction times (RTs). An exploratory factorial analysis (EFA) was performed on the 23 long-COVID symptom questions, identifying 4 factors (cognition, behavior, physical condition, presence of anosmia and/or ageusia). The most important predictors of RTs were cognition and physical factors. By dissecting the cognitive and physical factors, learning, visual impairment, and headache were the top predictors of subjects' performance in the VDT. Long-COVID subjects showed higher RTs in the VDT after a considerable time post-disease, suggesting the presence of an attention deficit disorder. Attention impairment due to COVID-19 can be due to the presence of headaches, visual impairments, and the presence of cognitive problems related to the difficulty in learning new activities. The link between the slowing of reaction times and physical and cognitive symptoms post-COVID-19 suggests that attention deficit disorder is caused by a complex interaction between physical and cognitive symptoms. In addition, the study provides evidence that RTs in a VDT represent a reliable measure to detect the presence of long-COVID neurological sequelae.

Rice Intake Is Associated with Longer Reaction Time and Interacts with Blood Lipids and Hypertension among Qatari Adults

We aimed to assess the association between rice intake and cognitive function among Qatari adults and test the interactions with health conditions. Data from 1000 adults aged ≥18 years old who attended the Qatar Biobank (QBB) study were used. Rice dietary intake was measured by a food frequency questionnaire (FFQ), and mean reaction time (MRT) was used as an indicator of cognitive function. Linear regression and structure equation models were used. The mean rice consumption was 7.6 times/week (SD 2.0). The sample had a mean MRT of 717 milliseconds (SD 205). Rice consumption was positively associated with MRT. Across the quartiles of rice intake, the regression coefficients (95% CI) for MRT were 0.0 (reference), 22.4 (-7.8, 52.6), 36.3 (5.1, 67.5), and 34.5 (2.6, 66.4). There was a significant interaction between rice intake and hypertension, BMI, and blood lipids in relation to MRT. The association between rice intake and MRT was only observed among those with hypertension, overweight/obesity, low LDL, and low total cholesterol levels. Serum magnesium did not mediate the association. High rice consumption was associated with a higher MRT, especially among those with hypertension, overweight/obesity, low LDL, and or low total cholesterol levels. Further longitudinal studies are needed to confirm the findings.

Using shoe-mounted inertial sensors and stepping exergames to assess the motor-cognitive status of older adults: A correlational study

Objective

Stepping exergames designed to stimulate physical and cognitive skills can provide important information concerning individuals’ performance. In this study, we investigated the potential of stepping and gameplay metrics to assess the motor-cognitive status of older adults.

Methods

Stepping and gameplay metrics were recorded in a longitudinal study involving 13 older adults with mobility limitations. Game parameters included games’ scores and reaction times. Stepping parameters included length, height, speed, and duration, measured by inertial sensors placed on the shoes while interacting with the exergames. Parameters measured on the first gameplay were correlated against standard cognitive and mobility assessments, including the Montreal Cognitive Assessment (MoCA), gait speed, and the Short Physical Performance Battery. Based on MoCA scores, patients were then stratified into two groups: cognitively impaired and healthy controls. The differences between the two groups were visually inspected, considering their within-game progression over the training period.

Results

Stepping and gameplay metrics had moderate-to-strong correlations with cognitive and mobility performance indicators: faster, longer, and higher steps were associated with better mobility scores; better cognitive games’ scores and reaction times, and longer and faster steps were associated with better cognitive performance. The preliminary visual analysis revealed that the group with cognitive impairment required more time to advance to the next difficulty level, also presenting slower reaction times and stepping speeds when compared to the healthy control group.

Conclusion

Stepping exergames may be useful for assessing the cognitive and motor status of older adults, potentially allowing assessments to be more frequent, affordable, and enjoyable. Further research is required to confirm results in the long term using a larger and more diverse sample.

Effectiveness of electrical vestibular nerve stimulation as adjunctive therapy to improve the cognitive functions in patients with Parkinson's disease

OBJECTIVES

The present study was undertaken to observe the effectiveness of electrical vestibular stimulation in improving cognitive functions in patients with Parkinson's disease.

METHODS

Randomized controlled trial (ClinicalTrials.gov Identifier: NCT04450550). 30 cases of PD, including both males and females were recruited in the study by convenient sampling after obtaining written informed consent. After recruiting, the participants were randomly assigned into two groups. The control group (n=15) received placebo stimulation whereas the intervention group (n=15) received electrical vestibular stimulation administered for 12 weeks. Auditory, visual reaction time and spatial and verbal memory were recorded before and after 6 weeks and after 12 weeks of intervention and compared.

RESULTS

There was a significant improvement in both auditory and visual reaction time of right and left-hand responses. Also, significant improvement was observed in both the spatial and verbal memory of the patients.

CONCLUSIONS

There was a significant improvement in the auditory and visual reaction time and spatial and verbal memory in the participants after the electrical vestibular nerve stimulation administration. No side effects were reported by the study participants and they have expressed willingness to continue the intervention after the study period also. The study recommends further detailed studies with a higher sample size to adopt electrical vestibular nerve stimulation as adjunctive therapy in the management of Parkinson's disease.

Acute Effects of Sprint Interval Training and Chronic Effects of Polarized Training (Sprint Interval Training, High Intensity Interval Training, and Endurance Training) on Choice Reaction Time in Mountain Bike Cyclists

