Behavioral effects of upper respiratory tract illnesses: a consideration of possible underlying cognitive mechanisms

Effects of upper respiratory tract illnesses, ibuprofen and caffeine on reaction time and alertness

RATIONALE

Compared with healthy individuals, those with upper respiratory tract illnesses (URTIs) report reduced alertness and have slower reaction times. It is important to evaluate medication that can remove this behavioural malaise.

OBJECTIVES

The aim of this study was to compare the effects of a combination of ibuprofen plus caffeine with ibuprofen and caffeine alone, and placebo on malaise associated with URTIs, as measured by psychomotor performance and mood testing.

METHODS

Volunteers were randomly assigned to one of four medication conditions as follows: 200 mg ibuprofen and 100 mg caffeine; 200 mg ibuprofen; 100 mg caffeine; placebo. A single oral dose was given and testing followed for 3 h. Efficacy variables were based on the volunteers' performance, measured by psychomotor performance and mood.

RESULTS

The pre-drug results confirmed that those with an URTI had a more negative mood and impaired performance. Results from the simple reaction time task, at both 55- and 110-min post-dosing, showed that a single-dose of caffeinated products (I200/C100 and CAF100) led to significantly faster reaction times than IBU200 and placebo. These effects were generally confirmed with the other performance tasks. Subjective measures showed that the combination of ibuprofen and caffeine was superior to the other conditions. There were no serious adverse events reported, and study medication was well tolerated.

CONCLUSIONS

The results from the post-drug assessments suggest that a combination of ibuprofen and caffeine was the optimum treatment for malaise associated with URTIs in that it had significant effects on objective performance and subjective measures.

Twenty-five years of research on the behavioural malaise associated with influenza and the common cold

Minor illnesses such as the common cold and influenza are frequent and widespread. As well as specific symptoms such as nasal problems and fever, these illnesses are associated with a behavioural malaise. One feature of this malaise is reduced alertness and this has been confirmed using subjective reports and objective measures of performance. Such effects have been obtained with both experimentally induced infections and in studies of naturally occurring illnesses. The mechanisms underlying the effects are unclear but possibly reflect effects of cytokines on the CNS which result in changes in neurotransmitter functioning that lead to reduced alertness. The malaise induced by these illnesses has many real-life consequences and activities such as driving and safety at work may be at risk. These illnesses not only have direct effects on performance and mood but also make the person more sensitive to effects of other negative influences such as noise, alcohol and prolonged work. Countermeasures include ingestion of caffeine and other drugs known to increase alertness.

Effects of the common cold on mood, psychomotor performance, the encoding of new information, speed of working memory and semantic processing

Previous research has shown that people with the common cold report a more negative mood and psychomotor slowing. Recent research suggests that memory speed may also be impaired. This was examined in the study reported here. A prospective design was used and all participants (N=200; half male, half female; mean age 21 years, range 18-30 years) carried out a baseline session when healthy. The test battery involved mood rating, simple and choice reaction time, verbal reasoning and semantic processing. Volunteers returned when they developed an upper respiratory tract illness (URTI) and repeated the test battery. If they remained healthy they were recalled as a control. One hundred and eighty-nine participants completed the study and 48 developed URTIs and 141 were in the healthy control group. Symptoms and signs suggested that those who were ill had colds rather than influenza. The results showed that those with colds reported lower alertness, a more negative mood, and psychomotor slowing. They were also slower at encoding new information and slower on the verbal reasoning and semantic processing tasks. The magnitude of the mood changes associated with being ill were correlated with symptom severity. The performance changes were not correlated with symptom severity, sleep duration or mood changes. Further research is now needed to elucidate the underlying mechanisms of the behavioral malaise associated with URTIs.