This study evaluated the acute effects of sprint interval training and chronic effects of polarized training on choice reaction time in cyclists. Twenty-six mountain bike cyclists participated in the study and were divided into experimental (E) and control (C) groups. The cyclists trained for 9-weeks and performed five training sessions each week. Types of training sessions: (1) sprint interval training (SIT) which consisted of 8-16, 30 s repetitions at maximal intensity, (2) high-intensity interval training (HIIT) included 5 to 7, 5-min efforts at an intensity of 85-95% maximal aerobic power (Pmax), and (3) endurance training (ET) performed at an intensity of 55-60% Pmax, lasting 120--180 min. In each week the cyclists performed: in group E a polarized training program, which included 2 × SIT, 1 × HIIT and 2 × ET, while in group C 2 × HIIT and 3 × ET. Before (acute effects) and after the 9-week training period (chronic effects) participants performed laboratory sprint interval testing protocol (SITP), which consisted of 12 maximal repetitions lasting 30 s. During SITP maximal and mean anaerobic power, as well as lactate ion concentration and blood pH were measured. Choice reaction time (RT) was measured 4-times: before and immediately after the SITP test-before and after the 9-week training period. Evaluated the average choice RT, minimal choice RT (shortest reaction), maximal choice RT (longest reaction), and the number of incorrect reactions. Before the training period as acute effects of SITP, it was observed: a shorter average choice RT (F = 13.61; p = 0.001; η2 = 0.362) and maximal choice RT (F = 4.71; p = 0.040; η2 = 0.164), and a decrease the number of incorrect reactions (F = 53.72; p = 0.000; η2 = 0.691), for E and C groups. After the 9-week training period, chronic effects showed that choice RT did not change in any of the cyclists' groups. Only in the E group after the polarized training period, the number of incorrect reactions decreased (F = 49.03; p = 0.000; η2 = 0.671), average anaerobic power increased (F = 8.70; p = 0.007; η2 = 0.274) and blood pH decreased (F = 27.20; p = 0.000; η2 = 0.531), compared to the value before the training period. In conclusion, a shorter choice RT and a decrease in the number of incorrect reactions as acute effects of SITP, and a decrease in the number of incorrect reactions and higher average power as chronic effects of the polarized training program are beneficial for mountain bike cyclists.

Acute effects of aerobic versus resistance exercises on cognitive function in individuals with intellectual disability

BACKGROUND

This study compared the acute effects of aerobic (AE) and resistance (RE) exercise on reaction time (RT) and working memory (WM) in individuals with intellectual disability.

METHODS

RT tests and Corsi test for WM were performed before and after three intervention sessions: AE, RE, or control session consisting on watching video.

RESULTS

The RT values decreased significantly (p < .001) after both of AE and RE with higher extend after the RE but did not vary following the control session. Corsi scores increased significantly (p < .001) after AE but not after RE or control session.

CONCLUSIONS

These findings suggest that the effects of acute exercise on cognitive function in individuals with intellectual disability depend on the exercise mode as well as the nature of the cognitive task. The RE seems to be more recommended for RT enhancement whereas only the aerobic one could improve WM in these individuals.

Fatigue Assessment of Sedentary Office Workers using Smart Phones: A Preliminary Study

BACKGROUND

Smartphone-based gait assessment provides a novel method to evaluate fatigue.

OBJECTIVE

This study aimed to examine self-reported fatigue and gait parameters recorded using a smartphone before and after an 8-hour work day in bank workers, and identify the relationship between self-reported fatigue and gait parameters.

METHODS

100 bank workers (20-45 years) were tested before and after an 8-hour work day using a reaction time test, self-reported fatigue scale, and gait test. Spearman correlation coefficient analysis and partial least squares regression were used to identify the relationship between self-reported fatigue and gait parameters.

RESULTS

Reaction time and self-reported fatigue increased significantly after work. Gait parameters (step frequency, minimum acceleration, acceleration root mean square, step regularity, and step counts) decreased; step time and step time variability increased significantly (p < 0.05). We found a significant correlation between Δwork engagement (delta: Δ) and Δstep frequency (r = -0.20, p < 0.05), Δwork engagement and Δstep time (r = 0.21, p < 0.05), and Δwork tasks and Δstep symmetry (r = -0.20, p < 0.05).

DISCUSSION

This study suggests that step frequency, step time and step symmetry measured using a smartphone have the potential to be used as predictors of work fatigue.

Feasibility of Volitional Reaction Time Tests in Athletes: A Systematic Review

This systematic review aimed to synthesize the current evidence on the feasibility of volitional reaction time (RT) tests to evaluate the information processing abilities of athletes. Four databases were searched, and, finally, 38 studies exploring the reliability, validity, or sensitivity of RT tests were included. Seven studies explored the reliability, which ranged from poor to excellent, while only three studies explored the validity of RT tests. The most important downside of the majority of the implemented RT tests is their nonspecific nature (i.e., stimulus and response did not resemble the sports actions). Sports scientists should focus on developing RT tests that are specific for each sport and refine the testing procedures to obtain accurate, reproducible, and sensitive measurements of RT.

Presbycusis and the Aging of Eye Movement: Common Attention Mechanisms

Presbycusis, physiological age-related hearing loss, is a major health problem because it is the most common cause of hearing impairment, and its impact will grow in the coming years with the aging population. Besides auditory consequences, the literature recently found an association between hearing loss and cognitive decline over the last two decades, emphasizing the importance of the early detection of presbycusis. However, the current hearing tests are not sufficient to detect presbycusis in some cases. Furthermore, the underlying mechanisms of this association are still under discussion, calling for a new field of research on that topic. In that context, this study investigates for the first time the interaction between presbycusis, eye movement latency and Stroop scores for a normal aging population. Hearing abilities, eye movement latency and the Stroop Victoria test were measured for 69 elderly (mean 66.7 ± 8.4) and 30 young (mean 25.3 ± 2.7) participants. The results indicated a significant relationship between saccade latency and speech audiometry in the silence score, independently from age. These promising results suggest common attentional mechanisms between speech processing and saccade latency. The results are discussed regarding the relationship between hearing and cognition, and regarding the perspective of expanding new tools for presbycusis diagnosis.

Diet Quality and the Risk of Impaired Speech Reception Threshold in Noise: The UK Biobank cohort

OBJECTIVE

Previous studies have examined the association between several diet quality indexes and risk of hearing loss, based on self-reported information or on audiometry test, with inconsistent results. However, the impact of healthy diets on the capacity to listening in noise, a proxy of disability due to hearing loss, is unknown. This research assessed the prospective association between five diet quality indexes and the speech reception threshold in noise in the UK Biobank study.

DESIGN

Prospective cohort with 105,592 participants aged ≥40 years. At baseline, adherence to the Mediterranean Diet Adherence Screener, the alternate Mediterranean Diet score, the Dietary Approaches to Stop Hypertension, the Alternate Healthy Eating Index-2010, and the healthful Plant-Based Diet Index were assessed. Functional auditory capacity was measured with a digit triplet test, and impairment was defined as a speech reception threshold in noise >-3.5 dB in any physical exam during the follow-up.

RESULTS

Over a median follow-up of 3.2 (SD: 2.1) years, 1704 participants showed impaired speech reception threshold in noise. After adjusting for potential confounders, the hazard ratios (95% confidence interval) of impairment per 1-SD increase in the Mediterranean Diet Adherence Screener, alternate Mediterranean Diet score, Dietary Approaches to Stop Hypertension, Alternate Healthy Eating Index-2010 and healthful Plant-Based Diet Index scores were, respectively, 0.98 (0.94 to 1.03), 1.01 (0.96 to 1.06), 1.02 (0.97 to 1.07), 1.01 (0.96 to 1.06), and 1.00 (0.96 to 1.05). Results were similar when analyses were restricted to those >60 years, with British ethnicity, without chronic disease, without tinnitus or with optimal cognitive function.

CONCLUSIONS

Adherence to a healthy diet did not show an association with the speech reception threshold in noise. More research is needed to identify the impact of individual foods or nutrients on this outcome.

Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study

Purpose

To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study.

Methods

This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up.

Results

Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women.

Conclusions

PUFA intake was associated with decreased risk of disabling hearing function in women, but not in men.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-021-02644-7.

Muscle Strength and Physical Performance Are Associated with Reaction Time Performance in Older People

Background: Functional mobility and muscle strength are well known risk factors for sarcopenia. Furthermore, possible associations have been suggested between predisposing factors of sarcopenia and reaction time among the elderly. This study aims to analyze possible associations of functional mobility and muscle strength and reaction times in a population of people aged >60 years. Methods: A total of 290 older people (69.35 ± 5.55 years) participated in this study. The following parameters were assessed: optoacoustic lower-limb reaction time (OALLRT); acoustic lower-limb reaction time (ALLRT); optic lower-limb reaction time (OLLRT, using an optical detection system), functional mobility (through the timed up-and-go test) and muscle strength (using a dynamometer). Results: Our results show that lower values of muscle strength were associated with increased reaction times in OALLRT (β = −0.170; 95% confidence interval −0.011–0.000; R² = 0.237; p = 0.035) and in ALLRT (β = −0.228; 95% confidence interval −0.011–0.002; R² = 0.199; p = 0.006). Conclusion: Increased muscle strength (which at low values are risk factors for sarcopenia) was associated with decreased reaction times in people >60 years of age.

Combined aerobic and resistance training improves physical and executive functions in women with systemic lupus erythematosus

OBJECTIVES

Exercise is considered as an adjuvant therapeutic modality to alleviate symptoms of several rheumatic diseases. However, data regarding the benefits of exercise to patients with systemic lupus erythematosus (SLE) are relatively scant.

METHODS

This study aimed to assess the effects of regular, moderate-intensity, aerobic exercise combined with resistance training on women with SLE who had no regular exercise. Patients were recruited and allocated into either the exercise or control group by their willingness. Patients in the exercise group (n = 12) underwent 12 weeks of combined exercise (five days per week), whereas those in the control group (n = 11) maintained their usual lifestyle.

RESULTS

At baseline, there were no between-group differences in body composition, disease activity, two-kilometer walking test, and executive function test. After the combined exercise intervention for 12 weeks, significant improvements of both fitness index and reaction time to the stimuli in the go/no-go test were observed in the exercise group, but not in the control group. The disease activities in both study groups did not change significantly at the end of the study period.

CONCLUSION

Our results suggest that regular moderate-intensity aerobic exercise combined with resistance training improves the physical and executive functions of SLE patients without exacerbating disease activity.

Diurnal Variation in Visual Simple Reaction Time between and within Genders in Young Adults: An Exploratory, Comparative, Pilot Study

Simple reaction time (SRT) is the minimum time required to respond to a stimulus; it is a measure of processing speed. Our study aimed to determine the variation in visual SRT with time among individuals of the same gender and between genders. We carried out a prospective, parallel group, pilot study involving ten male and ten female medical students aged 18–25 years. After obtaining written informed consent, the participants were familiarized with the procedures, and each completed a single practice session of a computerized visual SRT which was administered using Psychology Experiment Building Language Version 2.0 software. On a predetermined day, the participants completed the exercise at 10 a.m., 1 p.m., and 5 p.m. The results showed no statistically significant difference in SRT based on time of day between genders (χ²(2) = 4.300, p=0.116) as well as within gender (males (χ²(2) = 0.600, p=0.741); females (χ²(2) = 5.000, p=0.082). Our study showed that visual SRT does not change significantly at different times of the day and within and between genders. Intraindividual variations in visual SRT can mask the presence of a small but significant difference; hence, further studies are warranted.

Evaluation of the Reaction Time and Accuracy Rate in Normal Subjects, MCI, and Dementia Using Serious Games

The main purpose of this research is to evaluate the differences in the reaction time and accuracy rate of three categories of subjects using our serious games. Thirty-seven subjects were divided into three groups: normal (n1 = 16), MCI (Mild Cognitive Impairment) (n2 = 10), and dementia—moderate-to-severe (n3 = 11) groups based on the MMSE (Mini Mental State Examination). Two serious games were designed: (1) whack-a-mole and (2) hit-the-ball. Two dependent variables, reaction time and accuracy rate, were statistically analyzed to compare elders’ performances in the games among the three groups for three levels of speed: slow, medium, and fast. There were significance differences between the normal group, the MCI group, and the moderate-to-severe dementia group in both the reaction-time and accuracy-rate analyses. We determined that the reaction times of the MCI and dementia groups were shorter compared to those of the normal group, with poorer results also observed in accuracy rate. Therefore, we conclude that our serious games have the feasibility to evaluate reaction performance and could be used in the daily lives of elders followed by clinical treatment in the future.

Characterization of physical, functional, and cognitive performance in 15 adults with hypophosphatasia

OBJECTIVE

Given the small but growing body of literature related to physical functioning and the scarce data related to fine motor and cognitive functioning in adults with hypophosphatasia (HPP), our objective was to characterize physical, functional, and cognitive performance in adults with HPP. A future objective is to utilize this characterization to develop guidelines for evaluation by physical therapists (PT), occupational therapists (OT), and speech-language pathologists (SLP).

METHOD

We evaluated physical, functional, and cognitive performance in 15 adults with HPP through standardized assessments of mobility, balance, fine motor control, activities of daily living, cognition, and self-reported measures of health-related quality of life, fatigue, depression, and anxiety. The median age at enrollment was 44 years (range 26-79 years). Among the participants, 11 (73%) were women. Five participants (33%) were on enzyme replacement therapy.

RESULTS

Compared with the general population, HPP participants traveled shorter distances on the Six-Minute Walk Test (420 m (m) [SD: 132] vs 620 m [SD: 49], p < 0.00005), had slower gait on the 10-Meter Walk Test [HPP men (3.71 ft/s (f/s) [SD: 0.77] vs 4.70 f/s [SD: 0.14], p < 0.00005) and HPP women (3.39 f/s [SD: 0.67] vs 4.56 f/s [SD: 0.09], p < 0.00005)]. HPP participants had decreased upper extremity (UE) dexterity by Nine Hole Peg Test [right UE in HPP men (22.7 s (s) [SD: 2.3] vs 19.0 s [SD: 3.9], p = 0.03), left UE in HPP men (23.3 s [SD: 0.7] vs 19.8 s [SD: 3.7], p = 0.03), right UE in HPP women (19.8 s [SD: 2.0] vs 17.7 s [SD: 3.2], p = 0.01), and left UE in HPP women (21.1 s [SD: 2.5] vs 18.9 s[SD: 3.4], p = 0.02)], and some had abnormally slow bilateral UE reaction times via Dynavision (0.9 s [0.85,0.96], functional speed <1.15 s). On the Short Form-36 (SF36), HPP patients reported worse energy/fatigue (30.4 [SD 22.7] vs 52.2 [SD: 22.4], p = 0.0001), social functioning (54.5 [SD: 34.2] vs 78.8 [SD: 25.5], p = 0.0002), pain (46.1 [SD: 27.3] vs 70.8 [SD: 25.5], p = 0.0001), general health (36.8 [SD: 24.0] vs 57.0 [SD: 21.1], p = 0.0002), and health change i.e. perception of health improvement (32.1 [SD: 15.3] vs 59.1 [SD: 23.1], p < 0.00005) than the general population. Fatigue Severity Scale scores were well above the median for a healthy population (5.21 [SD: 1.8] vs 2.3 [SD: 1.21], p < 0.00005), indicating significant fatigue. HPP participants had significantly higher DASS scores for depression (8.5 [SD: 6.5] vs 5.0 [SD: 7.5], p = 0.02), anxiety (7.9 [SD: 6.7] vs 3.4 [SD: 5.1], p = 0.00009), and stress (14.7 [SD: 12.4] vs 8.1 [SD: 8.4], p = 0.0003) compared to the general population.

CONCLUSION

Objective functional assessments demonstrated defects in physical functioning, including decreased ability to walk distances, slow gait speed, and diminished ability to repeatedly rise from a sitting position. In addition, participants self-reported significant limitations due to physical dysfunction. Decreased upper extremity dexterity may indicate problems with activities of daily living and delayed reaction times can have safety implications. Some patients with HPP have increased difficulties with depression, anxiety, and stress. PT, OT, and SLP specialists can aid in establishing baseline assessment of impairment and objective metrics for assessing efficacy of treatment.

M, B.W.C. S, P.V. V, Ramaswamy P. How does cognitive function measured by the reaction time and critical flicker fusion frequency correlate with the academic performance of students?

BACKGROUND

The reaction time (RT) is "the time taken for the appearance of rapid voluntary reaction by an individual following a stimulus, either auditory or visual" and the Critical Flickering Fusion Frequency (CFFF) is "the rate at which successively presented light stimuli appear to be steady and continuous". RT and CFFF are commonly used for the assessment of cognitive functions that are known to influence academic performance. However, data about the exact correlation between these are scarce, particularly in India. This research aimed to study the association between visual RT (VRT), auditory RT (ART) and CFFF and their impact on the academic performance of undergraduate students.

METHODS

This cross-sectional study was conducted on 700 students of Faculty of Medicine and Dentistry at a private medical university in South India, during the period from 2015 to 2017. The VRT, ART and CFFF were evaluated, and the best out of three subsequent attempts was recorded. The mean score (in percentage) of the three best marks out of the five internal assessments for the course during each academic year was considered for analysis. The association between the different cognitive tests and the average academic performance was analysed.

RESULTS

Female students had faster VRT (n = 345, mean = 243.97, SD = 83.87) than male students (n = 273, mean = 274.86, SD = 96.97) (p = 0.001). VRT and ART had a moderate negative correlation with academic performance (for ART, r = - 0.42, p < 0.001; for VRT; r = - 0.40, p < 0.001). CFFF had a very weak positive correlation with academic performance (r = 0.19, p = 0.01). The only independent predictors of academic performance were RT and gender (Adjusted R2 = 0.11).

CONCLUSION

Although there is a correlation between CFFF and cognitive function, our study showed only a weak correlation between CFFF and academic performance. Female students had faster RTs, and gender was an independent predictor of academic performance. Rather, students with faster RTs appear to have an advantage in academic performance.

A Study to Assess and Correlate Serum Lipid Profile with Reaction Time in Healthy Individuals

Dyslipidaemia, metabolic syndrome, diabetes mellitus and arterial hypertension contribute to the risk of cognitive disorder and dementia. However very few and conflicting results are available with respect to the impact of lipoprotein ratios on cognitive functions in healthy individuals. Therefore, this study was aimed to investigate the association of lipid profile and its ratios with reaction time in young healthy individuals. 89 individuals (54 male and 35 female) with mean age of 31.20 ± 3.19 years were selected for this observational study conducted at AIIMS Rishikesh and written consent was obtained. TC, TG, HDL were measured by semi auto analyzer following the manufacturers' instruction and LDL was calculated by Friedewald formula. Reaction time (simple and choice reaction time) was assessed using a software package, Deary-Liewald reaction time task. Association of various parameters was calculated by pearson's correlation coefficient using SPSS version 23.0. Reaction time showed significant negative association with BMI (r = - 0.323, p = 0.002) in total study participants as well as with TG (r = - 0.440, p = 0.008) and TG/HDL (r = - 0.402, p = 0.025) in female individuals. From this study, it could be concluded that TG/HDL ratio, the superlative predictor of concomitant presence of cardiovascular disease, insulin resistance and metabolic syndrome may be considered as a biomarker for assessment of cognitive function in young healthy female individuals.

Findings of a Pilot Study Investigating the Effects of Mediterranean Diet and Aerobic Exercise on Cognition in Cognitively Healthy Older People Living Independently within Aged-Care Facilities: The Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study

BACKGROUND

Cognitive decline and Alzheimer disease are more prevalent in our aging population. Modifiable risk factors, such as diet and sedentary lifestyle, have been proposed as key to potentially ameliorating cognitive decline. Both exercise and Mediterranean diet (MedDiet) have been linked to reduced levels of cardiovascular disease and other comorbidities. Higher levels of exercise and MedDiet adherence may prove to be cognitively protective, both individually and synergistically.

OBJECTIVES

The aim was to investigate the effect of a 6-mo program of MedDiet, exercise, and a combination of both, on cognition, mood, and general health in older persons living independently in aged-care communities.

METHODS

The Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study (ACTRN12614001133628) involved 102 participants, aged 60-90 y, who were randomly assigned to 1 of 4 intervention groups. Change in overall memory performance was assessed as the primary outcome. Additionally, changes in cognitive task performance, as well as mood, wellness, cardiovascular function, and blood biomarkers, were investigated.

RESULTS

While there was no significant change in overall memory performance, there was a significant improvement in spatial working memory performance in the combined exercise and diet group, relative to controls. This combined intervention group also showed an overall improvement in their emotional state, as assessed by the Depression Anxiety Stress Scale, as did the exercise-only group.

CONCLUSIONS

This research indicates that diet and exercise programs have the potential to improve aspects of cognition and mood in an aging population. However, given the lower than optimal sample size and lack of resources to reinforce the interventions during the trial, further larger randomized controlled trials are required to substantiate whether the introduction of diet and exercise programs into independent-living facilities is a viable method to preserve cognitive health in older people. This trial was registered at www.ANZCTR.org.au ACTRN 12614001133628 (LIILAC Study).

Is obesity associated with impaired reaction time in youth?

BACKGROUND AND PURPOSE

Recent research demonstrates a significant relationship between weight status and impaired reaction time in young, adult, and elderly individuals. However, most such studies were performed on small samples, used only body mass index as the body obesity index, used simple reaction time, and oftentimes did not consider some potential confounders such as age, socioeconomic status, or physical activity in their studies. The present study explored the relationship between various reaction time tasks and various obesity indices in a sample of youth.

METHODS

Two hundred and thirty-four young males (19-24 years) underwent standard anthropometry, various information processing tasks (e.g., clinical reaction time, simple audio and visual reaction time, and choice reaction time), as well as an inhibitory control task (congruent and incongruent Simon reaction time).

RESULTS

Results revealed no significant relationship between any of the information processing tests and body mass index, nor for fat percentage, waist circumference, and waist-to-height ratio after adjustment for potential confounders. A weak positive association was observed only between congruent Simon reaction time (but not incongruent Simon reaction time) and waist circumference in participants (t value = 0.199; Std error = 0.0014; p = 0.047; Cohen's f² = 0.09).

CONCLUSION

Inhibitory control, but not information processing speed, was associated only with waist circumference in apparently healthy young men.

LEVEL OF EVIDENCE

Level I, experimental study.

The heart of cognitive control: Cardiac phase modulates processing speed and inhibition

Bodily states are heavily intertwined with cognitive processes. A prominent communication channel between bodily signals and brain structures is provided by baroreceptors. Their phasic activity associated with the cardiac phase has been shown to modulate cognitive control in socio-emotional contexts. However, whether this effect is specific to the affective dimension or impacts general cognitive control processes remains controversial. The aim of the present study is to investigate the effect of cardiac phase on different facets of cognitive control. We built a nonemotional cognitive control task to delineate mechanisms such as processing speed, response selection, response inhibition, and conflict monitoring. We showed that the systole (after the blood is ejected from the heart), compared to the diastole, was related to faster responses. Moreover, the cardiac phase dynamics also impacted response inhibition, with an increased probability of failure toward the middle of the course of systole. Although the reported effects were small in terms of magnitude, they highlight the influence of bodily states on abstract cognitive processes.

Dextromethorphan Analgesia in a Human Experimental Model of Hyperalgesia

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Central pain sensitization is often refractory to drug treatment. Dextromethorphan, an N-methyl-d-aspartate receptor antagonist, is antihyperalgesic in preclinical pain models. The hypothesis is that dextromethorphan is also antihyperalgesic in humans.

Methods

This randomized, double-blind, placebo-controlled, crossover study explores the antihyperalgesic effect of single and repeated 30-mg dose of oral dextromethorphan in 20 volunteers, using the freeze-injury pain model. This model leads to development of primary and secondary hyperalgesia, which develops away from the site of injury and is associated with central sensitization and activation of N-methyl-d-aspartate receptor in the spinal cord. The primary outcome was antihyperalgesia calculated with the area under the curve of the percentage change in mechanical pain threshold (electronic von Frey) on the area of secondary hyperalgesia. The secondary outcomes were mechanical pain threshold on the area of primary hyperalgesia and cognitive (reaction time) effect.

Results

Single 30-mg results are reported. Antihyperalgesia (% · min) is significantly higher on the area of secondary hyperalgesia with dextromethorphan than placebo (median [interquartile range]: 3,029 [746; 6,195] vs. 710 [–3,248; 4,439], P = 0.009, Hedge’s g = 0.8, 95% CI [0.1; 1.4]). On primary hyperalgesia area, mechanical pain threshold 2 h after drug intake is significantly higher with dextromethorphan (P = 0.011, Hedge’s g = 0.63, 95% CI [0.01; 1.25]). No difference in antinociception is observed after thermal painful stimuli on healthy skin between groups. Reaction time (ms) is shorter with placebo than with dextromethorphan (median [interquartile range]: 21.6 [–37.4; 0.1] vs. –1.2 [–24.3; 15.4], P = 0.015, Hedge’s g = 0.75, 95% CI [0.12; 1.39]). Nonserious adverse events occurrence (15%, 3 of 20 volunteers) was similar in both groups.

Conclusions

This study shows that low-dose (30-mg) dextromethorphan is antihyperalgesic in humans on the areas of primary and secondary hyperalgesia and reverses peripheral and central neuronal sensitization. Because dextromethorphan had no intrinsic antinociceptive effect in acute pain on healthy skin, N-methyl-d-aspartate receptor may need to be sensitized by pain for dextromethorphan to be effective.

WATER-BASED EXERCISE AND RESISTANCE TRAINING IMPROVE COGNITION IN OLDER ADULTS

ABSTRACT Introduction: Physical exercise has been associated with maintenance of physical abilities and the reduction of age-related cognitive decline, and is considered both a low-cost primary prevention strategy and a non-pharmacological treatment of cognitive dysfunction in older people. However, the contribution of each type of physical exercise to the cognitive health of the elderly population has not yet been fully investigated. Objective: This study investigated the possible influences of water-based and resistance training exercises on the cognitive performance of healthy older adults in automated tests, and investigated which test(s) would be the most effective indicator of differences in aging cognitive performance. Methods: Three groups of community-dwelling healthy older adults: water-based exercise group, resistance training group and sedentary group, were assessed using an automated set of neuropsychological tests (CANTAB) and tests to assess functional exercise capacity. Results were compared by one-way analysis of variance (ANOVA) and Pearson linear correlation. Results: The water-based exercise group had the best functional exercise capacity scores and the best performance in the reaction time evaluation (response and movement latencies). The resistance training group had less movement latency than the sedentary group. Functional mobility was positively correlated with response and movement latency. Conclusions: Taken together our findings show that physical exercise contributes to the preservation of cognitive function in healthy older adults and that water-based exercise has better results than resistance training in terms of reaction time. Moreover, the changes related to reaction time function were detected before the changes in working memory functions, sustained attention and learning in the sedentary participants, suggesting that this variable could be an early sensitive indicator of subtle cognitive changes associated with aging. Level of Evidence II; Retrospective study.

Association between physical fitness and cognitive performance in 19-24 year old males

The present study aimed to explore the association between physical fitness (PF) and cognitive performance in a sample of 19-24 year old males. Two hundred and eleven young males (20.2±1.5 years) participated in the study. Cognitive functioning tasks including information processing speed and inhibitory control were measured in addition to PF and motor fitness components such as aerobic fitness, static strength, explosive strength, agility and speed. Regression analysis showed that after adjustment for potential confounders (e.g. age, socioeconomic status, adiposity and physical activity), aerobic fitness (represented by shorter time in the one-mile run) was positively associated with composite inhibitory control scores (standardized β=0.17; p=0.04) and negatively associated with ∆ Simon (standardized β= -0.21; p=0.04). Explosive strength was negatively associated with composite information processing scores (standardized β= -0.24; P=0.01), and composite inhibitory control scores (standardized β= -0.22; p=0.02). Speed of movement, agility and static strength were not associated with any of the cognitive tests. In conclusion, aerobic fitness and explosive strength but not speed, agility or static strength might be indicators of underlying cognitive functioning tasks in 19-24 year old males.

Assessment of cognitive function in patients with metastatic cancer: Are we using the right tools?

OBJECTIVE

This study aimed at analyzing the validity and reliability of the continuous reaction time (CRT) test, the finger-tapping test (FTT), the Digit Span Test (DST), the Trail Making Test - part B (TMTB), and the Mini-Mental State Examination (MMSE) in patients with metastatic cancer.

METHOD

Eighty adult patients and 81 healthy controls were assessed between July of 2010 and November of 2015. The neuropsychological tests were analyzed regarding construct/discriminant/criterion validity and reliability.

RESULTS

In terms of construct validity, it was not possible to estimate a model for the MMSE because of a skewed response distribution. For discriminant validity, patients were slower on two measures of the CRT (p = 0.00483, p = 0.00030) and FTT dominant hand (p = 0.00306). Regarding sensitivity and specificity, only the DST and TMTB seemed to predict cognitive deficit; however, the ROC curve areas were ≤ 0.73. In terms of criterion validity, there were few significant correlations between the tests and the sociodemographic and clinical variables, and for the most part were very weak. Reliability was deemed to be adequate for the TMTB, DST, and FTT.

SIGNIFICANCE OF RESULTS

The findings of the full validation analyses were not clear-cut. However, CRT test, DST, FTT, and TMTB demonstrated partial positive results, indicating that these tests have good potential for use in clinical settings and require further study.

Simple reaction time and obesity in children: whether there is a relationship?

OBJECTIVE

Reaction time (RT) testing is one of the oldest diagnostic methods used in modern psychology, and is known as simple and sensitive cognitive test. It has been recently reported that RT is related to obesity in young, adult and elderly individuals. However, most of the studies included small sample of participants, used just body mass index (BMI) as body obesity index, and did not consider some potential confounders such as age, socioeconomic status and physical activity in their studies. Furthermore, there is little and contradictory results for children. Therefore, the present study aimed to examine the relationship between RT and weight status in a sample of children.

METHODS

Three hundred and fifty four 9-12 year old schoolboys underwent standard anthropometry, and various simple RT tests.

RESULTS

After controlling for potential confounders no significant relationship was observed between audio-RT (RTA) and clinical RT (RTclin) with BMI, %fat, waist circumference (WC) and waist to height ratio (WHtR) (P > 0.05). But, significant relationship (β = 0.18; P = 0.02) was observed between visual-RT (RTV) and %fat (but not BMI, WC and WHtR).

CONCLUSIONS

Among the various simple RT tasks and central and total body obesity indices, just significant relationship was observed between %fat and RTV in the schoolboys. According to the results, it is concluded that RT impairment due to obesity may less be observed, or may not be observed for some types of RT tasks and obesity indices during childhood.

Effect of vestibular stimulation on auditory and visual reaction time in relation to stress

The present study was undertaken to provide scientific evidence and for beneficial effects of vestibular stimulation for the management of stress-induced changes in auditory and visual reaction time (RT). A total of 240 healthy college students of the age group of 18–24 of either gender were a part of this research after obtaining written consent from them. RT for right and left response was measured for two auditory stimuli (low and high pitch) and visual stimuli (red and green) were recorded. A significant decrease in the visual RT for green light and red light was observed and stress-induced changes was effectively prevented followed by vestibular stimulation. Auditory RT for high pitch right and left response was significantly decreased and stress-induced changes was effectively prevented followed by vestibular stimulation. Vestibular stimulation is effective in boosting auditory and visual RT and preventing stress-induced changes in RT in males and females. We recommend incorporation of vestibular stimulation by swinging in our lifestyle for improving cognitive functions.

Characterizing cognitive control abilities in children with 16p11.2 deletion using adaptive 'video game' technology: a pilot study

Assessing cognitive abilities in children is challenging for two primary reasons: lack of testing engagement can lead to low testing sensitivity and inherent performance variability. Here we sought to explore whether an engaging, adaptive digital cognitive platform built to look and feel like a video game would reliably measure attention-based abilities in children with and without neurodevelopmental disabilities related to a known genetic condition, 16p11.2 deletion. We assessed 20 children with 16p11.2 deletion, a genetic variation implicated in attention deficit/hyperactivity disorder and autism, as well as 16 siblings without the deletion and 75 neurotypical age-matched children. Deletion carriers showed significantly slower response times and greater response variability when compared with all non-carriers; by comparison, traditional non-adaptive selective attention assessments were unable to discriminate group differences. This phenotypic characterization highlights the potential power of administering tools that integrate adaptive psychophysical mechanics into video-game-style mechanics to achieve robust, reliable measurements.

Neural Processing of Emotional Prosody across the Adult Lifespan

Emotion recognition deficits emerge with the increasing age, in particular, a decline in the identification of sadness. However, little is known about the age-related changes of emotion processing in sensory, affective, and executive brain areas. This functional magnetic resonance imaging (fMRI) study investigated neural correlates of auditory processing of prosody across adult lifespan. Unattended detection of emotional prosody changes was assessed in 21 young (age range: 18-35 years), 19 middle-aged (age range: 36-55 years), and 15 older (age range: 56-75 years) adults. Pseudowords uttered with neutral prosody were standards in an oddball paradigm with angry, sad, happy, and gender deviants (total 20% deviants). Changes in emotional prosody and voice gender elicited bilateral superior temporal gyri (STG) responses reflecting automatic encoding of prosody. At the right STG, responses to sad deviants decreased linearly with age, whereas happy events exhibited a nonlinear relationship. In contrast to behavioral data, no age by sex interaction emerged on the neural networks. The aging decline of emotion processing of prosodic cues emerges already at an early automatic stage of information processing at the level of the auditory cortex. However, top-down modulation may lead to an additional perceptional bias, for example, towards positive stimuli, and may depend on context factors such as the listener's sex.

Minimal hepatic encephalopathy characterized by parallel use of the continuous reaction time and portosystemic encephalopathy tests

Minimal hepatic encephalopathy (MHE) is a frequent complication to liver cirrhosis that causes poor quality of life, a great burden to caregivers, and can be treated. For diagnosis and grading the international guidelines recommend the use of psychometric tests of different modalities (computer based vs. paper and pencil). To compare results of the Continuous Reaction time (CRT) and the Portosystemic Encephalopathy (PSE) tests in a large unselected cohort of cirrhosis patients without clinically detectable brain impairment and to clinically characterize the patients according to their test results. The CRT method is a 10-minute computerized test of a patient's motor reaction time stability (CRTindex) to 150 auditory stimuli. The PSE test is a 20-minute paper-pencil test evaluating psychomotor speed. Both tests were performed at the same occasion in 129 patients. Both tests were normal in only 36% (n = 46) of the patients and this group had the best quality of life, a normal CRP, a low risk of subsequent overt HE, and a low short term mortality. Either the CRT or the PSE test was abnormal in a total of 64% of the patients (n = 83), the CRT in 53% (n = 69) and the PSE in 34% (n = 44). All these patients had a poorer quality of life, low-grade CRP elevation, moderate risk for subsequent overt HE, and a higher than 20% short term mortality. Both tests were abnormal in 23% (n = 30) of the patients and this group had more advanced cirrhosis and a 40 % short-term mortality. One of the tests was abnormal in the majority of the patients but concordant in only 60%. Most cirrhosis patients seem to have impairments of different cognitive domains and more domains with advancing disease. Two abnormal tests identified patients with an increased risk of overt HE and death.

Progress in diagnosis of minimal hepatic encephalopathy

Minimal hepatic encephalopathy (MHE) is defined as HE without symptoms on clinical/neurological examination, but with deficits in some cognitive areas that can only be measured by neuropsychometric testing. MHE is associated with reduced quality of working, driving, memory, and cognitive function, and is a risk factor for the development of overt HE. Compared with non-MHE patients, MHE patients have a high mortality rate, so positive screening and intervention in patients with MHE are needed to improve the quality of life in patients with cirrhosis and reduce traffic accidents and the social burden of medical care. The current approach to the diagnosis of MHE includes mental scales (paper pencil test, computer test, or the combination of the two), electrophysiological examination, and imaging examination. Diagnosis of MHE is still a challenge now, and it is needed to establish a better clinical diagnosis standard to improve the diagnostic level.

Visual memory in musicians and non-musicians

Many investigations have reported structural, functional, and cognitive changes in the brains of musicians, which occur as a result of many years of musical practice. We aimed to investigate if intensive, long-term musical practice is associated with improved visual memory ability. Musicians and non-musicians, who were comparable in age, gender, and education, were submitted to a visual memory test. The test consisted of the presentation of four sets of stimuli, each one containing eight figures to be memorized. Each set was followed by individual figures and the subject was required to indicate if each figure was or was not present in the memorized set, by pressing the corresponding keys. We divided the test in two parts, in which the stimuli had greater or reduced semantic coding. Overall, musicians showed better performance on reaction times, but not on accuracy. An additional analysis revealed no significant interaction between group and any part of the test in the prediction of the outcomes. When simple reaction time was included as covariate, no significant difference between groups was found on reaction times. In the group of musicians, we found some significant correlations between variables related to musical practice and performance in the visual memory test. In summary, our data provide no evidence of enhanced visual memory ability in musicians, since there was no difference in accuracy between groups. Our results suggest that performance of musicians in the visual memory test may be associated with better sensorimotor integration, since although they have presented shorter reaction times, such effect disappeared when taken in consideration the simple reaction time test. However, given existing evidence of associations between simple reaction time and cognitive function, their performance in the visual memory test could also be related to enhanced visual attention ability, as has been suggested by previous studies, but this hypothesis deserves more investigation.

The continuous reaction times method for diagnosing, grading, and monitoring minimal/covert hepatic encephalopathy

Existing tests for minimal/covert hepatic encephalopathy (m/cHE) are time- and expertise consuming and primarily useable for research purposes. An easy-to-use, fast and reliable diagnostic and grading tool is needed. We here report on the background, experience, and ongoing research regarding the continuous reaction times (CRT) method. The method has been in clinical use for decades in Denmark for the stated purpose. The method is a 10-minutes, computerised registration of a series of motor reaction times to an auditory stimulus, with results reported as the CRTindex (50 percentile/(90-10) percentile) as a parameter of reaction time variability. The index is a measure of alertness stability and is used to assess attention and cognition deficits. The CRTindex identifies half of patients in a Danish cohort with chronic liver disease, as having m/cHE, a normal value safely precludes HE, it has a broad outcome span reflecting the degree of brain impairment, it shows no learning effect, and it is independent on age and gender. The CRTindex is, therefore, a candidate tool for routine screening, detecting, grading, and monitoring m/cHE. Still, however, further methodological and clinical validation trials are required and are currently being conducted.

The development of organized visual search

Visual search plays an important role in guiding behavior. Children have more difficulty performing conjunction search tasks than adults. The present research evaluates whether developmental differences in children's ability to organize serial visual search (i.e., search organization skills) contribute to performance limitations in a typical conjunction search task. We evaluated 134 children between the ages of 2 and 17 on separate tasks measuring search for targets defined by a conjunction of features or by distinct features. Our results demonstrated that children organize their visual search better as they get older. As children's skills at organizing visual search improve they become more accurate at locating targets with conjunction of features amongst distractors, but not for targets with distinct features. Developmental limitations in children's abilities to organize their visual search of the environment are an important component of poor conjunction search in young children. In addition, our findings provide preliminary evidence that, like other visuospatial tasks, exposure to reading may influence children's spatial orientation to the visual environment when performing a visual search.

Long-term musical training may improve different forms of visual attention ability

Many studies have suggested that structural and functional cerebral neuroplastic processes result from long-term musical training, which in turn may produce cognitive differences between musicians and non-musicians. We aimed to investigate whether intensive, long-term musical practice is associated with improvements in three different forms of visual attention ability: selective, divided and sustained attention. Musicians from symphony orchestras (n=38) and non-musicians (n=38), who were comparable in age, gender and education, were submitted to three neuropsychological tests, measuring reaction time and accuracy. Musicians showed better performance relative to non-musicians on four variables of the three visual attention tests, and such an advantage could not solely be explained by better sensorimotor integration. Moreover, in the group of musicians, significant correlations were observed between the age at the commencement of musical studies and reaction time in all visual attention tests. The results suggest that musicians present augmented ability in different forms of visual attention, thus illustrating the possible cognitive benefits of long-term musical training.

Effect of a single dose of dextromethorphan on psychomotor performance and working memory capacity

BACKGROUND

Previous studies show that the prolonged use of dextromethorphan produces cognitive deterioration in humans.

AIM

The aim of this study was to investigate the effect of a single dose of dextroemthrophan on psychomotor performance and working memory capacity.

MATERIALS AND METHODS

This is a randomized, double-blind, controlled, and prospective study. Thirty-six (17 women, 19 men) medical students enrolled in the study; half of them (7 women, 11 men) were given placebo, while the other half (10 women, 8 men) received dextromethorphan. The choice reaction time, critical flicker fusion threshold, and N-back working memory task were measured before and after 2 h of taking the drugs.

RESULTS

Dextromethorphan showed a significant deterioration in the 3-back working memory task (P<0.05). No significant changes were seen as regards the choice reaction time components (total, recognition, motor) and critical flicker fusion threshold (P>0.05). On the other hand, placebo showed no significant changes as regards the choice reaction time, critical flicker fusion threshold, and N-back working memory task (P>0.05).

CONCLUSION

A single dose of dextromethorphan has no effect on attention and arousal but may significantly impair the working memory capacity.

Differential associations between psychopathy dimensions, types of aggression, and response inhibition

Findings on executive functioning in psychopathy are inconsistent. Different associations between psychopathy dimensions and executive functioning might explain contradicting findings. This study examined the role of psychopathy dimensions and types of aggression in response inhibition among 117 male adolescents (53 antisocial delinquents and 64 controls). Participants completed a self-report measure of aggression and a GoNoGo task. Psychopathy dimensions were assessed using the Psychopathy Checklist: Youth Version. Although high scores on the antisocial dimension and reactive aggression were associated with poor response inhibition, the affective-interpersonal dimension, proactive aggression, and verbal intelligence (IQ) were related to better response inhibition (two-factor model). Associations with the affective-interpersonal dimensions did not reach significance. Exploratory analyses showed that affective and antisocial facets accounted for the obtained opposing associations of the affective-interpersonal and antisocial psychopathy dimensions with response inhibition. The interpersonal and lifestyle facets (four-facet model) were unrelated to response inhibition. Results could not be explained by Attention Deficit Hyperactivity Disorder (ADHD). Findings suggest differential associations between the psychopathy dimensions, types of aggression, and response inhibition. Therefore, a dimensional approach to psychopathy and related concepts, such as aggression, might strongly improve diagnostic procedures. Global scores could mask important differential associations.

Critical flicker frequency and continuous reaction times for the diagnosis of minimal hepatic encephalopathy: a comparative study of 154 patients with liver disease

Minimal hepatic encephalopathy (MHE) is intermittently present in up to 2/3 of patients with chronic liver disease. It impairs their daily living and can be treated. However, there is no consensus on diagnostic criteria except that psychometric methods are required. We compared two easy-to-perform reproducible bedside methods: the critical flicker frequency (CFF) and continuous reaction times (CRT) tests. A CFF <39 Hz and CRT-index <1.9 (index: the ratio 50/(90 minus 10) percentiles of reaction times) indicates cerebral dysfunction. 154 patients with acute or chronic liver disease with out overt hepatic encephalopathy (HE) underwent both tests at the same occasion. Both tests were abnormal in 20% of the patients and both tests were normal in 40% of the patients. In more than 1/3 the two tests were not in agreement as CFF classified 32% and CRT-index classified 48% of the patients as having MHE (p < 0.005). The two tests were weakly linearly correlated (r(2) = 0.14, p < 0.001) and neither test correlated with the metabolic liver function measured by the Galactose Elimination Capacity (GEC), nor with the blood ammonia concentration. Both tests identified a large fraction of the patients as having MHE and cleared only 40%. The two tests did not show concordant results, likely because they describe different aspects of MHE: the CFF gives a measure of astrocytic metabolic state and hence pathogenic aspects of MHE, whereas the CRT measures a composite key performance, viz. the ability of reacting appropriately to a sensory stimulus. The choice of test depends on the information needed in the clinical and scientific care and study of the patients.